The Anti-Vaccine Movement

Summary

Throughline: The Anti-Vaccine Movement
Hosted by Rund Abdelfatah and Ramtin Arablouei
Released on February 13, 2025

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Introduction: Origins of Vaccine Fear

The episode opens by delving into the historical roots of vaccine skepticism in the United States, tracing back to significant events and influential figures that have shaped public perception over decades.

Notable Quote:

Paul Offit (00:52): “Now, nothing in this testimony should be construed as anti-vaccine. Rather, I advocate the safest vaccination strategies for the protection of children and the control of communicable disease.”

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The Wakefield Paper: A Catalyst for Controversy

In 1998, Andrew Wakefield published a paper in The Lancet proposing a link between the Measles, Mumps, and Rubella (MMR) vaccine and autism. This hypothesis emerged from a case series of 12 children, eight of whom exhibited signs of autism.

Notable Quotes:

Andrew Wakefield (01:03): “That's Andrew Wakefield at this moment in the year 2000. He's a researcher from the Royal Free and University College Medical School in London.”
Paul Offit (02:25): “My role in these proceedings is to explore the theories that have arisen due to concerns by the public that autism might be caused by the combination of measles, mumps and rubella vaccines known as MMR. No evidence exists that proves this association.”
Paul Offit (02:58): “I think Andrew Wakefield believed this was true, and even after study after study showed that he was wrong.”

Wakefield's claims quickly gained traction, despite lacking robust scientific evidence. Offit emphasizes that Wakefield's hypothesis was not supported by subsequent research, which meticulously debunked the supposed link.

Notable Quote:

Paul Offit (03:14): “Once you've rung a bell like that, it's very hard to unring.”

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Dissatisfied Parents Together: Early Anti-Vaccine Activism

The controversy surrounding the Wakefield paper reignited longstanding fears about vaccine safety. This resurgence was fueled by historical incidents like the 1955 Qatar polio vaccine incident, where improperly inactivated vaccines led to over 200 cases of paralytic polio and nearly a dozen deaths. Such events eroded public trust and highlighted vulnerabilities in vaccine regulation.

Notable Quote:

Andrew Wakefield (13:30): “But that's not what happened.”

Parents began organizing, forming groups like Dissatisfied Parents Together (DPT) to demand greater vaccine safety and transparency.

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The National Childhood Vaccine Injury Act and Its Aftermath

In 1986, in response to growing vaccine-related concerns, the National Childhood Vaccine Injury Act was enacted, creating the Vaccine Injury Compensation Program. This no-fault court aimed to compensate families harmed by vaccines while protecting manufacturers from lawsuits.

Notable Quotes:

Andrew Wakefield (20:52): “It was designed to compensate individuals or their families who were injured by certain vaccines.”
Elena Kannis (21:16): “This is really distinct in the history of anti-vaccination.”

While intended to balance interests, the Act inadvertently fueled skepticism by ensuring vaccine manufacturers were shielded from litigation, further deepening mistrust.

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Resurgence through Media and Influential Figures

The early 2000s saw a resurgence in vaccine skepticism, amplified by influential figures like Robert F. Kennedy Jr. (RFK Jr.). His 2005 Rolling Stone article, "Deadly Immunity," reignited debates by alleging that the pharmaceutical industry concealed vaccine risks.

Notable Quotes:

Paul Offit (35:21): “He had misstatements after misstatements after misstatements.”
Ramtin Arablouei (35:35): “This is Elena Kannis. And that argument had a lot of traction.”

RFK Jr.'s alignment with Wakefield's claims lent credibility to the anti-vaccine movement, attracting further attention and support.

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Celebrity Endorsements and Mass Movement Formation

Celebrities like Jenny McCarthy and Jim Carrey, driven by personal narratives of children diagnosed with autism, publicly advocated against vaccines. Their high-profile endorsements brought vaccine skepticism into mainstream discourse.

Notable Quote:

Andrew Wakefield (39:26): “Without a doubt in my mind, I believe vaccinations triggered Evan's autism.”

These endorsements galvanized public opinion, making the anti-vaccine movement more pervasive and influential.

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Scientific Refutations and Institutional Retractments

Despite the mounting skepticism, extensive scientific research consistently debunked the alleged link between vaccines and autism. Over a dozen studies across seven countries found no evidence supporting Wakefield's claims. In 2010, The Lancet retracted Wakefield’s paper, and investigative journalism exposed ethical breaches and data omissions.

Notable Quotes:

Paul Offit (42:38): “It should have never been published. You can't say anything about causality because there's no control group.”
Paul Offit (43:01): “I think the cage door got open and the devil came out.”

Despite these refutations, the narrative persisted, underscoring the challenge of countering misinformation once it gains momentum.

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Consequences: Measles Outbreaks and Public Health Crisis

Declining vaccination rates led to significant public health setbacks. Notably, the 2014 Disneyland measles outbreak infected 147 people across seven states, Mexico, and Canada, highlighting the real-world dangers of vaccine hesitancy.

Notable Quote:

Paul Offit (46:50): “If vaccination rates continue to decline, outbreaks like that could be much worse in the future.”

Efforts to strengthen vaccine mandates faced political pushback, particularly from Republican-led legislatures, further exacerbating the situation.

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Erosion of Trust and the Psychology Behind Vaccine Skepticism

The episode explores the deep-seated mistrust in public health institutions, exacerbated by events like the COVID-19 pandemic. Paul Offit reflects on how inconsistent messaging and perceived governmental failures have eroded public confidence.

Notable Quotes:

Paul Offit (47:05): “Having lived in a polio ward for six weeks, that's still with me.”
Elena Kannis (50:47): “Trust is fundamental to that story of success. But that trust has been eroded across the board.”

The psychological aspect emphasizes that skepticism can easily tip into cynicism, where individuals reject scientific evidence in favor of misinformation.

