The Pro V/s Anti Vaccine Debate

THE BACKGROUND

Homemade remedies and falsehoods are being shared widely on the Internet, as well as dismissals of expert advice. Opposition to vaccination against COVID-19 could amplify outbreaks, as happened for measles in 2019. There is a lack of understanding about how this distrust evolves at the system level. Although smaller in overall size, anti-vaccination clusters manage to become highly entangled with undecided clusters in the main online network, whereas pro-vaccination clusters are more peripheral. Health and medical experts have hailed vaccines as being one of the major achievements in the 20th century, but not everyone agrees.

HISTORY OF OPPOSITION

Vaccination opposition isn’t a new concept. As long as there have been vaccines, there have been people who objected to them.

Refusing vaccines started back in the early 1800s when the smallpox vaccine started being used in large numbers. The idea of injecting someone with a part of a cowpox blister to protect them from smallpox faced a lot of criticism. The criticism was based on sanitary, religious, and political objections. Some clergy believed that the vaccine went against their religion.

In the 1970s, the DTP vaccine received a wave of opposition when it was linked to neurological disorders. Trusted Sources have found out that the risks are very low.

To combat vaccination opposition, laws have been passed that require vaccinations as a measure of public health.

REASONS FOR NON-VACCINATION

There are a variety of reasons behind vaccine opposition. Some people have to forgo different vaccinations due to a high risk of potential allergic reactions. But for most who refuse vaccines, it should be known that there is little risk.

There are some common reasons that lead to vaccine opposition. Some cite religious beliefs as the reason behind their refusal to get vaccinated, though most mainstream religions do not condemn vaccines.

There was a belief that diseases were disappearing due to better sanitation and hygiene, not vaccines. This has been proven false by the resurgence of previously eradicated infectious diseases.

It was also believed that a vaccine wouldn’t protect you. Those who are vaccinated can still get sick, but they will experience mild symptoms.

People also think the risks outweigh the benefits. This is currently the biggest objection in the United States. Parents cite many medical risks, including autism, as potential consequences of being vaccinated.

There is the common belief that since these diseases have been eliminated, there’s no need for vaccinations. Diseases will only stay eradicated as long as vaccines are still used to prevent them.

And many think that pharmaceutical companies can’t be trusted. They believe that pharmaceutical companies only want to sell their products, regardless of the impact on the people who use them.

THE RESULT

Most of the concerns that create opposition to vaccination are nothing more than misconceptions.

Unfortunately, the decision not to vaccinate oneself or one’s children doesn’t just affect them. The large number of people refusing vaccines has led to the reemergence of infectious diseases in areas where they had been eradicated or nearly gone.

Measles was declared eradicated in the United States in 2002. But in 2014, there were over 600 reported cases. Measles is a potentially deadly disease, and health experts explain that parents refusing to vaccinate their children are the cause behind its resurgence.

Pertussis, or whooping cough, has also seen a dramatic increase in reported cases attributed to a lack of vaccinations.

CLARITY REGARDING SOME MISCONCEPTIONS

Q1) "Weren't diseases already disappearing before vaccines were introduced because of better hygiene and sanitation?"

Ideas like this are very common in anti-vaccine literature, the intent apparently being to suggest that vaccines are not needed. Improved socioeconomic conditions have undoubtedly had an indirect impact on disease. Better nutrition, not to mention the development of antibiotics and other treatments, have increased survival rates among the sick; less crowded living conditions have reduced disease transmission, and lower birth rates have decreased the number of susceptible household contacts. However, looking at the actual incidence of disease over the years can leave little doubt of the significant direct impact vaccines have had, even in modern times.

For example, since sanitation is not better now than it was in 1990, it is hard to attribute the virtual disappearance of diseases such as Haemophilus influenza type b (Hib) in children in recent years in countries with routine Hib vaccination to anything other than the vaccine.

