It is dismaying that fears and misinformation about vaccines have led the scourge of measles to return in the United States some 15 years after it had been officially eradicated here. And it's especially discouraging to see some early 2016 presidential hopefuls such as Chris Christie and Rand Paul pander on the issue rather than taking a strong evidence-based stance because the facts could not be more clear: Vaccines are safe and they save lives.
One of the tragic aspects of this story is that some of the 102 measles cases so far this year in the United States have struck children under a year old who are too young to receive vaccinations. These infants are helpless against the virus, which is carried primarily by children whose parents have endangered them and those around them by failing to vaccinate. The vulnerability of these infants alone should be enough to underscore the public health imperative at stake.
In this case, however, the spread of a wholly preventable disease is directly related to the dissemination of misinformation which, especially in our era, can often spread much like a contagious virus itself.
Resounding Scientific Success
The irony, of course, is that you would be hard pressed to find a scientific success as resounding and robust as vaccination programs around the world.
Since the British physician Edward Jenner discovered a vaccine for smallpox 200 years ago, immunization can be credited with saving more lives than practically any other public health intervention except perhaps the delivery of clean water. UNICEF -- the United Nations International Children's Emergency Fund -- estimates that vaccines save approximately 9 million lives worldwide each year. In all, vaccines have brought seven major human diseases -- smallpox, diphtheria, tetanus, yellow fever, whooping cough, polio, and measles -- under some degree of control.
Smallpox has actually been eradicated worldwide by vaccines. That alone saves approximately 5 million lives annually and represents a scientific triumph about which we should all be proud.
The case of polio also represents an enormous victory. As recently as the 1980s, polio struck more than 400,000 people globally, leaving many of them paralyzed. Since then, polio eradication efforts have cut the incidence of the disease by more than 99 percent. Some 80 percent of the world's people now live in polio-free areas.
Deborah Bailin, an analyst at the Center for Science and Democracy at the Union of Concerned Scientists, reviewed the history of vaccines in a case study, "Life, Liberty, and the Pursuit of Immunity." As she notes, Thomas Jefferson was one person who immediately saw the tremendous value of the first vaccine. "Every friend of humanity must look with pleasure on this discovery, by which one evil more is withdrawn from the condition of man," Jefferson wrote, adding "I know of no one discovery in medicine equally valuable."
Two centuries and a stellar track record later, Bailin seconds Jefferson's sentiments. "People used to die from smallpox and polio, now they don't," Bailin says. "That's not because of better nutrition or sanitation. It's because vaccines work -- and they work astonishingly well."
The Role of Misinformation
So, what has gone wrong in the United States to allow its vaccination rates to drop below the level of some Third World countries?
Much of the trouble stems from a notorious 1998 article in The Lancet, a British medical journal, that incorrectly reported a link between the incidence of autism and the vaccine for measles, mumps and rubella. Importantly, the report was quickly discredited by more than a dozen reputable studies. The article was retracted by the journal in 2010 and the author, found to have knowingly falsified his data, was even stripped of his medical license.
Unfortunately, though, misinformation thrives on half truths and this piece of inaccurate data was more than enough to feed many people's fears despite the fact that large-scale studies in Britain, Japan, and the U.S. have found absolutely no correlation between autism rates and vaccinations.
Poorly informed celebrities and politicians have also played a disproportionate role in fear mongering and spreading misinformation about vaccines. So has the endemic problem of "false balance" in the media where, by presenting "two sides" of the so-called vaccine "controversy" some print, radio and television reports wind up giving equal weight and attention to ill-informed vaccine opponents as to scientists and public health experts.
Cavalier Attitude
To some extent, the resurgence of measles is also a testament to the success of our vaccination programs. Many Americans have forgotten how serious measles can be because we have been largely spared for over a decade. But measles is a deadly disease. The World Health Organization estimates that, in 2013, there were 145,700 measles deaths globally -- that's roughly 400 deaths every day.
It bears noting too, that some of the areas in the United States with the lowest vaccination rates are in politically progressive regions, such as in some California communities where faith in holistic remedies and fears about traditional medical treatments fuel a particular version of science denial.
These problems are exacerbated by the fact that California is one of just 19 states that allow people to opt out of vaccination programs simply because of "personal beliefs." Laws in other states allow exemptions only for medical reasons or, in some cases, religious ones.
Interestingly, despite Americans' widespread beliefs in individual liberties, the measles outbreak is already causing some states to rethink current policies and priorities. Notably, in an amendment that just went into effect in 2014, California recently tightened its rule to require a form signed by a doctor for any parents seeking to opt out of the state's vaccination requirement, documenting that they have been fully apprised of the risks involved in failing to vaccinate their children.
More Than Science Needed
The current measles outbreak demonstrates that science alone -- even science with remarkable results -- is often not enough, especially in the face of virulent misinformation. Even the best, science-informed public health guidance is useless if it isn't followed. And the measles case shows the results starkly: namely, people get sick and suffer needlessly from preventable diseases.
As Bailin puts it: "We've done enough study and had enough experience to say that the risks of vaccination are negligible and the risks of not vaccinating are very high." She also notes that today's safe and effective vaccines are the result not just of scientific progress, but also of more than a century of effective science-informed safeguards dating back to the Biologics Control Act of 1902. Today's vaccines are rigorously tested and inspected. Robust and effective systems in place assess their safety, purity, potency, and effectiveness.
So, to prevent our children from being sickened and threatened with death by preventable disease, we need to ensure that they get vaccinated. But, to make our vaccination program successful, we also need to find better ways to inoculate ourselves against misinformation. A good place to start is to arm ourselves with the facts.
Seth Shulman is the editorial director at the Union of Concerned Scientists and a veteran science journalist whose work has appeared in Nature, The Atlantic, Discover, Technology Review, Parade and many other publications. A 2011 Guggenheim Fellow, Shulman is the author of six books including The Telephone Gambit:Chasing Alexander Graham Bell's Secret and coauthor of Cooler Smarter: Practical Steps for Low-Carbon Living.
Note: This version corrects an error in a previous version that overstated the number of people suffering paralysis each year from polio.