Would you trust your kids with this man? No? I didn't think so.

Today I want to shine a bit of light on the conspiracy theorist behind the film "Vaxxed" and its recent sequel, "Vaxxed II." I'm not going to provide any links to the movie, or to describe it, except to say that it's a slickly-produced conspiracy theory masquerading as a documentary. Don't watch it.

Anti-vax activists often use conspiracy theory tactics, which work like this: they simply make up a claim, out of thin air, that a secret cabal of doctors (or government scientists, or pharma companies) is out to harm patients by giving them vaccines, and is hiding the "truth" about the risks of vaccination. Never mind how irrational this is, and never mind that there's not a shred of evidence behind it: if you try to argue with the anti-vaxxer, you're part of the conspiracy.

So rather than try to disprove something that was never proven in the first place, let's look instead at the source of the anti-vax propaganda film, "Vaxxed." The source is one man: Andrew Wakefield. Who is this guy, and why is he so obsessed with vaccines?

Wakefield was once a doctor, before he had his license revoked a decade ago. In his former life, he was a gastroenterologist, with no special training in vaccines or infectious diseases. He first gained fame–a lot of fame–for a 1998 paper in a medical journal, The Lancet, in which he claimed to have discovered a link between the MMR vaccine (that's the one that covers measles, mumps, and rubella) and autism.

Here are some things you need to know about Wakefield before watching his movie:

1. Wakefield's 1998 paper, it eventually turned out, was "an elaborate fraud." Wakefield defrauded the public, his patients, and even his own co-authors on the paper, most of whom were unaware of his elaborate conflicts of interests.
2. Before he published his 1998 study, Wakefield was hired by a lawyer, Richard Barr, who was trying to build a lawsuit against vaccine makers. Barr paid Wakefield £435,000 (equal to $750,000 US dollars at the time) to help him build his case. Wakefield's co-authors were unaware of this contract.
3. The study claimed that 8 out of 12 children had been diagnosed with autism soon after getting the MMR vaccine. It described these children as "a consecutive series" of admissions to the hospital where Wakefield worked. That was a lie. It turned out, as investigative journalist Brian Deer revealed, that all 12 children and their parents were referred to Wakefield by Barr–the lawyer who was paying Wakefield to conduct the study, and who was trying to sue vaccine makers.
4. Wakefield also falsified data on all 12 of the children in his original study.
5. Wakefield conducted "invasive and distressing procedures" on the children without approval from his hospital's ethics board.
6. After learning some of the back story, 10 of his 12 co-authors tried to retract the paper in 2004. Wakefield refused to join them, so they published a partial retraction, signed by the 10 co-authors. The Lancet itself later fully retracted the paper (over Wakefield's objections), but it took until 2010 for them to act. By then, the anti-vax movement had spread widely.
7. Prior to publishing his paper, Wakefield filed a patent claim for a "safer" vaccine for measles, one that would have profited him greatly once he discredited the (perfectly safe) MMR vaccine.
8. After losing his license in the UK, Wakefield moved to Austin, Texas where he ran an organization called Thoughtful House, through which he paid himself a salary of $280,000. (Perhaps coincidentally, Austin is now a hotbed of anti-vaccination activism.)

For more than 20 years, Andrew Wakefield has made money off false claims that vaccines cause autism, first put forth in his discredited 1998 paper. He gives talks, writes books, conducts seminars, and now makes movies, of which make him money. Since the publication of his paper, dozens of studies involving literally millions of children have shown, time and again, that vaccines do not cause autism. Wakefield has denied every one of those studies, and continues to push his bogus claims.

(Why, you might ask, have scientists conducted studies looking for a link between autism and vaccines, if there was never any evidence for such a link? The answer is simple: anti-vaxxers have been so successful at scaring people about a nonexistent threat that scientists and public health experts felt it necessary to conduct those studies, in order to reassure people. Literally millions of dollars have been spent to prove something we already knew.)

Meanwhile, measles outbreaks have appeared with increasing frequency in the U.S., the UK, other European countries, and around the world, including the deadly outbreak in Samoa late last year, which caused 5,700 infections and 83 deaths in a population of just 200,000. Wakefield's new movie was released in the middle of that outbreak.

So to anyone who watched the movie Vaxxed and is now having doubts about vaccines, I ask: would you trust your children with this man? I wouldn't.

