## Anti-Vaccination Advocates Use Statistics to Lie

One common statement used in anti-vaccination literature is that when outbreaks of vaccine-preventable diseases occur, the majority of those infected turn out to be vaccinated children. 1 According to the anti-vaccination advocates, this shows that vaccines are not at all effective at preventing the disease. The problem is that the statistic quoted actually demonstrates exactly the opposite. You see, the problem with the statistic as quoted by the anti-vaccination advocates is that the vast majority of children are vaccinated. Thus, even if only a tiny percentage of vaccinated children get the disease, their numbers will be larger than the number of unvaccinated children who get the disease.

The best way to illustrate this is to think of an example. Suppose a measles outbreak occurs in a school that has a population of 1,000. About 98% of those students (980) will be vaccinated. That leaves 20 that are not vaccinated. Now, suppose that only 2% of the vaccinated population contracts measles. That means about 20 vaccinated students will get the disease. Next, suppose that 90% of the unvaccinated children contract measles. That means 18 of the unvaccinated students will get the disease. Thus, of those who got the disease, 53% were vaccinated, and 47% were not. Does this mean that the vaccines did not work? Quite the opposite! While only a tiny minority of the vaccinated students got the disease, the vast majority of the unvaccinated students got the disease. Being vaccinated made you only 2% likely to get the disease, while not being vaccinated made you 90% likely to get the disease! Clearly, then, the vaccine was quite effective, as vaccinated students were 45 times less likely to be infected than unvaccinated students.

When comparing one group to another, then, you must make sure to take into account that one population might be greater in number than the other. Anyone with a modicum of training in research or statistics know this. Thus, in the medical literature, statistics are always reported in this way. If you look at studies that have been done on measles outbreaks, for example, you will find that the research indicates that vaccinated children are up to 35 times less likely to catch measles than unvaccinated children.2 This is the proper way to report such a statistic.

The question is, since the statistics are always discussed properly in the medical journals, why do anti-vaccination advocates misquote them in their literature? They must look at the studies, or they could not get the numbers. Why, then, do they ignore the proper way to quote the statistic and instead use a deceptive way? I think that the answer is obvious: quoting the statistic the proper way will hurt their cause, while quoting them in a deceptive manner will help fool the general public into accepting their ideas.

## References

1. Neil Z. Miller, Vaccines: Are They Safe And Effective, New Atlantean Press, 2002, p. 29
2. Salmon DA, et al. “Health Consequences of Religious and Philosophical Exemptions From Immunization Laws: Individual and Societal Risk of Measles” JAMA, 1999; 282:47-53

Dr. Wile is not a medical doctor. He is a nuclear chemist. As a result, he does not dispense medical advice. He simply educates the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.

## Vaccines DO NOT Suppress the Immune System

If a parent follows the suggested vaccination schedule1, it might seem to the parent that the child is getting am inordinately large number of shots. Many anti-vaccination advocates prey on the fact that most parents are not informed enough to know what is “too much” when it comes to medicine, and they say that this large number of vaccines “overwhelms” the baby’s immune system. Of course, as is the case with most assertions in the anti-vaccination camp, this assertion does not stand up to the data.

Probably the most direct study on this comes from Paul A. Offit and others2. The data analyzed by these authors indicate the following:

1. Newborns are capable of mounting an immune response at birth. This goes counter to what some anti-vaccination advocates claim, but is nevertheless supported by the data. Of course, any Christian should immediately realize that this is the case. God would certainly design an immune system that was able to respond the moment a baby left the protection of his or her mother’s womb. Anything less would simply be shoddy workmanship!
2. Mild illness at the time of vaccination does not affect the level of antibodies produced by vaccination. Many who are fooled by the anti-vaccination advocates don’t even realize that we can chemically measure a body’s immune response to a vaccine (or to an infection) by actually measuring the level of antibodies produced in the blood. These antibodies are so well- characterized that we can actually determine which antibody fights which disease. Even though a child might be mildly sick (and thus his or her immune system is fighting off an infection), the child’s immune system makes the same level of antibodies in response to a vaccine as it would if the child were not at all sick. This indicates that God’s wonderfully designed immune system is not easily “overwhelmed!”
3. When comparing children who are given just one vaccine to children who are given several, there is no difference between the level of antibodies produced. In other words, multiple vaccines do not “fight” each other for attention from the immune system. Whether a child gets one vaccination or several, the level of immune response is the same for each disease. If multiple vaccines “overwhelmed” a child’s immune system, you would see the immune response for each disease decrease as the number of vaccinations increase. This is simply not the case.

Another important study comes from Otto and others3. This study investigated 496 vaccinated and unvaccinated children, comparing the health of the vaccinated children to that of the unvaccinated children. It found that children who received immunizations against diphtheria, pertussis, tetanus, Hib, and polio within the first 3 months of life had fewer infections than those who did not. Surprisingly enough, even the rates of infections unrelated to the vaccines were lower in the vaccinated group than in the unvaccinated group. Now, if vaccines really did “overwhelm” these babies’ immune systems, we would see the vaccinated group have a higher rate of infections as compared to the unvaccinated group. Instead, we see precisely the opposite, indicating that vaccines do not overwhelm an infant’s immune system.

For more information on the safety of vaccines, see our article entitled Vaccines are Very Safe.

## References

1. Recommended Childhood and Adolescent Immunization Schedule
2. Paul A. Offit, et al. “Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System?” Pediatrics Vol. 109 No. 1 2002; pp. 124-129
3. Otto S, et al. “General non-specific morbidity is reduced after vaccination within the third month of life-the Greifswald study.” J Infect. 2000; 41:172-175

Dr. Wile is not a medical doctor. He is a nuclear chemist. As a result, he does not dispense medical advice. He simply educates the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.

## Vaccines Actually Protect Against Sudden Infant Death Syndrome (SIDS)

For quite some time now, anti-vaccination advocates have tried to link vaccination to Sudden Infant Death syndrome (SIDS). In her book, Vaccination: 100 Years of Orthodox Research shows that Vaccines Represent a Medical Assault on the Immune System, Dr. Viera Scheibner, Ph.D., makes the outlandish claim that when the pertussis vaccination age was moved from 3 months old to 2 years old in Japan (1975), the phenomenon of SIDS (which she calls “cot death”) vanished. Here are a couple of quotes from her book:

“In 1975 Japan raised the minimum vaccination age to two years; this was followed by the virtual disappearance of cot death and infantile convulsions.”1

“The most important lesson from the Japanese experience is that when the vaccination age was moved to two years, the entity of cot death disappeared.”2

These claims are absolutely false, but they have been repeated over and over again by anti-vaccination advocates3.

How do we know that they are false? Because a study4 was done on the autopsy records of infants (aged 1 week to 1 year old) who died in the Tokyo area. This study found that the number of SIDS cases rose continually from 1975 through 1993, the last year that the study considered. In fact, from 1979 to 1993, the number of SIDS cases in the Tokyo region increased by more than a factor of 125! Clearly, then, SIDS did not disappear from Japan once the vaccination age was raised. In fact, it increased considerably.

Why did it increase considerably? Most likely, it was because the number of forensic pathologists who began recognizing the phenomenon of SIDS increased, not because the actual rate of SIDS increased. In Japan, an unexpected death is identified by the broad term “Sudden Unexpected Death” (SUD). From 1974 through 1993, the SUD rate for infants in the Tokyo area was shaky, but fairly steady, averaging about 30 cases per year6. Thus, the number of infants dying unexpectedly was fairly constant. However, the number of those cases recognized as SIDS rose significantly during the same time period. Most likely, then, it was the diagnosis of SIDS that increased, not the actual rate of SIDS.

