What Counts as "Truth" -- Reason Versus Emotion in Vaccine Decision Making

Abstract:

Vaccines are without question one of the most successful public health interventions the world has ever known. Despite this, for the past decade-and-a-half, industrialized countries around the world, from the United States to Germany and from Australia to Israel, have been confronted with specious panics about vaccine safety and efficacy, many of which center around claims that vaccines can cause autism. These fears can be traced to two events: a since-retracted paper published by a disgraced gastroenterologist claiming the measles-mumps-rubella vaccine was linked to a gut disease which, in turn, was linked to autism; and the United States's decision to remove a mercury-based preservative called thimerosal from standard pediatric vaccines in the late 1990s.

The effects of these scares are being felt worldwide. Each year for the past several years, the US has had more measles outbreaks than at any time since the mid-1990s, a fact which is especially frightening given that the WHO declared measles eliminated from North America in 2000. In France, a nationwide measles outbreak has caused thousands of hospitalizations and a number of deaths. I will address several issues central to this topic: Given the overwhelming amount of evidence showing vaccines are safe and the total lack of evidence showing they cause autism, why do these fears persist, and what can be done to combat them? Has the public health establishment's response to these fears been sufficient? To what extent do concerns about vaccines function as proxies for more opaque concerns regarding modern-day health care? And finally, what is the effect of a lack of evidence-based research on the best way to combat misinformation?