Recently on NPR I heard an interview with a young man who has the unusual occupation of being a Facebook content moderator. For eight hours a day he reads the crazy stuff people post and deletes it. The conspiracy theories (as in 9/11 was perpetrated by Jews), the Holocaust deniers, you know what I mean.
The most stressful aspect of his job (in addition to the egregiously low pay) was that by reading all this drivel, he felt his brain changing. He actually began to question the Holocaust and wonder if the Sandy Hook massacre had been staged.
Such is the power of suggestion. For many physicians who follow the insidiously dangerous anti-vaccination (anti-vaxx) movement–which will eventually cause an epidemic, probably of measles–the primary source of anti-vaxx disinformation is social media sites like Facebook.
And the source of the recent spate of anti-vaxx messages? You guessed it: Russia.
Parenthetically, if you’d like to see Russian trolls at work, return to this Health Tip in a couple weeks and read the comments at the bottom. Most will be rants against my stance, some of them lengthy and some really quite vicious. There will always be some clown who says I receive big money from Big Pharma for writing this stuff.
Sorry to disappoint, but Big Pharma and I have been at odds for decades.
Anti-vaxxers in the news
Just this week, the Arizona state legislature, having sipped the Russian Kool-Aid, will be voting on laws to expand the exemptions for mandated immunization. One law wants physicians to literally unfold each vaccine package insert (packed with the bottle) and explain it in detail to the child’s parents in order for them to make “an informed decision.”
Another new law seeks to expand the rights of religious exemptions, the standard excuse for anti-vaxxers to avoid immunizations until recently, when most states banned this on discovering that virtually no religion actually prohibits immunizing children.
Arizona’s governor said he’d veto these ridiculous and potentially dangerous bills, but apparently the Arizona legislators are spending too much time on Facebook and have become the victims of Russian trolls.
Of course the fact that these legislators are alive and well in middle age and beyond is in no small part due to the wisdom of their parents who had them immunized as children.
Midway airport and local hospital measles exposure
The consequences of not being immunized were laid bare at Midway last week when an unvaccinated and infectious passenger with measles arrived Feb 22 in Concourse B, potentially exposing others to the measles virus. Two days later, that same person went to the emergency department at Northwestern Medicine Delnor Hospital in west suburban Geneva, possibly exposing even more people.
We all know how savory the air is during plane travel. At some time in your life you got a terrific virus two or three days after a flight and just knew it was from the guy across the aisle with his drippy Kleenex. Public health officials are reminding potentially infected people that they could develop symptoms as late as March 20, including a rash, cough, high fever, and runny nose with red, watery eyes.
The airline sent warnings to all the passengers and employees on the flight about this infected passenger, literally telling them that if they were not immunized against measles they could be at serious risk.
The hospital also posted warnings to employees and patients who had visited during the time the measles carrier was sitting there coughing and sneezing. Measles counts are rising, thanks to the anti-vaxxers reading and re-posting deliberate misinformation from Russian bots and trolls.
If you still have doubts, first read this piece about a woman in Washington State who is afraid to leave her home with her newborn, who’s too young to have had his first measles vaccination.
Next, please read my earlier Health Tip on this subject, which I’ve pasted in just below, and educate yourself on the potentially fatal consequences of not vaccinating your children.
Immunizing Your Kids
At least once a week someone asks my opinion on mandatory immunization, I suppose because WholeHealth Chicago is so widely known as an alternative medical center. Most often, the inquirer is pregnant and she’s read something about the (totally disproven) link between the MMR (measles-mumps-rubella) vaccine and autism.
Another question is whether vaccines contain mercury, in the form of the preservative thiomersol, followed by queries about a possible link between mercury and autism. I tell my patients that while there’s been no thiomersol in childhood vaccines since 1999, sadly there has been a steady rise in autism throughout the 21st century.
Probably the single most damaging public health hoax of the 20th century was former physician Andrew Wakefield’s 1998 article published in the British journal Lancet that linked the MMR vaccine to autism. Unbeknownst to the Lancet editors, Wakefield had been receiving funding from anti-vaccine groups. And because this idea was such a hot topic, Wakefield received a tsunami of media attention that resonates to this day in the form of doubts from the pregnant patient sitting across from me in my office.
Post-Wakefield infection rates skyrocket
After Wakefield, childhood immunization rates fell around the world and infection rates of the three potentially fatal childhood illnesses rose dramatically. Once Wakefield was investigated, his data was proven to have been manipulated and false. Later, his medical license was taken from him, and he’s no longer allowed to practice.
Wakefield is considered indirectly responsible for dozens of totally preventable deaths around the world and yet to this day, still revered by anti-vax advocates, he just won’t let go.
