The wrong message on vaccines

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Unfounded fears about vaccines are already reaching worrisome proportions. No public figure should stoke them — as US presidential hopeful Michele Bachmann has done.

In 2009 and 2010, fewer than half of all US states reported that the proportion of children aged five to six who were properly vaccinated against measles before they entered school had reached the desired 95%. In parts of the country, the rate of refusal of mandatory childhood vaccinations for non-medical reasons stands at 25%. And as-yet-unpublished data show that this rate in continuing to increase.

The results of vaccine refusal are already evident in Europe. France reported 4,937 cases of measles in the first three months of this year — nearly as many as in all of 2010. In total, 30 countries in the World Health Organization's European region reported a marked increase in measles cases early this year. At some point, the herd immunity that protects the unvaccinated and the immunosuppressed could be lost.

Against this backdrop, it is vital that public debates on vaccination stick to the facts — and that politicians who make science-supported decisions be applauded. Unfortunately, it was Michele Bachmann who received the applause at the Republican presidential candidates' debate earlier this month. The Minnesota congresswoman had attacked rival candidate Rick Perry for his failed attempt in 2007, as Texas governor, to mandate vaccination against human papilloma virus (HPV) for 11- and 12-year-old schoolgirls, as recommended by the US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

Perhaps Perry did the right thing for the wrong reasons: he has close ties to pharmaceutical company Merck, a generous donor to his campaigns and the only maker of an HPV vaccine at the time of his attempt. But his goal was laudable: HPV is the most common sexually transmitted infection in the country and the major cause of cervical cancer, which kills 4,000 US women each year. The Food and Drug Administration has also approved the HPV jab for the prevention of vulvar and vaginal cancers, and of anal cancer in both males and females.

That did not stop Bachmann from making the astonishingly irresponsible claim, on national television, that the vaccine is a “potentially dangerous drug”. She later suggested that it is linked to “mental retardation”. Yet the CDC says that the vaccine is safe. Some 35 million doses have been delivered in the United States since its approval, but just 0.05% of recipients have reported side effects, mostly minor. Nor is there scientific support for the belief that presumably drives Bachmann's misstatements — that vaccinating prepubescent girls will somehow encourage them to become sexually active.

If Bachmann wants to do right by the millions of girls she claims to care about, she ought to retract her words and urge HPV vaccination. That might do more than anything else to combat an increasingly common parental mindset that takes for granted the past century of gains against infectious disease, and in so doing threatens to reverse them.


  1. Report this comment #26876

    Dario Antonio said:

    Worries about the effectiveness and dangers of vaccines ARE scientifically supported. A serious debate is appropriate. What I believe is reaching worrisome proportions is the amount of editorials and articles in Nature about this topic. These articles are not always very scientific, resorting to emotions (mainly fear) and always biased towards the praise of vaccines and against the dangerous individuals that question them.

  2. Report this comment #26881

    Geoffrey Vargish said:

    The declining rates of vaccination in both the US and abroad ARE cause for serious concern. What's more pressing is that the most salient messages regarding vaccine efficacy and safety often come from non-scientific sources, such as anti-vaccine advocates (most commonly founded by parents and/or celebrities not trained in scientific disciplines) and politicians more interested in garnering votes than disseminating accurate information. Unbeknownst to many, the US has a very effective system for monitoring the safety of vaccines in the Vaccine Adverse Events Reporting System (cosponsored by the CDC and DHHS). Adverse events occur in less than 1% of individuals receiving vaccination.
    As Art Caplan and a variety of other bioethicists have pointed out, the history of vaccine policy in the US is littered with fear mongering and non-scientific claims, threatening the safety of our population by deterring individuals from vaccinating. What's lacking in the vaccine debate is a true ethos, disseminating information backed by science and devoid of emotional, unsupported anecdotes. Vaccines are arguably the most important discovery in the history of public health, let's not disregard their value in protecting us from disease both as individuals and as a population.

  3. Report this comment #26883

    Christopher Lee said:

    I agree with Dario Antonio. This editorial, in the the thunderous style, could lead to suspicions that this commercial journal has been infiltrated. It is a serious mistake to connect the healthcare debate to the American partisan political scene, which has a long-standing worldwide reputation for irrationality and similar manifestations of madness.

