Vaccinate Vaccines From Partisanship

In 2016, the US experienced 70 cases of measles, a highly infectious disease that many don’t think about much anymore. The year before, thanks to a multi-state outbreak in California involving Disneyland, there were 188 cases, and the year before that 667.

Depending on the circumstance, those numbers go up or down from year to year. According to the Centers for Disease Control and prevention (CDC), “measles was declared eliminated (absence of continuous disease transmission for greater than 12 months) from the United States in 2000,” but since then due to exposure from overseas and pockets of non-vaccinated Americans, measles has proven to be far from eliminated.

Mumps, another infectious disease more common years ago than now, is still present in the US and each year cases can run from a few hundred to a few thousand like in 2010, when 2,610 cases were reported.

Rubella, or German measles, is just about eliminated in the U.S. and the Americas, which is a good thing because of its association with birth defects and pregnancy. Cases still occur from time to time due to overseas exposure.

All three of these illnesses are prevented by one vaccine (MMR), which is now standard to administer to children between 12-15 months and again at 4-6 years. This has been a very effective strategy for medical and public health officials to use, and until recently triggered very little controversy. Back in early 2015, the issue was treated as nonpartisan.

The risk for vaccines is not minimized. They are monitored and studied. Multiple studies have shown that there is simply no link to autism and reported adverse events are carefully tracked.

Things have changed. With the election of Donald Trump and his vocal support for both disproven vaccine-autism links and anti-vaccination champions such as Robert F. Kennedy Jr., things are not as they were. That’s a dangerous place to be if your main concern is the public interest.

It’s a dangerous place because politics injects a hazardous and unpredictable factor of partisanship into what should be a clear policy and science debate. It isn’t whether Trump is right or wrong about vaccines, it’s that people shouldn’t be taking sides on the question. Yet if vaccination policy is infused with partisanship, that’s exactly what will happen.

Multiple authors have written recently about the dangers of partisanship when it comes to vaccine policy (including here, here, here and here) and this threat of partisanship is occurring while protective vaccination rates in some areas of the country are slowly declining. For example, infectious disease expert Dr. Peter Hotez has written about rising non-vaccination rates in Texas, for example, and predicts more outbreaks of measles in the next year or two. In fact, you can use this handy measles outbreak simulator to visualize how different vaccination rates affect disease transmission. The less vaccinated the town, the more measles cases you get.

Last year, in a poll done by Pew Research Center, only 9 percent of the public thought vaccines were unsafe. This, and numbers like it, are a thing we will have to keep a close eye on. Any sign of the vaccination rate dropping or of increased resistance and decreased acceptance from the public will be an alarm bell for all of us to heed.

The concern here is that if we take a tribal nature to science (my tribe is right because it’s my tribe), we will all be in a much worse place.

Daniel T Rogers, writing in the Chronicle and referring to public policy and politics, notes:

“Finding our way back to the notion of truth as the result of a public process of search and debate and deliberation will not be easy.”

Even if it’s not easy, it’s necessary. At least, it is necessary if we want to continue to fight infectious diseases as a greater public good.