There is a dedicated fringe anti-vaccine movement. They are dedicated to some permutation of the collection of beliefs that vaccines are: 1) not effective; 2) have not reduced or eliminated any infectious disease; 3) are not safe; and 4) are a conspiracy of Big Pharma, the government, and paid-off doctors. Specific claims have wandered over the years, but they have as a central theme that vaccines are bad. When one specific claim collapses, they will move on to the next anti-vaccine claim.

While anti-vaccine cranks have been around as long as vaccines, it is only recently that they have captured the attention of the mainstream media and the skeptical movement and the battle has really been engaged.

Anti-vaccinationists have focused much of their recent efforts on the claim that vaccines cause autism. At first the MMR vaccine was blamed, sparked by a now-discredited study performed by Andrew Wakefield. This led to declining vaccination rates in the UK and a resurgence of measles.

As the MMR claim was in decline (although by no means abandoned), attention shifted to thimerosal – a mercury-based preservative in some vaccines. There are many flaws with the thimerosal hypothesis, and numerous studies have shown no link between thimerosal and autism or any neurological disorder. But the fatal blow to the thimerosal hypothesis was struck when thimerosal was removed from the routine childhood vaccine schedule (thimerosal, incidentally, was never in the MMR vaccine) in the US by 2002. In the subsequent 6 years the rate of autism diagnoses kept increasing at their previous rate, without even a blip. Only the most rabid (or scientifically illiterate) anti-vaccine fanatics still cling to the thimerosal claim.So attention has shifted yet again. Now the anti-vaccine crowd are hedging their bets with the “toxin gambit.” They blame various “toxins” in vaccines for its alleged and unproven side effects. Mercury is still on the list, but they have added aluminum, which is added to vaccines to make them more effective. They cite hydrochloric acid, which they don’t understand is added to balance the pH of vaccines. They try to scare people by saying vaccines contain formaldehyde, but neglect to mention that formaldehyde is already naturally present in our blood in higher amounts than are found in vaccines. They even make up some toxins (aided by their limitless scientific ignorance) by misreading chemical names. Jenny McCarthy, for example, has repeated numerous times (despite being called on it) the canard that vaccines contain ether and anti-freeze – both untrue. They also try the scare tactic of saying that vaccines contain viral proteins – uh, yeah, that’s the point. And that they may contain fetal tissue – which is a gross distortion. Some vaccine components were cultured in cells that were derived years ago from fetuses.

(For a more thorough review of the science behind recent anti-vaccine claims you can browse through my many blog posts on the topic, or read this overview I wrote for the Skeptical Inquirer.)

The Anti-Vaccine Players

Active players on the anti-vaccine side include a number of organizations, such as Safe Minds and Age of Autism. They have been given an incredible boost by the internet, as the skeptical movement has, and have been tireless in spreading their misinformation and ideology on their websites and blogs.

Andrew Wakefield, despite being discredited, has not recanted his claim that there is a link between MMR and vaccines. He now portrays himself as a martyr to the cause. As a doctor and researcher he remains an icon of the anti-vaccine movement.

Other anti-vaccine researchers include the father and son team of Mark and David Geier. They have made a career publishing bogus studies claiming to show a statistical correlation between vaccine and autism. Their studies crumble under peer-review, however. They have also spent a lot of time as expert witnesses for attorneys suing over vaccine injury. Their worst contribution to anti-vaccine nonsense, in my opinion, is a recent study in which they are treating autistic children with Lupron and chelation therapy. They were only able to get approval for this ethically dubious study by putting together their own IRB board packed with cronies.

Dr. Jay Gordon is a “pediatrician to the stars” and prominent figure in the anti-vaccine pantheon, despite his coy and unconvincing protests that he is not anti-vaccine. He is notorious for relying upon his gut instinct as a clinician rather than actual published scientific evidence, and makes a slew of anti-vaccine claims that are completely unsupported by evidence. For example he is proponent of the notion that the childhood vaccine program gives too many vaccines too soon – without any scientific rationale or evidence.