    Irrationality is, of course, a worldwide phenomenon. A result of of adverse public comments (sometimes related to connections between politicians and the pharmaceutical industry) is that the WHO is considered by many ordinary people to be discredited by the fact that the last predicted flu epidemic caused many fewer deaths than the 1918 one, which was due to a similar virus. Nasty forms of flu will be back, quite soon apparantly. Well, the biggest human problem at the moment is overpopulation, though that won't affect my own rational decision to pay my 8 euros (I'm not quite old enough to qualify for a free jab).

    There is, however, a need more more public information, and more clear information. The statistics of very rare adverse events are not obvious, even to statisticians. Scare stories sometimes turn around cases of babies who fall seriously ill shortly after a vaccination, and they always neglect the unfortunate fact that babies babies fall seriously ill every day. Do experts intervene in the common debate, for example by providing traceable and readable data on the incidence of such events in the absence of vaccination? Do they give the number of children dead or committed to mental institutions each year as a result of measles? Perhaps it's beneath their dignity to post on all those quack websites, but they could at least try to find some other medium that is not a sponsored journal or visibly tied to institutions that are either plugging expensive treatments or attempting to ration public health services.

  4. Report this comment #26895

    Bart Penders said:

    The vaccination problem is not a problem of who is right or wrong. It is about the public credibility of governments and scientists. While science focuses on universally valid claims, public debate is guided by particulars: single cases and stories of inexplicable deaths or diseases following inoculation. A well calibrated display of particulars enables many people to relate to such stories. Solely sticking to facts and arguments is destructive for public credibility as it does not satisfy the need for narratives. If our aim is to raise vaccination numbers, it is wise to take the people who oppose, or who are in doubt, seriously. The question here is where the doubts and worries of the US and EU populations come from.

    We need to realize that better science and improved dissemination does not solve the vaccinationists? credibility crisis. ?Antivaccinationists? play the game according to different rules – occasionally quite effectively. Thus, we need to study the strategies used by antivaccinationists to engineer credit for themselves and their claims, and take them seriously as competitors in the public credibility marketplace. Engineering credibility implies demonstrating the ability to take doubts seriously, not to reject them as ignorant. Beyond the boundaries of the lab, emotions and narratives contribute as much as data.

    Bachmann stating that the HPV vaccine is a ?potentially dangerous drug?, is in high contrast to the dominant scientific position towards the safety of the vaccine. It is, however, not coming from nowhere. Bachmann is aligning herself with a large part of the (US) population, who is worried about the status of this and other vaccines. This is an understandable and probably worthwhile path for someone who wants to be elected to office.

  5. Report this comment #26900

    A J said:

    Excellent Editorial on vaccines.

    The city Hyderabad (India) has witnessed a major measles outbreak January to March 2011, pushing the total number of cases to an alarming 345 as against 279 last year. What's more, several children who were vaccinated against the infection figure in this measle headcount. Surprisingly, that the itchy rash did not spare even the 40 and 50-year-olds.
  6. Report this comment #26907

    apostate scientist said:

    Bart Penders makes the only point worth making at the present stage in the debacle that the mass vaccination movement is developing into. That we now have entrenched ?pro-vaccination? and ?anti-vaccination? camps is evidence enough of the failure of communication that lies at the heart of all this. Use of language is always a good clue as to what is going on and the implications of unquestioning use of the word ?herd? by pro-vaccinationists says it all.

    The word ?herd? carries more baggage than even the recent London Fashion Week could probably handle. So, whilst pro-vaccinationists can talk assuredly about herd-immunity and less than one percent adverse reaction rates to a measles vaccine, members of that ?herd? are going to be thinking ?One percent ? that?s one-in-a-hundred ? that could be my child?. And whilst pro-vaccinationists can talk incontrovertible, herd-based evidences for herd benefit from HPV vaccination, female members of that ?herd? are going to be marching in on their parents demanding to know "What the hell are these people thinking of wanting to inject me on the assumption that I?m going to be screwing around?". And whilst pro-vaccinationists can justifiably assert that giving three vaccines at once will significantly augment the herd?s antibody response, members of that ?herd? are going to be thinking, ?Three at once ? doesn?t that increase the chances of an adverse reaction and, anyway, why should my boy be immunised against rubella when he?s never going to get pregnant?.

    The pro-vaccinationists' response to their herd failing to respond to the cattle prods has been strictly analogous to the caricature Englishman abroad who, when the ?natives? fail to understand his English simply shouts more loudly. Sorry doctors and scientists ? where vaccination is concerned ? and possibly not a few other preventive measures ? you?re going to have to learn a new language ? the language of individual experience rather than that of statistically tractable mass averages.

