Author: Vincent Iannelli, MD

Myths About Polio and Acute Flaccid Paralysis

Polio is one of the most well known causes of acute flaccid paralysis.

Although most people with polio infections have no symptoms at all ,or just have a very mild illness, with a sore throat and a low grade fever, a small percentage can develop:

  • a loss of superficial reflexes
  • severe muscle aches and spasms in their limbs or back
  • an asymmetrical flaccid paralysis with diminished deep tendon reflexes

This acute flaccid paralysis only affects the child’s strength in the affected muscle groups – there is no loss of sensation. The severity of the symptoms and the disease depends on which muscles are affected the most. If it is just your legs, then you will have trouble walking. On the other hand, if affects your chest, then you might not be able to bring unless you are put on a ventilator (iron lung).

Acute Flaccid Paralysis

Thinking about it in the context of polio, it becomes easy to understand acute flaccid paralysis or AFP.

It is the sudden onset (acute) of a flaccid (floppy or poor muscle tone) paralysis (weakness or inability to move) of one or more muscles.

But what many people don’t understand, is that in addition to polio, there are many more non-polio causes of AFP.

Non-Polio AFP

Many of us got a crash course in non-polio acute flaccid paralysis (NP-AFP) a few years ago when we started hearing reports of kids developing polio-like paralysis in 2014. Now thought to be caused by enterovirus D68 infections (EV-D68), the paralysis followed respiratory tract infections in many of the affected children. All together, at least 120 children in 34 states developed acute flaccid paralysis that year.

Interestingly, EV-D68 is one of more than 100 non-polio enteroviruses. The virus that causes hand, foot, and mouth disease, coxsackievirus A16, is another. Others cause pinkeye, meningitis, or encephalitis.

Keep in mind that many other viruses and conditions can cause non-polio AFP though, including:

  • Guillian-Barré syndrome
  • toxins (botulism)
  • tumors
  • transverse myelitis
  • traumatic neuritis
  • other infections, including novel enterovirus C105, a non-polio enterovirus, and even tick-borne (Lyme disease) and mosquito-borne (Japanese encephalitis) infections

How do you determine the cause and how do you know it isn’t polio?

These kids with AFP typically have extensive testing to determine what is causing their AFP, including an MRI, antibody tests, and testing of their cerebrospinal fluid, etc. Although it isn’t always possible to identify a cause, you can at least rule out many potential suspects, like trauma, polio, and other infections.

Myths About Polio and Acute Flaccid Paralysis

Some folks don’t believe in non-polio AFP.

They believe that polio never really disappeared because vaccines don’t really work and that polio was simply renamed to, you guessed it, acute flaccid paralysis.

“Unbeknownst to most doctors, the polio-vaccine history involves a massive public health service makeover during an era when a live, deadly strain of poliovirus infected the Salk polio vaccines, and paralyzed hundreds of children and their contacts. These were the vaccines that were supposedly responsible for the decline in polio from 1955 to 1961! But there is a more sinister reason for the “decline” in polio during those years; in 1955, a very creative re-definition of poliovirus infections was invented, to “cover” the fact that many cases of ”polio” paralysis had no poliovirus in their systems at all. While this protected the reputation of the Salk vaccine, it muddied the waters of history in a big way.”

Suzanne Humphries, MD on Smoke, Mirrors, and the “Disappearance” Of Polio

What’s there evidence?

A rise in cases of non-polio AFP in India since 1997.

How do we know that there has been a rise in non-polio AFP cases in India since 1997?

It’s very simple and explains why there isn’t any data on before that 1997. As part of the strategy to eliminate polio in that country, starting in 1997, all cases of AFP started getting tested for polio. It was a way to track the effectiveness of the immunization program. If you were seeing too many cases of AFP caused by polio, then not enough people were getting vaccinated. On the other hand, if you weren’t seeing any cases of AFP in an area, then the testing and surveillance probably wasn’t getting none, since there will always be some cases of non-polio AFP.

Unfortunately, they found many cases to track. And the cases kept increasing, although more and more, they weren’t being caused by polio. At least not by live polio virus.

Were they caused by the polio vaccine?

In some cases, yes. It is well known that the live polio vaccine can rarely cause VAPP and cVDPV.

By 2015, after polio was declared free of polio (the last case was in 2011), none of those cases of AFP were found to be caused by wild polio though. And India hasn’t had a case of cVDPV since 2010.

Why the increase in cases of non-polio AFP? It certainly isn’t because of Suzanne Humphries’ polio virus renaming conspiracy or any other anti-vaccine conspiracy involving the polio vaccine itself.

The 'data' that Susanne Humphries uses to try and make her case about AFP neglects to mention that in the pre-vaccine era, polio paralyzed 500 to 1,000 children in India each day! Those 180,000 to 365,000 cases of paralysis wouldn't fit on her chart though...
The ‘data’ that Susanne Humphries uses to try and make her case about AFP neglects to mention that in the pre-vaccine era, polio paralyzed 500 to 1,000 children in India each day! Those 180,000 to 365,000 cases of paralysis wouldn’t fit on her chart though…

If we simply renamed polio to non-polio AFP, why did the numbers drop for so long and then slowly start to increase? Shouldn’t it have been a rapid crossover?

More importantly,  why are the case of paralysis from non-polio AFP so much lower than the pre-vaccine era cases of AFP from polio?

And how come we rarely see large outbreaks of AFP like we did in the pre-vaccine era?

Sure, 120 kids in the EV-D68 non-polio AFP outbreak of 2014 is way more than any of us would like to see, but it is tremendously less than what we used to see in the pre-vaccine era from polio.

“Poliomyelitis is one of the important emergent viral diseases of the twentieth century… At its height, from 1950–1954, poliomyelitis resulted in the paralysis of some 22,000 U.S. citizens each year… Many thousands were left permanently disabled by the disease, while many others suffocated as a consequence of respiratory paralysis.”

Barry Trevelyan on the The Spatial Dynamics of Poliomyelitis in the US

While anti-vaccine conspiracy theories about AFP are as easy to dismiss as all of the rest they bring up,  what is behind the rise in AFP in some areas of the world?

