The Anti-Vaccine Generation: How Movement Against Shots Got Its Start
Mistrust and misinformation give a shot in the arm to measles vaccine naysayers.
Measles under the microscope: The airborne disease is one of the most infectious known.
You could call New Jersey Governor Chris Christie and Kentucky Senator Rand Paul members of the "vax generation."
Born in 1962 and 1963, respectively, they were in grade school when the newly developed measles vaccine became the life-saving advance that protected millions from a highly contagious childhood disease. Though not as scary as polio, it was potent enough to strike four million kids, hospitalize 48,000 of them with complications, and kill more than 400 every year.
That both men stoked an anti-vax movement this week by suggesting in the middle of a national measles outbreak that parents should be allowed to choose whether to vaccinate their children speaks to a generational shift in thinking about science and politics. Parents should have "some measure of choice" in vaccinating their children, Christie told a reporter, while Paul called the decision not to vaccinate "an issue of freedom."
Even though both men quickly revised their remarks in the uproar that followed—and Paul was photographed getting vaccinated for hepatitis A—their comments moved the topic of vaccine safety out of the fringes and firmly into the arena of presidential politics. Both men are considering running for the Republican nomination in 2016.
Their remarks—and the broader vaccination debate that's followed the measles outbreak that began in California in December—have been a wake-up call for many doctors and scientists who work on the front lines of infectious disease outbreaks. They have watched with growing unease as the anti-vaccination movement has gained voice.
"Chris Christie has a state law requiring car seats for children," says Paul Offit, a University of Pennsylvania pediatrics professor and director of the Vaccine Education Center at Children's Hospital of Philadelphia. "Why isn't that a matter of parental choice? This is a dangerous game to play."
Misinformation and Mistrust
William Schaffner, shown here speaking to the National Press Club in Washington in 2006, says vaccination programs have been so successful that Americans no longer fear measles.
How childhood immunization—once a given—crossed the divide from breakthrough science to public policy debate in the space of 50 years is a complicated picture. But it is rooted in distrust of government and science.
Stir together an even more intense distrust of Big Pharma—the multinational pharmaceutical companies that manufacture vaccines—the Internet as an incubator for misinformation like the
now-discredited theories linking vaccines to autism, and celebrity activism that turns small causes into bigger ones.
Then add the rise of citizen science-which has activists doing their own research-and grassroots movements focused on holistic lifestyles, and you are left with the distilled essence of parents who are skeptical and politicians who see opportunity.
But it's unlikely these elements would have come together and flourished if Americans had not become so utterly unfamiliar with the diseases of Christie's and Paul's childhoods.
"We have become prisoners of our own success," says William Schaffner, who chairs the department of preventive medicine at Vanderbilt University in Nashville, Tennessee. "Nobody knows what measles is.
"We now have two generations who haven't seen measles," he says. "The mothers were vaccinated. They never saw measles. Their mothers—the grandmothers—barely saw measles themselves. So the grandmother has no influence. The mother is clueless and so the child goes unvaccinated."
A few years ago, Schaffner was invited to speak to a group of 20 young mothers who had reservations about vaccine safety. His task was to educate, not argue, so he began by talking about polio and the vaccine developed in 1954 that practically eradicated it. He had barely begun speaking when one mother, looking confused, blurted out: "Why are you now talking about shirts?"
"She was bright, college educated, computer savvy, and she'd never encountered the concept of polio. She instead mixed it up with Ralph Lauren," Schaffner says. "It's a bit humorous, a bit tragic, and illustrative of the problem today."
A Natural History of Measles
Schaffner calls measles "the most infectious disease doctors know." It's an airborne illness, transmitted with stunning efficiency when an infected person exhales. Unlike the flu, which requires close proximity for transmission, measles can be spread over time and distance.
"An infected person can walk into a room and leave the room, and a susceptible person can walk into the same room an hour or two hours later and breathe in the residual air in the room and become infected," Schaffner says.
In the early part of the 20th century, measles was so common it was considered a rite of childhood. But it was not innocuous. Not only could it be fatal, complications included encephalitis. After the vaccine was licensed in 1963, some 19 million children were immunized over the next dozen years, according to the Centers for Disease Control and Prevention in Atlanta.
By 2000, the CDC declared measles eradicated in the United States. By 2011, the Pan American Health Organization announced that measles had been eliminated from Latin America.
"Talk about stunning," Schaffner says. "We have no measles upriver on the Amazon. None in Chile, Nicaragua, Mexico.
The only country that now has measles transmission in the Western Hemisphere is the U.S.
"You see on the Internet [people] worrying about illegal immigrants causing the outbreak we're seeing now," he says. "Hey, they're doing a better job than we are. We have these upper-middle-class parents of means in the U.S. who have decided they don't want to vaccinate their kids."
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