Blame Outbreaks on Vaccine Avoidance, Not Refugees

Editor's Note: This piece originally appeared on Medium.

By Layla Katiraee

Measles has been spreading throughout Europe, particularly in Romania. According to this recent article from the World Health Organization, Romania has “reported over 3400 cases and 17 deaths since January 2016”. Unfortunately, these deaths mostly occurred among individuals “who were immunocompromised or had other co-morbidities.”

I recently shared an article about this outbreak on Facebook, and several individuals commented asking whether it was tied to the recent wave of refugees that have entered Europe, particularly as a result of the Syrian war. It led to discussions about the possibility of refugees choosing to waive vaccinations due to religious beliefs, about the vaccination status of undocumented children in the United States, and other topics. As an individual of Middle-Eastern descent and immigrant of the United States, such discussions are challenging and hard not to take personally. I tried to steer the discussion towards the evidence, which I will outline here.

In this post, we’re going to explore how the current outbreak in Europe is spreading across the continent, and whether there’s any evidence to support the idea that refugees or immigrants are more/less involved in disease outbreaks in the United States.

Is the current measles outbreak in Europe associated with refugee populations?

Romania’s measles outbreak began in February 2016, and measles cases in Europe have been linked to individuals who travelled to Romania (see here and here). The World Health Organization (WHO) recommends that the vaccination rate for measles be greater than 95% so that the virus does not continue its transmission. This number is particularly high and is because of how contagious measles can be. The CDC states that “if one person has it, 90% of the people close to that person who are not immune will also become infected.”

Despite the recommendation from WHO, Romania’s vaccination coverage for the first dose of the MMR vaccine was estimated to be 88% in 2015, with a wide range in coverage across the nation. The World Health Organization states that these pockets of suboptimal immunization rate around the country are due to “certain cultural traditions, religious beliefs, fear of adverse effects of the vaccine or lack of confidence in public authorities”. The recent outbreak finds the majority of its cases in regions of Romania “where immunization coverage is especially low”.

Before anyone jumps to the conclusion that the “religious beliefs” exemption referred to above implies Islam, I could find no evidence to support this notion. A 2013 review published in the medical journal Vaccine explored the stance of major religious groups on the topic of vaccines. Although there are Islamic communities around the world that have opposed vaccines, Islamic leaders and thinkers have outlined how vaccinations are acceptable. Islamic medical scholars have examined the components in vaccines and have provided guidance to encourage Muslims to receive vaccinations.

The 1951 Refugee Convention as well as the “European Vaccine Action Plan” outline that refugees and asylum seekers should receive vaccines and/or preventive care, regardless of the individual’s legal status. Catching up on missed vaccines, particularly in children, is of importance as noted by WHO’s regional office in Europe: “Most of the refugees and migrants now arriving in Europe come from Middle Eastern countries where vaccines are widely accepted and coverage has traditionally been high. Those most at risk for vaccine-preventable diseases are young children who have not yet been vaccinated because the vaccination programmes in their home countries have been interrupted by civil unrest and war.”

WHO provides further guidance and recommendations in the document on how vaccinations should be provided to refugees across Europe.

In conclusion, I could find no evidence linking the current measles outbreak in Europe to refugees.
So, why has the vaccination rate in Romania declined? According to this document prepared by UNICEF, anti-vaccine sentiments have grown on social media in Romania, particularly by preying on parents’ fear around the use of chemicals and “toxins”. In other words, regions across Romania are just as susceptible to anti-vaccine arguments as Marin County, California.

Vaccines and Immigrants in the United States
Before we broach this topic, it bears noting that countries around the world include medical check-ups and vaccination records as part of the documents required for residency applications. I’ve lived in four different countries in three different continents. Each residency application required a visit to the doctor, including my green card application in the United States. My green card medical check-up took place while I was pregnant: I received a TdAP vaccine and I had to show my other immunization records.

The immigration process for refugees to the United States also involves medical examinations. Medical and religious exemptions can be granted to all immigrants and reasons for these exemptions are clearly provided. Most involve additional paperwork. In my personal experience, the immigration process is convoluted and long enough that I find it difficult to believe that an individual would seek an exemption unless it were absolutely necessary.

The question that remains is: are vaccine-preventable outbreaks associated with undocumented immigrants, particularly children, in the United States?

