Despite the indisputable fact that vaccines save millions of lives, their use has come under increasing criticism. In the US, vaccine-preventable infections kill more individuals annually than HIV/AIDS, breast cancer, or traffic accidents (Murphy, 60). Beginning in the 1950s, effective vaccines against major childhood illnesses, such as measles, mumps, rubella, diphtheria, polio, and tetanus have been developed and made widely available. Based on their profound individual and public health benefits, their use has become pervasive and required for attendance at public schools. The reduction in the incidence and morbidity of these childhood diseases is one of the crowning achievements of science and medicine in the 20th century. Despite this, there is a recent growing backlash against the use of the vaccines. Significant numbers of parents refuse to have their children vaccinated, putting not only their own children but also many other children in the community at risk. While there are some health risks associated with vaccines, most of the arguments against their use are scientifically flawed. Even though a lot of parents use vaccine exemption forms for their kids, I believe that requiring childhood vaccination is in the best interests of both children and society because the benefits from this far outweigh the risks such as mild side effects. This essay delineates the rationale for requiring universal childhood vaccination and considers the basis for their rejection by some parents.
While the acceptance of vaccination was initially high, the situation began to change once the target diseases began to be controlled, making their effects less known to emerging generations of parents. Many children who are vaccinated experience some minor side effects, including fussiness, swelling and mild to moderate pain at the injection site, fever, or prolonged crying. It is not rare for babies vaccinated with DTaP or rotavirus vaccines to experience mild vomiting and diarrhea. These side effects of vaccines, while somewhat frequent, pose no danger and spontaneously resolve. When vaccinations were administered to millions, rare side effects of vaccination began to be observed, including transient paralysis called Guillain-Barré Syndrome (GBS). Although this paralysis can last for more than several weeks, it too eventually resolves. Much has been made about the relationship between vaccinations such as flu shots and the incidence of GBS; indeed, some law firms specialize in litigating alleged vaccination-associated cases of GBS and other potential side effects (Brazil, 1). Moreover, more careful consideration of the relationship between vaccination and GBS suggests that many of the cases attributed to vaccinations may actually result from exposure to viruses from non-vaccine sources (Kinunnen, 69). The risk of getting one of the preventable diseases compared to the risk of getting one of these side effects led the Center for Disease Control and Prevention (CDC) to strongly recommend requiring vaccination when the diseases were still epidemic. However, as the incidence of the target diseases has fallen, the focus of some critics has turned to the risk of getting a side effect with little consideration of avoiding the target disease. The arguments against this are that the risk of getting a serious disease still outweighs the realistic side effect concerns and that unvaccinated children pose a public health risk because they can allow the spread of infectious diseases which have otherwise been contained. In this debate, the preponderance of the evidence favors still requiring vaccination, since the real life risk of becoming infected is greater than the risk of having a side effect, and the consequences of becoming infected are greater than those of the potential side effects, given their relative incidence rates. That said, this argument against compulsory vaccination has some merit on the basis of scientific facts and probabilities.
Many of the objections raised the use of vaccines relate to some parents’ disbelief that their children are at risk for diseases such as polio, chicken pox, measles and tetanus, which are, they think, now rarely seen in the U.S due not to the vaccination but the improved hygiene. In her book “ Over-The-Counter Natural Cures”, Shane Ellison, M.S, states: “But the vaccines came too late. Thanks to better hygiene, sanitation and nutrition, the rates of polio infection had already plummeted”(221). As recently as the early 1950s, polio was a rampant crippling illness, keeping children indoors and away from movie theatres and other public gatherings in the summer, filled hospitals with children in iron lungs to maintain their ability to breathe, and leaving a wake of people with withered limbs and crutches or braces for the rest of their lives. Improved hygiene and nutrition, among other factors, did certainly lower the incidence of some diseases. However, data documenting the number of cases of a disease before and after the introduction of a vaccine demonstrate that vaccines are overwhelmingly responsible for the largest drops in disease rates. For example, measles cases, that are associated rarely with a devastating inflammation of the brain, Sub-acute Sclerosing Pan-Encephalitis, which either kills its victims or leaves them brain dead for life, numbered anywhere from 300,000 to 800,000 a year in the United States between 1950 and 1963, when a newly licensed measles vaccine went into widespread use. In 1968, five years after the introduction of the Measles vaccine, the annual incidence of measles in the U.S. had fallen to 20,000 cases (Langmuir, 103). Sadly, the growing trend not to vaccinate has led to some resurgence of measles, with the highest incidence of measles in 20 years now observed in unvaccinated children (Plait,7). The dangerous risks to those unvaccinated for Rubella (German Measles) can lead to fetal retardation if a mother becomes infected during pregnancy. Diphtheria can cause fatal respiratory infections. Tetanus, known as Lock Jaw, is also potentially fatal and difficult to treat once contracted. It is the ravaging effects of these diseases fresh in people's memory that made it relatively easy to get broad public support for required childhood vaccinations. At its root, it is the ability of these vaccinations to prevent the incidence of these diseases that is the essential argument in favor of vaccinations.