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Conclusion: Navigating the Complex Landscape of Vaccine Trust

The episode concludes by acknowledging the multifaceted nature of vaccine skepticism, rooted in historical incidents, influential advocacy, media portrayal, and societal trust issues. It underscores the importance of rebuilding trust through transparent communication, robust scientific engagement, and addressing the emotional and psychological concerns of the public.

Notable Quote:

Elena Kannis (49:25): “Getting a vaccine is not just this simple cut and dried medical or political act...It can be painful. And when we do it to children and our little babies, it's emotional too.”

Through understanding the historical and social contexts, the episode urges listeners to engage thoughtfully with the complexities surrounding the anti-vaccine movement.

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Produced by:
Rund Abdelfatah and Ramtin Arablouei, along with Lawrence Wu, Julie Kane, Anya Steinberg, Casey Miner, Christina Kim, Devin Kadayama, and Irene Noguchi.

Fact-Checked by:
Kevin Voelkel

Music Composed by:
Ramtin Arablouei and his band Drop Electric, including Naveed Marvi, Sho Fujiwara, Anya Mizani.

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This comprehensive summary encapsulates the critical discussions and insights from the "The Anti-Vaccine Movement" episode, providing a nuanced understanding of its historical evolution, key players, and ongoing challenges.

Transcript

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[Paul Offit]

Wakefield, would you like to start this panel? Yes. Thank you, Mr. Chairman, members of the committee, it's a great privilege to be here. The purpose of my testimony is to report the results of the clinical and scientific investigation of a series of children with autism.

[Andrew Wakefield]

April 6, 2000. Doctors, researchers and parents of children with autism have been called in front of Congress to testify about a potential link between autism and vaccines.

[Paul Offit]

Now, nothing in this testimony should be construed as anti vaccine. Rather, I advocate the safest vaccination strategies for the protection of children and the control of communicable disease.

[Andrew Wakefield]

That's Andrew Wakefield at this moment in the year 2000. He's a researcher from the Royal Free and University College Medical School in London.

[Paul Offit]

A superb scientist who was at a superb institution.

[Ramtin Arablouei]

Sitting just to the left of Wakefield is Paul Offit. Paul Offit.

[Paul Offit]

I am the director of the Vaccine Education center at the Children's Hospital of Philadelphia and a professor of pediatrics at the University of Pennsylvania School of Medicine.

[Ramtin Arablouei]

At the time, Paul was also part of a committee that advised the CDC about the use of vaccines.

[Paul Offit]

I was subpoenaed to testify about whether I thought it made biological sense that vaccines could cause autism, and I didn't.

[Ramtin Arablouei]

Paul listens as Wakefield launches into his testimony.

[Paul Offit]

I just as a little bit of background, this represent 1212 years of intensive clinical and scientific research, collaborative research.

[Ramtin Arablouei]

Wakefield is summarizing the results of research he conducted at the Royal Free Hospital, research that first got the medical community's attention in 1998 when he published a paper in a renowned British medical journal called the Lancet. In that paper, Wakefield hypothesized that the measles, mumps and rubella vaccine could be connected to the development of autism in children.

[Andrew Wakefield]

When it's Paul's turn to speak, he doesn't waste any time beating around the bush.

[Paul Offit]

My role in these proceedings is to explore the theories that have arisen due to concerns by the public that autism might be caused by the combination of measles, mumps and rubella vaccines known as mmr. No evidence exists that proves this association.

[Andrew Wakefield]

Paul is right. By the time Wakefield landed in front of Congress, his paper had been debunked. And one of the scientists who had debunked it was even sitting on the panel alongside him.

[Paul Offit]

I think Andrew Wakefield believed this was true, and even after study after study showed that he was wrong. He believed he was right, but you could see that he was beloved at that meeting. He was godlike, whereas we were the bad guys.

[Andrew Wakefield]

This wouldn't be the last time Wakefield would be called in front of the US Government to repeat his debunked findings. Wakefield's paper gave the myth that vaccines cause autism real traction and staying power, the consequences of which we're still dealing with today.

[Paul Offit]

Once you've rung a bell like that, it's very hard to unring.

[Ramtin Arablouei]

Was a moment that health professionals and the medical field point to as evidence that people who are skeptical of the safety of vaccines are making it all up. But this moment also became a proxy for fears that have been around as long as vaccines have. Fears that in recent decades have intensified as the pharmaceutical industry has grown in size and influence, as the COVID 19 pandemic upended American life, as state mandated vaccination programs have faced backlash, and as a polarized political climate and a deluge of misinformation has made it harder for many people to know who to trust.

[Andrew Wakefield]

Today, those fears go beyond just the MMR vaccine and autism, with some powerful people casting doubt on vaccine safety in general.

[Ramtin Arablouei]

President Elect Trump has just announced on.

[Elena Kannis]

His Truth Social account that he is picking Robert F. Kennedy, Jr. To be.

[Andrew Wakefield]

The next Secretary of Health and Human Services.

[Paul Offit]

This is a highly anticipated confirmation and hearing, in part because the former presidential candidate's well documented history of spreading false and misleading claims about vaccines.

[Andrew Wakefield]

At the time of publication, the senate had held RFK Jr. S confirmation hearing for the role of Secretary of Health and Human Services, but had not yet taken a final vote.

[Paul Offit]

Mr. Kennedy, in your testimony today, under oath, you denied that you were anti vaccine. But during a podcast interview In July of 2023, you said, quote, no vaccine is safe and effective. I support the measles vaccine. I support the polio vaccine. I will do nothing as HHS secretary that makes it difficult or discourages people from taking anybody who believes that ought to look at them.

[Andrew Wakefield]

I'm Rund Abdelfatah.