Although one study that was published in Pediatrics, “Trends in Nonpolio Acute Flaccid Paralysis Incidence in India 2000 to 2013,” did find a correlation between the use of the OPV vaccine and the incidence of non-polio AFP, many experts think the rise is a result of better screening. Also, once polio gets under control, other more neglected diseases start getting more attention, like enteroviral infections. Not surprisingly, other parts of the world have had the same experience.

There is also the fact that in 2005, the Global Poliomyelitis Eradication Initiative began “to cast a wider net for poliovirus detection and to maximize sensitivity so that every poliomyelitis case is detected.” Why? If even a single case was missed, it could lead to continued outbreaks and would get in the way of polio elimination in the country.

“This large increase in NP-AFP cases, which represent AFP cases caused by agents other than poliovirus, probably reflects the excellent implementation of the expanded definition of AFP and highly sensitive surveillance and detection methods used by NPSP in India from 2005 onwards…”

C. Durga Rao on Nonpolio Acute Flaccid Paralysis in India

So did the polio vaccine recently cause 53,000 paralysis victims in India?

No. The polio vaccine has worked to get us on the brink of eradicating polio though.

What To Know About Acute Flaccid Paralysis

Acute flaccid paralysis can be caused by the polio virus, but non-polio acute flaccid paralysis becomes a more important cause once polio is eliminated in a region.

More About Acute Flaccid Paralysis

cVDPV

Circulating vaccine-derived polio virus or cVDPV are outbreaks of polio that are actually caused by the polio vaccine.

Very rarely, the attenuated (weakened) virus in the oral polio vaccine can revert to a form that can cause the person who was vaccinated or their close contact to actually develop polio.

It should not be confused with VAPP or vaccine-associated paralytic polio. With VAPP, the original strain of attenuated vaccine virus reverts to a form that can cause polio, but it does spread from one person to another, so does not lead to outbreaks.

cVDPV Outbreaks

Fortunately, both VAPP and cVDPV are rare.

How rare? VAPP only occurs in about 1 in every 1.27 million children receiving their first dose of OPV.

And according to the WHO, there had only been about 24 outbreaks of cVDPV over the past 10 years. Tragically, this has resulted in at least 750 cases of paralytic polio in 21 countries.

An outbreak of cVDPV in Syria will be controlled by 355 vaccination teams that will vaccinate up to 328,000 children.
The WHO reports that an outbreak of cVDPV in Syria will be controlled by 355 vaccination teams that will vaccinate up to 328,000 children.

A new outbreak of cVDPV in Syria adds to those numbers though.

After being polio free for 15 years, since 1999, Syria began having cases of wild type polio again in 2013 (35 cases) and 2014 (1 case). Those polio cases and the emergence of an outbreak of cVDPV2 (there are three strains of polio virus – this outbreak was caused by the type-2 strain) highlight the effects of years of poor immunization rates because of war.

While there are many challenges to getting kids vaccinated in Syria, up to 355 vaccination teams with 61 supervisors will be working out of five vaccine distribution centers to vaccinate 328,000 children to control the outbreak and get kids vaccinated.

Circulating Vaccine-Derived Polio Virus

Just like wild type polio, we can stop cVDPV by increasing vaccination rates and increasing access to improved sanitation facilities.

Why?

Although anti-vaccine folks routinely cry wolf about shedding, the oral polio vaccine really does shed – in the stool of people who have been recently vaccinated. You can then be exposed to the attenuated polio vaccine virus (which can help give immunity to others in the community by passive immunization) or a strain of cVDPV (which can, unfortunately, help give others, especially if they are not vaccinated, paralytic polio) if they are exposed to open sewage or can not practice proper hygiene, etc.

Can’t we just stop using the live, oral polio vaccine?

Although a serious side effect of the vaccine, the vaccine’s benefits clearly outweigh the risk of both VAPP and cVDPV while polio is endemic (lots of cases) in a region, after all, without the vaccine, hundreds of thousands of children would get polio and would be paralyzed.

In polio-free countries, the risks of VAPP and cVDPV becomes greater than the risk of polio though, and they move to the inactivated polio vaccine. That helps prevent a situation in which the polio vaccines actually causes more cases of polio than wild type polio viruses.

Eventually, all countries will move to the IPV vaccine as we move closer to polio eradication. We came one step closer to that point in April 2016 when all countries that were still using the oral polio vaccine switched from trivalent OPV (three strains) to bivalent OPV (two strains) for their routine immunization programs. This could eliminate up to 90% of cases of cVDPV (most are caused by the type-2 strain which is not in bOPV)!

What To Know About cVDPV

Circulating vaccine-derived polio virus outbreaks are a rare side effect of the oral polio vaccine.

More Information About cVDPV

Anti-Vaccine Movement Timeline and History

After 1883, Leicester became a a stronghold for the anti-vaccination movement. Outbreaks of smallpox soon followed, as is seen in this New York Times report from 1884.
After 1883, Leicester became a a stronghold for the anti-vaccination movement. Outbreaks of smallpox soon followed, as is seen in this New York Times report from 1884.

When did the anti-vaccine movement start?

Some people will be surprised to learn that it didn’t start with Bob Sears, or Jenny McCarthy, or even with Andy Wakefield.

The anti-vaccine movement started even before we started giving vaccines.

“By the 1930s… with the improvements in medical practice and the popular acceptance of the state and federal governments’ role in public health, the anti-vaccinationists slowly faded from view, and the movement collapsed.”

Martin Kaufman The American Anti-Vaccinations and Their Arguments

But while anti-vaccinationists might have “slowly faded from view” in the 1930’s, they came back…

And that’s why we often associate the modern anti-vaccine movement with Bob Sears, and Jenny McCarthy, and even with Andy Wakefield. But who inspired them? The modern anti-vaccine movement took root with a discredited bit of research that was published by a doctor in London, but it wasn’t by Wakefield.

