World AffairsToday\'s Affairs
Vaccination: For Both You and MeWorldwide anti-vaccination movements and its dangers to public health
Song In-jun  |  johnsong27@yonsei.ac.kr
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승인 2018.04.09  17:31:59
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BEN OBADIA was only two years old when he contracted leukemia. He was able to undergo treatment early, but, due to the chemotherapy, Ben was both unable to receive the right vaccination doses and contracted a feeble immune system. When Ben’s mother learned that a non-vaccinated, measles-stricken child was in the same hospital room as him, she felt despair, realizing her son might have to fight both leukemia and measles. Ben was placed in a separate room, but the fear did not subside. Ultimately, he did not end up contracting measles.* Although Ben was fortunate, many others going under chemotherapy cannot be vaccinated and are in danger of contracting potentially fatal diseases. And if he wasn’t fortunate, he could have easily become a victim of the pernicious belief they subscribe to—anti-vaccination.
 
Origins of the anti-vaccination movement
   The anti-vaccination movement arose from a ‘scientific’ study published in a 1998 paper in *Lancet*, a medical journal in the United Kingdom. In the paper, Andrew Wakefield and twelve other authors raised the possibility that vaccinations against measles, mumps and rubella (MMR) were linked to autism. Due to their claim, many parents started refusing to vaccinate their babies. This study impacted the United States the most, as vaccination rates for babies started to drop for the first time in decades. Even when the validity of the study was raised into question, the damage was already done. According to “Vaccines—Calling the Shots,” a PBS documentary, in 2014, 10% of mothers delayed or forewent giving some shots to their children, and 1% did not vaccinate their children for any kind of virus.
   Although the anti-vaccination movement made headlines when Wakefield published his article, people opposing vaccination have existed since the invention of the first vaccine. Before vaccines, there was no way of preventing someone from catching smallpox, a deadly disease during the late 18thcentury. However, scientist Edward Jenner witnessed that milkmaids who had contracted cowpox, a weaker version of smallpox, did not contract the smallpox. Afterwards, Jenner developed the first ever smallpox vaccine from lymph spewed out of cowpox blisters. However, as documented by *The History of Vaccines*, an online resource by the *College of Physicians of Philadelphia*, Jenner’s groundbreaking invention was not welcomed by his contemporaries for religious and sanitary reasons — the idea of injecting “dirty” material into a person’s skin was not well-received. Ultimately, however, the United Kingdom passed legislation mandating parents to vaccinate their children during the latter half of the 19th century. However, people protested the decision and almost 100,000 anti-vaccinators led a march to advocate their right to keep vaccinations a choice.
   During times of epidemics, the numbers of vaccinations rose greatly. For example, when the polio epidemic of the 1950s swept through the United States, mothers waited in line to get their children vaccinated after witnessing the lethality of the disease. However, as scientist Seth Mnookin said in his book *The Panic Virus*, “[Eventually,] vaccines became victims of their own success.” The vaccines proved to be so effective in eradicating diseases that people no longer realized the seriousness of the possible outbreaks, forgetting the necessity of preventative measures. Thus, even as the science of vaccinations grew more reliable, people remained skeptical of the need for the injections.
   Now, due to the 1998 study and persistent distrust in vaccines, some diseases are back on the rise. In 2000, the Central Disease Center (CDC) of the United States declared that the nation had eliminated measles, meaning that there was no case of a measles outbreak within its borders that year. However, measles have made a comeback since. At least 143 cases of measles were recorded during the first half of 2017 in the United States. In Europe, the situation is worse. According to the World Health Organization (WHO), Europe had 5,273 measles patients in 2016. The following year, the number quadrupled to a staggering total of 21,315 patients. In most cases, the outbreaks occurred in areas where vaccination rates were lower. In Italy, among the 5,006 people who contracted measles, 88% of them had not been vaccinated for the disease.
 
