If you’re a medical traveler or someone who works in the medical field, you already know about the science and facts backing up vaccines. But in an age of misinformation and social media, vaccines are a hot topic… and not always a positive one.
Anti-Vaxx and the Social Influence of Spreading Misinformation
It seems that wherever you go on social media, in neighborhood groups, and even across the entire internet, vaccine safety is at the forefront. And it makes sense. Safety in healthcare is important, especially when it comes to protecting our children and future health.
Ask any healthcare professional, there is no single preventive health intervention more cost-effective than immunization. Over and over, international societies have endorsed the value of vaccines in being a crucial component to keeping infectious disease at bay, improving the overall health of their societies and the globe.
Despite all the fantastic advances in immunization over recent decades, 1.5 million children still die annually from vaccine-preventable diseases. And not all our advances are secure. According to the World Health Organization, 25 countries reported a net decrease in immunization coverage from 2010 to 2017.
Increasing access to immunization is important. Not only do vaccinations prevent the spreading of infectious diseases, they also help promote other national priorities like education and economic development. When we can help societies stay healthy in medicine, we can help other areas thrive too.
But it's not just access to immunization that leave us scratching our heads on the lack of vaxx. Regardless of team vaxx or team anti-vaxx, everyone has a lot to say when it comes to the discussion on vaccines. We’re hoping to lay out the facts.
"Vaccines are available, but myths around them discourage parents from immunizing their children. We need to bust myths and promote the benefits of immunization more widely," said Dr. Flavia Bustreo, Assistant Director-General for Family, Women’s and Children’s Health at WHO and co-Chair of the Gavi Board
2019’s World Immunization Week theme is: #VaccinesWork
Let’s talk about why they do.
KEY FACTS ABOUT IMMUNIZATION*
*Provided by the World Health Organization
Fact: Immunization currently prevents between 2-3 million deaths every year.
Immunization prevents deaths every year across all age groups from diptheria, tetanus, pertussis, and measles. It is one of the most successful and cost-effective public health interventions we have today.
Fact: Immunization by vaccination is the safest way to protect against disease.
Vaccines cause an immune response, similar to a natural infection, but without the serious risks of death or disability connected with natural infection.
Fact: Get vaccinated, even when you think the risk of infection is low.
Sometimes misinformation can lead to dropping immunization rates, which means that deadly diseases that seem to have been all but eradicated can make a comeback. Take for example, the most recent measles outbreak in Europe. Measles is highly contagious and can lead to blindness and death. Global measles deaths have decreased 84% from 2000 to 2016 with the help of immunization. When everyone sticks to an immunization plan, societies can keep these vaccine-preventable diseases at bay.
Fact: Meningitis A epidemics were nearly eliminated in Africa through immunization.
Meningitis A can cause severe brain damage and is deadly to those who are infected. Since introducing this vaccine in 2010 to the “meningitis belt” African countries (26 different countries), mass vaccination campaigns have nearly eliminated this disease, and is now integrated into national immunization routines.
Fact: Combined vaccines are safe and beneficial.
Giving several vaccines at the same time has no negative effect on a child’s immune system. In fact, it can reduce discomfort (nobody likes needles!) and save time and money. Children are exposed to more antigens from a common cold than they are from vaccines.
Fact: There is no link between vaccines and autism.
There is no scientific evidence to link the MMR vaccine with autism or autistic disorders. This is an unfortunate rumor which started with a 1998 study and was quickly found to be flawed. It was also retracted by the journal that published it.
Fact: If we stop vaccination, deadly diseases will return.
Things have definitely changed since years before vaccines. Especially in the U.S., we have access to safe water, improved hygiene, and sanitation. Even with these advancements in healthcare, infections still spread. When people are not vaccinated, diseases that have become uncommon can quickly return and wreak havoc on our society.
