New Jersey Governor Chris Christie’s remarks on Monday that parents “ought to have some level of choice” when it comes to having their kids immunized against infectious diseases gave new breath to the laughably wrong—but undeniably dangerous—belief that early-childhood vaccinations can somehow cause harm.
Christie, whose own kids are immunized, later walked back his comments a bit, but not before Senator Rand Paul of Kentucky, another likely contender for the 2016 Republican presidential nomination (and a physician), cast his own doubt on one of the most successful developments in modern medicine.
With 102 cases of measles and counting stemming from a January outbreak at Disneyland, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, again reminds the public that the shots are safe and that parents who avoid getting their kids vaccinated undermine public health.
Fauci, one of 2014’s Washingtonians of the Year, is largely focused right now on treating the Ebola virus outbreak in West Africa. Monday marked the beginning of a clinical trial for a potential vaccine in Liberia, which has been hit hardest by the epidemic, and Fauci reports the initial lab phase was promising.
Christie and Paul’s comments still give the anti-vaccination crowd renewed exposure. You can’t blame Fauci for being, as he told Washingtonian Monday, “frustrated.”
All of a sudden, we’re talking again about the importance of parents making sure their kids get vaccinated. Do you have any sense of why this keeps coming back?
Years ago, before the availability of childhood vaccines, infections among children were common and could in fact be very serious. Things like polio, measles, mumps. rubella, et cetera. The vaccine programs have been, without a doubt, one of the—if not the—most successful ways of preventing disease caused by infections, including serious infectious diseases. When we were in an era when so many children and adults were suffering and dying and having lifelong adverse effects, vaccines were welcomed with open arms by the community. The alternative was getting serious illness. Over the years, all of these diseases, including measles, were either suppressed completely, or even—like polio—eliminated in the country.
Right. We’re talking about one of the great achievements of medicine.
What happens then is that when you get a period of time when the corporate memory of the community doesn’t quite remember the time these diseases were wreaking havoc. They focus on a couple of things: the rare, adverse event associated with the vaccine, or, even worse, misinformation about adverse effects of the vaccine, some of which have been completely discredited and have been shown to be fraudulent.
There was, years ago, a physician in the UK who was claiming that [the] measles [vaccine] had a number of adverse effects on children, including autism. Subsequently, those studies that he preached and published have been shown to be completely incorrect. However, that information still lingers. Obviously, we still have a very, very high uptake of measles vaccine in this country, with greater than 90 to 95 percent of the people getting vaccinated. However, it isn’t homogeneously distributed throughout the country. There are pockets of communities in which the lack of vaccination is dangerously high—8, 10, or more percent?
Where are these pockets coming from? Is it belief of discredited research?
I don’t think it’s one-size-fits-all, nor do I think it’s one reason why some parents in an era in which vaccines have been highly successful in preventing disease don’t vaccinate their children. Some are influenced by misinformation, and in fact it would be helpful if they could appreciate the lack of validity of certain information. Then there are others who don’t vaccinate for reasons that aren’t philosophical. Either they miss the appointment or they don’t have time to take their child or feel that the pinch of the needle is pain they don’t want their child to experience or they feel clustering of a number of vaccines at the same period of time makes the child uncomfortable. It makes them decide they would rather have the risk of the disease because they look around and they find there’s very little risk of that disease in the community.
That seems problematic.
One of the fundamental principals of vaccination is not only to directly protect the child who was vaccinated, it is also to the communal responsibility of protecting those children who can’t be vaccinated for one reason or another. The most simple reason is children less than a year old can’t be vaccinated. They’re vulnerable to measles. Children who have repressed immune systems. Children who are on chemotherapy for leukemia. Children who have other debilitating diseases. So when you have a very high uptake, you have what’s called “herd immunity,” and a society of vaccinated children protects those who can’t be vaccinated. When a certain percentage of people feel, for reasons that might not be completely valid, that they don’t want their children to be vaccinated, not only do they put their own children at risk, but they relinquish their societal responsibility to protect those children who can’t be vaccinated.
This is something that comes up again and again though. At this point do you groan?
I try not to have an emotional reaction to it, but it is unfortunate. I’ve had the experience in my early training seeing children with measles and seeing how it can be devastating. When I say that I’m frustrated by this, it’s because if you look at the facts, measles is one of the most contagious of all infectious diseases. We have a vaccine with measles that is one of the most effective vaccines of any infection known. The side effects of the measles vaccine are really minimal, despite the false information that says that it’s not. So it’s really frustrating when you have a disease that can be completely avoidable, and you don’t utilize the tools that you have to avoid it.
So what happens when you have a high-ranking elected official, like what happened with Chris Christie, say something like parents “ought to have some level of choice”?
I’m not going to comment on Governor Christie’s comments.
Fair enough. But but for a small minority, they do sometimes have a very loud megaphone. What’s to be done about that?
I think the best antidote to that is to continue to try and get the message across that the relative risk versus benefits of vaccination versus disease. You have to keep hammering away. Obviously there will be some people that no matter what you say, you won’t change their beliefs. I think if you get the correct information out, you can get enough of a number of people who might not have otherwise have vaccinated their children.
We’re having another conversation about measles immunization while your team is rolling out a possible vaccine for a disease that’s really ravaging several countries in West Africa. What would people there say when they hear about Americans who generally have easy access to vaccination actively refusing it?
I don’t want to get into those what-ifs. They tend to get distorted.
But with the experimental vaccine, what results have you seen?
Too early to say. We did a phase-one trial here in the United States. It was also done in the UK, it was also done in Mali, where there is no Ebola. And we found that the vaccine, asks the questions: is it safe? and does it induce a response that you predict might be protective? And the phase one trial, both of those were positive answers. Yes, it was safe, and it did induce the kind of response you would predict would be protective. The next phase is to do what we started Monday in Liberia. Now a very large phase two-three trial to determine if the vaccine actually works is underway. We have no results yet because it’s going to take a large number of people to be vaccinated to determine the results.
The press release says 27,000 adults.
That’s correct. But the proof of the pudding shows that it’s actually protective. We haven’t done that yet.
Find Benjamin Freed on Twitter at @brfreed.