Occasionally anti-vaccine activists gloat over statistics that show a decrease (any decrease) in vaccine uptake. It is often a childish victory dance, but more importantly is displays their true anti-vaccine motives.

The most recent example of this is Mike Adams at Natural News, who writes:

Vaccination rates among children insured by commercial health insurance plans have dropped four percent between 2008 and 2009, says a new report by the National Committee for Quality Assurance. In its annual State of Health Care Quality report, the organization revealed that vaccine rates are falling sharply among high-education families.

First, before we start to analyze the significance of these numbers (Adams leaps into this analysis with the zeal of a propagandist), let’s see what they actually are. Business Week reports:



The authors found a drop in several routine childhood vaccinations. Measles, mumps and rubella (MMR) vaccines decreased from 93.5 percent in 2008 to 90.6 percent in 2009; diphtheria, tetanus and whooping cough rates fell from 87.2 percent to 85.4 percent in that one-year period; and the proportion of kids getting vaccinated for chickenpox fell from 92 percent in 2008 to 90.6 percent in 2009.

In addition these numbers have been trending up in recent years, and the last year saw a reversal of this trend. So overall vaccine compliance numbers are very high, and there is a slight downturn this year. “If trends continue” – that’s a big if for a one time effect – then of course this will be concerning for public health. But it is very premature for anti-vaccine hysterics to claim victory.

What can this recent downturn mean? Many things. It could be an indication of the economic times, and unwillingness to pay high deductables for optional procedures. It could be a temporary reaction to the H1N1 fizzle last year. It could also very well be a reaction to anti-vaccine propaganda.

It is generally easier to stoke fear and confusion than reassure people with abstract scientific publications. Dr. Robert Frenck blames it partly on celebrity activists, saying:

Part of that misinformation may come from “very articulate, very good-looking movie stars or personalities that are giving information about how bad vaccines are,” Frenck said. “Frumpy, middle-aged doctors” are extolling the value of immunization and may not be heard above the fray.

A frumpy middle-age doctor – hmph. Actually I think a tend toward the nerdy, middle-aged look.

Adams makes a lot of the fact that the decrease in vaccine uptake last year was highest among high-income families. Again, he is quick to pontificate about the implications of this statistic. But no so fast:

Dr. Gabrielle Gold-von Simson, assistant professor of pediatrics at NYU School of Medicine, believes the success with the Medicaid rates “is due to the vaccines-for-children programs and other programs that are dedicated to supplying vaccines for children at low or no cost.”

In other words, the difference may be due to programs to offer vaccines to low income families. The absolute size of the effect is so small it is difficult to pin down one cause.

I actually think it is not surprising that well-educated middle-class families are the ones to react to the fear-mongering about vaccines (if that is the case). They would be more likely to have access to the “manufactroversy” over vaccines and therefore be affected by it.

Also, belief in many silly paranormal claims actually increases with education through the college level. It is not until you get to higher level science training that education actually decreases belief in the paranormal. While there are many potential ways to interpret this fact, it may indicate that higher education does not necessarily confer a better ability to grapple with complex scientific issues. It may cause more open-mindedness about unconventional ideas.

Therefore the vaccine statistics are following a larger trend that has been documented previously. Whatever the cause this strongly indicates that the vaccine effect is part of a larger cultural socio-economic effect, and cannot blithely be attributed to the simplistic notion that better educated people are making informed choices about vaccines.

Having grappled with the anti-vaccine propaganda for years, it is my opinion that the issues are very complex and require a fairly nuanced understanding of how to interpret the scientific literature. Even if we set aside the extreme conspiracy-mongering anti-vaccine advocates, the average person becomes concerned when they hear that there is a controversy over the safety of vaccines (even if it is a fake controversy). It then takes a lot of explaining to reassure them that the scientific data overwhelmingly supports the conclusion that vaccines are safe and effective.

The anti-vaccine crowd are quick to dismiss this kind of analysis as elitist – and then promptly misinterpret the science of vaccines.

Conclusion

I suspect that this one-year trend is part of the ups and down of public opinion regarding vaccines, and may also represent and economic effect. It is just one year, amidst a generally high level of vaccine support and compliance.

But Mike Adams is still using it for anti-vaccine propaganda. He epitomizes the notion of someone who does not want to be confused with the facts.