Anti-Vaccine Movement Timeline

Again, the anti-vaccine movement predates modern vaccines, but not surprisingly, they have always used the same arguments:

  • The Rev. Cotton Mather’s house is bombed after he started a smallpox variolation program in Boston in 1721

“Every year, thousands undergo this operation, and the French Ambassador says pleasantly, that they take the small-pox here by way of diversion, as they take the waters in other countries. There is no example of any one that has died in it, and you may believe I am well satisfied of the safety of this experiment, since I intend to try it on my dear little son. I am patriot enough to take the pains to bring this useful invention into fashion in England…”

Lady Mary Wortley Montagu On Small Pox in Turkey (1717)

  • Dr. Benjamin Mosely, who had a very busy practice inoculating people against smallpox, becomes “the first antivaccinist,” writing against Jenner’s new smallpox vaccine in 1798, warning about “cow mania” and “to guard parents against suffering their children becoming victims  to experiment.”
  • The satirical print, Admirable effet de la Vaccine, appears in France in 1801, depicting horns sprouting from the forehead of a man who was just vaccinated against smallpox.
  • Also in France, Dr. Jean Vernier and Dr. Joseph Vaume each publish pamphlets critical of Jenner’s vaccine.
  • In 1802, another satirical print appears in England, The Cow-Pock-or-the Wonderful Effects of the New Inoculation!, depicting people turning into cows after being vaccinated
  • The Anti-Vaccination League is created in England in response to the passage of the Vaccination Act of 1853, which made getting the smallpox vaccine compulsory
  • Dr. C. C. Schieferdecker, writes about the Evils of Vaccination in 1856 in which he set out to “prove vaccination to be nonsense before reason – a miserable illusion, in a scientific point of view, and, in regard to history, the greatest crime that has been committed in this last century.”
  • the Anti-Cumpulsory Vaccination League is founded after the passage of the Vaccination Act of 1867
  • The New York Times announced the formation of the American Anti-Vaccination Society in 1885.
    The New York Times announced the formation of the American Anti-Vaccination Society in 1885.

    Lewis Carroll argues with folks pushing anti-vaccine information about the smallpox vaccine in 1877

  • William Tebb, a British anti-vaccinationist, visits the United States in 1879 and helps start the Anti-Vaccination Society of America.
  • Alfred Russel Wallace is recruited to the antivaccination movement after reading Papers on Vaccination
  • Leicester Demonstration March of 1885 – around the time that Leicester had become “a stronghold of anti-vaccination.”
  • In 1882, Henry Bergh, founder of the ASPCA and a vocal member of the anti-vivisectionist movement, which were often anti-vaccine, writes an article against vaccines. He later helped found the American Anti-Vaccination Society.
  • Lora Little speaks out about vaccines and writes Crimes of the Cowpox Ring in the late 19th century
  • George Winterburn, like many homeopaths of the time (1886), becomes an outspoken critic of vaccines, writing the book The Value of Vaccination, in which he tries to proves “how little of scientific research it was adopted, and how much the whim of a few fashionable folk shaped its destiny.”
  • In 1890, Dr. AN Bell debates Dr. Robert A. Gunn, who had “long held that vaccination would in time be relegated to the long list of medical fallacies, and such works as I mention seem to indicate that it will not be long before that time comes,” in a series of articles over several months, “The Truth About Vaccination,” in their respective medical journals, The Sanitarian and Medical Tribune.
  • Dr. Immanuel Pfeiffer didn't think smallpox was contagious. He was wrong...
    Dr. Immanuel Pfeiffer didn’t think smallpox was contagious. He was wrong…

    William Tebb publishes the book Vaccination and Leprosy in 1893, in which he pushes the idea that an increase in leprosy is caused by smallpox vaccinations. A review in the New York Times wonders “Can it be possible that for all the years of the present century we have been believing in the potency of vaccination and been stupid enough to work in the wrong direction? Such a conclusion forms the basis of Mr Tebb’s arguments.”

  • In 1902, Dr. Immanuel Pfeiffer, argues that smallpox wasn’t contagious, was allowed to visit the Gallop’s Island smallpox hospital in Boston. A few weeks later, he was found to be critically ill at his home – with smallpox.
  • Dr. Reuben Swinburne Clymer, an osteopath, in 1904, writes Vaccination Brought Home to You, which “tells what vaccine is and how it is procured from the calf; tells how some have been killed and others made to suffer untold miseries by being inoculated with pure vaccine [poison]; gives facts and figures showing the results of vaccination… All of which show that vaccination don’t prevent small-pox, but rather tends to increase it. It exposes some of the lies of the wily Medicoes.” Clymer was also an occultist, an Rosicurcian (a self-proclaimed community of mystics who study and practice the metaphysical laws governing the universe, but more commonly called a fake secret society), and wrote about alchemy.

“Here I would like to say a word or two upon one of the most terrible of all acute infections, the one of which we first learned the control through the work of Jenner. A great deal of literature has been distributed casting discredit upon the value of vaccination in the prevention of small-pox. I do not see how anyone who has gone through epidemics as I have, or who is familiar with the history of the subject, and who has any capacity left for clear judgement, can doubt its value…

I would like to issue a Mount-Carmel-like challenge to any ten unvaccinated priests of Baal. I will go into the next severe epidemic with ten selected, vaccinated persons and ten selected unvaccinated persons – I should prefer to choose the latter – three members of Parliament, three anti-vaccination doctors (if they can be found), and four anti-vaccination propagandists. And I will make this promise – neither to jeer nor jibe when they catch the disease, but to look after them as brothers, and for the four or five who are certain to die, I will try to arrange the funerals with all the pomp and ceremony of an anti-vaccination demonstration.”

Sir William Osler, MD Man’s Redemption of Man (1910)

  • The anti-vaccine American Medical Liberty League is founded in 1918 by D.W. Ensign, the owner of Ensign Remedies (which sold mail-order cures to all diseases), and works against the American Medical Association, employs Lora Little and Charles M. Higgins of the Anti-Vaccination League of America
  • Mahatma Gandhi writes A Guide to Health in 1921 and states  that “vaccination is a violation of the dictates of religion and morality”
  • Dr. John H Tilden writes the book Toxemia Explained: The True Interpretion of the Cause of Disease in 1926 and explains that “Every so-called disease is built within the mind and body by enervating habits.” In addition to pushing germ theory denialism, he is of course, anti-vaccine, calling vaccines poison.
  • Louis Siefgried, a Brooklyn chiropractor, writes The Quest Against Vaccination and Cruel Vivisection in 1926 and is soon arrested for refusing to vaccinate his daughter
  • George Barnard Shaw wrote that “vaccination is nothing short of attempted murder” in a 1944 letter to the Irish Times

“I think it can be said that this demonstrates a conscious over-anxiety to appease what I may call the vaccine-damage lobby, which may have led to decisions being biased against the vaccine.”

