Measles Rampant Again, Thanks to Anti-Vaccinationists

Measles is on the march once more, even though vaccination against the disease has cut the number of worldwide deaths from an estimated 2.6 million per year in the mid-20th century to 110,000 in 2017. But thanks to the anti-scientific, anti-vaccination movement and the ever expanding reach of social media, measles cases are now at a 20-year high in Europe and as many U.S. cases were reported in the first two months of 2019 as in the first six months of 2018.

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Highly contagious, measles is not a malady to be taken lightly. One in 1,000 people who catch it die of the disease; most of the victims are children under five. Even those who survive are at high risk of falling prey to encephalitis, an often debilitating infection of the brain that can lead to seizures and mental retardation. Other serious complications of measles include blindness and pneumonia.

It’s not the first time that measles has reared its ugly head since the widespread introduction of the MMR (measles-mumps-rubella) vaccine in 1963. Although laws mandating vaccination for schoolchildren were in place in all 50 U.S. states by 1980, sporadic outbreaks of the disease have continued to occur. Before the surge in 2018-19, a record number of 667 cases of measles from 23 outbreaks were reported in the U.S. in 2014. And major epidemics are currently raging in countries such as Ukraine and the Philippines.

The primary reason for all these outbreaks is that more and more parents are choosing not to vaccinate their children. The WHO (World Health Organization), for the first time, has listed vaccine hesitancy as one of the top 10 global threats of 2019.

While some parents oppose immunization on religious or philosophical grounds, by far the most objections come from those who insist that all vaccines cause disabling side effects or other diseases – even though the available scientific data doesn’t support such claims. As discussed in a previous post, there’s absolutely no scientific evidence for the once widely held belief that MMR vaccination results in autism, for example.

Anti-vaccinationists, when accused of exposing their children to unnecessary risk by refusing immunization because of unjustified fears about vaccine safety, rationalize their stance by appealing to herd immunity. Herd immunity is the mass protection from an infectious disease that results when enough members of the community become immune to the disease through vaccination, just as sheer numbers protect a herd of animals from predators. Once a sufficiently large number of people have been vaccinated, viruses and bacteria can no longer spread in that community.

For measles, herd immunity requires up to 94% of the populace to be immunized. That the threshold is lower than 100%, however, enables anti-vaccinationists to hide their children in the herd. By not vaccinating their offspring but choosing to live among the vaccinated, anti-vaxxers avoid the one in one million risk of their children experiencing serious side effects from the vaccine, while simultaneously not exposing them to infection – at least not in their own community.  

But hiding in the herd takes advantage of others and is morally indefensible. Certain vulnerable groups can’t be vaccinated at all, including those with weakened immune systems such as children undergoing chemotherapy for cancer or the elderly on immunosuppressive therapy for rheumatic diseases. If too many people choose not to vaccinate, the percentage vaccinated will fall below the threshold, herd immunity will break down and those whose protection depends on those around them being vaccinated will suffer.

Another contentious issue is exemptions from mandatory vaccination for religious or philosophical reasons. While some American parents regard the denial of schooling to unvaccinated children as an infringement of their constitutional rights, supreme courts in several U.S. states have ruled that the right to practice religion freely doesn’t include liberty to expose the community or a child to communicable disease. And ever since it was found in 2006 that the highest incidence of diseases such as whooping cough occurred in the states most generous in granting exemptions, more and more states have abolished nonmedical exemptions altogether.

But other countries are not so vigilant. In Madagascar, for instance, less than an estimated 60% of the population has been immunized against measles – because of which an epidemic there has caused more than 900 deaths in six months, according to the WHO. Although the WHO says that the reasons for the global rise in measles cases are complex, there’s no doubt that resistance to vaccination is a major factor. It’s not helped by the extensive dissemination of anti-vaccination misinformation by Russian propagandists.

Next: The Sugar Industry: Sugar Daddy to Manipulated Science?

Corruption of Science: Scientific Fraud

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One of the most troubling signs of the attack on science is the rising incidence of outright fraud, in the form of falsification and even fabrication of scientific data. A 2012 study published by the U.S. National Academy of Sciences noted an increase of almost 10 times since 1975 in the percentage of biomedical research articles retracted because of fraud. Although the current percentage retracted due to fraud was still very small at approximately 0.01%, the study authors remarked that this underestimated the actual percentage of fraudulent articles, since only a fraction of such articles are retracted.

One of the more egregious episodes of fraud was British gastroenterologist Andrew Wakefield’s claim in a 1998 study that 8 out of 12 children in the study had developed symptoms of autism after injection of the combination MMR (measles-mumps-rubella) vaccine. As a result of the well publicized study, hundreds of thousands of parents who had conscientiously followed immunization schedules in the past panicked and began declining MMR vaccine. And, unsurprisingly, outbreaks of measles subsequently occurred all over the world.

