Update from 2021: This article, written in 2019, is primarily about the MMR (Measles, Mumps, Rubella) vaccine. Most likely I will be getting the COVID-19 vaccine when it is available to me. My children, of course, are too young to get the COVID-19 vaccine.
Vaccines cause autism!-Anti-vaxxer
Vaccines cause adults!-Pro-vaxxer
Although vaccines have contributed to the reduction of injuries and deaths due to diseases1, vaccine proponents frequently exaggerate the benefits of vaccines as well as the dangers of the diseases that vaccines attempt to inoculate against.2 On the other hand, vaccine opponents rely too heavily on anecdotes, cherry-picked data, and conspiratorial premises based on sensationalism rather than critical inquiry.
When my first daughter was born five years ago, we did not vaccinate her because we were skeptical of the necessity of vaccines. Almost six years later, after much reading, writing, and discussion, our position of skepticism still holds true, but I am at the point where I am comfortable articulating it in an article for public consumption. This article focuses mostly on the measles vaccines, but I believe my points apply to some other vaccines as well. This article should not be used as a rationale for avoiding any and all vaccinations, especially if one is leaving the country.
Measles Versus Automobiles
In the US in 2019, what is the risk of measles compared to automobiles? (I am focusing on deaths simply because they are easier to quantify than other forms of loss and suffering. )
Let’s consider the most controversial vaccine: MMR (Measles-Mumps-Rubella). The US mortality rate of measles has not decreased significantly since the introduction of the measles vaccine. What has decreased is the US incidence rate, although this is increasing as of late. Whereas in 2010 there were 63 cases of measles, in 2019 there were 1,282. For sake of argument, let’s assume that the incidents each year is 2,000, which means that the incidence rate is 0.0006%. The mortality rate is roughly 0.1%. When we multiply the incidence rate by the mortality rate, we get a risk of 0.000061%.3
The US had ~40,000 automobile fatalities in 2017. We’ll assume that 300M US residents use cars each year. The mortality rate for automobile-users, therefore, is 0.0133%. Consequently, the incidence rate of measles in the US would need to increase to 0.133% (~440,000 cases per year) in order to match the risk of automobile death. Obviously the burden of measles extends well beyond the possibility of death, but the same can be said for automobiles.
Let me be clear: My point is not that contracting measles is morally equivalent to using automobiles. One is obviously enjoyable and beneficial and the other is not. My point is that in 2019, the risk of putting a child in an automobile to take them to the doctor for measles vaccination is greater than the risk of measles itself.
Downsides to Vaccines
If there were no downsides to getting vaccines, none of what I just presented would have any merit. But there are downsides:
- Many vaccines are created from aborted fetal stem lines, making the usage of such vaccines ethically dubious. Personally I think that ethical vaccines should be used in non-emergency cases. I am not aware of an ethical MMR vaccine.
- Vaccines have known safety issues, as admitted by the US government, vaccine manufacturers, and other medical organizations.
- Vaccines require time and money. The average child is supposed to receive 70+ vaccines by the time they are 18 years old. This is the least significant downside but still worth mentioning.
Vaccine Mortality Rates
We don’t have good data on the mortality rate of any vaccine because determining the causes of non-sudden, non-catastrophic deaths is difficult. The deterioration of one’s health over days, weeks, or months can be caused by a single factor or numerous factors. How does one determine what those factors are and which ones played the greatest role?
The best data we have is from the Vaccine Adverse Event Reporting System (VAERS) and resulting payouts from the US vaccine courts. (The mere existence of a no-fault vaccine court is undoubtedly the largest admission by the government concerning the safety of vaccines, but I digress.) Since the reporting system is voluntary and many cases are denied hearing (as I’ll discuss in the section on autism), the numbers they report are undoubtedly on the low side, but its impossible to know just how low. On the other hand, its worth noting that although a payout requires reasonable evidence that vaccines caused an injury or death, it does not guarantee causation. Anyway, here are the numbers:
Since 1988, over 20,728 petitions have been filed with the VICP. Over that 30-year time period, 17,923 petitions have been adjudicated, with 6,597 of those determined to be compensable, while 11,326 were dismissed. Total compensation paid over the life of the program is approximately $4.1 billion.