The point, however, is quite clear. The SIDS rate in Japan either increased or stayed the same after the vaccination age was raised. It did not lower, much less disappear. Thus, the statement that Dr. Scheibner makes in her book is a lie, and that lie has been repeated over and over again. How in the world could Dr. Scheibner make such an outrageous claim and be believed? Because she referenced her claim to two studies7-8, and those who repeat her claim have obviously not checked those references.

If you bother to check her references, you will see that neither of them make any claim regarding the number of SIDS cases in Japan. Instead, they reference the number of claims made to Japan’s vaccine injury compensation program. Much like the United States’ vaccine injury compensation program, Japan offers a program whereby people who think that their child has been injured by a vaccine can apply for compensation. Their claim is reviewed, and if there seems to be any plausible link to the vaccine, the claim is paid. The two articles that Dr. Scheibner references say that the number of SIDS claims to the vaccination compensation program declined to zero once the vaccination age was raised to 2 years. Of course, that would logically have to happen, since SIDS is defined as occurring in children age 1 year or younger. Since no one of that age could get the vaccine anymore, it would be impossible for someone to make a SIDS claim to the vaccine injury compensation program!

So you see that one of the most popular claims made by anti-vaccination advocates is (as usual) untrue, and it has survived only because people who read the claim do not bother to check the references! As is the case with many anti-vaccination claims, a quick check of the medical literature simply destroys the claim entirely.

Not only does the supposed “demonstration” of a link between SIDS and pertussis vaccination in Japan not stand up to scrutiny, a cursory review of the medical literature provides many detailed studies that show that the rate of SIDS amongst unvaccinated children is actually higher than the rate of SIDS amongst vaccinated children! For example, Hoffman and others9 studied SIDS victims using data from the National Institute of Child Health and Human Development. In their study, they compared 757 SIDS cases to 1,514 living control children. The control children were matched to the SIDS cases based on age, race, and low birth weight. According to their results, the living children were 1.3 times more likely to have been immunized compared to the children who died of SIDS. In other words, according to this study, if a child was not vaccinated, he or she was more likely to die of SIDS than if the child were vaccinated!

Although that might sound like a surprising conclusion if you have been reading the anti-vaccination literature, you will find that it is the common conclusion in the medical literature. For example, another study by Walker and others10 focused on healthy babies with birth weights greater than 5.5 pounds. For these children, unvaccinated children were 6.5 times more likely to die of SIDS than were vaccinated children.

Why does vaccination actually provide a protective effect against SIDS? According to a biochemical study by Essery and others11, it is most likely due to the fact that the DPT vaccine produces antibodies that are cross-reactive to staphylococcal toxins, which are found in many SIDS cases. In other words, the study found that the antibodies produced by the DPT vaccine are able to fight the toxins produced in staph infections! Thus, the DPT vaccine not only protects the infant from diphtheria, pertussis, and tetanus, it also offers some protection against SIDS (or at least staph infection)!

So once again we see that the medical literature not only invalidates the claims of anti-vaccination advocates, it actually indicates that by opposing the DPT vaccine, anti-vaccination advocates are actually increasing the incidence of SIDS (along with the incidence of pertussis, diphtheria, and tetanus). This serves once again to illustrate the danger of listening to the anti-vaccination movement.

## References

1. Scheibner V. Vaccination: 100 Years of Orthodox Research shows that Vaccines Represent a Medical assault on the Immune System New Atlantean Pr, 1993, p. xix
2. Ibid, p. 49
3. See, for example, ( Richard Lanigan’s site) or ( Mercola’s website)
4. Funayama M., et al. “Autopsy cases of sudden unexpected infant deaths examined at the Tokyo medical examiner’s office, 1964-1993” Am J Forensic Med Pathol. 1996;17(1):32-7
5. Ibid, p. 33
6. Ibid
7. Cherry J.D., et al. “Report of the Task Force on Pertussis and Pertussis Immunisation – 1988” Pediatrics 1988; 81 (suppl): 939-84
8. Noble G.R., et al. “Acellular and Whole-Cell Pertussis Vaccines in Japan: Report of a Visit by US Scientists” JAMA 1987; 257(10): 1351-6
9. Hoffman H.J., et al. “Diphtheria-tetanus-pertussis immunization and sudden infant death: results of the National Institute of Child Health and Human Development Cooperative Epidemiological Study of Sudden Infant Death Syndrome risk factors” Pediatrics 1987;79(4):598-611
10. Walker, A.M., et al. “Diphtheria-tetanus-pertussis immunization and sudden infant death syndrome” Am. J. Public Health 1987;77:945-951
11. Essery S.D., et al. “The protective effect of immunisation against diphtheria, pertussis and tetanus (DPT) in relation to sudden infant death syndrome” Am. J. Public Health 1999;25:183-92

Dr. Wile is not medical a doctor. He is a nuclear chemist. As a result, he does not dispense medical advice. He simply educates the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.

## Vaccines are Incredibly Effective at Preventing Disease

Dr. Lewis Thomas, in his book, Lives of a Cell: Notes of a Biology Watcher, says that the best kind of medical technology is, “…the kind that is so effective that it seems to attract the least public notice; it has come to be taken for granted. This is the genuinely decisive technology of modern medicine, exemplified best by the modern methods for immunization against diphtheria, pertussis, and the childhood virus diseases.”1 Indeed, over the years, vaccines have become so effective at eliminating disease that they have become taken for granted. So much so that there is a growing movement trying to claim that vaccines do not even help to prevent disease. Nothing could be further from the truth! Vaccines have saved the lives of countless children and adults over the years, and anyone who truly cares for children cannot ignore this rock-solid fact.

There are three main ways that we want to demonstrate the efficacy of vaccines. First, we want to show you the historical data that demonstrate how disease rates fell dramatically as a result of mass immunization. Second, we want to discuss some of the detailed, controlled studies that demonstrate that people are significantly less likely to be infected by a disease against which they have been vaccinated as compared to those who have not been vaccinated. Finally, we want to discuss the devastation that occurs when vaccination rates drop in a population.

Let’s start with the historical data. Below, you will find two graphs showing you the polio and measles rates in the United States from 1944 to 2001:2

There are several important things to notice regarding these graphs. First, notice that in the case of polio, disease rate rose in a shaky but steady fashion from 1944 to 1952. Then, there was a slight (34%) decrease in the disease rate from 1953 to 1955. However, from 1955 to 1957, there was a dramatic decrease (80%) in the disease rate. What explains these drops in disease rate? Well, notice that the first polio vaccine was licensed in 1955. The dramatic decrease in disease rates, then, came right after the polio vaccine was licensed. What about the smaller decrease from 1953 to 1955? Well, Salk developed his vaccine in 1952 and began testing it. For example, in 1954, the Salk vaccine was tested in a double-blind study of 1.8 million children3. Thus, the benefits of the vaccine are apparent even in the testing phase!

Now look at the graph for measles. Once again, the story is similar. There is not nearly as much of a rise in the measles rate in the early years (1944-1958), but the disease rate follows the typical shaky pattern of epidemic cycles that is often seen in infectious disease rates. However, once again, there is slight decrease in the disease rate just prior to the licensing of the vaccine (during the testing phase), and then a dramatic decrease in the disease rate after the licensing of the vaccine.

