Measles cases number 206 so far this year, according to the Centers for Disease Control and Prevention. The biggest outbreak—71 cases—is in Clark County, Washington, where the vast majority those who have fallen ill were unvaccinated children.
At a Senate hearing yesterday, 18-year-old Ethan Lindenberger of Norwalk, Ohio, testified that after reading the scientific data, he decided to finally get himself immunized against the wishes of his anti-vaccine mother. At the same Senate hearing, Sen. Rand Paul (R–Ky.) noted, "I've vaccinated myself and I've vaccinated my kids. For myself and my children I believe that the benefits of vaccines greatly outweighing the risks."
That's the message a respected and responsible physician who knows the scientific evidence should be providing to the American people. Unfortunately, Paul didn't leave it there.
"Now proponents of mandatory government vaccination argue that parents who refuse to vaccinate their children risk spreading these diseases to immunocompromised community," Paul said. "There doesn't seem to be enough evidence of this happening to be recorded as a statistic." Paul added, "It is wrong to say that there are no risks to vaccines. Even the government admits that children are sometimes injured by vaccines."
Paul does a disservice to his constituents and concerned parents with these two claims. He should have pointed out many folks have for years been misled by a fraudulent 1998 article in The Lancet suggesting a link between the vaccine for measles, mumps, and rubella (MMR) and autism. That article was retracted in 2011 and the principal investigator lost his medical license.
And in fact, there are at least 10 million immunocompromised Americans (e.g., those being treated with chemotherapy for cancer, taking medications for chronic illnesses like rheumatoid arthritis, living with organ transplants, or suffering from HIV/AIDS) who are at risk of infection from people who refuse to protect themselves and their families from vaccine-preventable diseases. In 2015, an immunocompromised woman died of measles in Washington State after she had been at a hospital at the same time as a patient who later developed a rash and was diagnosed with measles. "A single death is a tragedy; a million deaths is a statistic," Joseph Stalin once reportedly quipped. The death of the Washington woman may not be a statistic, but it was a preventable tragedy.
When Paul references the government's own acknowledgement of the risks posed by vaccination, he might be referring to data from the Vaccine Injury Compensation Program (VICP) that was set up by the federal government in the 1980s to prevent predatory tort lawsuits from destroying the vaccine industry. The VICP reports that from 2006 to 2017, over 3.4 billion doses of covered vaccines were distributed in the U.S. During that same period, 6,094 petitions for compensation were filed and, of those, 4,172 petitioners were compensated. This means for every one million doses of vaccine that were distributed, one individual was compensated.
It is also worth noting that "almost 80 percent of all compensation awarded by the VICP comes as result of a negotiated settlement between the parties in which HHS [the Department of Health and Human Services] has not concluded, based upon review of the evidence, that the alleged vaccine(s) caused the alleged injury."
We can also contrast the VICP data with the toll of injuries and deaths caused by measles before vaccines became available in 1962. Annual measles cases averaged 530,000, of which 48,000 were hospitalized and 450 of those infected died. A 1985 study by a Centers for Disease Control and Prevention epidemiologist in the journal Pediatrics estimated that the first 20 years of measles vaccination in the U.S. had prevented 52 million cases, 5,200 deaths, and 17,400 cases of mental retardation.
In that same vein, an article in the Journal of the American Medical Association compared the annual average number of cases and resulting deaths of various diseases before the advent of vaccines to those occurring in 2006. Before an effective diphtheria vaccine was developed, for example, there were about 21,000 cases of the disease each year, 1,800 of them leading to death. No cases or deaths from the disease were recorded in 2006. Whooping cough saw around 200,000 cases and 4,000 deaths annually. In 2006, there were nearly 16,000 cases and only 27 deaths. Polio once averaged around 16,000 annual cases and 1,900 deaths. No cases were recorded in 2006. The number of Rubella cases dropped from 48,000 to 17, and the number of deaths dropped from 17 to zero.
These are the sort of data that likely persuaded Lindenberger to protect himself and others through vaccination. We should be troubled when an 18-year-old with no scientific training proves a more enthusiastic and informed witness to the benefits of modern medicine than a seasoned medical doctor. And yet that is where we are. On Monday, a comprehensive new study further backed up Lindenberger's views on the safety and benefits of vaccination. A team of Danish physicians analyzed the health data on more than 650,000 Danish kids who had been immunized against using the MMR vaccine. The researchers report that their "study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination."
