Manufacturing a Vaccine Controversy

by Sean Philpott, Director of the Center for Bioethics and Clinical Leadership

Last week, I got into an argument with a friend of mine about the flu vaccine. He felt that the vaccine was unnecessary and unsafe. In fact, he claimed, every time he’d been vaccinated, he came down with the flu.

Of course, everything he said or claimed in our discussion about whether or not people should be vaccinated against the flu was wrong. But this highly educated man is convinced that vaccines pose a serious threat to the health and well being of most Americans.

He’s not alone. Recent surveys suggest that over 40% of Americans believe that vaccines are unsafe. I’m not just talking about the flu vaccine. People are increasingly skeptical about the value and safety of all vaccines, including those that prevent such dangerous diseases as measles, whooping cough and polio.

Rates of vaccination in this country have decreased steadily over the last decade, particularly in more affluent and progressive communities. As a result, we are beginning to see a resurgence of otherwise preventable infectious diseases. For example, the US is experiencing the worst whooping cough epidemic in over 70 years.

Caused by a bacterium known as Bordetella pertussis, this disease is highly contagious and extremely dangerous, particularly for children. Over half of infants who catch the disease will require hospitalization. Some of these children will die.

Prior to the development of an effective vaccine to prevent whooping cough, nearly a quarter of a million Americans died from this disease annually. By the mid-1970s, however, the disease was largely eliminated in the US. Only a thousand cases of whooping cough occurred in 1976. Compare this with 2012, when nearly 50,000 cases were reported. Outbreaks were particularly common in Washington and Wisconsin, states that have some of the lowest rates of childhood vaccination.

All of this — declining vaccination rates, increasing skepticism about vaccine safety and effectiveness, and otherwise preventable outbreaks of dangerous infectious diseases — is the result of a militant anti-vaccination movement lead by celebrity ‘experts’ like former Playboy Playmate Jenny McCarthy.

The anti-vaccination movement is based on faulty science and fabricated research. The oft-cited claim that vaccines cause autism, for example, comes from a single now-discredited study by the fraudulent Dr. Andrew Wakefield. Despite this, the anti-vaccinationists increasingly have the support of the mainstream media.

For instance, Ms. McCarthy is the new co-host of the popular TV show “The View,” giving her a national platform to espouse her anti-vaccination opinions. Worse yet, veteran newswoman Katie Couric recently ran a segment on her talk show that questioned the safety and effectiveness of Gardasil and Cervarix, two vaccines that prevent the spread the most common cervical-cancer causing strains of human papilloma virus (HPV). The alarmist promo for that show: “The HPV vaccine is considered a life-saving cancer preventer, but is it a potentially deadly dose for girls?”

Katie and her producers, it seems, were more than willing to pander to fear-mongering anti-vaccinationists in exchange for ratings. The show’s guests included several women who made wild and unsubstantiated claims about vaccine safety and post-vaccination side effects. Known anti-vaccinationist Dr. Diane Harper also appeared on the show, questioning Gardasil’s effectiveness. Only one guest, Dr. Mallika Marshall, represented the pro-vaccination side. She was given but a few moments on the air, not nearly enough time to challenge the claims of the other guests. It was not exactly a ‘fair and balanced’ news segment.

Ms. Couric has since apologized, admitting in a Huffington Post blog that “criticisms that the program was too anti-vaccine and anti-science [were] valid.” Unfortunately, the damage is done and Katie’s apology, while seemingly heartfelt, did little to correct the myths perpetuated by the anti-vaccinationists who appeared on the show.

But we have a bigger problem. By even airing segments such as this, the mainstream media is actively promoting the idea that vaccines are neither safe nor effective. They are manufacturing controversy and debate where none exists.

The vast majority of studies show that vaccines are extremely safe and protect against a variety of dangerous diseases like whooping cough, influenza and cervical cancer. There is no uncertainty about the value of vaccines, at least not within the scientific and medical community. The benefits of vaccination clearly outweigh the risks.

That’s the news story the networks should be promoting, rather than giving anti-vaccination alarmists the opportunity to continue their campaign of misinformation and misdirection.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on December 19, 2013. It is also available on the WAMC website. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

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We Have Met The Enemy and He Is Us

by Sean Philpott, Director of the Center for Bioethics and Clinical Leadership

This past Sunday marked the 26th annual World AIDS Day, which is held every year on December 1st to remember the nearly 30 million people who have died from the disease since it was first identified in 1981.

