Beltz 1

Mackenzie Beltz

CAS 137H

11/2/14

Paradigm Shift in the Public Opinion of Vaccination

At the conception of modern vaccines, there was distrust. However, as vaccination

proved effective in curing disease, vaccines became widely accepted, and today, have all but

eradicated many antiquated diseases. A shift has occurred in recent years back towards the initial

fear and distrust, which has caused many parents to choose not to inoculate their children against

deadly viruses such as chicken pox and polio. Causes for this shift are strongly linked to the 1998

claim that vaccines cause autism, as well as the rise of the informed patient, who finds

potentially false medical information on the Internet and accepts it as fact. Although vaccinations

are proven to prevent a wide range of diseases, with the shift of power from doctors to patients,

the rise of the informed patient, and the false reports of the MMR vaccine leading to autism,

vaccinations are now beginning to be perceived as optional and harmful, rather than a necessary

measure to prevent disease.

There are a wide variety of reasons that people choose not to vaccinate: they may do so

for religious reasons, or because of a general distrust of modern medicine. Many believe that

contracting a mild disease like chicken pox is better for immunity than vaccines, and think that

childhood diseases are a rite of passage. Others reason that diseases have been eliminated in the

US, so there is no purpose in vaccinating any longer. Still others think that vaccines cause

autism, or that the side effects of the vaccine are worse than the disease itself. Many of these

theories are modern, especially those concerning autism, or those about the belief that

antiquated diseases have been eradicated. However, some of the fears, including suspicion of
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the safety of vaccines, have stood the test of time, beginning around the original popularization

of vaccination in the 18th century.

Although there is some debate over the true conception of vaccination, many scholars

credit Edward Jenner with the creation of the first widespread method of vaccination in 1798

(Bixby 2011). Smallpox was running rampant through all of Europe, boasting an estimated death

rate between 20% and 60% and leaving its victims with disfiguring scars (Riedel 2005). Jenner, a

country doctor, realized that milkmaids exposed to cowpox were not contracting smallpox.

Cowpox is a much weaker strain of smallpox that can be transferred from cows to humans.

Jenner took pus from a pox on a milkmaids hand and used it to inoculate a young boy.

Controversially, he later attempted to infect the boy with smallpox, but his experiment was

proved successful when the boy did not become sick (Bailey 2011).

As news of Jenners discovery spread, England started to make vaccination against

smallpox mandatory. Many had legitimate concerns regarding the safety of the new vaccines, but

those who had something to gain from the demise of vaccination stirred up a majority of the

controversy. Prior to the invention of vaccination, the method to inoculate against smallpox was

variolation, a technique where material from smallpox lesions was inserted directly into an

incision made on a patients arm. In China, the pox pus was put into the nose of the patient

(Leung 2011). This caused many cases of actual smallpox, whereas Jenners method using a

weaker form of smallpox, cowpox, generally resulted in immunity, rather than infection. The

popularization of Jenners method caused backlash from financial backers of variolation, who

anticipated a drop in profit. Syphilis was a big concern during this time period, and Benjamin

Moseley capitalized on this fear by spreading rumors that cowpox caused syphilis. Vaccination

was also rumored to cause horrific deformities, a tale popularized by William Rowley, another
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proponent of variolation (Williams 2010). Like in the 18th century, fear of vaccines today often

originates from a source that will profit financially, like with the linkage of the MMR vaccine to

autism in the late 20th century.

After variolation was virtually eradicated and vaccination became safer, vaccination was

accepted as standard. In 1806, President Teddy Roosevelt personally thanked Jenner for his

discovery and endorsed vaccination in the United States (History of Vaccines). Vaccines were

developed for a wide variety of diseases, including polio, tuberculosis, yellow fever, chickenpox,

and rabies (Vaccines and Preventable Diseases). The World Health Organization declared

smallpox completely eradicated in 1980, and the world has not seen an incidence of the disease

since an isolated case in Somalia in 1977 (Smallpox). The vast majority of parents chose to

inoculate their children, and disease rates dropped dramatically. Diseases such as polio and

yellow fever that had once killed thousands of people were all but eradicated.

This upswing in the positive public opinion of vaccination crashed in 1998, when

Andrew Wakefield, a young British gastroenterologist, published a paper in the British medical

journal The Lancet, linking the MMR vaccine to autism. The MMR vaccine is a shot that offers

immunity to measles, mumps, and rubella, and is generally given to children around the age of

two years old. In the decade following the introduction of this vaccine in 1971, all three diseases

were reduced to near inconsequential level (Hilleman 2011). Naturally, the results of

Wakefields study caused a media uproar, with furious parents of autistic children demanding the

instant recall of the vaccine. As a result of Wakefields study, more than 100,000 American

parents chose not to administer the vaccine to their children, and in the UK, the measles rate

skyrocketed to an all-time high since the introduction of the vaccination (Offit 2008).
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Just as with the proponents of variolation in the 1700s, it was later proven that

Wakefield was motivated by his own financial investment in his discovery. Wakefield had been

given $100,000 by a lawyer who represented parents of autistic children, who believed their

childrens autism was the consequence of vaccination. If Wakefield could find a link, the parents

would be able to sue for financial compensation. His trials on autistic children were also proven

to be highly unethical. He did spinal taps on five-year-olds, put them under general anesthesia,

and in one case, perforated the colon of an autistic child (Offit 2008). After teams of researchers

proved Wakefields study a sham, on March 4th, 2004, The Lancet withdrew Wakefields paper.