Measles is back. Blame the anti-vaxxers.

In the year 2000, the CDC announced that measles had been eliminated from the U.S. This was a fantastic public health achievement, made possible by the measles vaccine, which is 99% effective and which has virtually no side effects.

Unfortunately, measles is back. Just last week, the CDC announced that we've had at least 695 cases this year, the most since 2000, primarily from 3 large outbreaks, one in the state of Washington and two in New York. Because the CDC's surveillance is far from perfect, the true number of measles cases is likely much higher. And we're only four months into the year.

Also this week, UCLA and CalState-LA had to quarantine over 700 students and staff members who were exposed to measles from an outbreak in the Los Angeles area. At UCLA, one student who had measles attended multiple classes while still contagious, exposing hundreds of others to the highly contagious virus, according to a message from the university's chancellor.

No one has died as of yet, but if we don't quash these outbreaks, it's only a matter of time before someone will die. Measles has a fatality rate of 0.2%, or 2 deaths per thousand cases. That may sound small, but it's truly frightening when you consider that the U.S. had an estimated 500,000 cases per year before the vaccine was introduced in 1963.

Given the risks of measles, and given the remarkable effectiveness and safety of the vaccine, why don't people vaccinate their children? The primary reason is simple: it's the highly vocal, supremely confident, and utterly misinformed anti-vaccine movement. Anti-vaxxers spread their message daily on Facebook, Twitter, websites, and other media outlets. (I will not link to any of them here because I don't want to increase their influence.) They have launched systematic efforts throughout the U.S. and in other countries to convince parents not to vaccinate their children, claiming that vaccines cause a variety of harms, none of which are correct. (I won't list those here either, because even mentioning them gives the claims credibility.)

In one of the two outbreaks in New York, anti-vaxxers distributed highly misleading pamphlets in an effort to convince parents in an ultra-religious Jewish community not to vaccinate their kids. The anonymously-published pamphlet was "filled with wild conspiracy theories and inaccurate data," but it seems to have worked, as least among some of the parents.

The anti-vax movement is also behind the state-by-state effort to allow parents to opt out of vaccinations for their children in public schools. We're finally seeing some states roll this back, but it is still far too easy for parents to claim an "ethical" or "religious" exemption, allowing them to put their unvaccinated kids in school and thereby expose countless other children to measles and other preventable diseases. (I put those words in quotes because there is no valid ethical or religious objection to vaccines. All major religions strongly support vaccination.) Anti-vax websites provide how-to instructions telling parents how to get exemptions for their kids, and a small number of anti-vax doctors (I'm looking at you, Bob Sears) readily dispense large numbers of anti-vax exemptions. This needs to end.

The modern anti-vaccine movement started in 1998, with a fraudulent paper about the measles, mumps, and rubella vaccine, published by a former doctor who lost his medical license after the fraud was revealed. The lead author was eventually revealed to have taken large sums of money (unbeknownst to his co-authors) from lawyers who were trying to build a case to sue vaccine makers. That same ex-doctor, who I also won't name here (his initials are AW), is now a hero to the anti-vax movement, and he travels the world spreading his toxic message. He's even made an anti-vax movie.

I sincerely hope we won't see any children die before the anti-vaccine movement finally goes away. For any parents who are thinking that they won't vaccinate their kids, I urge them to read the heartbreaking words of Roald Dahl (author of Charlie and the Chocolate Factory, The BFG, and many other wonderful books), whose oldest daughter Olivia died of measles in 1962, at the age of seven:

"...one morning, when [Olivia] was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn't do anything.

'Are you feeling all right?' I asked her.

'I feel all sleepy,' she said.In an hour, she was unconscious. In twelve hours she was dead.The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her." 

The measles vaccine was a miracle of modern medicine, and it's been administered safely to hundreds of millions of people. Measles is a dangerous illness, but we can prevent it. No parent should have to go through what Roald Dahl went through.

Anti-vaxxers use religious exemptions as false cover for their beliefs

History of measles in the 20th century.

For several years now, anti-vaxxers have been claiming that they have religious objections to vaccines. This is nonsense.

