On Tuesday, Robert F. Kennedy Jr. announced that Donald Trump had tapped him to lead a special commission on “vaccine safety and scientific integrity.” Kennedy, an environmental attorney by day, is a proponent of a long-discredited conspiracy linking vaccines to autism. For public-health officials, pro-vaccine advocates, and anyone trying not to get whooping cough, the news was major cause for concern.
The Trump transition team temporarily quelled those fears by announcing that, though Trump is considering forming such a commission, no decisions regarding it’s leadership had been made. But an anti-vaxxer still has the ear of the president-elect, a man who has himself been sympathetic to conspiracy theories regarding autism and vaccines in the past.
While anti-vaxxing has been largely absent from presidential politics, opposition to vaccines has been around for at least as long as vaccinations themselves. When Boston physician Zabdiel Boylston began rubbing slices from smallpox sores into open wounds to try to protect the healthy from outbreaks in the early 1700s, his (then unproven) inoculation method was met with immediate resistance.
Over time, evidence accumulated that vaccination was an effective method to prevent disease. In the United States, local and state authorities began implementing mandatory vaccination policies in the early 1800s; Boston was the first to do so in 1809. Today, vaccinations are considered to be one of the greatest public-health achievements of the 20th century by the Centers for Disease Control and Prevention, reducing deaths from preventable diseases like polio, smallpox, and measles by nearly 100 percent. Yet opposition has never been fully eradicated.
There are lots of reasons as to why people have been distrustful of vaccines: Many people throughout history have found it counter-intuitive that exposure to a disease could provide protection, others felt vaccination violated God’s will, and others simply felt that mandatory vaccination policies violated personal liberty. The myth that vaccines cause autism is just the latest manifestation of this longstanding distrust of vaccination.
Autism was first described in the 1940s by Austrian-American psychiatrist Leo Kanner. At first, researchers believed the cause might be psychological in nature — the result of neglect by cold and distant mothers. In the 1960s, the psychologist (and father to an autistic child) Bernard Rimland suggested it was biology — not parenting — that was to blame. Since then, mainstream scientists have come to understand autism to be a neurodevelopmental disorder, with genetics playing a strong role.
But at the same time alternative biological theories of autism — namely that autism might be an immune or gastrointestinal disorder, and thus curable — emerged as well. These theories were often propagated by parents of autistic children, many of whom were frustrated by the lack of services in hospitals and schools for autistic kids. These parents then formed advocacy organizations to push for change, according to Jeffrey P. Baker, a medical historian at Duke University School of Medicine:
It was among these parental advocacy groups, not the medical or educational professions, that the notion of an autism “epidemic” first took root. These organizations provided a context to bring parents out of isolation and into a realization that others — many others — shared their hopes and frustrations. Against this background, an alarming possibility became more plausible: the cause of autism was not only biological but environmental, the consequence of some new exposure faced by young children.
Those parents’ fears about an autism epidemic aligned perfectly with the anti-vaxxing movement, which was still simmering in the world of immunizations.
One of the most important blows to the perception of the safety of the vaccination program in the United States occurred in 1955, when 200,000 children in the Western U.S. were given polio vaccines that contained alive, active virus. Roughly 40,000 developed polio, 200 were permanently paralyzed to some degree, and 10 children died. The Cutter Incident, so named because the defective vaccines were produced at the California-based Cutter Laboratories, sowed some of the strongest seeds of perceived modern safety issues with vaccines, which were crystallized in a 1982 documentary called DPT: Vaccine Roulette, aired by a Washington, D.C.-based NBC affiliate. DPT was a vaccine for diphtheria, pertussis, and tetanus, and the documentaryattempted to link the pertussis portion of the shot to horrifying health effects in children.
Seth Mnookin, a science journalist and co-director of the Massachusetts Institute of Technology’s Graduate Program in Science Writing, described the documentary and its outsized impact on the anti-vaccination movement in a blog post for PLoS:
The report, hosted by Lea Thompson, was an example of scare-mongering at it’s worst: Throughout the hour-long show, Thompson featured heart-breaking interviews with parents who described how their children had been left in near-comatose states after receiving a vaccine that was mandatory for public-school children in the vast majority of states. These were augmented by what turned out to be inaccurate statistics, cherry-picked quotes, and risible falsehoods about some of the “experts” Thompson used to support her thesis that the “medical establishment” was “aggressively promot[ing]” a vaccine while willfully ignoring “the consequences.” It also presented parents’ recollections as fact — and, as we know from countless studies, memory is imminently fallible. Those doctors and public health officials who disagreed with Thompson, on the other hand, were subjected to hours of grilling.