Such claims have been made by many individuals, including politicians, in the United States. However, there is no evidence to support the claim. The CDC has found that unaccompanied children that arrive at the US border pose little risk: “Countries in Central America, where most of the unaccompanied children are from (Guatemala, El Salvador, and Honduras), have childhood vaccination programs, and most children have received some childhood vaccines. However, they may not have received a few vaccines, such as chickenpox, influenza, and pneumococcal vaccines. As a precaution, ORR [Office of Refugee Resettlement] is providing vaccinations to all children who do not have documentation of previous valid doses of vaccine.”

However, to ensure that all children across the country receive the required vaccinations, laws such as California’s SB277 are needed, which ensure that children enrolling in the public school system are up-to-date on their immunizations.

It is my biased opinion that immigrants and refugees would be more likely to receive vaccinations. Individuals leave their home country in search of safer and better opportunities, and that includes better healthcare for their families. Vaccines have been a victim of their own success: many North Americans have not experienced the harms of forgotten diseases and have not experienced a dangerous disease outbreak. Yet many South Americans know and fear diseases: as a child living in Venezuela I remember a cholera epidemic, as a teenager my entire family got dengue fever, and we got our yellow fever vaccinations before moving to South America. It is my perspective that South American immigrants would have an immunization rate equivalent or greater than that of US-born Americans, and there’s some evidence to support this.

Finally, a paper published in 2016 examined the risk of importing measles from undocumented immigrants versus US travellers. The paper concluded (emphasis has been added):
“Overall, there are 10 times more annual US visitors to high measles incidence countries than there are unauthorized immigrants in the US from high measles incidence countries.

Efforts to prevent reestablishment of indigenous measles transmission in the US should focus on evidence-based risk assessments, highlighting a greater potential measles importation risk of from US residents travelling internationally than unauthorized immigrants coming to the US.”

Conclusion

It bears noting that there have been instances where vaccine-preventable illnesses have had outbreaks in refugee camps. These were associated with the living conditions in some camps and provided much learning to the organizations involved. However, vaccine-preventable illnesses have also had outbreaks in Disneyland and Manhattan. That we should assume that refugees or immigrants are more likely to “carry disease” points to our own prejudices about segments of our society that should be embraced rather than shunned and assimilated rather than outcast. We should be mindful of the agenda behind websites, like Breitbart, that promote such myths, and turn to health organizations such as WHO or CDC for information on disease outbreaks.

Layla Katiraee is a NGS production development scientist in California who blogs about GMOs. She is mother to a four-year-old.

Don't Call it "Research"

It has become standing advice in all camps—from pediatricians and public health officials to anti-vaccine mouthpieces and chiropractors: do your own “research” on vaccines and then come to a reasoned decision about whether you want to vaccinate your child. Imbedded in that directive is the suggestion that all parents have both the specialized education and critical thinking skills required to do biomedical research.

Of course that’s not what medical professionals are suggesting when they tell their patients to "research" vaccines. But they have acceded to the widespread misuse of the word “research” to describe web-based information gathering, and in doing so have tacitly agreed that Google searches, Facebook surfing, and reading the CDC’s website is equivalent to research. It’s not research. It’s reading. It’s information gathering, the way we gather information to build our family tree. It’s trying to making sense of complex scientific information the vast majority of us were not educated specifically to deconstruct. But it’s not research, at least not the way the term is used in medicine and science.

Part of the problem is the way the word has been loosely applied to any kind of information gathering—from genealogy to looking for the best esthetician in New York, we tend to refer to our efforts as “research.” And in some ways, perhaps, this term could be considered accurate in such contexts. After all, Merriam Webster defines research merely as a “careful and diligent search.” Most people would agree, however, that there’s a difference between a "careful and diligent" search for the best CSA and a "careful and diligent" internet search on whether vaccines are safe. That’s because scientifically valid information about vaccines is based on scientific research, which can be defined as the application of the scientific method to the investigations of natural phenomenon.

I believe it's time to change the language we use when we encourage parents to use available information to make a decision about whether to vaccinate their child. Let's take the word "research" out of the conversation and thereby avoid hinting that such information gathering is equivalent to the work done by vaccine researchers, biologists, and medical professionals.

