Talk:Vaccine hesitancy

This article was the subject of a Wiki Education Foundation-supported course assignment, between 8 January 2019 and 16 April 2019. Further details are available on the course page. Student editor(s): Mcguigan.m (article contribs).

Reason for Controversy

Along with religious and political reasons to avoid vaccines, parents choose not to vaccinate their children due to the fact that they are too young to experience serious diseases. Vaccines were invented in the 18th century, and were used quite frequently since then. Because of vaccines, many serious illnesses have been wiped out. Parents in this generation have not seen what polio, for example, can do to someone, so it is much easier for them to say that their children do not need to be vaccinated. This can cause major problems down the road.

References

Autism and aluminium adjuvants

The article incorrectly states that there is "no evidence" of vaccinations being linked to autism. This wording is inaccurate, as there is evidence, even if it has been deemed inconclusive, or outweighed by other evidence. See these studies, for instance. I haven't evaluated them all, but I find it hard to believe that every single one of these so flawed as to invalidate all results. It would thus be more correct to say, "the bulk of evidence strongly suggests no relationship between vaccines and autism."

Except that may no longer be true. In the last two years important evidence has emerged to link aluminium adjuvants to autism. Brain tissues of teenagers with autism were found to contain extremely high quantities of aluminium in microglia and astrocytes, and it appeared to have been carried into the brain by inflammatory cells. The strong suggestion is that these inflammatory cells had become heavily laden with aluminium in the blood and/or lymph, as has been observed for monocytes at injection sites for vaccines containing aluminium adjuvants.

See https://www.sciencedirect.com/science/article/pii/S0946672X17308763 and https://www.nature.com/articles/srep31578, as well as this blog post from one of the authors, explaining concisely and simply what the research indicates.

This is not conclusive yet, but it strongly suggests a relationship between aluminium adjuvants and autism. From what I can make out, the authors are reputable and the journals they have published in are prestigious. I have searched for articles or letters disputing their findings, and have not found any. Fuzzypeg★ 00:30, 15 May 2018 (UTC)

It should say "no credible evidence, and abundant evidence to the contrary". No, the evidence is not "important". It is anti-vax bingo. The claims about thimerosal were shown to be utterly bogus, so they paid Exley nd others (see the funding sources and follow he money) to publish a new "hypothesis" about aluminium. Some of those papers are already retracted. Guy (Help!) 21:13, 15 May 2018 (UTC)

So you're saying that every one of the articles I've linked to has been demonstrated to not be credible: either fatally flawed in its methods or an outright hoax. I'm particularly interested in the last two articles I cite, from the Keele University researchers, https://www.sciencedirect.com/science/article/pii/S0946672X17308763 and https://www.nature.com/articles/srep31578 : can you point me to the rebuttals?

I know a lot of papers have refuted links between autism and MMR vaccines, or themirosal. I don't see such refutations regarding aluminium adjuvants, though. On the contrary, the picture I see emerging from the literature is: Autism incidence has increased rapidly over the last 30 years and only 20-25% of that increase can be attributed to reporting practices (https://ehjournal.biomedcentral.com/articles/10.1186/1476-069X-13-73); this rise has correlated with a rise in use of Al adjuvants (https://ehjournal.biomedcentral.com/articles/10.1186/1476-069X-13-73); adverse affects to Al adjuvants have been observed in humans (https://www.tandfonline.com/doi/abs/10.3109/10408444.2014.934439); Al administered to mice in vaccine-relevant amounts is associated with adverse long-term neurological outcomes (https://www.sciencedirect.com/science/article/pii/S0162013413001773); aluminium contaminants fed intravenously to prem babies are correlated with adverse neurological outcome (https://www.nejm.org/doi/full/10.1056/NEJM199705293362203). Mechanisms have been proposed for Al's enhanced toxicity in the brain (http://www.ingentaconnect.com/content/ben/cic/2012/00000002/00000001/art00006). The 'Trojan horse mechanism' proposed by Shaw and Tomljenovic now seems to be corroborated in the last couple of years by the Keele University researchers, who have directly observed extremely high levels of aluminium in autistic teenagers' brain tissue, and found evidence of it having been transported into the brain by heavily laden monocytes.

I see a few naive dismissals of aluminium as a potential toxin on the basis that oral exposure to aluminium exceeds that of intravenous exposure, but there are many reasons to believe that the physiological response is very different in these two cases: not least the fact that concentrations of monocytes heavily laden with aluminium have been observed around injection sites, as the Keele researchers note.