But Wakefield’s paper was slowly discredited over the next 12 years, until the prestigious medical journal The Lancet formally retracted it. The journal’s editors then went one step further in 2011 by declaring the paper fraudulent, citing unmistakable evidence that Wakefield had fabricated his data on autism and the MMR vaccine. Shortly after, the disgraced gastroenterologist’s medical license was revoked.

In 2015, Iowa State University researcher Dong Pyou Han received a prison sentence of four and a half years and was ordered to repay $7.2 million in grant funds, after being convicted of fabricating and falsifying data in trials of a potential HIV vaccine.  On multiple occasions, Han had mixed blood samples from vaccinated rabbits into human HIV antibodies to create the illusion that the vaccine boosted immunity against HIV. Although Han was contrite in court, one of the prosecuting attorneys doubted his remorse, pointing out that Han’s job depended on research funding that was only renewed as a result of his bogus presentations showing the experiments were succeeding.

In 2018, officials at Harvard Medical School and Brigham and Women’s Hospital in Boston called for the retraction of a staggering 31 papers from the laboratory of once prominent Italian heart researcher Piero Anversa, because the papers "included falsified and/or fabricated data." Dr. Anversa’s research was based on the notion that the heart contains stem cells, a type of cell capable of transforming into other cells, that could regenerate cardiac muscle. But other laboratories couldn’t verify Anversa’s idea and were unable to reproduce his experimental findings – a major red flag, since replication of scientific data is a crucial part of the scientific method.

Despite this warning sign, the work spawned new companies claiming that their stem-cell injections could heal hearts damaged by a heart attack, and led to a clinical trial funded by the U.S. National Heart, Lung and Blood Institute. The Boston hospital’s parent company, however, agreed in 2017 to a $10 million settlement with the U.S. government over allegations that the published research of Anversa and two colleagues had been used to fraudulently obtain federal funding. Apart from data that the lab fabricated, the government alleged that it utilized invalid and improperly characterized cardiac stem cells, and maintained deliberately misleading records. Anversa has since left the medical school and hospital.

Scientific fraud today extends even to the publishing world. A recent sting operation involved so-called predatory journals – those charging a fee without offering any publication services (such as peer review), other than publication itself. The investigation found that an amazing 33% of the journals contacted offered a phony scientific editor a position on their editorial boards, four of them immediately appointing the fake scientist as editor-in-chief.   

It’s no wonder then that scientific fraud is escalating. In-depth discussion of recent cases can be found on several websites, such as For Better Science and Retraction Watch.

Next week: Consensus in Science: Is It Necessary?

Use and Misuse of the Law in Science

Aside from patent law, science and the law are hardly bosom pals. But there are many parallels between them: above all, they’re both crucially dependent on evidence and logic. However, while the legal system has been used to defend science and to settle several scientific issues, it has also been misused for advocacy by groups such as anti-evolutionists and anti-vaccinationists.

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In the U.S., the law played a major role in keeping the teaching of creationism out of schools during the latter part of the 20th century. Creationism, discussed in previous posts on this blog, is a purely religious belief that rejects the theory of evolution. Because of the influence of the wider Protestant fundamentalist movement earlier in the century, which culminated in the infamous Scopes Monkey Trial of 1925, little evolution was taught in American public schools and universities for decades.

All that changed in 1963, when the U.S., as part of an effort to catch up to the rival Soviet Union in science, issued a new biology text, making high-school students aware for the first time of their apelike ancestors. And five years later, the U.S. Supreme Court struck down the last of the old state laws banning the teaching of evolution in schools.

In 1987 the Supreme Court went further, in upholding a ruling by a Louisiana judge that a state law, mandating that equal time be given to the teaching of creation science and evolution in public schools, was unconstitutional. Creationism suffered another blow in 2005 when a judge in Dover, Pennsylvania ruled that the school board’s sanctioning of the teaching of intelligent design in its high schools was also unconstitutional. The board had angered teachers and parents by requiring biology teachers to make use of an intelligent design reference book in their classes.

All these events show how the legal system was misused repeatedly by anti-evolutionists to argue that creationism should be taught in place of or alongside evolution in public schools, but how at the same time the law was used successfully to quash the creationist efforts and to bolster science.

Much the same pattern can be seen with anti-vaccine advocates, who have misused lawsuits and the courtroom to maintain that their objections to vaccination are scientific and that vaccines are harmful. But judges in many different courts have found the evidence presented for all such contentions to be unscientific.