Justice Murray Stuart-Smith on Dr David Miller’s DPT study (1986)

  • Dr. John Wilson of London, in 1973, presents to the British Pediatric Association and later publishes an article, “Neurological complications of pertussis inoculation,” in the Archives of Disease in Childhood describing “36 children, seen in the past 11 years, who are believed to have suffered from neurological complications of pertussis inoculation.” While Wilson actually supported immunizations, like Wakefield, he later took to the media to scare parents because he had “seen too many children in whom there has been a very close association between a severe illness, with fits, unconsciousness, often focal neurological signs, and inoculation.” What followed was a drop in DPT vaccinations in many countries and vaccine lawsuits, even though his study was later found to be seriously flawed, with most having no link to the DPT vaccine.
  • Rosemary Fox, forms the Association of Parents of Vaccine Damaged Children, for which Wilson becomes an adviser. Fox, who believed that her daughter was “damaged by vaccination,” distributed questionnaires to the parents of suspected vaccine injured children, many who were seeking compensation in lawsuits, and many of which were then used in the National Childhood Encephalopathy Study by Dr Gordon Stewart and Dr David Miller.
  • Jack Ashley MP begins asking questions in Parliament about adverse events after vaccinations, soon after Wilson’s paper is published in 1974, supported by Rosemary Fox and almost 300 families from her Association of Parents of Vaccine Damaged Children.
  • Dr. Robert Mendelsohn, one of the first celebrity, anti-vaccine pediatricians, was a frequent guest on Donahue and other talk shows during the 1970s and 80s, prompting the AAP Committee on Infectious Disease to call him out in a “Red Book Update” published in Pediatrics in 1982, stating his “views are counter to scientific evidence and clearly they do not reflect Academy policy or recommendation.”
  • Dr. David Miller publishes a study in 1981 that showed a link between seizures in kids and receiving the DPT vaccine. A link that could not be confirmed in any other studies and a study that was published before all of the data had been completed. Like Wilson’s study, the Miller study quickly fell apart upon closer examination, including a finding that of seven children reportedly having vaccine damage, “three of the children had been incorrectly labeled as brain damaged when in fact they were normal both before and after vaccination.”
  • Lea Thompson‘s anti-vaccine documentary DPT: Vaccine Roulette aired in 1982 and is often credited as helping start the modern American anti-vaccine movement, but would she have been able to make her documentary without the groundwork laid out by Wilson and Miller?
  • Mirroring the work of Rosemary Fox, Barbara Loe Fisher, with Kathi Williams, soon form the group Dissatisfied Parents Together (DPT) shortly after watching Vaccine Roulette. They later changed their name to the NVIC, which was once described as the “single most powerful anti-vaccine organization in America.”
  • The press in Great Britain, when articles from daily and Sunday papers from 1982 were analyzed, were found to be “irresponsible in their attitude” towards vaccines and often depicted “rare, negative events.”

“…because so many parents refuse, either out of obstinacy or ignorance or fear, to allow their children to be immunised, we still have a hundred thousand cases of measles every year…

It really is almost a crime to allow your child to go unimmunised.”

Roald Dahl Death of Olivia (1986)

  • Lisa Bonet, of The Cosby Show, appeared on Donahue in 1990 and said that vaccines could “introduce alien microorganisms into our children’s blood and the long-term effects which could be trivial or they could be quite hazardous”
  • Barbara Loe Fisher writes A Shot in the Dark in 1991
  • Heather Whitestone becomes the first deaf Miss America, winning the Miss America pageant in 1994, and promptly gets media coverage for her ‘vaccine injury,’ which was really caused by a Hib infection. Not surprisingly, the true story, that her deafness wasn’t caused by a vaccine injury, didn’t get nearly as much media coverage.
  • Andrew Wakefield publishes his first study trying to find a virus that was causing inflammatory bowel disease in 1992, “Detection of herpesvirus DNA in the large intestine of patients with ulcerative colitis and Crohn’s disease using the nested polymerase chain reaction.” He moves on to the measles virus the next year with his study, “Evidence of persistent measles virus infection in Crohn’s disease.”
  • Andrew Wakefield publishes his first Lancet article in 1994, “Perinatal measles infection and subsequent Crohn’s disease.” The next year, he gets another study published in Lancet, “Is measles vaccination a risk factor for inflammatory bowel disease?” Foreshadowing what was to happen with his later “autism” study, his research was found to be “flawed because of biases from differential loss to follow-up and case ascertainment in the vaccinated and unvaccinated cohorts.” The findings of his study also could not be replicated by others and was flagged for “epidemiological weaknesses and lack of biological plausibility.”

“It would be most unfortunate if the publication of this controversial work led to public anxiety over the safety of measles vaccine.”

