Anti-vaccine activists love to employ the propaganda technique known as the Big Lie, which is a method of stating and repeating a falsehood, then treating it as if it is self-evidently true with the goal of swaying the course of an argument. Eventually, it is hoped by the proponents of the Big Lie, that it will be taken for granted, and not really critically questioned.
If you don't know much about the "Big Lie," Hitler, and his Nazi propaganda machine, used the Big Lie to blame all of Germany's problems, prior to World War II, on Jews, which may have contributed to the German people's support, either actively or passively, of the Holocaust. And that's what the anti-vaxxer does — provide the Big Lie until your average person can't tell the difference between scientific facts and anti-vaccine propaganda.
OK, I apologize. I went full-Godwin with this. In case you don't know, I'm referring to Godwin's Law, named after Mike Godwin, who asserted that "as an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches 1." In other words, in an online argument, it's almost a guarantee that someone will invoke a reference to Hitler or Nazis as the discussion gets more and more heated.
However, since the Big Lie was the cornerstone of Nazi propaganda, and it seems to be the same for the anti-vaccine gang, then is it really a Godwin? Probably not.
Let's take a look at how the anti-vaccine world practices the Big Lie.
The anti-vaccine world and the Big Lie
It's ironic that some of the basic anti-vaccine ad hominem hate speech tends to be extremely antisemitic, especially towards the publicly Jewish members of the pro-vaccine/pro-science side. It's doubly ironic that anti-vaccine activists utilizesNazi propaganda strategies while claiming that vaccination, especially mandatory vaccination, is somehow a modern-day holocaust. Truthfully, there's really not any mandatory (and certainly not forced) vaccination of anyone in the developed world. There are so many loopholes for those who refuse vaccines through various exemptions, that mandatory is truly not that mandatory.
Of course, comparing vaccinations to the Holocaust is a form of Holocaust denial, just as dangerous as climate change denial, evolution denial, or all other forms of denialism. In this case, comparing vaccination, which saves lives, to the Holocaust (in this definition, the murder of European Jews), which ended the lives of 6 million innocent human beings, either betrays their lack of knowledge of vaccines and the Holocaust or worse, that they think that vaccinations are somehow equivalent to the murder of 6 million Jews. Since vaccines are safe and effective, and that's settled science, and only a literal handful of children have ever died from vaccines, it is disgusting that anti-vaxxers compare the two.
For the anti-vaccine world, the Big Lie is not just one lie, it's a series of lies that have been repeated so often that even people who might be open-minded to vaccines are reluctant to vaccinate their children because they conflate the lie with scientific fact. Let's go through some of the big ones.
Vaccines have mercury
No, they don't (pdf). They never have had mercury. One vaccine, the multi-dose adult flu vaccine, contains a compound, thiomersal (also known as thimerosal), which is an additive that blocks bacterial growth. Thiomersal is a molecule called ethyl-mercury, which is extremely safe. Elemental mercury, which is the liquid-silver metal that we used to see in thermometers, cannot go into solution, so no one pours mercury into the vat making vaccines.
Ethyl-mercury is a form that is water-soluble and envelops the mercury atom, making it relatively safe. In addition, because it's water-soluble, it quickly flushes from the body, so it does not accumulate. If you want a dangerous form of mercury, go eat a can of tuna fish, which contains methyl-mercury and does accumulate in the body. Conflating elemental mercury with these organic forms is either ignorance of basic chemistry or an intentional lie. The end effect is the same — some well-intentioned people wonder if vaccines contain poison.
Just as an example of how chemistry works, elemental sodium is quite dangerous. Consume that, and you would explode. Elemental chlorine is quite dangerous, a gas that can kill quickly (and ironically was used by the German Army in WWI to kill Allied soldiers). However, you can create salt from elemental sodium and elemental chlorine, which makes your food tastes better. When I sprinkle table salt on my popcorn, I'm not consuming sodium and chlorine, I am consuming a salt of sodium ions and chloride ions.
And thiomersal is unrelated to and does not cause, any known neurodevelopmental disorder. Moreover, thiomersal-containing vaccines are unrelated to autism.
This Big Lie has been so debunked by so many people, that it really should be retired from the list of the anti-vaccine Big Lie list — but that's the thing about the Big Lie, it never hurts to keep repeating it, because some people will think that it's a fact.
Vaccines are dangerous
No, they aren't. But let me be clear, I don't think that any medical procedure, including vaccines, is 100% safe 100% of the time. I am a scientist, and I know that there is no such thing as perfection. An absolutist viewpoint, that vaccines must be 100% effective and 100% safe, is unscientific, but too many people in the anti-vaccine world embrace the Nirvana fallacy — if it's not 100% safe, it is worthless.
As we all know, pseudoscience, woo-pushing alternative medicine charlatans claim that they have a cure for cancer is painless and perfect, while real science-based medicine knows that there is no "cure" for cancer, and any specific treatment for a specific cancer type has a chance of failure. It also can be difficult and painful. The former will not "cure" cancer of any type, while the latter has a chance to do so.