This means that roughly 32% of filings were supposedly caused by vaccines. Applying value that to the filed deaths (1988 through June 2019) provided in the data sheet (1,304), we can conclude that 417 deaths were supposedly caused by vaccines over a 30 year period. I could not find data on the number of number of people vaccinated during that time period, but I would guess that it is over 120 million based on a liberal US average births per year of 4 million. Therefore, the VAERS-based mortality rate of vaccines (all vaccines, not just MMR) is 0.0003475%. The VAERS-based mortality rate of measles-related vaccines (82) is 0.00006833%.
Drawing upon calculations from the previous section:
- Measles mortality rate (assuming 2,000 US incidents per year): 0.000061%
- Measles vaccine mortality rate: 0.00006833%
Therefore, all things equal, measles vaccines are more deadly than measles themselves in the US in 2019. If the incidence rate increases significantly, measles will become much more deadly, although it extremely unlikely that measles will ever be as deadly as automobiles.
Of course, all things are not equal. Some people, for a variety of reasons, are more or less likely to catch measles or experience adverse vaccine side effects than others. While some of these factors are probably easier to identify than others, it is beyond the scope of this article to describe such factors in depth.4
Do Vaccines Cause Autism?
Depends on what you mean by “cause”. It appears that vaccines can neurological disorders that have no qualitative difference from autism. In that sense, yes, vaccines do, on rare occasion, cause autism. While you won’t find the CDC or vaccine manufacturers mentioning autism as a side effect, you will find them mentioning neurological disorders associated with autism as a side effect. From the Merck MMR vaccine insert:
The risk of serious neurological disorders following live measles virus vaccine administration remains less than the risk of encephalitis and encephalopathy following infection with wild-type measles (1 per 1000 reported cases).
I’d encourage readers to read the surrounding text in the Merck insert. The neurological disorders mentioned are not synonymous with autism or even frequently a precursor to autism, but they are associated with autism, as was admitted in the Hannah Poling case. The CDC makes a similar admission when answering whether vaccines can worsen mitochondrial diseases:
As of now, there are no scientific studies that say vaccines cause or worsen mitochondrial diseases. We do know that certain illnesses that can be prevented by vaccines, such as the flu, can trigger the regression that is related to a mitochondrial disease. More research is needed to determine if there are rare cases where underlying mitochondrial disorders are triggered by anything related to vaccines. However, we know that for most children, vaccines are a safe and important way to prevent them from getting life-threatening diseases.
Notice how both quotes are quick to mention that vaccines aren’t as bad as the disease itself. The problem, of course, is that a vaccinated child is guaranteed to take on the risk of the vaccine, whereas an unvaccinated child is not guaranteed to take on the risk of the disease (since they may never contract it). This is a common pro-vaxxer fallacy: ignoring incidence rate in discussions on vaccines.5 That being said, it raises this question: if measles or the flu can cause injuries or conditions associated with autism, wouldn’t the rate of autism increase as the incidence rate of these diseases increase? I don’t know the answer. If the answer is yes, then its not enough to avoid vaccines to reduce the chance of neurological disorders, one must also avoid the disease itself.6
I would encourage readers to do additional study on the Hannah Poling and the Omnibus Autism Proceeding because they prove that the vaccine court data is not useful for determining whether vaccines cause autism. That’s simply because the vaccine courts denied these people a hearing on the ground that 1) they were not equipped to handle the massive number of filings (more than 5,000), 2) a favorable ruling for one of the plaintiffs “might have serious adverse public health effects by discouraging vaccine manufacturers from producing more childhood vaccines”. Consequently, cases like Hannah Poling were settled administratively and you will not find them numbered with the payouts I presented earlier. In my mind, this is disturbing evidence that the US government is biased toward the vaccine industry.
