Tag: misinformation

Vaccine Cartoons and Caricatures

It shouldn’t surprise anyone that the anti-vaccine movement has long been a good source of material for folks who draw cartoons and caricatures.

Mr. X let everyone know about that flu shots were being used to control people's minds!
Mr. X let everyone know about that flu shots were being used to control people’s minds!

And it still is!

Vaccine Cartoons and Caricatures

Of course The Simpsons, although they are often ahead of their time on things, wasn’t the first cartoon to send a message about vaccines.

Remember the children being fed to the Vaccination Monster?, with John Birch and other anti-vaccination heroes of the day marching to slay it?

John Birch (B) and the other anti-vaccine heroes of the day on their way to fight the vaccination monster.
John Birch (B) and the other anti-vaccine heroes of the day on their way to fight the vaccination monster.

This etching of Charles Williams was made in 1802 as “propaganda against the introduction of vaccination as a preventative measure against smallpox.”

The Cow Pock is an etching by James Gillray.
The Cow Pock is an etching by James Gillray.

That was also the year of the etching by James Gillray of Edward Jenner vaccinating people, who were then turning into cows!

“Dr. Jenner, an excellent portrait, is seen in the exercise of his discovery; a workhouse lad, impressed into the service as his assistant, is holding a milk-pail filled with “vaccine pock hot from the cow.” A second doctor is in attendance, dispensing medicines to promote the effects of the vaccination, which are strongly developed on all sides. Various whimsical results are pictured in the unfortunate subjects with whom the process may be said to have “taken.” A picture in the background, founded on the worship of the golden cadf, represents the adoration of a cow.”

The satirical etchings of James Gillray

Yes, the Cow Pock etching is satire. He was poking fun at anti-vax folks.

And while he was maybe the first, Gillray certainly wasn’t the last to use cartoons to help illustrate the dangers of the anti-vaccine movement.

Or the benefits of vaccines.

Vaccination against small pox, or mercenary & merciless spreaders of death & devastation driven out of society was printed in 1808.

Vaccination against Small Pox. Courtesy of The British Museum.
Vaccination against Small Pox. Courtesy of The British Museum.

The etching by Isaac Cruikshank depicts Edward Jenner driving “three old-fashioned doctors, practicers of inoculation” out of town.

This wood engraving from 1881 shows a crying child getting vaccinated in a room full of people waiting their turn.
This wood engraving from 1881 shows a crying child getting vaccinated in a room full of people waiting their turn. Courtesy of the National Library of Medicine.

In 1838, The Chirurgico Comico Alphabet included this Vaccination cartoon.

The Chirurgico Comico Vaccination.

There wasn’t an entry for smallpox…

How well do vaccines work?

Not well enough to inoculate us against a “Swindling Bank President…

"Now, my friends, step right up and be vaccinated for all forms of disease to which bank officials are liable!"
“Now, my friends, step right up and be vaccinated for all forms of disease to which bank officials are liable!”

The illustration above was made by Joseph Ferdinand Keppler in 1885.

Vaccine Cartoons That Make You Think

Who is most likely to allow misinformation to blindly lead them “off a cliff?”

This cartoon illustrates how misinformation blindly leads people off of a cliff to their getting vaccine preventable diseases.
This cartoon illustrates how misinformation blindly leads people off of a cliff to their getting vaccine preventable diseases.

These cartoons from the 1930s American Public Health Association “Health in Pictures” cartoon booklet can help us see that the anti-vaccine movement hasn’t changed much over the years.

Controlling these diseases is going to take more than just good hygiene and sanitation.
Controlling these diseases is going to take more than just good hygiene and sanitation.

Well maybe they have.

Vaccines are important for people and our pets.

Anti-vax folks today aren’t vaccinating and protecting their animals either!

Let's give them something to think about.
Let’s give them something to think about.

Many of these cartoonists, like Anne Mergen, did indeed give people something to think about.

What would you think about if you saw this cartoon?

The cartoon "Wonder Why My Parents Didn't Give Me Salk Shots?" was published on January 12, 1956.
“Wonder Why My Parents Didn’t Give Me Salk Shots?” was published on January 12, 1956 and “was aimed at parental apathy surrounding the new cure for polio.”

Tom Little won the Pulitzer Prize in Editorial Cartooning in 1957 for his cartoon advocating the use of Jonas Salk’s polio vaccine.

Vaccine Cartoons Today

Unfortunately, the anti-vaccine movement continues to give cartoonists, animators, and writers plenty of material.

