Popular tattoo and makeup artist Kat von D recently re-ignited the debate between the anti-and pro-vaccine communities by stating that she will raise “a vegan child, without vaccinations.” Since this debate crept into Hollywood via Jenny McCarthy and other celebrities, it has maintained a hold in popular culture. Over the years, McCarthy has made several controversial comments about vaccines, including stating on Larry King Live in 2008 that vaccines can trigger autism.
Clinical literature tells us that vaccines do a world of good in protecting us against deadly diseases. Yet there is still a community of parents who avoid vaccinating their children at all costs, leading to increased risk of disease. The World Health Organisation (WHO) reported a 300% increase in measles cases in 2017 compared to 2016, prompting the regional director for Europe, Dr. Zsuzsanna Jakab, to state, “Every new person affected by measles in Europe reminds us that unvaccinated children and adults, regardless of where they live, remain at risk of catching the disease and spreading it to others who may not be able to get vaccinated.”
So, why do individuals continue to question the authority of WHO and other health leaders? What myths about vaccination persist, and how can these myths be dismantled? The following are five of the most recurrent themes in the discussion.
1. You are not a true vegan if you vaccinate.
Vaccines often contain animal-derived products, and as such, should not ordinarily be fit for consumption by vegans. However, many leading advocates of veganism, such as Rebecca Fox at The Reasonable Vegan, remind people that it is both impossible and impractical to avoid animal-derived vaccine products until vegan versions become available. Because of this, vaccine usage is still in line with the definition of veganism provided by The Vegan Society: “Veganism is a way of living which seeks to exclude, as far as is possible and practicable, all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose.” The Vegan Biologist blog elaborates on this definition, claiming that vaccine abstinence is not “the lesser of two evils,” since the eradication of vaccines would lead to loss of human life on a grand-scale. This blog aligns vegan ethics with what vaccines seek to do: reduce harm. The consensus among these authorities is that veganism should not be conflated with the anti-vaccine message.
2. MMR causes autism.
It has been two decades since the publication of the article by Andrew Wakefield that caused a global healthcare scandal by falsely linking autism with the MMR Vaccine, and it has been 14 years since The Lancet subsequently retracted that article. But the damage has been done, as many continue to fear vaccines. Recently, some have noted that this misconception is rooted in ableism, explaining that parents fear autism more than MMR. Why do parents frame autism as the real tragedy, instead of measles, which is known to cause tens of thousands of fatalities globally? Many autistics do not regard their condition as a catastrophe; nor do they regard the fully able body as the epitome of human worth. From these critics’ perspective, it is time for anti-vaccine advocates who promote this myth (that MMR causes autism) to confront their prejudices against disability.
“Why do parents frame autism as the real tragedy, instead of measles, which is known to cause tens of thousands of fatalities globally?”
3. Herd immunity is a myth and/or If herd immunity actually exists then why should I have to vaccinate my kids?
Herd immunity refers to the phenomenon whereby a large proportion of unvaccinated individuals in a population are protected from developing a disease because a significant number of individuals within that same population have been vaccinated against that same disease. These vaccinated individuals are referred to as “vaccinees.” Herd immunity was noted over a century ago, and it has been consistently evidenced in the healthcare literature. The valid question is, how many individuals need to be vaccinated to induce herd immunity? Dr. Manish Sadarangani, an expert in pediatric infectious diseases, explains that the number of vaccinees required to induce protective herd immunity depends on how contagious the disease is. For example, whereas herd immunity against measles requires 90–95% of vaccinees within a given population, polio requires less at 80– 85%. Dr. Sadarangani also points out that there will always be certain individuals, such as very young children or those with compromised immunity, who cannot receive vaccination. For these individuals, herd immunity is the only option for protection. Because of this, it is crucial for the majority of a population to receive vaccines and have direct protection, rather than for these individuals to rely on indirect herd immunity.
4. Thimerosal is mercury, therefore vaccines containing it are poisonous.
Vaccines contain active and added ingredients. The active ingredient is made from bacteria or viruses and will induce an immune response in the vaccinee. Added ingredients include stabilisers, preservatives, and compounds known as “adjuvants,” which strengthen the vaccinee’s immune response. Thimerosal is a preservative that is mercury-based, and, in the past, it has been contained in some vaccines in very small quantities. But the fear of Thimerosal stems from misunderstanding the mercury compound that it contains. Methyl mercury is a hazardous substance that condenses through the food chain and affects human health after ingestion of contaminated fish. However, the mercury contained in Thimerosal is ethyl mercury. These two compounds, methyl mercury and ethyl mercury, are chemically different. Nonetheless, as a precaution, Thimerosal was removed from vaccines in the UK, Europe, and the USA. It is further worth noting that the ethyl mercury in Thimerosal was found to only be contained in the bloodstream for 30 days, rendering it harmless. Of even further note, Thimerosal was never contained in the MMR vaccine, so it should not be associated with the MMR vaccine scandal. To avoid confusion regarding drug ingredients, trustworthy websites such as medicines.org provide drug make-up via patient leaflets. The American Academy of Pediatrics provides vaccine safety information here.
5. “Vaccines are just another money-making scheme to Big Pharma.”
There are legitimate concerns about pharmaceutical companies funding research and controlling the narrative when it comes to drug development and reporting results thereafter. In this vein, some have noted that Big Pharma generates large profits through vaccine products. But as Bourree Lam and others counter, “profits from vaccine production aren’t a valid argument against vaccinations.” Until we have a better model for prescription drug pricing, we can support societies such as Access to Medicine Foundation, which is committed to analyzing the actions and policies of Big Pharma and making suggestions on how the pharmaceutical business model can be improved. Research groups such as the Oxford Vaccine Group also promote good practice by involving explicit conflict of interest statements and open opportunities for the public to engage on issues. Both lend transparency to collaborations between pharmaceutical companies and research institutes.
It is important to recognize vaccines as one of the most significant healthcare initiatives that currently exists. This is possible without invalidating individuals’ concerns and experiences. Pro-vaccine advocates need to stay informed about the latest research and to base conversations about vaccines upon evidence; but they also need to dialogue respectfully with those with opposing views. As the author of 2011 Vaccine article observes, the pro-vaccine community appeals to reason, whereas anti-vaccine advocates appeal to emotions. There thus needs to be genuine empathetic rhetoric when spreading the message about vaccinations.