Do these graphs demonstrate conclusively that the polio and measles vaccines stopped these dreaded diseases? Of course not. After all, this could all be explained by an amazing coincidence. Perhaps something else stopped each of these diseases, and that “something” just happened to occur during the testing and licensing phases of the vaccine. However, it does add some evidence to the pile. If you truly want to believe that vaccines are not effective, you have to believe in a couple of amazing coincidences in order to explain this data. Of course, this is not the only data available. We can look at other diseases whose infection rates dropped dramatically after the vaccine was introduced. Thus, the number of coincidences in which you must believe (if you think that vaccines are not effective) just keeps increasing!

There is one other very important thing to note from the graphs. Anti-vaccination advocates often try to explain the dramatic decrease in vaccine-preventable diseases in terms of increased sanitation. They say that these disease rates are so low because we have developed better sanitary practices over the years. However, these graphs show that this is just not true. After all, the polio disease rates decreased dramatically in the late 1950s. However, the measles rates did not decrease dramatically for another 10 years. If good sanitary practices were responsible for the drop in disease rates, you should see the disease rates fall roughly at the same time. That’s just not the case. The disease rates fell only when vaccines were tested and then approved. Also, note the short time over which the disease rates fell so dramatically. Do sanitation practices change so quickly that they completely “clean up” a country in a matter of a few years? Definitely not! Improved sanitation just does not explain the data.

In fact, most medical historians blame increased sanitation for the rise in polio from 1944 to 1952. When sanitary practices were rather poor, people were regularly exposed to small amounts of the polio virus, usually when they were babies and therefore had the extra protection given to them by the antibodies they received through their mothers’ milk. Their immune systems were able to conquer the weak exposure to the virus with the help of their mothers’ antibodies, and thus they became immune. As a result, the poor sanitation was actually acting like a “dirty” vaccine! As sanitary practices improved, fewer people were exposed to small amounts of the virus as infants. As a result, when they were exposed to concentrated amounts of the virus (from a person who already had the disease, for example), they would succumb to the disease4. Note that this makes sense in the light of the data, because the rise in the polio rate occurred slowly, which is what you expect when sanitation is playing a role.

Although these graphs are very effective illustrations of the power of vaccines, as we stated before, they are not definitive evidence. After all, coincidences could explain the graphs. By far, the best evidence of how effective vaccines are comes from controlled studies. In these studies, vaccinated people are compared directly to unvaccinated people, and the results are astounding.

For example, Feikin and others studied all measles and pertussis cases among children (age 3-18) in Colorado from 1987 to 19885. When they compared the vaccinated children to the unvaccinated children, they found that vaccinated children were 22.2 times less likely to contract measles than were the unvaccinated children. In the same way, vaccinated children were 5.9 times less likely to contract pertussis than were unvaccinated children. In other words, according to this study, if you do not vaccinate your children, you have increased their risk of getting measles by 2,220%, and you have increased their risk of getting pertussis by 590%!

Another finding from this study is that schools in which outbreaks occur have 2.9 times the percentage of unvaccinated students as do schools in which outbreaks do not occur. Thus, this study tells us that those who do not vaccinate their children are not only putting their own children in danger, but they are also putting other people’s children in danger, because the larger the number of unvaccinated children in a group setting, the more likely an outbreak is to occur.

Another study by Salmon and others was even more comprehensive but focused only on measles. They studied measles cases over seven years (1985-1992) using the Center for Disease Control’s Measles Surveillance System6. In their study, they found that vaccinated children (ages 5-19) were 35 times less likely to contract measles than were unvaccinated children. Another important result of their study was that the general measles outbreak that was seen in 1991 (note the small bump at 1991 in the measles graph above) actually started a year earlier among the unvaccinated population. In other words, that outbreak was most likely started by the unvaccinated population! This is another example of parents that do not vaccinate actually putting everyone’s children at risk.

These kinds of studies are done on all vaccines, and the results are just as stunning. In a double- blind, placebo-controlled trial of the flu vaccine, for example, 1,602 children were given a flu vaccine or placebo. Vaccinated children were 13.6 times less likely to catch the flu than those who got the placebo7. That study was expanded to a second year for 1,358 of the children and, in addition, 4,561 adults were added to the study. Once again, those who received the flu vaccine were many times less likely to get flu than those who received the placebo8. Even in the elderly, the flu vaccine is very effective at preventing illness. According to a meta-analysis done on flu-related data in seniors, the flu vaccine reduced mortality rates in people 65 years and older by 50%9.

We could go on and on, but the results are quite clear. When vaccinated people are compared to unvaccinated people, the vaccinated ones are significantly less likely to contract the disease than the unvaccinated ones. Thus, controlled studies clearly show that vaccines are quite effective.

A particularly sad way of illustrating the effectiveness of vaccines is to see what happens when vaccination rates in a population are low. Consider, for example, the following graphs of pertussis rates in the United Kingdom10:

The graph on the left shows the number of pertussis cases in the UK per year along with the number of pertussis deaths per year (multiplied by 60 so that you can see them on the graph) from 1940-1997. Notice that the disease rate is steady but shaky (as is typical for infectious diseases) until mass immunization begins. As vaccination becomes standard practice, the disease rate decreases.

Now look at the graph on the right. This graph contains the same data (pertussis cases and pertussis deaths – this time multiplied by 700) along with the pertussis vaccination rate from 1966 to 1997. Notice what happened in 1972-1973. The vaccination rate began to decline. This was caused primarily by anti-vaccination advocates who made claims that the pertussis vaccine was linked to devastating side effects such as SIDS. (Detailed, controlled studies show that the DPT vaccine actually lowers a child’s risk of SIDS11-13). Notice what happened as the vaccination rate went down – the disease rate went up. This kind of data is nearly impossible to explain if you think that vaccines are not effective. Clearly there was no appreciable difference in sanitation, nutrition, etc. during the1970’s. Nevertheless, that period saw an increase in the number of pertussis cases, and it coincides perfectly with a lowering of the vaccination rate. Then, once the vaccination rate increased again, the disease rate decreased in kind.

While looking at graphs like the one above is very instructive, it is important to note that these data are more than just numbers. They represent innocent children who suffered (and sometimes died) because their parents (or others who were in charge) were fooled by anti-vaccination advocates. The death of any child is tragic, but it is doubly so when it could have easily been prevented through vaccination. If you would like to learn more about the ravages induced on innocent children by the anti-vaccination movement, please see our discussion entitled, Small Decision, Large Impact: Why Not Vaccinating Your Child Is Dangerous or Individuals Who Have Suffered or Died Because They Were Not Vaccinated.

We need to make one more point before we finish this discussion. Anti-vaccination advocates are adept at coloring the facts to suit their agenda (see, for example, Anti-Vaccination Advocates Use Statistics to Lie). Often, anti- vaccination advocates quote death rates from disease and state that the death rates due to diseases like pertussis were declining long before the vaccine was introduced, and this shows that the vaccine is not necessary in combating the disease. However, as is typical, the anti-vaccine advocates who make such statements are either showing their ignorance of medicine or willfully lying.

