Anti-Vaccination: Unfolding the story of a deadly misinformation epidemic

Imagine if you could travel through time back to the medieval times. You would observe disease and death knocking at every door, every hour, every day. The Dark Ages saw monsters and indeed, men lurking in the shadows, ready to devour their prey. Today, these monsters lurk, not in the dark, but under a bright, gleaming spotlight. Perhaps the deadliest of these is the epidemic of misinformation. Misinformation has now begun to adulterate the very source of authentic information and exploration we have: science. As scientists continue to introduce new technologies, skepticism and distrust spread through the common man. This skepticism towards science has morphed into a movement that has now intensified into propaganda.

Now, if you were to take a broad brush over history, you would find it lacerated with disease epidemics of unimaginable horrors. The Bubonic plague shook three continents, killing 200 million people. The flu epidemic of 1918 took another 50 million. In the modern age, indeed, the game is still afoot.

The start of 2019 brought with it an unpleasant surprise for the United States government. The Centers for Disease Control and Prevention (CDC) confirmed the news everyone was hoping and praying to be fake. The news of the comeback of a disease that had been eradicated in 2000. A whopping 980 measles cases were reported across 26 states crowning it the largest measles outbreak in 25 years. Meanwhile, in Pakistan, the state of the polio eradication campaign worsens every day. Despite being eradicated from practically the entire world, new cases are reported every year, the latest being the outbreak in Karachi and Khyber Pakhtunkhwa.

We owe both of these outbreaks and the failure of the polio eradication campaign in Pakistan to anti-vaccination, a misinformation epidemic that is currently in full swing to disrupt the entire public health sector.

Anti-vaccination is the rejection and abject denial of vaccines and the fact that they work against communicable diseases. It includes the belief that the ingredients used in vaccines are doing more harm than good. Skeptics have opposed vaccines for as long as they have existed. Negative sentiments towards vaccination have been around since the 18^th century when a Catholic priest, Reverend Edmund Massey called vaccines, “diabolical operations” in his 1772 sermon -The Dangerous and Sinful Practice of Inoculation.

Over the years, hostility against vaccination itself and vaccination workers has intensified. Antivaccination took the shape of a movement in the mid-19^th century when the Anti-Vaccination League was founded in London.

At the dawn of the 21^st century, anti-vaccination has evolved into a political debate, influenced not only by scientists but also by clerics and religious leaders – particularly in a country like Pakistan where clerics hold immense power and are revered by masses. Over the course of history, vaccination has been opposed by Muslim clerics, Christians and Jews alike. Only now, it has taken a violent form.

In November 2018, the Indonesian Ulama Council (MUI) passed a Fatwa declaring the new Measles-Rubella vaccine haram, claiming that it contained ingredients of porcine origin. This led to plummeting vaccination rates on Indonesian islands with strict Sharia Law. In Afghanistan and Pakistan’s tribal regions, the Taliban have popularized the notion that vaccines are the USA’s propaganda to sterilize the Muslim population. This superstition has had deadly consequences, for herd immunity, the general public and most drastically for vaccination workers.

Polio eradication campaigns in Pakistan have virtually suffered the most at the hands of anti-vaccination. Incidences of attacks on polio workers have become commonplace particularly in Khyber Pakhtunkhwa and tribal areas. In April this year, a polio worker was gunned down by two gunmen in Chaman, Peshawar. Back in 2009, the Taliban assassinated vaccination officials, including Abdul Ghani Marwat, who was the head of the government’s vaccination campaign in Bajaur Agency in the Pakistani tribal areas.

You must be wondering why people are so viciously targeting vaccines. What is it about them that ignites controversy? It is, to put it simply, a lack of understanding of science on part of the public. Too many blogs and discredited sources spread information through social media and the public believes them without question. It has now become a responsibility of all scientists and science students to debunk anti-vaccine myths.

A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body’s immune system to recognize the agent as foreign, destroy it, and “remember” it so that the immune system can more easily recognize and destroy any of these microorganisms that it later encounters.
According to the World Health Organization (WHO).

A vaccine quite simply mimics the body’s natural defense system against pathogens. A weakened or killed pathogen elicits the body’s immune response, the body produces antibodies which sort of act as grenades; when attached to the pathogen, they instantly kill it. A vaccine simply enables the body to have a storehouse of the cells that produce these antibodies, making them available in advance to fight incoming infections.

A major chunk of the dilemma around vaccines perhaps stems from the ingredients used in them. Apart from the active ingredient itself which is the dead or weak germ, various other chemicals are added to vaccines. These range from suspending fluid, preservatives to stabilizes and adjuvants – a substance that enhances the vaccines’ effectiveness. This prevailing criticism is largely due to misinformation about the functions these chemicals perform in vaccines.

Since a vaccine is a biological preparation, it requires preservatives and stabilizers to increase its shelf life and protect the weakened pathogen from fluctuating temperatures. All of the ingredients used contribute to the efficacy and safety of the vaccine.

The most controversial ingredient has, no doubt been the mercury-containing chemical, Thimerosal. The presence of mercury, a metal popular for being toxic definitely raises questions. It is important to understand that mercury is naturally present in seafood and milk in trace amounts. Research proves that mercury used in such minute amounts does not pose a health risk. Aluminum in vaccines acts as an adjuvant. Just like mercury, aluminum is also used in trace amounts, only about .125 to .625 mg which is drastically less than the amount we’re exposed to every day from food and drinking water. Formaldehyde is another chemical used in a vaccine in trace amounts, much less than what we’re exposed to every day.

Perhaps the most recent and most prominent antivaccination controversy was sparked by a research paper published in 1998 by the Lancet, a reputed scientific journal. The lead scientist was Andrew Wakefield and his research proposed a link between autism and vaccines, specifically the Measles-Mumps-Rubella (MMR) vaccine. But there is another piece of information that was not popularized as much as the controversy itself: the study was riddled with research loopholes. The scientific community calls these loopholes, research misconduct.

It is this misconduct that forced The Lancet, a highly reputed scientific journal to retract the paper in 2010. From then on, the study was consistently debunked by a large number of scientists. Since the false claims this paper made reach far and beyond, it is equally necessary to highlight the scientific misconduct involved.

First and foremost, the study dictates a sample size of 12. In scientific research, a large sampling size is of paramount importance. Let’s elaborate what we understand by sampling size. A sampling size is the number of people or subjects on which the hypothesis of the study will be tested. It is a preliminary requirement of research that the sample size is large enough to help draw a conclusion that represents the entire population being studied. In some cases, as in epidemiological studies, a sampling size of 100-300 is still insignificant. Brian Deer, an investigative journalist, interviewed all the children involved in the study. He remarked, “No case was free of misreporting or alteration.”

The paper’s bold claims about a vaccine-autism link have already been disproven by a number of studies conducted on thousands of individuals.

Moreover, the paper itself is just a case report which indicates that it explains a few cases in detail. Therefore, the claims made will definitely not be applicable to the entire population.

Another aspect that raises questions in the replicability of the study. Replicability is a prime requirement of research. A scientist failing to do so quite possibly falsified his findings.

Wakefield has been given ample opportunity either to replicate the paper’s findings or to say he was mistaken. He has declined to do either.
Editor, BMJ

This epidemic of antivaccination cannot simply be blamed on botched up research. The firestorm and controversy around Wakefield’s falsified claims were aggravated by the mainstream media. We live in an age where rumors and myth travel farther than the truth which is why we must learn to question every piece of information we receive. Go ahead, question the sources, look for different opinions and most importantly, think critically.

Edited by: Momina Malik