THE HISTORY OF ANTI-VAXXING
Believe it or not, the recent rising of the anti-vaxx movement isn’t the first time. In fact, the anti-vaxx movement has been around as long as vaccination itself. Vaccination critics have taken several different stances over the years. Here’s a brief rundown:
Mid to late 1800s: Opposers of the smallpox vaccine in England and the United States resulted in a rising of anti-vaccination leagues.
1879: The Anti Vaccination Society of America was founded.
1902: The smallpox outbreak in Cambridge, Massachusetts caused the board of health to mandate all residents receive the smallpox vaccine. When resident Henning Jacobson refused, stating that the law violated his right to care for his own body, the city filed charges against him. The first U.S. Supreme Court case dealing with power of state in public health law came when Jacobson lost his local court battle and appealed to the U.S. Supreme Court. They ruled in favor of the state.
Jump to: The most recent vaccination controversies are those debating the safety and effectiveness of the diphtheria, tetanus, and pertussis immunization (DTP), and the measles, mumps, and rubella (MMR) vaccine. There is also the debate of the use of a thimerosal, a preservative that contains mercury.
In the U.S., the controversy began with focused media on the alleged risks of DTP with two things: A 1982 documentary, DPT: Vaccination Roulette and a 1991 book titled A Shot in the Dark. As a result of this documentary and this book, angry and concerned parents formed victim advocacy groups. Well-educated medical organizations, like the Academy of Pediatrics and the Centers for Disease Control and Prevention counter-responded, and the hysteria seemed to die down again.
Nearly 25 years later, controversy was brought to light again, but this time over the MMR vaccine. (This is the most recent controversy we see in media today.)
British doctor Andrew Wakefield recommended investigating the possible relationship between bowel disease, autism, and the MMR vaccine and that the vaccine was not properly tested before being used. Once again, a media storm raged on, feeding into public fear and confusion over the vaccine safety.
In 2004, The Lancet, the journal that originally published Wakefield’s work, stated that it should not have published the paper and the General Medical Council found that Wakefield had a “fatal conflict of interest.” This “fatal conflict of interest”… he had been paid off. A law board paid Wakefield to find evidence to support a litigation case by naysayer parents. These parents believed, through no scientific evidence, that vaccination had negatively affected their children.
In 2010, the Lancet formally retracted the paper. The General Medical Council ruled against Wakefield in several areas and he was struck from the medical register in Great Britain and may no longer practice medicine there. The following year, the BMJ published reports by journalist Brian Deer showing evidence that Wakefield had falsified data, had committed scientific fraud, and that he had motive to financially profit from his medical investigations.
For more details on the history of vaccines and anti-vaccination movements, check out this handy interactive timeline that starts all the way back from the year 1000 up to 2018.
WE HAVE THE FACTS. WE HAVE THE SCIENCE...
SO WHY AREN'T SOME PEOPLE VAXXING... STILL?
The popularity of anti-vaxx information has reached critical heights in the past decade. In 2013, a survey of pediatricians conducted by the American Academy of Pediatrics reported 87% had an experience with vaccine refusal. Comparing this to 2006 (74.5%, P<0.001), this is a significant increase. They also reported the reasoning for parental refusal: 73% of these parents believed vaccines to be unnecessary.
With some celebrities hopping on board the anti-vaxx train, the public wonders “if it’s really true.” So why all the controversy between science and fiction? This NBC article titled: When it comes to vaccines, celebrities often call the shots highlights the reasoning for the madness—
“Why do people take the word of a celebrity who has no medical expertise? Status often superseded information in our overconnected world, experts say.”
And isn’t that the most dangerous form of misinformation out there? With an internet-connected world, we often look to social media, product reviews and celebrities to tell us our truth. In fact, a huge surge in the anti-vaxx movement began in 2007 when celebrity Jenny McCarthy started promoting alternative medical treatments for autism. She has been described as “the nation’s most prominent purveyor of anti-vaxxer ideology” and appeared on a 2008 Larry King Live special, arguing that vaccines can trigger autism.