I say this as a veteran “researcher” myself. I’m a parent of two children, and when my first was born, I was what is now termed “vaccine-hesitant.” I wasn’t fervently anti-vaccine, but I was scared. So I began reading about vaccines, and, like many new parents, I simply typed “vaccines” into Google. The first site that came up was the vaguely governmental-sounding National Vaccine Information Center. It described itself as a “clearinghouse” of vaccine information. The only thing that tipped me off to its anti-vaccine stance at first were the advertisements for Joseph Mercola’s alterna-empire. (Tanning beds, anyone?) Still, I deposited this late-night study into my “research file.” I spent hours upon hours reading until my eyes crossed. Deep down, I knew when I was in over my head, though I pretended to myself that I understood what I was reading when I began to gather research articles. Though the NIH helpfully links to any number of research papers on vaccines, they don't provide a translator.

Still, if anyone had ventured to tell me at that time that what I considered diligent research was not, in fact, research, I would have been offended. After all, I was good at it. I’d written a well-received book of narrative journalism that had required several years of archival research, interviews, even a Freedom of Information Act request resulting in reams of hydrological charts and paperwork, all of which I carefully studied. I had a Master’s degree from an Ivy League university. I was good at this.

It was only much later, when I went from vaccine-hesitant to vaccine advocacy, that I realized just how arrogant I’d been. And it all came down to this: I thought I knew more than my doctor. Or if I didn’t know as much as she did, I could catch up with a few weeks of serious "research." Her medical school education, her extensive reading, and her long clinical experience meant nothing to me if I could not come to the same conclusion about the safety and effectiveness of vaccines using what information I had at hand. 


Astonishingly, medical providers are enabling this point of view—for understandable reasons. One of the reasons parents were opting out of vaccines was because doctors were often not taking their concerns seriously. Part of this, I suspect, has to do with the fact that the science is so overwhelmingly clear that vaccines are beneficial to the human species. Vaccination became as foundational a part of childhood preventive medicine as a weight check or an eye test. Questioning the necessity of a footing may strike an engineer, for example, as bonkers. But a question about its safety should be heard. 

And too often it wasn’t. The result was more and more parents choosing not to vaccinate their children. Now the pendulum swings wide the other way, where many medical providers and public health officials fear that the only way to bring vaccine-hesitant parents back into the fold is to put their abilities to discern the safety and efficacy of vaccines on par with that of their providers. Hence, the gentle suggestion for parents to “do their own research.” But we are not on equal footing when it comes to science. That’s not how science works. We shouldn't blindly follow the recommendations of our medical providers--frankly, we shouldn't do that in any realm of our life. But at the same time, we need to understand our limitations. And in the vaccine conversations, few of us parents have acknowledged the fact that we might not know as much about vaccines as the people who study them.

In fact, we live in a society that grapples with basic scientific literacy. Take, for example, the fact that in a recent Pew Research study on Americans’ grasp on science and technology issues that fewer than half of Americans knew that an electron is smaller than an atom. More than 80% of Americans did not know that nitrogen made up most of our atmosphere.

The “highly educated” gambit doesn’t work when it comes to vaccines, either; if anything, it makes us, as parents, more susceptible to falling into the anti-vaccine camp because we overestimate our abilities to research. We think because we researched Ovid’s The Metamorphosis for our thesis that we can fully understand why a paper about the peripheral blood mononuclear cells of autistic children and whether the measles virus persists in them exonerates the MMR vaccine from any connection to autism.


So I want to propose something that in this day of conspiracy theories and artisinal, small-batch internet research, is radical: people with medical degrees know more about medicine than those of us who don’t have medical degrees. More, they know how to write research papers on immunology, vaccinology, or infectious diseases, and they know how to read and make sense of them. The vast majority of us do not. 

In this time of measles outbreaks and pertussis clusters, it's time for parents to practice a little humility and trust what we do know: vaccines are one of the most successful medical interventions in modern history, they save countless lives, most of them in the developing world, and they have a long and proven track record of safety. And the research on this is clear.

We Must Stand Up and Be Counted: Saving HB 393

We are in danger of seeing a commonsense change in Minnesota's immunization law go down without a fight, thanks to the anti-vaccine movement's attempts to derail it. HB 393 would add an education component to our existing personal belief exemption.

