Recent misgivings expressed by Green Party presidential candidate Jill Stein on the safety of vaccinations has created another round in the vaccine/autism debate. I use the word debate loosely here as we’ll see, there really should not be a debate at all on this topic. In all fairness, Stein expressed concerns over potential industry capture of vaccine regulators, but that concern has been shot down effectively and some view this as merely a dog whistle for anti-vaxxers. To be clear on this, the purported link between vaccines and autism is simply a case of scientific fraud and should be reported as such without mitigation. However, once an idea, even a fraudulent one is let loose, it is very difficult to dislodge from the public mindset. And that presents an arduous challenge for educators and policy makers alike.
The case for linking autism with vaccines began with the 1998 paper authored by Andrew Wakefield and 12 others stating their case. Serious reservations regarding the research was expressed shortly after its publication. The study had a small sample size and relied too heavily on parents recollections rather than hard data. As is the case for scientific protocol, attempts were made to replicate the results of the Wakefield study. In 2004, an extensive report by the National Academy of Sciences refuted any link between vaccines and autism. The Center for Disease Control has followed up with nine studies confirming the National Academy of Science’s report. As it turned out, there was a reason the Wakefield study was not confirmed. The Wakefield report was not just bad science, but a fraud perpetrated to cash in on a potential lawsuit against manufactures of vaccines.
In 2011, the medical journal BMJ issued a retraction of the Wakefield study bluntly titled, Wakefield’s article linking MMR vaccine and autism was fraudulent. And the retraction is damming. Among the charges are:
“Is it possible that he (Wakefield) was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.”
The BMJ also published an article by journalist Brian Deer that exposed Wakefield’s motivation for engaging in the fraud. As it turned out, the medical records for all 12 children in the study were falsified. The motive? Wakefield was receiving compensation by a law firm to provide research that could bring a favorable result in a lawsuit against vaccine manufactures. The compensation amounted to £435,643 ($700,000 in 1999). And the damage done? In the UK, the vaccination rate for measles, mumps, and rubella (MMR) dropped to 80% by 2003. Fortunately, that has rebounded back to 92%. In the United States, vaccination rates held steady between 90-92%, but geographical pockets of low immunization rates put children at risk of acquiring easily avoidable diseases such as the 2015 measles outbreak in Southern California.
So how could such a fraud still be considered a legitimate topic to debate in some quarters? The answer lies in confirmation bias. Science works by matching theory with data. Sometimes, the theory comes first and is later proved by experiment. This happened with James Clerk Maxwell’s theory of electromagnetism developed in 1867 and proved correct with the discovery of radio waves in the late 1880’s. Sometimes the data comes before a theory is devised to explain it as the case with dark energy discovered in 1998. Astrophysicists are currently attempting to devise a theory to describe the accelerated expansion of the universe caused by dark energy. Sometimes both, as in the case of general relativity published by Einstein in 1916. Einstein’s theory solved the existing problem of Mercury’s orbit that Newton could not, but had to wait until the Eddington Expedition in 1919 to prove space-time could bend light waves.
The key point here is that in science, a theory or model of a physical process must match the experimental data or it is wrong. If an experiment cannot be devised to prove a theory, such as currently the case with string theory, it is simply unproven until such an experiment is produced. However, those not trained in science tend to construct understanding via a narrative. In the case of autism, the vaccine issue fills a gap in the narrative that science presently does not, that being an understanding how to prevent it. And once a narrative is constructed, confirmation bias develops when facts that go against the narrative are rejected which is the opposite of how science works. So how to go about getting the facts out?
To begin with, especially in a classroom situation, do not belittle the other person. Doing so only motivates retrenchment. This is why arguments are rarely, if ever, resolved on social media. Once the insults start flying, forget about it. In the class, it is important for each student to feel they have a fair role in the discussion. For example, if a student holds creationist beliefs, I point out the father of the Big Bang really was a father, that is, Fr. Georges Lemaitre who was both a Catholic priest and astrophysicist responsible for conceptualizing the Big Bang by analyzing relativity theory. Holding religious beliefs does not preclude someone from appreciating science and in the case of Lemaitre, performing scientific work at a high level. In the case of vaccinations, expressing an understanding the other side’s concerns with a serious children’s health issue can go a long way in creating a constructive dialog. The public generally does not read medical journals and the media, in some quarters, has been irresponsible in its reporting leading to the construction of a false narrative.
Once the student understands you are giving them a place at the table in the debate, go over the scientific method once again. In a one off argument this is a bit difficult and thus, is something that is to be emphasized throughout the course. Theory must meet experimental data which must be independently confirmed. Over the course of time, the goal is to move a student from an ideological to a scientific mindset. Doing so will open the student up to being more receptive to data that contradicts a previously held belief which in turn can reduce confirmation bias. And sometimes, it is best to acknowledge science does not currently offer an explanation. In the case of autism, we have to admit we do not know what its cause is rather than allowing a charlatan to fill a gap in a narrative.
On the other hand, those such as Andrew Wakefield, who have perpetuated this myth with the intent of monetary and/or political gain, simply deserve to be rebuked and marginalized from any policy debate regarding vaccinations.
*Image atop post is polio vaccinations during 1954 in Kansas. Credit: March of Dimes.