Vaccination refers to the administration of antigenic material (the ‘vaccine’) to stimulate an individual’s immune system to develop adaptive immunity to a pathogen. The method was trialed by Edward Jenner in the eighteenth century, to develop a vaccine against smallpox.
While vaccines help to protect people against a range of diseases, any vaccine can cause side effects. Generally these are minor (for example, a sore arm or low-grade fever) and they tend to disappear within a few days. Weighing up the side effects against the potential protection, the suffering with the disease that the vaccine protects the individual from is always worse that the side effects.
The World Health Organisation has described the two public health interventions that have had the greatest impact on the world’s health are clean water and vaccines. Despite this, not everyone chooses to receive vaccines and, most importantly, some parents make decisions not to have their children vaccinated. For some, this is based on the belief that the body can develop immunity and fight infection; for others, this is due to concern with potential side-effects (autism is sometimes called out as a potential side effect). The bulk of medical opinion is that vaccines are safe and links to effects like autism are tenuous and ill-supported.
In the U.S., public health officials and physicians have been combating misconceptions about vaccine safety for over twenty years. The autism misconception has probably accounted for a fall in rates of vaccination, particularly against whooping cough and measles.
The concern that vaccines increase risk of autism began with a 1997 study published by Andrew Wakefield, a British surgeon. This paper specifically looked at the the combined measles, mumps, and rubella (MMR) vaccine. This study has since been discredited and the findings unsupported. The Lancet, which published the original paper, went onto declare the vaccine–autism connection as “perhaps the most damaging medical hoax of the last 100 years.”
Additionally, according to the U.S. Centers for Disease Control and Prevention (CDC) multiple studies have shown that there is no link between receiving vaccines and developing autism spectrum disorder.
This weight of evidence makes a recent comment by U.S. President-elect Donald Trump somewhat worrying. According to BioPharma Reporter, Trump has said he supports lower vaccine dosages and longer administration schedules. This is because he appears to accept the autism connection, despite medical evidence against this. Trump’s position seems to match his general anti-establishment rhetoric.
While being anti-establishment may be appropriate on some economic issues, those within the science and medical fields have, for many years, been attempting to place evidence-based medicine at the forefront of health and medical decisions. This stands mid-way between the claims of the pharmaceutical sector and the concerns and observations of the general public. Evidence-based medicine is centered on carefully constructed clinical trials in which the results are independently evaluated using proven statistical techniques. One of the leading proponents of this approach is Dr. Ben Goldacre who runs the website ‘Bad Science.’ Essentially the evidence approach seeks to ensure that a clinician’s opinion, which may be limited by knowledge gaps or even biases, is reinforced with available knowledge from the scientific literature in order that best practice can be determined and applied.
Whether Trump will attempt to push through changes to vaccinations in the U.S., and seek to change the stance of the CDC remains to be seen. If he does so, it will unravel twenty years of accepted medical evidence and it will probably lead to further confusion and the risk of greater pathogen spread within the U.S.