Though they present themselves to the legislators as champions of parental rights and "informed consent" these individuals do not want vaccine requirements of any kind on the books in Minnesota, or in any state. They have deluged the representatives with e-mails, and several representatives now believe their point of view represents that of parents and have "concerns" about the bill. Those of us who vaccinate--a whopping 9 out of 10--have stayed silent. We have let, and even after the measles outbreak, are continuing to allow the anti-vaccine fringe to speak for us. This must change. You may contact the following Minnesota legislators to ask them to holding a hearing on HB 393. Even if you live out of state, please consider e-mailing the representatives--the anti-vaccine movement has done so, with great success. Below you will find my letter and the names and e-mail addresses of the representatives who need to hear from you.

Rep. Tara Mack (chair): rep.tara.mack@house.mn
Rep. Roz Peterson (co-chair): rep.roz.peterson@house.mn
Rep. Jeff Backer: rep.jeff.backer@house.mn
Rep. Dave Baker: rep.dave.baker@house.mn
Rep. Matt Dean: rep.matt.dean@house.mn
Rep. Duane Quam: rep.duane.quam@house.mn
Rep. Joe Schomacker: rep.joe.schomacker@house.mn


***

Dear Representative X,

I am the parent of two young children who is writing to you today to urge you to give HB 393 a hearing in committee. I am part of the “silent majority” of parents who vaccinate their children on time, every time—and do so as a commonsense part of our family’s healthcare. In fact, well over 90% of us choose to vaccinate—that is 9 out of 10 parents who believe that vaccines are a valuable, in fact, essential tool to keeping our children and communities healthy. The reason we’ve been silent is because few of us ever imagined that we’d have to advocate for disease-free schools.

Like many new parents, I researched vaccines online before my children received their immunizations, and I was scared to my core by the “horror stories” I read about. At the time, I took these anecdotes at face value, a fact made even more embarrassing by the fact that I was an environmental investigative journalist for much of my twenties. In fact, I was being sold a bill of goods by individuals who have made it their aim to sow fear and doubt in the minds of parents in order to protect their own ability to keep their unvaccinated children in the schools and day cares with absolutely no trade-off whatsoever.

The measles outbreak of 2015 was, of course, an inevitable result of this fear and doubt spread by the anti-vaccine movement, which cleverly refers to its mission as “vaccine choice” or “parental choice,” or even “informed consent.” As a parent, it seems their choice to keep their children unvaccinated and at a higher risk of disease trumps my right to keep my own children safe from disease. In fact, their choices affected my own healthcare choices: During the measles outbreak of 2011, caused by unvaccinated children, I had to get my two-year-old toddler her MMR booster a full two years early. As a loving parent, I had no choice. The choice was made for me by the parents who did not vaccinate their children and yet were able to keep them in the schools and day cares of Minneapolis.

HB 393 is a bare-bones, commonsense change in the law that simply requires more education before a parent can simply choose not to vaccinate. It preserves a parent’s choice to refuse vaccines while giving parents who are simply hesitant—as I was—or who need more information the safety net of a meeting with a caring doctor. Those who don’t want to vaccinate, do not have to vaccinate. It’s curious that anti-vaccine activists, under the cloak of “parental choice,” could oppose a bill that preserves that choice. The truth is, this movement wants no laws on the books that require vaccines.

Of course, the bill does not address my concerns about leaving my children and the other children in my life whom I love in a school setting with unvaccinated children. But it’s a start. Not giving it a hearing would be elevating the vocal minority that is mischaracterizing this discussion as an attack on “parental rights” while denigrating the more than 90% of us who vaccinate, and disregarding the rights of infants, the children going through chemo, and other vulnerable people in our community.

I wish those of us who vaccinate were more vocal—we are well aware that the small anti-vaccine community has mobilized and enlisted people across the country to e-mail you and your colleagues with their objections. However, those of us who vaccinate our children face a dilemma—to us, vaccinating our children is one of the most important healthcare decisions we make, but it’s also so commonsense that we never thought we’d have to join a movement called the “pro-vaccine” movement. Please don’t mistake the many emails you’re getting from anti-vaccine voices for the true feelings of parents across this state. Our statistics speak for themselves.

Thank you,

Ashley Shelby 

Dear Vaccine-Refusing Parents

By Karen Ernst

Dear Vaccine Refusing Parents,

I get it. Vaccine Advocates like me have put a lot of pressure on you. Refusing to vaccinate your child is not as popular as it used to be, and some of your peers consider you a pariah, fearing that your children will make them sick. So you’ve gone underground.