Q2) "Can vaccines cause the disease? I've heard that the majority of people who get diseased are the same ones who got vaccinated."

This is another argument frequently found in anti-vaccine literature, the implication being that this proves that vaccines are not effective. In fact, it is true that in an outbreak those who have been vaccinated often outnumber those who have not — even with vaccines such as measles, which we know to be about 98% effective when used as recommended.

This apparent paradox is explained by two factors. First, no vaccine is 100% effective. To make vaccines safer than the disease, the bacteria or virus is killed or weakened (attenuated). For reasons related to the individual, not all vaccinated persons develop immunity. Most routine childhood vaccines are effective for 85% to 95% of recipients. Second, in most high-income countries, the people who have been vaccinated vastly outnumber those who have not.

How these two factors work together to result in outbreaks in which the majority of cases have been vaccinated can be more easily understood by looking at a hypothetical example:

Consider a high school of 1,000 students where none has ever had measles. All but 5 of the students have had 2 doses of measles vaccine, and so are fully immunized. The entire student body is exposed to measles, and every susceptible student becomes infected. The 5 unvaccinated students will be infected, of course. But of the 995 who have been vaccinated, we would expect several not to respond to the vaccine. The efficacy rate for 2 doses of measles vaccine can be as high as >99%. In this class, 7 students do not respond, and they, too, become infected. Therefore 7 of 12, or about 58%, of the cases occur in students who have been fully vaccinated.

As you can see, this doesn't prove the vaccine didn't work — only that most of the children in the class had been vaccinated, so those who were vaccinated and did not respond outnumbered those who had not been vaccinated. Looking at it another way, 100% of the children who had not been vaccinated got measles, compared with less than 1% of those who had been vaccinated. The measles vaccine protected most of the class; if nobody in the class had been vaccinated, there would probably have been 1,000 cases of measles.

Q3) "Will vaccines cause harmful side-effects, illnesses, or even death? Could there be long-term effects we don't know about yet?"

Vaccines are very safe, despite implications to the contrary in many anti-vaccine publications. Most vaccine adverse events are minor and temporary, such as a sore arm or mild fever. These can often be controlled by taking paracetamol after vaccination. More serious adverse events occur rarely (on the order of one per thousands to one per millions of doses), and some are so rare that risk cannot be accurately assessed. So few deaths can plausibly be attributed to vaccines that it is hard to assess the risk statistically. Each death reported to ministries of health is thoroughly examined to assess whether it is really related to the administration of vaccines, and if so, what exactly is the cause. When, after careful investigation, an event is felt to be a genuine vaccine-related event, it is most frequently found to be a programmatic error, not related to vaccine manufacture.

Q4) "Isn't even a small risk too much to justify vaccination?"

Looking at risk alone is not enough; you must always look at both risks and benefits. Even one serious adverse effect in a million doses of vaccine cannot be justified if there is no benefit from the vaccination. However, if there were no vaccines, there would be many more cases of the disease, and along with them, more serious side effects and more deaths. For example, according to an analysis of the benefit and risk of DTP immunization, if there was no immunization program in the United States, pertussis cases could increase 71-fold and deaths due to pertussis could increase 4-fold. Comparing the risk from disease with the risk from the vaccines can give us an idea of the benefits we get from vaccinating our children.

The fact is that a child is far more likely to be seriously injured by one of these diseases than by any vaccine. While any serious injury or death caused by vaccines is too many, it is also clear that the benefits of vaccination greatly outweigh the slight risk, and that many, many more injuries and deaths would occur without vaccinations. In fact, to have a medical intervention as effective as vaccination in preventing disease and not use it would be unconscionable.

Now that we have looked at the most common misconceptions regarding vaccinations, ket's look at the particular case of COVID-19 vaccination.