Just last month, the New England Journal of Medicine featured an article describing how the federal Equal Employment Opportunity Commission (EEOC) has been suing hospitals that deny employee requests for religious exemptions to the hospitals' vaccination requirements. The NEJM documented 14 cases where employees sued claiming that they had religious objections to the flu vaccine. Six of the cases were settled, and in the other cases, sometimes the hospital won, sometimes the employees. It's a mess.

The NEJM article focused on the legal perspective, advising hospitals on how they might avoid lawsuits. That's understandable, but it misses the broader point: there's virtually no such thing as a religious objection to vaccines. All of the world's major religions support vaccination, and only a few tiny, extremist sects teach their followers that vaccines are contrary to their faith.

What's really going on is that anti-vaxxers are using religious exemptions as cover for non-religious (and erroneous) objections to vaccines. The anti-vaxxers have convinced people that vaccines are harmful, or scary, or both. They are wrong.

Vaccines are the probably the greatest success story in the history of medicine. They've saved millions of lives. Consider that in the decade before the measles vaccine was introduced in 1963,

"3 to 4 million people in the United States were infected each year [and] an estimated 400 to 500 people died, 48,000 were hospitalized, and 1,000 suffered encephalitis (swelling of the brain) from measles." (Source: CDC)

And that's just measles. People no longer suffer and die from smallpox and polio, which have been eradicated worldwide (except for a few countries where polio still has a foothold). Vaccines protect us from multiple other formerly common childhood infections, and they've been so effective that people are no longer afraid of these diseases. That very success is the opening that the anti-vaxxers use to spread disinformation and fear.

It's not just the EEOC that has been enabling anti-vaxxers. Many U.S. states have passed laws that allow religious exemptions to vaccination. (Note that vaccines are required before children can enroll in public school systems, an incredibly important public health requirement. The exemptions refer to this requirement.)

Here, though, there are signs of hope. After suffering from repeated outbreaks of preventable diseases like measles, many states have recently awakened to the risks caused by unvaccinated children in public schools, and they are moving to remove or tighten these exemptions.

New Jersey is the latest state to act. While the bill introduced in the New Jersey legislature last week doesn't quite eliminate religious exemptions, it makes them harder to get, requiring considerably more documentation from parents claiming a religious exemption from vaccines for their children. NJ took action after realizing that these so-called "religious" objections had risen dramatically, from 3,865 in 2009 to 10,407 in 2016. That rise was fueled, apparently, by anti-vaxxers taking advantage of the loophole in the law, not by any genuine religious objection to vaccines.

It's worth noting that all states allow medical exemptions to childhood vaccination, which are legitimate and necessary. For example, a child undergoing leukemia treatment may have a severely weakened immune system, and a vaccine would be ineffective and possibly harmful. These children are precisely the ones who can only be protected by requiring all the other children in their school to be vaccinated.

Meanwhile, the EEOC should stop suing hospitals. Hospitals are filled with very sick and vulnerable people, and employees have an obligation not to expose patients to possibly deadly infections. If a hospital employee doesn't take that obligation seriously, then s/he should find another job.

Germany takes action to stem measles outbreak. Anti-vaxxers to blame–again.

Measles is on the rise in Europe, driven by "vaccine gaps" which in turn are due to misinformation about the benefits of vaccines. Vaccines are possibly the single greatest contribution to human health in the past century. Literally millions of people are alive today who would not be, thanks to vaccines.

And yet: vaccine rates have dropped in recent years in multiple countries. In March, the BBC reported that measles had become endemic (meaning that it is self-sustaining, continuing to spread within the country) in France, Germany, Italy, Poland, Romania, Switzerland and Ukraine. The worst measles outbreak is in Romania, which reported over 3,400 cases and 17 deaths in just the first 3 months of this year.

Now measles is spreading in Germany, which is scrambling to contain it. Germany had 504 cases through mid-April, versus just 33 cases for the same period last year. At least one person, a young mother of three children, has died. The primary reason for the spread of the disease, as reported by the German news outlet RT, is unvaccinated individuals, and the reason their numbers are growing is simple: the anti-vaccine movement.

In the U.S., the anti-vaccine movement caused the worst measles outbreak in 20 years in 2015. The outbreak in Germany appears even worse, despite the fact that parents can be fined as much as €2500 ($2800) for failing to vaccinate their children. In a remarkable effort to try to get this outbreak under control, the German parliament has decided to require kindergartens to report parents who don't vaccinate their kids. Let's hope this works.