Lois and Peter are alone at their anti-vaccine rally, but still manage to trigger a measles outbreak at Stewie's daycare.
Lois and Peter (The Family Guy) are alone at their anti-vaccine rally, but still manage to trigger a measles outbreak at Stewie’s daycare.

Even SouthPark has done an episode about vaccines, as Cartman, who is afraid to get a shot, tries to get a religious exemption to stay in school.

Chicken pox party - The Simpsons did it.
Chicken pox party – The Simpsons did it.

And whether it was in the 1800s or the 21st Century, all of these cartoon images can provide some understanding of how people view public health and the need for vaccines.

“Nuisances and other perceived threats to health were not, of course, seen only in the pointed exaggerations of caricature; they were also available in news drawings and, sometimes, through direct personal observation. But an essential characteristic of the cartoons is their agitational character. They strove for change. To do this, they selected targets, they uncovered less visible problems, and they assigned responsibility for these problems.”

Bert Hansen on The image and advocacy of public health in American caricature and cartoons from 1860 to 1900.

Fortunately, most understand that vaccines are safe, with few risks, and are necessary.

More on Vaccine Cartoons

Is It Rational to Be Anti-Vaccine?

Why do some people think that they are making a rational decision when they skip or delay their children’s vaccines?

Are parents making a rational decision when they skip or delay their children's vaccines?
Are parents really making a rational decision when they skip or delay their children’s vaccines?

Is it because they “know” that they are right?

Or because others reinforce their beliefs?

Is It Rational to Be Anti-Vaccine?

Whatever the reason, we should be clear that skipping or delaying vaccines, leaving your child at risk to get a vaccine-preventable disease and putting others at risk, is really not a rational decision.

“It is not the case, of course, that people make decisions about vaccination based solely on rational, evidenced-based, scientific perspectives.”

Timothy Caulfield et al on Injecting doubt: responding to the naturopathic anti-vaccination rhetoric

Instead, people often seem to skip or delay vaccines after fear helps a number of cognitive biases, heuristics, and logical fallacies take hold and change their perception of risk into something that is much different from reality. That fear is stoked by misinformation and propaganda they see on the Internet or hear from friends and family.

Or they become influenced by the idea that their child has been damaged or injured by a vaccine, even though in the great majority of cases, it has been shown that vaccines do not cause those problems.

“Well, if you’re going to inform yourself about vaccines, I think anybody who’s truly informed will realize that getting a vaccine is much better than not getting one. If you’re choosing not to vaccinate your child, it’s because you’re getting, frankly, bad information about vaccines.”

Paul Offit, MD

So call it what you want, but no, in general, it is not rational to be anti-vaccine, especially considering that:

Do you know what the biggest clue that it isn’t a rational decision in most cases?

Changing Your Mind About Vaccines

When a rational person is given new evidence or information that not only challenges their worldview, but blows it out of the water, what do they do?

They change their mind.

“It is irrational to hold any view so tightly that you aren’t willing to admit the possibility that you might be wrong.”

What would it take to convince you that you were wrong?

When do anti-vax folks change their minds?

“I don’t feel I’m putting my child at risk. There’s nothing that’s going to change my mind on this on that specific vaccination.”

More often than not, it is after one of their kids gets sick or there is a disease outbreak nearby.

Instead of changing their minds in the midst of disease outbreaks and immunization mandates, some parents decide to break the law

If you are not vaccinating and protecting your kids, what would it take to get you to change your mind about vaccines?

Do you need to see double blind placebo controlled studies, studies with saline placebos, studies with vaccines tested together, or long term safety studies?

Do you need to remind yourself what the pre-vaccine era was like? Or understand what will happen if too many people stop vaccinating their kids?

Don't wait until it's too late to vaccinate your child.
Don’t wait until it’s too late to vaccinate your child.

Whatever it takes, hopefully you don’t wait too long and regret your decision.

Of course, no one wants to intentionally harm their children. But you can’t do what’s right and make a rational decision if you are relying on bad information and advice.

More on the Idea of Rational Anti-Vaccine Beliefs

Are More Polio Cases Now Being Caused by the Vaccine Than by Wild Polio Viruses?

Why would people think that more polio cases are now being caused by the vaccine than by wild polio viruses?

More polio cases are now being caused by the vaccine than by wild polio viruses.

Well, it’s true…

Are More Polio Cases Now Being Caused by the Vaccine Than by Wild Polio Viruses?

Wait, what?

“It is no exaggeration to describe it as a crisis. Even worse, looking more widely at the current state of polio eradication, the crisis has three peaks: the first is the level of wild polioviruses in Pakistan; the second is the way that the escalating restrictions in access in Afghanistan have created a huge immunity gap; and the third peak is the widespread occurrence of vaccine-derived polioviruses.”

