Vaccine denial is public irresponsibility, not personal risk

In a few backwards parts of the world, extremists resist universal childhood vaccinations. The Taliban in tribal areas of Pakistan. Boko Haram militants in Northern Nigeria. Oh, yes, and some politicians in the United States.

Sen Rand Paul — a doctor — told CNBC he had delayed his own children’s immunisations and cited “many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines”.

After an uproar, Sen Paul retracted his remarks and tweeted a photo of himself getting a Hepatitis A vaccination. After that irresponsible scaremongering, I’d say he deserves to get shots daily for a decade.

Gov Chris Christie of New Jersey weighed in as well, suggesting that vaccinations are partly a matter of family choice — before later seeming to retreat as well. Sen Paul and Gov Christie are Republicans, but public health illiteracy is bipartisan: Vaccination rates are particularly low in some liberal Democratic enclaves in California. At the Waldorf Early Childhood Centre in Santa Monica, California, 68% of the children had “personal belief exemptions” to avoid vaccination requirements, according to The Hollywood Reporter. That suggests that kids in some wealthy areas are as well vaccinated as children in, say, Somalia.

President Barack Obama made ambiguous remarks in 2008 that also seemed to suggest that the science is inconclusive about a link between vaccines and autism. And Hillary Rodham Clinton suggested the same thing that year. (Since then, both have emphasised strong support for vaccines.)

Let’s call this out as the nonsense it is. If we’re going to denounce the Taliban for blocking polio vaccinations, we should be just as quick to stand up to health illiteracy.

First, a word on vaccines: They have revolutionised public health.

Can you name the discoverer of the smallpox vaccine? Probably not. Edward Jenner is little known today. He lived roughly when Napoleon did, and he managed before he died to save many millions more lives than Napoleon cost in his wars over the same period.

Jenner’s vaccine appears to have saved more than half a billion lives since 1800, notes Dr D A Henderson, who led the effort to eradicate smallpox. Jenner should be counted as one of the great heroes of the modern world, yet he is forgotten while everybody knows of Napoleon. That’s emblematic of the way vaccines get short shrift.

In reporting on poverty worldwide, I’ve seen how much vaccines improve human well-being. I understand how troglodytes in the Taliban or Boko Haram can be suspicious of vaccines, but politicians here in affluent, well-educated America?

Granted, for a time, it was plausible to wonder about a possible link between vaccines and autism, based on a 1998 article in The Lancet, the British medical journal. But that report was quickly discredited by at least 13 studies, and it was retracted in 2010. The author has been stripped of his medical licence.

In Britain, for example, researchers found no change in the rate of autism diagnosis after the 1987 introduction of the MMR vaccine against measles, mumps and rubella, and MMR vaccination rates were similar for autistic children and for others.

Likewise, studies in California and Atlanta found no correlation between autism rates and MMR vaccinations. Japan suspended the MMR vaccine because of health concerns, yet a careful study found that autism continued to rise.

Dr Philip J Landrigan, chairman of the department of preventive medicine at the Mount Sinai medical school, says that there may be environmental factors linked to autism, but these relate to endocrine disrupting chemicals in consumer products, not to vaccines. “Rather than worry about a vaccine-autism connection that has been proven not to exist, parents should be banding together and writing their elected officials to insist that chemicals be properly tested for toxicity to children before they are allowed to enter the American market,” Dr Landrigan told me. “The Europeans have passed such legislation. We should, too.”

Yet American parents remain fixated on vaccines in ways that endanger kids. According to the World Health Organisation, the measles vaccination rate in 2013 stood at 91% in the United States — lower than in Zimbabwe or Bangladesh.

Sen Paul and Gov Christie seemed, initially at least, sympathetic to a “personal choice” argument that parents should be allowed to endanger their children in some circumstances. But that’s not the issue here.

The point of immunisation isn’t just to protect your own child, but also to protect others. Especially those like Rylee Beck, a five-year-old girl in Orange, California, who is fighting leukaemia and can’t be vaccinated. To stay safe, she depends on others getting vaccinated and creating “herd immunity” to keep the disease at bay.

“Rylee is in pre-school, and it’s a scary thing sending her there every day,” her mother, Melissa Beck, told me. In December, the family took Rylee to Disneyland and then was terrified when a measles outbreak infected visitors to the park at that time.

“It just scared us to death,” Ms Beck said. “We were just holding our breath, hoping nothing was going to come out of it.” Fortunately, Rylee was not infected.

It’s not just cancer patients who can’t be immunised, but also infants, those with vaccine allergies, and people with medical conditions that leave them immunocompromised. And a small proportion of people get the vaccine but never develop immunity, so they, too, depend on others to get vaccinated.

Thus refusing to vaccinate your children is not “personal choice” but public irresponsibility.

You no more have the right to risk others by failing to vaccinate than you do by sending your child to school with a hunting knife. Vaccination isn’t a private choice but a civic obligation.

Ms Beck says that other parents are universally kind and helpful when they see Rylee, frail and learn that she is fighting cancer.

She’s sure that other parents aren’t deliberately putting children like Rylee at risk; they just don’t know better.

“It’s a matter of life and death for these kids,” Ms Beck said. “Maybe that would change these parents’ minds.” Nicholas D Kristof is a columnist with The New York Times.