[Ramtin Arablouei]

And I'm Ramtin Arablouei. On this episode of Throughline from npr, the roots of the modern anti vaccine movement and of the fears that still fuel it. From a botched polio vaccine to the 1998 Lancet paper to today.

[Andrew Wakefield]

This is Dylan calling from Denver, Colorado.

[Ramtin Arablouei]

Your line is my favorite show and I listen every week.

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[Ramtin Arablouei]

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[Ramtin Arablouei]

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[Andrew Wakefield]

Part 1 Vaccine Roulette Dr.

[Ramtin Arablouei]

Paul Offit has been working in the field of infectious disease for over 40 years. His focus on vaccines, like many peoples, began in the shadow of polio.

[Paul Offit]

This year, the enemy, polio myelitis, struck with such impact and fury that it shook the entire nation. I certainly remember polio.

[Ramtin Arablouei]

When Paul was five years old, he got surgery on his foot.

[Paul Offit]

When you're in an orthopedic hospital in the mid-1950s, you're in a polio ward.

[Ramtin Arablouei]

Newsreels about polio show kids in wards filled with rows of beds, the kind with the iron headboards that you always see in old hospitals.

[Paul Offit]

I remember children screaming. I remember the children in our lungs. It was really like something out of a Charles Dickens novel. It spread its crippling tentacles from ocean to ocean and border to border. That is not a disease you want to relive.

[Andrew Wakefield]

Starting in the late 1940s, polio outbreaks.

[Elena Kannis]

Were just getting worse and worse.

[Andrew Wakefield]

This is Elena Kannis, and I'm a.

[Elena Kannis]

Historian of medicine and public health and a professor and journalism and history at the University of California, Berkeley.

[Andrew Wakefield]

She wrote the book Vaccine America's Changing Relationship with Immunization.

[Ramtin Arablouei]

Polio was a serious threat. A single case could send a community into a panic because polio is really contagious. It can spread through saliva, mucus, feces, contaminated water or food.

[Paul Offit]

It has closed the gates on normal childhood. It has swept our Beaches stilled our.

[Elena Kannis]

Boats and emptied our pox, because a single case meant that an outbreak was sure to come. And an outbreak meant that dozens, if not hundreds or thousands of people would be infected. People who were infected with it could end up paralyzed from the waist down, and many, many scores of them would die. So when the polio vaccine is approved for use by the Federal Government in 1955, it is literally this moment where, like, everybody pauses, people run into the streets, church bells ring, sirens go off, and then this massive effort gets underway to distribute this vaccine. And parents bring their kids and they line up in droves and they get this vaccine.

[Ramtin Arablouei]

The science behind the polio vaccine worked the same way some types of vaccines do today.

[Paul Offit]

So the goal of a vaccine is to induce the immunity that is typically acquired from natural infection without paying the price of natural infection.

[Ramtin Arablouei]

Vaccines do that by introducing your body to a version of the virus so your body can learn and recognize it and fight it off. Today, vaccines contain a weakened or dead bacteria or virus or bits of a virus's genetic material. Any of those things can help your body develop immunity.

[Elena Kannis]

The effective polio vaccine contained a version of the polio virus that had been inactivated or quote, unquote, killed with chemicals. The problem is, like, that's definitely a way to make an effective vaccine, but you've really got to kill the virus.

[Andrew Wakefield]

So By April of 1955, the polio vaccine was being produced at a mass scale.

[Elena Kannis]

And in this one lab here in Berkeley, there was a batch that went out. Nobody realized that the virus hadn't been fully inactivated.

[Andrew Wakefield]

Oh, my God.

[Elena Kannis]

Yeah. So people who believed that they were turning out for a perfectly safe and effective vaccine ended up contracting polio because.

[Andrew Wakefield]

In that case, they just. They literally injected people with polio accidentally.

[Elena Kannis]

Yes, they did. They did. So this came to be known as the Qatar incident. And while it caused many, many cases of polio that likely went undetected, it caused 200 plus cases of paralytic polio and led to just under a dozen deaths. The federal government stepped in to say, okay, there's more we can do in the space of regulation and safety. And we had this relatively new government agency, the cdc, that stepped in and said, we are going to keep track of all of these vaccines. We're going to work with the FDA and other agencies to make sure that all vaccines are safe.

[Andrew Wakefield]

In May 1955, the government paused all polio vaccinations for over a week while they rechecked the vaccines for safety. The Qatar incident led to a comprehensive investigation and Increased federal safety protocols aimed at ensuring that something like this never happened again. The government wanted to send a message.

[Elena Kannis]

You can count on the federal government to ensure your personal safety and this won't happen again. And in the late 1950s, this was a really effective message.

[Andrew Wakefield]

Despite the Qatar incident, polio vaccination continued. By 1961, more than 85% of all school age children had received a polio vaccine.

[Elena Kannis]

It's so hard for us to put ourselves in the shoes of somebody living through 1955. They were so terrified of polio, they just might have taken their chances with the vaccine with a lot of fear in their hearts. But different from how we might react today, today something like that we would never get past.

[Andrew Wakefield]

Cases of polio began to plummet. The polio vaccine became an example of a national triumph.

[Elena Kannis]

And at this point, immunization and health professionals were saying, we are definitely on our way into an era of just biomedical supremacy and freedom from infectious diseases like measles, smallpox, chickenpox, mumps, polio. We're just going to become the dustbins of history.

[Ramtin Arablouei]

But that's not what happened.

[Elena Kannis]

So we get to the end of the 1960s and what becomes apparent is that nobody's turning out for these vaccines the way they did for the polio vaccine. People feared polio, but they had a very different relationship with mumps, with measles, with rubella.

[Ramtin Arablouei]

They weren't as afraid. So more people skipped the shots.

[Elena Kannis]

And what scientists and epidemiologists start noticing also is that where you have communities that are highly vaccinated, you aren't really seeing outbreaks of things like measles anymore. But where communities aren't highly vaccinated, you're getting outbreaks of polio and measles. So at the end of the 1960s, there starts to be more and more of a push to strengthen the enforcement.

