Running head: VACCINE MYTHS AND MISCONCEPTIONS 1

Vaccine Myths and Misconceptions: An Examination of the Various Aspects of Immunizations

Allison C. Stewart

First Colonial High School Legal Studies Academy

Abstract

This paper covers various aspects of immunization. The legal aspect of this paper includes

general legislation affects in history and historical, current, and pending legislation related to

vaccinations. The author also examines constitutional questions, such as the right to privacy

versus state interests and if vaccination mandates are constitutional, and court cases such as

Shalala v. Whitecotton and Gottsdanker v. Cutter. After this, injuries from vaccines are discussed,

which brings the subject of the paper to four of the most common myths and misconceptions

surrounding vaccines. These are the connection between vaccines and Sudden Infant Death

Syndrome, the connection between vaccines and autism, the existence of unsafe toxins in

vaccines, and the idea that there is no need to vaccinate. The author discusses these myths,

provides evidence against them, and argues in favor of the truth. As the paper concludes, the

author advocates for the maintenance and strengthening of the herd immunity effect.
VACCINE MYTHS AND MISCONCEPTIONS 3

Vaccine Myths and Misconceptions: An Examination of the Various Aspects of Immunizations

The World Health Organization estimates that in 2008 alone, vaccination against

whooping cough saved 687,000 lives (Barnes & Burke, 2015, p. 153). If this is true, then why is

there such a big controversy over immunizations? Vaccine critics distrust medical and scientific

organizations research despite the transparency and rigor of their studies and findings because

much of the fear around vaccination has not resulted from hard scientific evidence but from

superstition and bad science (p. 154). Many might ask if it is the parents right to refuse a

vaccination even if the parent is misinformed. However, failing to vaccinate infants and children

not only puts their lives at risk, but also threatens the health of others by breaking down the herd

immunity effect.

General Legislation Effects in History

Studies from the 1970s can attest that school immunization laws are very effective

(Rodewald, 2007). In a 1978 Morbidity and Mortality Weekly Report, a series prepared by the

Center for Disease Control, a study was published that compared six states that strictly enforced

measles vaccination school entry requirements to those who did not. The study found that once

the laws were enforced incidences of measles fell dramatically. Mandatory vaccination laws date

back to the early 1800s; smallpox vaccinations were required for school entry in England (Shaw,

2007).

Legislation

Historical Legislation

The first direct federal regulation of medicine was the 1902 Biologics Control Act

(Barnes & Burke, 2015, p. 154). The first state school vaccination law was established in
VACCINE MYTHS AND MISCONCEPTIONS 4

Massachusetts in the 1850s to prevent smallpox transmission (Goodman et al, 2003, p. 344). By

1963, 20 states along with the District of Columbia and Puerto Rico required children to be

vaccinated before entering school (p. 344).

National Childhood Vaccine Injury Act. In 1986, the National Childhood Vaccine

Injury Act was approved by Congress (Goodman et al, 2003, p. 341). As stated by Goodman et

al (2003),it established the National Vaccine Program within the Health Department to

coordinate vaccine research/development and monitor vaccine safety. It also provided

compensation for parents who proved their child had been injured in relation to a recent

vaccination (p. 341).

Current Legislation

Federal Legislation.

Vaccine Safety Study Act (H. R. 1636). The purpose of this piece of legislation is to

direct the Secretary of Health and Human Services to do a comprehensive study comparing total

health outcomes with and without vaccines, tested in vaccinated and unvaccinated communities

within the United States. This includes researching the risk of autism related to vaccination rates

(Civic Impulse, 2016).

Head Start on Vaccinations Act (S. 486). This piece of legislation amends the Head Start

Act to ensure that all children in Head Start programs are vaccinated. Exemptions are only

allowed for children with medical conditions and the doctors professional recommendation that

they should not be vaccinated (Civic Impulse, 2016).

Pending Legislation.

Recognizing the importance of vaccinations and immunizations in the United States

(H.Res.117). This bill lays out the importance of vaccinations. It states figures of how vaccines
VACCINE MYTHS AND MISCONCEPTIONS 5

have almost completely eradicated deadly diseases and commends all organizations that assisted

with the vaccination effort. The proposed legislation says how vaccines, along with widespread

vaccination, are vital and that a public health crisis would occur in their absence. It is for this

reason that Congress encourages continued research on vaccines and that parents vaccinate their

children (Helmsworth, 2015).