KC Calman on Wakefield’s 1995 Measles Vaccination Study

  • Beginning from at least 1995, and over the next 10 years, 37% of all vaccine safety articles “had a negative take-home message.”
  • Katie Couric does a segment on the NBC News show Now with Tom Brokaw and Katie Couric about DPT “hot lots.”
  • David Miller writes a letter to the BMJ about a study he did, “Measles vaccination and neurological events,” and in which he concluded that “these findings provide no evidence of a risk of long-term neurological damage associated with measles vaccine.” Not surprisingly, Wakefield took issue with Miller’s study, but many will be surprised about one of  Wakefield’s problem – ” a reaction to vaccination resulting in regressive autism is likely to be a rare event, so the number of cases used for Miller and colleagues’ analysis is woefully inadequate to investigate such a reaction.”
  • At one of the first anti-vaccine conferences of the modern era, the First International Public Conference on Vaccination, in September 1997, Andrew Wakefield gives a presentation and Lea Thompson gets an award.
  • Andrew Wakefield publishes another study in the Lancet in 1998, setting off a media frenzy by stating that “Again, this was very contentious and you would not get consensus from all members of the group on this, but that is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR, rather than the single vaccines.” Although widely discredited, his paper isn’t formally retracted until 2010.
  • In 1999, ABC’s 20/20 airs a segment about the hepatitis B vaccine, “Who’s Calling the Shots?,” which has been described as “a program that deeply scared the American public.” ABC’s Nightline also does a segment on vaccine injury featuring Barbara Loe Fisher.
  • Beginning in 2000, Dan Burton begins holding Congressional hearings trying to prove that there is a link between vaccines and autism
  • Also in 2000, Andrew Wakefield appears on the 60 Minutes segment “The MMR Vaccine”
  • And that’s the year that Cindy Crawford appeared on Good Morning America with her celebrity pediatrician, Dr. Jay Gordon, after which he said “They edited the segment to make me sound like a vaccination proponent. We also have to understand the impact of a person as well-known as Cindy Crawford delaying vaccines for over six months.”
  • The CBS Evening News begins their four year run of “extremist views of vaccines and autism,” including going “after vaccine makers and the make-believe link between vaccines and autism, taking up the cause of trial attorneys on the one hand and glossing over the scientific data demonstrating no relationship on the other.” This 2004 segment by Sharyl Attkisson, on “Vaccine Links to Autism?,” featured a ‘landmark study’ by Dr. Mady Hornig about overdosing  mice with thimerosal.
  • Bill Maher appears on Larry King Live in 2005 and warns people about flu shots
  • Robert F. Kennedy, Jr. gets his “error-laced” expose “Deadly Immunity” published in Rolling Stone magazine in 2005 (it is later retracted). He also appears on the CBS Evening News with Dan Rather.
  • Jenny McCarthy appears on Oprah, Good Morning America, Larry King Live, and 20/20 in 2007 to promote her book about how she cured her non-Indigo autistic son who got the “autism shot”

“When a well-meaning parent like Jenny McCarthy blames vaccines for her child’s autism, placing the fear of God into every parent who has a baby, it’s not only irresponsible – it’s dangerous. Why? It’s simple math: vaccines are less effective when large numbers of parents opt out. And the more who opt out, the less protected ALL our children are.

Celebrity books come and go . . . but the anxiety they create lives on in pediatricians’ offices across the country. A small, but growing number of parents are even lying about their religious beliefs to avoid having their children vaccinated, thanks in part to the media hysteria created by this book.”

Ari Brown, MD on The New McCarthyism in the Wall Street Journal (2007)

  • Dr. Bob Sears publishes his Vaccine Book in 2007 which leads vaccine hesitant parents across the country to request that their pediatricians follow Sears’ non-evidence based alternative immunization schedule instead of the standard CDC schedule, leaving these kids unprotected from many vaccine preventable diseases
  • In 2008, Jenny McCarthy and Jim Carrey lead the Green Our Vaccines rally in Washington, D.C.
  • The pilot episode of Eli Stone aired on ABC in 2008, a show described as “anti-vaccination idiocy about autism.”
  • The CBS Evening News with Katie Couric, airs a segment in 2008, “How Independent Are Vaccine Defenders?,” pushing the idea that “strong financial ties” between vaccine manufacturers and the AAP and other groups pushing the idea that “industry ties could impact the advice given to the public about all those vaccines.”
  • Jenny McCarthy in Time magazine in 2009 and appears again on Larry King Live
  • Matt Lauer interviews Andrew Wakefield on Dateline in 2009 in the hour-long episode “A Dose of Controversy”
  • Barbara Loe Fisher discussing “Forced Vaccinations” on Lou Dobbs Tonight in 2009
  • Bill Maher again warns people about flu shots in 2009 (during the H1N1 pandemic), this time on his own show Real Time with Bill Maher
  • Bill Gates gives a Ted Talk in 2010, says that “The world today has 6.8 billion people. That’s heading up to about nine billion. Now if we do a really great job on new vaccines, health care & reproductive health services, we could LOWER that by perhaps 10 or 15 percent,” and folks think he has a plan to depopulate the world using vaccines.

“The way forward is clear. Because no credible evidence during the past 13 years supports the hypothesized connection between the MMR vaccine and autism disorders, it is bereft of credible evidence and must be discarded. At the same time, autism is a public health concern that must be addressed by enhancing research funding and directing that funding toward studies of credible hypotheses of causation.

To continue pouring money into futile attempts to prove a connection to the MMR vaccine when multiple high-quality scientific studies across multiple countries and across many years have failed to show any hint of a connection, and in the face of biologic nonplausibility, is dangerous and reckless of lives, public funding, and ultimately public health.”

Gregory A. Poland, MD on Vaccine Nihilism and Postmodern Science (2011)

  • The Greater Good movie, which has been described as “pure, unadulterated anti-vaccine propaganda,” debuts at the Dallas International Film Festival in 2011
  • Rep. Michele Bachman in a 2011 interview on Fox News discussing the HPV vaccine, says that “There’s a woman who came up crying to me tonight after the debate. She said her daughter was given that vaccine. She told me her daughter suffered mental retardation as a result of that vaccine. There are very dangerous consequences. It’s not good enough to take, quote, ‘a mulligan’ where you want a do-over, not when you have little children’s lives at risk.”
  • Katie Couric has a segment about HPV on her show Katie in 2013 in which she “promotes dangerous fear mongering”
  • In 2014, the Dwoskin Family Foundation creates and funds the Children’s Medical Safety Research Institute, which is reported to fund much of the anti-vaccination research that is done over the next few years. Previously, much of that research was funded directly through the Dwoskin Family Foundation itself.
  • Robert DeNiro appears on the TODAY Show in 2016 to discuss why his film festival pulled Andrew Wakefield’s movie about the CDC Whistleblower, VAXXED
  • Robert F. Kennedy, Jr. who has said both that he is “not anti-vaccine” and that after kids get vaccinated, “their brain is gone. This is a holocaust…,” also claimed, in 2017, that he is to lead Donald Trump’s “vaccine safety commission.”

