A Challenge to Scientific & Medical Professionals (and anyone concerned with the health of our children)

A recent search of Twitter using the simple keyword “vaccine” revealed a smattering of advertisements, with the majority of postings originating from the anti-vaccinator community. To my surprise, many had surprisingly attractive graphs and tables excoriating the overuse of vaccines and their rumored relationship to autism. 

These disconcerting visuals recall a conversation from the summer of 2016. Earlier that year, the Center for Research Innovation in Biotechnology, which I lead at Washington University in St Louis, embarked on a project to catalog all innovative vaccine products ever approved by FDA and the key innovators behind each breakthrough. This work, published in a December 2017 edition of Expert Reviews of Vaccines, highlighted 135 key innovations but disconcertingly, also showed the number pathogens preventable by vaccines has stalled in recent decades.

In researching the subject, I was struck that virtually all new innovations in vaccine development had been met with skepticism, if not outright hostility. It soon became apparent this denial is not a product of the internet era. Overt hostility to vaccines predates even the first vaccine (a smallpox vaccine mis-attributed to Edward Jenner but first tested by a Dorset dairy farmer by the name of Benjamin Jesty). These early critics feared those immunized with cowpox would sprout horns and begin a metamorphosis into a half-human, half bovine chimera. Likewise, vaccines to prevent other deadly infectious disease often met with similar rancor. The public even turned against the highly-praised Salk polio vaccine, the news of which had initially triggered the ringing of church bells. Yet, this bonhomie quickly disappeared after a bungled preparation of one batch of vaccine paralyzed or killed dozens of children in California.

Based on these disparate stories, I spoke with a few scientific colleagues with deep expertise in the field and bounced the idea of writing a book on the history of vaccines and the parallel rise of the anti-vaccine movement. To my surprise, each dismissed the idea, stating frankly the ideas behind the anti-vaccinator movement had been repeatedly disproven and that my efforts would be better placed elsewhere. Heeding their advice, I abandoned the idea and moved on. 

Everything changed on the evening of November 8, 2016. Like many others, I was stunned by the election results but more importantly, was concerned by the nation had just elected an individual with a consistent track record as a prominent and highly vocal anti-vaccinator. As the night wore on, I turned off the television and revisited the notes from the abandoned project.

The resulting book, Between Hope and Fear, details the parallel rise of vaccines and its deniers. While an obvious goal is to convey impartial information about the efficacy (and occasional dangers) of vaccines, it is also a wake-up message for the biomedical community. As we near the one-year anniversary date of the March for Science, first held on April 22, 2017, the need and challenges of accurately communicating about science has never been as high.

The scientific craft is one of conceptualizing and testing hypotheses. As one idea is verified or rebutted, we move on to the next. What many of us has forgotten is that too few of our fellow citizens (and voters) have had the privilege to dedicate themselves to evaluating the complex and specialized data arising from medical trials. In doing so, we have distanced ourselves from the real consumers, owners and potential benefactors of this work. Appropriating the title of a 2018 book by Tom Nichols, we have all contributed to the Death of Expertise that has alienated medical researchers and professionals and threatens the continuation of work we hold so dear.

We need to actively engage skeptics, be it critics doubting climate change or the safety of vaccines. The key word here is active. Using vaccines as an example, we need to reach out and engage in uncomfortable discussions with expectant parents and, depending on your age and associations, expectant grandparents or great-grandparents. The anti-vaccine movement did not grow out of anger or hatred, but was propelled (mostly) by well-meaning parents and grandparents seeking to optimize the health and happiness of their family.

A small minority of anti-vaccinators were motivated by greed, the most prominent example being the exploitation of fears about the MMR vaccine by charlatans such as Andrew Wakefield, who fabricated his results driven by a desire for fame and profit. While my colleagues presume demonstrated swindlers like Wakefield have been ostracized and are perhaps living a life of shame in some sleepy backwater, they may be shocked to learn he is a wealthy resident of Austin, Texas, who still makes a comfortable living peddling his disproven ideas. Beyond a lucrative lecture circuit, Wakefield has penned books on the subject and produced a feature-length film on the subject, which was initially selected as a headliner for Robert De Niro’s 2016 Tribeca Film Festival. 

In the frenetic days before and then after his election, Donald Trump took time out to meet with Wakefield. Indeed, Wakefield was invited to, and attended, one of the inaugural balls on January 20, 2017, where he called for a restructuring of the Centers for Disease Control and Prevention.

The fact the public health, medical and scientific communities have not been able to nullify the damage done by a discredited scientist peddling falsified data speaks volumes about the challenge we face. In a time when even our most fundamental assumptions about the world seem to be coming into question, we must rise together to the challenge and actively confront the denial of facts. In researching “Between Hope and Fear,” I was fortunate to communicate with Brian Deer, the insightful English investigative reporter, who first exposed the Wakefield fraud and in doing so, has saved countless number of lives. During these discussions, Brian shared some of the messages he still receives from vaccine skeptics (none of which are appropriate to print here). This primal hostility reveals a principled stand against the growing anti-science block will not be easy. However, much hard work lies ahead and is absolutely essential if we seek to improve the health of our children.