Monday, January 24, 2011

The value of education?

Here is another instance of the relationship -- or not -- between education and an educated public.
Just a slim majority of Americans -- 52 percent -- think vaccines don't cause autism, a new Harris Interactive/HealthDay poll found. 
Conversely, 18 percent are convinced that vaccines, like the measles-mumps-rubella (MMR) vaccine, can cause the disorder, and another 30 percent aren't sure. 
The poll was conducted last week, following news reports that said the lead researcher of a controversial 1998 study linking autism to the MMR vaccine had used fraudulent research to come to his conclusion.
The poll also found that parents who have lingering doubts about the vaccine were less likely to say that their children were fully vaccinated (86 percent), compared to 98 percent of parents who believe in the safety of vaccines.
For many years many people did not have their children vaccinated against childhood diseases like measles, mumps, or pertussis (whooping cough) because there were allegations that the vaccines were toxic in some ways and could cause autism.  Mercury is in thimerosol, a vaccine preservative, and the MMR vaccine was said to have some other brain-damaging properties.
Figure from

The absolute risk was low but the consequences when the problem arises are lifelong and can be devastating.  So children were going unvaccinated, but this itself had consequences.  Directly, the unprotected child could suffer harm from disease itself, and some children have apparently died as a result.  Indirectly, a large unvaccinated subpopulation could provide a transmission reservoir for the pathogens.

Many expensive studies were carried out to see if the evidence for the connection between vaccination and autism was real -- which meant a lot of research energy thus diverted from other problems.  Lawsuits were instigated by angry and devastated parents against the producers of the vaccine, who naturally denied any liability.

Well, as we've posted earlier and you've seen in the news, the original Lancet paper was apparently very flawed, if not indeed a fraud, with faked or at least incompetently analyzed data.  The Lancet withdrew the paper, the author was disbarred from medical practice in Britain, and so on.  It seems now that there is consensus about the false nature of the first result.  This has been widely publicized, with great sighs of relief by the established infectious disease community: now, finally, we can get with the modern program and have every child vaccinated and remove the burden of these various diseases!

But no!  This new survey shows that a substantial fraction of the population still believes that the vaccines are dangerous.  Some may feel there's an Establishment conspiracy to silence the risk to feed the greed of Big Pharma.  Some may just not accept the recent outcome because they're so fearful for their children in regard to autism.  And there is the contributing problem that the actual causes of autism remain largely unknown.

So what is the role of education in this kind of situation?  Risks are low (even if they exist) and that means it is difficult to estimate, assess, or dismiss them.  And peoples' sociopolitical views, including suspicion of government, are deeply entrenched.  Conspiracy theories, and advocacy group solidarity, conspire to reinforce tribal feelings of us vs. them.  Since everyone, even scientists (believe it or not) have their own vested interests, it is not easy to define what is 'education' and what is 'propaganda'.  The emotional side of this keeps people in their camps.  Unclear causation is partly responsible.  Low risks or slow risks are very problematic and play into the hands of all of us, in the way we view the world: climate change, evolution, environmental pollutants, and so many other similar issues reflect this.

When we give a lecture in class or write papers, we believe that by educating our students or readers, we are helping in societal progress and enlightenment.  But we're flattering ourselves, at least to some extent.  Knowledge, and action based on knowledge, are vague areas in society and the tide of action is the result of many factors, of which our teaching and writing are but a part, and sometimes perhaps even just a small part.


James Goetz said...

Not only was the original study retracted, but according to a CNN article, 'Since that time, 18 controlled epidemiological studies have investigated the possible connection between autism and vaccines, and "they have all come back showing the same thing," says Alison Singer, founder and president of the Autism Science Foundation, and a mother of a 13-year-old with autism. "There is no link between vaccines and autism."'

I suppose that this is a highly emotionally charged topic for anybody that knows an autistic person. And I know one autistic child who first began symptoms of autism after a vaccine. That deeply impressed me. However, I still thought that if a minuscule percentage of children had bad side effects from immunizations, then the overall protection was worthwhile. But now I see that there's no significant evidence for even a minuscule percentage.

Also, many chiropractors are anti-vaccine. And people subject to that anti-vaccine PR might need a lot of counter evidence.

Ken Weiss said...

Well, the problem is trust, isn't it? Estimating miniscule risks is not easy, and if your child has been an unlucky one, you're certainly not going to be very sanguine about the argument that overall the risk-benefit calculus favors vaccination.

And in a culture awash with vested interests, and the usual suspicions of self-interest on the part of those in power or wealth, it's not surprising that people will be hard to persuade when those same authorities deny wrongdoing and say that what they are promoting (in this case, the vaccinations) is perfectly fine.

There are diseases that first appear suddenly after some event, even though no clear biological reason for it--epilepsy in the case of trauma or just seeing a strobe light, some autoimmune diseases after an apparently unrelated infectious disease. So it's not surprising that if a child develops--or is first diagnosed with--autism after a vaccination, the parents might put 2 and 2 together. Separating cause from chance is not easy in such situations.

Many times the distrust of the System is warranted. So it's an uphill climb for those who are on the side of truth in such a situation, even if, in this case, the truth seems to lie on the side of the safety of the vaccines.

James Goetz said...

"So it's not surprising that if a child develops--or is first diagnosed with--autism after a vaccination, the parents might put 2 and 2 together. Separating cause from chance is not easy in such situations."

After I posted, I thought that I should add something along these lines.