University of Pennsylvania bioethicist Art Caplan told a symposium of global health leaders that "those who chose not to vaccinate" are responsible for the resurgence of contagious diseases like measles in the U.S. and other countries.
PHILADELPHIA -- Despite the definitive debunking of a 1998 research paper linking vaccines and Autism that triggered a national anti-vaccination movement, many parents still won't vaccinate their children, even as the rate of vaccine-preventable diseases like measles and whooping cough continues to rise.
American's mainstream media shares much of the blame for this, according to University of Pennsylvania bioethicist Art Caplan. He's director of the University's Center for Bioethics and a nationally-renowned authority on the moral dilemmas in medicine and health care delivery.
Speaking at a recent Global Vaccines 202X symposium at the Franklin Institute, Caplan charged that mainstream U.S. media companies
More than 25 percent of U.S. parents still believe that vaccines can cause Autism.
continue to "promote fringe and fraudulent views about vaccine dangers," because their editors and producers treat the facts of vaccine safety "as if they were still in dispute, fostering fear and confusion on the part of the public."
"The media has goofed up this story and has done a very poor job," said Caplan. "It's as if we were having a debate about the Holocaust and demand that we always have a Holocaust denier to represent the 'other' side of the argument. But in the area of vaccines, the confusion that causes has affected the behavior (of parents)."
Anti-vaccination movement The vaccine safety dispute began in 1998 with a paper by British physician Andrew Wakefield that purported to link vaccines and Autism. The fact that it was published by the prestigious British medical journal, The Lancet, gave it maximum gravitas, generating worldwide publicity and a tidal wave of parental panic. The subsequent media frenzy went on for a decade, fueling countless TV shows, print articles, radio commentaries, internet rants and DVD documentaries such as "Vaccine Nation," "Shoot 'em Up: The Truth About Vaccines," and "The Vaccine War" by Jenny McCarthy. The publishing industry sent authors tramping across the country to promote a raft of new works including "Saying No to Vaccines," "Vaccine Epidemic," "Raising a Vaccine Free Child" and even Andrew Wakefield's own "Callous Disregard: Autism and the Truth Behind a Tragedy."
But Wakefield's "truth" turned into something else as he became the center of a global scholarly research scandal that tarnished even the lofty Lancet, forcing its editors to retract the article and admit it contained false claims. The British doctor and anti-vaccine media celebrity himself was investigated by the British Medical Council. It cited him for unprofessional conduct and barred him from the further practice of medicine in the United Kingdom.
'Not associated with Autism' Through it all in the U.S., the position of the Centers for Disease Control and Prevention and other top infection disease authorities was that "studies continue to show that vaccines are not associated with Autism spectrum disorders."
But, much like conspiracy theories about the Kennedy assassination or the existence of UFOs, the controversy over vaccines and autism has continued to rage across the blogosphere and in the minds of many American parents. For instance, earlier this year, a survey of 4,556 parents, published in the journal, Pediatrics, found that 26.2% believed that vaccines may cause Autism.
Why are such beliefs still prevalent? Caplan characterized the media as the "prime culprit" because "by giving equal airtime on shows like Oprah to 'experts' like (actress and anti-vaccine activist) Jenny McCarthy and other celebrities to inveigh against vaccination, and by treating the facts concerning vaccine safety as if they were still in dispute, the media fosters fear and confusion on the part of the public. Parents bombarded by mixed messages about the dangers of technology are prone to listen to the dangerous stories."
Whooping cough deaths But, he pointed out, "those who choose not to vaccinate are part of the cause for the resurgence of infectious diseases in the U.S., the U.K., Canada, Japan and the Netherlands. Whooping cough is making a rapid and deadly comeback. California has had the worst whooping cough outbreak in sixty years. Ten infants are dead. An analysis of state data shows that more than half of the people diagnosed with Whooping cough had not been immunized. Half of all cases in the outbreak have been in children under 10 and infants less than a year old. Vaccination rates there are lousy, and in major cities the percentage of children entering kindergarten, whose parents chose not to vaccinate them, went up from 2% to 3.1% just last year."
At the same time Caplan was addressing the Franklin Institute vaccine symposium, CDC headquarters in Atlanta was preparing to release its announcement that the annual number of U.S. measles cases has hit a 15-year high.
"The price of non-vaccination is right in front of your face," said Caplan. "You can look at these outbreaks both here and in other countries, and see what happens when you don't vaccinate."
Combating anti-vaccine message Caplan's remarks to the more than one hundred global health leaders also took some of them to task for being as naive as they are slow in their public response to the onslaught of anti-vaccine messaging across virtually all media channels.
"Public health agencies do not seem to be pulling their weight in the vaccine wars," he said. "Those in charge do not speak out forcefully and vehemently enough in support of vaccines. For instance, there's a very odd recent article in the Journal of Immunotoxicology by Helen Radezhack, who says she has found how vaccines cause Autism. When the Center of Disease Control was asked by a journalist if it wanted to challenge this paper, the CDC said that a comprehensive review was going to take quite a bit of time."
"Meanwhile all over the Internet, this paper is being used to proclaim that vaccines are not safe," Caplan continued. "The public, the critics, and the way information moves today demands immediate rapid response to something along the order of, 'that's an interesting theory and until something gets confirmed it's just interesting.' We are not responding (fast enough and effectively enough) to the latest minor publication of someone speculating something in a Wakefieldian manner. We do not try and knock down that argument before it can get rooted."
'Choice' and public health consequences "I think what you have to do is switch the way the vaccine community promotes, sells and tries to educate about vaccines," he said. "When people argue the right of 'personal choice' to refuse vaccination, I rarely hear anyone within the vaccine community saying 'you should behave according to community values.' I think we have to start to get in their face and say, 'you know choice has it's limits too'. Big limits. You're not supposed to kill other people, particularly helpless newborns, by your choices. You shouldn't really end the lives of the frail, elderly and immunologically vulnerable by your choices. You should feel some duty to protect your neighbors and your community."
"We should remind them that citizens who choose to live among others, and to use public facilities like stores and airports, have duties not to spread contagion; it's part of an ethics message that I think the vaccine community should sell," said Caplan. "It's part of the message that I think should be on the vaccine community agenda for the coming decade."
