Vaccine myths

There is a cut-and-paste list of vaccine "facts" that has been doing the rounds for years. It tends to appear on any internet argument about vaccine safety, comments on news stories, even pages by actual doctors (eg http://getwellstaywellathome.com/blog/2012/07/vaccine-damage-alert). Not, generally, medical doctors.

When I first encountered this list I knew very little about vaccine safety, so I spent a few hours researching. What a shocker, most of the "facts" turned out to be either untrue, badly reported or distorted.

Feel free to link to this blog to answer such nonsense, if you care to get into an argument. (First rule of the internet - never argue with people with fixed ideas.)

(I'll save for another time my rant about people who cut and paste things from the internet without checking them. Suffice it to say that even the unsubstantiated elements on the list were fairly easy to track down and blow out of the water. Where a reference is given, there is really no excuse.)

1. - In 1871-2, England, with 98% of the population aged between 2 and 50 vaccinated against smallpox, it experienced its worst ever smallpox outbreak with 45,000 deaths. During the same period in Germany, with a vaccination rate of 96%, there were over 125,000 deaths from smallpox. (The Hadwen Documents)

At the time mentioned there was indeed a smallpox outbreak in the UK. At the time, vaccination was only free and compulsory for children, and thanks to anti-vaccination campaigners (yes, even back then!) the number of children being vaccinated was falling. So it's extraordinarily unlikely that 98% of the population was vaccinated. After this outbreak, the number of cases of smallpox fell steadily, with virtually no cases by 1910, and it is now eradicated worldwide thanks to vaccination (http://www.who.int/mediacentre/factsheets/smallpox/en/). Interesting question: if the decline of smallpox were only due to increases in cleanliness, as some say, why is it eradicated even in areas of the world where people still live in extreme poverty?

The Hadwen Documents are copies of speeches and articles by Dr Walter Hadwen, a Victorian anti-vaccine campaigner.  He said during a speech (http://www.soilandhealth.org/02/0201hyglibcat/020119hadwin/020119hadwenrallytalk.html) that 98% of children in Leicester were vaccinated, but gave no reference; this is where the 98% comes from. He doesn't give the 96% for Germany – this has presumably been made up later.

2. - In Germany, compulsory mass vaccination against diphtheria commenced in 1940 and by 1945 diphtheria cases were up from 40,000 to 250,000. (Don't Get Stuck, Hannah Allen)

During the time mentioned, Germany was at war. People were being bombed, living in refugee conditions and dying in their millions on two fronts. If diphtheria was rampant, it's hardly surprising; I also think it's highly unlikely that any vaccination program was rigorously carried out during wartime.

3. - In the USA in 1960, two virologists discovered that both polio vaccines were contaminated with the SV 40 virus which causes cancer in animals as well as changes in human cell tissue cultures. Millions of children had been injected with these vaccines. (Med Jnl of Australia 17/3/1973 p555)

Obviously, vaccines should not be contaminated. This is an argument for the safe production of them, not against vaccines themselves. Fifty years on, we're a lot better at making them. But anyway, nobody actually got cancer from those vaccines, and recent studies find no evidence that SV40 is even linked to cancer in humans (Studies Find No Evidence That SV40 is Related to Human Cancer, National Cancer Institute, National Institutes of Health website)

4. - In 1967, Ghana was declared measles free by the World Health Organisation after 96% of its population was vaccinated. In 1972, Ghana experienced one of its worst measles outbreaks with its highest ever mortality rate. (Dr H Albonico, MMR Vaccine Campaign in Switzerland, March 1990)

I can't find any support for this "declaration by the WHO". Vaccination against measles only began in Ghana in 1967. I think it's unlikely that 96% of the population was reached in the first year; that rate for vaccination of babies hadn't even been reached by 2010 when it was 93% (http://www.unicef.org/infobycountry/ghana_statistics.html). Nor can I find any evidence that the WHO declared the country "measles-free". There may have been a bad outbreak of measles in 1972, but cases have been falling since then, and in 2007 the government announced that no child had died of measles in Ghana for the last three years (Ghana scores zero death rate of measles, GhanaWeb 16/02/2007).

5. - In the UK between 1970 and 1990, over 200,000 cases of whooping cough occurred in fully vaccinated children. (Community Disease Surveillance Centre, UK)

Presumably that's the Communicable Disease Surveillance Centre? I can't find that reference, but let's assume it's true. The (pertussis) whooping cough vaccine is certainly not completely effective. But compare 200,000 cases over 20 years with the pre-vaccination 120,000 cases per year (Department of Health Green Book, chapter 24) . That's a whopping decrease.