You’ve been encouraged to go underground by charlatans, like the anti-vaccine Dr. Bob Sears, who uses fear of vaccines to promote his brand. In his book, he told you not to share with your neighbors the fact that you have left your children vulnerable to disease, and to “hide in the herd.” He probably didn’t bank on the fact that the herd would thin out and your choices would leave us all vulnerable. He sold you two lies: one–that you should be afraid of vaccines, and two–that disease would never visit your children.

So you’ve decided to lie about not vaccinating your children. You’ve told ER doctors that your children are up-to-date on immunizations. You’ve told nurses that your children have allergies that they do not have so that you could avoid vaccinating. And you’ve rationalized it all with the falsehood that if your child ever did become ill, you would keep her at home and not expose others.

But your children, as they’ve grown, have not learned that last part. They have only learned, as you have stated time and again, that they only need to be concerned about their own well being and that they don’t owe anyone the truth or anything else.

It turns out that one of you brought your unvaccinated children to Disneyland while they were contagious with the measles. Because measles is so infectious–90% of those not immune can catch measles from a space where a contagious person had been for up to two hours after he leaves–other unvaccinated people caught it.

One woman went home to Pasadena and visited her unvaccinated sister, who is now refusing to be quarantined. Her mother defended her, saying "It's not nice when my daughter is threatened like this because she's not even sick.”

Of course she can pass along measles before becoming ill with it. Chances are she will. But you’ve been lied to. Someone told you that your children were special and they couldn’t get measles. Someone told you that your children were owed more than children like Ben, who had to be quarantined after a potential measles exposure because his chemotherapy had wiped out all his immunity to the disease.

Someone told you it was okay to lie and to hide from the consequences of your decision not to vaccinate. And now it is time for you to own the truth. Are your children unvaccinated? Be honest about it so ER doctors can treat them appropriately, so schools can exclude them during outbreaks (for their own protection), so your neighbors will know not to visit you and catch diseases we can easily and safely prevent.

I know I’ve been tough on you, and that you disagree with me and all the science showing vaccines are safe. But you still need to have some honesty about your vaccine refusal so that we have some choices about how to protect our children best.

Give on Giving Tuesday...to Give Pro-Vax Voices a Boost!

Our friends at Voices for Vaccines work tirelessly to make sure the anti-vaccine movement does not succeed in presenting itself as the default "parent voice" heard in any immunization conversation. VFV instead garners the power of the more than ninety percent of parents who choose to protect their children, and the community, by vaccinating. Because of the grassroots nature of the organization, and the fact that VFV does not accept any pharmaceutical funding, it relies entirely on individual donations from members and others supportive of the mission.

Tomorrow, December 2, VFV is asking for our help to turn up the volume on pro-vaccine voices by gathering 1,000 donors who are willing to give to VFV as part of their Giving Tuesday drive.

Moms Who Vax is happy to support Voices for Vaccines and to take these simple steps to help spread the word to 1,000 potential donors for tomorrow!


1. Join the Facebook event and invite friends.

2. Visit VFV on Giving Tuesday and donate any amount, great or small.

3. Share this video widely with friends, family, and colleagues:

You Might Be Anti-Vaccine If...: The Hidden Mission of "Children of God"

By Karen Ernst

It’s no secret that anti-vaccine organizations like to hide the fact that they are anti-vaccine. By name alone, one might never guess that the National Vaccine Information Center was anti-vaccine, but its main purpose is to frighten people away from vaccines, and they spend the bulk of their bandwidth and energy opposing any legislation aimed at increasing immunization rates. While NVIC claims it is “pro-safe vaccines,” you would be hard-pressed to look at its efforts and conclude anything other than that the organization is anti-vaccine.

But there are some organizations that are anti-vaccine without presenting their primary purpose as the opposition of immunization. These organizations can be a pitfall for people not actively attuned to the world of the immunization advocacy. Chili’s fell into such a trap a few months ago when it tried to support autism awareness and services and ended up promoting an organization that promotes the debunked vaccine-autism link, National Autism Association, before it abruptly canceled the promotion after a nationwide outcry.