J.B. Handley is the co-founder of generation rescue, a parent-based autism support group that is dedicated to the notion that autism is a vaccine-injury. His group also favors and promotes a number of biological therapies for autism, such as chelation therapy, all based either on the mercury poisoning hypothesis, or any dubious alternative therapy that comes along.

David Kirby is a journalist who gave the thimerosal hypothesis a huge boost with his 2006 book Evidence of Harm. In it he puts forward the claim that there is a vast conspiracy among the pharmaceutical industry, the government (via the FDA and CDC) and the medical establishment to hide the evidence that thimerosal in vaccines causes autism. He has subsequently built his career around that book, and clings tenaciously to the thimerosal claim. He blogs for The Huffington Post, where he repeats his anti-vaccine propaganda on a regular basis. Kirby is most notorious for specifically claiming that autism rates should plummet following the removal of thimerosal from the vaccine schedule, and then subsequently moving the goalpost on his prediction.

Robert F. Kennedy Jr. is a lawyer and environmentalist who has championed the hard-core conspiracy theories surrounding the anti-vaccine claims. He wrote Deadly Immunity (published simultaneously Rolling Stone magazine and Salon.com), and followed up with a ridiculous screed called Attack on Mothers. He has been particularly shrill and paranoid in his writings, and just as scientifically clueless. This was the primary reason for the controversy that erupted when his name was floated for an Obama appointment to head the EPA.

The reigning superstar of the anti-vaccine movement is actress Jenny McCarthy. After deciding that her son, Evan, was an indigo child (actually, she is an “indigo” and Evan is a “crystal” – divine manifestors here to save the earth, so they have that going for them) McCarthy later decided that Evan had autism caused by the MMR vaccine. So she shifted from crusading to spread the word of indigo children to the world to spreading anti-vaccine propaganda. She has subsequently been relentless in spreading her scientific illiteracy and fear mongering, and was the primary force behind the “Green or Vaccine” march earlier this year. She believes that we should listen to her “mommy instinct” rather than scientific evidence. Eager for a celebrity face to put on their movement, McCarthy was rapidly positioned as the de facto leader of the anti-vaccine crowd.

Her celebrity has indeed made her dangerous. She has also managed to rope in her boyfriend, Jim Carrey, who is also as clueless as he is famous.

Also a huge player in the anti-vaccine movement is the media. In general the mainstream media have been mixed in the quality of their approach to this issue. Sometimes a mainstream outlet does a decent job, but mostly they allow Jenny McCarthy and her ilk to have a free ride, with perhaps lame token skepticism thrown in.

But beyond mainstream media incompetence, there are several outlets that have actively promoted the anti-vaccine movement, and they deserve a large share of the blame for the harm that results. This includes the Huffington Post, which I already mentioned as the blog home of David Kirby. Larry King has also allowed his show to be used to promote anti-vaccine pseudoscience. But the queen of shilling for dangerous quackery is Oprah Winfrey. She has the largest and most adoring audience. She has promoted Jenny McCarthy and Dr. Jay Gordon on her show numerous times. She doesn’t even bother with the token science.

There are many others, but those are the names that have been prominent in the media recently.

Defending Science

The list of players opposing the anti-vaccine movement is not as long. The most prominent opponent is Dr. Paul Offit, a pediatrician and researcher who recently published a book on the topic called Autism’s False Prophets. He has endured personal threats in order to tirelessly attack the pseudoscience of the anti-vaccine crowd. He is certainly their enemy #1. He understands the issue inside and out and is an effective public speaker and writer.

Recently actress Amanda Peet decided to go up against Jenny McCarthy in a celebrity death match over the issue (or at least that’s how the media likes to play it). She has become a spokesperson for the vaccine program, and has specifically targeted anti-vaccine propaganda. She also has made an effective swipe at McCarthy exploiting her celebrity to promote her own wacky ideas. Peet stresses that she is not an expert, and that she defers to the scientific consensus on vaccines. She is not trying to substitute her own opinion for that of experts, she is simply trying to get the word out that vaccines are a safe and effective public health measure.

