Why Parents Fear the Needle (and the gene)

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DESPITE overwhelming evidence to the contrary, roughly one in five Americans believes that vaccines cause autism — a disturbing fact that will probably hold true even after the publication this month, in a British medical journal, of a report thoroughly debunking the 1998 paper that began the vaccine-autism scare. says Michael Willrich, a professor of history at Brandeis University in todays NYT

Similarly, according to Dr Oz, the TV host, papaya genetically engineered with a snippet of a mild strain of a virus to make it disease free, causes infertility. This in face of overwhelming evidence from peer-reviewed studies that the papayas, which have been consumed for 15 years and have been embraced by farmers as the most appropriate method to control the deadly papaya ringspot virus, are safe to eat. In contrast, to GE papaya that carry trace amounts of a mild strain of the virus, conventional or organic papaya are chalkfull of the virus. How should such papaya be labeled?

It is the same story for GE cotton, a cotton engineered with a certified organic insect control agent called BT. The GE cotton is thriving with half the amount of insecticide, yet many still view it with suspicion. And vitamin A fortified rice has yet to reach the poor who need it because of concerns that the fortification was added with genes rather than synthetic chemicals that has been the norm for many years. The non-profit Golden Humanitarian Board has launched research and education programs to assist parents in understanding the dangers of vitamin A deficiency, which causes some 250,000 to 500,000 children to go blind every year. More than half of those children also die within a year of becoming blind.

As Willrich points out, the clear benefits to children’ s health is often obscured by the public’s deep and underlying fear of vaccines and genes. “Until officials realize that, and learn how to counter such deep-seated concerns, the paranoia — and the public-health risk it poses — will remain”.

The evidence against the original article of the vaccine-autism scare and its author, a British medical researcher named Andrew Wakefield, is damning. Among other things, he is said to have received payment for his research from a lawyer involved in a suit against a vaccine manufacturer; in response, Britain’s General Medical Council struck him from the medical register last May. As the journal’s editor put it, the assertion that the measles-mumps-rubella vaccine caused autism “was based not on bad science but on a deliberate fraud.”

In the same vein, Oz and associates uses anecdotes to suggest that genetic engineering is dangerous, even though such stories are contradicted by a vast body of data and scientific experience and like Wakefield are riddled with undisclosed potential conflicts of interest.

But public fear of vaccines and genes did not originate with Dr. Wakefield’s paper or Smiths stories. Rather, their claims tapped into a reservoir of doubt and resentment toward these life-saving, but never risk-free, technologies.

“Vaccines have had to fight against public skepticism from the beginning. In 1802, after Edward Jenner published his first results claiming that scratching cowpox pus into the arms of healthy children could protect them against smallpox, a political cartoon appeared showing newly vaccinated people with hooves and horns”.

When iodized salt was first promoted in Kazahastan, it was thought to be a government plot to poison people. SImilarly, many view Golden rice (to be released through non-profit channels, with seed to be saved and replanted by farmers) with suspicion.

Nevertheless, during the 19th century vaccines became central to public-health efforts in England, Europe and the Americas, and several countries began to require vaccinations. Similarly, following an education campaign, iodized salt was eventually accepted today Kazakhstan is 94% free of iodine deficiency disorders.

Many people saw mandatory vaccinations and iodized salt as an invasion of their personal liberty. An antivaccine movement began to build and, though vilified by the mainstream medical profession, soon boasted a substantial popular base and several prominent supporters, including Frederick Douglass, Leo Tolstoy and George Bernard Shaw, who called vaccinations “a peculiarly filthy piece of witchcraft.”

Willrich goes on to describe the history of the vaccination movement:

“In America, popular opposition peaked during the smallpox epidemic at the turn of the 20th century. Health officials ordered vaccinations in public schools, in factories and on the nation’s railroads; club-wielding New York City policemen enforced vaccinations in crowded immigrant tenements, while Texas Rangers and the United States Cavalry provided muscle for vaccinators along the Mexican border”.

Public resistance was immediate, from riots and school strikes to lobbying and a groundswell of litigation that eventually reached the Supreme Court. Newspapers, notably this one, dismissed antivaccinationists as “benighted and deranged” and “hopeless cranks.” In the case of GE crops, research fields are destroyed in France and even when the vandals are caught, they are let go.

These kinds of opposition movements reflect “complex attitudes toward medicine and the government. Many African-Americans, long neglected or mistreated by the white medical profession, doubted the vaccinators’ motives. Christian Scientists protested the laws as an assault on religious liberty. And workers feared, with good reason, that vaccines would inflame their arms and cost them several days’ wages.”

