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Posted By: Lawrence Herman, MPA, PA-C
March 08, 2019
The World Health Organization recently listed what they call “vaccine hesitancy”—the reluctance or refusal to be vaccinated despite the availability of these medicines—among the 10 major threats to global health in 2019.
We’ve had tremendous strides in public health in this country through the use of vaccines. Those of us who have seen the occasional case of a vaccine-preventable death know this especially. In 2000, measles was declared eliminated in the United States: no continuous disease transmission had been seen for more than 12 months. Prior to development of the MMR vaccine in 1963, each year between three and four million people in the United States got measles; 48,000 were hospitalized; 400 to 500 died; and approximately 4,000 developed encephalitis.
Now, misinformation—spread primarily through the internet, especially social media—is eroding this victory. Declines in use of the MMR vaccine appear to be allowing the virus to regain a foothold. According to the Centers for Disease Control and Prevention (CDC), this year, from January 1 to February 21, 159 individual measles cases were confirmed in 10 states in the United States. Unfortunately, measles is one of the most infectious diseases known to mankind and can no longer be considered eradicated in this country.
But the facts are clear: the measles vaccine is safe and, when given in accordance with the recommended regimen, is 97% effective, making it one of the single most effective vaccines. Yet, social media is helping to spread concerns about the MMR vaccine. Originally this was the result of a 1998 Lancet publication, now debunked, authored by Andrew Wakefield, a physician since stripped of his license, who falsified data to form a link between the MMR vaccine and autism. Both Facebook and YouTube search algorithms may steer viewers toward a plethora of misinformation about a link between the MMR vaccine and autism—in spite of the fact that this was shown to be false by the Institute of Medicine and National Academy of Medicine in 2004.
This has taken root in the minds of “anti-vaxxers” and continues to be spread by social media.
While overall vaccination rates are high with approximately 92% of children receiving the MMR vaccine, 1 in 12 children in the United States are not receiving the first dose of the MMR vaccine on time, and the CDC reported that in 2017 there were 11 states where more than 10% of toddlers had not received even a single dose of MMR vaccine. The CDC revealed that in Clark County, Washington—where there is an on-going measles outbreak—only about 81% of 1- to 5-year-old children, and just 78% of 6- to 18-year-olds, had received the age-appropriate number of MMR vaccine doses as of the end of last year. And while some states are examining limiting vaccine exemptions for religious and personal reasons, others have approved three bills to expand these exemptions.
What role does social media have in preventing the spread of this misinformation when it is a threat to public health? Should a search algorithm preferentially, or even marginally, direct parents to sites that spread misinformation that potentially can kill hundreds of citizens? Some may claim First Amendment rights, but does anyone have the right to scream “Fire!” in a crowded theater when no fire exists?
- World Health Organization. Ten threats to global health in 2019. www.who.int/emergencies/ten-threats-to-global-health-in-2019. Accessed March 6, 2019.