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Vaccine Hesitancy — A Public Health Crisis of Our Own Making

By Suraj Patel, Esq.

The latest measles outbreak in New York has hit almost 200 people. This previously unfathomable number is part of a larger national trend with 12 states having had measles outbreaks since 2014 — a disease once declared eradicatedin the year 2000. The reason behind its comeback is not a new strain of the disease or antibiotic resistance, rather, it’s a scourge of our own making vaccine hesitancy thanks to the peddling of misinformation by anti-vaxxer conspiracy theories. And aside from the humanitarian concerns its creating, this self-made crisis is extremely costly to the public — last week we learned an unvaccinated Oregon boy almost died from tetanus, the first caseof the bacterial infection in the state in 30 years. The boy spent 57 days in excruciating pain in a hospital at a cost of over $1 millionto the public for a disease that could have been avoided with a $30 routine vaccination.

The World Health Organization has ranked vaccine hesitancy — the growing resistance to widely available lifesaving vaccines — as one of the top 10 health threats in the world for 2019. But despite the facts, on the internet, anti-vaccine propaganda has outpaced pro-vaccine public health information. The anti-vaxxers, as they are colloquially known, have hundreds of websites promoting their message, a roster of tech- and media-savvy influencers and an aggressive political arm that includes at least a dozen political action committees. Defense against this onslaught has been meager.

Misinformation and the Persistence the Anti-Vaxxer Movement

The anti-vaccine episode is a symptom of a larger societal problem of misinformation, of underinvestment in science education, and of two-sides-ism without evidence. It also has the hallmarks of fraud most of the information is peddled by people with a pecuniary interest to take advantage of others. In this case, the false vaccine/autism link can be traced to British doctor Andrew Wakefield in 1998. His study — the first ever to propose a vaccine/autismlink, however, consisted of evaluating just 12 children with autism and was later retractedwhen it became clear he falsified data. Wakefield was later barred from practicing medicine in England, and The Washington Post reported thatWakefield predicted he “could make more than $43 million a year from diagnostic kits” for the new condition, autistic enterocolitis.

Since then, researchers and doctors have thoroughly debunked these claims againandagain, but attempting to prove a negative is impossible.In fact, just last week, a study published in the Annals of Internal Medicine looking at 657,461 children in Denmark over a decade found that there was no correlation between autism and the MMR vaccine. Like most fake news and conspiracy theories, the myth persists despite all the evidence to the contrary.

One reason it’s so difficult to combat pseudoscience, whether on climate denial or vaccine safety is because you’re put in impossible position of proving a negative. The burden of persuasion ought to be on the party alleging something without evidence, not on real science. That is why it is time to affirmatively fight back against vaccine misinformation.

This has become a public health crisis of our own making and it requires an active response from society as a whole. It is no longer enough to passively support vaccines — we have an affirmative obligation to root out misinformation and help others understand the risks of pseudoscience.

Fighting Misinformation Requires Affirmative Action

Social platforms including companies like Amazon, Facebook, and Twitter ought to affirmatively root out misinformation. Amidst the growing national health crisis, they have begun to finally react. Facebook is banning anti-vaccine informationfrom being promoted by ads and lowering its rank in search results. But they could go further. Pinterest, for example, hasblocked searcheson vaccinations, and Amazonpulled anti-vaxx documentariesfrom their catalog altogether. Facebook ought to ban anti-vaccine posts outright and we need to move towards a model where social media platforms are regulated like media companies rather than permitted to self-regulate.

We Need Federal Legislation on Vaccine Mandates

Currently, even though all 50 states have legislation requiring vaccines for students entering school, almost every state allows exemptions for people with religious beliefs against immunizations and 17 states grant philosophical exemptions for those opposed to vaccines because of personal or moral beliefs. It’s on policymakers to close loopholes, eliminate personal belief exemptions, and make our schools safe for every child.

A patchwork of state by state vaccine mandates are not enough — we need a strong Federal vaccine mandate because infectious disease knows no state boundaries. National regulation is not unprecedented. Just two weeks ago in Italy, a lawwent into effectthat barred unvaccinated children under six from school and fined parents of children older than six for not vaccinating their kids.A Federal law would preempt state laws and protect us from misguided lawmakers on both sides of the aisleacross the country. Even now, amidst the largest measles outbreak in years, some statesare moving to relax vaccination requirements for kids.

In the Meanwhile, Progressive States with Dense Urban Populations Should Take the Lead

While we await real Federal action on vaccines, more states — especially those with dense urban areas should support proposals like one in New York which hasa bill in the state legislatureallowing teenagers 14 and up to get vaccinated — even if doing so goes against their parents’ wishes. This bill is the result of courageous Congressional testimonyby 18-year old Ethan Lindenberger who attempted to get vaccinated after he said his mother was victim of “deeply rooted misinformation” online. He said parents who question vaccines are not acting out of malice but actual concern for their children. But at the same time, Ethan Lindenberger said organized groups that spread disinformation “instill fear into the public for their own gain, selfishly” and “should be the primary concern of the American people.”

Thanks to that testimony, several states have proposed bills to that would authorize anyone 14 or older to get immunizations even if their parents object. The American Academy of Pediatrics welcomed the New Yorkbill saying “Young people are often more conscious about the misinformation on the internet and can in many cases disagree with parents who have bought into unfounded and dangerous anti-immunization diatribes and pseudoscience,” the AAP said in a statement provided to the Times. “These young people have a right to protect themselves.” Bills like these need support at the state level until we have a Federal vaccination mandate with no loopholes and only bona fide exemptions for medical reasons.

Regulating in the Public Interest.

There are many areas in American public life where reasonable people can disagree. But for issues like this one, there’s no room for that kind of disagreement. Vaccines aren’t an opinion; they’re scientific fact and unless we fight for them, the harm we bring upon our kids will only continue to grow.

We regularly regulate individual conduct for the sake of public interest (both in terms of affirmative obligations one must do and prohibitions); we make people wear seat belts and helmets, we prohibit smoking on airplanes, we quarantine people who have come from an area with an Ebola outbreak, we regulate what food you can sell, what medicines can be prescribed, and limit what drugs you can take. And we do all of those things because of a strong public interest, just as there is in vaccinating children for their own safety and the safety of the public. `

Conclusion

We are in a dangerous moment as a city, state, and nation as our social conversation is full of commentary that questions the validity of proven science. From climate change to conversion therapy to vaccinations, science is clear, offers use concrete, non-negotiable realities, and often provides real solutions to the problems we face. If we want to keep our children safe, if we want to finally safeguard the United States from preventable diseases, we need action from social media companies, cultural influencers, and politicians to stop empowering science deniers and start working with the experts to address the challenges facing our nation.


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