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As the novel coronavirus continues to infect millions of people, scientists are frantically trying to develop a vaccine that will allow a semblance of ‘normal life’ in spite of this deadly and contagious virus. But, we live in an age where a global pandemic and anti-vaccine groups coexist in time and space. How did this come to be? Why might a SARS-CoV-2 vaccine become controversial and rejected by thousands of people? First, we have to understand measles and some history of the measles vaccine.

Measles and the MMR vaccine

It was not too long ago that almost everyone could agree that vaccines were a life-saving innovation that saved humanity from countless deaths each year. For instance, in the last 40 years, global measles cases have steadily dropped, showing how effective vaccines can be for a highly contagious disease. 

Graph data from the World Health Organization

 In 1980, there were 4.3 million reported measles cases around the world. In 2016 we hit the lowest recorded number of global cases at ~132,000. Of course, deaths from measles dropped dramatically as well. The US was considered free of measles in 2000, however our status has been threatened in recent years with push back against vaccines. Note: there has actually been a slight uptick in measles cases in the last few years, in part thanks to folks opposed to vaccinations. For instance, a 2019 outbreak of measles occurred in un-vaccinated communities.

To learn more about measles, how crazy contagious it is, how deadly it can be, and about the vaccine,  I recommend this podcast: Measles, the worst souvenir.

How the “anti-vaxx” movement began 

In 1998, a paper was published in the Lancet, a well-respected medical journal, that claimed that the measles, mumps, and rubella (MMR) vaccine was responsible for causing autism in a group of boys. You can see the paper (which, incredibly, was not retracted until 2010, here.)

I cannot emphasize enough the MAJOR issues with this paper, ethically and otherwise:

  1. The sample size was excruciatingly small. The paper tried to make the claim that medical information from 11 boys was enough to make a solid connection between the MMR vaccine and autism. For reference, for this claim to be scientifically sound, scientists typically require hundreds, if not THOUSANDS of patients in order to make a confident connection between an environmental factor and a disease. It’s an understatement to say that this paper was making an immensely inappropriate stretch when they made this claim. 
  2. Wondering why the sample size was so small? It came out later that the authors had cherry-picked the study participants in order to make the data look more convincing. This is scientific fraud and anyone in the scientific community who is caught ‘messing with’ the data in a manner such as this is subject to firing, and if they are a doctor, you can have your medical license revoked. 
  3. This ‘study’ was unethical too. The parents did not give consent for their children to participate.
  4. The lead author, Andrew Wakefield, had a clear conflict of interest in publishing this paper. He was receiving financial compensation from lawyers that were defending parents in cases against vaccine-makers. 

So, fraud, conflict of interest, unethical treatment of children, and scientific misconduct were ALL present here. 

There have been many debates and conversations in the scientific community as to how this paper made it through peer-review and was allowed to be published. It will forever be considered a horrible example of the consequences of scientific fraud.

IMPORTANT NOTE:  Many subsequent large, and scientifically sound studies have concluded that the MMR vaccine IS UNRELATED to the occurrence of autism. They are not connected. Full stop. 

But the false conclusion had already seeped into the minds of many people…

The Fallout

Amazingly, like I mentioned previously, it took the lancet 12 years to officially retract the paper, which is absurd and very disheartening. The “results” from this paper were spread far and wide, causing skepticism of vaccines all over the world. A LOT of damage was done in that time as anti-vaccine movements took root, and they continue today.

Many celebrities (looking at you Jenny McCarthy, Jessica Biel, Alicia Silverstone, and Jim Carey to name a few), have been vocally against vaccinations with the false belief that they cause autism, which has further moved the anti-vaccination movement from fringe to forefront. 

A lot of these folks think that ‘it’s the decision of each family’, but that’s not how vaccines work. For one, they are not causing autism (I will repeat that as many times as needed…). Two, there are portions of the population who are unable to get vaccinated (small children, immuno-compromised folks, older folks). 

These vulnerable populations do not have the luxury of getting vaccinated, and their health and well-being is in many ways, in the hands of the rest of us. If a population collectively vaccinates, then the few people who are unable to vaccinate will likely be just fine, especially in a country like the US where a disease like measles has been eradicated. It’s safe to say that the MMR vaccine has saved the lives of millions of people.

It’s safe to say that the MMR vaccine has saved the lives of millions of people. If we are able to create an effective vaccine for SARS-CoV-2, it will save the lives of a ton of people as well. As it stands right now (Sept of 2020), it sounds as though the covid-19 vaccine will be more akin to the flu shot (that is, you will need a new shot each year). I hope its similarity to the flu shot will make it less controversial, but based on the politicization of the pandemic, I think there will be bigger political forces to worry about.

My biggest fear is that the government will push to get a vaccine out before it has been carefully and fully tested. Given that vaccine adoption has decreased in recent years, it will literally be deadly if there is another decline in confidence. 

In summary, please vaccinate fully if you have the privilege to do so.

Want to learn more?

If you are curious to learn more about infectious diseases and epidemiology, the podcast I mentioned before is called “This podcast will kill you” and they have episodes on all types of diseases. They all make me VERY thankful for vaccines and modern medical technology! 

References:

Sathyanarayana Rao, T., & Andrade, C. (2011). The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Indian Journal of Psychiatry, 53(2), 95. https://doi.org/10.4103/0019-5545.82529

Eggertson, L. (2010). Lancet retracts 12-year-old article linking autism to MMR vaccines. Canadian Medical Association Journal, 182(4), E199–E200. https://doi.org/10.1503/cmaj.109-3179

Wakefield, A., Murch, S., Anthony, A., Linnell, J., Casson, D., Malik, M., Berelowitz, M., Dhillon, A., Thomson, M., Harvey, P., Valentine, A., Davies, S., & Walker-Smith, J. (1998). RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, 351(9103), 637–641. https://doi.org/10.1016/s0140-6736(97)11096-0

Measles Elimination in the U.S. | CDC. (2019). Measles Elimination. https://www.cdc.gov/measles/elimination.html

Klein, K. C., & Diehl, E. B. (2004). Relationship Between MMR Vaccine and Autism. Annals of Pharmacotherapy, 38(7–8), 1297–1300. https://doi.org/10.1345/aph.1d293

www.CDC.gov   

www.WHO.int