Even a first-year medical student knows that you cannot track a disease with its death rate. This is because modern medicine learns how to treat the symptoms of a disease before it learns how to treat the disease itself. As a result, the death rate from a disease regularly decreases once the disease has been characterized, even though the number of people catching the disease is constant or increasing. You can see that from the left-hand figure above. From 1940 to 1953, the average pertussis rate in the UK stayed rather steady, while the death rate dropped quickly. This is simply because doctors were treating the symptoms of the disease well, allowing those who contracted it to live longer.

To properly track the prevalence of a disease, then, you must look at the disease rate, not the death rate. This is important for two reasons. First, the disease rate tells you the prevalence of the disease itself, and it is not affected by the ability of doctors to treat the symptoms of the disease. Second, by monitoring only the death rate, you are ignoring the devastating long-term health consequences (deafness, blindness, paralysis, etc.) that accompanies many cases of childhood disease. Many of those who actually survive diseases such as pertussis are faced with a life-long disability that resulted from contracting the disease. These children are not accounted for in a study of the death rate. Thus, the disease rate is the important indicator when tracking the prevalence of a disease, and as the data clearly show, when the vaccination rate increases, the disease rate decreases, and when the vaccination rate decreases, the disease rate increases!

The bottom line is quite simple: Whether you look at disease rates over time or detailed, controlled, scientific studies, vaccines are incredibly effective at preventing disease. There is just no other way to explain the data.

## References

1. Lewis Thomas, The Lives of a Cell: Notes of a Biology Watcher, New York: Viking Press, 1974, pp. 34-35.
2. Morbidity and Mortality Weekly Report, Volume 42:#53 (1994),pp.83-88; Volume 50:#53 (2003), p. 119
3. Francis Jr T, et al. “An evaluation of the 1954 poliomyelitis vaccine trials: summary report.” Am J Public Health 1955; 45(suppl): 1-50.
4. Hileman, B. “Risk Assessment in Medical Innovation.” Chemical and Engineering News, May 5, 2003;29-34
5. Feikin DR, et al. “Individual and Community Risks of Measles and Pertussis Associated with Person Exemptions to Immunization.” JAMA, 2000; 284:3145-3150.
6. Salmon DA, et al. “Health Consequences of Religious and Philosophical Exemptions From Immunization Laws: Individual and Societal Risk of Measles.” JAMA, 1999; 282:47-53
7. Belshe RB, et al. “The efficacy of live attenuated, cold-adapted, trivalent, intranasal influenzavirus vaccine in children.” N Engl J Med., 1998; 338(20):1405-12.
8. Belshe RB, et al. “Safety, efficacy and effectiveness of the influenza virus vaccine, trivalent, types A and B, live, cold-adapted (CAIV-T) in healthy children and healthy adults.” Vaccine, 2001;19(17-19):2221-6.
9. Vu T, Farish S, Jenkins M, Kelly H. “A meta-analysis of effectiveness of influenza vaccine in persons aged 65 years and over living in the community.” Vaccine, 2002;20(13-14):1831-6.
10. Data from the Public Health Laboratory Service Communicable Diseases Surveillance Centre, 61 Colindale Avenue, London NW9 5DF.
11. Hoffman H.J., et al. “Diphtheria-tetanus-pertussis immunization and sudden infant death: results of the National Institute of Child Health and Human Development Cooperative Epidemiological Study of Sudden Infant Death Syndrome risk factors” Pediatrics 1987;79(4):598-611
12. Walker, A.M., et al. “Diphtheria-tetanus-pertussis immunization and sudden infant death syndrome” Am. J. Public Health 1987;77:945-951
13. Essery S.D., et al. “The protective effect of immunisation against diphtheria, pertussis and tetanus (DPT) in relation to sudden infant death syndrome” Am. J. Public Health 1999;25:183-92

Dr. Wile and Erica A. Sommerville are not medical doctors. Dr. Wile is a nuclear chemist, and Miss Sommerville is a college student. As a result, they do not dispense medical advice. They simply educate the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.

## The Pharmaceutical Companies Do Not Control the Scientific Research on Medicines

Those who consider vaccines to be unsafe or ineffective have a serious problem when faced with the medical literature, because study after clearly shows that vaccines are both safe and effective. Of course, this is not a problem for many in the anti-vaccination movement, as they are unfamiliar with the scientific literature. However, those who are familiar with the scientific literature are forced to find some way to discount this overwhelming evidence. Thus, they often posit that the medical literature is controlled by the “evil” pharmaceutical companies. According to the theory, these pharmaceutical companies are so heavily invested in the production of medicines that they keep the bad news about vaccines from getting out, and they “rig” the studies that are published in order to make sure that vaccines come out looking good.

There are, of course, several things wrong with such an outlandish conspiracy theory. First and foremost, the vast majority of those who perform and publish the studies which appear in the medical literature are not associated in any way with any pharmaceutical company. Thus, they would have no reason to do the pharmaceutical companies’ bidding.

Second, if the pharmaceutical companies really were able to manipulate the research, they would be just as likely to “rig” the data of a study on a competitor’s product to make it look bad as they would be to “rig” a study on their product to make it look good! For example, GLAXO Smithkline makes a Hepatits A vaccine. However, it does not make an MMR vaccine. Merck and company makes both. Clearly, GLAXO Smithkline would benefit greatly if it were determined that the MMR vaccine is fatally flawed. This would cause Merck and company to lose profits, possibly putting it out of business. If that were to happen, GLAXO Smithkline would suddenly get all of the Hepatitis A vaccine business. Thus, from a business point of view, GLAXO Smithkline should “rig” the studies on the MMR vaccine. Nevertheless, we do not see these things happening.

Thirdly, you might not be familiar enough with the medical literature to know this, but studies come out regularly which are really bad for the pharmaceutical companies. Let’s start with vaccines themselves. Respiratory Syncytial Virus (RSV) is one of the biggest killers of infants and young children in the U.S. For years, pharmaceutical companies have tried to make a vaccine. If a pharmaceutical company could get an RSV vaccine licensed, it would make millions! However, one has never been approved. Why? Because the studies done on the vaccines that have been made demonstrate that they are not safe enough or effective enough to be considered a reliable medicine1,2.

Now if the pharmaceutical companies were able to “rig” things to make their products look good so as to cash in on the misery of the American people, why didn’t they “rig” these studies to show that the RSV vaccines were safe and effective? After all, since RSV is still a big childhood killer, they would stand to make a lot of money if they could get their vaccine licensed. Nevertheless, they are missing out on this cash cow just because of a couple of annoying studies. Why haven’t they buried those studies or “rigged” them to come out in favor of the vaccine?

Another example of how the medical literature is clearly not slanted in the pharmaceutical companies’ favor comes from studying the history of the rotavirus vaccine. In 1998, the rotavirus vaccine was licensed because it passed all levels of controlled studies required for licensure. However, in the final level of clinical study, five children of the 10,054 who received the vaccine came down with a serious bowel obstruction. Only one child of the 4,633 who did not receive the vaccine (the control group) came down with the same malady. However, the difference between five out of 10,054 and one out of 4,633 was not statistically significant, so the vaccine was licensed3. Even though it was licensed, this serious bowel obstruction was listed as a possible side effect and was specifically flagged for surveillance once the vaccine was given to the general public.

In 1999 (just ONE YEAR later), the Vaccine Adverse Effects Reporting System (VAERS) logged 15 reported cases of the serious bowel obstruction amongst those who received the rotavirus vaccine. Even though the frequency of this side effect was low (15 out of 1.5 million doses), it generated enough concern that studies were quickly done to see if these cases were related to the vaccine.