Of greater concern is the rejection of vaccination for children because parents are being misled by faulty pseudo-science. In a recent survey, published in Scientific American, of more than 1,500 parents, one quarter held the mistaken belief that vaccines can cause autism in healthy children, and more than one in 10 had refused at least one recommended vaccine (Dalley, 9). It is an indisputable fact that the incidence of autism in the United States has been growing at an alarming rate. In 1996, fewer than one child in 1000 was diagnosed with autism. By 2007, this had grown to more than 5 children in 1000 (approximately 1 in 200). The most recent statistics on autism suggest that now the incidence is 1 in 80, with even higher incidence in boys (1 in 68). While some of this increase may reflect increased diagnosis rather than incidence, it is undeniable that there is more autism today than before. One of the biggest boosts to the anti-vaccine movement came in 1998, when, in a paper in Lancet British medical researcher Andrew J. Wakefield proposed that measles vaccine could cause autism in susceptible children (351). In particular, they advanced the belief that Thimerasol, a mercury-containing organic compound used as a preservative in many of the childhood vaccines, could cause severe neurological damage. Mercury is a neuro-toxin. There were widely publicized incidents where mercury poisoning from eating top predator fish led to epidemic retardation. This type of mercury-induced retardation even became associated with an eponymic term: Minamata disease (Harada, 25). The argument therefore goes as follows: the incidence of autism has been growing roughly in the same time frame as the increased widespread use of vaccines. Many of these vaccines contain Thimerasol, a mercury containing compound. Mercury is known to cause mental retardation. Autism and mental retardation are both disorders of the brain. Therefore, the mercury in vaccines has caused the increased incidence of autism. This argument is entirely fallacious, however. It is based on the worst kind of pseudo-science. The amounts of mercury which are involved in retardation are massively greater than those involved in vaccination. Autism is entirely different from mercury-induced retardation. The pattern of incidence of increased autism and that for vaccination are not well correlated, although both seem to be features of developing nations. The hypothesis that vaccinations cause autism has now been soundly repudiated by detailed scientific analysis (Thompson,1281). In 2008, Paul Offit, M.D., Chief of infectious diseases at Children's Hospital of Philadelphia and a vaccine expert, stated, "The science is largely complete. Ten epidemiological studies have shown MMR vaccine doesn't cause autism; six have shown thimerosal doesn't cause autism; three have shown thimerosal doesn't cause subtle neurological problems; a growing body of evidence now points to the genes that are linked to autism; and despite the remove of thimerosal from vaccines in 2001, the number of children with autism continues to rise”(12). Indeed, Wakefield himself and the colleagues that originally raised the concern that vaccines caused autism retracted his paper in Lancet, repudiating his previous speculations (Eggerston, 199). The lasting damage done by poor or pseudo-science is driven home by the observation, reported in Scientific American, that even after being made familiar with the fact that Wakefield’s connecting vaccination and autism have been thoroughly discredited, parents remain reluctant to have the children vaccinated based on a fear of risk of autism (Brownstein, 11).