Vaccination is safe and remarkably effective, but the anti-vax movement is furiously trying to convince parents not to vaccinate. Their latest gambit is "Vaxxed," a conspiracy-mongering anti-vaccine screen produced by Andrew Wakefield, the notorious ex-doctor who published a fraudulent (and later retracted) study claiming that MMR vaccines caused autism. Nearly 20 years later, despite Wakefield losing his medical license because of his "elaborate fraud," he continues to push his debunked claims.

Fortunately, many people are now pushing back. Just last week, noted New Zealand physician Dr. Lance O'Sullivan jumped up on stage at a screening of "Vaxxed" to warn people in the audience that they were being defrauded. O'Sullivan was named New Zealander of the Year in 2014 for his efforts to bring health care to disadvantaged people in rural areas. I will close with his words from a Radio New Zealand story describing the dangers of vaccine refusal:

"We are trying to save a child's life, we put it on a helicopter, it flies to Starship Hospital. The kidneys are failing, its heart's failing, its lungs are failing. All because we didn't put a bloody $7.50 meningococcal vaccine into that child's thigh."

Anti-vax movement helps create worst year of mumps in a decade

The year isn't quite over yet, but we've already had 4,258 cases of mumps in the U.S., more than any year since 2006, when we also experienced a dramatic spike in cases. As the chart here shows, before 2006 we only saw a couple of hundred cases per year, but the numbers have been trending higher since then. After two years with about 1200 cases each, this year looks to quadruple last year's total when the final numbers come in.

Source: CDC, Morbidity and Mortality Weekly Report (MMWR), Notifiable Diseases and Mortality Tables

Just as in 2005, the outbreaks were centered in a few states, mostly on college campuses in the middle of the country, especially Iowa, Illinois, and Indiana. (The 6500+ cases in 2005 were mostly in or near Iowa and Illinois.)

Why are we seeing this increase?

At least some of the blame, if not all of it, belongs to the anti-vaccine movement. Despite overwhelming evidence that vaccines save lives, and that the risks are miniscule compared to the enormous benefits, the anti-vaxxers remain in denial. They claim that the government–usually the CDC–and pharmaceutical companies have been conspiring for years to hide the so-called harms of vaccines, and they spread misinformation and fear in a continual effort to get parents to withhold vaccines from their children.

The main harm claimed by the anti-vax movement is autism. This belief, though fervently held by many anti-vaxxers, is absolutely false. It was originally proposed in a now-retracted, discredited 1998 study by Andrew Wakefield, who was later shown to have fraudently manipulated data, hidden his secret payments from lawyers who wanted to sue vaccine makers, and treated the children in his own study unethically. In 2010, Wakefield was stripped of his UK medical license. As the BMJ editors wrote in a 2011 editorial:

"Who perpetrated this fraud? There is no doubt that it was Wakefield."

Nonetheless, Wakefield he continues to promote his bogus claims (most recently with an anti-vax movie, which I won't name here to avoid promoting it), and remains a hero to the anti-vax movement, who seem blind to his flaws.

This is reprehensible–and frightening. If all parents followed the anti-vaxxers advice, we would see massive surges in vaccine-preventable illnesses, sometimes leading to permanent harm or even death in helpless children. Fortunately, most children are still getting their vaccines, but the anti-vaxxers have succeeded in reducing vaccination rates in many communities around the country, illustrated most recently by the 19-fold increase in vaccine exemptions in Texas.

Twenty years ago, we had under 200 cases of mumps per year, and it was no longer endemic in the United States. In other words, the only cases in the country were imported by people traveling here from other counties. The same was true for measles, which is much deadlier than mumps. Fortunately, rates of measles are low again this year, after the major outbreak that started in Disneyland in 2015, but if anti-vaxxers have their way, more outbreaks are in our future.

This amazing progress was all thanks to the mumps vaccine, which today is part of the MMR vaccine, which also protects you from measles and rubella. Before the vaccine program started in 1967, we saw about 186,000 cases of mumps annually in the U.S. The vaccine led to a 99% reduction in mumps (and measles). It's not perfect: the mumps vaccine is about 88% effective, but when everyone is vaccinated, "herd immunity" prevents the disease from spreading, even if a few people get sick. As the CDC explains,

"outbreaks are much larger in areas where vaccine coverage rates are lower."