And note the graph on page 278 of the above reference, showing how the major pertussis outbreaks followed a slump in vaccination coverage thanks to anti-vaccination campaigners, and how since then the incidence of the disease has fallen as the vaccination coverage has increased.

6. - In the 1970's a tuberculosis vaccine trial in India involving 260,000 people revealed that more cases of TB occurred in the vaccinated than the unvaccinated. (The Lancet 12/1/80 p73)

The study referenced by the Lancet can be found here: Trial of BCG vaccines in South India for tuberculosis prevention: first report. It was a landmark study known as the Chingleput trial, and it showed that in India BCG confers no protection against TB for adults, but some for children. The follow-up study published in 2000 shows the same thing.

This is part of a large body of literature showing that in some countries (eg the UK) BCG is very effective against TB, but in other countries (eg India) it is not, and that its efficacy is not lifelong. However, although it is not always effective against pulmonary tuberculosis (TB), it is very effective in preventing tuberculous meningitis, which is why it is still widely used while a better TB vaccine is sought (http://en.wikipedia.org/wiki/Bacillus_Calmette%E2%80%93Gu%C3%A9rin#Variable_efficacy).

7. - In 1977, Dr Jonas Salk who developed the first polio vaccine, testified along with other scientists, that mass inoculation against polio was the cause of most polio cases throughout the USA since 1961. (Science 4/4/77 "Abstracts" )

This is out of context. There were 20,000 – 50,000 polio cases per year in the US in the early 50s. When vaccination started in 1955 the number of cases immediately fell, with only 161 in 1961. The polio vaccine can cause polio, but rarely. So yes, it's possible that all the cases of polio since 1961 were caused by the vaccine. Better a few a year than 50,000, and by 1994 polio was eradicated in the US.

To put polio in perspective, the Global Polio Eradication Initiative was launched in 1988 to vaccinate children around the world (http://www.polioeradication.org/Polioandprevention/Historyofpolio.aspx). At that time, polio paralysed a thousand children a day. By 2006, the immunisation of more than 2 billion children had caused the incidence of polio to fall by 99%. Today there are fewer than 2000 cases a year worldwide. With any luck, in a few years we might be able to stop vaccinating, just like with smallpox.

8. - In 1978, a survey of 30 States in the US revealed that more than half of the children who contracted measles had been adequately vaccinated. (The People's Doctor, Dr R Mendelsohn)

Unfortunately, Dr R Mendelssohn does not provide any sort of bibliography for his many claims. I have nothing to say about this point, because I can't find the reference. But an study from 1981 looking at measles rates in 54 different areas across the US found a correlation between high levels of immunisation and low levels of measles (Low Measles Incidence: Association with Enforcement of School Immunization Laws, Robbins et al).

9. - In 1979, Sweden abandoned the whooping cough vaccine due to its ineffectiveness. Out of 5,140 cases in 1978, it was found that 84% had been vaccinated three times! (BMJ 283:696-697, 1981)

Sweden used a different vaccine from the rest of the world, and it was generally considered ineffective. After collaborative trials with the US and UK, Sweden restarted its whooping cough immunisation program in 1996. Cases of whooping cough then fell (Declining pertussis incidence in Sweden following the introduction of acellular pertussis vaccine, Olin et al).

10. -The February 1981 issue of the Journal of the American Medical Association found that 90% of obstetricians and 66% of pediatricians refused to take the rubella vaccine.

The abstract of this article does not say that they "refused" to take it, only that they were unvaccinated for some reason (Rubella Vaccine and Susceptible Hospital Employees, Poor Physician Participation, Orenstein et al). The study looked at one hospital, and "90% of obstetricians" actually refers to only 10 out of 11 obstetricians surveyed. It's hardly statistically significant.

11. - In the USA, the cost of a single DPT shot had risen from 11 cents in 1982 to $11.40 in 1987. The manufacturers of the vaccine were putting aside $8 per shot to cover legal costs and damages they were paying out to parents of brain damaged children and children who died after vaccination. (The Vine, Issue 7, January 1994, Nambour, Qld)

I can't find this reference. Since 1988 compensation in the US has been provided by the National Vaccine Injury Fund and only 75c per vaccine goes towards that (http://www.hrsa.gov/vaccinecompensation/index.html). I don't know what the prices were like between 1982 and 1987. Bear in mind, though, that any such compensation claims were brought regarding the old version of DPT that caused adverse effects in some children, and not the new one that causes fewer side effects.