But World AIDS Day is more than just a day of remembrance. It is also an opportunity to show support for the 35 million people who are currently living with HIV, and a chance to raise awareness of the continuing impact of the most devastating pandemic in recorded history.

I’ve been involved in the fight against HIV/AIDS for nearly two decades, starting when I joined the New York State Department of Health in mid-1990s and continuing through my recent work with disease advocacy organizations in the US, Africa and Southeast Asia. Although I am no longer on the frontlines in the war against HIV/AIDS, I still think and write about the topic daily.

In looking back at my 18 years as a foot soldier in this battle, what strikes me first are the amazing victories that have been achieved. When I first enlisted in this war in 1995, we were losing the fight. The few antiviral drugs we had to treat those living with HIV/AIDS, for example, were partially effective at best. Acronymic medications like AZT, ddI and 3TC offered only short-term benefit, prolonging the lives of those infected for a few months.

The epidemic also seemed unstoppable. Here in the US, infection rates were continuing to increase, despite the best efforts of public and private organizations like the CDC, the Gay Men’s Health Crisis, the National Minority AIDS Council, TeenAIDS, and the AIDS Council of Northeastern New York. Globally, the picture was even grimmer. In the hardest hit countries of Africa, for instance, rates of infection were approaching 30% of the total population.

Things quickly changed. The very next year, the fortunes of war began to favor the researchers, physicians and activists engaged in the fight against HIV/AIDS. In 1996, the number of new cases diagnosed in the US declined for the first time since the start of the epidemic. Similar gains were also seen worldwide, with countries like Uganda slashing infection rates in half. New and more effective antiretroviral drugs also became available. When used in combination, these new drugs prolonged the lives of those living with HIV for years and years. Being infected with the virus was no longer a death sentence.

We’ve made remarkable progress since. In the last decade, the annual number of new infections has fallen markedly. In 2001, there were 3.5 million new cases of HIV globally. This past year, there were fewer than 2.0 million new cases. Due to the significant increase in people receiving treatment, the number of AIDS-related deaths has also declined. But the war is not over, and a new and more dangerous enemy threatens our hard-won gains. That enemy is complacency.

During much of the 1980s and 1990s, HIV/AIDS was seen as the major health problem facing the US. That is no longer the case. A recent survey by the Kaiser Family Foundation found that AIDS now ranks seventh among national health concerns, after cancer, obesity, health insurance, heart disease, health care costs and diabetes. More disturbing is the fact that among those with the highest rates of infection (including gay and bisexual men and African Americans), many do not recognize their risk or believe that HIV is not a serious health threat.

Financial support for HIV prevention and treatment efforts is also slipping, in part because AIDS is no longer seen by public or private donors as a serious crisis. The federal government recently slashed funding to the Ryan White HIV/AIDS Program, which supports AIDS organizations across the country. Similarly, private funding for HIV/AIDS programs has remained stagnant since 2008.

That drop in support is likely to have serous consequences. We know, for example, that treating those living with HIV/AIDS not only prolongs their lives but also dramatically decreases the likelihood that they will spread the virus to others. By identifying and treating everyone who has the virus, we could effectively end the epidemic. Despite this, cash-strapped public health agencies and programs have cut back on their HIV testing and treatment efforts. As a result, nearly a quarter of the 1.2 million Americans living with HIV/AIDS still don’t know that they are infected. Of those who do know, less than half are receiving treatment. We could win the war on HIV/AIDS now, but choose not to.

As Pogo once said, “we have met the enemy and he is us” … or rather our apathy and complacency. The perception that HIV/AIDS is no longer a serious threat is a dangerous one. Despite the remarkable gains for the last two decades, we are all still at risk. AIDS is as much of a public health crisis as it was when the first cases were identified over 30 years ago. We need to be reminded of that fact, not just on World AIDS Day but everyday. We need to continue to raise awareness and fund prevention programs. HIV never sleeps, and neither should we.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on December 5, 2013. It is also available on the WAMC website. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]