Perhaps more alarming than the surge in mumps cases is that the U.S. has just elected the first anti-vaccine President in history. Others have documented Trump's "long, sordid antivaccine history," so I won't attempt to describe it here. We can only hope that reason will eventually prevail, and Trump's ignorance about vaccines won't lead to thousands of unnecessary cases of measles, mumps, whooping cough, and other diseases that vaccines can prevent.

California passes pro-vaccine bill, protects children

In a victory for children’s health, California passed a new law this week removing the “personal belief” exemption from the state’s vaccine requirements for children. Assuming that Governor Jerry Brown signs the bill this week–which no one is certain about–California will be transformed from a haven for anti-vaccine demagoguery to a state that protects children instead.

How this came to pass is a long tale, but the immediate impetus was the outbreak of measles in Disneyland in January–the worst outbreak in 20 years–which spread mostly through unvaccinated children. During that outbreak, we learned that in some areas of California, anti-vaccination hysteria had grown so widespread that more than half the children in some schools were unvaccinated.

And just three years ago, California had the worst whooping cough epidemic in 70 years, thanks to the anti-vaccine movement.

After the recent measles outbreak, California state Sen. Richard Pan, who is also a pediatrician, introduced SB 277 to remove personal and religious exemptions from vaccines in the state. In February, he and I were guests together on an episode of NPR's On Point with host Tom Ashbrook discussing this issue. Senator Pan spoke passionately and from direct experience about the need to protect children from disease. 

All states in the U.S. require children to be vaccinated in order to attend public schools, a policy that has been the foundation of our national effort to control infectious diseases. Under California’s current law, parents can opt out of vaccines for their children for almost any reason, simply by claiming a “personal belief” exemption. Anti-vaxxers have encouraged parents throughout the state to use this law to withhold vaccines from their children.

With this new bill, California moves back into the modern age. Without vaccinations, hundreds of thousands of children in the U.S. would get sick every year with measles, mumps, whooping cough, chicken pox, and other diseases. Thousands would die, and tens of thousands would be permanently injured. School-based vaccination policies have essentially eliminated these diseases from the U.S. in recent decades. I should add that SB 277 still allows medical exemptions, for those (rare) cases where a child has a legitimate medical reason (for example, because he/she is undergoing chemotherapy to treat cancer) to forego vaccination.

Ironically, vaccines’ very success has allowed anti-vaccine propaganda to spread. Vaccines have been so successful that most people don’t even remember the era when these diseases were a constant fear of childhood. Thus when anti-vaxxers spread (erroneous) claims that vaccines cause harm–most notoriously, that vaccines cause autism–new parents sometimes become convinced that the potential harm isn’t worth the benefit. Vaccines are safe, as the Institute of Medicine explained in a detailed report not long ago, and they are enormously beneficial.

Anti-vaxxers will continue to make extreme, and erroneous claims about vaccines. Just two months ago, the noted anti-vaxxer Robert F. Kennedy Jr. was in California campaigning against SB 277, calling vaccines a “holocaust” – perhaps the most extreme scaremongering I’ve seen on this issue. An anti-vax group called A Voice for Choice announced Thursday, after the vote, that they are “pulling out all the stops” and will try to challenge the new law in court.

Let’s hope that reason wins out–that Gov. Jerry Brown signs the bill and that California’s children are once again protected from vaccine-preventable diseases. We shouldn’t need another measles or whooping cough outbreak, or any more children dying of preventable diseases, to convince people once again that vaccines save lives.

Anti-vaxxers are to blame for a new epidemic of measles in the U.S.

Measles is now spreading outward from Disneyland in California, in the worst outbreak in years. The epidemic is fueled by growing enclaves of unvaccinated people. 

The CDC reports that in just the past month, 84 people from 14 states contracted measles, a number that is certainly an under-estimate, because the CDC doesn’t record every case. California alone has 59 confirmed cases, most of them linked to an initial exposure in Disneyland. A majority of people who have gotten sick were not vaccinated.

For years, scientists (including me) have warned that the anti-vaccination movement was going to cause epidemics of disease. Two years ago I wrote that the anti-vaccine movement had caused the worst whooping cough epidemic in 70 years. And now it’s happening with measles.

Finally, though, the public seems to be pushing back. Parents are starting to wake up to the danger that the anti-vax movement represents to their children and themselves. 

