Many people are familiar with the story of Andrew Wakefield. Wakefield was a medical doctor in the United Kingdom. A little over a decade ago, he produced a study purporting to link autism with the MMR (mumps, measles, and rubella) vaccine. The most distinguished medical journal in the UK, The Lancet, published the study. Not long after, widespread fear grew over the potential link between the vaccine and autism—except that there was no such link. Wakefield deliberately fabricated the data for the study and subsequent studies (of which there were many) proved that the MMR vaccine does not cause autism. The supposed causative agent in the vaccine, a mercury-based preservative known as thimerosal, was removed as a precaution. Eventually, Wakefield’s fraud was uncovered and The Lancet officially retracted the study. The UK’s medical licensing authorities took away Wakefield’s medical license shortly thereafter. Wakefield left the UK and now lives in Austin, TX, where he continues to advocate the disproven link between vaccines and autism.
The reaction against vaccines spurred the adoption of more and looser public school vaccine exemption statutes in many states. Wakefield’s fraud was in no small part a driving factor in this development. Even though Wakefield is now unmasked, many of these exemptions remain. Most of those against vaccines either rejected the scientific consensus, or found other largely pseudoscientific reasons to avoid giving their children vaccines. Vaccine exemptions are an important legal tool. They allow a student with genuine medical or religious exemptions to avoid compromising their health or violating their beliefs. Many states, however, rarely do more than require a parent to affirm that they fulfill the criteria for an exemption. Worse, more than a dozen states now allow so-called philosophical exemptions. Basically, if a parent simply has a bona fide belief that their children should not be vaccinated, then they can opt out.
Vaccine exemptions, however, do not affect only the child who does not receive the vaccine. An important part of vaccines’ effectiveness is the herd immunity resulting from mass vaccination. Even if one child does not develop immunity or still gets a disease, the disease cannot spread to the immune children around the sick child. In essence, herd immunity chokes off the spread of a disease until it is extinct. Nevertheless, the widespread availability of exemptions is causing cracks in this herd immunity. Thus, the “philosophical” decision not to vaccinate one’s child potentially imperils other children as well. Many of these childhood diseases are not well understood by parents because they were brought under control or wiped out in the United States long ago. Many can be life threatening . The legal framework of vaccine exemptions, which is not based in sound scientific evidence, is creating a dangerous and growing public health problem. It is up to policymakers to chart a wiser course not based on bad data and false fears of parents. Otherwise, many diseases we had long thought vanquished may make a comeback among the youngest members of our society.