For a long time, I had given another organization, Children of God for Life (CoG), a wide berth because I took the organization’s statements about vaccines at face value. The people running the organization claim to want pharmaceutical companies “to produce safe, effective alternatives for the existing vaccines and medical products and to use ethical alternatives in future products.” This statement has to do with their pro-life stance. I had always assumed that CoG were parents who were so passionate about being pro-life that they hoped to petition companies to make vaccines that are not produced through the use of cell lines derived from aborted fetuses. If that were truly their mission, they might not be pro-vaccine, but you’d be hard pressed to characterize them as anti-vaccine, either.

In the last week, however, I have had encounters with CoG that have convinced me that they are anti-vaccine, and in sharing the tell-tale signs of this anti-vaccine organization, I’m hoping to help others avoid being ensnared by such anti-vaccine organizations.

Reliance on weak science to prop up their position

Children of God has a number of doctors and PhDs associated with their organization, and discerning the science that is valuable from the science that is junk ought not to be difficult for them. So it is troubling that they latch on to science that comes from unreliable sources and is flimsy, poorly constructed, and dismissed by the majority of experts in that field.

Their current scientific cornerstone is a recently published article by Dr. Theresa Deisher that claims that autism incidence increased at points in time when vaccines grown in human cell lines were added to the CDC schedule and that residual DNA from the cell lines is itself inserted into the cells of children, then replicated, making them autistic. A thorough debunking of this idea can be read here, here, here, and here. Earlier analyses of these claims can be found here, here, and here.

Children of God has also latched on to anti-vaccine activist Brian Hooker’s recently published article (which has now been taken out of public domain) claiming that the MMR vaccine given between 24 and 36 months increases the risk of autism in African-American boys (as compared to “not specified”). This study, conducted by a man who is actively seeking compensation from the government for a claim that vaccines caused his son’s autism and who partnered with fraud Andrew Wakefield to promote his claims, is thoroughly eviscerated here, here, and here.

Caption: CoG Director Debi Vinnedge shares Hooker study on the CoG public Facebook group.

Anti-vaccine organizations often try to use science to their advantage, but they put ideology ahead of evidence. Science is about data and evidence. Science isn’t about promoting a cause, and any group that makes claims about vaccines and science in order to promote their primary agenda (be it a pro-life agenda or an autism “recovery” agenda) might just be anti-vaccine.

Replacing evidence with ad hominem attacks against vaccine-promoting people

Anyone who promotes science should expect close scrutiny of their claims and the evidence he or she presents to support those claims. As with government testimony or professional publication, conflicts of interest should absolutely be examined, and, if found, remedied. However, unsupported accusations of conflicts of interest should not be the sole basis of any critique.

It is telling when the director of an organization lobs the Pharma Shill Gambit to distract from her absence of argument. Debi Vinnedge, CoG’s Director, can be found in several places using the Pharma Shill Gambit.

In one blog’s comment section, Debi Vinnedge call infectious disease specialist, author, pediatrician, and rotavirus vaccine inventor Paul Offit a “shill for the pharm industry.”

But here’s the thing, according to CoG’s guidelines, Offit’s rotavirus vaccine is ethically produced. They should have no problem with him, according to their primary goals. (More on that in a bit.) Perhaps the problem for CoG is that after working for twenty years on inventing a vaccine, Paul Offit was paid for his work.

But the attacks are not limited to vaccine inventors or public figures.

In another blog combox, Ms. Vinnedge calls a fellow pro-life, Catholic parent a “shill” because she once wrote (without pay) a blog post for Voices for Vaccines. The rest of the comment is ugly as well and not worth commenting on, except to say that if the director of an organization willingly slings mud on those who should agree with her but are in favor of vaccines, that organization might just be anti-vaccine.

Public statements against vaccines with no connection to the organization’s primary purpose

If I were director of a pro-cancer organization, it would make sense that I would rally against the HPV vaccine, since it is a vaccine that prevents cancer. If I were an organization whose main purpose was to promote abstinence-only education, I might be under the very wrong impression that the HPV turns girls to a life of promiscuity, and then maybe--maybe maybe-- it would “make sense” to be against the HPV vaccine. However, any autism organization or pro-life organization that has anything negative to say about the HPV vaccine is merely demonstrating its deep anti-vaccine tendencies.

