Perspective: Truth decayThe Message of Measles

Because of the success of the anti-vaccination movement, measles cases have since turned up in twenty-nine states, but New York has had by far the most cases: 1,046 as of last week, out of a national total of 1,203. This has threatened to wind back decades of success in the containment of the disease since the first measles vaccines were introduced, in 1963—an era when the United States saw between three million and four million cases a year. In 2000, the U.S. declared that measles had been eliminated in the country; if this outbreak isn’t contained by October, it could jeopardize the nation’s so-called measles-elimination status. This would be a dire step back for our public-health system, and a national embarrassment. (Britain, well acquainted with national embarrassment, lost its elimination status this year.)

Nick Paumgarten writes in the New Yorker that the global count of measles cases, which had been declining steeply during this century’s first fifteen years, is rising again; the first six months of 2019 saw more than any full year since 2006, according to a report by the World Health Organization. A 2017-18 survey indicated that the measles-vaccination rate for children in the state, before entering kindergarten, was more than ninety-seven per cent, but, in pockets of anti-vaccination sentiment, or of widespread vaccine hesitancy, as the more gray-shaded kind of reluctance is called, the numbers had fallen far enough to compromise what epidemiologists call herd immunity—that is, broad enough protection to cover even for the tiny minority who, for whatever reason, aren’t vaccinated. (Scientists typically say that a ninety-five-per-cent vaccination rate does the trick.)

Paumgarten writes:

One need not relitigate the case for vaccines here. There have been more than a dozen large-scale, peer-reviewed studies—the most recent one in Denmark, involving more than six hundred and fifty thousand children—that have found no connection between the M.M.R. vaccine and autism. Are there side effects to vaccines? Sometimes. Are there bad doses or batches? If there weren’t, there would be no such thing as the National Vaccine Injury Compensation Program. Does Big Pharma benefit from the vaccine protocol? You bet. At the end of July, Merck, the only U.S. manufacturer of the M.M.R. vaccine, announced that it had earned six hundred and seventy-five million dollars in the previous quarter from the M.M.R. vaccine and the chicken-pox vaccine, a fifty-eight-per-cent increase from the same period last year.

But vaccines work, both for individuals and for the general public. They are one of the great advances of modern times. And they do not cause autism. The science on this point is settled, to the extent that any science ever is, in the pursuit of proving a negative.

>The measles outbreak has helped clarify for many public-health professionals that the virus they’re fighting isn’t so much measles as it is vaccine hesitancy and refusal. “With the spread of mass shootings and conspiracy theories like QAnon, we are becoming more comfortable with the concept that ideas behave like viruses,” Paumgarten writers. “This pandemic’s Patient Zero is harder to pinpoint. Suspicion of authority, rejection of expertise, a fracturing of factual consensus, the old question of individual liberty versus the common good, the checkered history of medical experimentation (see: Tuskegee, Henrietta Lacks, Mengele), the cynicism of the pharmaceutical industry, the periodic laxity of its regulators, the overriding power of parental love, the worry and suggestibility it engenders, and the media, both old and new, that feed on it—there are a host of factors and trends that have encouraged the spread of anti-vaccination sentiment.”

Paumgarten adds: “But, if we have to pick a Patient Zero, Andrew Wakefield will do. Wakefield is the British gastroenterologist who produced the notorious article, published in in 1998, linking the M.M.R. vaccine to autism. The study, which featured just twelve subjects, was debunked, the article was pulled, and Wakefield lost his license to practice medicine—as well as his reputation, in scientific circles anyway. But, owing to his persistence in the years since, his discredited allegations have spread like mold. In the anti-vaxxer pantheon, he is martyr and saint.”