Where did science go? Social media enables one to interact with a number of individuals. Some of my most fascinating conversations have occurred with individuals who have chosen not to vaccinate their children.
In medicine we rely on four levels of evidence to grade the research – an expert opinion, for example is a grade of D. Studies that are done at multiple institutions, and multiple populations would get a grade of A. There are some who go to a higher standard of “science based medicine,” where the bench work of science is applied to medicine and only that which can be shown to work in the lab as well as in level A studies makes the mark. In academic medicine these journal articles are debated all the time- the conclusions that they draw, and whether there is even a statistical power to approach the conclusions they make.
So when someone challenges the integrity of that system, based on level F evidence (not an expert, not someone trained in the field, but a person’s anecdote or belief) – it is difficult for this physician-scientist to comprehend.
On one hand, you have the anti-vaccination crowd – a movement that started with the premise that vaccinations are unnatural and therefore bad (this was long before Wakefield made up the data about autism and preservatives in vaccine). These conclusions were not based on any studies- and contrary to decades of studies from the scientists bench (Salk, Sabin, Jenner, Pasteur, Huggins, and others) that applied to large populations wiped out polio in this country, small pox almost entirely around the world, and nearly eliminated measles.
Wakefield’s publication in Lancet, as well as others crying that the mercury in the vaccine could cause autism led scientists and physicians to do a number of studies that (a) contradicted Wakefield’s study (b) showed no association with autism in multiple populations from multiple centers and (c) showed that Wakefield’s data was forged and other authors of that paper asked to have Lancet remove the article and (d) Lancet took the unusual step of stating the article was worthless. Still , because of some public concerns, mercury preservatives were removed from most of the vaccines sold in the US starting in 2002 – and yet autism rates did not go down (multi-dose influenza vaccines being the exception). To quote from the FDA:
Several animal studies have evaluated the toxicity of thimerosal. In 1931 Powell and Jamieson reported acute toxicity studies in several animal species. Maximum tolerated doses not associated with death of the animals were 20 mg thimerosal/kg (rabbits) and 45 mg/kg (rats). Blair evaluated the administration of thimerosal intranasally for 190 days and observed no histopathological changes in the brain or kidney (Blair et al. 1975). Magos et al. directly compared the toxicity of ethyl- versus methylmercury in adult male and female rats administered 5 daily doses of equimolar concentrations of ethyl- or methylmercury by gavage (Magos et al 1985). Magos concluded that ethylmercury, the mercury derivative found in thimerosal, is less neurotoxic than methylmercury, the mercury derivative for which the various guidelines are based.
Did that satisfy the anti-vaccination crowd? No. No credence was given to the plethora of multiple scientists, physicians, with studies from multiple centers – producing the highest level of evidence all showing vaccines as safe and effective.
Now the anti-vaccination crowd’s concern is the levels of aluminum and formaldehyde in the preservatives of vaccines. They would state that aluminum is a concern because it is a “heavy metal, “ (its not, aluminum is, in fact, a light metal). While it is true that toxicity can occur with those aluminum and formaldehyde at high levels, there are levels that are safe. By the way formaldehyde is a natural byproduct of human cellular metabolism, and all humans have detectable levels of formaldehyde in their blood. The level of aluminum in vaccines is small, and while some attribute local reaction some experience to the vaccine, – aluminum as a cause of that local reaction has only been speculated about, never proven. By the way, there is more aluminum in most drinking water, and aluminum has been used safely in deodorants and antacids for years.
The bench scientists have shown that autism comes from an array of DNA coded errors- so the anti-vaccination crowd says – ah ha – it is those toxic agents causing an environmental issue with those bits of DNA. Odd that it only affects that DNA and not other DNA- and no evidence that the changing of DNA in a two year old could ever happen.
So where do the anti-vaccination people get their “evidence?” It is anecdotes- what someone sees and interprets, or from blogs – and not from scholarly research meeting science based medicine, or cohort studies with even level D evidence based medicine. The anti-vaccination crowd becomes excited when some “scientist” gives them the slightest nod – answering their concern, but not agreeing with their principles (this doesn’t even meet level D evidence, but they become quite excited about anyone giving them thumbs up).
Meanwhile what is the number one cause of fetal death in America? Influenza contracted by the mother because she did not get vaccinated for the flu. Has there ever been a case in the literature of a vaccination causing harm to a fetus—none.
What about sixty years of safety with vaccines – they pay no mind to that.
Ask why not trust the physicians or scientists – the argument is the large pharmaceutical corporations buy the scientists – and data is therefore bought and sold (much like their hero Wakefield was). It is sad when this does happen, and those cases are well publicized.
What is more sad is when anecdotes, politics, bloggers are given more credence than the world of evidence and science based medicine. When we give politics, anecdotes, and bloggers more heed than science and medicine – we have entered back into the dark ages.
While I can appreciate the concerns of anyone for their health or their child’s health, the record is clear and science took seriously Wakefield’s initial data (and disproved it) – at some point, we have crossed the line between science and belief. Sadly, when a parent crosses that line, they put their child and other children at risk – serious risk.
Of note: Dr. Simpson has written numerous scientific articles, participated in multiple medical studies, done basic research with viruses, written several books, and provided scientific opinions for the FDA. He has not been paid by any pharmaceutical corporation for any work related to, or involved with vaccines or any drugs
Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.