Immunization Is a Question of Science, Not Faith:
How I Evaluated the Immunization "Debate"

Chanda Cooper-Warren

Every mother and father who has welcomed a baby into the world understands the immediate desire to do what is best for their child; and immunization is one of the first important health issues parents must confront. With the birth of our first child in 1999, my husband and I began understanding the "debate." In forming our opinions we did our own research, and since then have had another child and remain interested in this public health issue.

The pro-immunization position is that immunizations are one of the greatest achievements of medicine and have spared millions of people from devastating diseases. The anti-immunization position is that it is an unreliable and extremely risky way of preventing childhood disease, a worldwide conspiracy, rife with side-effects.

For most parents, immunization is not a battle between two legitimate sides of an argument; it is fundamentally a 'Them vs Us' debate—you immunize or you don't. We found the best way to judge those positions was simply to look at the differences in way claims were presented and defended. Like most things in life, just because you believe something, doesn't make it so. What made the difference for me, as I read, was deciding to make a distinction between scientific evidence and individual opinion. I tried to understand where both sides were coming from, and value any attitude and claim which resulted from a critical and informed review of the evidence.

There has to be a starting point from which to frame any argument; and my starting point was science. Simply put: A medical issue should be judged by science. There is no other valid alternative, at least not if you want to understand the facts. If I were going to accept any claim by either party, then the claim had to be scientifically valid and up to date—in other words, based on scientific data such as large, controlled studies published in respected scientific journals. The studies that the World Health Organisation and scientific medical community take seriously include double-blind trials and are peer reviewed and prepared by medical experts such as epidemiologists. I was happy to put my faith in this rigorous kind of analysis.

Fear of immunization is not unusual, nor unreasonable, and it is from this fear that arguments against immunization accumulate much of their power. World history shows that fear is the single most effective motivator to act or not act.

My friends who don't immunize present compelling arguments that are largely driven by fear. When I listened to or read the information they gave me I became concerned and fearful, yet instinctively I wanted to know what sort of science they were basing their claims on. Their arguments are usually based on either a rejection of evidence supporting immunization, or are based on alternative views of health and health care, while ignoring or distorting scientific studies. There are two excellent examples of this.

Recently, The New Zealand Herald reported on research that has contradicted the findings of Dr Andrew Wakefield, a British gastroenterologist and lead author of a 1998 paper that suggested there may be a relation between the MMR vaccine and autism. This single claim gathered enormous publicity, and was used in every single anti-immunization argument, providing another chance for the immunization campaigners to frighten parents away from protecting their children against preventable diseases. The claim was reported the year before our son was born, and was used relentlessly as an example of why not to immunize him. Who in their right mind, wants to impose a risk of autism on a healthy child?

Since then, ten of Wakefield's co-authors have published a formal retraction of the suggestion of a link in the medical journal, the Lancet (March 2004) and they have strongly dissociated themselves from the idea that the vaccine is in any way related to autism. Dr Wakefield is also under investigation for alleged failure to declare a financial interest when he submitted his research for publication, as he failed to mention he was paid £50,000 towards research for a legal action by parents claiming the MMR vaccine had harmed their children.

The retraction was great news, but I wonder how many parents declined to immunize because of his unfounded claims. By now, their views are probably firmly entrenched and their positions impossible to change, especially if their children rarely get sick, which simply reinforces the wisdom of their decision.

The second example concerns one of the most public opponents of immunization, Viera Scheibner. She prepared a report that is widely circulated among anti-immunization campaigners and was given to me on two separate occasions by those wanting to influence my decision. The document is terrifying if you don't understand the basis of her claims.

After reading the report, I decided to check her validity. I found that Scheibner was awarded the bent spoon award by the Skeptics Society of Australia, which said she uses doubtful science and science methodologies: "She uses vast numbers of quotes from a number of sources, taking isolated snippets of information which support her contention but does not cite the tenor of the article or the context in which the quote is included." The society believes that her high-profile anti-immunization campaign promotes new age and conspiracy mythology; owes little to scientific methodologies or research; amd poses a serious threat to the health of Australian children.

I was fortunate to have the time to check her claims, but someone who does not have the time to check the scientific references could certainly be impressed.

Reading about this continual focus on elaborate conspiracy theories, with attempts to blame immunization for all kinds of social and medical ills, was staggering. The conspirators are deeply suspicious of science and modern medicine and repeatedly make evidence-free claims that doctors conspire with the government and drug companies to promote vaccines as safe and effective. Which of course raises the question of why governments would want to promote anything that costs them millions of dollars each year, and why scientists, researchers, and the medical community, who are notoriously jealous of their academic reasoning, should voluntarily conspire not to reveal their research outcomes.

I stopped engaging in these arguments years ago.

If you're having an argument with somebody about something they have deep beliefs about, those views are not going to change simply with the presentation of facts. Quite the opposite; the more facts that are presented, the more opposed they become. Once reputations are staked, any discussion of the scientific evidence is almost impossible to acknowledge, regardless of the sources.

Like any other medical intervention, immunization has risks. No medical procedure is 100% effective or 100% safe for every person. This cannot, however, be validly used as an argument against immunization, just as the occasional tragic outcome from surgery is not a valid argument for abolishing surgery. Immunization remains the only proven way to protect against vaccine-preventable diseases.

Although the arguments about safety will continue to rage, the most compelling statistic is the difference in infant mortality rates between countries which provide immunizations and those that don't. immunization has repeatedly been demonstrated to be one of the most effective medical interventions we have to prevent disease, and it is estimated to save 3 million lives a year throughout the world.

I will leave the last word to measles. Measles is one of the most severe and contagious diseases of childhood and is virtually universal among un-immunized children in all countries. Eventually, nearly everyone who has not been immunized will contract measles, and 90% will do so before the age of 20. Among non-immunized people, measles was the eighth leading cause of death throughout the world in 1990, ahead of road traffic accidents and lung cancer.

There is no need to be fearful about immunization. World history and recent local events demonstrate that vaccine-preventable diseases are severe. Immunization can prevent them.

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Chanda Cooper-Warren is a mother who lives in Aukland, New Zealand.

This page was posted on February 4, 2005.