Several studies were done4-5. The most thorough one demonstrated that there was a slightly elevated risk of serious bowel obstructions (one case in every 11,073 children vaccinated) for those who received the vaccine. Even though the risk is rare, the severity of the bowel obstruction combined with the low mortality of rotavirus in the United States led to the decision to pull the rotavirus vaccine from the standard vaccination schedule.

This story is illustrative in three ways. First, it shows the efficacy of the surveillance that is constantly done on vaccines. In just over one year after the licensure of the vaccine, an extremely rare side effect was reported, analyzed, and was serious enough to outweigh the benefits of the vaccine. As a result, the vaccine was pulled from the vaccination schedule. Second, it shows the risk/benefit analysis that is important for any medicine. The rotavirus vaccine was effective. It prevented the disease in many children who would have otherwise gotten it. However, the risk of death or long-term side effect from the disease is relatively low. Thus, even though this vaccine produced a benefit, that benefit was small. In addition, the medical studies clearly showed a risk that, although small, was not insignificant. Thus, the data indicated that on balance, children were probably more at risk getting the vaccine than not getting the vaccine, so the vaccine was pulled from the standard vaccination schedule. This is the kind of solid, medical reasoning that must be used when evaluating any medicine, including a vaccine.

Finally, this story clearly shows that the pharmaceutical companies do not manipulate the scientific studies. Even the studies done for licensure noted the problem. Those studies suggested surveillance after the vaccine was given to the general public. Thus, the pharmaceutical company did not “hide” the problem. In fact, they made sure that the problem was well understood so that surveillance could be done. Then, when the problem began to appear on VAERS, studies were quickly done, and the studies implicated the vaccine, causing it to be pulled from the vaccination schedule.

If the pharmaceutical companies were able and willing to manipulate the studies, they certainly did not do it here, and the result was a huge loss of money! Clearly, at a rate of 1 case every 11,073 children, this problem could have been easily “swept under the rug.” However, it was not. Why? Because the scientific literature is not easily manipulated.

I want to pause here a moment and point out that this whole rotavirus vaccine issue once again shows how ignorant anti-vaccine advocates are when it comes to the medical literature. If anti-vaccine advocates were even passingly familiar with the medical research on vaccination, they would not only know about the rotavirus vaccine issue, but they would also notice that many of the same authors on the study showing a definite problem with the rotavirus vaccine are also authors of studies that show other vaccines do not have problems. For example, these authors: Destefano F, Lieu T, Black SB, Shinefield H, and Chen RT are all a part of the study that caused the rotavirus vaccine to be pulled from the market. However, they are all also on a major study that showed no connection between thimerosal-containing vaccines and autism or ADD.6 So could some anti-vaccination advocate please explain to me how these same authors can be “in league” with the big, bad pharmaceutical companies when it comes to thimerosal-containing vaccines, but not when it comes to the rotavirus vaccine?

Vaccine studies are not the only ones that end up being bad for the pharmaceutical companies. Studies are constantly being performed on medicines that have been licensed by the FDA. Although most of these studies end up demonstrating the safety and efficacy of the medicine studied, this is not always the case. For example, a recent study shows that Lipitor and other cholesterol-lowering drugs can cause nerve damage7. Drug companies raked in more than 9 billion dollars on such drugs in the year 2000. Nevertheless, this study will reduce sales considerably, as it identifies an entire class of people who should not be taking such drugs.

Another example of a medical study that is bad for the pharmaceutical companies comes from the area of estrogen therapy. A major study was recently published which shows that estrogen therapy can have significant side effects8-9. This has already radically changed how doctors are prescribing the third most prescribed drug in the United States. Wyeth, a leading maker of estrogen therapy drugs, made more than 2 BILLION dollars from them in 2001. The company’s stock plunged 24% when the study’s results were announced. Wyeth itself actually informed all of the doctors in its database about the study, even though they knew it would dramatically decrease sales.10

So you see that the medical literature is decidedly not “pro-pharmaceutical company.” It is simply a forum for the publication of data. These data many times support the medicines made by the pharmaceutical companies, but sometimes they do not. It is the data, not the finances of the pharmaceutical companies, that drives the medical literature. Anyone who has dealt with the rigorous peer-review process necessary to publish in the standard medical journals knows that. However, the public does not, and anti-vaccination advocates prey on the public’s ignorance so as to cast doubt on the reliability of medical science.

## References

1. Fulginiti VA, et al. “Respiratory virus immunization. A field trial of two inactivated respiratory virus vaccines: An aqueous trivalent parainfluenza virus vaccine and an alum-precipitated respiratory syncytial virus vaccine.” Am J Epidemiol 1969; 89: 435-448.
2. Chin J., Magoffin R.L., Shearer L.A., Schieble J.H., Lennette, E.H. “Field evaluation of a respiratory syncytial virus vaccine and a trivalent parainfluenza virus vaccine in a pediatric population.” Am J Epidemiol 89, 449-63 (1969)
3. Rennels M.B., Parashar U.D., Holman R.C., Le C.T., Chang H.C., Glass R.I. “Lack of an apparent association between intussusception and wild or vaccine rotavirus infection.” Pediatr Infect Dis J 1998;17:924-5
4. Kramarz P., et al., “Population-based study of rotavirus vaccination and intussusception.” Pediatr Infect Dis J. 2001 Apr;20(4):410-416
5. A good review of many of the studies: Morbidity and Mortality Weekly Report, 48: 577; 1999.
6. Verstraeten T., et. al., “Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases.” Pediatrics 112:1039-48, 2003
7. Gaist D, Jeppesen U., Andersen M., Garcia Rodriguez L.A., Hallas J., Sindrup S.H. “Statins and risk of polyneuropathy: a case-control study.” Neurology 2002 May 14;58(9):1333-7.
8. Writing Group for the Women’s Health Initiative Investigators, “Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women’s Health Initiative Randomized Controlled Trial” JAMA 2002; 288:321
9. Lacey, James V. Jr, et al. “Menopausal Hormone Replacement Therapy and Risk of Ovarian Cancer” JAMA 2002; 288:334
10. Thayer, Ann “Halted Estrogen Study Hits Wyeth” Chemical and Engineering News, July 15, 2002; 8

Dr. Wile is not a medical doctor. He is a nuclear chemist. As a result, he does not dispense medical advice. He simply educates the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.

## Small Decision, Large Impact: Why Not Vaccinating Your Child Is Dangerous

“Study Shows Autism Is Linked to the MMR Vaccine,” the newspaper’s headline reads. A television news magazine runs a story filled with testimonies from parents about the deaths of their children just days or weeks after they received the DPT vaccine. Coalitions of parents form to call for the banning of current vaccines until better and safer ones are discovered. Meanwhile, medical professionals and politicians call for increased coverage rates with vaccines and encourage parents to continue immunizing their children.

Many parents, their heads spinning from listening to all of this, compromise and adopt an attitude like this one: “If everyone else is immunizing, then the immunity of others will keep my child safe and I won’t have to worry about the potential side effects from vaccines.” Often those who practice this are unaware of the consequences of their decision for both their own children and society at large.

Robert Chen and Frank DeStefano point out that criticism of vaccines becomes more common when the risk of the contracting the disease is low. This happens because, at that point, coverage of the vaccine is high and reports of side effects (whether genuinely associated with the vaccine or simply coincidental events) are bound to be more common1.

