How vaccine scares respect local cultural boundaries.

April 24th, 2013 by Ben Goldacre in africa, bad science, book, MMR | 16 Comments »

I was on Newsnight this evening, discussing the measles outbreak in Swansea, and how we can get people vaccinated with MMR when they’ve previously refused. In my view: prevention is better than cure, it’s hard to reverse a scare story once the toothpaste is out of the tube, and we must innoculate ourselves against future vaccine scares, because they will come. That’s why services like Behind The Headlines are important. Here’s the video:

www.bbc.co.uk/iplayer/episode/b01s5bn7/Newsnight_24_04_2013/

At the end, Jeremy Paxman seemed (endearingly) amazed to hear that vaccine scares respect local cultural boundaries. Here’s what I was discussing, in an extract from my first book Bad Science (this bit’s from pages 292-4 of the red paperback):

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Vaccine scares in context

…Before we begin, it’s worth taking a moment to look at vaccine scares around the world, because I’m always struck by how circumscribed these panics are, and how poorly they propagate themselves in different soils. The MMR and autism scare, for example, is practically non-existent outside Britain, even in Europe and America. But throughout the 1990s France was in the grip of a scare that hepatitis B vaccine caused multiple sclerosis (it wouldn’t surprise me if I was the first person to tell you that).

In the US, the major vaccine fear has been around the use of a preservative called thiomersal, although somehow this hasn’t caught on here, even though that same preservative was used in Britain. And in the 1970s – since the past is another country too – there was a widespread concern in the UK, driven again by a single doctor, that whooping-cough vaccine was causing neurological damage.

Looking even further back, there was a strong anti-smallpox-vaccine movement in Leicester well into the 1930s, despite its demonstrable benefits, and in fact anti-inoculation sentiment goes right back to its origins: when James Jurin studied inocu- lation against smallpox (finding that it was associated with a lower death rate than the natural disease), his newfangled numbers and statistical ideas were treated with enormous suspicion. Indeed, smallpox inoculation remained illegal in France until 1769. Even when Edward Jenner introduced the much safer vaccination for protecting people against smallpox at the turn of the nineteenth century, he was strongly opposed by the London cognoscenti.

And in an article from Scientific American in 1888 you can find the very same arguments which modern antivaccination campaigners continue to use today:

The success of the anti-vaccinationists has been aptly shown by the results in Zurich, Switzerland, where for a number of years, until 1883, a compulsory vaccination law obtained, and small- pox was wholly prevented – not a single case occurred in 1882. This result was seized upon the following year by the anti-vacci- nationists and used against the necessity for any such law, and it seems they had sufficient influence to cause its repeal. The death returns for that year (1883) showed that for every 1,000 deaths two were caused by smallpox; In 1884 there were three; in 1885, 17, and in the first quarter of 1886, 85.

Meanwhile, WHO’s highly successful global polio eradication programme was on target to have eradicated this murderous disease from the face of the earth by now – a fate which has already befallen the smallpox virus, excepting a few glass vials – until local imams from a small province called Kano in north- ern Nigeria claimed that the vaccine was part of a US plot to spread AIDS and infertility in the Islamic world, and organised a boycott which rapidly spread to five other states in the country. This was followed by a large outbreak of polio in Nigeria and surrounding countries, and tragically even further afield. There have now been outbreaks in Yemen and Indonesia, causing lifelong paralysis in children, and laboratory analysis of the genetic code has shown that these outbreaks were caused by the same strain of the polio virus, exported from Kano.

After all, as any trendy MMR-dodging north-London middle-class humanities-graduate couple with children would agree, just because vaccination has almost eradicated polio – a debilitating disease which as recently as 1988 was endemic in 125 countries – that doesn’t necessarily mean it’s a good thing.

The diversity and isolation of these anti-vaccination panics helps to illustrate the way in which they reflect local political and social concerns more than a genuine appraisal of the risk data: because if the vaccine for hepatitis B, or MMR, or polio, is dangerous in one country, it should be equally dangerous everywhere on the planet; and if those concerns were genuinely grounded in the evidence, especially in an age of the rapid propagation of information, you would expect the concerns to be expressed by journalists everywhere. They’re not.

