Recently I watched a clip of Andrew Wakefield being interviewed on Good Morning America, and it gave me the chills.
Andrew Wakefield, if you haven't heard of him, is the guy who pretty much singlehandedly scared thousands of parents away from the MMR vaccine with a study he published in the Lancet linking the vaccine with autism. The study has since been retracted by Lancet, something journals almost never do, after it was discovered that data in it was falsified. Not only that, Wakefield lost his medical license.
But is he backing down? No way. On the contrary: he is suing the BMJ for defamation. And he is still defending his findings.
It was stunning to watch. George Stephanopoulos, who was interviewing him, pointed out that his colleagues who worked with him had backed away from the study. Wakefield said they hadn't. Stephanopoulos pointed out that no scientist had been able to replicate the study; Wakefield said it wasn't true, that his study had been replicated. He sat there and said none of it was true.
How do you fight someone who feels free to ignore facts?
Not that I want to fight him. For me, this isn't about fighting. I'm not on a pro-vaccine crusade. My only crusade as a pediatrician is to keep my patients healthy -- and vaccines are part of what I use to do just that.
That's what gets me angriest about the anti-vaccine rhetoric: those of us doctors who think vaccines are a good idea, if we aren't portrayed as out to hurt children, are portrayed as brainwashed by pharmaceutical companies or the government. As if being anti-vaccine was somehow more free or enlightened.
In medical school, we are taught to make decisions based on evidence, on solid science. We are taught to be aware of the risks of anything we do (primum non nocere, first do no harm), and weigh those risks against the benefits. Well, the science abundantly shows that immunizations are both effective and safe. Yes, side effects are possible and sometimes vaccines don't work -- that's true of any medical treatment. That's why we have a whole system for collecting information about any problems with vaccines -- it was that system that caught problems with the first rotavirus vaccine, and we stopped giving it and made a better one. We take immunizations as seriously as we take any other medical treatment, and work diligently to be sure we are doing the right thing, always.
We stick to the facts. But people like Andrew Wakefield don't, and as Seth Mnookin writes about in his book Panic Virus, it doesn't take much to scare parents. Some guy like Wakefield gets up and says authoritatively, as he did in the interview I watched, that the vaccine system in the U.S. isn't safe, and what responsible parent wouldn't be at least a little worried? And somehow, people like Wakefield and Jenny McCarthy keep getting airtime and headlines (I guess I'm contributing to that myself now), while the thoughtful people like Paul Offit get drowned out.
I have been at this doctoring stuff for more than 20 years, long enough to have seen kids with meningitis and epiglottitis from haemophilus influenzae -- we don't see that anymore. I've seen kids die of pneumococcal disease and chickenpox -- we immunize against both now. I'm not quite old enough to have seen polio -- but isn't that amazing enough for people, that in the U.S. we have wiped out a disease that could paralyze you forever? It's really clear that vaccines save lives.
As for the argument that getting the illness gives you stronger immunity -- this comes up a lot with chickenpox -- that may be true, but the illnesses we immunize against have real risks. Kids with chickenpox might have a mild case and be fine, but they could also end up with infected blisters (some of those infections are very serious), dehydration, pneumonia, or a brain infection. Is that a chance you'd really want to take with your child?
At the end of the interview, Wakefield encouraged parents to get educated, and to read about immunizations. He even suggested the CDC website. He said, emphatically, that there are two sides to the story.
I couldn't agree more. But just one of them is grounded in facts.
*In its original form, this post incorrectly stated where Andrew Wakefield's study had been published. It was in fact the Lancet.