A potent example of this occurred in the early 1970s. Pertussis, more commonly known as whooping cough, was at record lows in developing countries with the use of the whole-celled pertussis vaccines. Studies appeared that seemed to link the vaccine to serious side effects in rare cases, and in extremely rare situations, death. Some countries continued their immunization programs with very little interruption in coverage while others, listening to the voices of worried parents and health professionals alike, terminated or modified immunization for pertussis for several years. E.J. Gangarosa and his colleagues researched the medical literature, popular literature, and disease case rates of several countries during this period and into recent years to chart the effects of this interruption, and their work has much to say about the costs associated with listening to the anti-vaccination movement.

Sweden’s immunization program against pertussis began in the 1950s. Disease case rates were at their lowest in the years leading up to the termination of the program in 1979, though several voices began to question the necessity and safety of the program early on, among them Justus Storm. A leading member of the Swedish medical community, he claimed that medical technology had advanced so much that pertussis was less dangerous than it once was and national vaccination programs could be terminated. When case rates for pertussis saw a minor increase, doctors began to question the efficacy of the vaccine as well. Later, some neurological problems were attributed to the vaccine, and pertussis immunization came to a screeching halt2. For the next three years, pertussis levels were still low, but then the climb in case rates began, and there were serious outbreaks in 1983 and 1985. Annual case rates for the general populace rose from about 75 per 100,000 people to 100-200 per 100,000 people (about a 2-fold increase). It is estimated that the annual number of cases per 100,000 children (age 0-6) rose from 700 in 1981 to 3200 (a 4.6-fold increase) in 19853. So we see that the children were hardest hit by the fact that the vaccination rate fell.

One particularly striking way of seeing the effect of Sweden’s drop in the pertussis vaccination rate is to compare pertussis in Sweden to pertussis in Norway. While Sweden was persuaded by the anti-vaccination movement; Norway was not. Norway continued its pertussis vaccination program, and as a result, its population remained protected. Compare the pertussis rates in the two countries as shown in the graph below4:

Since Norway and Sweden are neighboring countries at roughly the same socioeconomic level, one would not expect any significant difference in their level of health care, sanitation, etc. This is why the pertussis rates in the two countries were roughly equivalent from 1974-1982. Notice, however, that starting in 1983, the number of pertussis cases in Sweden began to rise dramatically, while the number of pertussis cases in Norway continued to decrease.

This graph dramatically illustrates the problem with listening to the anti-vaccination advocates. Due to the drop in the pertussis vaccination rate in Sweden, thousands of innocent children in Sweden needlessly suffered (and sometimes died) from the ravages of pertussis. Unfortunately, this sad tale has been repeated in several countries. Spain, Greece, the UK, Japan, and Canada also experienced drops in the pertussis vaccination rate. Directly following that, they experienced pertussis case rate increases of 10 to 100 times compared to their neighboring countries who did not listen to the anti-vaccination advocates 5.

The key concept behind the need for high vaccine coverage is that of herd immunity. That is, if everyone is immunized, the transmission of the disease can be slowed or stopped. This is important for three reasons. The first is that no vaccine is 100% effective for all people. As a result, there will always be a small percentage of people for whom vaccination does not work because their immune systems do not respond to vaccination, and thus they will always be at risk for those diseases.

The second reason, an increasing problem in the face of HIV and similar disorders, stems from the vaccination of those suffering from immune deficiency disorders. Their immune systems are too weak to handle vaccination, and therefore they should never be vaccinated. For those who cannot be immunized for such reasons, it is imperative that those around them be vaccinated so that the organism that causes the disease will no longer be transmitted to them. This is the only way that they can be safe from the risk of disease.

The last reason is for the sake of infants who are too young to be immunized. In a study done of infants hospitalized for pertussis, most of them contracted it from family members. “The clear message is that, if herd immunity is lost,” Nick Pigott and his colleagues say, “the most vulnerable children (preimmunisation infants) are at greatest risk. The consequences are potentially devastating.”6 In light of the importance of herd immunity, the attitude mentioned earlier (refusing to vaccinate a child assuming that your children will be protected by others’ vaccination) is shown to be dangerous. Indeed, the immunity of everyone around a child does help protect the child to an extent, but that child is also at risk to a much greater extent than his immunized neighbors. More importantly, as more people follow this practice, fewer people surrounding him are immunized.

In country after country, in many varying circumstances, the result is the same – a lack of vaccination coverage is a recipe for epidemic. When a parent does not vaccinate his or her child, not only is that child’s health at risk, but the health of everyone around that child is also at risk.

## REFERENCES

1. Robert Chen and Frank DeStefano, “Vaccine Adverse Events: Causal or Coincidental?” The Lancet. 1998;351:612 ( Available online)
2. EJ Gangarosa, et al. “Impact of Anti-Vaccine Movements on Pertussis Control: the Untold Story.” The Lancet.1998;351:357 ( Available online)
3. V Romanus, R Jonsell, and SO Bergquist. “Pertussis in Sweden After the Cessation of General Immunization in 1979.” Pediatric Infectious Disease Journal. April, 1987; pp.364-71
4. Gangarosa et al. Ibid, p.360
5. Ibid, p.360
6. Nick Pigott, et al. “The Importance of Herd Immunity Against Infection.” The Lancet. 2002;360:645.( Available online)

*Erica A. Sommerville is not a medical doctor but a college student. She does not dispense medical advice. Her aim is to educate the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself

## Vaccines Do Not cause Multiple Sclerosis

According to anti-vaccination advocates, vaccination (with the Hepatitis B vaccine in particular) can cause neurological diseases such as multiple sclerosis (MS)1. This is supposedly the result of the vaccine producing antimyelin antibodies that attack the myelin sheath which exists around some nerves. However, a quick look at the medical data shows that this is just not the case.

In February of 2000, for example, Sadovnick and Sheifele reported on their study2 of school and hospital records in British Columbia, Canada. In this province, the Hepatitis B vaccine has been given to students age 11-12 (grade 6) since October, 1992. Thus, the researchers examined the number of multiple sclerosis cases amongst 6th grade students from January, 1986 to September, 1992 and compared it to the number of multiple sclerosis cases amongst 6th grade students from October, 1992 to September, 1998. The number of students in each case was similar, but the frequency of multiple sclerosis was actually a bit higher in the students prior to October of 1992 as compared to those after October of 1992. The difference was not statistically significant, but the result is clear. The hepatitis B vaccine cannot be associated with multiple sclerosis, as the multiple sclerosis rate was slightly lower after the vaccine was routinely given.

Another large-scale study comes Ascherio and others3. They used data from the Nurse’s Health Study, which has followed 121,700 women since 1976. They found no association between hepatitis B vaccination and the development of multiple sclerosis.

Another study was done on patients who had relapses of multiple sclerosis. After all, if the hepatitis vaccine produces antimyelin antibodies, it should exacerbate multiple sclerosis in patients whose disease is in remission. However, Confavreux and others4 followed 643 patients with relapses of multiple sclerosis and demonstrated that there was no association between exacerbations of multiple sclerosis and the hepatitis B vaccine, the tetanus shot, or the influenza vaccine.