 


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16 Responses



  1. sam said,

    April 25, 2013 at 8:19 am

    Newsnight link at BBC iPlayer is here:

    www.bbc.co.uk/iplayer/episode/b01s5bn7/Newsnight_24_04_2013/

    Full piece starts at 01:25, interview with Ben and co at 08:23.

  2. DeborahCowell said,

    April 25, 2013 at 7:59 pm

    Hi Ben. Good points, but I’m not convinced that MMR and autism is insignificant in the US, especially since the arrogant self-publicist that is Wakefield set up his fiefdom there. I happened to write a review on Amazon.com giving my succinct opinion of the ‘children’s’ book Melanie’s Marvelous Measles, and since I wrote it fairly early on in the outrage about it, it comes up as the most helpful review. I have been stalked by the antivax crew, in particular one Cia Parker, who thinks vaccinations cause all ills, Wakefield is a demi-god, and that MMR not only causes autism (which in her world did not exist before vaccinations) but maims and kills more than it saves. It was bait of an eye-opener on the American viewpoint, and a rather scary one.

  3. Ben Goldacre said,

    April 25, 2013 at 8:12 pm

    Hi, the US MMR scare happened much later than ours (and has tended to be built more around thiomersal, as I said above).

  4. DeborahCowell said,

    April 25, 2013 at 8:28 pm

    True, although the aforementioned stalker does at least know that thiomersal was never used in MMR, and it doesn’t stop her ranting about it. Do you think it occurred later because Wakefield moved there, or is it a Jenny McCarthy/Jim Carey thing?

  5. sickpuppy said,

    May 12, 2013 at 7:01 am

    I recently was looking at old newspapers form 19111 in county meath ireland. In it was lots of “letters to the editor” saying Jenner wasn’t a “real” doctor and this was a money making scam by the rich . Big pharma conspiracys existed back then too

  6. whisperingmum said,

    May 12, 2013 at 5:43 pm

    P.S. To clarify – I don’t live in the States at the moment but my husband is American and we have four children aged six and under so this is an understandably important issue for us!

  7. whisperingmum said,

    May 12, 2013 at 5:47 pm

    Sound Choice are looking for ethical alternatives rather than completely anti-vaccine I should add.

  8. jdc said,

    May 21, 2013 at 7:32 pm

    Whisperingmum – do you mean this Sound Choice: Sound Choice Twitter account?

    “Autism rates have skyrocketed to 1 in 50. Stop using aborted fetal cells for vaccines now!”

    “Isn’t the CDC paid based on how many children are vaccinated? Can we trust their data on vaccines and autism?”

    “CDC vaccine autism study like saying smoking doesnt cause cancer b/c among a group who smoke the same amount, some get cancer and some dont”

    Forgive me for being skeptical, but I’m not sure Sound Choice are simply looking for ethical alternatives. It looks to me like they’re talking absolute bollocks and scaremongering about vaccines & autism.

  9. Alec Duncan said,

    June 2, 2013 at 4:03 pm

    I take issue with the assertion that the Autism/MMR scare is limited primarily to the UK. It is huge here in Australia, and is widely promulgated by such anti-fax groups as the (misnamed) Australian Vaccination Network.

    As a result, MMR rates have fallen catastrophically, particularly in certain parts of NSW. And, not coincidentally, measles has had two outbreaks in recent years, in areas of low vaccination rates.

    Further, social networking sites like Facebook have been used to spread all the other lies and misinformation of the anti-vaxxers.  It is a very rare day that my newsfeed does not include a number of so-called “information posters”, full of the lies of these dangerous lunatics.

    The posters come from all over the world, from all the usual suspects, not just the AVN. The power of social networking to spread these lies in a matter of hours is astonishing. I see them take hold and go mini-viral: hundreds of shares, thousands of likes, multitudes of approving comments.