I've spent a little time browsing the subject using google scholar. I see a large body of evidence consistently pointing to a likely link between aluminium adjuvants and autism. I don't see any strong evidence contradicting that picture. I think this article should reflect the science. Fuzzypeg★ 04:49, 17 May 2018 (UTC)

Please list a few articles which 1) demonstrate a clear link between aluminium and autism. 2) Are in a respected journal. 3) Have not been retracted. 4) Don't have a number of others pointing out the flaws in their papers. 5) Are not by an author who seems bent on proving such link. Unfortunately, there seem to be many papers published with poor experimental design. As well as authors who are doing experiments who are convinced of the link before they do the study - which is really a bad way to do science.

I and other would prefer not to vet articles for you. Thank you Jim1138 (talk) 19:49, 17 May 2018 (UTC)

First and foremost, hundreds of studies from dozens of countries encompassing tens of millions of children over several decades have consistently failed to support any link, causal or otherwise, between vaccines and autism. Speculation on how vaccines cause autism may be a favourite activity among antivaxers, but the fact is that they don't.

doi:10.1016/j.jtemb.2017.11.012 is by Christopher Exley, and was paid for by Children’s Medical Safety Research Institute, funded by the Dwoskin Foundation. Claire Dwoskin was a board member of the National Vaccine Information Center, the Orwellian-titled antivax group (https://leftbrainrightbrain.co.uk/2015/02/06/cnn-the-money-behind-the-vaccine-skeptics/). It covers 10 samples and is methodologically terrible.

doi:10.1038/srep31578 is also Exley, also funded by Dwoskin, and is unbelievably speculative.

doi:10.1186/1476-069X-13-73 is a single-author paper, is contradicted by much larger and more robust studies, and acknowledges Mark Blaxill, a well-known antivaxer and conspiracy theorist.

doi:10.3109/10408444.2014.934439 says nothing about autism and its comments about vaccines appear wholly speculative, it also suggests a link between aluminium and Alzheimer's, whihc has been comprehensively studied and found not to be true.

10.1016/j.jinorgbio.2013.07.022 is by the much-retracted duo Shaw and Tomljenovic, and involves mice - is this the one where they also gave them a neurotoxin? Or was that another of their crappy papers?

doi:10.1056/NEJM199705293362203 is about intravenous feeding, so not relevant.

The one in Current Inorganic Chemistry is in a non-medical journal and is by Russell Blaylock, who seems to support a grab bag of debunked conspiracy theories.

So, a lot of motivated reasoning, some conflicts of interest, and a total of pretty much zero actual in-vivo work on humans, amounting to a pile of tooth-fairy science. And again, there is a mountain of research showing there is no link. As Harriet Hall reminds us, before we try to explain something, we should be sure it actually happened.

Also: Déjà-moo - the uncanny feeling you've heard this bull before. Guy (Help!) 20:41, 17 May 2018 (UTC)

Thanks, this is very helpful. I've found a couple of critiques of Exley's work as well, which make sense: no control, and lots of uncertainty around what substance actually got dyed, what reference levels should be, and what cells those substances were found in. I'm surprised that these critiques appear in the blogosphere and not in journals. I didn't find them using scholar.google.com, and I would have thought that back-and forth debate would be much messier in the blogosphere and more likely to devolve into bunfighting. According to WP's reliability standards, are the peer-reviewed articles under critique considered more reliable than the blogged critiques? Seems odd and not entirely satisfactory.

I am coming at this as an amateur with some scientific and research experience. I could see immediately that this article contains false hyperbole ("no evidence"). That false claim encouraged me to seek what evidence there actually was, and then seek opposing views (which I didn't initially find).

While there may be a desire to not encourage anti-vaxers by conceding anything, the statement about "no evidence" is (a) not quite true, (b) uninformative and patronising, (c) a red rag to any amateur researcher. I would encourage saying "no credible evidence" rather than "no evidence". I also recommend explaining the aluminium claims and their counter-evidence as you have done for thimerosal and MMR. Especially, it would be useful to cite some research that addresses vaccines containing aluminium adjuvants (e.g. DTP vaccine): you say there is a mountain of such research, but what I've found so far focuses on MMR vaccines, thimerosal and mercury. It would be very helpful to fill that gap. The article should ideally lead me to everything I need to read to understand the current state of play.

