It’s natural and important to ask questions about vaccines, to have hesitations and doubts. Luckily, for pretty much every question parents ask there are reassuring answers. There is a reason the expert consensus – across countries, and at the local, national, and international level – supports vaccines so uniformly: the data is clear that the vaccines we give children have tremendous benefits that far outweigh their small, if real, risks.
In addition to the reliable information available, there is also extensive misinformation from anti-vaccine sites and people who promote an anti-vaccine agenda. And identifying who is anti-vaccine should be an important objective.
As pointed out by several bloggers, including and especially Orac in this post and in this one, those promoting anti-vaccine information rarely admit that they are anti-vaccine. The National Vaccine Information Center, America’s largest, oldest and probably most savvy anti-vaccine organization denies being anti vaccine. The Australian Vaccination Network, as it was then known, does the same.
Similarly, individuals may deny they are anti-vaccine even when they are. This can be tricky, because people may sincerely believe they are not-anti-vaccine while actively promoting anti-vaccine claims.
It may be hard for those not constantly involved in the dialogue surrounding vaccines to identify who is, in fact, anti-vaccine. I previously found extremely useful Dr. David Gorski’s post on this issue where he addressed in detail several arguments that can help you identify someone as anti-vaccine. The problem is that Dr. Gorski’s article may be too long and complex for those wanting a quick way to identify whether their interlocutor is anti-vaccine – or those who want to point out to others that someone is anti-vaccine.
So, as a public service, here is a short checklist. I am including it as part of this post and also as a stand-alone handout (pdf) people can send to anyone who needs it or use themselves.
Who is Anti-Vaccine?
This short checklist was prepared to help identify who is anti-vaccine. Some people and organizations that use other labels can be fairly characterized as anti-vaccine.
Generally, it is fair to characterize someone as anti-vaccine if they:
- Consistently and dramatically overstate vaccines’ risks, including attributing to vaccines risks the literature shows they do not have.
- Consistently understate or deny vaccine benefits.
Sometimes, the person in question will claim a conspiracy to hide evidence to dismiss the data that counters their claims.
Additional literature on this1, and explanations of each point, are included in the endnotes. Generally, a person is probably anti-vaccine if they make two or more of the following claims:
Examples of Overstating Risks:
- Using VAERS numbers as the number of vaccine injuries.2
- Claiming vaccines cause autism3, SIDS4, allergies5, and other conditions we know they don’t cause.6
- The toxins gambit: claiming the ingredients in vaccines are very dangerous.7
- Children get too many vaccines too soon.8
- Claiming schedule never tested.9
- There has never been a study comparing vaccinated to unvaccinated children.10
Examples of Understating Benefits:
- Claiming diseases went down before vaccines.11
- Claiming diseases were mild before vaccines or don’t harm people in developed countries.12
- Claiming vaccines don’t work.13
- See: Kata A. A postmodern Pandora’s box: anti-vaccination misinformation on the Internet. Vaccine. 2010 Feb 17;28(7):1709-16. doi: 10.1016/j.vaccine.2009.12.022. Epub 2009 Dec 30. PubMed PMID: 20045099.; Kata A. Anti-vaccine activists, Web 2.0, and the postmodern paradigm–an overview of tactics and tropes used online by the anti-vaccination movement. Vaccine. 2012 May 28;30(25):3778-89. doi: 10.1016/j.vaccine.2011.11.112. Epub 2011 Dec 13. PubMed PMID: 22172504.; Deadly Choices: How the Anti-Vaccine Movement Threatens Us All.
- VAERS is a voluntary database. Reports are not evaluated. Using the numbers as showing number of injuries does not correctly reflect what vaccines cause or not. While some vaccine-related problems are probably not reported (underreporting) there is also evidence of substantial overreporting – reporting of things that are not caused by vaccines. Here is one example: VAERS #379570: “…patient accidentally fell in open well (granite quarry filled with water), drowned and expired. This event occurred 49 days of receiving first dose of GARDASIL.”For information on over-reporting, see Goodman MJ, Nordin J. Vaccine adverse event reporting system reporting source: a possible source of bias in longitudinal studies.Pediatrics. 2006 Feb;117(2):387-90. PubMed PMID: 16452357; Loughlin AM, Marchant CD, Adams W, Barnett E, Baxter R, Black S, Casey C, Dekker C, Edwards KM, Klein J, Klein NP, LaRussa P, Sparks R, Jakob K. Causality assessment of adverse events reported to the Vaccine Adverse Event Reporting System (VAERS).Vaccine. 2012 Nov 26;30(50):7253-9. doi: 10.1016/j.vaccine.2012.09.074. Epub 2012 Oct 9. PubMed PMID: 23063829.For more information about VAERS generally, see this article.