But those who have been in the trenches countering anti-vaccine propaganda at every turn are skeptics and science bloggers. I have been writing about the issue since 2005, and in fact have been engaged directly by David Kirby and others. David Gorski, who blogs for Science-Based Medicine and Respectful Insolence, has also been blogging very effectively on this issue for years. Dr. Gordon, in fact, treats him as his personal nemesis. Our allies across the pond include Ben Goldacre who write the Bad Science column. Even non-physician skeptical bloggers will occasionally take on anti-vaccine nuttery. Phil Plait, for example, will take time away from astronomy to dismantle the latest anti-vaccine pseudoscience. There are others, and my apologies to anyone I did not specifically mention.

Some bloggers in the autism community, like the autism diva, have also opposed the anti-vaccine crowd, partly because in order to bolster their fear mongering the anti-vaccinationists have portrayed autism as a universally “life sucking”disorder. It is not hard to understand why some autism parents would be offended at that characterization of their children, or why they would resent the use of autism to fear-monger about vaccines.

The government and mainstream medical community has been largely ineffective on the issue. They try, with occasional official statements about the science, but they simply don’t have the experience dealing with a dedicated pseudoscientific popular movement.

The Stakes

The consequences of this particular battle are quite high. Obviously, everyone wants effective vaccine regulation and safety monitoring. There is broad support for the vaccine compensation program, that streamlines the process of financially compensating children and families that have suffered legitimate side effects from vaccines. On any particular claim, we want the scientific chips to fall where they may. If some vaccine ingredient is causing harm, we need to find out right away and make the necessary changes. Only a cartoonish, handlebar mustache-twisting villain would want to allow children to be harmed through compulsory vaccines. Anti-vaccine hysteria, however, hampers effective vaccine safety by diverting attention and resources to false claims.

The most direct consequence of the anti-vaccine movement, and their recent successes with Jenny McCarthy and Oprah, is stoking public fears about the vaccine program leading to declining vaccination rates. This has already resulted in increased outbreaks of measles and mumps. Vaccine hysteria in Nigeria set back the goal of eradicating polio from the world for years.

Not having ones’ children vaccinated does not only put your children at risk but others as well. As vaccination rates drop, infectious diseases they would normally prevent are allowed to spread through the population. This puts everyone at risk, but especially those people who cannot be vaccinated because of a medical contraindication.

The anti-vaccine crowd has also opposed attempts to shield vaccine manufacturers from liability. No one is arguing that vaccine producers get a free pass – they are still responsible for their product, and are certainly tightly regulated by the government. However, if they were vulnerable every lawyer trying to make a buck off of anti-vaccine pseudoscience, it would quickly become impossible to produce vaccines. It would not be worth it for any company to sell vaccines – and of course that is the goal of the anti-vaccine movement. They want to end vaccines, and harassing lawsuits are just one method. This is partly why the government set up the vaccine compensation program – there is a small tax attached to every vaccine, and that tax goes into a pool that is then paid out to those injured by vaccines, as determined by a federal court.

This brings up another risk of the anti-vaccine movement. There are now about 5,000 cases before the vaccine injury compensation program by parents who allege that their children’s autism was caused by vaccines. The courts now have to spend time and taxpayer money legally settling a question that the scientific community already has.

Conclusion

The anti-vaccine movement is a recent skeptical battleground, and one that is still very active. This is certainly one of the biggest issues from 2008, and likely will continue to be for the foreseeable future. Skeptics have been particularly effective in dissecting the claims of the anti-vaccinationists and pointing out the dangers of anti-vaccine hysteria. But the anti-vaccinationists have the momentum, due largely to Jenny McCarthy and Oprah Winfrey. Vaccine rates are declining.

It seems as if we may be seeing a momentum shift, however. Next year will be very telling.

One thing is clear – the skeptical movement has to keep vigilant and keep the pressure on. We have to oppose anti-vaccine pseudoscience at every turn. We need to make ourselves available to the mainstream media and be effective at the public relations end of the game. We need to get the mainstream scientific and medical communities more active and show them how it’s done.

This is a fight we can win, and I think we are making headway.