Despite my caveats about medical procedures, vaccines are extremely safe with amazingly tiny risks of serious adverse events. This particular Big Lie is based on misuse of information.
First, the anti-vaxxers troll vaccine package inserts to find all of the adverse events listed. But vaccine package inserts are legal documents and information about vaccines (or truly of any drug) that must be read carefully. For example, the list of adverse events is just reactions observed during the clinical trial without any information about causality. In the most simple terms, anything that happens, without regard to a true relationship to the vaccine, is listed.
The only way to tie a vaccine to particular adverse events requires a clinical trial or some sort of case-controlled epidemiological study with large numbers that help tell us if there's a link. In fact, just at a basic level, most of the adverse events listed (except ones that actually are related to vaccines like pain at the injection site) are not compared to what might be the background rate of that event in the general population.
I use this analogy to help understand it. The annual risk of a fractured bone in children under the age of 16 appears to be around 180 per 10,000. The risk goes up and down depending on a number of factors. Let's say a particular vaccine listed in the adverse events that 5 out of 3000 studied also had broken bones.
Oh no! Vaccines cause broken bones. But not really. Setting aside the scientific issue with plausibility, by what mechanism could we imagine a vaccine causing weaker bones, while the numbers are too small to make any kind of statistical conclusion. If you do a study with a million vaccinated kids and find that 25,000 had broken bones, a rate above the expected level for a "normal" population, you might wonder.
So why do package inserts include all that scary stuff? Well, partially it's a legal/regulatory document that has the function of protecting companies against potential regulatory or legal action. Throw everything in there, just in case it's really an adverse event. As I mentioned previously, the only way to find real adverse events is to review controlled studies which are powered to separate real adverse events from background noise. Almost everything in a package insert is background noise.
The second "source" for the Big Lies about the dangers of vaccines is dumpster diving through the VAERS (Vaccine Adverse Event Reporting System) database, which is a system to capture patient and physician reports about vaccines. The problem with the database is that it is not scientific. Anyone can report anything, and the system cannot distinguish between causality, correlation, and randomness. As the VAERS website states:
VAERS is a passive reporting system, meaning that reports about adverse events are not automatically collected, but require a report to be filed to VAERS. VAERS reports can be submitted voluntarily by anyone, including healthcare providers, patients, or family members. Reports vary in quality and completeness. They often lack details and sometimes can have information that contains errors.
In simple scientific terms, these are observations, even anecdotes. On the hierarchy of scientific data, this information barely rises above the bottom of the barrel. VAERS can be useful as a tool to see potential issues, but it needs to be confirmed by controlled clinical or epidemiological studies before stating some sort of the evidence-based change in vaccination policy. Real scientists do examine the database, and so far, little conclusive information has been found. Unless you are an anti-vaccine zealot pushing the Big Lie.
No real science-based vaccine proponent will state that vaccines are absolutely safe. But what we will say is that the tiny risks of vaccines are overwhelmed by the scientifically established benefits.
Vaccines didn't eliminate diseases
Read enough of the anti-vaccine Big Lie propaganda, and you'll see that they not only deny basic science, but also basic history. I consider this particular Big Lie to be one of the most intellectually dishonest of the anti-vaxxers. Essentially, the anti-vaxxers believe, with a straight face, that vaccines did not stop smallpox, polio, or name your disease.
Mostly, the vaccine deniers claim that vaccines were irrelevant — nutrition and sanitation conquered all of these diseases. I have no doubt that better nutrition and sanitation had some effect on the rate of these diseases, but they couldn't have actually eliminated them.
But this Big Lie is actually more complicated, much more complicated. The antivaccination gang focuses on the mortality rate of these diseases, which did indeed drop, probably as a result of better medical care available to more children just when the drop happened. But the diseases never went away.
And one more thing–the mortality rate never dropped to zero. For some reason, which drives me nuts, the vaccine deniers quickly dismiss that vaccines might "only" save a few hundred lives from measles. Maybe they think that those few hundred lives are genetically inferior to them–oh wait, I'm going Godwin again.
But there's actually recent, real-life, evidence of the success of vaccines. The Haemophilus influenzae type B (Hib) vaccine, which has been shown to be effective in preventing meningitis in children, was introduced in 1990. The rate of Hib infection has dropped, in the USA, from 20,000 children (leading to about 1200 deaths) per year in 1990 to 7130 cases (and 1050 deaths) in 2019. The number would be much lower if the Hib vaccination rate were higher. And we can assume that the sanitation system of the USA didn't suddenly improve from 1990 until today. Nor did our children's nutrition suddenly improve.