First Responder Anthrax Preparedness Act (H.R.1300). The First Responder Anthrax

Preparedness Act would instruct the Department of Homeland Security to take the extra anthrax

vaccines from the national stockpile and offer them as a choice for first responders. The pilot

program would last eight months, administering vaccines and microbials to first responders. This

bill strives to provide the maximum protection in case of an anthrax attack (Revell, 2015).

Constitutional Questions

Are vaccination requirements constitutional?

The United States Constitution makes no reference to a citizens right to privacy, nor do

any of its amendments. There are no federal laws requiring vaccinations against certain diseases.

State laws require specific diseases to be vaccinated against for public school children. This is

because most communicable diseases have a high incidence in school-age children because of

the large potential for transmission in the congregate setting (Goodman et al, 2003, p. 341).

Some may take this to mean that there is not a vaccine requirement because a parent can choose

not to send their child to public school, instead opting for homeschooling or a private school.

However, if a family does not have the financial means to homeschool or send their child to

private school, the vaccine requirement emerges when the child attends public school. The

Nevada Supreme Court realized and came to the conclusion in the 1994 case of Allison v. Merck

that a [school entry] vaccine mandate was more than just a deprivation of a service, it was
VACCINE MYTHS AND MISCONCEPTIONS 6

something that must be obeyed in the absence of an exemption if there are no private schools

nearby and homeschooling is not an option (Shaw, 2007, p. 107). Courts have shown almost

universal approval for vaccination school entry laws, comparing them to requiring people to

wear motorcycle helmets (p. 108).

Right to privacy vs. state interests. The evolved right to privacy gives people a strong

interest in freedom of bodily integrity (Shaw, 2007, p. 107). However, this right must be

balanced against state interests (p. 107). The Routine Childhood Vaccination Schedule prevents

about 33,000 premature deaths each year, along with 14.5 million cases of vaccine-preventable

deaths (Rodewald, 2007, p. 106). This saves society about $42 billion, including $10.5 billion in

direct medical costs (p. 106). Mandates are more justifiable when the disease is associated with

high economic externalities, including expensive individual care where the cost must be

absorbed by taxpayer money.

Are religious exemptions constitutional?

The First Amendment to the United States Constitution states Congress shall make no

law respecting an establishment of religion, or prohibiting the free exercise thereof. According

to this clause, the government cannot pass laws that aid one religion, aid all religions, or prefer

one religion over another. Religious exemptions do aid religions by helping them rise above the

law, which violates the First Amendment and the separation of church and state. Eighteen states

allow philosophical exemptions and all states except Mississippi and West Virginia allow

religious exemptions. When taken to court, there have been mixed results. A Mississippi court

voided a religious exemption because it was found to discriminate against children who were

vaccinated. Courts have confirmed that there is no constitutional right to any exemption from

school entry vaccination requirements. Currently, most legal action and issues revolve around
VACCINE MYTHS AND MISCONCEPTIONS 7

whether or not people have the level of proof necessary to be granted religious exemptions

(Shaw, 2007, p. 108).

Is it constitutional for states to mandate vaccines that create immunity to a disease only in

the individual vaccinated as opposed to vaccines that create a herd immunity?

This question is from Shaw (2007, p. 108) and references vaccinations such as the tetanus

shot, which protects only the individual it was administered to but is still required. The idea

behind this mandate stems from the states desire to protect people from themselves and to

reduce the negative public externalities of people being injured. It connects to parens patraie,

which is the traditional authority of governments to protect the welfare of children and

incompetent persons and the states traditional police power (p. 108).

Case Law

Shalala v. Whitecotton

Shalala v. Whitecotton was a United States Supreme Court case that concerned

compensation for symptoms of injury after a vaccination under the National Childhood Vaccine

Injury Act of 1986. The main point in this case was proving that the claimant had shown

symptoms of an injury after the administration of a vaccination. The court held a unanimous

opinion, ruling favor of Whitecotton, as it was proven that she had experienced seizures, a

symptom of encephalopathy, in the 72 hour period after receiving the diphtheria, pertussis, and

tetanus vaccinations. This case demonstrates how a citizen successfully used the National

Childhood Vaccine Injury Acts Vaccine Injury Table to prove their injury to possibly be in

relation to a vaccine and receive government compensation for their injuries (Oyez, n.d.).