Independent Monitoring Board 17th Report

Yes, as we are getting close to eradicating polio, we had been seeing fewer and fewer cases of wild polio in the world.

“In rare cases, the live virus in oral polio vaccine can mutate into a form capable of sparking new outbreaks.”

Report raises concern about rare polio cases caused by oral vaccine

And we have been seeing more cases of vaccine-derived polio, which is rarely caused by the oral polio vaccine.

Fortunately, something that most folks miss is that the polio vaccine protects against both wild polio and vaccine-derived polio.

“As recently as 30 years ago, wild poliovirus paralysed more than 350,000 children in more than 125 countries every year. In 2018 there were fewer than 30 reported cases in just two countries – Afghanistan and Pakistan.”

“Zero polio transmission and health for all”, WHO Director-General gives new year’s wish to the people of Afghanistan and Pakistan

And of course, if we weren’t using these polio vaccines, while that would solve the problem of vaccine associated polio, we would simply be seeing lots more wild polio.

More polio cases are now being caused by the vaccine than by wild polio viruses.

Even though cases of wild polio are up this year, after years of decline, they are still tremendously below what they were in the pre-vaccine era.

Remember, we are comparing about 300 cases of wild and vaccine-derived polio that we see today with more than 300,000 of wild polio that we used to see!

“Global efforts to immunise children with the oral polio vaccine (OPV) have reduced wild poliovirus cases by 99.9% since 1988.”

Fact Sheet: Vaccine-Derived Poliovirus

And even those 300 cases of wild and vaccine-derived polio cases can be eliminated if more kids get vaccinated.

“Today, global leaders convened at the Reaching the Last Mile (RLM) Forum in Abu Dhabi to affirm their commitment to eradicate polio and pledge US$2.6 billion as part of the first phase of the funding needed to implement the Global Polio Eradication Initiative’s Polio Endgame Strategy 2019-2023.”

Global leaders pledge US $2.6 billion to eradicate polio at the Reaching the Last Mile forum in Abu Dhabi

And we will get those kids vaccinated.

“Fourthly, rumours and deliberate social media seeding of misinformation about the polio vaccine has had a big impact on refusal rates. Fifthly, organised boycotts of the Polio Programme to gain political concessions have reduced some communities’ acceptance of the polio vaccine.”

Independent Monitoring Board 17th Report

And we will eradicate polio.

More on Polio Eradication

Has Gardasil Really Eliminated Cervical Cancer in Australia?

Why do some folks think that Gardasil hasn’t eliminated cervical cancer in Australia yet?

“New research from Cancer Council NSW, being presented this week at the International Papilloma Virus Conference (IPVC 2018) in Sydney and published in The Lancet Public Health, has shown that if vaccination and screening coverage are maintained at their current rates, cervical cancer is likely to be eliminated as a public health issue within 20 years.

The new research predicts that cervical cancer rates will drop to less than 6 in 100,000 by 2022 – meaning that it will soon be considered a rare cancer. Rates will continue to drop further, dropping below 4 in 100,000 by 2035. These findings indicate that Australia is on-track to be the first country in the world to eliminate cervical cancer by successfully implementing a combined approach to vaccination and screening.”

Australia set to eliminate cervical cancer by 2035

Maybe it is because Gardasil really hasn’t yet eliminated cervical cancer in Australia…

Has Gardasil Really Eliminated Cervical Cancer in Australia?

Wait, so why is anyone trying to say that something that hasn’t happened yet isn’t true?

Is Bobby Kennedy trying to get in the way of work to eliminate cervical cancer?
Who is Dr. Robert Reichert?

Perhaps “Dr. Reichert” just misspoke and did say that Australia had already eliminated cervical cancer instead of that they were on their way to eliminating cervical cancer

It is true, after all. Australia is really on their way to eliminating cervical cancer thanks to the HPV vaccine!

What about all of the slides and tables that Bobby Kennedy included with his post?

Does Slide 1 really show a terrifying increased risk of cervical cancer?

Anti-vax folks like to misrepresent the results of this study.
Anti-vax folks like to misrepresent the results of this study.

Of course not.

It actually shows how thoroughly vaccines are tested before they are approved!

In this case, they were evaluating “the potential of Gardasil to enhance cervical disease in subjects who had evidence of persistent infection with vaccine-relevant HPV types prior to vaccination.”