[Ramtin Arablouei]

Of mandates, vaccine mandates. Over the next decade, this became a priority. And in 1977, President Jimmy Carter launched a national initiative to increase childhood vaccination rates. States began to enforce mandates that required children to get a set of vaccinations before they enrolled in school.

[Andrew Wakefield]

When we think of the word mandate. Right. It's very much sort of top down, right?

[Elena Kannis]

Yes.

[Andrew Wakefield]

And I think especially when it comes to children, that seems like it could strike a nerve for parents in particular. Right. That some authority is telling them, I know what's best for your child.

[Elena Kannis]

Absolutely.

[Andrew Wakefield]

More so than you do.

[Elena Kannis]

Absolutely. We were a country founded on libertarian values. Those values shaped the medical landscape of the 19th century and really like the medical landscape up to today, there's a tension between the authority of the parent and the authority of the state. And you know, this has implications for all different kinds of sectors and questions in society from, you know, mandatory schooling down to, you know, bike helmet laws and other public health measures and yes, vaccination.

[Ramtin Arablouei]

And in 1982, that tension would come to a head around a vaccine against diphtheria, tetanus and pertussis. Known as the DPT vaccine, the diphtheria.

[Paul Offit]

Tetanus pertussis vaccine had a difficult safety profile when it was first invented.

[Andrew Wakefield]

The vaccine could cause rare but severe side effects like prolonged crying and seizures in infants. These symptoms were temporary, but claims began to circulate that the vaccine was doing permanent damage to children.

[Elena Kannis]

So in the early 1980s, there is a reporter, Lee Thompson, a reporter at.

[Andrew Wakefield]

NBC affiliate WRCTV in Washington D.C. who catches wind of these claims and she.

[Elena Kannis]

Embarks on this reporting project and it ends up becoming the basis for a 1982 hour long news broadcast titled Vaccine Roulette.

[Paul Offit]

DPT Vaccine Roulette.

[Andrew Wakefield]

Just a note here. The people call this vaccine both DTP and dpt. So you'll hear both in the episode, but they're referring to the same thing.

[Elena Kannis]

And what Thompson reports is that scientists have known for some time that there are adverse events associated with this vaccine, but that they aren't disclosing them to parents. And that parents are therefore, as she put it, kind of playing a game of roulette with their children. If we kind of keep the Cutter incident in mind, we just marveled at the fact that parents at that moment in time knew that there was this horrible chance that something could go wrong. And yet people still got their kids vaccinated against polio anyway. But a couple decades later, the early 1980s, that's not what the parent population of the US is ready to sign on for.

[Ramtin Arablouei]

At that point, between the Qatar incident and DPT vaccine roulette, a lot had changed in the us. There was a string of government cover ups, Watergate, the Pentagon Papers. These things had put the American people on edge. And there was a series of protest movements, from civil rights to the anti Vietnam War movement that changed the attitudes of the country towards their government.

[Elena Kannis]

Their attitude in the wake of the anti authoritarian movements is hold on, there were risks and we weren't informed. Why weren't we informed?

[Ramtin Arablouei]

After seeing the documentary, some parents began to allege publicly that their children had suffered permanent harm after getting the vaccine.

[Elena Kannis]

They organized themselves into a group that they call dissatisfied Parents together, dpt, they.

[Ramtin Arablouei]

Picked that acronym on purpose, and they.

[Elena Kannis]

Were a pretty formidable group.

[Ramtin Arablouei]

Parents also began to sue pharmaceutical companies.

[Paul Offit]

The whole issue was like, it was.

[Ramtin Arablouei]

Very complicated to determine with certainty whether.

[Paul Offit]

It was the reaction that a kid had was coincidental with the vaccine or was it some underlying condition that was triggered by the fever that they got.

[Ramtin Arablouei]

As a result of this vaccine.

[Andrew Wakefield]

This is Arthur Allen. He's a senior correspondent for nonprofit KFF Health News and author of the book Vaccine the Controversial Story of Medicine's Greatest Lifesaver.

[Paul Offit]

You wouldn't really blame the vaccine for that because maybe if they'd had a fever the next week from a regular viral illness, the same thing would have happened to them. So there's the scientific answer to that and then there's the legal answer to that.

[Andrew Wakefield]

The scientific answer became clear pretty quickly.

[Paul Offit]

Studies actually fairly quickly showed that that wasn't the vaccine that was doing it. If you looked at children who got the vaccine or didn't, there was no increased incidence of any permanent defects associated with that vaccine.

[Andrew Wakefield]

The legal answer was a little murkier.

[Ramtin Arablouei]

I mean, vaccines are supposed to be really safe, and they should be, you.

[Paul Offit]

Know, much safer than almost any medication.

[Ramtin Arablouei]

You can think of. But that doesn't mean that they're completely safe. It doesn't mean that there's no harms.

[Andrew Wakefield]

Parents were winning personal injury lawsuits against the vaccine makers, with the average claim rising to tens of millions of dollars by 1984.

[Paul Offit]

It really drove vaccine makers from the market.

[Andrew Wakefield]

But the activists powering dissatisfied parents together also wanted alternatives to lawsuits. They wanted a law on the books that would protect children from harm.

[Elena Kannis]

They, over the course of the next four years, worked tirelessly in the Capitol to introduce new laws that said that the federal government would do even more to ensure that the vaccine supply was safe.

[Ramtin Arablouei]

In 1986, they had a breakthrough. A new law called the National Childhood Vaccine Injury act, which creates the Vaccine Injury Compensation Program, commonly known as the Vaccine Court.

