6 things to say when you're faced with anti-vaccination rhetoric.

To finish up the year that was, we’re going to bring you the 14 most popular Mamamia posts of 2013. It’s like a countdown, an advent calendar of sorts, but one that gets your through the post-Christmas blur and into the new year. We’ve been lucky to have some truly wonderful writers join us to share their thoughts on Mamamia this year. This is the very, very best of what they had to offer. Enjoy.

The issue of vaccination is a major hot button right now – and shows no signs of being eradicated any time soon.

Not while people are continuing to expose others to misinformation -either deliberately or inadvertently.

Sugar-free author and blogger Sarah Wilson faced a tsunami of opposition last year when she went on Sunrise and made some wildly ill-informed and inaccurate comments about vaccination, claiming research about the safety and efficacy of vaccines was “not conclusive”.

She also claimed that “the gold standard studies, right, that are done to really absolutely conclusively prove things, the double-blind placebo cross something or other tests have not been done”.

Those two arguments are very familiar to those who campaign against the lies and fear-mongering of the anti vaccination lobby – they’re utterly false.

But clearly, the anti-vaxxers have been alarmingly effective in sewing seeds of doubt in certain pockets of the community. Particularly among those who are interested in alternative medicine, diets or lifestyles such as Sarah.

Immediately after making her comments, all manner of social media hell rained down on Sarah as she was very swiftly informed of the inaccuracy of her claims and the irresponsibility of making them.

Some people were more polite than others – there’s a lot of emotion in this debate. And while there’s never an excuse for abuse, here is why so many people feel so strongly about this issue:

Vaccination is more than a personal choice, it’s a social responsibility. Like not driving drunk or not smoking around people who don’t want to breathe in your nicotine.

Because immunisation is something that effects everyone in our community and especially the vulnerable – those who can’t vaccinate because they are too young or too sick.

When you have someone in your life that falls into one of those categories or you or a loved one plans to have a baby some day, this issue cuts particularly deep. It can literally be a matter of life and death.

Dr Rachael Dunlop is a medical researcher, science communicator and campaigner for science-based medicine in Australia; she has previously written an article about vaccination myths for Mamamia. Now, she writes about what to do when you’re faced with anti vaccination rhetoric or anyone who tries to deny science…

1. “Vaccines cause autism.”No. No. No. Do I need to say this again? No. One of the most powerful pieces of evidence to show that there is no link between vaccines and autism comes from Japan where they replaced the triple vaccine Measles Mumps Rubella (MMR) with single vaccines mid-1993. Guess what happened? Autism continued to rise.

This should have been the final nail in the coffin for the autism/vaccines link but instead opponents just shifted the blame to thiomersal, the mercury-containing component that was present in small amounts in some vaccines where it was used as a preservative (MMR never contained thiomersal).

This component was removed from all scheduled childhood vaccines in the year 2000, solely because of the scary word “mercury” and not for any fears or evidence for harmful effects. If it were contributing to rising cases of autism then you would expect a dramatic drop following its removal. Instead, like the MMR in Japan, the opposite is true, and autism continues to rise.

Of course these are not the only pieces of evidence, and scientists continue to test, and re-test the safety of vaccines. A recently published exhaustive review examining 12,000 research articles covering 8 different vaccines concluded there was no link between vaccines and autism. While scientists still don’t know the exact causes of autism, we are looking like mad and one thing we can be extremely confident of is that it’s not vaccines.

2. “Vaccines cause and spread the disease they’re supposed to prevent.”

This is a common misunderstanding particularly for the flu vaccine as many of us experience side effects following a vaccine that can easily be confused with influenza. For example, you can expect to get a sore arm at the site of injection, perhaps a slight fever, maybe a headache – symptoms synonymous with flu.

But you absolutely definitely cannot get the flu from the vaccine because there is no “live” virus in it to infect you. The mild response you get following a flu vaccine, or any vaccine for that matter, is in fact a good sign since it indicates your immune system is responding, thus the vaccine is working.

In the pages of history there are cases of vaccines causing the disease they were meant to prevent – for example in the USA in 1955, a bad batch of polio vaccine exposed several thousand children to live polio virus upon vaccination – but advances in technology and testing ensure the likelihood of this happening again is virtually zero.

3. “I had the chicken pox and I’m fine.”

Many of us old enough to have been grown up before vaccines for chicken pox was widely available probably remember getting childhood diseases. But does this mean we should risk it for our own kids, especially when there’s an option to prevent it? Well let’s look at the risks from the disease versus the vaccination and you can decide.

In every case, the benefits of vaccination far outweigh the risks, and even more significantly outweigh the harm potentially caused by the disease. In the case of measles, the risk of encephalitis, which can lead to brain damage is 1 in 1,000. The risk of contracting encephalitis from the measles vaccine it’s 1 in 1,000,000 (note, all vaccines have side effects without which they would have no effect). Without any vaccine, 6 out of 100 children infected with measles will get pneumonia and 2 kids out of every 1,000 infected will die.