    The net has changed: once these lies were only to be found on the actual websites of the anti-vaxxers. That was bad enough, but at least their audience was limited to those who sought them out. Now there is a well-organised and powerful lobby who spread it via Facebook. And that means all their friends see this material too.

     Those friends may not yet be confirmed anti-vaxxers; they probably aren’t yet convinced. But the more they see these posters, the more likely they are to catch the anti-vax madness. The posters look superficially convincing to people without knowledge of the science, and they play on parents’ fears.

    There are many groups and Pages on Facebook that try to counter the misinformation, but unfortunately they do not have the reach and influence of the opposition.  Sometimes I despair.

  10. ianf said,

    June 12, 2013 at 3:02 pm

    Its not rocket science MMR / autisim is the story its time to get over it ; if we REALLY want to get kids vaccinated then off a choice old style single jabs or mmr.

    While the courts are not the place to decide Science Italy the UK and the USA have held the mmr jab liable for vaccine damage to children

  11. Joe Choi said,

    June 19, 2013 at 6:30 am

    I think fear of vaccines comes from quite a few places. First, people fear technology they don’t understand, even if it beneficial (vaccines are technological). Second, people distrust the sources of those vaccines, making it even harder to implement.

    Still, we can’t force them to take something they don’t want. It’s unjust to have the children suffer for their communities beliefs, but the children are the communities responsibility in the end. www.legalmatch.com/law-library/article/vaccine-lawsuits.html

  12. lnd1985 said,

    July 10, 2013 at 9:52 pm

    In an exerpt from your new book you state…
    “Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects.”

    I would assume this applies to vaccines too? And if so is it so far fetched to think they may not be as safe and effective as we have been led to believe?

  13. stv said,

    July 19, 2013 at 7:11 am

    You are intelligent person but in the case of Vaccination you appear more like a “Cross dresser”.
    Vaccines are “evidence based” the same way as many other medicines are, and you are very well aware of the issue. In addition, there is the fear and pressure tactics on public to comply, in the name of prevention. These are long time Big Pharma or rather H(p)arma tactics and some of their drug salesman also known as Physicians. What next? Everyone gets a chemo treatment in the absence of any disease for the prevention of cancer? Cancer is more prevalent in most societies than any other disease (- cardio); one in three or one in four, will suffer from, depending on how’s evidence you side on with.
    Vaccines are as useful as bloodletting in the past or for more contemporary “science based” Monsanto’s GMO food. They are both a ploy.
    This aside I do enjoy your articles.

  14. JPH said,

    August 13, 2013 at 4:15 am

    I’m a bit concerned about this link that is currently making the rounds on facebook:

    www.trueactivist.com/courts-quietly-confirm-mmr-vaccine-causes-autism/

    The court cases they list include one, where the reaction was encephalitis (which is a known risk for a few vaccinations, but a much lower risk than the illness of course) and the 2nd involves a girl with a mitochondrial disorder.

    People are seeing this presentation as a strong vindication for their original fears, and I worry that it will start all over again.

  15. loushillito said,

    October 9, 2013 at 11:32 am

    I think fear of Mercury is now prevalent here in Britain.

    A lady the other day told me the had seen babies ‘poisoned’ by the mercury [that isn’t] in vaccines.

    So- do you have any words of wisdom on convincing vaccine-refusers? It seems as futile as trying to persuade creationists about evolution to me………..

  16. tst350 said,

    December 1, 2013 at 9:48 pm

    I’m afraid that you people are no wiser than the Bad Pharma-phyles against whom you rally.

    Hep B vaccine DOES cause MS. It also causes diabetes, Lupus, RA, and a host of other diseases. This is because it is such a deadly poison that it destroys the body’s ability to fight off anything to which you might be susceptible. It destroys your health – sometimes slowly – sometimes right away. But it’s always poison.

    Next to Gardasil, Recombivax might be one the deadliest health hazards in our society.

    I wish I had read this blog before spending all that money on my new Goldacre books!

    Mr. Shillito – You certainly do seem to know it all. You should go work for Big Pharma yourself. I’m sure they’d love to have you.