Clearly, then, the medical literature does not support any kind of link between multiple sclerosis and the hepatitis B vaccine. Indeed, after reviewing all of the available evidence on the subject, the Institute of Medicine came to the conclusion that the hepatitis B vaccine does not increase a person’s risk of multiple sclerosis, nor does it trigger multiple sclerosis attacks.5

Another way of demonstrating that there is no medical evidence that the hepatitis B vaccine is linked to multiple sclerosis is to look at what the National Multiple Sclerosis Society says about hepatitis B vaccination. Since the mission of this society is “to end the devastating effects of MS,”6 they would definitely be interested in publicizing a link between multiple sclerosis and the hepatitis vaccine. Instead, they encourage the use of the vaccine7.

Clearly, then, the available medical data indicates that vaccines do not cause multiple sclerosis.

## References

3. Alberto Ascherio, et. al., “Hepatitis B Vaccination and the Risk of Multiple Sclerosis” NEJM 2001;344:327-332 Return to text
4. Confavreux C., et al. “Vaccinations and the Risk of Relapse in Multiple Sclerosis” NEJM 2001;344:327-332 Return to text
5. Board on Health Promotion and Disease Prevention and the Institute of Medicine Immunization Safety Review: Hepatitis B Vaccine and Demyelinating Neurological Disorders 2002 ( Available online) Return to text
6. See ( The National Multiple Sclerosis Society website ) Return to text
7. See ( The National Multiple Sclerosis Society website ) Return to text

Dr. Wile is not medical a doctor. He is a nuclear chemist. As a result, he does not dispense medical advice. He simply educates the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.

## Vaccines are Recommended Based on Health Concerns, Not Monetary Concerns

While reading through anti-vaccination literature, I often come across the argument that vaccines are a multi-billion dollar business, and that the standard vaccination schedule is built mostly out of a desire to line the pockets of the pharmaceutical companies rather than out of concern for people’s health1.

As is the case with most of what the anti-vaccination movement claims, this idea cannot stand up to scrutiny. If the standard vaccination schedule is meant to line the pockets of the pharmaceutical companies, it is doing a lousy job! After all, there are many, many vaccines that are available today and licensed for use but are not on the standard vaccination schedule.

For example, we do not routinely vaccinate against smallpox anymore. Why? Because the vaccine has completely destroyed smallpox (see “The Unique History of Smallpox”). As a result, the only smallpox viruses left are in laboratory samples. This means that the chance of catching smallpox (barring some terrorist act or horrible laboratory accident) is zero. As a result, there is no need to be vaccinated against smallpox, so it is no longer on the standard vaccination schedule. If the goal were to simply enrich the pharmaceutical companies, why aren’t we still vaccinating against smallpox? The vaccine has already been used on millions and millions of Americans. Why not still use it today? Because medically, there is no reason to use it anymore.

We also have vaccines against diseases that still exist today but are not found in the United States. There are vaccines against yellow fever, typhoid, tuberculosis, and Japanese encephalitis2, for example. These vaccines have all been shown to be safe and effective, and they are used in many parts of the world. Why aren’t they a part of the standard vaccination schedule? Because as long as you stay in the United States, you have almost no chance of being exposed to these diseases. Thus, there is simply no medical reason for you to get vaccinated. Now, if you end up traveling to parts of the world where these diseases are a problem, you definitely should be vaccinated against them, because you are likely to be exposed to them. Otherwise, however, there is simply no reason for you to be vaccinated. As a result, these vaccines are also not a part of the standard vaccination schedule.

Now once again, if the goal were to simply make money for the pharmaceutical companies, why not throw the yellow fever, typhoid, tuberculosis, and Japanese encephalitis vaccines into the standard vaccination schedule for everyone? After all, they are all licensed, which means that they have been demonstrated to be safe and effective. Indeed, they are used routinely on people for whom the risk of these diseases is significant. Why not just use them for everyone in the United States as well? The answer is simple – the standard vaccination schedule is determined based on the health of the people of the United States. If there is little or no risk for contracting a disease in the United States, there is no reason to spend the time and money vaccinating everyone against the disease. In addition, there are risks associated with any activity, including vaccination. A vaccine is recommended for everyone on the standard vaccination schedule when the risk of not vaccinating exceeds the risk of vaccinating (see “Vaccines are very Safe”). For the yellow fever, typhoid, Japanese encephalitis, and meningococcal vaccines, the risks of vaccination exceed the benefits of vaccination, except for certain high-risk groups. As a result, vaccination is only recommended for those high-risk groups. This is the kind of sound, medical thinking that goes into modern medicine, and it is the same kind of thinking that is sorely lacking in most anti-vaccination literature.

## References

2. Center for Disease Control (CDC) “Vaccine Recommendations for Infants and Children” (Available online) Return to text

Dr. Wile is not a medical doctor. He is a nuclear chemist. As a result, he does not dispense medical advice. He simply educates the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.

## Vaccines DO NOT Cause Autism

One of the most popular claims in the anti-vaccination literature is that vaccines (often the MMR vaccine) are linked to autism1. This claim has gotten even more popular since Dan Burton’s Congressional committee has held hearings on this subject. However, Congressional hearings are hardly scientific forums, given the fact that such environmental experts as Meryl Streep testify before Congress on the effects of pesticides2, and biochemistry luminaries like Ben Affleck3 testify before Congress on current advances in genetics. Congressional hearings are forums for disgruntled citizens to make impassioned pleas and for craven politicians to “perform” for their constituents. If you want to know the truth about medicine, you must look at the medical literature, and the medical literature is quite clear – there is no link between vaccines and autism.

Let’s start with the idea that the MMR is somehow linked to autism. Taylor and others4 looked at autism cases in the United Kingdom from 1979 to 1999. Since the MMR vaccine was introduced in the UK in 1988, this study encompassed 9 years prior to use of the MMR and 11 years after its use began. They found that the autism rates increased steadily from 1979 to 1999, with no increase in the rate after the MMR was introduced. If the MMR were linked to autism, you would expect a “bump” in the autism rate shortly after the MMR became widely-used. No such “bump” occurred. Also, comparing vaccinated children to unvaccinated children, there was no difference in the average age at which diagnosis occurred. If the MMR were linked to vaccination, you would expect that the vaccinated children’s autism would occur nearer to the vaccination as compared to unvaccinated children. This was not the case.

In a similar study, Dales and others5 looked at the number of autism cases in California from 1980 to 1994. They also looked at the rate of MMR vaccination over the same time period. Here is what they found:

Notice that there is no correlation between the number of autism cases and the vaccination rate. The vaccination rate of those at or under the age of 17 months increased by roughly 50% over the period, while the number of autism cases increased by 600%. Also, if you look at the date range of 1988 to 1994, you will see that the vaccination rate of those at or under the age of 17 months barely changed at all, while the number of autism cases increased by 300%. The data are even more striking for the vaccination rate of those at or under the age of 24 months. That vaccination rate barely changed over the entire time period, but the number of autism cases increased by 600%.

These data are fairly straightforward. There seems to be no association between the MMR and autism. It also illustrates another lie told by many anti-vaccination advocates. They often claim that the number of autism cases have increased as the vaccination rates have increased. These data show that such a claim is simply wrong. Autism rates have skyrocketed as vaccination rates have barely changed.