An article about celebrities who "speak out about illness" was published in 2015 in Medscape. In this article, psychiatrist Jeffrey Lieberman criticized McCarthy and her views on vaccines: "She has no idea what she is talking about. What she said is misleading and harmful, and the measles outbreak is a clear indication of the response to the spread of such pseudoscientific myths."
Since then, McCarthy has backtracked a little on her stance, stating that she is not anti-vaccine, but that she opposes too many vaccines in one sitting.
If you want a list of well-known celebrities who are anti-vaxx, take a look at this Jezebel article from 2015, which sheds comedic light of the dangers of misinformation celebrities can bring to the public eye.
And now the term “celebrity” isn’t just a movie star you’ve seen and admired, a Grammy nominee hanging out in Malibu, or the latest co-host on The View. Celeb status can be achieved as a brand influencer. YouTube stars, brand endorsers and lifestyle bloggers have all reached a form of status to influence their followers.
Social media makes our world more insular, and more available on-the-go. Which is incredibly important when you're a traveling medical professional, but it also means a torrent of information (some accurate and some not) being thrown around every which way. In an article from Infectious Disease Advisor, they describe the anti-vaxx movement as vaccine hesitancy, which is defined as “a decision-making process that is dependent on trust in healthcare providers and mainstream medicine, among other variables. However, through the combination of homophily—a theory that asserts individuals tend to form connections with others who are similar to them in characteristics such as socioeconomic status, values, beliefs, or attitudes—and the convenience of social media, individuals who have anti-vaccine beliefs can consume information that adheres to their system of beliefs and ignore dissenting information.”
Our social media world is rife with misinformation. Do a quick search on Facebook and you’ll notice a lot of these self-proclaimed wellness groups are cobbled together from one-off hero stories. It’s important to point out there are no scientific or fully research-led groups advocating for anti-vaxx. Here’s what my Facebook search pulled up:
Additionally, a quick Google search of bloggers and brand influencers who are anti-vaxx pulled up this “mommy blogger” named Meghan Rose. However, when I searched her site further, looking for additional data and scientific research on her anti-vaxx stance, several pages pulled up with a no results found tag:
So, if your favorite mommy blogger all of a sudden starts rattling off misinformation about vaccines, of course it makes the rest of the world stop and pause. After all, they are a parent. They’ve built an entire empire of followers on their lifestyle habits. If they say no to vaccines, maybe you should too?
It’s understandably easy to get sucked into the tornado without doing your own research. Hey, not everybody gets joy from rifling through journal articles or seeking out real scientific information on Google. If you're a medical traveler, you're busy balancing your job and your adventures. Some people would much rather spend that time with their families, cheering their kiddos on at soccer, or trying to perfect that “10-minute lasagna” recipe their coveted blogger posted yesterday. I get that it’s easy to take people at their word, especially when you like them. They are good people. You relate to them.
… But what if their word is dangerous? What if you’re in a social media echo chamber?
Harmful information can be classified as:
- Your neighborhood or carpool gossip chain
- The story chain with no name and, like, twelve degrees of separation (i.e. - your “friend’s sister’s college roommate’s brother”)
- A celebrity or brand influencer with no medical background (a “wellness coach” title doesn’t count as medical background, #sorrynotsorry)
- Your alarmist mother-in-law who saw or heard “something about deadly vaccines” on the internet or through a friend
- Social media “groups” or pages created by social users with no medical background
- Shared stories about “heroic anti-vaxxers” that are hodgepodged together with only thoughts and personal feelings, and no scientific evidence
- Websites or news sources of dubious origin that clearly seem to not be traditional, vetted news sources
...Ok, but how dangerous is misinformation?
Misinformation, especially when it comes to societal health, can be deadly. For example, take this measles outbreak from as recent as January in Clark County, Washington. A confirmed 65 cases and two suspected cases since the beginning of the year declared this a public health emergency. Most of the cases affected children younger than 10.