What's sad about this – tragic, really – is that we eliminated measles from the U.S. in the year 2000, thanks to the measles vaccine. As this CDC graph shows, we've had fewer than 100 cases every year since. 

But we had 644 cases in 27 states in 2014, the most in 20 years. And 2015 is already on track to be worse. Measles may become endemic in the U.S, circulating continually, thanks to the increasing numbers of unvaccinated people. Until now, each outbreak was caused by someone traveling from abroad and bringing measles to us. The anti-vaccine movement has turned this public health victory into defeat.

Anti-vaxxers have been relentless in the efforts to spread misinformation. Despite overwhelming scientific evidence that vaccines are beneficial, they endlessly repeat a variety false claims, such as

• Vaccines cause autism. They don’t.
• The preservative thimerosal in vaccines causes autism. It doesn’t.
• Natural immunity is all you need. It isn’t. Measles infects 90% of people exposed to it unless they are vaccinated.
• A healthy lifestyle will protect you from measles. It won’t.

Now, finally, some parents are pushing back. Parents and schools in California, where the epidemic began, are concerned that their children will be exposed to measles from unvaccinated children in schools. And the schools are starting to do something they should have done long ago: send the unvaccinated kids home.

The problem arises from California’s vaccine exemption policy: although public schools require kids to be vaccinated, parents can exempt their kids simply by saying they have a personal objection to vaccination. It’s not just California: only two states, Mississippi and West Virginia, don’t allow parents to claim a philosophical or religious exemption to vaccines  And Colorado has the worst rate of vaccination, at just 82%, primarily due to parents claiming a “philosophical” exemption.

These parents are the anti-vaxxers. Thanks to them, we now have large pockets of unvaccinated children through whom epidemics can spread further an faster than we’ve seen in decades. The CDC reports that in 2014, 79% of measles cases in the U.S. involving unvaccinated people were the result of personal belief exemptions.

Anti-vaxxers don't recognize the threat their behavior poses to others, especially to children whose immune systems aren’t functioning properly. CNN reported this week on the case of Rhett Krawitt, a 6-year-old California boy who has gone through 4 years of chemotherapy for childhood leukemia. His leukemia is in remission and he’s back in school, but the treatment wiped out his immunity, and he’s still not ready to get vaccinated. If Rhett gets measles, he might not survive. His father Carl wrote to school district officials to ask them to ban unvaccinated children from school.

Krawitt expects the schools to deny his request.

Meanwhile, the parents who refuse to vaccinate their kids aren’t budging. The New York Times reported on one mother, Crystal McDonald, who refused to vaccinate any of her four children, after “researching the issue” by reading anti-vaccine websites. When their high school sent her daughter home for two weeks, the daughter asked if she could get the measles shot so she could return. As quoted in the Times, McDonald told her daughter “I said ‘No, absolutely not.’ I said I’d rather you miss an entire semester than you get the shot.’”

Where does this breathtaking science denialism come from? It’s been building for years, as I and many others have written. The wave began with a 1998 paper published in The Lancet by Andrew Wakefield, claiming that the MMR vaccine was linked to autism. Wakefield’s work was later shown to be fraudulent, and his claims about the vaccine "dishonest and irresponsible." After lengthy investigations, the paper was retracted and Wakefield lost his medical license. Despite this very public repudiation, Wakefield has stuck to his claims, though, and has spent much of the past 15 years speaking (or perhaps “preaching” would be a better term) to anti-vaccine groups, to whom he is a kind of folk hero.

It’s not just Wakefield, though. Anti-vaccine messages have been broadcast aggressively by the group Generation Rescue, led by former Playboy playmate and MTV host Jenny McCarthy, and by Age of Autism, a group dedicated to the proposition that vaccines cause autism. (Age of Autism is doing it again right now.) And just last summer, Robert F. Kennedy Jr. published a new book further promoting the long-discredited claim that thimerosal causes autism. 

Most of the anti-vax crowd have no scientific training or expertise, which might explain (but doesn't excuse) their complete ignorance of the science. Over the past 15 years, dozens of studies involving hundreds of thousands of people have shown convincingly that neither vaccines nor any of the ingredients in them are linked to autism. Vaccines are not only safe, but they are perhaps the greatest public health success in the history of civilization.