COVID- 19 Vaccination

Those who promote anti-vaccination consistently use a standard set of strategies. Although it can be hard to see patterns of argument in the modern context, looking back at historical instances of epidemic and misinformation provides a useful case study for revealing today’s recurring anti-vaccination strategies. An example of the same could be found when in the 1880s smallpox was prevalent. We have the benefit of living in a world that has eradicated smallpox using a vaccine. Yet in the past, smallpox vaccination was hotly contested, despite the evidence in favour of its effectiveness.

To be anti-vaccine in today’s world, you have to subscribe to some conspiracy theories, because there is so much data on the other side. That’s not to say anything about peoples’ intelligence. You can be very intelligent and very grounded and still believe in conspiracy theories.

Popular anti-vaccine Covid-19 theories suggest technology is to blame. Keri Hilson, an American singer with 4.2 million Twitter followers, posted now-deleted tweets attempting to link the coronavirus to 5G mobile networks. “People have been trying to warn us about 5G for YEARS,” she wrote, adding that 5G launched in China in November of 2019, and then people started dying. Joshua Coleman, an anti-vaccine activist who claims a vaccine injury caused his son to need a wheelchair, claimed on Facebook that coronavirus is in fact caused by 5G. In the United Kingdom, authorities say the conspiracy theory has led to the damage of dozens of wireless towers and other telecommunications equipment.

Meanwhile, Larry Cook, an anti-vaccine influencer who runs the popular Facebook page “Stop Mandatory Vaccination,” has claimed — without evidence — on his personal page that lockdowns and social distancing are a way to make it easier for the government to track people and require them to be tested for the virus. That way, he has said, the government would mandate vaccinations for everyone. “This lockdown and ‘social distancing’ is psychological and economic warfare against us so we will accept mandatory vaccination,” he wrote on April 12.

Still, other anti-vaccine advocates focus on ongoing efforts to create and test a Covid-19 vaccine. The Children’s Health Defense, a nonprofit founded by Robert F. Kennedy, Jr. that links conditions like autism and diabetes to vaccines, pesticides, and other exposures, said the rush to find a vaccine — instead of focusing on treatments — is a looming problem that is driven by profit. A blog post on the group’s website claims: “For the moment, our government is prioritizing vaccine development (with the enticing promise of lucrative patents) over existing therapeutics (such as vitamin C and already-FDA-approved drugs) that do not offer comparable financial windfalls.” The post goes on to claim, without citing evidence, that “fast-tracked vaccines are a sweetheart deal for both biopharma and government.”

Of course, even with Covid-19 treatments — which have not yet been rigorously studied — many health experts agree that life is never going to be normal without a vaccine.

And another common thread in anti-vaccine groups focuses on the belief that natural immunity — the kind you get from actually having a disease — is better than immunity from a vaccine. The logic, they argue, is that if natural disease is a healthy and normal process, people should just go ahead and get infected with a disease, which will eventually give them immunity and protect more people.

While it’s true that, in most cases, natural immunity can last longer than vaccine-induced immunity, public health experts say the risks of the former outweigh the risks of the latter for every recommended vaccine. None of these denials or conspiracy theories are new — they’re classic beats in the anti-vaccination world. The new context matters, though — Covid-19 is a public health crisis on a level that hasn’t been seen in 100 years.

CONCLUSION

The anti-vaccination movement is actually a promising feature of human development, as it demonstrates a widespread tendency of individuals to think critically and independently. This is, however, not to say that the arguments are correct, only that they indicate a desire on the part of individuals to research and reach independent conclusions about important health-related topics. In order to sustain global vaccination rates sufficient to maintain herd immunity, scientists may have to adapt their approaches to research, while public health officials adapt their approaches to raising awareness to address the anti-vax movement. Specifically, scientists must learn how to expose logical fallacies and other problems with denialists, and public health experts must elevate the use of storytelling over data presentation. It is fear, misinformation, and mistrust that are driving the anti-vax movement, and scientists, the healthcare profession, and public health must provide open discourse and fair, balanced, accurate information that can assure patients rather than reinforce their despair.