Although I think vaccines are playing a small part in the increase in autism, I do not believe that there is an autism epidemic. Most of the increase is undoubtedly due to better diagnosis. At this point, a pro-vaxxer will probably bring up the seemingly endless cohort studies and meta-studies that show no link between vaccines and autism. My problem with these studies is that they only refute that claim that vaccines cause autism outside of the margin of error of the study. But any study performed isn’t going to have a MOE so small that it could detect whether vaccines rarely cause autism at a rate of 0.01% or lower.7 Nor are any of them double-blind or placebo-controlled, nor are we likely to ever see such a study (see here and here).
The Utilitarian (Herd Immunity) Argument
Finally admitting that vaccines are not perfectly safe, the pro-vaxxer will inevitably bring up the herd immunity argument: despite the risks of vaccines, its still important that we keep the herd immune so that those who cannot be vaccinated are less susceptible to the disease. In other words, the utilitarian “greater good” argument. Let’s examine the greater good argument with this story:
You live in an isolated village of 10,000 people that is surrounded by forests. In these forests live terrible beasts that eat roughly 10 people at random per year — sometimes more, sometimes less. The beasts and leaders of the village come to an agreement: the village will provide one sacrificial person, selected randomly, to the beasts per year. In exchange, the beasts will not kill random people at other times.
While this story might seem contrived, it is not. Vaccines will kill people, but measles will almost certainly kill more people. Do we force society to sacrifice some of their own to vaccines in order to prevent an overall higher death count due to measles? I am not aware of how such utilitarianism can be defended from the Bible.8 What can be defended from scripture is the concept of personal responsibility.
My position, therefore, is that parents with unvaccinated infants should reduce said infant’s exposure to a particular disease. I mention “infants” and not “immunodeficient children” because it is a myth that immunodeficient children cannot receive vaccinations.
Where there is risk, there ought to be choice. This idea is not respected by pro-vax zealots:
It is unethical to state that a child qualifies for an exemption to vaccines based on reasons not supported by science.David Gorski, MD, PhD (@gorskon), Jun 27, 2019
When people believe they are objective they become dogmatic. When they become dogmatic they become zealots. David Gorski is one such pro-vax zealot who would do well to understand that science is a fallible, subjective enterprise, hence the self-contradiction of phrases like “settled science”. Nevertheless, his opinion is increasingly common: “the science is settled; a moral society will force people to act accordingly.”
Even if most pro-vaxxers won’t embrace Gorski’s “science-based authoritarianism”, they will still frequently support the US public education system, which mandates vaccinations of students, thereby forcing low-income families to vaccinate in states where religious and philosophical exemptions are disappearing. (Horrifyingly, the only remaining exemption, the medical exemption, can only be attained if your child experiences a dangerous reaction to a vaccine.) School choice is the answer: if parents want to surround their children with only vaccinated children, they may choose to do that without fear of prohibitive costs.
Beyond “Anti-Vax” and “Pro-Vax”
“Anti-vax” literally means “against vaccines”. In controversial, polarizing topics like vaccines, I think it helpful to define “against” as meaning “moral opposition”. Indeed, I have no problem being labeled anti-abortion, anti-slavery, and anti-Marxism because I am morally opposed to these ideologies and practices regardless of the circumstances. The same cannot be said of my view of vaccinations, which is why I prefer the term “vaccine skeptic”.
I am not opposed to vaccinations across but board but rather am skeptical of the importance placed on vaccines by government and medical organizations. I agree with such organizations when they say that vaccinations are reasonably safe. But here’s the crux: just because something is reasonably safe doesn’t mean it is necessary. In the United States in 2019, if it is rational for me to drive my homeschooled children at least once a week then it is certainly rational to forego vaccinating them.
Are there people who oppose vaccines purely on philosophical grounds regardless of whether vaccines are safe? Probably, but they are few. A better litmus test for whether someone is “anti-vax” is what they believe about “big pharma”: are vaccine manufacturers and the CDC covering up the truth about vaccines? Conspiracies are exciting but difficult to substantiate. Even the most professionally produced anti-vax documentaries have failed to convince me.