A responsible senator and physician should also have been highlighting those data, instead of kowtowing to anti-vaccination fearmongers. After all, if Paul thinks that vaccination is good enough for his family, he should be explaining to other families how he reached that conclusion, rather than providing them with additional reasons to endanger their own children.
For more background, see Reason's debate, "Should Vaccines Be Mandatory?"
*UPDATE: Sen. Rand Paul (R–Ky.) on March 7 submitted the following response:
How sad that a magazine that purports to extoll individual choice editorializes against choice in vaccines. I wonder if there is any point at which a patient should get to choose their treatment. Deciding whether or not to have a medical treatment injected into your body sounds like it might involve personal choice. The government now requires over 71 vaccines administered in 53 injections. Forty-eight of these vaccines are required before age 6.
What if the government decides that 'public health' requires 241 vaccines in 170 injections? Would that be OK? Are libertarians really OK with letting the government dictate what diseases you must be vaccinated for and when? Really? To those who justify coercion in the name of public health, be forewarned that the security you think you get when you exchange your liberty often turns out not to be that secure, and the small amount of liberty you offer up is greedily gobbled up by government until your original offering of liberty becomes much greater than you intended.
For those with open minds, I offer my unedited remarks, that actually are quite tempered, pro-vaccine, and pro-freedom:
For much of modern history, science and freedom have lived in relative harmony.
Traditionally, as medical discoveries came about, like the smallpox or Polio vaccine, antisepsis, or antibiotics, the results were so overwhelming that, over time, the vast majority of the public accepted these advances voluntarily.
In fact, innovations like the smallpox vaccine had to overcome initially great public prejudice.
Dr. Zabdiel Boylston learned about the Middle Eastern technique from his servant, for the famous pastor Cotton Mather. His first patient was actually his son, an incredibly brave choice.
The consensus of the medical community, though, was entirely opposed to him at the time. The vaccine was a live vaccine, and as Dr. Boylston learned, about one in fifty of those inoculated would die from the vaccine. And yet, the death rate from smallpox was approximately 50 percent.
The government did not mandate the vaccine, though, but within two generations it was accepted enough that George Washington insisted that Martha be vaccinated with the smallpox vaccine before visiting him in the military camps.
Today, though, instead of persuasion, many governments have taken to mandating a whole host of vaccines, including vaccines for non-lethal diseases.
Sometimes these vaccine mandates have run amok, as when the government mandated a rotavirus vaccine that was later recalled because it was causing intestinal blockage in children.
I'm not a fan of government coercion, yet given the choice, I do believe that the benefits of most vaccines vastly outweigh the risks.
Yet, it is wrong to say that there are no risks to vaccines. Even the government admits that children are sometimes injured by vaccines. Since 1988, over $4 billion has been paid out from the Vaccine Injury Compensation Program.
Despite the government admitting to and paying $4 billion for vaccine injuries, no informed consent is used or required when you vaccinate your child. This may be the only medical procedure in today's medical world where an informed consent is not required.
Now proponents of mandatory government vaccination argue that parents who refuse to vaccinate their children risk spreading these diseases to the immunocompromised community.
There doesn't seem to be enough evidence of this happening to be recorded as a statistic, but it could happen. But if the fear of this is valid, are we to find that next we'll be mandating flu vaccines?
Between 12,000 and 56,000 people die from the flu or are said to die from the flu in America, and there's estimated to be a few hundred from measles. So I would guess that those who want to mandate the measles [vaccine] will be after us on the flu next.
Yet the current science only allows for 'educated guessing' when it comes to the flu vaccine. Each year, before that year's flu strain is known, scientists put their best guess into that year's vaccine. Some years, it's completely wrong; we vaccinate for the wrong strain of flu.
Yet five states already mandate flu vaccines. Is it really appropriate to mandate a vaccine that more often than not vaccinates for the wrong flu strain?"
As we contemplate forcing parents to choose this or that vaccine, I think it's important to remember that force is not consistent with the American story, nor is force consistent with the liberty our forefathers sought when they came to America.
I don't think you have to have one or the other, though. I'm not here to say "don't vaccinate your kids." If this hearing is for persuasion, I'm all for the persuasion. I vaccinated myself. I vaccinated my kids.
For myself and my children, I believe that the benefits of vaccines greatly outweigh the risks, but I still do not favor giving up on liberty for a false sense of security.