The Korean anti-vaccination movement
   In South Korea’s case, most parents are not as skeptical of vaccinations as parents in the United States or Europe. According to the Korea Disease Control Center (KDCC), the measles vaccination rate for babies born in 2013 was at 97.5%. The high vaccination rates were similar for other infectious viruses; the rates for five major vaccinations (BCG, HepB, DTap, IPV, Hib) for 1-year old babies were around 95,9%. However, these high rates might not stay constant as anti-vaccination movements are gaining popularity, proclaiming the virtues of raising children “naturally.”
The most recent example is of a Naver *café*, or blog, “An-ah-key,” which is an abbreviation of “raising children without medicine.” Founded by a controversial doctor of Korean medicine, Kim Hyo-jin, the *café* had almost 60,000 active members at its peak. The founder advocated for scientifically unfounded medical practices of raising children “naturally,” which included anti-vaccination. In an interview with *JoongAng-Ilbo*, Kim said that because “getting measles at an early age allows for antibodies that last a lifetime,” she wishes for a “nationwide measles party.” Currently, the original *café* is deactivated after Kim was indicted of violating food hygiene laws by the prosecutor’s office. But a similar online *café* with the same name of “An-ah-key,” was founded, in this case standing for “raising children safely”—since the original meaning of never using medicine was not welcomed by the public. The community now has around 10,000 users. In addition, books discouraging vaccinations have become prevalent in Korea. In fact, when searching up the Korean word for “vaccination” on portal site *Naver Shopping*, the first two books that come up pertain to anti-vaccination.
   When confronted with the fact that the WHO recommends essential vaccinations, Kim replied that she is “only fulfilling parents’ rights to know and choose for their children.” However, this is a dishonest statement for a medical professional to make. Most parents are not properly informed about the complicated process of vaccination and are prone to inaction if they feel that the effects could be dangerous.
 
The arguments of the anti-vaccination movement
1.     Vaccines contain dangerous chemicals.
 Vaccines do contain chemicals, such as aluminum and mercury, that have negative connotations in regard to health. To quote Kim, “vaccines contain ‘dangerous’ heavy metals.” However, it is wrong to label the chemicals inside vaccines as dangerous or poisonous, as the dosage amount renders the chemicals practically non-existent. For example, opponents claim that aluminum, an adjuvant used to facilitate the immune response, is included in vaccines, making it a health hazard. However, the amount of aluminum, on average, is 0.125mg. Furthermore, the average person takes in more than 30 mg of aluminum a day. It is important to note that many chemicals enter our bodies in daily life, but in tiny amounts that are harmless to us.
In addition, some opponents to vaccination claim that the chemicals inside the vaccines cause allergic reactions. It is true that there may be harmful side effects, however unlikely. In an interview with *The Yonsei Annals*, Lee Duk-chul (Director, Yonsei Health Service Center) said that this holds true for all medical practices, so the goal should be to minimize possible side effects, not to halt vaccinations entirely. As Director Lee mentioned, vaccines are always closely monitored and scrutinized by medical professionals. While the concern is understandable, the safety of children should be in the hands of researchers and doctors, not with misguided parents, however well-intentioned.
2.     Vaccines cause autism.
   The supposed causation between vaccines and autism is the strongest piece of evidence supporting the anti-vaccination movement, but it is also their most dishonest. Wakefield’s study, which claims to prove the causation, only studied 12 children—far too few to draw a definitive conclusion from. Furthermore, Wakefield was revealed to have distorted the numbers of the medical data to claim the connection between autism and vaccination. Consequently, his medical license was taken away and the study removed from the journal. Later, 10 out of the 12 co-authors of the study retracted their positions. Unfortunately, even though Andrew Wakefield received criticism from the medical community, he still denies his ethical wrongdoings and continues to hold talks promoting his fraudulent research.
In the interview with the *Annals,* Director Lee expressed that he also did not agree with the results of the study. He comments that the traditional, or Oriental, medical community does not agree with any anti-vaccination arguments.
 