Moberly v. Secretary of Health and Human Services

Molly Moberly, an infant, received her first set of immunizations on July 17, 1996. The

set included the first dose of the Diphtheria-Pertussis-Tetanus ("DPT") vaccination. On

September 17, 1996, the child received her second DPT vaccination and on September 19, 1996,

Moberly suffered two brief seizure episodes. On October 6, she suffered from two more seizures.

The child continued to experience seizures throughout the next year. Teresa Moberly, the childs

mother, filed a claim seeking compensation under the National Childhood Vaccine Injury Act.

Two doctors testified in support of the Moberly family, but both were found to not be credible. It

was concluded that a simple correlation between the vaccination and Molly's first seizures, even

in the absence of an alternative explanation for those seizures, was insufficient to prove

causation and the family was denied compensation. The case was appealed and the Court of

Federal Claims upheld the finding. It was then appealed to the United States Federal Circuit

Court of Appeals, which affirmed the previous courts decision. This case demonstrated how the

federal government required the claimants to establish causation in order to receive

compensation under the National Childhood Vaccine Injury Act (Moberly v. Secretary of Health

and Human Services).

Gottsdanker v. Cutter

The Cutter Disaster in 1955, was when a live polio virus was distributed to children

who then became infected with polio and spread it to others. As the nations largest vaccine

maker, Cutter was the biggest target for personal injury lawsuits and was sued sixty times. One

of the most prominent cases of this time period was Gottsdanker v. Cutter, which concerned a

five year old child who developed polio after being administered with Cutters vaccines.

Ultimately, the childs legs were paralyzed. Her lawyer argued that in making an unsafe

vaccine, Cutter had breached an implied warranty of safety. The Gottsdanker family was
VACCINE MYTHS AND MISCONCEPTIONS 9

awarded $147,300. This case was decided during a period where product liability law was

evolving. For example, privity of contract meant that warranties of safety only existed between

the buyer and the seller of a good. However, vaccines are usually bought by doctors and clinics

from distributors and then administered, so there is no concrete, direct relationship between the

patient and the vaccine manufacturer. Under these grounds, the case should have been thrown

out. However, a California appeals court noted that privity of contract had been abolished in food

sales and extended the abolition to vaccines (Barnes & Burke, 2015).

Jacobson v. Massachusetts

In this case, the social contract of the good of the whole was put into law (Shaw, 2007,

p. 107. Jacobson refused to comply with a smallpox vaccination requirement and was fined five

dollars. The question of this case was whether or not the mandatory vaccination law violated the

plaintiffs fourteenth amendment rights (Jacobson v. Massachusetts). The Court, citing the states

police power, held that the law was legitimate to protect the health and safety of its citizens and

that no citizen has a right to be wholly free from constraint (Shaw, 2007, p. 107). However, the

court also said that the state governments do not have unlimited powers. In order to not challenge

the U.S. Constitution, public health interventions must be public health necessities. In addition,

they must be reasonable compared to their benefit, have a substantial relation to the problem, and

present no burden greater than the expected benefits (p. 107).

Injuries From Vaccines

As safe and effective as vaccines are, they are not perfect; some people may be injured

because of a vaccine and some people may not be protected (Goodman et al, 2003, p. 339).

According to Barnes & Burke, 2015, a small percentage of those vaccinated suffer severe

reactions, however, research says the scope of this problem is relatively narrow (p. 153). Most
VACCINE MYTHS AND MISCONCEPTIONS 10

adverse injuries reported to have been caused by vaccines are simply soreness or redness at the

injection site and a possible fever for a day (p. 339). Reactions to vaccines are usually associated

with an allergy to the gelatin or egg protein component (S. Antony, Personal communication,

November 17, 2016). It is difficult to establish a concrete relationship between vaccines and

injuries, but it is more difficult to completely disprove a relationship between the two (Barnes &

Burke, 2015, p. 154). It is also difficult to ascertain whether a more serious injury was caused by

the vaccine or another outside event, especially during infancy because of the large number of

developments that the child is experiencing within such a short amount of time during the first

year of their lives (Goodman et al, 2003, p. 339).