  7. Report this comment #27088

    Jms rndll said:

    The problem here I think more lies in the fact that science has lost a lot of credibility over the past years, in the fact that most science seems to be geared towards making a product that can be sold for profit. Sure this is fine and dandy, but the less popular more radical theories are never given any head wind because of the less economic value of the research. As for vaccinations themselves, I wonder about the evolutionary implications of preventing a mechanism that is supposed to control animal population numbers from doing its job? Are we really constantly on this teetar toter of 'hopefully polio won't come back', as we see with recent TB in Africa. Wouldn't it be innovative if scientists took a scientific approach when dealing with human populations as well as animal populations? Do you not see that the whole 'save every child possible born' is only serving to weaken us as a species? Where is the sound science in this? Is the goal of modern science to live as far out of balance with the natural world as possible? Or is there some crossover there? What are we going to do when we are on the brink of the next mass extinction, try and stop it? What then, will the planet be able to take a cycle without being 'refreshed'? I am anti vaccination simply because I do not trust the science behind it.

  8. Report this comment #27106

    David McRae said:

    Chistopher, Dario,

    There is a debate. Presentation of evidence in a peer-reviewed journal is scientific debate.

    Who can yell the loudest, charm the best or sound the most convincing is not a scientific debate and contributes nothing to science – however entertaining, and these debates can be.

    Please advance scientific knowledge and publish your data.

  9. Report this comment #27151

    louis patrizzi said:

    As any change in current vaccine schedule/ formula would be legally construed as an admission that it is dangerous/harmful, our gov't WILL NOT do anything about the dangers of vaccines, even if that means continuing to harm children. This may seem too appalling 4 most of us 2 believe but it is the reality we must accept if we are 2 protect our kids. Since gov't REQUIRES these vaccines4 school,admitting they are harmful becomes a liability nightmare. So instead of enacting legislation that protects gov't prior2 studies proving danger, as long as they act as soon as info is realized- under current system- they just deny & pay 4 false studies. SOLUTION? An alternative SAFE GREEN VACCINE. If any1 gave parents 'choice' we would choose the merc free1 & whoever markets this will make a fortune while saving kids from autism. Please any1 w resources- FEEL FREE 2 STEAL THIS IDEA! PLEASE DO SO!!

  10. Report this comment #27152

    louis patrizzi said:

    Pro-vaccine = I fell 4the B .S. studies the pharm Co.'s paid 4 to protect their sales & @sses.
    Anti-vaccine = I'm an idiot who probably wouldn't be alive if it weren't 4 vaccines but I'm2 stupid2 know this.
    Is there not one other person in MY category? I'm 4 vaccinating kids with safe vaccines( & educating that tylenol w vaccine increases chance of autism by 1000 fold! )
    CHANGE THE VACCINE FORMULA! The health risk isn't in the IMMUNO-stimulating components of these shots! But in the stabilizing, ant-contaminan,t growth elements that were ignorantly added, found 2 be dangerous, & left in2 save Pharmaceutical Companies from liability lawsuits.
    And if we ever get this inexcusable situation resolved, there should be criminal charges brought against the individuals within the pharm co.'s that when faced with info regarding the dangers of the vaccines, chose to bury/deny instead of change vaccine formula. We also need 2legally protect pharm.'s from frivilous lawsuits that have caused them2 be so leary of admitting dangers when new scientific evidence comes in.Should be grandfather laws that if u took drug b4 info was discovered- they not liable.

  11. Report this comment #27187

    Geoffrey Vargish said:

    Jms Rndll, there were so called "scientists" that used a "scientific approach" in dealing with human populations, as you put it. They were part of the Eugenics movement and their work was, among other things, deemed grossly unethical. One of the greatest assets of our species is our superior cognitive abilities, which allow us to understand the concept of morality. It would be unethical and immoral to develop a life-saving technology, such as vaccines, only to deny the world it's use on the basis that it skews one's fitness for survival. The modern world is, in many cases, far from the "natural world" you speak of. In fact the very medium through which you conveyed your opinion is hardly natural.

  12. Report this comment #62843

    Alice Pham said:

    Well! I just have some question: Do experts intervene in the common debate, for example by providing traceable and readable data on the incidence of such events in the absence of vaccination? Do they give the number of children dead or committed to mental institutions each year as a result of measles? I'm working as Mn web designer in Minneapolis. I hope to learn more from your site. thanks!

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