[Andrew Wakefield]

It was designed to compensate individuals or their families who were injured by certain vaccines. It was a no fault court. And the compensation money came from a government trust fund funded by attacks on vaccine manufacturers. But the Vaccine Corps also protected those vaccine manufacturers from lawsuits that threatened to hold up their production or even drive them out of business.

[Elena Kannis]

So it's really important to pause here and look at this moment. The parents who came together were from across the political spectrum, and they did something that we'd seen happen before. They turned to Washington, they turned to the federal government and said, do more to ensure that vaccines are safe. This is really distinct in the history of anti vaccination. And I hesitate to call it that because it does not seem accurate at all. This is a movement that's saying, you know, some of our members actually have real reservations about vaccines, but we are the parents who got our kids vaccinated and we want future parents to get vaccines for their children and feel absolutely confident in those vaccines.

[Andrew Wakefield]

Huh? Oh, see, that's a really important nuance that it wasn't a, I don't want to vaccinate my child and you shouldn't vaccinate your child. It's. We need to demand that we are continuing to improve these vaccines and make sure that they are as foolproof as possible.

[Elena Kannis]

Exactly, exactly. It's a lot easier to tell a story of simple anti vaccinationism. It, you know, boils everything down to black and white.

[Ramtin Arablouei]

This parent group, Dissatisfied Parents Together fractured.

[Elena Kannis]

After a while, there were those who found themselves just absolutely devoted to the cause and stuck with it and kept pushing and pushing and pushing. And then there were parents who said, okay, we got what we wanted and now I'm moving on.

[Ramtin Arablouei]

Dissatisfied Parents Together would later morph into the National Vaccine Information Center, a group that today has been criticized for spreading misleading information about vaccine safety. The movement spawned by the documentary Vaccine Rollette lived on, really.

[Paul Offit]

In many ways, that vaccine caused the birth of the modern American anti vaccine movement.

[Ramtin Arablouei]

Some parents began to draw connections between vaccines and any unexpected diagnoses when Vaccine.

[Elena Kannis]

Roulette aired in 1982. And it resonated with parents who feared that we were seeing as a nation, more and more learning differences and developmental delays and disabilities in children. And they were really struggling to understand, like, why their kids had disabilities like this when they didn't and nobody in their family did. And vaccines started to suddenly seem like a possible explanation. Concerns about the connection between vaccines and autism were circulating for close to two decades before they were published in the Lancet.

[Ramtin Arablouei]

Coming up, Andrew Wakefield publishes his paper Giving the movement New life.

[Elena Kannis]

Hello, I'm calling from Milwaukee, Wisconsin.

[Paul Offit]

And the only reason I'm calling is.

[Elena Kannis]

To say that I heard the program called Throughline last Friday night, and it was the most wonderful program I've ever heard. Thank you.

[Paul Offit]

Thank you so much.

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[Andrew Wakefield]

In 1996, a man named Richard Barr approached a doctor named Andrew Wakefield with an offer. Barr was a personal injury lawyer with ties to an anti vaccine group. He offered to pay Wakefield to research a link between the MMR vaccine and and autism so that he could use Wakefield's research as evidence in his lawsuits.

[Ramtin Arablouei]

Wakefield's paper was published in 1998 in the Lancet, one of the world's leading medical journals, sending shockwaves through the medical community.

[Paul Offit]

Now, his paper wasn't a study, it.

[Andrew Wakefield]

Was a case series, which is different from a full blown scientific study. A case series is when doctors notice a trend in their field, maybe like a group of patients exhibiting mysterious symptoms, and they think there could be something more to look into. So they write up a paper on a very limited group of people detailing their findings.

[Paul Offit]

It was 12 children, eight of whom had developed signs and symptoms of autism.

[Andrew Wakefield]

Wakefield's paper suggested a link to the.

[Paul Offit]

MMR vaccine, for which he had no evidence.

[Ramtin Arablouei]

Again, this is Paul Offit, director of the Vaccine Education center at the Children's Hospital of Philadelphia.

[Paul Offit]

You could have published a paper saying, here's eight children who recently ate a peanut butter and jelly sandwich that now have signs and symptoms of autism, because it was really no better than that.

[Ramtin Arablouei]

But when it was published, people in the medical field took it seriously because that's how a case series is supposed to work. Someone notices a strange pattern, publishes a paper about it, and it prompts other scientists to look into it.

[Paul Offit]

Because it's fair enough, right? My child was fine, they got this vaccine, now they're not fine. Could the vaccine have done it? That is an answerable question. It's a scientific question that can be answered in a scientific venue, and was. And so study after study after study, more than a dozen studies done in seven countries on three continents, involving thousands and thousands of children, none of them.

[Ramtin Arablouei]

Found any evidence that linked the MMR vaccine to the development of autism.

[Paul Offit]

So asked and answered.

[Ramtin Arablouei]

But the doubts Andrew Wakefield had sowed were powerful. And that's what landed Paul in front of Congress, testifying opposite Andrew Wakefield in April 2000.

[Paul Offit]

My concern, Mr. Chairman, is that parents listening to or reading about this hearing might incorrectly conclude that vaccines cause autism. This is not the case. Vaccines are extremely safe and highly effective.

[Andrew Wakefield]

I'd love to get a sense of even more of what it was like to be in that room listening to him.

[Paul Offit]

It was like the world had turned upside down. In my world, it's always the data that mattered. And it's fair to ask a question, it's fair to have a hypothesis, but if it's a testable hypothesis, which this was. Does MMA Mark cause autism? You're not asking how many angels can dance on the head of a pen? This was a question that could be answered in a scientific venue and was being answered in a scientific venue. And it just. And so I saw this man standing up, ignoring those data and just declaring his own truths, including scientific truths, and I just couldn't believe it. I wasn't used to that. I'm getting much more used to it now, but I wasn't used to that then.

[Andrew Wakefield]

Did you have any interaction directly with him?