But wait… I thought measles was ancient history!
Interesting thing, though… The affected county has one of the lowest vaccination rates in the state. One in four kindergarten students during the 2017-18 school year did not get all their immunizations, according to data from the Washington Department of Health. Welcome back to the team, Measles.
Don’t get me wrong. Nobody is saying there shouldn’t be questions asked to clarify medical information. We do it all the time when we’re in the hospital, or when we go to the doctor. If you’re in healthcare, you probably hear these questions all the time. Everyone wants to know what’s happening with our bodies and with our kids. Asking questions are how we learn, right?! So, do it. Ask your health providers and check accurate websites for information. If you’re a healthcare worker, state the facts.
Don’t know where to start with research? Vaccine Safety Net is a global network of vaccine safety websites that are certified by the World Health Organization. This site provides easy access to accurate and trustworthy information on vaccines. The network has 47 member websites in 12 languages, and reaches more than 173 million people every month with credible information on vaccine safety, which helps counter harmful misinformation.
In fact, the spreading of misinformation is so high, that in the past few months Pinterest has blocked searches on vaccinations to help curb it. According to USA Today, the social media site has blocked all searches using terms related to vaccines or vaccinations as part of a plan to stop the spread of misinformation related to anti-vaxx posts.
"We want Pinterest to be an inspiring place for people, and there's nothing inspiring about misinformation," said a statement to CNBC from a Pinterest spokesperson.
"That's why we continue to work on new ways of keeping misleading content off our platform and out of our recommendations engine."
Just some more recent food for thought, a CNN story from this March, titled MMR vaccine does not cause autism, another study confirms highlights a very recent study, further evaluating the link between the MMR vaccine and autism. Researchers used a population registry to evaluate if the MMR vaccine increased the risk of autism in children born in Denmark between 1999 and 2010. A total of 657,461 children were followed through August 2013. Researchers documented diagnoses of autism spectrum disorder and known risk factors including parental, sibling diagnosis of autism, preterm birth and low weight at birth. Over 95% of the children received the MMR vaccine, and 6,517 were diagnosed with autism. The MMR vaccine did not increase the risk of autism in children who were not considered at risk for the disorder and did not trigger it in those who were. The study can be found in the journal Annals of Internal Medicine.
"This idea that vaccines cause autism is still around and is still getting a lot of exposure in social media," said Anders Hviid, the lead study author and senior investigator at Statens Serum Institut in Denmark.
Because anti-vaccine groups have become more vocal, and celebrities and politicians have spread fear and misinformation as well, Hviid and his team wanted to provide solid scientific answers.
Another story from NPR published a month ago titled The Unintended Benefits Of Vaccines discusses the other surprising benefits vaccines can offer and how they discovered them by chance. A new study shows that that vaccination with a weak strain of salmonella protects against typhoid fever but also amps up the immune system to fight off other illnesses, such as influenza and yeast infections.
"Live vaccines have the very broad benefit of going much further than protecting just against the targeted disease," said Dr. Michael Mina, a pathologist at the Harvard T.H. Chan School of Public Health.
"This reinforces the benefits of vaccinating kids. Vaccines are benefiting kids even more than we imagined."
With more and more scientific research backing up the benefits of vaccines, anti-vaxxing misinformation is equivalent to flat-Earth beliefs or moon landing conspiracies… but far more dangerous to overall public health. Most people in medical staffing understand this. And to others, well, you’re either high-fiving me or formulating some hate mail. After all, I am a 30-something millennial writer who eats avocado toast. What do I know? Well, don’t take me at my word. Do your research. Medicine knows facts, so check your facts and check your sources.
We shouldn’t just rely on people around us to stop the spread of disease. We all have a responsibility to do what we can. And with that, we should all be thankful for this powerful modern medicine. We are fortunate to live in a time where we have the means to eradicate infectious diseases through our knowledge of vaccines. Let’s use it.