And although Bobby Kennedy is claiming that is what they found, the women in the Gardasil group (6.5%) were much more likely to have a Pap test with HSIL (high grade squamous intraepithelial lesion) as those in the placebo group (3.7%) at the start of the trial! That’s before they were vaccinated and that’s why they were more likely to have cervical cancer. Remember, the HPV vaccines prevent cervical cancer. They do not treat cervical cancer.

Bobby Kennedy left this out, but during these trials, when they looked at other subgroups, they “did not raise a concern about enhancement of cervical disease due to HPV.”

And Bobby Kennedy‘s other slides?

In Slide 2, just after telling you to look at the vaccine insert, he claims that “nearly half of all women have had prior exposure to HPV – with 38% being exposed before age 10.”

Is that in the vaccine insert?

Nope, it comes from a small study he found, Genital HPV in Children and Adolescents: Does Sexual Activity Make a Difference?, which says that “sexual activity was associated with increased risk for genital high-risk HPV infection.”

Most studies find that prepubertal girls are negative for HPV.
Most studies find that prepubertal girls are negative for HPV.

Surprisingly, the study did find that some girls somehow had exposure to HPV even though they were not sexually active and some, even while they were prepubertal.

“The finding of asymptomatic HPV DNA in children, and correlation with live virus, infectivity, or disease is unclear.”

Jayasinghe et al on Genital warts in children: what do they mean?

Again, Bobby Kennedy leaves out the fact that almost all other studies have found that prepubertal kids and those who are not sexually active are negative for HPV.

And Bobby Kennedy‘s other slides?

The UK doesn't have vaccine mandates and rates of stage II or worse cancers were lower than ever.
The UK doesn’t have vaccine mandates and rates of stage II or worse cancers were lower than ever.

Did rates of cervical cancer increase “in the vaccinated group (20-24)” just after the start of a school vaccination campaign?

“Screening from age 20 yrs, rather than from age 25 yrs, would not prevent any more cancers from spreading beyond the cervix (stage II or worse) by age 27 yrs. The substantial increase in stage I cervical cancers in 24 and 25 year old women, corresponds to changes whereby a high proportion of women are now screened for the first time between ages 24.5 and 25.5 yrs. Previously some of these early stage screen detected cancers would have been prevented by treatment of high-grade cervical intraepithelial neoplasia following earlier screening and a few would have been screen-detected later – at age 26 or 27 yrs. Others may be slow-growing cancers, some of which could be argued to be over-diagnosed.”

Castanon et al on Is the recent increase in cervical cancer in women aged 20–24 years in England a cause for concern?

It kind of did, but only in the lowest grades and because they changed the ages for when these women were screened!

“Reassuringly no increase in stage II or worse cancers was observed in women under age 27 yrs. In fact, numbers of stage II or worse cancers diagnosed at age 24.5–25.0 yrs in 2014 are lower than in any other year since 2007.”

Castanon et al on Is the recent increase in cervical cancer in women aged 20–24 years in England a cause for concern?

And that’s not all they found!

Wait, Bobby Kennedy doesn’t mention that rates of cervical cancer are getting lower since 2007…

“Amidst these changes HPV vaccination was introduced in 2008 for girls aged 12–13 with catch-up for those aged 14–18.”

Castanon et al on Is the recent increase in cervical cancer in women aged 20–24 years in England a cause for concern?

What else happened since 2007?

That’s right. That’s about when we started vaccinating girls with the HPV vaccine.

A vaccine that has been very well studied since to see it’s effects on cervical cancer, including a large meta-analysis of 65 studies in 14 countries.

“More than 10 years have elapsed since human papillomavirus (HPV) vaccination was implemented. We did a systematic review and meta-analysis of the population-level impact of vaccinating girls and women against human papillomavirus on HPV infections, anogenital wart diagnoses, and cervical intraepithelial neoplasia grade 2+ (CIN2+) to summarise the most recent evidence about the effectiveness of HPV vaccines in real-world settings and to quantify the impact of multiple age-cohort vaccination.”

Brisson et al on Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis.

What did they find?

They found “compelling evidence of the substantial impact of HPV vaccination programmes on HPV infections and CIN2+ among girls and women, and on anogenital warts diagnoses among girls, women, boys, and men.”

“In countries like the UK, Australia, and Canada there has been dramatic reduction in HPV related infections and diseases, while in countries with very low coverage there has been very little impact.”

Marc Brisson on HPV vaccine: high coverage could eradicate cervical cancer within decades, say researchers

HPV vaccines are safe and effective and they prevent cancer!

Why are some folks still trying to scare parents away from vaccinating and protecting their kids with these necessary vaccines?

More on Gardasil Eliminating Cervical Cancer in Australia