While the names change and we now have anti-vaccine propaganda on the internet instead of hand printed pamphlets, the key messages they use to scare parents away from vaccinating and protecting their kids are surprisingly the same.

What To Know About the History of the Anti-Vaccine Movement

As you follow the anti-vaccine movement from the very beginning, it is easy to see the common threads that connect all of the players from the Victorian Age to the 21st Century. Germ theory denialism. Alternative medical providers. The media.

What else?

Fear, especially fear of vaccine-injury.

And although George Bernard Shaw once wrote that “the antivaccinist is facing very serious persecution without any prospect of personal gain,” you just have to look at all of the eBooks, eCourses, conferences,  seminars, supplements, and autism “cures” many of them push and sell to know that isn’t true.

The modern anti-vaccine movement certainly also has a wider forum these days, making them an even more vocal minority. Facebook. Twitter. YouTube. E-books.

But not much else has changed.

One can’t even really say that the names have changed. Folks in the modern anti-vaccine movement continue to bring up the work of long discredited anti-vaccinated propagandists from the past, even going so far as continuing to believe that germs don’t really cause disease, vaccines don’t really work, and that vaccines aren’t really necessary.

Tragically, we are also mostly fighting the same vaccine-preventable diseases.

More About the Anti-Vaccine Movement Timeline and History

Updated on June 12, 2017

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How the Anti-Vaccine Movement Hurts Autistic Families

Many people see Jenny McCarthy battling doctors to save or recover her son as being anti-autism.
Many people see Jenny McCarthy battling doctors to save or recover her son as being anti-autism.

People have different reasons for skipping or delaying vaccines.

Some are simply scared of things they have heard from friends or family members – the common anti-vaccine myths and misinformation that float around on Facebook.

Others feel that either they or someone in their family has been a victim of a vaccine injury. While vaccine injuries are real, as no vaccine is 100% safe, these injuries almost certainly don’t occur as often as some people think they do.

Consequences of the Anti-Vaccine Movement

Although the anti-vaccine movement has been around as long as there have been vaccines, we are starting to see new consequences.

In addition to harming herd immunity levels and triggering outbreaks, by pushing their anti-vaccine ideas, many of these folks often hurt autistic families too.

How the Anti-Vaccine Movement Hurts Autistic Families

Many people think that the anti-vaccine message is anti-autism.

“Autism, as I see it, steals the soul from a child…”

Dr. Jerry Kartzinel writing in the introduction to Jenny McCarthy’s first autism book Louder Than Words

Why?

In addition to the imagery of a soulless child, Jenny McCarthy said multiple times that it would be better to have a life threatening vaccine-preventable disease instead of autism. Folks would line up for it she said.

This “deficit model” of thinking about autism, “which focuses almost exclusively on impairments and limitations, ultimately leads us to see autistic individuals as broken people who are ill and, as my child’s first psychologist explained, need to be fixed.”

“I look at autism like a bus accident, and you don’t become cured from a bus accident, but you can recover.”

Jenny McCarthy

Hopefully, no one looks at their autistic child and thinks about a child in a bus accident, or a child who has lost their soul, been kidnapped by autism, or that they have a damaged child.  That kind of thinking is offensive to many, and hopefully more and more people.

Other reasons the anti-vaccine message is often seen as anti-autism include that:

  • Anti-vaccine/anti-autism rhetoric might get in the way of a parent accepting their child’s diagnosis of autism.
  • They push expensive, often unproven, sometimes disproven, and dangerous  non-evidence based biomedical treatments and cures on hopeful parents of autistic kids. Things like bleach enemas (miracle medical solution), chemical castration with Lupron, hyperbaric oxygen chambers, chelation, restrictive diets, stem cell therapy, raw camel milk, vitamin supplements, antifungal drugs for Candida, secretin injections, and so on, etc.
  • They waste resources. Every dollar that is spent defending vaccines, refuting an antivaccine study, controlling an outbreak, or on a MAPS doctor (the new DAN! doctors), is a dollar that cannot be invested in the needs of actually autistic people and their families.
  • They lead others from understanding that “communicating a strengths-based approach to autism may not only afford autistic patients the respect and dignity they deserve, but may also help family members better understand and support their loved ones.”
  • It leads to ableist messaging when we respond to anti-vaccine fears by saying “don’t worry, vaccines don’t cause autism” without pointing out that “autism and neurodiversity are far from the worst things that could happen to a parent.”

The anti-vaccine movement also harms the relationship many of these parents have with their pediatrician (who they characterize as vaccine pushers controlled by Big Pharma), pushing them to alternative providers who will be more likely to pander to their fears about vaccines and allow their kids to follow a non-standard, parent-selected, delayed protection vaccine schedule. These are often the same types of providers who push biomed treatments, instead of more standard therapies that a pediatrician or neurologist might recommend, who would also be more likely to explain that “autistic children can and do exhibit improvement in their symptoms simply through growth and development.”

And of course, in addition to being anti-autism, the anti-vaccine movement is typically anti-science.

Sarah Kurchak sums it up well in her recent article, Here’s How the Anti-Vaccination Movement Hurts Autistic People, saying that “The anti-vaccine argument is wrong in both the scientific and moral sense.”

“A huge thing for parents in the anti-vaccine movement is the emotional support. The talk of cures and biomedical interventions is almost secondary to the feeling of connectedness with other parents. A lot of the appeal of the community is just being able to talk to people who can relate to what you’ve been through.”

Seth Mookin author of The Panic Virus

It is certainly understandable to want and need support, but parents of autistic children should know that they can get that support from other parents who don’t think that their child is damaged.

In advocating for vaccines, I refuse to stigmatize autistic people.
In advocating for vaccines, I refuse to stigmatize autistic people. I will use neurodiversity over ableist messaging.

What To Know About the Anti-Vax Movement Hurting Autistics

Autism is not vaccine damage. Instead of a deficit model, it is best seen through a neurodiversity model, which “sees autistic individuals as possessing a complex combination of cognitive strengths and challenges.”

More on How Anti-Vax Movement Hurts Autistic Families

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Challenging the Concept of Herd Immunity

Before we talked about clusters of unvaccinated children, experts warned about pockets of susceptibles.
Before we talked about clusters of unvaccinated children, experts warned about pockets of susceptibles.
The idea of herd immunity has been around since at least 1923 and became used to describe “the indirect protection afforded to individuals by the presence and  proximity of others who are immune.”