[Paul Offit]

Yes, as he was walking out, I shook his hand and he looked at me and sort of kept his eyes parallel, as if he was looking at something behind me, which was unnerving.

[Andrew Wakefield]

In that moment, did you have a sense of just how big this idea that he had launched into the world that vaccines cause autism was going to become?

[Paul Offit]

No, not at all. I still believed at that time, in a world dominated by logic and reason, that it's okay to ask the question, it's okay to have the hypothesis, but that when that question has been thoroughly answered, that that would end it. And I was just naive. I was wrong. It didn't end it at all. If anything, it's gotten worse over time as we have less and less trust in public health agencies. I will never forget that when that meeting was over and there was an overflow room for parents, because parents really wanted to hear this, parents of children with autism. And afterwards, there were a number of parents that came up to tell me what a jerk I was for sort of standing up for what I thought was the science of vaccines. The thing that struck me then and still strikes me is that we were like the scientists or we were the doctors, but here he was representing the parents. And, you know, we were parents too, so we cared deeply about vaccine safety.

[Andrew Wakefield]

Wakefield seems like he knew how to command a room. He knew how to shape the narrative. And that seems to have been really important in terms of getting this idea traction.

[Paul Offit]

He comes off as someone who's speaking truth to power, and that power is pharmaceutical companies who are never going to be seen as sympathetic. So if you're on the other side, I mean, you're just saying, look, this isn't true. I mean, this isn't causing autism, but you don't have anything to offer. You don't have a clear cause or causes of autism. He does. He's offering parents something, and we're not.

[Ramtin Arablouei]

The prevalence of autism diagnoses was rising dramatically during this time. From the 1970s to the 1990s, the US had seen a tenfold increase. Some people attributed the rise, at least in part, to greater awareness and changes in diagnostic criteria. But there wasn't a conclusive explanation.

[Andrew Wakefield]

Wakefield's theory was just one theory. Others started to emerge. Some parents latched onto an ingredient in some vaccines called thimerosal. It's a preservative used to keep germs from growing in some vaccines. It was never used in the MMR vaccine, but it was used in others. And it contains levels of mercury. Some parents believed exposing children to thimerosal could cause autism. This has been studied extensively since then, and there has been no scientific evidence linking the two. Still, the concerns about mercury led to change. There are now thimerosal free versions of most vaccines available to people.

[Ramtin Arablouei]

Even if Wakefield's theory and thimerosal theory were pretty different, the people who believed in them had a common enemy.

[Elena Kannis]

In the early 2000s, what we have is this moment in which a handful of things have been happening.

[Ramtin Arablouei]

Alaina Konis professor of journalism and history at the University of California, Berkeley there's.

[Elena Kannis]

Been growing attention to mercury exposure, growing crackdown on it. There's been growing attention to the abuses of the pharmaceutical industry. And what I mean by that is like, very broadly, the practices of the pharmaceutical industry in courting doctors and selling diseases in order to sell drugs, in, like, concealing data, in turning out.

[Andrew Wakefield]

It's the opioid crisis, right?

[Elena Kannis]

Yes, but like, long before the opioid crisis, like, you know, we even have, like the editor of the esteemed New England journal of medicine, writing a whole book about things that big pharma had done wrong. It has become like a national punching bag. There are these myriad concerns that parents and others have been raising about vaccines. The fact that autism rates were just skyrocketing in a mind blowing way like it just in the early 2000s. Everywhere you looked, every classroom, there were kids with autism diagnoses. They were all across the spectrum. The statistics coming out of the CDC were absolutely terrifying. And they just went higher and higher like the rate of.

[Andrew Wakefield]

With no good explanation, no explanation at first.

[Elena Kannis]

And gradually like partial explanations coming together. Other. But you can kind of start to see the issues here overlapping, like hold on mercury exposure, hold on more and more vaccines and these mandates and autism. And this very active group of parents kind of join forces with some of the extant vaccine critical groups and start bringing attention to again, as they called it at the time, vaccine safety issues in a way that hadn't happened in a full 20 plus years. Like things had gone really quiet after the passage of the 1986 law. All of this is kind of like coming to a boil at the same time. Like imagine the stove with all of these pots and they're all hitting like the boiling point.

[Ramtin Arablouei]

Soon the pots on the stove would boil over and concerns about vaccines and autism would spread much further.

[Paul Offit]

Around 2004, RFK Jr called me.

[Andrew Wakefield]

That's coming up.

[Ramtin Arablouei]

Hello, this is Steve from Tampa, Florida.

[Andrew Wakefield]

And you're listening to throughline from npr.

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This message comes from Bombas. Their slippers are designed with cushioning so every step feels marshmallowy soft. Plus, for every item purchased, Bombas donates to someone in need. Go to bombas.com NPR and use code NPR for 20% off your first order. This message comes from Warby Parker. If you wear glasses, you know how hard it is to find the perfect pair. But step into a Warby Parker store and you'll see it doesn't have to be. Find a Warby Parker store near [e-mail] retail.

[Andrew Wakefield]

Part 3 Deadly Immunity June 2005.

[Ramtin Arablouei]

Dr. Paul Offit wakes up to an article from Rolling Stone titled Deadly Immunity. The author is a well known environmental lawyer named Robert F. Kennedy Jr. Who called him up while researching the article a year earlier.

[Andrew Wakefield]

For years, RFK Jr had been concerned about mercury and the environment. He'd pushed back on the coal industry to clean up rivers where the mercury in fish had been found to have a harmful impact on humans who ate them. So when he learned there was mercury in vaccines, he decided to investigate and he called up Paul.

[Paul Offit]

It was a good conversation. We talked for about an hour.

[Andrew Wakefield]

At least that's what he thought before he read the article.

[Elena Kannis]

Although the vaccination industry insists that ethylmercury poses little danger because it breaks down rapidly and is removed by the body, several studies suggest that ethylmercury is actually more toxic.