If I can find time I could try to make a start, but as I say, I don't have all the research at hand. Even one large-scale study covering aluminium-containing vaccines such as DTP would be a great help. Thanks again. Fuzzypeg★ 00:06, 29 May 2018 (UTC)

In matters of anti-vaccine activism, "amateur researcher" is unfortunately synonymous with Google-driven confirmation bias (nothing about you here, that's my observation form the outside world). Bear in mind that a couple of years ago near-identical claims were made about mercury (the preservative thimerosal is a mercury salt). Despite the absence of any credible evidence of risk, thimerosal was removed from virtually all childhood vaccines, with exactly zero effect on autism rates. It has finally become impossible to ignore this, so they have switched to aluminimum, and that is exactly how it always goes. Oceania has always been at war with Eastasia. I remind you: before investigating how something happens, it's wise to first establish whether it does. Vaccines do not cause autism. There is no link between vaccines and autism. Vaccine ingredients do not cause autism. And the cottage industry of anti-vaccine autism quackery will do anything in its power to try to make that not true, because it is not actually about autism, it is, always has been, and always will be, about vaccines. Guy (Help!) 08:58, 29 May 2018 (UTC)

Thanks Guy, I've looked through the report you linked from the CDC, and the research they cite (1,2,3). Buried in all that (in the IOM report) is mention of only one study examining risk of autism after an Al-containing vaccine (which in fact claimed there was such a risk), which was dismissed for methodological reasons. The authors of the IOM report therefore could not conclude anything for or against a link between that vaccine (DTP) and autism.

The Taylor, Swerdfeger & Eslick meta-analysis is behind a paywall, but examining their references they appear to only cite studies on non-Al-containing vaccines, with a focus on MMR and thimerosal.

So there is a substantial body of distrusted evidence positing a link between Aluminium adjuvants and autism, but as yet no research that you or I have unearthed to vindicate aluminium adjuvants. Please, no more vague statements about a "mountain of research". If you know of even one paper, please cite it. Fuzzypeg★ 09:46, 7 June 2018 (UTC)

You can complain about the nature and amount of sources all you like; unless and until you show an equal or greater weight of contradicting sources, there is nothing to be done here. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 13:31, 7 June 2018 (UTC)

You're not following. I've seen there is a body of disputed research suggesting a link between aluminium adjuvants and autism. Now I'm trying to find any contradicting research that addresses aluminium adjuvants and autism, or any aluminium-containing vaccine such as DTP and autism. Or any research on autism and vaccines generically, as long as Al-containing vaccines are included in the study. Neither Guy nor I have turned up anything yet, and I'm asking for help. My only complaint about the nature and amount of sources is that I haven't seen a single one yet. Any help would be appreciated. Fuzzypeg★ 22:27, 7 June 2018 (UTC)

The fact that vaccines have no demonstrated link to autism would indicate that aluminum adjuvants in vaccines don't have a link to autism. One would only start looking for the vaccine-component causing autism if the vaccine was demonstrated to be a cause of autism. It would seem to be a waste of time and money to do so. Jim1138 (talk) 22:51, 7 June 2018 (UTC)

There are disputed demonstrations of a link between vaccines containing aluminium adjuvants and autism going back several years, and autism/vaccines is an area of intense public interest. Given that, I can scarce believe that there has been no counter-research. Such counter research need not even mention aluminium as long as it addresses a vaccine that contains aluminium; so an epidemiological study of autism and DTP, for instance, would be a great find. But I can't find even that. Fuzzypeg★ 00:26, 8 June 2018 (UTC)

You do realize that WP:NOTFORUM applies? If there is a proposal to improve the article, please make it. Otherwise, please find another website to seek evidence. Johnuniq (talk) 03:46, 8 June 2018 (UTC)

Seconded. Furthermore, this is a non-starter for the talk page to begin with. Either you're not proposing a change of content, in which case we have a bit of a problem here, or you're proposing that we add to the article a meta-analysis we performed ourselves on the available literature, for the purpose of intentionally softening our tone regarding the possibility of a link between vaccines and autism, in which case we have an entirely different problem.

The good news is that either problem is easy to fix. In the first case, we simply end this discussion. In the second case we simply start an entirely new thread.

