New measles outbreaks constantly appear around the globe and vaccination hesitancy and skepticism is at least in part to blame. Latest clinical evidence unequivocally denies any link between autism and the vaccine for measles, mumps, and rubella, in hopes of mitigating the re-emergence of potentially fatal diseases.
Two decades ago Andrew Wakefield wrote a paper in which he claimed vaccines might cause autism. In 2010, the British medical panel concluded he had been “dishonest, irresponsible and showed a callous disregard for the distress and pain of children.” But consequences of his acts are felt in 2019 more than ever before. An increasing number of parents are not immunizing their children. This trend could reverse the progress that allowed officials to declare measles eliminated in the US in 2000. In just the first two months of 2019, 206 individual cases of measles were confirmed in 11 states.
In a paper published in the journal Annals of Internal Medicine, researchers from Denmark’s Statens Serum Institut describe how they analyzed data from about 657,461 children born in Denmark between 1999 and 2010. The epidemiologists and statisticians used population registries to link information on vaccination status to autism diagnoses, as well as to sibling history of autism and other risk factors. The analysis has not shown any connection between vaccination and increased risk of developing autism. Vaccination is not likely to trigger the developmental disorder in susceptible populations and is not associated with a clustering of cases appearing after immunization. Once again, a medical consensus that vaccines do not cause autism was confirmed.
In an editorial accompanying the study, Omer and a colleague suggest resources might be better spent on promising leads in autism research than on continuing to engage with “vaccine skeptics.”
The Danish paper is “the largest, or one of the largest, studies on the subject,” said Omer. Its only limitation, he said, was one basic to all observation studies, that “you can’t intentionally vaccinate people or prevent them from vaccinating to study the effects, which would be unethical.”
At a recent U.S. Senate hearing on vaccines and the outbreak of preventable diseases, Omer gave an expert testimony alongside public health officials and other researchers, as well as a teenager, who got vaccinated against the wishes of his parents. Six outbreaks are ongoing in the US and seventy-one people have been infected in Washington state, where an outbreak took hold this year in Clark County, an anti-vaccination “hot spot”. Experts are warning that this trend could lead to a nation-wide outbreak.
In Europe, measles have also reached thehighest levels in two decades. The WHO reported 72 deaths from measles in 2018. An unvaccinated French 5-year-old recently reintroduced the disease to Costa Rica. An outbreak in one Jewish community in New York began when an unvaccinated child returned home after contracting the disease in Israel. The disease can spread fast and easy.
Measles arehighly contagious and can remain in the air of a room where an infected person was present for as long as two hours after they have left. Although most people recover completely, it can cause some serious complications such as encephalitis, meningitis, febrile convulsions, pneumonia, severe diarrhea, vision loss or liver infection. Vaccination has helped reduce the occurrence of measles to a minimum.
“It is in some sense a victim of its own success,” the Emory professor said of the vaccine. “It’s hard to see the benefit if you don’t see the disease.”
Suzinne Pak-Gorstein, a pediatrician in Seattle and a professor at the University of Washington, said public awareness had grown since Washington Gov. Jay Inslee, declared a state of emergency in January. Still, she is not pleased that a crisis had to appear before residents start protecting themselves and the government took a step in the right direction.
“People forget that they should be worried, and then, here we go again,” she said. “I do blame our non-vaccinated population, which has been scared by unfounded links to autism, which have been shown to be false.”
Almost a decade after the journal, in which Wakefield published his findings, the Lancet, fully retracted his 1998 paper. Wakefield turned the criticism into a catchphrase for his 2010 book, “Callous Disregard: Autism and Vaccines – The Truth Behind a Tragedy,” which represents the main literature for the anti-vaccination movement. The book was reprinted in 2017 and is selling well on Amazon as “Preventive Medicine”. It seems in today’s America, Wakefield’s platform has expanded.
There were numerous attempts to stamp out misinformation about the vaccine including a similar study conducted in 2002. These efforts haven’t been successful and the situation is getting worse.
“The question to my mind is should we continue to do more studies on this topic or is the uncertainty that is needed for having a researchable question gone at this point,” Omer said. “This new study isn’t going to change anyone’s mind.”
Researchers hope focusing on developing communication strategies and behavioral science interventions (deployed by clinicians) will help. At the moment, patients can opt to get vaccinated or not. Consequently, requiring patients to opt out of vaccines would increase protection. Furthermore, the practice of “presumptive communication” in which clinicians frame immunization as an expectation, rather than an option, should also contribute to better protection.
“So it would be, ‘Time for little Johnny to get vaccinated,’ instead of, ‘Should little Johnny get vaccinated?’” Omer said. “That sort of framing has an effect.”
Learn more about why parents fear vaccines in the video below:
By Andreja Gregoric, MSc