[Paul Offit]

He just said that mercury is in vaccines at a level that's toxic. He had misstatement after misstatement after misstatement.

[Ramtin Arablouei]

In that article, Paul had developed a vaccine for an illness called rotavirus. And as he says he told RV on that call, study after study had shown that a child would ingest more mercury from breast milk than from any vaccine. There was no evidence that such small quantities caused damage.

[Andrew Wakefield]

So back to the article. In it, RFK Jr also repeated a claim from a scientific paper published in the late 90s by a doctor in England named Andrew Wakefield. The claim that vaccines are linked to autism.

[Ramtin Arablouei]

We should quickly note. RFK Jr. And Andrew Wakefield did not respond to our request for comment for this episode.

[Elena Kannis]

He was arguing another thing, namely that the pharmaceutical industry was aware of something and was concealing it.

[Ramtin Arablouei]

This is Elena Kannis.

[Elena Kannis]

And that corporations like that actually needed more regulation and oversight than they were getting. The scientists and researchers, many of them sincere, even idealistic, who are participating in efforts to hide the science on thimerosil.

[Andrew Wakefield]

Claim that they are trying to advance.

[Elena Kannis]

The lofty goal of protecting children in.

[Andrew Wakefield]

Developing nations from disease pandemics. They are badly misguided. Their failure to come clean on thimerosil will come back horribly to haunt our.

[Elena Kannis]

Country and the world's poorest populations. Deadly immunity Rolling Stone, June 2005 and coming from an environmental lawyer, that argument had a lot of traction.

[Ramtin Arablouei]

RFK jr's article reignited debates over vaccines and Andrew Wakefield started to get noticed in the us.

[Elena Kannis]

Wakefield becomes this high profile individual. He had been one in England and.

[Andrew Wakefield]

He inspires other high profile supporters. We do not need that many vaccines.

[Elena Kannis]

A number of celebrities start talking about their own concerns about vaccines going on nationally televised talk shows. Among the most vocal were Jenny McCarthy and Jim Carrey.

[Andrew Wakefield]

Without a doubt in my mind, I believe vaccinations triggered Evan's autism. Actress Jenny McCarthy and comedian Jim Carrey were dating at the time. And Jenny's son had been diagnosed with autism. So I think they need to wake up and stop hurting our kids. Together they organized a rally in the nation's capital called Green Our Vaccines.

[Paul Offit]

I just want to start by asking.

[Elena Kannis]

The CDC one question.

[Paul Offit]

How stupid do you think we are?

[Andrew Wakefield]

RFK Jr spoke at that rally.

[Elena Kannis]

They've removed the thimerosal from the vaccines.

[Paul Offit]

And autism rates have not gone down. How many times have you read that repeated by these people from the press? That is an industry talking point that the industry knows is a lie.

[Andrew Wakefield]

National news outlets turned out story after story about vaccines.

[Elena Kannis]

Local newsrooms were closing down and there was increasing competition for news consumers. And the vaccine story was one of these stories that resonated broadly. And meanwhile, social media is taking off. The public can actually weigh in. And so this thing really snowballs and it's really creating a mass movement.

[Ramtin Arablouei]

So as this mass movement continued to make headlines in the 2000s, it also began to face more scrutiny.

[Elena Kannis]

A lot of really critical media attention then starts to focus on the kind of characterization of vaccine skeptics as ignorant, selfish, uninformed and worse. And it's become kind of a moral position that many in media and politics have become comfortable taking. Vaccines save lives. If you don't get vaccines, you don't care about people and you don't believe in science. Without including any of the vast context around the question. Yesterday, a respected British medical journal retracted a study that said the MMR vaccine may trigger autism. CBS News correspondent Richard Roth.

[Ramtin Arablouei]

With more eyes on the movement, the Wakefield paper came under more scrutiny. The Lancet retracted it in 2010. And a British journalist named Brian Deer published an investigation revealing that it wasn't just flawed, but omitted key facts. Dear had already confirmed that Wakefield was paid to conduct his research by people with an interest in its outcome. His new work revealed that some children in the study had already exhibited signs of autism before getting vaccinated. RFK Jr. S article in Rolling Stone was also removed.

[Andrew Wakefield]

You went through the sort of fallacies of the Wakefield paper. Do you remember when it was retracted and what your reaction to the retraction was? And what happens to Wakefield?

[Paul Offit]

My reaction was it's too late. It should have never been published. You can't say anything about causality because there's no control group.

[Andrew Wakefield]

But were you surprised that even after the retraction, the, the narrative continued?

[Paul Offit]

I'm not even sure if they'd retracted it a month later. It would have mattered. I think the, the cage door got open and the devil came out.

[Ramtin Arablouei]

After the retraction, Wakefield lost his medical license in the uk, but he had already moved to the US and gotten involved in the anti vaccine movement. Eventually he made a documentary which controversially reiterated the claims in both his paper and and RFK Jr. S article as for RFK Jr. He launched an organization called the World Mercury Project that was committed to, quote, exposing the government and corporate corruption that has led to increasing exposures to neurotoxic mercury in foods and medicines.

[Elena Kannis]

And in the meantime, vaccine preventable diseases are starting to break out in really troubling numbers.

[Paul Offit]

Health officials fear thousands may have been exposed to the measles at Disneyland and Disney California Adventure last month.

[Elena Kannis]

Then in 2014, there's this measles outbreak that starts at Disneyland.

[Paul Offit]

I think the original case may have come in from outside of this country because measles is still prevalent in the world.

[Andrew Wakefield]

Measles had been eliminated in the US by the year 2000, which meant enough people were vaccinated that even if someone came into the country with measles, it wouldn't be able to spread. Think of it as like a bunch of people holding up umbrellas in a group. So even if a few people don't have an umbrella, they're still shielded from the rain.