The HPV vaccine is not made with human cell lines, and is therefore made ethically according to CoG standards.  And yet, on their home page, CoG has a warning about “Gar-duh-$-ill.”

It’s clever because it tells you in one word that a cancer-preventing vaccine studied across the globe on millions of girls and found to have no severe side effects is dumb (duh), made only for the profits ($), and will make you ill.

Want to know if an organization is anti-vaccine? Ask them what they think of the HPV vaccine. If they have a clearly negative opinion based on the work of known anti-vaccine organizations, they just might be anti-vaccine.

Reliance on information from other anti-vaccine sources

There are plenty of organizations and websites that exist in order to frighten parents away from vaccinating. They often use conspiracy theories to further their mission while favoring unsubstantiated rumors over scientific proof. Natural News is among the most preposterous of these sources, and no legitimate organization would share information from Natural News unless they were trying to stoke fear about vaccines.

Another anti-vaccine website is SaneVax, whose sole purpose is to scare parents away from the HPV vaccine by sharing unsubstantiated and medically unverified stories on their website.

And if your public supporters include anti-vaccine group National Vaccine Information Center and Vaccination Liberation, you might just be anti-vaccine. After all, the company you keep shines a light on what you believe.

Organizations with a clear purpose should shy away from establishing anti-vaccine goals

Many solicitors visit our front door, and often these solicitors are representatives of non-profit organizations looking to further their cause. The environmentalists are frequent visitors, and I never think to ask them their stance on vaccines (although I did once dismiss a young lady who told me of the danger of “toxins” in our environment because I was suspicious).

How can you tell if an organization is anti-vaccine? Look at its use of science. Check out how it handles disagreement and if it is able to bring evidence to support its arguments or if it relies on personal attacks. Investigate its public statements about vaccines that have absolutely no connection to their mission. And make sure they are not associated with other anti-vaccine organizations or sources.

And if you agree with their primary purpose, ask yourself if you are really willing to support an organization willing to endanger public health and the lives of children in order to further their mission.

What Does Climate Change Have to Do with Vaccines?

I come from a family of science-loving, science-minded people. While none of us went into the sciences as a profession, some of us have gone into professions in which science literacy matters. One hot-button issue in our family is climate change—specifically, climate change denialism. We’ve seen the damage done by these anti-science zealots whose aim is to create enough doubt in the minds of the regular citizen to thwart legislation that could help halt the relentless march toward global disaster. We’ve watched as journalists, for many years, decided to present the climate change issue as a controversy requiring equal air time for both the climate change scientists and the denialists, prolonging this period of doubt. The result? While more than 98% of scientists are in agreement that our planet is warming, people in the United States are split about 50/50 on the issue. This will have devastating impacts on our future, and it deeply bothered members of my extended family, as well as myself. Several members of my family are particularly vociferous about how damaging denialism is in the climate change discussion, rivaling perhaps only me in my drive to counter anti-vaccine rhetoric. They do not let any opportunity pass them by in which they don't speak up in favor of the science. It's one of the many things I admire about them.

So what does this have to do with vaccines? Well, there is an interesting parallel between the climate change “controversy” and the vaccine “controversy.” Namely, that the so-called controversy was manufactured in both cases despite the fact that there exists remarkable scientific consensus; that this resulted in doubt sown in the minds of the public that was not backed by science; and that the results will be harmful to human beings. The parallel is so complete that even the media’s handling on both of issues is strikingly similar. Nowadays, the media does not, for the most part, feel that journalistic balance is achieved when a climate change story features a denialist. If anything, it puts the whole story out of balance. Over really the last year or so, the media has stopped featuring anti-vaccine activists in every vaccine story published or produced. But the media has been complicit in both cases of misrepresenting science. This parallel is something we talk about with some regularity in my family.

Then this happened: one of my "climate change guru" family members went to the doctor after contracting pneumonia. In the exam room, she decided to ask the nurse her advice regarding vaccines. She tells me that the nurse replied: “I think there are too many.” I'm not sure what else the nurse said, because Climate Change Guru immediately realized this was about to turn into a "conversation." I was sick to my stomach that a health professional would sow fear and doubt about vaccines in an exam room. I was sick because I knew exactly how powerful this nurse's doubt about vaccines could be. I'd been in that position before--a scared new parent with a baby, looking to any and all medical professionals in the clinic for information about vaccines and vaccine safety. I know a great deal more about vaccines and the lies of the anti-vax movement now than I did as a new parent. I have no doubt that if a nurse had said these words to me in that lull between the doctor’s exam of my child and the administering of the vaccines, I would have been filled with fear. I know I would have delayed the vaccine in question, perhaps even skipped it altogether.

