Fear & vaccines

I realize that, despite the scientific evidence to the contrary, there is still a lot of fear and misunderstanding about vaccine safety. Two recent articles discuss this "epidemic of fear" and why it affects us all, the first here at Wired magazine, and the second here at the Gotham Skeptic. I especially like the second, which has some excellent points:

My pediatric practice is situated at the nexus of three Manhattan neighborhoods (the West Village, Chelsea, and the Meat Packing District) that seem to comprise just the right balance of wealth, edginess, and socio-cultural awareness that lends itself to this new mistrust of vaccines. But these neighborhoods are not unique. According to sources at the NYC DOH, the Upper West Side of Manhattan and Park Slope in Brooklyn are also hot-spots of parental vaccine resistance. What stands out about these neighborhoods, and others like them, is that they contain a high percentage of middle to upper middle class families that tend to be young, well educated, and liberal in their political and social views. Because I live in one of these areas, work in another, and fit this description pretty squarely, I can identify with the underlying tendencies at work behind the concerns of these parents. A healthy questioning of authority (doctors), an underlying mistrust in the competence of the government (the CDC), overt mistrust and a general level of cynicism of big business (the pharmaceutical industry), and a sense of empowerment that comes with one's social status, all contribute to this tendency to mistrust vaccines and those who recommend them. The difference between these concerned parents and myself (also a parent), is an understanding of the scientific method and the role it plays in this issue. One term that I have purposefully left out as a key element in this new epidemic is "skepticism." While many of these parents believe they are being skeptical of vaccines, their manufacturers and the agencies that recommend them, this couldn't be further from the truth. What they are being is misled and taken advantage of. They would actually be better characterized as anti-skeptics. To quote Brian Dunning of Skeptoid.com:

"The true meaning of the word skepticism has nothing to do with doubt, disbelief, or negativity. Skepticism is the process of applying reason and critical thinking to determine validity. It's the process of finding a supported conclusion, not the justification of a preconceived conclusion."

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Good to see you posting again, even if only sporadically.

Perhaps a better word would be "empiricism"? I suppose perhaps it's not a common enough word.

Do you think that there is an element of "fear itself" at work?

Given that there is something 'real' to be afraid of here - i.e. the H1N1 flu virus - what is it, exactly, that parents think they are protecting their children from? Government, physicians and BigPharma are not "outcomes" the way severe illness and death as a result of the flu are. What are the negative health effects that parents think they are avoiding by skipping the vaccine?

Autism would probably be the most likely answer, right? Does anyone have other thoughts as to the things parents are trying to avoid?

p.s. I'm think that the initial research claiming to connect vaccines with autism has since been debunked pretty thoroughly as scientifically unsound and politically-motivated.

Tara,

Please get educated because you are being used. I recovered my son from vaccine-induced Autism. My brother was recently rushed to the hospital with yet again, viral meningitis and encephalitis (hint - Coast Guard - numerous vaccines - another hint - learning disabled/ADD/vaccine damaged as a child already!). Come on, are doctors really this clueless? Read "Fear of the Invisible" by Janine Roberts for a catch up session on all of the government meetings that have taken place over years regarding the vaccine contaminants.....they are causing all of these "new diseases"! Breast cancer - caused by the SV40 virus, HPV - vaccine contaminant - I could go on, but I think you have some reading to do. Your patients are counting on people like you to do their homework.

Dawn

Dawn, I prefer to read the primary literature rather than sensationalistic books by HIV-deniers. I also have been involved in a number of "government meetings" (was just on the phone with senate staffers today, in fact) and all the allegations of this huge scientific cover-up are absolutely absurd to a scientist. Do you have any idea how competitive a field science is? Do you really think the government could "muzzle" every single researcher in the US--and even if they could, foreign researchers certainly aren't covered and could easily publish these results in international journals, so lying to US scientists would be futile anyway.

I am glad to hear your son is doing better, but how can you be sure that he recovered due to your actions/treatments, when other autistic children also have been reported to be diagnosed with autism at one point, and to have "lost" the diagnosis later in childhood, without any active treatment program? To me, it seems these are cases of either 1) misdiagnosis, or 2) a process that we simply don't understand yet, but I don't see evidence of science-based programs to "heal" autism.

There are plenty of primary sources that link Vaccines to brain damage. Monkeys injected with the Thimerosal containing Hepatitis b vaccine get brain damaged while the controls don't. (Hewitson et al)

3 different studies show urinary poryphrins pattern that has a pattern of mercury poisoning in autistic patients and not in controls (Nataf et al geier and Geier, one more forgot the name but I referenced it before)

Of course there is also the Hannah Poling case where it was clearly proven that vaccines played a major role in triggering autism. Hannah had no symptoms besides mild ear infections and was developing normally, she received many vaccines and became autistic right after.

Science is not democratic anymore, that is why huge blunders are possible. Science is now run by a small number of very powerful public health officials and drug companies. Their influence is much more than financial, they also are able to convince millions through indoctrination campaigns (note they aren't trying to convince people with compelling experiments) as we see today with their flu vaccination campaigns.

Hi Tara,

Thank you for som very interesting references. I can see that the debate in the States is so much more heated than here in Denmark. I would likew to point everyone who believes that there is a connection between autism and vaccination to a Danish study that includes almost one tenth of the population. It was publisked in The New England Journal of Medicine in 2002 (KM Madsen, et al.: A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism, NEMJ Vol. 347:1477-1482, No. 19). The abstract says it all:

ABSTRACT

Background It has been suggested that vaccination against measles, mumps, and rubella (MMR) is a cause of autism.