Wakefield produced, directed, and stars in “Vaxxed: From Cover-Up to Catastrophe,” a pseudo-documentary laden with scary misinformation. “Vaxxed” was recently yanked from Tribeca Film Festival by festival director Robert DeNiro (father of an autistic child) because “we do not believe it contributes to the discussion.”
Among other things, the film erroneously accuses Blue Cross of giving doctors financial kickbacks for immunizing kids. This link provides the (false) basis for that accusation.
In actual fact, the alleged kickbacks are simply a standard reimbursement for the cost of the vaccines themselves.
Persistent opposition and immunization’s global reach
Yet the very vocal opponents to childhood immunization persist in their endeavors on websites and in chat rooms around the world. Interestingly, organized vaccine opposition first began with smallpox vaccination in 1798 and in one way or another has never let up. When you read the history of anti-vaccine movements, the tenor is much less about safety and much more about government control. The phrases used by the opposition are similar to those employed against water fluoridation, designated smoking areas, and mandatory seat belt use.
Keep in mind that except for seriously underdeveloped countries, mandatory immunization requirements exist worldwide. This is not an American thing. The government health departments of various countries may have slightly different immunization schedules, but virtually all developed countries will not let a child attend school if he or she arrives without immunization documents.
In fact, in every country where immunization was suspended (such as occurred after the MMR hoax) there was a documented rise in infection and death. Here in the US, the so-called Disneyland measles outbreak in 2014 triggered a six-fold rise in measles. It began with a single unimmunized tourist walking through the crowds. The virus quickly spread around the country, exclusively infecting those who had not been immunized.
One issue I have with opponents of immunization is they’re too young to remember the physical and psychological devastation these illnesses once caused:
–Mumps could leave a child permanently deaf or sterile.
–Although apparently a mild viral infection, a pregnant women catching German measles (rubella) might give birth to a blind or brain-damaged child.
–Diphtheria and measles could kill, and did.
–Polio was the terror of my own childhood. A kid could be fine on Monday, catch polio that afternoon, and be crippled for life a few days later.
Herd immunity and Illinois law
Understand that not only is your child protected by these immunizations, but with everyone immunized the disease can disappear altogether. There is virtually no smallpox anymore. Polio is almost gone as well. The term for this is “herd immunity,” which is the protection of an un-immunized person because everyone else is immune. And while herd immunity is highly useful in protecting anyone with a compromised immune system, parents choosing not to immunize their children are relying on everyone else’s children to protect their own.
Here in Illinois (and in California), the otherwise egregiously incompetent state legislature passed some of the most stringent mandatory immunization rules in the country, making it very difficult for an anti-vaxx parent to avoid the system. Formerly, the most common way people got around immunization was to get a religious exemption from their physician, and a quick note could do it. Now parents are required to complete a more complex form that must signed by both by parents and physician. Parents needs to state a reason for the exemption for each individual vaccine.
In addition, before the form is completed parents also need to sign a statement verifying that they have been informed of the dangers of each illness their child is no longer protected from, that they have an understanding of herd immunity (i.e., they’re relying on other responsible parents to protect their child), and that the child might be denied admission to school (even with the religious exemption).
What anti-vax parents are often surprised to hear is “I hope you’re prepared to home-school your child.”
Pediatric docs oppose non-medical exemptions
In 2016, the president of the American Academy of Pediatrics said, “We believe there should be no religious or personal exemptions.”
In fact, finding a physician to sign an exemption form may be quite difficult. Because (just like parents) pediatricians want what’s best for the children they care for, getting a doctor’s signature on a form that renders a child vulnerable to illness may be well-nigh impossible. As a doctor, I would not want to be held responsible for a measles outbreak because I’d signed an exemption for a child who carried the virus into his classroom.
Yes, there are still some anti-vaxx physicians out there, and yes, if you go online you probably can find one, but are you really willing to place your child at risk because of your politics?
Some of Chicago’s top-notch pediatric practices simply will not accept any child whose parents refuse vaccination. They won’t sign the exemption form because they don’t want a possibly infectious (and potentially dangerous) child in the waiting room with babies who have not yet completed their vaccination programs.
Yes, autism is scary, but the vaccine-autism link was a hoax. Yes, the needle coming at your infant’s behind looks like a tenpenny nail. Yes, your daughter will wail when stuck.
But when all the kids come to your house for your daughter’s birthday looking so wild and healthy, you’ll know that none of them is at home in an iron lung (polio), dealing with deafness (mumps), covered with a nasty rash (measles), or choking for breath (diphtheria).
David Edelberg, MD