Richard Gallagher, Editor, The Scientist, 17(22):6, November 17, 2003
For more than 200 years, vaccines have made an unparalleled contribution to public health. The writer and commentator Samuel Butler (1835-1902) wrote: "Vaccination is the medical sacrament corresponding to baptism." Considering the list of killer diseases that once held terror and are now under control, including polio, measles, diphtheria, pertussis, rubella, mumps, tetanus, and Haemophilus influenzae type b (Hib), one might expect vaccination to have achieved miracle status, not just sacramental.
Unfortunately, this could hardly be farther from the truth. Vaccines are unattractive targets for industry, underappreciated from the public health perspective, underfunded by basic research organizations, and treated with suspicion by the public. Multiple reasons exist for this, but the one that gets me steamed is the malign influence of three groups: antivaccine lobbyists, journalists, and lawyers.
The antivaccine lobby strikes me as ignorant. A simple Web search turns up numerous sites that are virulently antivaccination.1 Often these sites have a veneer of scientific respectability, but a more than cursory glance reveals otherwise. They are run by health nuts, conspiracy theorists, or misguided physicians who indulge in the logical fallacy of coincidental correlation. This fallacy, post hoc ergo propter hoc (after this, therefore because of this), assumes that because one thing follows another, then the other caused that thing. Medical events that occur after immunization are blamed on the immunization, but solid evidence uniformly is lacking. This, however, may not be clear to the public and an urgent need exists to put efforts in place to counteract the possible harm done.
You don't have to go searching on the Internet to find unscientific propaganda. The second group, journalists, churns out badly researched and poorly argued scare stories about the dangers of vaccination. A prime example is this quote from a respected UK daily: "Do we need so many vaccines? Could they be causing more health problems than they solve by overloading immature immune systems? Could they even be contributing to long-term problems such as MS or cancer in ways we don't yet understand?"2
This wild speculation is irresponsible. Worse, it was published amid a crisis in uptake of the MMR (measles, mumps, rubella) vaccine, which was being linked to autism, a link that has no known basis in fact. What is a fact is that reduced uptake of the vaccine creates the possibility of an outbreak of measles, which has known morbidity consequences.
The third group, the one I find the most odious, is the Plaintiffs' Bar. Some of these lawyers actually scour the literature seeking opportunity from adverse medical events, from which they try to build liability cases. They know which courts can be fooled with flawed "scientific" evidence and which ones provide the biggest damages settlements, and they file there.
Vaccine manufacturers are running scared,3 and who can blame them? What sensible company would launch a product with annual sales in the tens of millions of dollars if a punitive damages settlement in the billions of dollars is an ever-present threat? This is not to absolve the manufacturers who are less than forthcoming on adverse reactions and happily threaten lawsuits when it suits them.
A vaccine act would help greatly. It could set rules for demonstrating adverse reactions--yes, these do occur--and provide a framework for compensation to affected parties. Within this stable framework, companies could be attracted to compete in the development of safe and effective new vaccines that would benefit public health programs throughout the world.
Richard Gallagher, Editor
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