Dear Bill,

Years ago you invited me to appear as a fellow skeptic several times on your ABC show Politically Incorrect, and I have ever since shared your skepticism on so many matters important to both of us: creationism and intelligent design, religious supernaturalism and New Age paranormal piffle, 9/11 “truthers”, Obama “birthers”, and all manner of conspiratorial codswallop. On these matters, and many others, you rightly deserved the Richard Dawkins Award from Richard’s foundation, which promotes reason and science.

However, I believe that when it comes to alternative medicine in general and vaccinations in particular you have fallen prey to the same cognitive biases and conspiratorial thinking that you have so astutely identified in others. In fact, the very principle of how vaccinations work is additional proof (as if we needed more) against the creationists that evolution happened and that natural selection is real: vaccinations work by tricking the body’s immune system into thinking that it has already had the disease for which the vaccination was given. Our immune system “adapts” to the invading pathogens and “evolves” to fight them, such that when it encounters a biologically similar pathogen (which itself may have evolved) it has in its armory the weapons needed to fight it. This is why many of us born in the 1950s and before may already have some immunity against the H1N1 flu because of its genetic similarity to earlier influenza viruses, and why many of those born after really should get vaccinated.

Vaccinations are not 100% effective, nor are they risk free. But the benefits far outweigh the risks, and when communities in the U.S. and the U.K. in recent years have foregone vaccinations in large numbers, herd immunity is lost and communicable diseases have come roaring back. This is yet another example of evolution at work, but in this case it is working against us. (See ScienceBasedMedicine.org for numerous articles answering every one of the objections to vaccinations.)

Vaccination is one of science’s greatest discoveries. It is with considerable irony, then, that as a full-throated opponent of the nonsense that calls itself Intelligent Design, your anti-vaccination stance makes you something of an anti-evolutionist. Since you have been so vocal in your defense of the theory of evolution, I implore you to be consistent in your support of the theory across all domains and to please reconsider your position on vaccinations. It was not unreasonable to be a vaccination skeptic in the 1880s, which the co-discovered of natural selection — Alfred Russel Wallace — was, but we’ve learned a lot over the past century. Evolution explains why vaccinations work. Please stop denying evolution in this special case.

As well, Bill, your comments about not wanting to “trust the government” to inject us with a potentially deadly virus, along with many comments you have made about “big pharma” being in cahoots with the AMA and the CDC to keep us sick in the name of corporate profits is, in every way that matters, indistinguishable from 9/11 conspiracy mongering. Your brilliant line about how we know that the Bush administration did not orchestrate 9/11 (“because it worked”), applies here: the idea that dozens or hundreds pharmaceutical executives, AMA directors, CDC doctors, and corporate CEOs could pull off a conspiracy to keep us all sick in the name of money and power makes about as much sense as believing that Bush, Cheney, Rumsfeld, and their bureaucratic apparatchiks planted explosive devices in the World Trade Center and flew remote controlled planes into the buildings.

Finally, Bill, please consider the odd juxtaposition of your enthusiastic support for health care reform and government intervention into this aspect of our medical lives, with your skepticism that these same people — when it comes to vaccinations and disease prevention — suddenly lose their sense of morality along with their medical training. You excoriate the political right for not trusting the government with our health, and then in the next breath you inadvertently join their chorus when you denounce vaccinations, thereby adding fodder for their ideological cannons. Please remember that it’s the same people administrating both health care and vaccination programs.

One of the most remarkable features of science is that it often leads its practitioners to change their minds and to say “I was wrong.” Perhaps we don’t do it enough, as our own blinders and egos can get in the way, but it does happen, and it certainly happens a lot more in science than it does in religion or politics. I’ve done it. I used to be a global warming skeptic, but I reconsidered the evidence and announced in Scientific American that I was wrong. Please reconsider both the evidence for vaccinations, as well as the inconsistencies in your position, and think about doing one of the bravest and most honorable things any critical thinker can do, and that is to publicly state, “I changed my mind. I was wrong.”

With respect,
Michael Shermer

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The Centers for Disease Control has put out an alert: in Minnesota in 2008, there were five confirmed cases of Haemophilus influenzae type b (or Hib) among children younger than five years old. Of these five cases, three of the children were unvaccinated, one had started the series of vaccines but did not complete the series due to shortages, and the fifth — who had been fully vaccinated — had an immune deficiency.

Five cases may not sound like a lot… until you learn that one of the unvaccinated children died. This was a baby, just a seven-month-old infant.

