This paper explores
nine published articles that report on results from research conducted on
vaccines and the recent controversy that has arose from a case study The Lancet that was published in 1989. First
discussed is what exactly a vaccination is and the two differing types; living
and non-living. A brief history of Edward Jenner and his creation of the
measles vaccine in 1796, is provided, which then lead to the further expansion
of vaccination creations and the prevention of a long list of infectious
diseases. This paper then moves into the controversy that arose from the case
study and public figures that aided in spreading the fraudulent information, as
well as provides the evidence that disproves anti-vaccinator beliefs and the
repercussions of their beliefs.
The Controversy That Arose from Fraudulent Studies
Regarding Vaccinations and The Repercussions the United States Now Face Because
is a Vaccine?
There are two major types of
vaccines that are used today in the United States. One of those is the
replicating live attenuated vaccines (Kang, & Compans, 2009). A live viral
vaccine works by efficiently triggering “the activation of the innate immune
system which recognizes vaccine or pathogen-associated signals through pattern
recognition receptors” (Kang, & Compans, 2009). When an individual receives
this vaccine, the injection will start to mock a natural infection (Kang, &
Compans, 2009). This mimicking effect will then activate the dendritic cells or
other antigen presenting cells at multiple sites, which will “migrate towards
the corresponding lymphoid nodes or spleen, and initiate adaptive immune (T and
B cells) activation” (Kang, & Compans, 2009).
Non-living vaccines work
differently. Their innate responses are triggered directly at the injection
site (Kang, & Compans, 2009). Therefore, “most formulations of non-living
vaccines include an adjuvant to trigger a sufficient activation of the innate
system as danger signals” (Kang, & Compans, 2009).
Edward Jenner, in 1796 was the first
to invent and test a vaccine “against the smallpox, an illness that had a very
high index of mortality in the 18th century” (Alvarez-Zuzek, La
Rocca, Iglesias, & Braunstein, 2017). With much success, and with smallpox
being practically eradicated, “different vaccines were elaborated to prevent a
long list of infectious diseases, ranging from poliomyelitis to the influenza” (Alvarez-Zuzek,
La Rocca, Iglesias, & Braunstein, 2017).
In January of 2017, the Center for
Disease Control listed vaccinations as one of the “Ten Great Public Health
Achievements in the 20th Century” (Barraza, Schmit, & Hoss,
2017). This title was awarded to vaccinations due to the low morbidity rates
and mortality rates in the United States (Barraza, Schmit, & Hoss, 2017).
Though vaccinations were on the rise
and seemingly improving the healthcare system of the United States, controversy
arose. In 1998, a case series titled The
Lancet by Andrew Wakefield and his colleagues was published linking the
connection between the childhood vaccination against Measles-Mumps-Rubella
(MMR) to autism (Scott, 2016). The study
conducted to publish the series took place at London’s Royal Free Hospital by
Wakefield. (Scott, 2016) The goal in this case was to make a connection between
the vaccinations and autism with 12 subjects. “Controversy of vaccinations and
autism arose as the prevalence of autism ha(d) been increasing at the same time
that infant vaccination coverage ha(d) increased” (deStefano, & Chen,
2001). The use of “ethyl mercury-based vaccine preservative thimerosal fueled
the controversy” as well (Scott, 2016).
After this case study was published,
celebrities began making the same claims against vaccinations and with such
publicity parents began avoiding them. “This resulted in the reemergence of
once-rare communicable diseases such as measles and pertussis” (Scott, 2016) Actress
and model, Jenny McCarthy was a large public figure advocating for
anti-vaccination (Gottlieb, 2016). Another alarming figure to publicly show
their disregard for vaccinations is Robert F. Kennedy Jr. and president of the
United States Donald Trump (Knopf, 2017). It “was with great concern that the
pediatric medicine community heard that Donald Trump, had met with Robert F.
Kennedy Jr., a proponent of the idea that vaccines cause autism” (Knopf, 2017).
“Kennedy wants to undo laws that require child vaccination, and Trump has long
been critical of vaccines” (Knopf, 2017).
With the numbers on the rise for
intentional non-vaccination, 23 outbreaks and a reported 668 cases of the once
removed measles arose in the United States in 2014 (Barraza, Schmit, & Hoss
2017). Those “intentional unvaccinated individuals comprised substantial
portion of recent United States cases of measles” (Barraza, Schmit, & Hoss
“Estimations of risk in public
debates and in parental discussions with pediatricians do not incorporate the
understanding that those who refuse vaccines at or near the threshold, thereby
allowing for the reduction of community-level immunity to the point where herd
immunity is no longer protective, risk having the worst health outcomes” (Fefferman
& Naumova, 2015).
Evidence That Disproves Non-Vaccinators Beliefs
The study Wakefield conducted in The Lancet was found to be fraudulent.
“It had been funded by lawyers for parents who were suing vaccine companies,
the paper was retracted in 2010, and Wakefield lost his license” (Knopf, 2017).
Since this occurred, “large studies have found no connection between vaccines
and autism. This includes thimerosal” (Knopf, 2017) According to Dr. Marie C.
McCormick, the committee of experts appointed by the Institute of Medicine
chairwoman, “The overwhelming evidence from several well-designed studies
indicates that childhood vaccines are not associated with autism.” (Bowman,
“As more of the population are
vaccinated, the vaccination of each additional person provides a diminishing
protective return because of the reduced number of potential carriers of
infection circulating in the population. The individual incentive is to avoid
vaccination while the rest of the population accepts the vaccine, thereby
gaining indirect protection from immune individuals who are incapable of
catching or carrying infection, making contact with an infected person from
whom to catch the disease highly unlikely (ie, herd immunity9 )” (Fefferman & Naumova, 2015). Ultimately,
with less and less people becoming vaccinated the security of herd immunity
begins to diminish putting more people at risk for contracting these once
declared eliminated diseases.
In conclusion, the publication of The Lancet and the public figures that have
failed to educate themselves on the
results of many well-designed studies have led to the growing number of parents
that chose to intentionally not vaccinate their children. This disregard for
their children’s immune system in fear of autism, has resulted in “23 outbreaks
and a reported 668 cases of the disease in the United States in 2014” of a once
declared eliminated measles (Barraza, Schmit, & Hoss, 2017) With this
decrease in vaccinations the safety threshold of herd immunity is at risk, and
not only those who have intentionally chosen to avoid the vaccination are at
danger, but those with immune systems not strong enough to receive the vaccine
are at risk for contracting these diseases.