Another anti-vax litmus test, in my opinion, is whether someone defends Andrew Wakefield, the notorious former doctor who was stripped of his medical license in the UK due to his efforts to promote a link between vaccines and autism. Wakefield made many ethical missteps surrounding his retracted Lancet paper, which almost every other co-author has since denounced. Certainly it is not necessary to invoke Wakefield or his research in discussing vaccines and autism, as this article has demonstrated.
Switching sides: if pro-vax is the opposite of anti-vax, and anti-vax is a philosophical position, then it follows that pro-vax is not a scientific position but a philosophical position as well. Consequently, the two litmus tests I use for “pro-vax” are servile or uncritical adherence to the consensus of the medical community and authoritarianism (e.g., mandatory vaccination). Both are dangerous to individuals and society and both should be opposed.
Vaccines are an important medical advancement that serve an important place in modern civilizations’s medical arsenal, but they do not deserve a place in every human body. My wife and I have chosen not to vaccinate our children for these reasons:
- It is highly unlikely that they will get a vaccine-preventable disease, but if they do, modern-day sanitation, medical knowledge, and health care are sufficient to greatly reduce the likelihood of injury or death due to that disease.
- Two of my children have moderate to severe food allergies and had moderate to severe eczema when they were infants. Their immune system disorders make us wary of vaccination.
- We dislike the fact that so many vaccines are bundled together, given that some diseases are more threatening than others. I might, for example, consider a tetanus vaccine for our children if it weren’t bundled.
- Finding doctors friendly to alternative vaccine schedules who offer ethical vaccines is quite difficult.
If the mortality and incidence rate of certain diseases were higher, and if our children had no immune system disorders, and if vaccines weren’t brewed like cocktails using ingredients obtained unethically then we absolutely would get our children vaccinated. Should we do missions work in certain parts of the globe we will also get vaccinated. We also respect other parents’ rights to vaccinate their children. What we do unequivocally oppose is the government forcing parents, directly or indirectly, to vaccinate their children. I am not anti-vax, but I am anti-tyranny.
- Vaccines are not single-handedly responsible for reducing deaths due to preventable diseases. Sanitation and increased health awareness deserve much if not most of the credit. This is obvious by looking at virtually any graph for any vaccine-preventable disease for the past 100 years.
- Vaccines do not always succeed in inoculating the patient, as admitted by health organizations. “Vaccine failure” is recognized by medical practitioners but rarely discussed in the general pro-vax community and therefore alarming when it happens. I also have to wonder if the inoculation rates consider only patients who are actually exposed to measles. If that is the case then actual inoculation rates are significantly lower than advertised.
- In this article I am defining terms as follows. I include these definitions because I have seen different usage even in medical literature.
- Incidence rate is the number of incidents divided by the total population.
- Mortality rate is the number of deaths divided by the number of incidents.
- Risk is the incidence rate multiplied by the mortality rate.
- In the case of my children, their being homeschooled, their strong genetics (both of their parents have strong immune systems), their living near high-immigration areas, and their being exposed to international airports at least once a year affect their risks, positively and negatively.
- Likewise, pro-vaxxers have a tendency to use global mortality and incidence rates (which would include third-world countries with a lower quality of life) in an effort to exaggerate the threat of a disease.
- The nonchalance with which anti-vaxxers treat diseases like measles is one of their main failings. When news stories about measles outbreaks occur, I can only roll my eyes at ignorant comments like, “My siblings and I had measles as kids, and we’re just fine!” As though a sample size of one family has any bearing on a national debate.
- Complicating the reliability of vaccine-related studies by the medical community is confirmation bias, which we would expect from a community whose reputation and profit is threatened by the admission of even the slightest vaccine-autism link.
- Some pro-vaxxers claim that herd immunity is based on the golden rule: “Do unto others as you would have them to unto you.” But this assumes that unvaccinated people are a danger, and I believe I have already established that they are not in 2019. What I am questioning as biblical is the simple idea that certain people can be sacrificed for the greater good.