That’s not much different from how the CDC defines herd immunity today:

A situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community.

Also called community immunity, it is often misunderstood by folks in the anti-vaccine movement.

Challenging the Concept of Herd Immunity

That the idea of herd immunity is being challenged is not new.

“Along with the growth of interest in herd immunity,  there has been a  proliferation of views of what it means or even of whether it exists at all.”

Paul E. M. Fine Herd Immunity: History, Theory, Practice

If you get educated about vaccines and understand how herd immunity works, it is easy to refute these challenges, especially the idea that herd immunity isn’t real just because we still have outbreaks of vaccine-preventable diseases among highly vaccinated communities.

Why do we still have outbreaks then?

It is mostly because we live in open communities that don’t mix randomly.

Keep in mind that the best model for herd immunity is a randomly mixing closed community – “one in which the probability of contact within any time interval is the same for every choice of two individuals in the population.”

Again, that doesn’t mean herd immunity doesn’t work.

It just means we can expect to see some outbreaks when someone in a well vaccinated community visits another community with lower vaccination levels and more disease, gets sick, and returns.

“However,  within the population of a community,  there may be pockets of  susceptibles, either because prior epidemics have failed to spread into the group or because they have not accepted immunization.”

John P. Fox Herd Immunity

You must also consider the size of the community when thinking about herd immunity, for example, a family, school, neighborhood, or city, versus the entire state. So you can have herd immunity levels of protection at the state or city level because of high average vaccination levels, but pockets of susceptibles who live in the same neighborhood or go to the same school can mean that you don’t have herd immunity in those places, leading to outbreaks.

“Hib vaccine coverage of less than 70% in the Gambia was sufficient to eliminate Hib disease, with similar findings seen in Navajo populations.”

RA Adegbola Elimination of Hib disease from The Gambia after…

Lastly, there is not one herd immunity level for all diseases. It is a separate threshold for each and every disease, depending on how easily it spreads, how many people are already immune, how long immunity lasts, if there is a vaccine, and the effectiveness of the vaccine, etc. That means that a community can have herd immunity for Hib and polio, but not the flu, and for rubella and measles, but not pertussis.

What happened in The Gambia is a great example of herd immunity. After introducing a three dose primary Hib immunization schedule (no booster dose), rates of Hib meningitis quickly went from 200 per 100,000 to none. A few years later, there were 6 cases of Hib meningitis in mostly vaccinated children (no booster dose) and in the majority of cases, “close contacts had a history of frequent or recent travel to Senegal, a neighboring country with strong kinship links with The Gambia and where vaccination against Hib was not introduced” until the following year.

With a Hib meningitis rate of 3 per 100,000, they are still far below pre-vaccine levels of disease, and their situation doesn’t mean that herd immunity isn’t real, as you will understand once you review these myths about herd immunity.

Myths About Herd Immunity

What are some common myths about herd immunity?

  • that natural immunity is better than getting vaccinated. Not True. Natural immunity often comes with a price. Remember, many vaccine-preventable diseases are life-threatening, even in this age of modern medicine.
  • you can just hide in the herd. Not True. “Freeloaders” can gamble and hope that their intentionally unvaccinated kids won’t get a vaccine-preventable disease, but it won’t always work. There is a risk to “free-riding, in which individuals profit from the protection provided by a well-vaccinated society without contributing to herd immunity themselves.”
  • most adults aren’t immune because they haven’t been vaccinated or don’t get boosters, but since we aren’t seeing that many outbreaks, herd immunity itself must be a myth. Not True. Adults were either born in the pre-vaccine era and likely have natural immunity or were born in the vaccine era and are vaccinated and immune. But again, herd immunity is disease specific, so when we talk about herd immunity for measles, it doesn’t matter if they have immunity against hepatitis A or Hib. And adults get few boosters or catch-up vaccines. Also, some vaccines, like Hib and Prevnar, have indirect effects, protecting adults even though they aren’t vaccinated because vaccinated kids are less likely to become infectious.
  • most vaccines wear off too soon to provide long lasting protection for herd immunity to be real. Not True. While waning immunity is a problem for a few diseases, like pertussis and mumps, and you need boosters for others, like tetanus, vaccine induced immunity is typically long lasting and often life-long.
  • herd immunity wasn’t developed by observing immunized people, it was all about natural immunity. Not True. The first experiments about herd immunity by Topley and Wilson in 1923 involved vaccinated mice. Ok, they weren’t immunized people, but it wasn’t just about natural immunity! And much earlier, in 1840, it was noted that “smallpox would be disturbed, and sometimes arrested, by vaccination, which protected a part of the population.” That’s herd immunity he was talking about.
  • herd immunity is not a scientifically validated concept. Not True. It has been well studied for almost 100 years.
  • if herd immunity was real, diseases would be eradicated once you reached herd immunity levels. Not True. Reaching herd immunity levels simply starts a downward trend in disease incidence. A little more work has to be done at the final stages of eradication, like was done for smallpox and is being done for polio.
  • natural immunity causes much of the decrease in mortality from a disease in the developed world, even before a vaccine is introduced. Not True. While it is certainly true that there was a big drop in mortality in the first half of the 20th century for most conditions because of improvements in sanitation, nutrition, and medical science, it was not a consequence of natural herd immunity. And we continue to see significant levels of mortality and morbidity for many diseases in the modern era, especially for those that can’t yet be prevented by a vaccine, like RSV, West Nile Virus, and malaria, etc.
  • vaccines aren’t 100% effective, so herd immunity can’t really work. Not True. Part of the equation to figure out the herd immunity threshold for a disease takes into account the effectiveness of a particular vaccine.
  • folks with medical exemptions for vaccines put the herd at risk just the same as those who intentionally skip vaccines. Not True. Children and adults with medical exemptions, including immune system problems, those getting treatments for cancer, and other true medical exemptions don’t have a choice about getting vaccinated.

So, like other anti-vaccine myths, none of the herd immunity myths you may have heard are true.