The most notable example was a slew of cases – 5,600 in all – that came before the U.S. Vaccine Court in 2007. Alleged in these cases was that autism, the often devastating neurological disorder in children, is caused by vaccination with the measles-mumps-rubella (MMR) vaccine, or by a combination of the vaccine with a mercury-based preservative. To handle the enormous caseload, the court chose three special masters to hear just three test cases on each of the two charges.

In 2009 and 2010, the Vaccine Court unanimously rejected both contentions. The special masters called the evidence weak and unpersuasive, and chastised doctors and researchers who “peddled hope, not opinions grounded in science and medicine.”

Likewise, the judge in a UK court case alleging a link between autism and the combination diphtheria-tetanus-pertussis (DTP) vaccine found that the “plaintiff had failed to establish … that the vaccine could cause permanent brain damage in young children.” The judge excoriated a pediatric neurologist whose testimony at the trial completely contradicted assertions the doctor had made in a previous research paper that had triggered the litigation, along with other lawsuits, in the first place.

But, while it took a court of law to establish how unscientific the evidence for the claims about vaccines was, and it was the courts that kept the teaching of unscientific creationism out of school science classes, the court of public opinion has not been greatly swayed in either case. As many as 40% of the general public worldwide believe that all life forms, including ourselves, were created directly by God out of nothing, and that the earth is only between 6,000 and 10,000 years old. And more and more parents are choosing not to vaccinate their children, insisting that vaccines always cause disabling side effects or even other diseases.

Although the law has done its best to uphold the court of science, the attack on science continues.

Next week: Subversion of Science: The Low-Fat Diet

No Evidence That Aluminum in Vaccines is Harmful

Part of the anti-vaccinationist stance against immunization is the belief that vaccines contain harmful chemicals such as aluminum, formaldehyde and thimerosal. Although mercury-based thimerosal is no longer used in any U.S. vaccines except certain flu shots, and the amount of formaldehyde is a tiny fraction of that found in many foods – including those fed to babies such as pureed bananas or pears – aluminum remains a villain among the anti-vax crowd. But, as with the discredited link between the measles vaccine and autism discussed in a previous post, no medical evidence exists to support the aluminum hypothesis.

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Aluminum salts are employed as powerful adjuvants to enhance the immune system response to a vaccine, thus reducing the number of repeat injections needed. What anti-vaccinationists fail to understand, however, is that less than 1% of aluminum in vaccines is actually absorbed by the body. The same is true of the aluminum found in our food supply, in drinking water and even in the air we breathe, as well as the breast milk or infant formula ingested by babies. For vaccination, the daily quantity of aluminum absorbed by a vaccinated newborn infant is 10 times smaller than the FDA’s threshold for neurotoxicity.

Because it has been suggested that aluminum could be linked to certain neurological disorders such as Alzheimer’s Disease, anti-vaccinationists maintain that injected aluminum rapidly enters the bloodstream and thereby accumulates in the brain, causing neurological damage – reminiscent of Wakefield’s fraudulent claim about autism. There are several scientific fallacies underlying this assertion, however.

The first fallacy is that injected aluminum finds its way into the body more rapidly than ingested aluminum. In fact, most of the aluminum adjuvant in a vaccine remains near the injection site for a long period and is only absorbed slowly into the bloodstream, at approximately the same daily rate as ingested aluminum. Even though the amount of ingested aluminum is much larger, most of that is absorbed in the intestines and only released slowly into the blood.

Another fallacy involves the neurotoxicity of aluminum in the brain. Although aluminum and other chemicals can enter the brain from the bloodstream, they first have to penetrate a protective semipermeable membrane that separates flowing blood from brain tissue, known as the blood brain barrier. The blood brain barrier normally keeps circulating pathogens and toxins from getting into the brain, while allowing the passage of water, nutrients and hormones.

The flawed claim is that injected aluminum sneaks its way into the brain by hiding in macrophages – a type of first-responder white blood cell that devours germs, cellular debris and foreign particles, and plays an important role in the body’s immune system. Unable to digest metals, say anti-vaccinationists, the aluminum-loaded macrophages travel to the brain via the blood or lymphatic system. If the brain is already inflamed, the macrophages can cross the blood brain barrier and unload aluminum inside the brain. The aluminum supposedly causes further inflammation, leading to autism and other neurological disorders.

But none of this makes sense to many doctors and scientists who work in immunology or neuroscience. A neurovascular biologist who’s an expert on the blood brain barrier faults the science in several of the papers behind the Trojan-horse macrophage hypothesis. And he calls out the claim in one paper that macrophages digest injected aluminum as “not only exaggerated … but also provocative and fraudulent,” though this criticism was later accepted as justified on a major anti-vaccinationist website.