Some of the arguments against vaccination are truly ludicrous and put forth by people posing as expert and spreading their viewpoints through by means of the internet. A good case in point is the article “Six Reasons to Say NO to Vaccinations”, by “Sarah, The Home Health Economist”. Sarah’s reasons include: “Pharmaceutical companies can’t be trusted”, “ALL vaccines are loaded with chemicals and other poisons”, “Fully Vaccinated Children are the Unhealthiest, Most Chronically Ill Children I Know”, “Other Countries Are Waking Up to the Dangers of Vaccines”, “A Number of Vaccines Have Already Had Problems/Been Removed from the Market”, and “You Can Always Get Vaccinated, But You Can Never Undo a Vaccination” (Pope, 6). While Sarah, the Home Health Economist, presents herself as an informed expert, delving into her credentials reveals otherwise. “Sarah holds a Bachelor of Arts in Economics from Furman University … and a Masters of Government Administration with a major in Public Financial Management from the University of Pennsylvania. Sarah worked for over 10 years in the field of Information Technology before retiring in 1998” (Pope, 15). Surely, none of these experiences qualifies her to opine expertly on an issue with serious personal and public health implications.
Other lines of argument against vaccinations relate to the ideas that vaccines are not responsible for the reduced incidence of childhood diseases and that getting infected and developing natural immunity is superior to being vaccinated. Examples of these arguments are laid out (verbosely) by Dr. Kurt Perkins, actually a chiropractor (Perkins, 20). Perkins shows data that suggest that the incidence on polio in the U.S. began to fall in the year before the introduction of the Salk vaccine. He ignores that reporting practices might account for this variability. He also ignores the fact that after the introduction of the vaccine, the cases which were observed were overwhelmingly in the unvaccinated. He also misstates the risk of having paralysis with polio as between 0.5-2.0%, even though the very graph he presents shows that about 50% of cases are paralytic. Perkins alleges that the waning of the polio threat is not due to the polio vaccines but to better but public health after the Great Depression. He also argues that the drive to vaccinate is pushed by the greed of pharmaceutical companies based on the profits they reap. These theories have been extended into the realms of paranoid conspiracy. Rumors have been promulgated that the use of polio vaccines (invented independently by two Jews, Salk and Sabin) is part of a vast Zionist conspiracy for world domination, is the source of the intentional introduction of HIV into humans, and is being abetted by various co-conspirators, including the Bill and Melinda Gates Foundation, WHO, the CDC, and UNICEF (Talib, 75). Perkins also asserts that the immunity produced to a natural infection is superior to that produced by a vaccine. While in some cases actual infection with a pathogenic organism produces more lasting or stronger immunity than does vaccination with an inactivated or attenuated version of that organism, he conveniently ignores the fact that in the first instance the person actually gets the disease and risks the sequelae of having done so whereas with vaccination the disease and its manifestations (symptoms and sequelae) are avoided. He points out that the vaccines in current use were not subjected to rigorous placebo-controlled clinical trials and therefore have not been shown to work. He ignores the fact that modern scientific methods of immunological monitoring can readily confirm that vaccination produces anti-infectious immunity and that a comparison of disease incidence in vaccinated and non-vaccinated children who mingle in the same community clearly shows that the vaccinated children – but not the organically and holistically raised – children are protected from the diseases for which vaccines have been administered. Closer examination of arguments against vaccination made by Perkins are couched in scientific terminology but are fundamentally at odds with reputable and firmly grounded modern science and medicine. At their heart, these arguments are a manifestation of the Luddite rejection of technological advances and fundamental distrust of the institutions of industry and government.
Overall, while vaccines are not risk free, they are one of the most cost-effective and high-impact health care innovations of the last century. Their use has created an ironic situation. As the diseases that they prevent fades from living memory, the rationale for their use has come under question by the population that they protect. The earlier fears that vaccinations might cause autism have been completely refuted. Unfortunately, education has not completely removed this stigma, however. There is a vast, misinformed mythology regarding vaccines, overplaying their risks and underplaying their benefits. These arguments against their use, however, are flawed and largely emanate from lay sources and are largely underpinned by half-baked pseudoscience. Reputable and qualified opinion is united in highlighting the great importance of vaccines in maintaining individual and public health. Vaccination should remain a required practice to protect children in the U.S. Greater use of vaccines in the U.S. and beyond could save millions of lives each year.