In a more direct study, Madsen and others6 examined all children (more than half a million) born in Denmark from 1991 through 1998. Of those children, 82 percent had received the MMR vaccine. The other 18% had not. The researchers found that there was no difference between the autism rate of vaccinated children as compared to unvaccinated children. In such a large study, even a slight increase in the risk of autism due to the MMR vaccine would show up. However, no such increase was seen. This is strong evidence that the MMR vaccine is not linked to autism.

The thought that vaccines are somehow linked to autism has also come about due to the fact that a mercury-containing compound (thimerosal), is sometimes used as a vaccine preservative. As a result, when a person gets certain vaccines, he also gets a small dose of mercury. Since high doses of mercury have been linked to neurological problems, there are those who think that the small amount of mercury in some vaccines can cause neurological problems such as autism. However, several studies have been done specifically looking for a link between the thimerosal in vaccines and autism, and none can be found.

For example, Heron and others7 studied almost 13,000 children in the United Kingdom. They tracked the amount of mercury the children were exposed to through vaccination as well as other sources (such as the consumption of fish). They also examined many other factors that lead to developmental disorders. When they adjusted for all of those factors, they found no link between thimerosal exposure and developmental disorders, including autism.

Probably the most convincing study showing that thimerosal is not linked with vaccination comes from Denmark8 , where all thimerosal-containing vaccines were discontinued in 1992. The study looked at all autism cases diagnosed from 1971 to the year 2000. The results indicate that the number of autism cases was fairly steady until 1990, and after that, it rose steadily throughout the study period. If thimerosal were to blame for autism, you would expect the number of autism cases to drop, remain steady, or at least not increase as dramatically after 1992, when the use of thimerosal-containing vaccines was discontinued. That did not happen. Thus, autism is simply not related to thimerosal exposure through vaccination.

Many studies using many methodologies have been done trying to link vaccines or the thimerosal contained in some of them to autism, and the link is simply not supported by the data. Just recently, the Institute of Medicine examined all available studies on autism and vaccination. Five large studies conducted in the U.S., Denmark, the U.K., and Sweden since 2001 showed no link between thimerosal-containing vaccines and autism. In addition, 14 large epidemiological studies showed no link between the MMR and autism. A few studies showed a tenuous link between vaccines and autism, but each study had flaws, and none of them were nearly as large or far-ranging as the studies that showed no link. Thus, the vast majority of the data show that there is simply no link between vaccines and autism. This is why the Institute of Medicine clearly states, “The committee concludes that the body of epidemiological evidence favors rejection of a causal relationship between the MMR vaccine and autism. The committee also concludes that the body of epidemiological evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism.”9 In other words, the data clearly say that vaccines are not related to autism.

In fact, the latest research indicates that autism is a genetic disorder. A French team of scientists10 has identified two mutated genes that appear to cause autism. Both genes are located on the X-chromosome, which makes sense, since autism is four times more prevalent in men than women. Since women have two X-chromosomes, they are less likely to be affected by a mutated gene on that chromosome. After all, a woman would have to acquire one mutated gene from her mother and another mutated gene from her father to be affected. This is rather unlikely. On the other hand, a man needs only inherit one mutated gene on the X-chromosome, and he will be affected by the gene.

What do these genes do? They tell the cell to produce proteins called “neuroligins,” which appear on the junctions between nerve cells. These junctions are called “synapses,” and they allow nerve cells to communicate with one another. Neuroligins are crucial for the proper function of a synapse. Thus, if a neuroligin is not made properly because the gene that codes for its production is mutated, it makes sense that the person affected by such a gene would have a neurological disorder.

The sad thing about the anti-vaccination advocates’ lies regarding vaccines and autism is that they have distracted medical researchers from finding the real cause of autism. Let’s hope that no more distractions occur and that medical researchers can do what they should have been doing all along. That’s the hope of Dr. Peter J. Hotez, whose son has autism. He not only knows the challenges of having a child with autism, he also knows the medical research behind the condition. You can read about his book refuting the anti-vaccination movement here.

## References

2. Health Effects of Pesticide Use On Children: Hearing Before the Subcomm. on Children, Family, Drugs and Alcoholism of the Senate Comm. on Labor & Human Resources, 101st Cong., 1st Sess. 32 (1989)28 Return to Text
3. Promise of the genomic revolution : hearing before a subcommittee of the Committee on Appropriations, United States Senate, One Hundred Seventh Congress, first session, special hearing, July 11, 2001, Washington, DC. Return to Text
4. Taylor B, et al. “Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association” Lancet 1999;353:2026-9 Return to Text
5. Dales, L, et al., “Time Trends in Autism and in MMR Immunization Coverage in California” JAMA 2001;285:1183-5 Return to Text
6. Kreesten Meldgaard Madsen, et al. “A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism” NEJM 2002;347:1477-1482 Return to Text
7. Heron J, et al. “Thimerosal Exposure in Infants and Developmental Disorders: A Prospective Cohort Study in the United Kingdom Does Not Support a Causal Association. ” Pediatrics 2004;114: 577-583 Return to Text
8. Kreesten Meldgaard Madsen, et al. “Thimerosal and the Occurrence of Autism: Negative Ecological Evidence from Danish Population-Based Data. ” Pediatrics 2003;112: 604-6 Return to Text
9. Institute of Medicine Immunization Safety Review: Vaccines and Autism 2004, p. 1 (Available online) Return to Text
10. Jamain S, et al., “Mutations of the X-linked genes encoding neuroligins NLGN3 and NLGN4 are associated with autism” Nat Genet. 2003;34(1):27-9 Return to Text

Dr. Wile is not a medical doctor. He is a nuclear chemist. As a result, he does not dispense medical advice. He simply educates the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.

## Vaccines are the Reason That the Childhood Diseases are so Rare Today

In some ways, the effectiveness of vaccines has become a problem. Today, you almost never hear of children dying from diseases such as smallpox, polio, measles, mumps, pertussis, etc. It still happens (See “Individuals Who Have Suffered and Even Died Because They Were Not Vaccinated”), but it is rare. Why is it rare? Because vaccines have virtually eliminated such diseases! As a result, people tend to think that these diseases are “a thing of the past” and thus connect them with an age where sanitation and medical practices were poor. In fact, many anti-vaccination advocates make the specific claim that vaccines are not responsible for the decline in these diseases1.

This lie can be refuted in many different ways. If you look at our article entitled “Vaccines are Incredibly Effective at Preventing Disease,” you will find two graphs that clearly show that the declines in polio and measles are directly correlated with the licensure of the vaccines for those diseases. In addition, you will find a discussion of the many detailed, controlled experiments that show that those who are vaccinated are significantly less likely to be infected than those who are not.

Another way to refute the lie is to see what happens when vaccination rates decrease. You can find a discussion of that in our article entitled, “Small Decision, Large Impact: Why Not Vaccinating Your Child Is Dangerous”

Of course, the best way to refute the lie is to simply discuss the histories of the diseases that vaccines have conquered. Below, you will find links to a discussion of the history of smallpox and a discussion of the history of polio. Those histories clearly show how important the vaccine was in the destruction of these terrible diseases.

The Unique History of Smallpox

The Continuing History of Poliomyelitis

## REFERENCES

1. See, for example, ( There’s More to Vaccination than the Shot) Return to Text

Dr. Wile and Erica A. Sommerville are not medical doctors. Dr. Wile is a nuclear chemist, and Miss Sommerville is a college student. As a result, they do not dispense medical advice. They simply educate the public about scientific issues. Please consult a board-certified medical doctor before making any medical decisions for yourself or your family.