As a final, general note, I would like to add that there are plenty of sources disputing any link between aluminum and autism: Every reliable source that lists adverse effects of aluminum exposure and does not include "autism" on that list is -inescapably if implicitly- disclaiming any such link. There are at least two used in the article already, one of which focuses on the aluminum content of vaccines.ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 19:41, 8 June 2018 (UTC)

No, the overwhelming preponderance of evidence shows no link between vaccines and autism. You don't balance that by citing a few crappy studies that are "disputed" because they are worthless, and you certainly don't fix it by proposing conflicted junk science (which, incidentally, keeps getting retracted, another four pulled in recent weeks) attempting to show the mechanism for a thing that doesn't happen. Guy (Help!) 20:13, 8 June 2018 (UTC)

On the whole no link to Autism conclusion which I do agree with I feel like it is a little short. Seeing as this seems to be one of the main reasons why parents are not vaccinating their kids I think more of can be said on it. later I'll probably add some more if that's ok? KodyForinger (talk) 03:05, 31 October 2018 (UTC)

I refer you to the replies above and below. You need reliable independent secondary sources meeting WP:MEDRS. The autism thing was ginned up by antivaxers, thimerosal is pretty comprehensively disproven so they have plucked another supposed rationale out of their arses. We're not going to give it the time of day until there is some decent science. Guy (Help!) 09:20, 31 October 2018 (UTC)

The controversy about "autism" is a red herring that derives in pointless discussions about its inconclusive causes. The definition of the term has been expanding to encompass an ever broader range od cognitive impairments. By labeling all of them as "autism" and forcing a "genetic cause" into the definition, vaccine-ibnduced brain injury can be plausibly denied. Long-term persistence of vaccine-derived aluminum hydroxide is associated with chronic cognitive dysfunction, see "Biopersistence and Brain Translocation of Aluminum Adjuvants of Vaccines". However, vaccine-caused brain damage clearly exists, whether it's "autism" (by the shifting definition) or not is pointless, still those affected experience a permanent, life-changing cognitive regression that they don't deserve. 145.64.134.242 (talk) 09:16, 22 March 2019 (UTC)

Individual liberty

@Shock Brigade Harvester Boris: I didn't think I was removing material, I was removing the specifically US part because I didn't see a need to single out the US controversy when the source describes similar controversies and arguments in various times and places, and I didn't see anything in the source that talks about a public-private merger. Did I miss something?. Tornado chaser (talk) 22:43, 13 October 2018 (UTC)

It's an interesting one because while antivaxers always spin this as individual liberty, there is an equal case for presenting it as child endangerment, as with the wilful withholding of any other potentially lifesaving medical treatment. Guy (Help!) 10:01, 21 October 2018 (UTC)

@JzG: An interesting what? It is not clear if you are proposing any change to the article or just commenting on the general issue, if you think the article needs to be changed in any way, please be more clear. Tornado chaser (talk) 16:42, 21 October 2018 (UTC)

Tornado, stop the edit warring. This is a sensitive topic with real life deadly consequences. Anti-vaxxers are child abusers. "They kill children." Bill Gates. There's a special corner of hell reserved for them. -- BullRangifer (talk) PingMe 17:05, 21 October 2018 (UTC)

Edit warring? Part of my edit was reverted for reasons I did not understand, so I left a message on the talk page pinging the user who reverted me, I know my ping went through, so I waited for a response, after 2 weeks I restored my edit, with an edit summery that said it was OK to revert as long as you were willing to discuss your objections to my edit, that is not edit warring. Tornado chaser (talk) 17:17, 21 October 2018 (UTC)

@BullRangifer: Do you object to my edit itself or just because you considered it edit warring? Tornado chaser (talk) 17:30, 21 October 2018 (UTC)

Both. It's generally wrong to remove properly sourced content. See WP:PRESERVE. If you think there is some sort of lack of balance, then fix the problem by adding, not removing.

Otherwise, get consensus for making such a change, especially since your deletion was challenged. See WP:BRD.

I didn't notice the 8 days (not two weeks), so edit warring might have been a bit strong, but seeing whose content you deleted, I would have been very cautious. @Shock Brigade Harvester Boris: is a very experienced and respected editor who knows what he's doing.