Myths and Misconceptions

Sudden Infant Death Syndrome

Sudden Infant Death Syndrome is the most common cause of death in infants under one

year in age. The cause of this disorder is still largely unknown. It is defined by the sudden death

of a child of under twelve months that is unexplainable even after an autopsy and an in-depth

review of the childs medical history. The peak age for Sudden Infant Death Syndrome (SIDS) to

occur is when the infant to two to four months old (Hunt & Hauck, 2006).

A large case control study of if and how SIDS may be connected to the hexavalent

vaccine with professional multi-variate analysis was conducted in Germany from 1998 to 2001.

Scientists collected data from 307 SIDS cases with 971 controls. The study found that SIDS

cases were vaccinated less frequently and later than the controls and that there was no increased

risk of SIDS in the fourteen days following the vaccination. There was no evidence to suggest

that the hexavalent vaccines were associated with an increased risk of SIDS. This study actually
VACCINE MYTHS AND MISCONCEPTIONS 11

provides further support that vaccines may help reduce the risk of SIDS (Vennemann et al.,

2007).

Another population based case control study was conducted in England from February

1993 to March 1996. The objective was to investigate whether the accelerated immunization

schedule program in the United Kingdom was associated with SIDS. The subjects in this study

were the parents of children who had died from SIDS. Researchers conducted interviews with

the parents to obtain information on the childs age, locality, time of sleep, and immunization

status. Controls were obtained for a five to one ratio of non-SIDS infants to SIDS infants and

potential confounding factors were then controlled for. The results of the study showed no

association between vaccines and SIDS. The researchers noted that the data suggested that

immunization does not contribute to the risk of Sudden Infant Death Syndrome and may protect

against it (Fleming et al., 2001).

Autism

One of the biggest misconceptions surrounding immunizations is that they cause the child

to be infected with or develop the autism spectrum disorder. The so-called link between

vaccinations and autism wascreated by junk science, dishonest researchers, professional

misconduct, outright fraud, lies, misrepresentations, irresponsible reporting, poor judgment,

celebrities who think they are wiser than the whole of medical science, and a few maverick

doctors who ought to know better (Hall, 2009).

In 1998, Andrew Wakefield, a British doctor, published in The Lancet, a medical journal.

He had done intestinal biopsies via colonoscopy on 12 children with intestinal symptoms and

developmental disorders (Hall, 2009). Ten of the children were autistic. Wakefield claimed to

have found a pattern of intestinal inflammation. Parents of eight of the autistic children told the
VACCINE MYTHS AND MISCONCEPTIONS 12

doctor that they thought their child had developed autistic symptoms right after getting the

measles, mumps, and rubella (MMR) vaccine. At the end of the published paper, Wakefield

included the disclaimer of "We did not prove an association between measles, mumps, and

rubella vaccine and the syndrome described." However, Wakefield soon after held a press

conference and said that the MMR vaccine probably caused autism and recommended giving

the three components separately with intervals of a year or more in between. The fact that the

three components of the vaccine are not available separately must have slipped Wakefields

mind. Because of this, people simply stopped vaccinating their children.

The immunization rate in the United Kingdom dropped from 93% to 75% and to 50% in

London. Confirmed cases of measles rose from 56 in 1998 to 1348 in 2008. Two of the

children died. In a hospital in Ireland, 100 children were admitted for pneumonia and

brain swelling caused by measles. Three of them died. Fourteen years after measles had

been declared under control in the U.K., it was declared endemic again in 2008. (Hall,

2009)

Wakefields data was later discredited. He made no attempt to compare the rate of intestinal

inflammation in autistic children to the rate in non-autistic children or to show that the rate of

autism was greater in children who got the vaccine and verify that autism developed after the

shot. The Lancet retracted Wakefields paper and he was charged with professional misconduct.