Understandably, advocates for universal immunization then and now have tended to see only the harm done by their critics. But in retrospect, such wariness was justified: at the time, health officials ordered vaccinations without ensuring the vaccines were safe and effective. Lack of public confidence in government regulatory polices is one of the reasons that some consumers fear the process of GE.

“Public confidence in vaccines collapsed in the fall of 1901 when newspapers linked the deaths of nine schoolchildren in Camden, N.J., to a commercial vaccine allegedly tainted with tetanus. In St. Louis, 13 more schoolchildren died of tetanus after treatment with the diphtheria antitoxin. It was decades before many Americans were willing to submit to public vaccination campaigns again.”

“Nevertheless, the vaccination controversy of the last century did leave a positive legacy. Seeking to restore confidence after the deaths in Camden and St. Louis, Congress enacted the Biologics Control Act of 1902, establishing the first federal regulation of the nation’s growing vaccine industry. Confronted with numerous antivaccination lawsuits, state and federal courts established new standards that balanced public health and civil liberties”. Regulation of GE crops so far seems to be working. So far, not a single instance of harm to human health or the environment has been documented.

Most important, popular resistance taught government officials that when it comes to public health, education can be more effective than brute force. By midcentury, awareness efforts had proven critical to the polio and smallpox vaccination efforts, both of which were huge successes. For GE crops, the story is not so clear. Although the GE crops on the market, especially GE cotton and GE papaya have had clear economic and environmental benefits, much of the public is unaware of these successes.

“One would think such education efforts would no longer be necessary. After all, today’s vaccines are safer, subject to extensive regulatory controls. And shots are far more numerous: as of 2010, the Centers for Disease Control recommended that every child receive 10 different vaccinations. For most Americans, vaccines are a fact of life.

Still, according to a 2010 C.D.C. report, 40 percent of American parents with young children have delayed or refused one or more vaccines for their child. That’s in part because vaccines have been so successful that any risk associated with their use, however statistically small, takes on an elevated significance.

It also doesn’t help that, thanks to the Internet, a bottomless archive of misinformation, including Dr. Wakefield’s debunked work, is just a few keystrokes away. All of which means the public health and agricultural communities must work even harder to spread the positive news about vaccines and disease resistant papaya.

Health officials (and scientists!) often get frustrated with public misconceptions about vaccines (and genes); at the turn of the last century, one frustrated Kentucky health officer pined for the arrival of “the fool-killer” — an outbreak of smallpox devastating enough to convince his skeptical rural constituency of the value of vaccination.” Hawaiian farmers embraced GE papaya precisely because it was so effective against a disease that could not be controlled using other methods (organic or conventional).

Willrich points out:

“But that’s no way to run a health [or agricultural] system. Our public health leaders would do far better to adopt the strategy used by one forward-thinking federal health official from the early 20th century, C. P. Wertenbaker of the Public Health and Marine-Hospital Service.

“As smallpox raged across the American South, Wertenbaker journeyed to small communities and delivered speech after speech on vaccinations before swelling audiences of townsfolk, farmers and families. He listened and replied to people’s fears. He told them about the horrors of smallpox. He candidly presented the latest scientific information about the benefits and risks of vaccination. And he urged his audiences to protect themselves and one another by taking the vaccine. By the time he was done, many of his listeners were already rolling up their sleeves. [cant say scientists that talk about GE have always had such success]

America’s public health leaders and scientists need to do the same, to reclaim the town square with a candid national conversation about the real risks of vaccines and GE crops, which are minuscule compared with their benefits. Why waste another breath vilifying the antivaccination and anti GE minority when steps can be taken to expand the pro-vaccine majority and we can demonstrate that GE crops have reduced insecticide use?

“Obstetricians, midwives, pediatricians [and agricultural scientists] should present the facts about vaccines [and insect and viral resistant crops as well as the soon to be released vitamin A fortified rice] and the nasty diseases they prevent early and often to expectant parents [and other consumers]. Health agencies should mobilize local parents’ organizations to publicize, in realistic terms, the hazards that unvaccinated children can pose to everyone else in their communities [and the advantages of vitamin fortification and reduced applications of insecticides]. And health [and agricultural] officials must redouble their efforts to harness the power of the Internet and spread the good word about vaccines [and even some GE crops].

You can bet that Wertenbaker would have done the same thing”.

Follow Pamela Ronald:
Pamela Ronald is Professor of Plant Pathology at the University of California, Davis, where she studies the role that genes play in a plant’s response to its environment. Her research focuses on the genetics of rice. With her husband, she co-wrote Tomorrow's Table: Organic Farming, Genetics and the Future of Food. She writes a blog of the same name.