You wrote: "I didn't think I was removing material, I was removing the...." So you were removing material. Period. Don't try to use that admission as a defense. -- BullRangifer (talk) PingMe 18:20, 21 October 2018 (UTC)

Thanks for the kind words although I don't deserve any consideration beyond other editors. User:Tornado chaser reverted my change and attempted to open discussion but I didn't have a block of time available to make a detailed reply and eventually forgot about it -- my editing is mostly in brief moments when I need a break from what I'm supposed to be working on. So that was my fault. While I of course think my revert was justified better sourcing is always a good thing. Shock Brigade Harvester Boris (talk) 20:11, 21 October 2018 (UTC)

Tornado chaser's edit was weaselly junk, the revert was good. Alexbrn (talk) 17:35, 21 October 2018 (UTC)

@Alexbrn: I am open to constructive criticism and alternate suggestions for wording, but calling my edit "weaselly junk" is not helpful. I want to fix some issues with the current wording, so please tell me what was wrong with my edit. Tornado chaser (talk) 17:46, 21 October 2018 (UTC)

Maybe you should discuss (not edit) the issues you'd like to fix. Let's work on it. Maybe a consensus can form around your proposed improvement. -- BullRangifer (talk) PingMe 18:20, 21 October 2018 (UTC)

I see how my original post here was confusing, what I am trying to say is that the content I want to remove is not well supported by the source. The source cited does not talk about a public-private merger at all, and it dosen't say that in the US opposition is specifically from anti-govt or libertarian groups or that anything about the US controversy is significantly different from the european controversies, in fact the source says that the controversies are very similar in different times and places. Tornado chaser (talk) 18:50, 21 October 2018 (UTC)

The sentence "In the United States, mandatory vaccination laws sometimes provoke opposition from members of anti-government or libertarian factions, who express concern for what they view as the intrusion of the government into their private lives." is not supported by the source cited, if you don't want me to remove this, please explain why. Tornado chaser (talk) 19:50, 27 October 2018 (UTC)

Doctors dismissing patients, ethical issues

@JzG: Regarding this revert[1] I have a few questions, first which of the authors were anti-vax? (I have never heard of any of them). Second, would you still object to saying that there may be ethical issues with doctors dismissing unvaccinated patients if a better source was used? Third, why is MEDRS the sourcing standard you are applying to this? I thought regular RS would work because this is describing an ethical controversy rather than making statements of fact regarding the effectiveness of any medical intervention. Tornado chaser (talk) 23:29, 26 October 2018 (UTC) @Bilby: pinging to inform of this talk page section, given related edit. Tornado chaser (talk) 03:16, 27 October 2018 (UTC)

The article is published in the peer-reviewed Paediatrics & Child Health, which is in turn published by the Canadian Paediatric Society - it is a decent journal and a peer reviewed paper rather than an op-ed. While I don't know all of the authors, one of them is Noni MacDonald, who is highly regarded for her research into vaccine acceptance [2]. The other three co-authors are all from the Canadian Center for Vaccinology, Health Policy and Translation Group based at Dalhousie University. I can't see an issue with the reference, and the point being referenced is largely self-evident and well covered in multiple sources [3], [4], [5]. - Bilby (talk) 03:36, 27 October 2018 (UTC)

It's an old article and states opinion. The real problem is that this was presented as a view without the balancing view that it's actually the parents who are the problem. I have added more sources and content to make that point. It's a difficult question, framed by antivaxers as a simple case of "my choice is my right", but in fact their choice is an objectively bad one made on behalf of others to whom they bear a legal duty of care and imposes a non-zero risk on others who have no choice (e.g. the immunocompromised). It's a bit like stating that refusing to allow someone to drive because they routinely drive while drunk might endanger their children because they won't be able to get to school or a doctor's appointment. Guy (Help!) 10:48, 27 October 2018 (UTC)

It would have been helpful if you had explained that rather than using a false edit summary. I'll dig around and see what we can do to further develop the section. - Bilby (talk) 12:49, 27 October 2018 (UTC)

It wasn't a "false edit summary". It was, however, a case of mistaken identity: there is an antivax nurse with a similar surname. And yes, it is op-ed.

I still have a problem with the way this is all framed, as it succumbs to the classic antivax trope of ignoring all externalities. By begging the question of whether parents' choice to fail to protect their children from infectious disease is legitimate, and ignoring the risk they pose to others, thus they argue narrowly that the medical establishment is acting unethically, when the correct response to a doctor's refusal to accept an unvaccinated child is actually to vaccinate the child. Guy (Help!) 14:04, 27 October 2018 (UTC)

Isn't the risk posed to others addressed under "Individual liberty"? Also, while the correct response to a doctor's refusal to see an unvaccinated child certainly is to vaccinate the child, this is not necessarily what the parents will do (if they were rational they wouldn't be refusing vaccines in the first place) and the idea that it could be unethical to dismiss the child is a legitimate point of view that belongs in the article. Tornado chaser (talk) 14:20, 27 October 2018 (UTC)

