The summer issue of Juno Magazine explores, among other things, what they refer to as ‘the vaccine debate’. The exploration is conducted by a Devon doula named Claire Arnold, who solemnly informs us on the first page that an informed decision “can only be taken when one is in full possession of the facts surrounding the issue in question”, that media coverage, NHS guidelines and alternative advice can create confusion and anxiety around the subject, and that it is very difficult to find unbiased, factual information about vaccinations.
The author found it so difficult to find unbiased, factual information about vaccination that they were compelled to cite, among their five references, one article from a homeopath’s website, one from the anti-vaccine group JABS (penned by Richard Halvorsen), one from the Vaccination Council website (which is a site I’ve written about before) and one from the notorious Natural News site. There was one single reference to an actual academic paper which, when I looked, turned out to be unrepresentative of the literature (i.e. it had been cherry-picked).
On page two of the article, we are told that “many on both sides of the debate cite anecdotal evidence”, which hasn’t been my experience of discussions of vaccination – but perhaps we move in different circles. We are then told about the risks of vaccination and disease. Except there’s something odd about the way these risks are framed. If you wanted to make a fair comparison of vaccination and disease then I suppose you could compare one important outcome, such as death. Or you might want to compare all adverse outcomes (perhaps giving more weight to the more serious adverse outcomes). What the author does is to compare only deaths from disease with all adverse outcomes from vaccination: “reactions to vaccines are far more common than deaths from the illnesses”. (In a country where, partly because of the high uptake of vaccines, death from preventable infectious diseases has become relatively rare.)
Next, there is a section on ingredients. We are told the names of some of the things that can be found in vaccines (some are not actually ingredients but substances used in the manufacturing process that are present only in trace amounts – if at all) but we’re not told why we should be concerned about them at the levels that may be present in vaccines. We’re told that if we know the product name “a simple search brings up all the required information” (actually, you can find information on the ingredients and side-effects of Pediacel by searching for “5-in-1 vaccine” too). However, the author then says “I feel frustrated, as a parent, that this information is so difficult to find”.
We’re then told we should take into account the chances of catching each disease and the likelihood of complications. Bizarrely, homeopath Noam Bar is then quoted on pertussis and vaccination.
Bar claims that incidence of pertussis in the West “has been declining fast before the introduction of the vaccine”. Now, every reliable source I can find claims that pertussis vaccination began in England and Wales in the 1950s (the CDC, BBC and HPA all state 1957 for the introduction of the vaccine and a journal article in Vaccine states that active promotion of the jab began in 1957). Even the unreliable, notoriously anti-vaccine sources that came up in the search results agree that pertussis vaccination began in the late 50s (whale.to, for example, states that extensive pertussis vaccination began in 1958). The HPA has a PDF here: http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317133571994 with incidence and deaths. While the mortality rate did decline (but only as far as 1 in 1,000), I can’t see where incidence declined before the pertussis vaccine was introduced. In fact, it looks like incidence declined from 1958 onwards. There were around a hundred thousand cases a year in the 40s and 50s, and twenty five thousand cases a year in the 60s. By comparison, in the 1990s as vaccine uptake neared the herd immunity threshold there were around 4,000 cases a year and in the following decade there were less than 1,000 cases a year. (There is an issue with waning immunity and in 2012 there was a spike in pertussis cases, with nearly 10,000 cases being reported and 14 deaths in babies under three months old, with various solutions proposed and vaccination for pregnant women being introduced.)
We move on to efficacy of vaccines and discussion of the use of graphs to illustrate the reduction in disease. The author states at one point that “the full data for measles is shown below”. Scrolling down, you will find a graph that ends in 1976. And illustrates the reduction in mortality rate rather than incidence of the disease. The author compares the mortality rate in the mid-19th century with that in the mid-1960s and declares that by the 60s the rate was “virtually zero”. As this is the same claim made by Jayne Donegan, I’ll simply repeat my previous comment on this: Virtually zero? I suppose it depends on your point of view. There were 800 deaths from measles in the 1960s: HPA. The population was around 50 million.
There follows a muddled explanation of herd immunity from Russell Blaylock, who claims (among other things) that natural immunity from infection is life-long (here’s just one example as a counter to that: a review of the published data on duration of immunity reveals estimates that infection-acquired immunity against pertussis disease wanes after 4-20 years and protective immunity after vaccination wanes after 4-12 years). Blaylock and Arnold appear to believe that herd immunity can only be achieved by natural infection. For diseases with a high basic reproduction number such as measles or pertussis, around 90-95% must be immune to achieve herd immunity. Which means to get herd immunity against measles or pertussis naturally, 90-95% of the population would have to catch a disease which kills 1 in 5,000 (measles) or 1 in 1,000 (pertussis). If 90% of the population of this country caught measles, with a mortality rate of 1 in 5,000 (as given in the HPA Green Book) we’d have to sacrifice 9,000 lives for the natural herd immunity that some of those who are anti-vaccination seem so keen on. For pertussis the figure would be 45,000. In reality, we would not see 90-95% of the population catching these diseases, and we would not see natural herd immunity.
The final paragraphs of the piece introduce a conspiracy theory – “perhaps the entire issue of vaccinations can be seen as a effective smokescreen distracting us from the bigger picture, whereby the state encourages us to hand over responsibility for our health and wellbeing” – and end with an expression of the author’s desire to move “towards a place in which we understand our bodies and can make truly informed decisions about healthcare for our children and ourselves”. Personally, I don’t think that the article helps us to move to such a place.