Measles, though, is dangerous. The CDC’s Anne Schuchat had a message for parents this week:

“I want to make sure that parents who think that measles is gone and haven't made sure that they or their children are vaccinated are aware that measles is still around and it can be serious. And that MMR vaccine is safe and effective and highly recommended.”

Make no mistake, measles is a very dangerous infection. In the current outbreak, 25% of victims have ended up in the hospital. And it is extremely infectious: the CDC’s Schuchat explained that 

“You can catch it [measles] just by being in the same room as a person with measles even if that person left the room because the virus can hang around for a couple of hours.”

Perhaps the Disneyland epidemic, which has now spread to 14 states, will finally convince parents, schools, and state legislatures that they need to insist that children get vaccinated before going to school. Perhaps it will also convince parents to stop listening to nonsense, and choose wisely by getting their children vaccinated against measles. We won this battle before, and we can win it again.

The Baltimore Sun dives into the anti-vaccination pool

In recent weeks, the Baltimore Sun, once an excellent newspaper, has dived headfirst into the pool of anti-vaccination pseudoscience. With two prominent opinion pieces, the Sun has given a platform to the anti-vaccine movement that they probably didn't expect, and that they certainly didn't deserve. The puzzle is, why? Who on the Sun's editorial board decided to offer their pages to the voices of fear and unreason?

First, on June 16, the Sun printed an Opinion article by Mark Geier, where he argued that his unfounded theories about the causes of autism make it okay for him to chemically castrate young boys. (I know this sounds shocking, but it's all too true.) I wrote about Geier two years ago: he and his son David administer what they called the "Lupron protocol" to autistic boys. They charge $5000-$6000 per month for their treatment, which is based on their belief that autism is caused by an excess of testosterone. Lupron, the drug they give to children, is a testosterone-suppressing drug that is the chemical equivalent of castration. It is a harsh treatment used to treat advanced prostate cancer. There is no evidence that it helps autistic boys. When the Chicago Tribune interviewed Simon Baron-Cohen, a professor and director of the Autism Research Center at Cambridge University, here was his reaction:

"The idea of using it [Lupron] with vulnerable children with autism, who do not have a life-threatening disease and pose no danger to anyone, without a careful trial to determine the unwanted side effects or indeed any benefits, fills me with horror."

Finally, after Geier had spent many years of selling his quack treatment to vulnerable families, the state of Maryland suspected his medical license suspected in April. Now, for reasons I cannot fathom, the Baltimore Sun has given him a huge billboard to ask for his license back so he can resume his discredited Lupron protocol.

(Geier also claims that mercury in vaccines causes the rise in testosterone levels that he claims to treat. He ignores the overwhelming evidence, re-affirmed again last year, that there is no link between mercury-containing vaccines and autism.)

This wasn't enough bad science for the Sun, which just a few weeks later published another Opinion piece, this one by anti-vaccine activist Margaret Dunkle. In her article, Dunkle claims that the vaccine schedule includes too many doses, and she further claims that these are harmful to children. This "too many, too soon" argumen is a constant refrain of the anti-vax movement (particularly Jenny McCarthy), despite the lack of science to support it. The evidence on her side: a new study published by Gayle Delong, claiming that autism rates and vaccination rates are linked. Who is Gayle Delong? It turns out she is an economist, not a scientist, and she's a board member of SafeMinds, a well-known anti-vaccination group. Delong's study has already been thoroughly debunked by Neuroskeptic, Sullivan, Liz Ditz, and others, who pointed out its deeply flawed statistics and other problems. Dunkle, though, was happy to jump on this junk science and ignore the real science.

The real science tells just the opposite tale. For example, a thorough review published in Pediatrics in 2002 showed that infants today are exposed to fewer antigens than they were 40 years ago, due to better vaccine formulations. It also found that vaccines "prevent the weakening of the immune system." Countless other articles have shown the efficacy of vaccines; the Immunize for Good site is a good source for a realistic picture of the risks versus the benefits.

Is the Baltimore Sun responsible for the anti-vaccination stories appearing on its Opinion pages? I can imagine their response: "we're just presenting both sides," they might argue. Debates are just fine when political opinions are concerned, but you don't get to argue about facts. Scientific facts are not debated from "both sides" - for example, we don't waste time arguing that diseases are caused by "miasmas" as was once believed. And when the subject is vaccines, presenting the anti-science, anti-vaccine argument has real, and harmful, consequences.

