James H. Conway

James H. Conway is a pediatric infectious disease specialist at the University of Wisconsin-School of Medicine & Public Health. He also chairs the Immunization and Infectious Diseases Committee for the Wisconsin chapter of the American Academy of Pediatrics.

Vaccine rejectionism has been around for 200 years, since Edward Jenner used the harmless cow pox virus to immunize people against deadly small pox. Cartoons from the early 1800s showed people sprouting cow heads because of Jenner’s vaccine, and in some cities, mass hysteria sparked riots.

Anti-vaccine beliefs ebb and flow through the years, lying dormant like a virus, stirring at the slightest provocation. The latest outbreak can be traced to a troubled researcher named Andrew Wakefield, and a flawed study inexplicably published by a prestigious medical journal.

It’s a fascinating story that will be told by Brian Deer, the investigative reporter who first uncovered the fraud, when he appears Thursday and Friday at the University of Wisconsin-La Crosse.

Wakefield associated the measles-mumps-rubella (MMR) vaccine with autism in a 1998 paper published in The Lancet. His hypothesis had a Rube Goldberg quality to it — the vaccine-strain measles virus supposedly caused the inflammation in the intestines, which created toxins, which caused a breach in the gut wall, which let the virus travel through the bloodstream to the brain, where it caused the symptoms of autism.

Never mind that the 12 children in his case study didn’t have measles, or that some were showing developmental delay before their MMR shots.

In 2004, the article was retracted by 10 of its 13 authors, because the findings could not be supported, and Wakefield’s clear conflicts of interest had affected the findings. In 2010, The Lancet retracted the entire article, after Deer exposed ethical concerns and falsification of data. Multiple studies and reviews since also have found no association between the MMR vaccine and autism, and Wakefield’s results have never been replicated.

But the damage was done. Measles and mumps roared back in Europe and elsewhere due to Wakefield’s false alarm. Meanwhile, it’s evident that unimmunized children are no more likely to be diagnosed with autism than immunized children.

There is plenty of blame to go around. Wakefield loaded the gun with his “study,”  but a credulous news media that valued sensationalism over scientific accuracy pulled the trigger. And let’s not ignore the Hollywood celebrities, “alternative” health providers and a noisy community of internet activists quick to embrace any conspiracy, no matter how unlikely.

I have a professional and personal interest in preventing unnecessary suffering through immunization. I’ve seen the horrible cost of vaccine preventable diseases, both here in Wisconsin, and in poor, under-resourced countries where the human toll is greatest.

And I am saddened and frustrated, as are most health care professionals, by the misguided belief that vaccines are more dangerous than the diseases they prevent. Even health care workers are susceptible to “the panic virus,” as author Seth Mnookin describes vaccine rejectionism in his book by the same name.

According to the Centers for Disease Control and Prevention, one third of health care workers declined flu vaccines during the 2011-12 season. The three most common reasons given are a belief that they did not need it (28.1 percent); concern about the vaccine’s effectiveness (26.4 percent); and concern about side effects (25.1 percent).

Sadly, anti-vaccine groups have hijacked the autism advocacy movement and blamed vaccines for many disorders. Valuable funding that should be used to support families and to investigate the real causes and pursue treatments for autism are spent on the anti-vaccine agenda.

Despite what Wakefield and his followers claim, there is neither any evidence for conspiracy between vaccine manufacturers and public health authorities nor a logical reason for why these institutions would “trick” Americans into exposing their children to dangerous toxins. Demonizing vaccines without evidence, and scaring people into missing out on this simple, inexpensive and safe means to protect individuals and their loved ones is an avoidable tragedy.

Given the re-emergence of infectious diseases around the globe, it’s clear that we are no longer protected by our current vaccination rates. An erosion in vaccine confidence hurts public health. Even with 90 percent vaccine coverage rates, Wisconsin has experienced a protracted outbreak of pertussis in many communities.

We have the tools to protect more people from potentially devastating diseases, and we have had some success already. But we cannot become complacent. Needless suffering is the worst kind.


James H. Conway is a pediatric infectious disease specialist at the University of Wisconsin-School of Medicine & Public Health. He also chairs the Immunization and Infectious Diseases Committee for the Wisconsin chapter of the American Academy of Pediatrics.

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