The Lancet stated, We wish to make it clear that in this paper no causal link was established

between MMR vaccine and autism as the data were insufficient (Offit 2008). However, the

damage was already done, and vaccination rates continued to decline. The New York Times

declared it the most damaging medical hoax of the past 100 years.

The effects of Wakefields studies are still being seen today, especially on the Internet.

Parents turn to the web for information about vaccines, and are confused by the misleading

names of anti-vaccination organizations. These organizations, championed by celebrities like

Jenny McCarthy, have official-sounding names that make them seem legitimate and

scientifically based, like the National Vaccine Information Center. In reality, these organizations

employ tactics such as misrepresenting science, using emotional anecdotes, saying that they are

only pro- safe vaccines, arguing that vaccines are unnatural, and stating that vaccine

companies are only looking out for their own bottom line (Kata 2012). Even though Wakefields

study was proven false by many credible organizations, fear-mongering sites still claim that

vaccines cause autism, confusing parents seeking information.

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Another factor in the recent decrease in vaccination rates is the rise of the informed

patient. On websites like WebMD, one can easily transform something as innocent as a cold

into rare stage-five cancer. Medical knowledge is no longer limited to those with medical

degrees: a quick Google search can give patients the knowledge to understand, to a point, what is

happening with their bodies. Although the easy access of information can be a good thing, the

accuracy of the information available online varies (DeMaria 2008). The rise of the informed

patient has led to the belief for many that they do not need doctors, and that they can ignore vital

medical and scientific facts. It is only natural that this line of thinking would create patients with

little patience for vaccines, especially if they had seen false claims on the internet that vaccines

can cause autism or lead to side effects worse than the disease itself. This leaves patients to be

easily exploited by the web resources they are trusting with their health.

In the past few years, there has been a huge push by the scientific community to reshape

public opinion of vaccination. On their website, the Center for Disease Control has an entire

section dedicated to clearing up rumors surrounding the safety of vaccines, and demonstrating

their many benefits. They even have pamphlets that can be printed and distributed in doctors

offices and clinics that specifically address parents to give them unbiased and factual data about

the safety and necessity of vaccines (Vaccine Safety). Many are also realizing that after the

decline in vaccination rates, many vaccine-preventable diseases are making comebacks. In 2012,

more than 2,000 cases of measles were reported in the UK (How Vaccine Fears Fueled The

Resurgence Of Preventable Diseases). Hopefully, more parents will make the connection

between the lack of vaccination and the diseases themselves, and vaccination will see a

comeback in the years to come.

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Throughout history, there have been multiple shifts of opinion on the subject of vaccines.

The most notable modern shift, which occurred in 1998 with the false statement that the MMR

vaccine causes autism, hugely influenced many parents' decisions to not vaccinate their children.

Before this event, many antiquated diseases such as polio that had been all but eradicated are

now seeing a dangerous comeback. In addition to the false claims by Wakefield regarding the

MMR vaccine, the rise of the informed patient, and the faulty information spread by anti-

vaccination organizations on the Internet have also influenced public opinion of vaccines. So far

there hasn't been a widespread movement back towards mass support of vaccines, but

organizations like the CDC are working to promote the safety of vaccines and dispel rumors of

autism-causing vaccines. With their own Internet push, we may be able to expect another

paradigm shift back towards near-total public acceptance of vaccines in the future.
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Works Cited

Baxby, D., & Plotkin, S., (2011). Edward Jenners Role in the Introduction of Smallpox Vaccine.
In History of Vaccine Development (pp. 13-19). New York: Springer.

Riedel, S. (2005, January 1). Smallpox: The Origin of a Disease. Retrieved October 24, 2014.

Bailey, I., & Plotkin, S., (2011). Edward Jenner, Benefactor to Mankind. In History of Vaccine
Development (pp. 21-25). New York: Springer.

Leung, A., & Plotkin, S. (2011). Variolation and Vaccination in Late Imperial China, Ca
15701911. In History of Vaccine Development (pp. 5-12). New York: Springer.

Williams, G. (2010). Angel of Death: The Story of Smallpox (pp. 87-94). Basingstoke: Palgrave
Macmillan.

History of Vaccines: All Timelines Overview. (n.d.). Retrieved October 26, 2014.

Vaccines and Preventable Diseases. (n.d.). Retrieved October 28, 2014.

Smallpox. (n.d.). Retrieved October 28, 2014.

Hilleman, M., & Plotkin, S. (2011). The Development of Live Attenuated Mumps Virus Vaccine
in Historic Perspective and Its Role in the Evolution of Combined MeaslesMumpsRubella. In
History of Vaccine Development (pp. 207-218). New York: Springer.

Offit, P. (2008). Autism's False Prophets. New York: Colombia University Press.

Kata, A. (2012). Anti-vaccine Activists, Web 2.0, and the Postmodern Paradigm--an Overview
of Tactics and Tropes Used Online by the Anti-vaccination Movement. Vaccine, 30(25), 3778-
3789.

DeMaria, A. (2008). The Informed Patient. Journal of the American College of Cardiology,
51(15), 1505-506.

Vaccine Safety. (n.d.). Retrieved October 28, 2014.

How Vaccine Fears Fueled The Resurgence Of Preventable Diseases. (n.d.). Retrieved October
28, 2014.