A just-released Polish study has dealt another blow to the idea that childhood immunizations are linked to autism. This new study, which found no evidence that children who received measles vaccinations are more likely to contract autism, comes on the heels of the recent revelation that the British health paper, The Lancet, has officially retracted a 1998 article it had published that purported to link autism to childhood vaccines. While hundreds have articles have now reported on The Lancet's retraction and the anti-vaccine movement's dangerous impact on childhood diseases, there has been precious little discussion of the threat that anti-vaccine fears pose to our ability to fight bioterrorism. In fact, the dangers in this area may be even greater, and our responsiveness to potential acts of bioterror will depend in part on the ability of homeland security officials to address the challenges posed by the vaccine-autism link.
The dangers of the purported vaccine-autism have been clear for some time. On the heels of Andrew Wakefield's original paper in The Lancet, a host of self-appointed celebrity public health "experts" have claimed, but not demonstrated, a link between vaccines and autism. The noise on this issue has led to second-guessing the need for vaccines, which remain vital for preventing deadly diseases like polio, measles, mumps, and rubella. When people opt out of vaccinating their children, it diminishes herd immunity, the ability of communities to withstand potentially deadly outbreaks.
These outbreaks are not just theoretical, as there have been recent measles flare-ups in the UK, Israel, and the U.S. Since measles is preventable, the main cause of these outbreaks is insufficiently high vaccination rates, which are exacerbated in the U.S. by Hollywood celebrity campaigns against the Center for Disease Control's childhood vaccination schedules.
Public health officials already understand the importance of breaking the vaccine-autism link and have taken a variety of steps to combat it. For the last decade, public health officials have struggled against an increasingly skeptical public in their efforts to get out the message on the importance of vaccines in preventing disease and saving lives. When I served at the Department of Health and Human Services, we found that the anti-vaccine forces had so demonized the Centers for Disease Control that CDC messages on vaccines had been significantly devalued. As a result, senior officials up to and including the Secretary of HHS had to spend precious time better directed elsewhere fighting back against anti-vaccine messages because of the skepticism with which CDC messages were received.
While our public health officials are working hard to fight back against these problems, homeland security officials must also recognize the serious impact of vaccine skepticism on domestic preparedness against biological threats, be they natural or man-made. Our No. 1 defense against many biological threats, including pandemic influenza, smallpox, and anthrax is vaccinations, and it is essential that the public be ready and willing to secure vaccinations in case of outbreaks of these deadly diseases. All of these pathogens represent significant threats. Smallpox is easily spread, has a high fatality rate, and is not treatable after the fourth day of infection. Influenza kills 36,000 Americans a year, and the H1N1 has killed over 10,000 Americans thus far. And anthrax, as we know, has already been successfully used as a biological weapon in the United States, in the postal system attacks of 2001.
Unfortunately, we saw this fall that anti-vaccine notions have moved beyond skepticism towards childhood immunizations and into the realm of vaccines in general. The best, or worst example of this was Bill Maher, who called people who took the H1N1 vaccine "idiots." Glenn Beck contributed to this problem as well, telling listeners "I'd do the exact opposite of what the Homeland Security says." And Louis Farrakhan also participated, claiming that the H1N1 vaccine was some sort of population control measure, saying that the goal was to "Kill as many as you can. We have to develop a science that kills them and makes it look as though they died from some disease."
These anti-vaccine sentiments are not classifiable in any one ideological category, but they have all been enabled, to some degree, by the anti-vaccine skepticism initiated by the Wakefield study in The Lancet. Wakefield has now been repudiated, both by the Lancet and the new Polish study, but the nagging doubts about vaccines he unleashed will be hard to eradicate. In the 12-year period since the initial publication, a great deal of damage has already been done. And this damage, once done, cannot be easily undone. As Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia, put it, "It's hard to unring the bell." In the years ahead, U.S. planners charged with protecting our nation against biothreats will have to try to unring that bell if they are going to protect us from the worst our enemies have in store for us.