America’s lethal fear of science

A rare, deadly and highly contagious disease is spreading across the United States, having infected more than 100 people since the beginning of the year, with thousands more at risk.

This is not the doomsday Ebola scenario that so many were envisioning when the first case in the US was diagnosed five months ago. The resurgence is of the measles — a disease that the US Centres for Disease Control and Prevention declared eradicated in 2000, thanks to a highly effective and safe vaccine.

What went wrong?

Since 2000, measles cases in the US have been attributed largely to travellers bringing the disease into the country. In recent years, however, measles has become increasingly common, with the number of cases climbing above 150 in 2013, and then jumping to 644 last year — the most cases recorded in a single year since the late 1990s.

This year already appears likely to top that record.

The upsurge in cases can be explained largely by the increase in the number of unvaccinated children. Americans are learning the hard way that scientifically baseless scepticism about the safety of vaccines is extremely dangerous.

Measles may have a lower mortality rate than Ebola, but its potential to inflict suffering and death — especially on young children — remains considerable.

Indeed, before vaccination made measles a rarity, the disease was widely feared, killing thousands of children every year.

The tragic irony of vaccination in America is that it has become a victim of its own success.

As the number of people who have witnessed firsthand the effects of measles and other childhood diseases — such as mumps, rubella, polio and whooping cough — has declined, so has society’s commitment to keeping them away.

Even after panicked claims that vaccines cause visible conditions like autism were proved to be nonsense, they remain more compelling than the threat of a disease that people have never seen or do not remember.

Of course, vaccinations can have some side effects, such as a rash, fatigue, headache or a fever. But claims that significant, permanent damage resulting from vaccines is widespread are entirely unfounded.

Andrew Wakefield first claimed that there was a relationship between the measles, mumps and rubella vaccine, and autism in 1998. But it soon came to light that he had falsified his evidence, and his “research” was retracted.

Wakefield was later banned from practising medicine in his home country, the United Kingdom, for “serious professional misconduct”.

But the damage had been done.

Despite Wakefield’s ostracism from the medical community and the exposure of his deceptions — not to mention numerous scientific studies that did not find any link whatsoever between vaccines and autism — he has retained a devoted
following in the US.

Making matters worse, irresponsible and ignorant celebrities have seized upon his lies, using their access to the media to spread conspiracy theories and propaganda against vaccinations.

As a result, vaccination rates continue to decline — and in some communities, especially in California and Oregon, they have plummeted.

From 1996 to 2015, there was a
sixfold increase in the rate of vaccine exemptions for students entering elementary school in California. This has contributed to the spread not only of measles, but also of whooping cough and mumps.

Parents argue that vaccination, like all other decisions about how to raise and care for their children, should be their choice. But when it comes to vaccination, one family’s poor judgement can mean sickness or even death for another’s.

When enough members of a community are vaccinated, a sort of “immunity buffer” is created, adding an extra layer of protection for vaccinated individuals, while shielding those who are not eligible for particular vaccines, such as infants or people with compromised immune systems — individuals for whom disease-mortality rates are highest.

This phenomenon is called “herd immunity” and it has been vital to vaccines’ effectiveness.

This is not the first time that the American public has allowed fear to dictate public policy.

Just a few months ago, Americans were terrified that Ebola could take hold in their country. Rather than providing responsible leadership, politicians like New Jersey Governor Chris Christie and Senator Rand Paul of Kentucky stoked the panic in an effort to win support in advance of last November’s mid-term elections.

Experts’ attempts to impress upon Americans how difficult Ebola is to transmit, and how unlikely an Ebola epidemic in the US was, fell largely on deaf ears.

Today, Americans are again refusing to heed experts’ advice — only, this time, they really are facing a serious threat. Worse, politicians like Christie and Paul have tacitly (or not so tacitly) supported parents who choose not to vaccinate their children, regardless of the scientific consensus that such parents are contributing to a genuine public health crisis.

Paul — who is, ironically, a physician — went so far as to mention the many children he knew who suffered “profound mental disorders” after having had vaccinations, indulging the anti-vaccination advocates who might support him politically, while stopping short of making a false scientific claim. (By his logic, vaccines make people taller, too; after all, nearly every child I have known has grown taller after being vaccinated.)

The scientific method is perhaps the greatest arbiter of truth humanity has ever devised. We must trust in it to help make sense of an uncertain world, and to help us determine how best to nourish and protect our children and ourselves.

When parents are allowed — or, worse, encouraged — to choose fear over science, we all pay the price.

Abdul El Sayed is a professor of epidemiology at the Mailman School of Public Health, Columbia University. ©Project Syndicate, 2015. www.project-syndicate.org