Pertussis or whooping cough is most severe in kids under the age of 1, commonly requires hospitalisation and kills 1 in 200 unvaccinated children. Severe complications occur almost exclusively in the unvaccinated and include pneumonia, seizures, cracked ribs from severe coughing, brain damage from lack of oxygen, vomiting after coughing fits, and long-term lung damage. There is no cure for whooping cough. Antibiotics are administered to prevent infection of others, but the only truly effective preventative measure is vaccination.

4. “There are two sides.”

There are two sides to the vaccine “debate” just like there are two sides to the “earth is round” debate (yes, the Flat Earth Society really does exist). On the one hand there is the scientific consensus backed by extensive research that vaccines are safe and effective, and on the other there is obfuscation, half-truths, misinformation and debunked research.

The only debate is one that has been manufactured by those with a vested interest in undermining confidence in vaccines. Those like Andrew Wakefield, who has been accused of deliberate fraud by the British Medical Journal for suggesting there was a link between the MMR and autism all the while pocketing money from lawyers tasked with suing the vaccine manufacturers.

Wakefield was also poised to submit a patent on a single measles vaccine, from which he stood to profit substantially once he’d scared everyone away from the triple antigen MMR. He also stood to make millions from a diagnostic kit he had developed for autistic enterocolitis, a new condition he claimed to have identified in his 1998 Lancet paper (which has since been retracted by the publisher). So yes, I guess there are two sides, there is the side where all the evidence lies in support of vaccination, then there are the cranks and quacks with a vested interest.

5. “Major illnesses like polio have disappeared so we don’t need vaccines.”

Major illnesses like polio have disappeared precisely because of vaccines. Anyone heard of someone contracting smallpox recently? No? Well that’s because the last remaining supplies of smallpox now reside locked in a deep freezer in the depths of the Centres for Disease Control in Atlanta, USA. Smallpox was wiped out because of a concerted vaccination programme.

Indeed measles was also heading the same way – Australia was declared measles free in 2005 by the WHO – before we became complacent, stopped being so diligent about vaccinating and it got a chance to take hold again. The impact of not vaccinating for measles can be seen in the current epidemic in Wales where there are now over 500 cases, many of the age who missed out on their MMR vaccination following the famous 1998 Andrew Wakefield scare.

In Australia in 2010, doctors were shocked by the death of a 22 year old who died from diphtheria, a disease now unheard of, after contracting it from a friend who caught it during an overseas holiday. It is believed she wasn’t vaccinated against the bacterial infection.

In many ways, vaccines are a victim of their own success, since they create an “out-of-mind, out-of-sight” scenario lulling us into a false sense of security. We don’t see kids in calipers anymore, or hospitals full of iron lungs, but if we stop vaccinating then we create an environment where they can return.

6. “Vaccines can overwhelm the undeveloped immune system in kids’ tiny bodies.”

The concept of “too many too soon” has been championed by celebrity Mom Jenny McCarthy and Dr Bob Spears, and as a result has been the subject of intense scrutiny by scientists. Very recently a detailed analysis of the US childhood immunisation schedule was conducted to look for any deleterious effects of the number of vaccines kids receive.

The Institute of Medicine specifically looked for evidence that vaccination is linked to “autoimmune diseases, asthma, hypersensitivity, seizures, child developmental disorders, learning or developmental disorders, or attention deficit or disruptive disorders”, including autism. They confirmed what other researchers have also observed, that the childhood schedule is safe.

With respect to overwhelming kids’ immune systems, the tiny amount of antigens in vaccines pales in to comparison to what they are exposed to every day via playing, eating and drinking. The amount of immune challenges that children fight every day (2,000 — 6,000) in the environment is significantly greater than the number of antigens or reactive particles in all their vaccinations combined (about 150 for the entire vaccination schedule).

Also, because of innovations in the way vaccines are made, today’s vaccines contain far fewer antigens than those administered in the past. The new pertussis vaccine for example has significantly less antigens than the older style “whole cell” vaccine meaning it causes fewer side effects (but that it is also less effective).

You can read Rachael’s original post “9 vaccination myths busted! With science!’ here.

Dr. Rachael Dunlop is a medical researcher, science communicator and campaigner for science-based medicine in Australia, with a special interest in the anti-vaccination movement and alternative medicine  Rachael is a vice president of the Australian Skeptics and a contributor to their magazine and website. She blogs at the Skeptics Book of PoohPooh and tweets at Dr Rachie. Rachael was the winner of the 2010 Shorty Award for Health and enjoys combining her love of science and art to communicate science to the public.