Matter of choice?
   Apart from the health concerns, anti-vaccination movement advocates have voiced that they have the right to refrain as a matter of personal choice, whether that be religious, political or cultural. Also, while the number of parents who completely avoid vaccines are decreasing, more and more parents are deciding to delay or skip certain vaccines. These people call themselves ‘pro-safe’ vaccine advocates and believe that it is up to the parents to decide when to vaccinate their children, even if their opinions run contrary to recommended dates of vaccination. In fact, President Trump shares a similar view with the ‘pro-safe’ vaccine advocates. During one of the Republican candidate debates, Trump suggested that vaccines should be applied in small doses over a long period of time. “You take this little beautiful baby and you pump (chemicals)… I mean it looks like it’s meant for a horse, not a child.” Trump later tweeted, “No more massive infections.”
Regarding the pro-safe vaccination movement, Director Lee did agree that the search for the safest and most cost-effective way to vaccinate is crucial. He said that the discussion should “go on as much as needed,” and that it should be “edited and improved upon.” On the other hand, Director Lee emphasized the reasoning behind the current vaccination guidelines of WHO and KCDC. “The current guideline has been researched and tested for decades and is approved globally. There is a reason for that.” He additionally mentioned that edits to the current guidelines should be based on scientific evidence.
   Whether one is completely against vaccines or for a delayed vaccination, the result is the same; the vulnerable are the ones dealing with the consequences. If babies are not vaccinated, their delicate immune systems will not be able to fight against the intruding viruses. Moreover, the vaccination rates of communities must be high to maintain herd immunity, providing protection to those who cannot be vaccinated. In other words, vaccinated people serve as a buffer zone to those who cannot be vaccinated for various reasons, such as in the case of Ben. Director Lee adds that high vaccination rates are important to cut off any possible routes the virus can spread to, hopefully eliminating it altogether. In cases of diseases like measles, which has a 90% infection rate, herd immunity proves to be essential. In 2007, France had a 95% national immunization rate and just 40 cases of measles. That rate dropped to 89%—a mere drop of 6%—in 2015, resulting in around 15,000 cases of measles that year. Even when just a few people opt out of vaccination, the effects are felt exponentially.
   Due to the possible disastrous effects of not vaccinating, Korea has placed measures to ensure the safety of the vaccines. The KDCC, for example, has national compensation measures for children with adverse reactions to vaccines. Furthermore, the *Infectious Disease Control and Prevention Act* sets out the vaccination standards for 17 infectious diseases. According to the law, municipality leaders *must* make sure all children and students are vaccinated. Unfortunately, the *must* part is not properly enforced as legislature does not explicitly state that authorities can punish those refusing vaccination. Thus, National Assembly Member Park In-suk has proposed the *An-ah-key Prevention Act*, which would place a fine of ₩500,000 on parents who refuse to vaccinate their children. The legislative move follows nations like Italy and France, where state schools do not accept non-vaccinated children. Although the act was not put into vote, there is a high chance that low vaccination rates may one day lead to vaccination enforcement. It is best for people to willingly vaccinate that such measures are never necessary. 
 
*                 *                 *
Ever since the advent of the first vaccine, there have always been those skeptical of vaccines. While high vaccination rates prevented the deaths of millions, vaccinations have now become so successful that people have forgotten the devastation these injections prevent. In addition, fraudulent studies have mongered fear in parents who are becoming increasingly reluctant to vaccinate their children. Parents should vaccinate their children, within the timeframes set by medical professionals, not only for the health of their children, but also for the sake of those who cannot be vaccinated for medical reasons. If vaccination rates drop low enough to cause an outbreak, the “choice” to vaccinate becomes a matter of public emergency, a matter of life or death.    
 
*Ben Obadia’s story was aired on *Last Week Tonight with John Oliver* and has his own website (www.benobadia.com).
 
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