That makes it hard to understand why Dr. Russel Blaylock goes so far as to say “that vaccine-induced herd immunity is mostly myth can be proven quite simply.” Does he just not understand herd immunity? That is certainly a possibility, because “although herd immunity is crucial for the elimination of infectious diseases, its complexity and explicit relationship to health politics cause it to remain under-explained and under-used in vaccine advocacy. ”

He is also really big into pushing the idea that adults have no or little immunity, because when he was in medical school, he was “taught that all of the childhood vaccines lasted a lifetime,” but it has now been discovered that “most of these vaccines lost their effectiveness 2 to 10 years after being given.”

The thing is, Blaylock graduated medical school in 1971, when the only vaccines that were routinely used were smallpox (routine use ended in 1972), DPT, OPV, and MMR (it had just become available as a combined vaccine in 1971). Of these, it was long known that smallpox, diphtheria, and tetanus didn’t “last a lifetime,” and the live vaccines OPV and MMR, except for the mumps component, actually do.

Blaylock, like most anti-vaccine folks who push myths about herd immunity, is plain wrong. And like most anti-vaccine myths, using herd immunity denialism to convince parents that it is okay to skip or delay vaccines puts us all at risk for disease.

What To Know About Herd Immunity Myths

Herd immunity is not junk science or a false theory. Herd immunity is real, it works, and explains how people in a community are protected from a disease when vaccination rates are above a certain threshold.

More About Herd Immunity Myths

Vaccine-Preventable Diseases

The latest immunization schedule from the CDC and AAP.
The latest immunization schedule from the CDC and AAP.

Today, in the United States, children typically get:

  • 36 doses of 10 vaccines (HepB, DTaP, Hib, Prevnar, IPV, Rota, MMR, Varivax, HepA, Flu) before starting kindergarten that protect them against 14 vaccine-preventable diseases
  • at least three or four more vaccines as a preteen and teen, including a Tdap booster and vaccines to protect against HPV and meningococcal disease, plus they continue to get a yearly flu vaccine

So by age 18, that equals about 57 dosages of 14 different vaccines to protect them against 16 different vaccine-preventable diseases.

While that sounds like a lot, keep in mind that 33% of those immunizations are just from your child’s yearly flu vaccine.

Vaccine-Preventable Diseases

Of course, kids in the United States don’t get all available vaccines and aren’t protected against all possible vaccine preventable diseases. Some vaccines are just given if traveling to a high risk area or in other special situations.

Vaccine-preventable diseases (in the United States, children and teens are routinely protected against the diseases highlighted in bold) include:

  1. adenovirus – a military vaccine
  2. anthrax – vaccine only given if high risk
  3. chicken pox – (Varivax, MMRV)
  4. cholera – vaccine only given if high risk
  5. dengue – vaccine not available in the United States
  6. diphtheria – (DTaP/Tdap)
  7. hepatitis A – (HepA)
  8. hepatitis B – (HepB)
  9. hepatitis E – vaccine not available in the United States
  10. Hib – (Hib)
  11. HPV – (Gardasil)
  12. Haemophilus influenzae type b – (Hib)
  13. measles – (MMR, MMRV)
  14. meningococcal disease – (MCV4 and MenB and MenC)
  15. mumps
  16. pneumococcal disease – (Prevnar13 and PneumoVax23)
  17. pertussis – (DTaP/Tdap)
  18. polio – (bOPV and IPV)
  19. Q-fever – vaccine not available in the United States
  20. rabies – vaccine only given if high risk
  21. rotavirus – (RV1, RV5)
  22. rubella – (MMR, MMRV)
  23. shingles – vaccine only given to seniors
  24. smallpox – eradicated
  25. tetanus – (DTaP/Tdap)
  26. tick-borne encephalitis – vaccine not available in the United States
  27. tuberculosis – (BCG) – vaccine only given if high risk
  28. typhoid fever – vaccine only given if high risk
  29. yellow fever – vaccine only given if high risk

Discontinued vaccines also once protected people against Rocky mountain spotted fever, plague, and typhus.

These vaccine-preventable diseases can be contrasted with infectious diseases for which no vaccines yet exist, like RSV, malaria, norovirus, and HIV, etc., although vaccines are in the pipeline for many of these diseases.

What To Know About Vaccine Preventable Diseases

Available vaccines are helping to eliminate or control a number of vaccine-preventable diseases, like polio, measles, and diphtheria, but a lot of work is left to be done.

More About Vaccine Preventable Diseases

Which Vaccines Are Vegan

The rabies vaccine is made with gelatin. Are you going to skip it if your vegan child is bit by a rabid dog?
This rabies vaccine is made with gelatin. Are you going to skip it if your vegan child is bit by a rabid dog?

Vegans do not eat meat, fish, poultry, etc., and also do not use animal products or their by-products.

So in addition to eating a plant-based diet, like vegetarians, you also don’t eat eggs or cheese, drink milk, or wear leather, etc.

Are Vaccines Vegan?

Since many vaccines contain some ingredients, like gelatin, that are derived from animals, they aren’t considered to be vegan.

Still, since there aren’t many vegan vaccines, it isn’t possible or practical to avoid getting vaccinated, so most vegans do seem to get their families vaccinated and protected against vaccine-preventable diseases.

Although people argue both ways, you should consider that:

  • many medicines, like Tamiflu, aren’t vegan, so what happens if you get sick with a vaccine-preventable disease?
  • many of the ingredients in vaccines that aren’t considered to be vegan are removed in final processing and aren’t present in the final vaccine, except in residual amounts
  • vaccines save lives, both human lives and animal lives
  • if you are not vaccinated and you get sick, you put others at risk for getting sick too

And mostly understand that just like people abuse religious exemptions and medical exemptions, many vegans don’t vaccinate solely because they are against vaccines.

Which Vaccines Are Vegan

So are any vaccines really vegan?

A newer flu vaccine, FluBlok, definitely is. It is produced using an insect cell line and grown in serum-free medium.

What To Know About Vaccines and Vegans

You can be vegan and feel comfortable about your decision to get your family vaccinated and protected against vaccine-preventable diseases. You can be a pro-vaccine vegan.

More About Vaccines and Vegans