Last month, I was lucky enough to get a chance to attend the Pacific Health Summit in Seattle. As I wrote at the time, it was an alternatingly inspiring and frustrating experience. One of the issues I wished had gotten more attention was the ways in which the misinformation campaigns that have influenced public perceptions about vaccines in places like the US and the UK play out in the developing world, where the primary issue regarding vaccine uptake is typically access as opposed to attitudes.
This morning, Art Caplan, the director of the Center for Bioethics at the University of Pennsylvania, a vocal advocate of vaccines, and a polio survivor, emailed me a link to a study in the journal Human Vaccines titled “Informed consent in vaccination in India: Medicolegal aspects.” Judging by the study’s summary, it seems to validate Caplan’s previously stated concerns about the potential impact of Western fears about vaccines on vaccination efforts elsewhere in the world:
Surprisingly, even when serious life threatening complications are not only reported but on a steady rise due to vaccines, informed consent in vaccination is neither in vogue nor practice. … This paper attempts to present an overall comment on the necessity of informed consent before any vaccination especially in the Indian context in the backdrop of the beginning of vaccine compensation claims and litigation against the complications of vaccination in India.
What’s most jarring to me is how easily the authors obfuscated the difference between “reported” complications and an actual “steady rise” in those complications. The Omnibus Autism Proceeding, in which more than 5,000 families claimed that vaccines had caused their children’s autism, provide a good example of why claims of causal connections are not the same thing as evidence of an actual link. Here’s a brief excerpt from one of the Omnibus rulings. (“Michelle” refers to Michelle Cedillo, a severely autistic girl whose case was one of three “test cases” for the theory that thimerosal-containing vaccines and the MMR vaccine had caused her autism. “Dr. Krigsman” is Arthur Krigsman, a former colleague and collaborator of Andrew Wakefield.)
Nor do I doubt that Michelle’s parents and relatives are sincere in their belief that the MMR vaccine played a role in causing Michelle’s devastating disorders. Certainly, the mere fact that Michelle’s autistic symptoms first became evident to her family during the months after her MMR vaccination might make them wonder about a possible causal connection. Further, the Cedillos have read about physicians who profess to believe in a causal connection between the MMR vaccine and both autism and chronic gastrointestinal problems. They have visited at least one physician, Dr. Krigsman, who has explicitly opined that Michelle’s own chronic gastrointestinal symptoms are MMR-caused. And they have even been told that a medical laboratory has positively identified the presence of the persisting vaccine-strain measles virus in Michelle’s body, years after her vaccination. After studying the extensive evidence in this case for many months, I am convinced that the reports and advice given to the Cedillos by Dr. Krigsman and some other physicians, advising the Cedillos that there is a causal connection between Michelle’s MMR vaccination and her chronic conditions, have been very wrong. Unfortunately, the Cedillos have been misled by physicians who are guilty, in my view, of gross medical misjudgment.