Methods We conducted a retrospective cohort study of all children born in Denmark from January 1991 through December 1998. The cohort was selected on the basis of data from the Danish Civil Registration System, which assigns a unique identification number to every live-born infant and new resident in Denmark. MMR-vaccination status was obtained from the Danish National Board of Health. Information on the children's autism status was obtained from the Danish Psychiatric Central Register, which contains information on all diagnoses received by patients in psychiatric hospitals and outpatient clinics in Denmark. We obtained information on potential confounders from the Danish Medical Birth Registry, the National Hospital Registry, and Statistics Denmark.

Results Of the 537,303 children in the cohort (representing 2,129,864 person-years), 440,655 (82.0 percent) had received the MMR vaccine. We identified 316 children with a diagnosis of autistic disorder and 422 with a diagnosis of other autistic-spectrum disorders. After adjustment for potential confounders, the relative risk of autistic disorder in the group of vaccinated children, as compared with the unvaccinated group, was 0.92 (95 percent confidence interval, 0.68 to 1.24), and the relative risk of another autistic-spectrum disorder was 0.83 (95 percent confidence interval, 0.65 to 1.07). There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder.

Conclusions This study provides strong evidence against the hypothesis that MMR vaccination causes autism.

By Jan Helldén (not verified) on 22 Oct 2009 #permalink

I am troubled by Dr. John Snyder's description of his neighborhood: "What stands out about these neighborhoods, and others like them, is that they contain a high percentage of middle to upper middle class families that tend to be young, well educated, and liberal in their political and social views. " Dr.Snyder goes on to state: "The difference between these concerned parents and myself (also a parent), is an understanding of the scientific method and the role it plays in this issue."

By no means are all vaccine refusers "young, well educated, and liberal." And all of those folk are not vaccine refusers. Dr. Snyder does not give figures (he does cite a NEJM article which gives state figures in the range 1-2.5%, with some counties in Washington state with 26.5% refusal) for his neighborhood, but I seriously doubt the suggestion that the well educated are lacking in "an understanding of the scientific method." The well educated are the ones most likely to understand scientific method. And I suspect the vast majority of them, including Dr. Snyder's patients, get vaccinations. They might ask a lot of questions, and perhaps Dr. Snyder grows weary answering them. If he's too busy to deal with their questions, perhaps he should hire someone to answer such questions. I'd be happy to send him my resume.

By Paul Heikkila (not verified) on 26 Oct 2009 #permalink

The New York Times this evening is reporting that from 5 to 50 percent of public school children are signing up for the H1N1 vaccine. http://www.nytimes.com/2009/10/29/nyregion/29vaccine.html?_r=1&hp
The Times does not attribute this rather low acceptance rate to the youth, middle class status, educational level, or liberalism of the parents.

By Paul Heikkila (not verified) on 28 Oct 2009 #permalink

Unfortunately swine flu came to Turkey. And There are a question every person's mind. Should I get vaccine or not?
Because We don't know about the risks of vaccine. I think we should, but Nobody know repercussion of swine vaccine.
What do you think this situation?

Much of the vaccine debate has become rather tedious, I know - especially in these comment threads, which are so routinely hijacked by the Konspiracy Kru. I was wondering, though, if you'd be good enough to share your thoughts on something I've discovered recently.

I live in a European country where the usual hysteria about vaccines (esp mmr) seems to have little foothold. Rejection of all flu vaccines, though, is almost universal - especially so among doctors. Is this because the costs of flu (to the individual) are so much lower in a country with near-socialized madicine? Is it mere fashion/faddism in the medical community? I'm really mystified...

It's been ages since I've visited her, Tara. I see the anti-vax crowd still lurks in the shadows.

I read somewhere (maybe Orac's place) that one doctor reports his immigrant patients are the ones who most want vaccinations, because they have experienced first hand what communicable diseases can do. Most other Americans haven't a clue, because it's been so long since polio, whooping cough, etc., have been subdued by vaccinations.

I'm living in China now, and there was a small outbreak of H1N1 on our campus, principally among students in our college. One of our profs was out for a week with it, too. So we faculty were expected to get our flu shots, which all of us (save one from the UK with a bad cold) did. There were no negative reactions, other than sore arms.

China is serious about containing the pandemic. With 1.3 billion people, many living in close quarters, not controlling H1N1 would be an epic disaster.

To abandon any thought of mitigating climate change, to quit now while we can, at least in theory, head off the worst of what's to come, strikes me as a lazy and cowardly approach.

To be sure, I am a conspirator theorist, albeit one who allows reality to get in the way. Or perhaps I am generally mistrusting. That being said (grain of salt) I donâtâ believe all vaccines are bullets aimed at the unknowing masses. Many have proven to be âgodsendsâ. What I would like to see, though, is a comprehensive study on the effectiveness of flu vaccines. The data I have seen, comparing annual flu cases against vaccinations (or non vaccinations in years when they werenât released on time or vaccinations against the âwrongâ flue strain), paints a picture where vaccinations were as effective against the flu as the picking of ones nose. So if you know of any scientifically run (double blind, etc.) studies supporting the effectiveness of the flu vaccines please, please share.
Thank you.

I read somewhere (maybe Orac's place) that one doctor reports his immigrant patients are the ones who most want vaccinations, because they have experienced first hand what communicable diseases can do. Most other Americans haven't a clue, because it's been so long since polio, whooping cough, etc., have been subdued by vaccinations