Posted on by rjonakait

So Many Unanswered Questions (II)

My last post discussed some unintended consequences from policy decisions made during the Covid pandemic. One issue was the misinformation and disinformation that occurred during the period and raised the question of who should be the arbiter of “truth” and how it should be determined for such public health-related policies. One continuing issue of dangerous misinformation has arisen during the tenure of Robert F. Kennedy, Jr., as head of the Department of Health and Human Services. It surrounds the controversial issue of vaccinations.

The controversy appears to have begun in 1998 when Andrew Wakefield and colleagues famously published in The Lancet, one of the world’s leading medical journals, case studies that purported to show a link between the measles, mumps, and rubella vaccine and autism. Many, many other studies in response, however, found no connection between autism and the MMR vaccine. Further investigation showed that Wakefield had conflicts of interest and that he had altered patient medical histories and fabricated data. In 2004, Wakefield co-authors partially retracted the 1998 conclusions, and in 2010, The Lancet unconditionally retracted the original paper. Also in 2010, Wakefield was stripped of his license to practice medicine in the United Kingdom because of his serious professional misconduct. Study after study since then has shown that the MMR vaccine does not cause autism.

This story is recounted by Kira Ganga Kieffer in Unvaccinated Under God: Religion and Vaccine Hesitancy in Modern America (2026). She also presents the depressing news that more than a decade after Wakefield’s paper was withdrawn and dozens of studies showing it was wrong, one in three Americans believe the MMR vaccine causes autism. Kieffer makes clear that this scenario is not limited to that one vaccine. After the Covid vaccine was developed, stories circulated that it was unsafe. As information poured in, however, it became clear that not only was the Covid vaccine efficacious, it was safe with only very rare, and almost always minor deleterious side effects. Even so, Kieffer reports that few people who had believed the vaccine was dangerous changed their minds even in the face of the mounting data that their belief was wrong.

Kieffer identifies a part of human nature that tends to reject information that is unsatisfying. We want to know the cause of an infirmity. I have a cold or the flu. Who gave it to me? My child has autism. What is the cause? It gives some parents satisfaction to tell them that it was the MMR vaccine. Information tends to be rejected that says that the cause is unknown, but it was not that vaccine. Similarly, what caused my recent illness? Oh, I had the Covid vaccine just before I got sick. The vaccine must have caused it.

While we should be grappling with the rejection of good information for misinformation and disinformation, the problem is only getting worse. We now have a government that regularly promotes misinformation and disinformation not just on healthcare issues but on many topics. Steven Macedo and Frances Lee, who are critical of many Covid policies in their book, In Covid’s Wake: How Our Politics Failed Us (2024) also maintain it is hard to credit what Trump and Republicans say when they are election deniers, climate change skeptics, and deny structural racism.

Macedo and Lee also discuss the difficult weighing of the health benefits of the Covid policies against their negative collateral consequences. Kieffer raises another difficult balancing act for vaccines generally.

In the 1960s and the 1970s every state mandated the immunizations recommended by the Centers for Disease Control for school attendance but also allowed non-medical exemptions for religious or personal reasons. According to Kieffer, few exemptions were sought until the 2010s when some ultra-orthodox Jewish communities and some evangelical Christians, groups already prone to government opposition, adopted vaccine hesitancy as a moral or religious commitment. Vaccine mandate exemptions have since increased. They get support from some government officials such as Rand Paul, who has denounced such mandates as violations of parental rights. Kieffer states that an animating issue for Covid vaccine hesitancy was not so much the safety of the vaccine but the question of personal liberty.

The vaccine resisters, however, have still benefited from vaccines. When enough other people get vaccinated, herd immunity develops and both the vaccinated and unvaccinated benefit. If there are enough resisters, however, herd immunity breaks down. Resisters may say it is my choice not to take the vaccine. I risk the consequences. You can get vaccinated, and you will be protected. There are flaws in this logic, however. Vaccines often are not given to infants in the first year of life. Normally, they are protected by herd immunity, but they will not have that protection if many do not get vaccinated. Furthermore, while the vaccines are efficacious, the efficacy is never 100%. Even a small number of the vaccinated can get the disease.

The decision not to be vaccinated is not just a personal choice; it affects society as a whole. A difficult question then becomes when do claims of “religious freedom,” “personal liberty,” and “parental rights” outweigh societal safety?

Posted on by rjonakait

“For Example” is not Proof. Yiddish Proverb

We have had an outbreak of measles even though a vaccine had seemingly eliminated this childhood disease. A lot of people don’t have their children vaccinated, putting their offspring and other people’s babies, who are not normally vaccinated in the first year of their lives, at risk for the disease.

One outbreak has been in orthodox Jewish communities where parents cite religious beliefs for the lack of vaccinations. I do not know what these religious beliefs are, but I don’t think measles or vaccines are mentioned in the Hebrew Bible. Other parents claim a non-religious personal belief for the failure to vaccinate. Many of these people believe the canard that the measles vaccine causes autism.

This belief can be traced to Andrew Wakefield, then a gastroenterologist, who published a paper in the prestigious British medical journal Lancet in 1998, linking the MMR (measles, mumps, and rubella) vaccine to autism in eight children. A dozen years later, a British medical agency found Wakefield had committed professional misconduct and revoked his medical license, and Lancet retracted his study.

Almost a dozen studies since Wakefield’s paper have examined the connection between the vaccine and autism. None found a link. The latest and largest study was of 657,461 Danish children between 1999 and 2010. It, too, found that the vaccine did not cause autism, but it noted that autism often appears at about twelve months, the time when the vaccine is first given, leading to the unwarranted conclusion that the vaccine and autism are connected.

The United States National Vaccine Injury Compensation Program, a no-fault system started in 1988, covers claims related to fifteen childhood vaccines and seasonal flu shots. That program’s data show that during the last dozen years, over 126 million doses of measles vaccine have been delivered, but only 284 people have lodged claims with NVICP about harm from it. A mere143 claims were found to be meritorious.

The vaccine does not cause autism, and other harms from the vaccine are exceedingly rare. On the other hand, measles itself is much more dangerous than the vaccine. Hundreds of people die from measles each year around the world. Before the vaccine in 1963, 3 to 4 million people were annually infected in the U.S. with the measles causing 400 to 500 annual deaths. About one in four who get measles are hospitalized, and one to two out of a thousand are likely to die. Why, then, do parents put their children, and other children, at risk of measles?

Part of the reason is a mistrust of government and other “official” institutions. I saw that in strange way in the recent college class I taught when the measles vaccine was discussed. A student said that it was only natural that people were leery of vaccinations and referred to Osama bin Laden and the polio vaccine. I looked up some old news articles that indicated that our CIA had used a hepatitis B vaccination campaign to help locate the al Qaeda leader by seeing if the DNA of vaccinated people in a certain compound were his relatives, and this CIA initiative had added fuel to a Pakistani movement against the polio vaccine. I did not understand this story’s relevance to the measles vaccine. I am not aware of the anti-vax people in the U.S. citing the hunt for bin Laden as a reason for not vaccinating their children, but the comment, while not entirely correct in its details, conveyed a suspicion of governments that has prevented vaccinations. On the other hand, such suspicion does not undercut the fact that the measles, polio, and hepatitis B vaccines work, and that their benefits far outweigh any harms. The real takeaway from the bin Laden story is that Pakistan is now facing a polio outbreak because parents have an irrational fear of the vaccine.

(continued July 24)