The science is clear: vaccines have been the single greatest boon to public health in the history of mankind. Vaccines have saved millions of lives, and allowed parents to live without the fear that their children will sicken and die. Here are some facts: pre-vaccination, whooping cough caused 9000 deaths per year in the U.S. Post-vaccine, this has dropped to 20 deaths per year. Pre-vaccination, there were 350,000 polio cases worldwide in 1988. In 2009, there were just 1,604, and there's a chance we can eliminate polio entirely. Back in 1921, diptheria caused 206,000 cases in the U.S. alone. In 2001, there were just 2 cases.

If we stop vaccinating, these diseases will return. And make no mistake about it: if measles, whooping cough, polio, and other vaccine-preventable diseases return, children will die. I'm sure that the editors of the Baltimore Sun don't want this to happen. But through their ignorance of the science around vaccines, they have allowed their newspaper to become a voice for a dangerously misinformed group of activists whose main goal is to stop vaccines.

How to correct the damage? Well, the Sun could publish multiple articles on their Opinion pages explaining how many lives vaccines have saved. They could help to re-educate parents about how valuable these medicines are, so they will demand them for their children, rather than refusing them as some parents now do. I have only a faint hope that the Sun's editors will take such action, but I'm calling for it anyway. They owe it to the public.

Measles invades U.S.: anti-vaccine movement scores again

How can we keep unvaccinated people from bringing infectious diseases into the U.S.? These diseases are a real threat to public health, and while we're spending billions on national security, almost all that money goes towards "security theater," such as full-body scanning equipment at airports, which does almost nothing to protect the public. We'd be much better off spending those scarce funds on detecting infections at the border.

In the most recent invasion, the measles virus has snuck in thanks to a single unvaccinated student from Utah, who picked up the disease in Poland. The junior high student traveled to Poland with his family to pick up his sister, who was there as a Mormon missionary. As reported by the Associated Press, up to 1000 people have already been exposed, and the circle could easily spread beyond that.

Measles is a dangerous and incredibly infectious virus, transmitting easily between people. According to the CDC:

"About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. For every 1,000 children who get measles, one or two will die."

This is not a disease to take lightly. Fortunately, the vaccine is highly effective, which means the real challenge is getting people to take it.

Utah requires measles vaccinations for public schools, but (as in many other states) parents can refuse vaccines for personal or religious reasons. California now has about 2% of parents refusing vaccines for their children for personal beliefs. This gaping hole in our public health system needs to be closed: if parents refuse to vaccinate their children, they are putting the rest of us at risk, and these children need to be kept out of public schools.

Most of the parents refusing vaccines for the children are doing so out of fear that vaccines cause harm. Despite countless studies showing that vaccines are safe (and in particular, that vaccines do not cause autism), these rumors persist, amplified greatly by the anti-vaccine movement, which seems impervious to evidence or reason.

Meanwhile, anti-vaccine groups such as Age of Autism are fighting to keep or even expand these exemptions. Other sites such as ThinkTwice.com http://www.thinktwice.com/laws.htm and Internet quacks Joseph Mercola and Sherri Tenpenny advise parents to refuse vaccination and use whatever loopholes they can to enroll their kids in school. Parents who follow this advice rely on the immunization of others to protect their own children, but they appear unconcerned about the risk they forcing on the rest of us. They also neglect to consider that vaccines are never 100% effective, so even those of us who vaccinate our kids are still bearing a greater risk by allowing the unvaccinated to attend school.

Europe has its own problems with vaccine coverage, and measles is spreading rapidly this year, having hit 24 countries so far. France had 3749 cases and one death in the first two months of this year. Many of the victims are children too young to be vaccinated, but the disease is often spread by people who simply refuse to get the vaccine.

The latest measles outbreak in Utah could have been avoided if the student involved had simply been vaccinated. Realistically, though, we will always have citizens traveling abroad and bringing infectious diseases back. If the U.S. really wants to use its security dollars wisely, we should implement greater screening at the border to keep these disesases out. We could start by telling people to get vaccinated before they leave the country. If they refuse, we could require them to be tested for infections when they return. We could implement this using funds we'd save when we stop telling everyone to take off their shoes at the airport.