To my mind, a nurse is a member of the medical establishment, and if there is widespread disagreement in the medical establishment about the safety of vaccines, I would never put my child in what I had been convinced, by a medical professional, was harm’s way. But by walking out that door with my child left unvaccinated, I would have left him vulnerable to any number of devastating illnesses. How would I have made sense of things if my son had contracted, say, pertussis during the seemingly constant pertussis outbreaks? Or measles, during the various measles outbreaks we've experienced? If he'd been hospitalized, and the doctors caring for him asked me why I hadn't vaccinated him in order to spare him this pain and suffering, I would have said: "A nurse told me there are too many vaccines and I got scared." And I would have felt betrayed by the medical establishment I trusted. 

“This nurse speaks to countless patients,” I told my Climate Change Guru. “I am certain some of them are parents. What if a parent chooses not to vaccinate based on what this nurse says and the child contracts pertussis? What if that child passes pertussis on to an infant? What if the infant dies?” I could feel my heart racing, the anger coursing through my body. “You have to say something,” I continued. “You have to write a letter.”

            “I will not do that.”

            “What?” I sputtered.

            “I’m not going to get a nurse fired for sharing her opinion with me.”

            “You don’t get her fired. You don't even have to mention her by name. Hell, write it anonymously if you want. The head of the clinic may take it as an opportunity to clarify clinic policy. She can’t be allowed to continue saying this stuff in a medical setting. She’s entitled to her own opinion, but it is flat-out wrong for her to spout misinformation in a medical setting to patients. There is absolutely no evidence to back up her opinion, and all kinds of evidence to the contrary.”

            My Climate Change Guru abruptly ended the conversation and walked out. She would not mention this experience to anyone at the clinic, and was, I could tell, regretting even telling me it had happened.

            I’m still angry. I’m disappointed. And I’ve done a lot of thinking about this experience over the last few days. I’ve realized that the climate change/vaccine parallel continues in ways I hadn’t even considered, and it’s helped me pinpoint why, exactly, I’m still angry.

Imagine this: My Climate Change Guru attends parent-teacher conferences for her child. In that parent-teacher conference, she asks her child’s teacher about his teaching philosophy regarding the science of climate change. The teacher replies: “Well, I believe climate change is a hoax, but I teach ‘both sides of the issue.’” My Climate Change Guru would not leave that classroom until she’d given the teacher a piece of his mind. She’d likely go to the principal and complain, perhaps pull her child from the class. It’s not just about her child. It’s about all the other children this teacher is educating. In a position of power and influence, he is capable of affecting these children’s educational outcome, even their world view. His views on climate change could “infect” his students. Would Climate Change Guru walk away quietly?

Not a chance.

            Then why did she walk away from the nurse? What is different in this scenario? After all, the parallel is complete. The nurse is in a position of power and influence. What she says and does can have a substantial impact on a child’s health outcomes—and by extension the health outcomes of the entire community. If a family chooses not to vaccinate because of her opinion that there are too many vaccines, that family could contract a vaccine-preventable disease. They could then pass that disease on to others in the community. The response to this? A shoulder shrug. It was the nurse’s “opinion.” Climate Change Guru wasn’t going to make trouble.

           Of course there are anti-vaccine nurses, just as there are anti-vaccine teachers, anti-vaccine car mechanics, anti-vaccine postal workers. In fact, since beginning work in this vaccine world, I’ve come to understand that there are far more nurses who believe vaccines are harmful than I could have dreamed possible. This is one reason why groups such as Nurses Who Vax are so crucial. What bothers me most is my family member’s decision to say nothing, in her failure to see the parallel. We have a moral obligation to speak up at moments like this—which is exactly what my Climate Change Guru would have me believe about the climate change discussion. “We can’t let this happen on our watch,” is something she’s said to me before. I challenge her, and anyone else who has heard similar sentiments in the exam room: will you let anti-vaccine rhetoric echo in the halls of medicine on your watch?