I can barely type that sentence out; my heart is aching so. I can only imagine what the parents are feeling. I literally have nightmares about such things.

There are several things to note about this incidence of Hib:

1) It’s the largest number of cases in one year since 1992 in Minnesota, when 10 cases were reported. In the intervening years, between 0 and 4 cases were reported per year (1994 saw four cases, the average is about 2). These are small number statistics, so 5 cases may just be a normal statistical fluctuation. But the stakes are very, very high here.

2) We do not know why three of the five children were unvaccinated. It may be due to the antivax crowd, or it may be due to any number of other factors; the report doesn’t say (however, see (5) below).

3) Out of three unvaccinated children, one died. The historical rate of death from Hib, once infected, is about 1 in 20, so this is something of a fluke. But 1 in 20 is still way, way too high… and of the ones who do survive the infection, 1 in 5 will suffer deafness, blindness, or severe, permanent brain damage.

Russian roulette has better odds than 1 in 5; do you want to play that with your baby? If that sounds harsh, good. We’re dealing with babies’ lives here. The best thing you can do is make sure they don’t get the disease in the first place.

4) Getting a vaccine does not guarantee not getting the disease. We don’t know how many babies were vaccinated, and how many weren’t that didn’t get the disease. But with 1 in 20 odds, I know which way I fall.

5) There is a shortage of Hib vaccines right now, and it’s expected to last for a few more months. However, according to the CDC report, there are adequate supplies to have infants inoculated and complete the primary three-dose infant series.

Data were reviewed for 25,699 children born between November 1, 2007 and March 31, 2008… Among children aged 7 months, 3-dose primary Hib series coverage was 46.5%, which is lower than the age-appropriate coverage for children who had received pneumococcal conjugate or diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccination. In contrast, data from the 2007 National Immunization Survey, conducted prior to the shortage, showed that Hib vaccination coverage among children in Minnesota aged 19 months to 35 months was high and did not differ from the national average, suggesting that coverage has declined as a result of the shortage.

So there has been a decline in coverage due to the shortage, with roughly half the children in the survey being vaccinated.

Putting this all together is difficult, with so many unknowns. But to belabor the obvious, we do know one thing: of the three unvaccinated children who got Hib, one died. The doctors from the CDC add this editorial comment:

Before development of Hib conjugate vaccines, Hib was the most common cause of bacterial meningitis in children aged <5 years. Since implementation of the Hib conjugate vaccine immunization program in the United States in the early 1990s, the incidence of Hib disease has declined from a peak of 41 cases per 100,000 children aged <5 years in 1987 to approximately 0.11 cases per 100,000 in 2007.

In other words, the infection rate among infants dropped by a factor of nearly 400 after the Hib vaccination was developed. This recent increase may reflect a loss of herd immunity, meaning too many kids are not getting vaccinated.

Folks. Please. Vaccinate your children. The science is in, the tests have been done, the results are solid: vaccinations do not cause autism. What vaccines do is save the lives of thousands of children who would otherwise be suffering the effects of preventable diseases… and one of these effects can be death.

Save your kids’ lives. Take them to a doctor and get his or her advice on this. And if they recommend vaccinations, then do it.

My thanks to Dr. Joe Albietz for providing me with some of the numbers in this article.

NPR aired a story this week about a new pairing between medicine and Hollywood. Whereas many Hollywood moms like Jenny McCarthy have been extremely vocal about denouncing vaccines for children, Amanda Peet didn’t take the gossip at face-value. She has now teamed up with Dr. Paul Offit, author of Autism’s False Prophets: Bad Science, Risky Medicine and the Search for a Cure, in order to combat the propaganda being vocalized by other celebrities.

From the story:

“Offit notes that this year there have been 135 cases of measles in the United States — the highest number in more than a decade. Most of the cases were children, he says, “and most of those children’s parents chose not to vaccinate them, chose not to vaccinate them because they feared the MMR vaccine would cause autism, when clearly it doesn’t.”

This is a topic I know is very close to the hearts of many skeptics, including our own Dr. Novella. I personally have family members and friends who have not vaccinated their children. It makes me angry that they would place the safety of their own children on everyone else. Their choice puts the onus on the rest of the public to vaccinate. But, the more that people don’t vaccinate their children, the more that we will see resurgences of terrible diseases.

I applaud Amanda Peet for using her celebrity to make this statement. Maybe people will begin to listen to reason if it comes from someone they revere.