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Balancing Benefit with Risk: The Resurgence of the Anti-Vaccination Movement in the U.S.

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November 2018: 36 individuals contract chickenpox in a school in North Carolina, in which 110 out of 152 individuals are unvaccinated against chicken pox, largely due to religious reasons. This is the largest outbreak in North Carolina in two decades.

January 2019: A measles outbreak in near Portland, Oregon occurs in an area with low vaccination rates; 20 out of 23 infected have not been vaccinated against measles.

April 2019: New York declares that individuals unvaccinated against measles must get vaccinated or pay a fine. The policy is a direct response to the March outbreak in Rockland County; 285 individuals in NY have been infected with measles since Fall 2018.

Data from Centers of Disease Control and Prevention, updated as of April 4th, 2019.

Relevancy

The debate on vaccines—and whether their benefits outweigh their risks—has been brought back into public light following the recent outbreaks. Areas with low rates of vaccination or high anti-vaccination sentiment are particularly vulnerable to outbreaks if a pathogen is reintroduced from oversea traveling.

Moreover, herd immunity for diseases such as pertussis and measles requires 95% of a population to be vaccinated to protect individuals who cannot get vaccinated for medical reasons—a concept known as herd immunity.

Vaccine hesitancy is one of ten entries on The World Health Organization’s 2019 list of greatest global threats.

Vaccine Hesitancy: Origins

Modern-day vaccines—first conceptualized by Edward Jenner in 1796—work by introducing modified (harmless) forms of a bacteria or virus to the immune system. The immune system develops antibodies to the pathogen and can thus recognize and eliminate the pathogen upon future exposure.

Isabella B. represents the effects of vaccines visually. She encourages readers to use the data she has cited to reconstruct the graphs she has created.

There is less than a 0.000001 (1/1,000,000) chance of having an allergic reaction to a measles vaccine. Choosing to opt out of receiving a vaccine has much more serious risks. 80% of 183 children who died from influenza in 2018 did not receive a flu shot. 90% of unvaccinated individuals who come in contact with the measles virus will contract the disease.

Andrew Wakefield, the author of one of the first anti-vaccination sources (linking MMR vaccines to Autism), has had his article unpublished from the Lancet and his medical license revoked for conflict of interest, but much of the movement still hedges on his work—or similar ideas (that vaccines are a cause of mental illness or disability).

Some proponents of Wakefield’s argument use the increase in vaccination rates and the increase in Autism Spectrum Disorder (ASD) cases to contend that vaccines are in fact an environmental cause of autism. However, the higher number of autism cases is—at least in part—due to an increased understanding of the ASD allowing more diagnoses to be made.

Furthermore, scientists have since repeatedly disproven Wakefield’s claims: this study by Copenhagen’s Statens Serum Institut, spanning from 1999 to 2010 and involving over half a million individuals, supports the medical consensus that there is no link between MMR vaccines and autism.

SciShow explains why the anti-vaccination movement has held its appeal:

Hank Green from SciShowdiscusses the reasons and fallacies behind the recent resurgence of the anti-vaccination movement.

My Thoughts (and A Song)

I respect that parents should be entitled to their own decisions when making personal choices for their children, but this isn’t merely a personal choice; due to the nature of herd immunity, if people choose not to have their children vaccinated and the percentage of the population that is vaccinated drops below a certain threshold (about 90-95%), others who cannot get vaccinated for medical reasons become at risk.

We cannot be complacent. Vaccines have turned national epidemics into diseases which are practically obsolete in the U.S., but if we stop vaccinating we put ourselves at risk. In Japan, the reduction of vaccination rates in children for pertussis—from 80% vaccinated in 1974 to 10% vaccinated in 1979—followed an increase from 393 annual cases of pertussis (1974) to more than 13,000 (1979). History repeats itself if we let it.

I’ve offered the science; now all I can offer is my voice.

Lyrics:

You stack alternative facts and hypotheses,
Reject scientific consensus to be at ease.
Tell yourself it’s just a government conspiracy,
Like everyone’s out to get you, I see.
I understand you are concerned, you think it’s common sense,
But we’re looking at facts and numbers in present tense.
Epidemics start again if we have no defense,
The choice you make is made at someone else’s expense.

Your Thoughts?

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COMMENTS: 6
  1. April 28, 2019 by Claire Irigoyen Reply

    The vaccination crisis that has resulted in a surge of measles cases when the disease was eradicated in the early 2000’s is a contemptible cause for concern. I was so happy to see that someone chose to address this issue, especially with the rising cases of measles in California this week. I remember discussing this with my parents years ago. Apparently there was a publication in a medical journal some years ago that correlated vaccines with the rising incidence of autism. Sadly for those currently suffering from the symptoms and long-term ramifications of measles, that paper was retracted as scientifically altered data. This misguided and misleading study has resulted in a resurgence of measles in the United States, has left parents struggling to overcome the losses associated with debilitating and preventable diseases like measles, and most unfortunately not everyone knows that that paper was retracted. Again, this presentation is well done and timely. I will recommend this presentation for review amongst my classmates.

    • May 04, 2019 by Annabelle Reply

      Hi Claire,

      Thank you for the feedback! It’s really unfortunate that there was another outbreak in between my writing of the article and the end of the conference. The publication you refer to is the likely the one I mentioned in my article, by Andrew Wakefield, and you’re completely right—the paper has since been retracted from the journal it was published to, and Wakefield’s medical license has been revoked due to conflict of interest. Certainly, there are a lot of new arguments and proponents to the vaccine hesitancy movement, but Wakefield was one of the central figures of its incipience. I agree that his story (and, as you said, especially the retraction) should be more widely known.

  2. April 30, 2019 by George.Downs Reply

    What would suggest when attempting to convince a parent that they should vaccinate their child and they are obstinate. For instance, I know someone who chooses to not vaccinate her children and is vehement that she shouldn’t. What would you say to her?

    • May 04, 2019 by Annabelle Reply

      Hi George,

      It’s hard to say. I think it’s important to ensure that this is a conversation and not just a one-sided lecture, you know? People tend to be more inclined to take advice from someone who comes off as nonthreatening. At the end of the day, parents—misinformed or not—want the best for their children, so phrase your concerns with that in mind. And listen to her/find out why she believes that vaccination is harmful; some people avoid it for really personal reasons; your conversation can be a lot more specific if you know why she has the perspective she has. Best of luck; it’s a really important conversation to have!

  3. May 02, 2019 by Ira.Kadet Reply

    I completely agree with you, especially about how while parents have some right over making choices for their children, it is important for kids to be vaccinated for the protection of them, and those around them. Maybe it’s a good idea to have governmental regulations that make people take vaccines?

    • May 04, 2019 by Annabelle.Perng Reply

      Hi Ira,

      I’m happy to hear that you have the same stance! New York has implemented the type of regulation you mention, but I agree that it should be enforced on a larger scale (with people who choose not to vaccinate having to pay a fine). Of course, such a law would exempt individuals who cannot be vaccinated for medical reasons (such as known allergic reactions or immunodeficiency). I think that if this trend of outbreaks continues, that level of legislation may be necessary.

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