Controversies
Historic Anti-Vaccine Movements
One of the main cruxes of the anti-vaccination movement dating back to the early 1800s is that vaccination is an encroachment onto personal liberty, an argument that inflamed tensions as governments began legally mandating vaccinations. Additional anti-vaccination sentiment stemmed from sanitary and religious grounds. At various points early in vaccine history, clergy were against the practice because the smallpox vaccine required the introduction of animal tissue into people.35 Because public education around vaccination was brand new and because the germ theory was not yet proven, some of this pushback is understandable.
But, progress continued and England passed the 1853 Vaccination Act making the inoculations mandatory for infants up to 3, and later expanded to age 14. Citizens responded by protesting and demanding the rights to control what would happen to their children. By 1885, demonstrations of up to 100,000 people took place in Leicester. Legal penalties were removed from the laws as a result, and conscientious objection was allowed as a way to avoid vaccination.36
Anti-vaccination campaigns also spread in the United States. However, Cambridge Massachusetts issued a mandate in 1902 after a smallpox outbreak. Henning Jacobson refused to be vaccinated claiming a violation of his personal rights. The case went all the way to the U.S. Supreme court, where the court found in favor of the compulsory law.37
Figure 4: 1804 cartoon caricature of Smallpox and Inoculation Hospital in Pancras London. Caption reads “Cow-Pock—or—The Wonderful Effects of the New Inoculation!” Library of Congress.
Modern Anti-Vaccine Movements
Historic opposition to vaccines is at least to some degree understandable. The adoption of a new technology with the possible downside of illness or death, or even transmission of additional disease in the case of arm-to-arm transfer of immunity, were real issues. However, in the modern context, vaccines have a track record for safety, disease eradication and reduction in mortality from disease.
Despite all this, some parents have concerns that are not necessarily based on rational evidence. For example, one survey reports that a quarter of parents felt that their children receive too many vaccines and the result is a weakened immune system, with worries of a “pincushion effect” due to the number of vaccines a child is recommended to get in the first two years of life. 38
It is common wisdom that vaccination has fallen victim to its own success as a medical treatment. Because it works so well, many of the most harrowing childhood diseases have all but disappeared in some parts of the world. Because of this, people no longer see the need to subject their children to the practice.
We expect sound logic from those who serve at the highest level of our Justice system, and in this case an analogy used by Supreme Court Justice Ruth Bader Ginsberg applies to vaccines. Regarding the voting rights act, Justice Ginsberg stated: “Throwing out preclearance when it has worked and is continuing to work to stop discriminatory changes is like throwing away your umbrella in a rainstorm because you are not getting wet.”
Similarly, throwing out vaccinations because you are not getting sick is tantamount to the same thing: Throwing away the umbrella you are standing under in a rainstorm because you are not getting wet.
Despite this logic, a number of controversies around vaccination have cropped up over the years. Perhaps the most pressing of the 21st century deals with the MMR (measles, mumps and rubella) vaccine.
Measles Mumps and Rubella Vaccine Controversy
Much of the modern anti-vaccination movement hinges on a study published by medical journal, The Lancet, claiming a link between autism and the MMR vaccine. Andrew Wakefield and fellow authors had a small sample size (12), and uncontrolled design, in a study that spurred a drop in parents vaccinating for MMR.
The shoddy research conducted by Wakefield spurred research debunking the claims, which pointed out that there is a correlation in time between vaccination and when autism symptoms first appear which is not causal.39
The Lancet retracted the paper in 2010; Wakefield had undisclosed financial interests in his findings, and was finally held accountable for ethical violations, and for scientific misrepresentation.40
Wakefield lost his medical license, and Time magazine reports that it took almost 20 years for the vaccination rate to recover in the United Kingdom following 12,000 cases of the measles and at least three deaths. Wakefield has continued in recent years on his anti-vaccination crusade, including a documentary film called Vaxxed. His activities have been linked to 25 measles related deaths in 2017.41
In the United States, measles had been declared a disease of the past by the year 2000. But since the Lancet published Wakefield’s work, there have been more than 2,216 cases reported including an outbreak at Disneyland amusement park in California that lead to 130 infections. Additionally, there have been a number of outbreaks in 2017 in Minnesota where Wakefield’s message was directly responsible for parents choosing not to vaccinate.42
Science is a process that requires trust, and when scientists break that trust, the outcomes can be negative and even fatal. The media unfortunately also played a role in publicizing the initial 1998 claims, and the Lancet ran a tiny retraction more than ten years later. The follow up to the story has not been as splashy or sensationalized as the initial false claims were, which hurts public trust. The proliferation of antivax propaganda not only through the traditional media, but also through social media has also added to the problem.
This of course leads me to the question: How do I teach my students how to be critical thinkers and readers able to sort good information from bad information? Time magazine quotes Mark Twain to great effect: “A lie can travel halfway around the world while the truth is putting on its shoes.”43
The problem with misinformation about vaccines is that it is literally putting lives in danger. Because the spread of misinformation is an outbreak of its own, it is more important than ever to promote good science and information literacy. It is my hope that I have written information that will enable teachers to impart the background knowledge and skills students need to navigate the vaccine issue.
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