12. - In Oman between 1988 and 1989, a polio outbreak occurred amongst thousands of fully vaccinated children. The region with the highest attack rate had the highest vaccine coverage. The region with the lowest attack rate had the lowest vaccine coverage. (The Lancet, 21/9/91)

This outbreak in Oman (Outbreak of paralytic poliomyelitis in Oman: evidence for widespread transmission among fully vaccinated children, Sutter et al) was not the only one to affect immunised people. It turned out that some strains of polio virus were different from others, and the immunisation program has evolved to deal with this. See point 7 for a discussion of polio.

13. - In 1990, a UK survey involving 598 doctors revealed that over 50% of them refused to have the Hepatitis B vaccine despite belonging to the high risk group urged to be vaccinated. (British Med Jnl, 27/1/1990)

This small study (Attitudes of general practitioners towards their vaccination against hepatitis B, Kinnersley) asked 699 Lancashire general practitioners whether they thought GPs should be vaccinated against HepB and whether they actually had been. 86% of them thought they should be vaccinated, but half of that 86% hadn't been. This was a personal opinion, as there is no requirement for GPs to be vaccinated against HepB. 80% of the non-vaccinated group said they just hadn't got round to it, with others saying they thought they were at low risk.

Contrast this summary with the emotive one given above: they "refused" to be vaccinated, they were in "a high risk group urged to be vaccinated". They haven't even got the number of doctors right.

14. - In 1990, the Journal of the American Medical Association had an article on measles which stated " Although more than 95% of school-aged children in the US are vaccinated against measles, large measles outbreaks continue to occur in schools and most cases in this setting occur among previously vaccinated children." (JAMA, 21/11/90)

The article did not say that the immunisations didn't work, just that they ceased to be effective after a period of time. It urged booster schemes for all teenagers (Risk Factors for Measles in a Previously Vaccinated Population and Cost-effectiveness of Revaccination Strategies, Mast et al).

15. - In the USA, from July 1990 to November 1993, the US Food and Drug Administration counted a total of 54,072 adverse reactions following vaccination. The FDA admitted that this number represented only 10% of the real total, because most doctors were refusing to report vaccine injuries. In other words, adverse reactions for this period exceeded half a million! (National Vaccine Information Centre, March 2, 1994)

First, let's note that the National Vaccine Information Center is not a government body, as its name implies, but a "watchdog" charity. And again, I can't find the reference; it isn't on the NVIC site. But let's assume the quotation is true.

A doctor should report any adverse event to the FDA following a vaccination, even if they aren't sure if it is linked, so many of the adverse events are coincidence. Many of the adverse events are a rash, a stomach ache, a blister at the injection site – they are not hospital-admission events. Looking at the VAERS data (the FDA adverse reaction data at http://vaers.hhs.gov/data/index), it seems that at that time 15% of the reactions were classed as serious.

But consider this: over a three-year period, how many vaccines are given in the US? Over 30 million according to the FDA. 54,072 adverse reactions represents 1.8% of this. If 15% of them were serious, that means that a serious adverse reaction happened after 0.027% of vaccinations. So let's assume this 54,072 represents only 10% of all reactions because doctors "refuse" to report them and we have a result that 0.27% of vaccinations were followed by a serious adverse event.

So we can see that, in context, this huge number of half a million is really very small. And as always, let's not forget that CORRELATION DOES NOT EQUAL CAUSATION! Without trials, there is no evidence that the vaccines caused any of the adverse events.

16. - In the New England Journal of Medicine July 1994 issue a study found that over 80% of children under 5 years of age who had contracted whooping cough had been fully vaccinated.

This is true, and in this case the vaccinations were not successful (The 1993 Epidemic of Pertussis in Cincinnati -- Resurgence of Disease in a Highly Immunized Population of Children, Christie et al. This vaccine isn't used any more.

17. - On November 2nd, 2000, the Association of American Physicians and Surgeons (AAPS) announced that its members voted at their 57th annual meeting in St Louis to pass a resolution calling for an end to mandatory childhood vaccines. The resolution passed without a single "no" vote. (Report by Michael Devitt)

Note the word "mandatory". Many physicians believe you shouldn't force a parent to have their child vaccinated, especially when sometimes it is mandated only by a local council. They didn't vote to get rid of vaccinations, just that they shouldn't be compulsory. A quote from the Executive Director of the AAPS, Jane Orient: "This is not a vote against vaccines" (Doctors’ group votes to oppose vaccine mandates).