According to Hall (2009),two years before his study was published, Wakefield was hired by a

lawyer representing families with autistic children to research justification for a class action suit

against MMR manufacturers. The children were referred to Wakefield for the study. Eleven of

his twelve subjects became litigants. It was later found that Wakefield was paid about 500,000
VACCINE MYTHS AND MISCONCEPTIONS 13

pounds plus expenses by the lawyer to publish false findings or anything that would support the

lawyers case.

Unsafe Toxins

Usually when people express concerns about unsafe toxins in vaccines, they are referring

to formaldehyde, aluminum, or mercury. However, formaldehyde is harmless in small amounts

and is even produced naturally in the human body (Hall, 2009) and is produced in much higher

concentrations in our metabolism than in vaccines(S. Antony, Personal communication,

November 17, 2016). Aluminum helps enhance the body's immune response to an

antigen("Adjuvant," n.d.) and is not harmful (Hall, 2009). Also, aluminum is found in higher

doses in many other foods that are readily available, such as pickles and cheese spreads (S.

Antony, Personal communication, November 17, 2016). In 1998, the United States government

mandated the measuring of mercury in food and drugs. It was discovered that infants could get as

much as 187.5 mcg of mercury from the thimerosal in their vaccines. The mercury in the

vaccines was ethylmercury, a component of thimerosal, a preservative. It was tested and found to

be safe. The body is able to break down ethylmercury quickly and safely (S. Antony, Personal

communication, November 17, 2016). In 1929 in Indiana it was tested as a treatment in a

meningitis outbreak. Adults were injected with 2 million mcg (10,000 times the total amount in

all children's vaccines) and didn't develop symptoms of mercury poisoning (Hall, 2009). In

1999 the U.S. removed thimerosal from vaccines not based on evidence but as a precautionary

measure to appease the public.

Other unsafe toxins that the public might be worried about are ether, anti-freeze, and

human or animal tissue. Ether is sometimes used in the manufacturing process but is not used in

the actual vaccine. Antifreeze is ethylene glycol, which there is none of in immunizations. As
VACCINE MYTHS AND MISCONCEPTIONS 14

Hall (2009) says, to obtain enough virus to make a vaccine, the virus must be grown in tissue

from animal or human cells; but there is no tissue in vaccines. Apple trees grow in soil, but there

is no soil in applesauce.

No Need to Vaccinate

Although no unvaccinated person can be completely free of risk of acquiring a disease

in a community with a high vaccination rate, the herd effect significantly reduces the chances of

a unimmunized individual acquiring an infectious disease (Goodman et al, 2003, p. 339). Some

parents believe that because of herd immunity effect, their child can remain unvaccinated so the

child does not have to experience the risk of possibly having an allergic reaction. However,

choosing to not be vaccinated, as opposed to not being able to be vaccinated, weakens the herd

effect (p. 339). The herd immunity effect is when there are enough people vaccinated in a

community that the disease is no longer present even though some of the members of the

community are not vaccinated against the disease. Only a certain number of people in society can

not be vaccinated without compromising the herd immunity. The only people who should fall

into this category are those who absolutely cannot be vaccinated, such as newborns,

chemotherapy patients, and people with severe allergies to immunizations.

Conclusion

Obtaining and maintaining the herd immunity effect through vaccinations is vital to

societys overall health and well-being. The herd immunity effect protects those who are not able

to be vaccinated, such as chemotherapy patients, newborn infants, and those who experience

severe allergic reactions to vaccines.

We must acknowledge that vaccines, as with any medication, are not without risk to the

recipient and that vaccines, unlike other medications, are a medical intervention generally
VACCINE MYTHS AND MISCONCEPTIONS 15

administered to healthy people, and that vaccination has benefits beyond the individual

by creating and strengthening the herd effect. (Goodman et al, 2003, p. 341)

Throughout history, vaccines have progressively become more reliable and safer through

rigorous research. Vaccinations are held to a high standard of safety because of the large number

of children who must receive certain immunizations each year, required by school entry

mandates. The vast majority of children receiving the vaccine will not experience anything worse

than a short-lived redness or itching at the injection site. Weighing this against the potentially

life-threatening disease they might contract or spread, it seems that there is no contest saying that

vaccines protect more than they harm individuals and society.

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