The documentary was a hit. It re-aired twice in D.C., and was even screened to a national audience on NBC’s The Today Show. It catapulted the career of Thompson, who went on to become a correspondent for The Today Show and NBC Nightly News With Tom Brokaw. She won an Emmy for the documentary, and would go on to win multiple Peabody awards, Polk awards, National Press Club awards, a Loeb award, and nearly every other major broadcasting award. As Dr. Paul Offit wrote in Deadly Choices: How the Anti-Vaccine Movement Threatens Us All:
And her reporting made a difference. As a result of her stories, unsafe toys have been removed from shelves, millions of hairdryers containing asbestos have been recalled, procedures at Sears now ensure that old batteries aren’t sold as new, grocery stores have adopted policies for checking ground beef, warning labels have been placed on infant Tylenol, and the largest manufacturer of defibrillators in the United States has been shut down. But no story had a greater impact than Vaccine Roulette. If the government hadn’t stepped in several years later, Thompson’s show could have eliminated vaccines from the American marketplace.
Among Vaccine Roulettes’ disciples was Barbara Loe Fisher, co-founder of the National Vaccine Information Center, which has spent decades trying to convince parents that vaccines are far more dangerous than the alternative, preventable diseases. Thompson’s bio as a Dateline NBC correspondent still cites the documentary, and notes that it was “widely credited for bringing about the use of a new DPT vaccine in this country.” But the new vaccine has proven to be less effective than the DPT version, as Mnookin pointed out in PLoS. Still, the documentary certainly united a group of parents dissatisfied with their children’s medical treatment against a common enemy — vaccines.
In the 1990s, amid rising rates of autism, parents and anti-vaccine advocates began to point the finger at vaccines, which they already believed to be damaging. A 1998 paper from the researcher Andrew Wakefield linking an additive in the measles, mumps and rubella (MMR) vaccine to autism offered the movement a stamp of scientific validity — for a moment. The research was quickly invalidated and Wakefield himself discredited, as Sarah Kaplan reports in the Washington Post:
Evidence emerged that Wakefield had been paid by attorneys for parents who were suing MMR manufacturers and that Wakefield’s data were fraudulent. The Lancet retracted his study in February 2010. That year, Wakefield was found guilty of professional misconduct by Britain’s General Medical Council and his license was revoked.
The additive, called thimerisol, was removed from almost all vaccines (despite an absence of evidence that it caused harm), but Kennedy and others in the anti-vaxxer community continue to think vaccines are dangerous, and believe the medical establishment and the government to be in cahoots to cover up that fact in order for the pharmaceutical industry to profit.
“If, as the evidence suggests, our public-health authorities knowingly allowed the pharmaceutical industry to poison an entire generation of American children, their actions arguably constitute one of the biggest scandals in the annals of American medicine,” Kennedy wrote in a 2005 Rolling Stone article.
Kennedy is a longtime opponent of mandatory vaccination laws, and has lobbied for non-medical exemptions for parents who want to skip required vaccinations for their kids. It’s inevitable that a public-health measure mandated by the government would become a political issue, and the politicization of vaccines has only increased as our government has become more polarized. Trump and many Republicans have questioned both the science around vaccines and the government’s authority to meddle in how parents choose to raise their kids.
But vaccination is not just a personal choice — getting vaccinated protects the community as well; the more healthy people who are vaccinated against preventable diseases, they less likely it is that those who are too young, sick, or weak to get vaccinated themselves will be exposed to the disease. And the effectiveness of vaccines can wane over time, putting even those who were vaccinated as children at risk if these diseases begin to circulate again.
Just as the media helped to create anti-vaccination groups like the NVIC, news organizations can contribute to the politicization of health issues, and influence how people behave. A 2015 paper in The Annalsof the American Academy of Political and Social Science found that the politicization of the HPV vaccine, spurred by media coverage that gave a voice to politicians on both sides of the debate, reduced public support for the vaccine requirements, state immunization programs at large, and confidence in both doctors and government.
If vaccines continue to become more tightly linked to political identity than public health, it could further reduce vaccination rates. And that would endanger us all.