Immune to controversy

The recent outbreak of mumps in the NHL has served to fuel the simmering public controversy surrounding immunization.

  • Tue Dec 30th, 2014 8:00am
  • News

Immunizations continue to be controversial. Medical professionals warn that anecdotal reports of illness after immunization are problematic.

The recent outbreak of mumps in the NHL has served to fuel the simmering public controversy surrounding immunization and the need to address what one health care professional has called a “disturbing trend toward the acceptance of misinformation and junk science.”

“It’s all part of a trend toward a sort of anti-authoritarian movement in which people don’t want to be told what to do,” said Dr. Monika Naus, Medical Director, Immunization Programs and Vaccine Preventable Diseases for the B.C. Centre for Disease Control (BCCDC).

“And to make things worse that’s been coupled with a regrettable anti-science movement. In all it has created an environment in which vaccinations are a natural target for fringe groups.”

 

Misinformation a problem

Anti-immunization groups, like Vaccination Choice Canada have also found a useful tool in the internet, a venue that allows for the publication of misinformation and junk science, according to Dr. Dee Hagaro, a medical health officer for the Vancouver Island Health Authority (VIHA).

“There’s a lot of bad information out there and it’s regrettable that people are taking these sites seriously.”

The iconic example of this sort of junk science and misinformation came when Jenny McCarthy,  former Playboy playmate and co-host of TV program The View, began to advocate against vaccinating children, publicly linking vaccinations to autism. Her crusade was based upon a widely discredited study published in the British Medical Journal, The Lancet and the fact that her own child had developed some autism-like symptoms some time after being immunized. The Lancet study was subsequently debunked and withdrawn but it didn’t stop McCarthy from continuing on her public denunciation of the measles vaccine.

The spread of that misinformation is just part of the problem, said Dr. Naus.

“In part, vaccines are the victim of their own success,” she said. “Not many of us know anyone who was crippled by polio and as a result we don’t stop to think about how it was vaccines that all but eradicated that disease in North America. But the disease is still out there and if enough people choose to forgo the inoculation, it could make a comeback.”

 

Role of vaccines denied

But according to Heather Fraser, a Director of  Vaccination Choice Canada, people shouldn’t credit vaccinations for the virtual elimination of polio or any other disease.

“Diseases are cyclical in nature and will rise and decline naturally,” she maintained.

She explained how her organization just wants people to be informed about vaccines and doesn’t advocate against vaccination — this despite statements like the following which appear on their website:

“The medical establishment considers vaccines effective if they suppress a few targeted illnesses — but at what cost? An emerging body of evidence indicates that vaccines can damage a child’s developing brain and immune system, leading to neurodevelopmental disorders, learning disabilities, ADHD, asthma, anaphylactic food allergies, diabetes and autoimmune disorders.”

Fraser acknowledges that there have been no clinical, peer reviewed studies to back up the position advocated by her organization, but cites “thousands of reports of serous adverse reactions” to vaccines.

Linking anecdotal reports of illnesses that occurred after immunization to the immunization, said Naus, is a popular fallacy in reasoning.

“Just because something happened after something else, doesn’t mean that it was caused by the preceding event,” she said. “There are a thousand other factors that may have caused the second event … diet, environmental factors. You can’t just pick one thing and place the blame there. It’s dangerously flawed.”

 

Outbreaks of forgotten illnesses

But that flawed reasoning has led to a marked decrease in immunization and the comeback of diseases like mumps, measles and whooping cough.Dr. Monika Naus, BCCDC

For example, a March 2014 measles outbreak in the Fraser Valley led to the infection of more than 400 victims of the once nearly eradicated disease.

“We have doctors out there who had never seen a case of measles,” said Dr. Naus. “Now, because people are choosing not to immunize, these outbreaks are back.”

That outbreak was linked to a low level of vaccination amongst a local congregation that objected to vaccines on religious grounds.

In another case, in October 2014, the city of Nelson, in B.C.’s West Kootenay region saw more than 40 people diagnosed with pertussis, or whooping cough. That’s a bacterial lung infection that can be debilitating and sometimes fatal, particularly to infants. The disease is preventable with immunization but in Nelson over a third of parents had refused to immunize their children against the disease, according to Dr. Rob Parker, an Interior Health medical health officer.

But this decline in immunization isn’t just a problem in B.C., according to a  2013 UNICEF report that ranked the well-being of Canada’s children as 17th out of 29  of the world’s so-called rich countries. It cites the low levels of immunization as a contributing factor for this rating, reporting that, internationally, Canada ranks amongst the lowest in immunizing its children. The report cites public fears arising from discredited research linking immunization to serious medical problems like autism as a likely contributing reason for that decline.

 

Herd immunity lost

“Immunizations are safe, effective and benefit people of all ages,” says Dr. Susan Bowles, Chair of Immunize Canada. “They protect individuals and communities by preventing the spread of disease. As more people are immunized, the disease risk for everyone is reduced.”

It’s a concept called “herd immunity” and it occurs when a large proportion of a population is immunized.

That large percentage of immunity disrupts the chain of infection and individuals who have not developed immunity through inoculation or other methods are less likely to become infected.

“Reduce that percentage of immunization and there’s a tipping point where the community immunity will not protect those who are not immunized,” said Naus. “Your decision to not immunize has an impact on the entire community … not just you or your family.”

 

Administrative and systemic problems in part to blame

The role of governments and administrative authorities should be reconsidered, according to Dr. Naus. In some provinces there is a requirement that parents produce immunization records when registering their children for school. She said that, while that registration does not prevent un-immunized children from attending schools, it does let school administrators identify potentially vulnerable children in the event of an outbreak.

“It also forces parents to explain why they haven’t immunized their child.”

And there are some reasons that Naus said are common.

“I suppose religious objections are the most common. But there are also cases of compromised immune systems due to other conditions … things like that.”

Having the registry in place, however, ensures that children are not left without immunization due to the “benign neglect” of parents.

“I think a registry of that kind would do a lot to help the situation in B.C.”

That’s not about to happen. According to Kim Rosenburg, a spokesperson for B.C.’s provincial government, there are no plans to make immunization a mandatory prerequisite for school registration, as it is in some other provinces like Ontario.

In B.C., writes Rosenburg, “The School Act requires school districts to provide student data delivery of public health programs in schools, including immunization, but when and how this takes place is decided at the school district level in cooperation with regional health authorities. School boards have immunization polices. There is no legislation.”

The Saanich School Division responded to requests for information on their policy by saying that they have no plans to insist on immunization for their students.

 

Trust your doctor … if you have one

Perhaps the biggest problem in B.C., according to Dr. Naus, is that the best advocates for immunization are trusted health professionals like the family doctor.

“Unfortunately, in B.C., we have a shortage of family doctors and more and more people are relying on walk-in clinics and the emergency room for their health care.”

Naus said that this sort of medical care doesn’t allow for the kind of necessary trust to develop and that people will then turn to the internet to decide about issues like inoculations.

— Tim Collins/News staff