Outrage at the public health threat posed by anti-vaxxers is necessary, but we also need to scrutinize corporate corruption and systemic fraud that engenders faulty science, and poses an arguably larger threat to public health.
The recent measles outbreak with its epicenter in Disneyland has highlighted a problem in media discourse around public health and vaccines, though it may not be the problem that first comes to mind: The problem is selective outrage.
While a minor outbreak of measles may certainly be newsworthy, there have been several, more serious recent outbreaks stemming not from an anti-vaccination movement, but rather from the purveyor of MMR vaccines itself: Merck & Co Inc.
Merck is currently facing a whistleblower-led lawsuit and serious accusations from two former Merck virologists. The whistleblowers assert that outbreaks in 2006 and 2010 occurred due in no small part to the bad science used by Merck in attempts to bolster the flagging efficacy of its MMR vaccines.
Merck is the dominant producer and distributor of MMR (measles, mumps and rubella) vaccines in the United States - holding the sole licensing rights to MMR, MMR II, and their more recently developed MMRV or ProQuad, which includes measles, mumps, rubella and chickenpox in one super vaccine. Being the only company licensed to produce MMR vaccines in the United States, Merck has a monopoly on the MMR vaccine market.
There have been three serious outbreaks of mumps in 2006, 2010 and 2014, where thousands of unsuspecting people were infected despite the vast majority having been vaccinated with one of Merck's MMR vaccines.
In 2006, there were over 6,500 cases of mumps, which spread rapidly throughout eight states in the Midwest. Of those whose vaccination status was known, approximately 90 percent had been MMR II vaccinated, with 63 percent of those having received two or more doses.
Similarly, 2010 saw an outbreak among 1,500 people in the New York-New Jersey area. Of those whose vaccine status was known, 88 percent had been MMR II vaccinated with 75 percent of those receiving at least two doses.
As recently as April 2014, there was an outbreak at Ohio State University where 225 students contracted mumps. Again, 97 percent of those infected had been vaccinated against mumps with Merck MMR II.
In 2010, in the wake of these serious outbreaks, two whistleblowers, Stephen A. Krahling and Joan A. Wlochowski, both former Merck virologists, brought a lawsuit to bear against Merck. The lawsuit alleges that Merck scientists have consistently and knowingly falsified data on the efficacy of its line of MMR vaccines. Although Merck attempted to have the case dismissed, in September 2014, a federal court in Pennsylvania decided to hear the case.
Hard on the heels of this news, a third whistleblower came forward in August 2014, this time a senior scientist at the US Centers for Disease Control and Prevention (CDC), William W. Thompson, who made a statement that he and the co-authors of a 2004 study, which claimed to definitively absolve the MMR vaccine of any connection to autism, in fact omitted crucial data:
I regret that my coauthors and I omitted statistically significant information in our 2004 article . . . The omitted data suggested that African American males who received the MMR vaccine before age 36 months were at increased risk for autism. Decisions were made regarding which findings to report after the data were collected, and I believe that the final study protocol was not followed.
The Obama administration granted whistleblower immunity to Thompson on February 3. If Thompson's claims against his own study and practices at the CDC are proved true, it has earth-shattering consequences in considering the alleged universal safety of current MMR vaccines.
While the Disneyland outbreak has affected a few dozen unvaccinated citizens, the mumps outbreaks over the past nine years have negatively affected the lives of thousands of people, the vast majority of whom were vaccinated.
So where's the outrage?
If what concerns the public in the Disneyland measles outbreak is chiefly that it was the actions of a comparatively small group that led to a dangerous public health crisis, which was preventable, jeopardized herd immunity and will cost potentially millions in taxpayer money, then what should be the reaction to the outbreaks that occurred due to failed vaccines, bad science, fraud and corruption?
What is it that has people so disproportionately riled about 92 people with measles? It may simply be media-fueled hysteria that has grossly exaggerated the threat of the so-called "anti-vaccination movement."
The motivations of those who were unvaccinated at Disneyland are currently unknown. Respecting that fact, it may even be too simplistic to paint each person involved as part of a unified "anti-vax movement" at all. For those of us concerned with herd immunity, expending a disproportionate amount of time and energy on anti-vaxxers distracts us from asking other important questions that affect everyone's public health.
Why the anger and media firestorm around this arguably minor outbreak while the much larger and more dangerous outbreaks in recent years have slipped under the radar?
If the highest priority truly is public health, then it would seem that a far graver threat to that health is bad science being used as a tool to mask the danger of a potentially defective product - in this case Merck's MMR vaccine - pushed into the marketplace at the cost of public safety and tax dollars. At the very least, if the media is outraged at the threat posed by a fringe group of "anti-vaxxers" who represent a vocal though extremely small minority of citizens who have chosen to exercise a legal right to remain unvaccinated, then there must be proportional outrage at a multibillion-dollar corporation that may have been unethically pushing a faulty product onto an unknowing public to increase its profits at the expense of public health.
Instead of limiting the debate in terms of "pro-science" and "anti-science," the media and public should always be demanding rigorous standards for good science.
With allegations of fraudulent science, mass outbreaks resulting from ineffective vaccines, combined with accusations of institutional corruption at the CDC, should we truly be surprised that some have chosen to exercise their legal right to avoid certain vaccines? More importantly, given the context, would we be just to deny them that right?