- See this article.
- See Kuhnert R, Schlaud M, Poethko-Müller C, Vennemann M, Fleming P, Blair PS, Mitchell E, Thompson J, Hecker H. Reanalyses of case-control studies examining the temporal association between sudden infant death syndrome and vaccination. Vaccine. 2012 Mar 16;30(13):2349-56. doi: 10.1016/j.vaccine.2012.01.043. Epub 2012 Jan 28. PubMed PMID: 22289512.; Vennemann MM, Höffgen M, Bajanowski T, Hense HW, Mitchell EA. Do immunisations reduce the risk for SIDS? A meta-analysis.Vaccine. 2007 Jun 21;25(26):4875-9. Epub 2007 Mar 16. Review. PubMed PMID: 17400342.
- See Offit PA, Hackett CJ. Addressing parents’ concerns: do vaccines cause allergic or autoimmune diseases? Pediatrics. 2003 Mar;111(3):653-9. Review. PubMed PMID: 12612250.
- On what vaccines cause or do not cause see this article; and Myers M, Pineda D. Do Vaccines Cause That?! A Guide for Evaluating Vaccine Safety Concerns. Immunizations for Public Health (2008).
- Ignoring the fact that each ingredient is there for a reason and none in large enough amounts to be harmful. See this article, and this one (pdf).
- See this article (pdf).
- Multiple Institute of Medicine reports looked at that issue (pdf); Maglione MA, Das L, Raaen L, Smith A, Chari R, Newberry S, Shanman R, Perry T, Goetz MB, Gidengil C. Safety of vaccines used for routine immunization of U.S. children: a systematic review. Pediatrics. 2014 Aug;134(2):325-37. doi: 10.1542/peds.2014-1079. Epub 2014 Jul 1. Review. PubMed PMID: 25086160. Also, see this article.
- See this article, this article, and this article.
- If you look at Table 1 & 2 you will see number of cases was high until vaccine, see Roush SW, Murphy TV; Vaccine-Preventable Disease Table Working Group. Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. JAMA. 2007 Nov 14;298(18):2155-63. PubMed PMID: 18000199. Note: disease mortality – deaths – went down prevaccine; but cases continue. For example, iron lung prevented deaths from polio, but cases still happen.
- For information on how many deaths/harms vaccines prevent each year, see Zhou F, Shefer A, Wenger J, Messonnier M, Wang LY, Lopez A, Moore M, Murphy TV, Cortese M, Rodewald L. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014 Apr;133(4):577-85. doi: 10.1542/peds.2013-0698. Epub 2014 Mar 3. PubMed PMID: 24590750. That’s not harmless. 42,000 early deaths per cohort preventing.
- In reality, modern vaccines have high rates of effectiveness, ranging from around 70-97%. To give two examples from opposite ends of the scale, the mumps vaccine, one of the least effective vaccines, is estimated to be 78% effective in practice. Steven A. Rubin & Stanley A. Plotkin, Mumps Vaccine, in Vaccines 419, 435 (Stanley A. Plotkin et al., eds., 6th ed. 2012)[infobox icon=”quote-left”]The effectiveness of mumps vaccines determined in field studies (Table 22-9) is lower than efficacy determined in clinical trials. Effectiveness of a single dose of the Jeryl Lynn strain of mumps vaccine (given as a monovalent vaccine or as trivalent MMR) under conditions of routine use is approximately 78% (95% CI, 75%-82%), compared with 95% or more demonstrated in efficacy trials.”) The Hepatitis B vaccine is 95% effective in children, but slightly less effective in adults. Pink Book, supra note 15, at 159 (“After three intramuscular doses of hepatitis B vaccine, more than 90% of healthy adults and more than 95% of infants, children, and adolescents (from birth to 19 years of age) develop adequate antibody responses.[/infobox]