Most people who catch these diseases are vaccinated
This Big Lie is based on one of the most ridiculous misunderstandings of simple mathematics and statistics. The anti-vaxxers will take a small sample size in a disease outbreak to state forcefully to anyone who will listen, that more people who are vaccinated catch a particular disease. This ranks as one of the most egregious examples of bad math, which morphs into one of their most beloved of their Big Lies, employed by the antivaccination forces everywhere.
We should look at some simple math. Let's assume there is a population of 10,000 people, living in a small town in Nebraska, 95% of whom are vaccinated against COVID-19. So, that means that 500 are not vaccinated, and 9500 are. A local COVID-19 outbreak occurs because an anti-vaccine family decides to wear a mask while attending a large political rally where no one wears masks. They come back home with the highly infectious disease.
COVID-19 is highly contagious, so let's assume that the whole town is exposed, and about 50% of the town becomes infected. Thus, out of the 500 unvaccinated individuals, we would predict that about 250 would be infected with COVID-19.
The COVID-19 vaccine is about 90% effective, so, of the 9500 vaccinated individuals, about 950 might be susceptible to the disease. If 50% of the susceptible and vaccinated people actually catch COVID-19, we'd expect about 475 would eventually become infected, a number that appears, on the surface, to be nearly double what we observed in the unvaccinated group, "only" 250 individuals.
So the anti-vaccine activists who employ the Big Lie would push these numbers saying, "vaccinated people are more at risk of COVID-19 than unvaccinated. Vaccines are really useless and dangerous, because only 250 unvaccinated people caught the disease, whereas 475 vaccinated people became infected."
But that's not the way to look at it statistically. It's not the raw numbers that matter, but it's the risk and rate. In my simple math example, the rate of infection for the unvaccinated is 250 out of 500, a 50% risk. The risk of infection for the vaccinated group is 475 out of 9500, with a 5% risk of contracting the disease. I'll take a 5% over a 50% risk any day.
If we focus, as we should, on the risk of contracting COVID-19, the risk of disease falls from 50% to 5% from unvaccinated to vaccinated.
This Big Lie tries to run a feint by misusing the simplest of math, which is ignoring the rate and focusing on the raw numbers, rather than actually doing real science and examining the risk and rate. This Big Lie is so fundamentally bogus that you'd think they would stop. But I see this particular Big Lie over and over in "debates" (there isn't a debate) about vaccines.
It's all about Big Pharma profits
This is ridiculous on so many levels. This Big Lie claims that Big Pharma is just out for profits on vaccines, so they, are usually in league with the CDC, FDA, WHO, and (place name of your favorite conspiracy organization here). It might make a great story, except it's ridiculous.
Let's be clear. Big Pharma, in general, is made up of for-profit organizations. They need to create profits, and they need to sell medicines, supplies, equipment, and devices. It's capitalism, but Big Pharma provides most of the tools that allow us to live healthier and longer..
The Big Lie claims that Big Pharma sets aside everything for the almighty bar of gold. But, Big Pharma isn't made of one megalomaniac executive, it's made up of scientists, physicians, engineers, salespeople, accountants, and management — thousands upon thousands of people. The implication that there is some scientist discovers that smoking weed cures every cancer known to man (no, it doesn't) and prevents every preventable disease out there, then destroys the evidence so that the Big Pharma corporation can continue to make profits on cancer drugs and vaccines is patently ridiculous.
It's clear that those who push this Big Lie are bought out cheaply and have no morals, so they apply their moral and ethical code to people who work at Big Pharma. In fact, most Big Pharma companies know that they actually make more and more money if they make products that work, products that don't harm, and products that save lives.
But let's assume that the Big Lie is right, and Big Pharma is so immoral that the only thing that matters is pushing vaccines to make money. Well, given the extraordinary cost of researching, manufacturing, marketing, and shipping vaccines, a true profit- and revenue-driven Big Pharma would probably think that there has to be a better way.
In fact, they'd make several times more profits if they quit selling vaccines and focused on providing all of the medications and products for all of those hundreds of thousands of children and adults that end up in hospitals.
Maybe all the money being spent on the antivaccination groups is really funneled in from Big Pharma. I'm not really saying, just saying.
Conclusion about the anti-vaccine Big Lie
- Vaccines have mercury — Big Lie
- Vaccines are dangerous — Big Lie
- Vaccines didn't eliminate disease — Big Lie
- Vaccinated people catch diseases more than unvaccinated ones — Big Lie
- Vaccines are the most important profit factor for Big Pharma — Double Big Lie
The vaccine deniers really don't have any real scientific evidence to support their beliefs, so they need to make it a propaganda war (not a debate). They need to push these lies to either make them feel better about putting their children (and everyone's children) at risk of vaccine-preventable disease or because they have some underlying personality disorder that makes them feel good about pushing misinformation and outright lies about vaccines.
It's frustrating, but once you see that it is an anti-vaccine Big Lie, maybe we can stop it in its tracks. Because if we suddenly stop vaccinating kids and adults, we will have a real Holocaust of dead and dying humans, not an imaginary, invented one.
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