When asked about the measles outbreak, New Jersey Gov. Chris Christie gave an ambiguous non-answer, presumably to avoid offending alienating potential voters. He said that he and his wife, Mary Pat, chose to vaccinate their children because he thinks “it’s an important part of being sure we protect their health and the public health.” But then he went on to add, “I also understand that parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide.”
Christie may hope this kind of wishy-washy-appeal-to-both-sides approach may help him win elections, but he’s actually just wrong. There are not two equal sides here. There are not a number of compelling arguments that should be carefully considered. There is not room for debate. There is, in fact, a right answer to whether people should vaccinate their children, and that answer is yes. Public officials should understand that.
The United States is in the midst of the worst measles outbreak in more than 15 years, with 102 cases reported across 14 states in January alone. This comes on the heels of a year in which there were a record 644 cases. By contrast, from 2002 to 2007, there were fewer than 100 total cases annually.
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This is particularly distressing because in 2000, the Centers for Disease Control and Prevention (CDC) announced that measles had been eliminated from the United States. The reason for this success was clear: widespread use of the combined measles, mumps, and rubella (MMR) vaccine, which was licensed in 1963. That did not mean that there were no cases of measles in this country, but that there had been more than 12 months without “continuous disease transmission.” If someone did contract measles and bring it into the United States, herd immunity ensured that it did not lead to an outbreak.
Eliminating measles was, and remains, an important public health goal because the disease has serious complications, especially in children. According to the CDC, as many as one out of every 20 children with measles gets pneumonia, itself the leading cause of measles-related deaths; one in every 1,000 children who gets measles will develop encephalitis (which can lead to convulsions and leave the child deaf or with developmental disabilities); and ultimately, one or two of every 1,000 children who get measles will die from it.
Having grown up at a time in which vaccinations were common and measles was rare, today’s parents may not realize how serious it can be. But only a few decades ago, the disease had a devastating effect on many families. In a pamphlet published by the Sandwell Health Authority, the famous children’s author Roald Dahl wrote poignantly about the death of his daughter from measles:
Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.
“Are you feeling all right?” I asked her.
“I feel all sleepy,” she said.
In an hour, she was unconscious. In twelve hours she was dead.
Dahl’s point in that piece, which he wrote in 1988, was not to sadden or scare parents but to promote the vaccine, which was not available when Olivia was born in 1955 or even when she died in 1962. After explaining that the measles vaccines are safe, he wrote: “So what on earth are you worrying about? It really is almost a crime to allow your child to go unimmunized.”
Unfortunately, a decade after that piece was written, one lone scientist would undermine parents’ faith in vaccines perhaps irreparably. In 1998, Andrew Wakefield published a study in the medical journal The Lancet, in which he argued that the measles vaccine caused autism. His sample size was tiny: 12 case studies. His explanation was complicated—it involved chronic measles infections of the gut—and his results were never replicated. But his timing was perfect, and his results had a disturbing, lasting resonance.
They spoke to a generation of parents who had never seen measles up close but had seen an unexplained and scary rise in autism. They spoke to those who felt birth and babyhood had become too medicalized and wanted to see a return to more “natural” ways of having and raising children. They spoke to people with who had increasingly begun to see big pharmaceutical companies as valuing profits over health. And they spoke to those who felt the government’s reach into parental decisions—like vaccinations—was too intrusive.
His study also came at a time when celebrity moms were being given platforms to spread their opinions on parenting, which meant that people like Jenny McCarthy and Holly Robinson Peete could appear on talk shows explaining with absolute certainty that the MMR vaccine had caused their own child’s autism—further seeding the fear and distrust of inoculations among viewers.
Wakefield’s study was wrong; it has been debunked by a number of agencies, including the CDC and the National Health Service. But it was also blatantly fake. It has since been revealed that Wakefield apparently falsified his data. Why? Because he was being paid by a law firm that planned to sue the manufacturers of vaccines, and he had not disclosed this conflict of interest. In 2010, The Lancet retracted the paper and the General Medical Council in the UK revoked Wakefield’s medical license. But the damage was done. Vaccinations rates in Britain dropped as low as 80 percent in 1994; 90 to 95 percent is considered the threshold for herd immunity. In the United States, national vaccinations rates have been steady since the government instituted a program to pay for vaccinating those in need, but the CDC says there are now pockets of high concentrations of unvaccinated individuals around the country.
The retraction came at just the “right” time too: When mainstream media outlets have decided there are two sides to every issue, and that in order to be “fair and balanced” both sides should be given a chance to explain and persuade—no matter how factually incorrect one side may be.
A recent study suggested that it is going to take a lot of work to undo the damage that Wakefield’s paper—and the 15 years of talking about it—have done. For the study, on which Rewire reported last March, researchers gave parents who believed that the measles shot caused autism correct information and then asked them what they believed and what they would do for their own children. It turned out that their beliefs could be changed—after getting the right information, they were less likely to believe the vaccine-autism link—but their intention could not be. They were also less likely to vaccinate their own kids than before the study.
In this environment, where people still hold fast to opinions based on fictitious claims—thanks in part to the way the mainstream media sets those falsehoods as equal to scientific reality—it is more important than ever that our public figures take a strong stand. No matter who they are, what party they belong to, or what office they are running for, elected officials must say that measles is a dangerous disease and that vaccines are safe and necessary if we want to protect all of our children. President Obama did it on Sunday, when he said, “I understand that there are families that, in some cases, are concerned about the effect of vaccinations. The science is, you know, pretty indisputable.”
My governor, on the other hand, wimped out in so many ways. First, he tried to appeal to both sides with his original answer about how vaccinations are important but parents should have a choice. Then, when people expressed outrage over that, he had his staff walk it back with a ridiculously generic statement that once again tries to appease everyone:
The Governor believes vaccines are an important public health protection and with a disease like measles there is no question kids should be vaccinated. At the same time different states require different degrees of vaccination, which is why he was calling for balance in which ones government should mandate.
But the governor has taken the side of the anti-vaccination crowd before. In an interview with Fox Radio’s Don Imus in 2009, he was asked about vaccine mandates and said:
I’ve sat with a lot of these parents of children with autism who absolutely firmly believe that it was vaccinations that caused these problems in their children and then they have additional children and they’re being required to go in there and go through that again when they in their heart and in their minds believe this was the contributing factor to their children’s condition … that’s what I meant before about them having a seat at the table to talk about how we deal with these things, whether we can have some more opt-outs for parents who feel strongly about it.
I can imagine that sitting with parents who believe in their hearts and their minds that vaccines caused their child’s autism would provoke some sympathy. But given the definitive science—that vaccines do not cause autism, and that they do keep people safe from a dangerous disease—the answer is not to come up with more rules that allow parents to exempt their child from the vaccination requirements of their state or school district. There are legitimate reasons to have these opt-outs: Some kids can’t get vaccines because of underlying health issues and some parents have genuine religious beliefs. But opt-outs that leave too many loopholes are part of why measles is wreaking havoc in school systems in California right now.
Perhaps the governor doesn’t understand that if he continues to pretend there are two sides to this issue, he will soon have to sit with parents who know that measles caused their child’s deafness, developmental disabilities, or death, and know that their suffering was entirely preventable.