[Paul Offit]

There was essentially a moat around them.

[Andrew Wakefield]

But that protection wouldn't last forever. For decades, California had allowed some people to opt out of vaccines for non medical reasons. The state actually created that exemption when it started mandating that kids get the polio vaccine before enrolling in school. Back in the 1960s, California had a philosophical exemption to vaccination, and vaccination rates had begun to fall.

[Paul Offit]

Once vaccination rates fray, that moat disappears. High fever, aching eyes, hacking cough. And after a week, every square inch of you covered by red dots, measles. Tonight, the CDC warns it's back and it's spreading.

[Andrew Wakefield]

So Oregon is now the latest state.

[Elena Kannis]

To have a case of measles traced back to that outbreak that started at Disneyland.

[Paul Offit]

As health officials try and contain the.

[Elena Kannis]

Virus late 2014 into 2015, health professionals and lawmakers come together in California and elsewhere and say, like enough is enough. We have had enough vaccine skepticism. We have had enough use of vaccine exemptions. And so they start cracking down on exemption clauses.

[Andrew Wakefield]

But there was a backlash. Jim Carrey is really upset with California Governor Jerry Brown for signing a new.

[Ramtin Arablouei]

Vaccination law this week.

[Elena Kannis]

The rule makes vaccines mandatory for all.

[Ramtin Arablouei]

School children, regardless of their religious and personal beliefs. Kerry went off on Twitter and called.

[Andrew Wakefield]

Governor Brown a corporate fascist who must be stopped.

[Paul Offit]

In 2017, you started to have these Republican led legislatures that were very skeptical of vaccination.

[Ramtin Arablouei]

Arthur Allen is a senior correspondent for KFF Health News. Republicans had always been as pro vaccine as anybody else.

[Paul Offit]

It was a reaction to this effort to sort of crack down on vaccine exemptions that were causing this measles outbreak. And it created incredible power in the anti vaccine movement.

[Ramtin Arablouei]

The Disneyland outbreak led to 147 people being infected with measles across seven states, Mexico and Canada. No one died. But Paul Offit says if vaccination rates continue to decline, outbreaks like that could be much worse in the future.

[Paul Offit]

So I just fear this. I think we're just so blase about this. We don't remember these diseases. And I guess having lived in a polio ward for six weeks, that's still with me.

[Andrew Wakefield]

Let's play out the scenario. What are we looking at? If vaccination rates for these different diseases.

[Paul Offit]

Fall, then you'll see children start to die from measles again, because that's always the first one to come back. It's already starting to come back. Measles is the single most contagious vaccine preventable disease. The contagious index for viruses like influenza or SARS CoV2, the cause of COVID is like 2 to 4, meaning you'll infect 2 to 4 people. The contagiousness index for measles is 18. It's much, much higher. You just have to be in the person's airspace within two hours of them being there. And sadly, that may be what it takes that we have to see children suffer this, But I'm not even sure that will do it. I think we have lost trust. I think a lot of that happened during the COVID pandemic in part because we weren't always right, because we were learning as you go, because you're building the air penalty while it's still in the air and we're sort of dictating things and that really rubbed people the wrong way.

[Andrew Wakefield]

Yeah, I have to say I feel that I had my first kid last year and, you know, you're getting vaccines basically from the time they're what, like two months old? And I have a new kind of empathy for that kind of fear that many parents have. Because you have this desire to sort of control everything you know about their well being and health and care and all of that.

[Paul Offit]

I think it's perfectly reasonable for a parent to be skeptical of anything that they put into their child's bodies. Vaccines certainly among them. I mean, we ask parents to give as many as 25 shots in the first few years of life to prevent diseases most people don't see using biological fluids. Most people don't understand. I think it would be surprising if parents weren't skeptical of vaccines. But I think that there's, there's a difference between skepticism and cynicism. And when you cross the line to cynicism now, you just don't believe what people are telling you. You don't believe the data, you don't believe the science. And that's different. All you have that separates truth from superstition are excellent scientific studies. And if you're throwing those out, then you feel like there's no hope.

[Elena Kannis]

I will say that when you sit down to get a vaccine, you're placing an enormous amount of trust in a long chain of people and institutions that you may not know, you may never see, you may never understand. That trust is fundamental to that story of success. But that trust has been eroded across the board. Getting a vaccine is not just this simple cut and dried medical or political act like it's a human act. And it can be painful. And when we do it to children and our little babies, it's emotional too. All of that is part of the reality of getting vaccinated. So yes, vaccines, vaccines save lives. And I wish that could be the end of the story. But the entire reason why I study the history of vaccination is because it's not.

[Andrew Wakefield]

That's it for this week's show. I'm Rund Abdelfatah.

[Ramtin Arablouei]

I'm Ramtin Arablouei and you've been listening to throughline from npr.

[Andrew Wakefield]

This episode was produced by me and.

[Ramtin Arablouei]

Me and Lawrence Wu, Julie Kane, Anya.

[Andrew Wakefield]

Steinberg, Casey Miner, Christina Kim, Devin Kadayama, Irene Noguchi. Voiceover work in this episode was done by Devin Katayama.

[Ramtin Arablouei]

Thank you to Greta Pittenger at rad, Brett Neely, Scott, Hensley, Johannes Durgi, Johnette Oakes, Keandre Starling, Toni Cavan, Nadia Lancy, Edith Chapin and Colin Campbell.

[Andrew Wakefield]

Fact checking for this episode was done by Kevin Voelkel. This episode was mixed by Jimmy Keighley. Music for this episode was composed by Ramtin in his band Drop Electric, which.

[Ramtin Arablouei]

Includes Naveed Marvi, Sho Fujiwara, Anya Mizani and finally, if you have an idea or like something you heard on the show, please write [e-mail] or hit us up on Twitterlinempr.

[Andrew Wakefield]

Thanks for listening.

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