The website, whose authors prefer to remain anonymous, claims to be science-based and guided only by scientific evidence – the same as the emphasis of the present blog. The site also attempts to defend itself against charges of cherry picking research papers supporting its position that aluminum adjuvants cause autism. But it merely lists just the abstracts of a handful of the many papers backing the emerging consensus that autism is caused by maternal exposure to infections or toxins during pregnancy.   

In any case, even if the aluminum hypothesis were correct, the fact that the amount of aluminum absorbed from vaccines is comparable to the amount absorbed from aluminum ingested by the body means that macrophages could sweep up swallowed aluminum just as easily as injected aluminum. There’s no good evidence that either occurs, although the mechanisms by which adjuvants act are still not fully understood. 

Hat tip: Mike @realiwasframed

Next week: Politics Clashes with Science over Glyphosate and Cancer

Measles or Autism? False Choice, Says Science

Perhaps nowhere is the attack on science more visible than in the opposition to vaccination against infectious diseases such as hepatitis, polio and measles. To anti-vaxxers, immunizing a child with the measles vaccine is a choice between sentencing him or her to the lifelong misery of autism, or exposing the child to possible aftereffects of a disease that the youngster may never contract. This view, passionately held by a substantial minority of the population, is completely at odds with the logic and evidence of science.

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Despite the insistence of anti-vaccinationists to the contrary, there’s absolutely no scientific evidence of any linkage between vaccines and autism. The myth connecting them was first suggested by U.S. activist Barbara Loe Fisher in the 1980s. It gained steam when British gastroenterologist Andrew Wakefield claimed in a 1998 study that 8 out of 12 children in the study had developed autism symptoms following injection of the combination measles-mumps-rubella (MMR) vaccine.

But Wakefield’s paper in the prestigious medical journal The Lancet was slowly discredited until, in 2011, the journal’s editors took the unprecedented step of declaring the paper fraudulent, saying that Wakefield had falsified his data. Die-hard anti-vaccinationists refused to accept this conclusion, despite Wakefield’s medical license being subsequently revoked by the UK General Medical Council, who found that his fraud was compounded by ethical lapses and medical misconduct in the same study.

The autism episode generated worldwide publicity and led to thousands of court cases in a special U.S. Vaccine Court set up as part of the National Vaccine Injury Compensation Program. To cope with the enormous caseload, the court assigned three special masters to hear just three test cases on each of two theories: that autism was caused by the MMR vaccine together with a mercury-based preservative known as thimerosal, or that it was caused by thimerosal-containing vaccines alone.

In 2009 and 2010, the special masters unanimously rejected both contentions. But they emphasized that their decisions had been guided only by scientific evidence, not by the poignant stories of autistic children. One of the masters declared in her analysis:

“Sadly, the petitioners in this litigation have been the victims of bad science, conducted to support litigation rather than to advance medical and scientific understanding of autism spectrum disorder. The evidence in support of petitioners’ causal theory is weak, contradictory, and unpersuasive.”

Yet, despite the Vaccine Court’s findings in the U.S. and The Lancet’s accusation of fraud against Wakefield in the UK, anti-vaccinationists continue to connect the MMR vaccine to autism.  In 2016, Wakefield directed a documentary, “Vaxxed,” alleging that the U.S. Centers for Disease Control and Prevention (CDC) covered up contrary data in a 2004 study that drew the same conclusions as the Vaccine Court and numerous epidemiological studies.  His allegations were baseless, however, as the 2014 research paper behind his outrageous claim was subsequently retracted.

According to CDC statistics, autism spectrum disorder afflicted 1 in 59 U.S. children in 2014. Diagnosis of the condition can be devastating and highly stressful for the desperate parents of an autistic child, who naturally tend to grasp for explanations and are often quite willing to believe the hype about vaccination.  Currently, the causes of autism remain unknown, although several risk factors have been identified: certain genetic conditions have been implicated, and it’s thought that exposure during pregnancy to toxic chemicals such as pesticides, or to bacterial or viral infections, plays a role.

While there’s no medical evidence tying autism to vaccines, it’s also true that serious adverse reactions to a vaccine shot do occur occasionally – typically about once in every one million vaccinations. Negative and occasionally fatal reactions to various vaccines have been documented in approximately 400 research papers. But these 400 cases need to be weighed against the hundreds of millions of vaccine doses administered every year in the U.S. without any reported side effects, cases that aren’t even worth studying.

And the odds of suffering an adverse reaction have to be compared with the risk of contracting the disease itself. One of 1,000 children who get the measles, for instance, will end up with encephalitis, which can have devastating aftereffects such as seizures and mental retardation; some children still die from measles, often after getting pneumonia. It’s a lot less dangerous to subject a child to an MMR shot than risk exposing the child to a disease as contagious and potentially deadly as measles.