The question is not whether any specific response to an unethical action is itself ethical, but what is the most ethical response to the unethical action. In this case, it's to stop the unethical action and vaccinate your goddamn kids. Guy (Help!) 14:35, 27 October 2018 (UTC)

That's great and all, but not what is being discussed. In situations where vaccination is not mandatory, the medical profession needs to determine to what extent they can refuse to treat a voluntarily unvaccinated child, given the risk a child carries to those who are medically unable to be vaccinated, and the alternative risk of refusing to treat an unvaccinated child who is suffering from a medical issue in regions where other doctors may not be available. There's a fair bit of recent discussion of this issue in the literature. - Bilby (talk) 14:47, 27 October 2018 (UTC)

Which American cities have only one paediatrician? Regardless, the ER will always treat any medical emergency. Guy (Help!) 21:07, 27 October 2018 (UTC)

First off the source was talking about Canada, and it did say there was a doctor shortage, also, what if there are 2 or 3 pediatricians in town and they all won't see an unvaccinated child? The ER is not a substitute for the pediatrician's office, and is not well suited to managing chronic issues. Anyway, our personal opinions on this don't matter, what matters is that RS describe this as a legitimate controversy, so both sides deserve mention in the article. Tornado chaser (talk) 21:30, 27 October 2018 (UTC)

The child has a right to be protected from preventable disease. The parents have the right to wrong their hands about it and give them homeopathic cures for mercury poisoning if they like. Guy (Help!) 22:25, 21 November 2018 (UTC)

#ICanHazPdf

https://www.medscape.com/viewarticle/902956 - may be relevant but paywalled. Guy (Help!) 21:43, 30 October 2018 (UTC)

Yep, I can't see it. :/ TylerDurden8823 (talk) 05:36, 13 November 2018 (UTC)

Medscape has "free" registration. Just fork over some info: name, country, work-zip, email, and profession - I selected non-professional. Jim1138 talk 07:18, 13 November 2018 (UTC)

I had completely forgotten about that! I confused it with another site that requires proof of professional registration. Thanks. Guy (Help!) 10:54, 13 November 2018 (UTC)

Question

@Natureium: I didn't understand the purpose of this edit[6] so I reverted it, but i'm giving you an opportunity to justify your edit here. Tornado chaser (talk) 03:25, 13 November 2018 (UTC)

I thought it was fairly obvious, and I tried to explain what I was doing in my edit summaries. That section is focused on a particular incident, and the placement of those sentences suggest WP:SYNTH. Natureium (talk) 03:29, 13 November 2018 (UTC)

@Natureium: The source cited says that Wakefield visited around the same time that people were becoming concerned about autism anyway, implying that he exacerbated the fear of autism, I thought the article as it was accurately reflected the source. Tornado chaser (talk) 03:33, 13 November 2018 (UTC)

Lead

@Alexbrn: The lead as currently written implies that every vaccine safety scare is unsubstantiated, in light of the recent issues in China and the Philippines, this should be adjusted, I don't know exactly what the best wording would be, but as currently written this seems to be too US-centric. Tornado chaser (talk) 22:14, 21 November 2018 (UTC)

Don't know about the US, but inserting original ideas not supported by the sources cited is certainly not the way to go. Alexbrn (talk) 22:18, 21 November 2018 (UTC)

No, that's not true. You've naively fallen for the antivax bullshit again. The lede says that unsubstantiated scares still occur, and this is precisely correct. The existence of problems in specific places where the regulatory regime is profoundly different from the West is not in any way relevant to the Western phenomenon of fake vaccine injuries. Even the Cutter incident isn't relevant, because it's not a controversy, it's an error and a tragedy and science did its best to fix the problem as soon as it was identified. Vaccine controversies are basically a collection of zombie memes, where the specifics are switched around (mercury becomes aluminium, Eurasia was always at war with Eastasia) but the bogeyman always remains. Guy (Help!) 22:24, 21 November 2018 (UTC)

@JzG: Your comment seems to imply that this article should be only about western issues, despite the fact that wikipedia should not have geographical bias. User:Alexbrn is right that my first edit was unsourced OR, looking back at the diff I feel a bit stupid for not including sources. I read the current lead as inaccurately saying that no scare over vaccine safety anywhere in the world is ever valid. I will look for sources before I change anything though. Tornado chaser (talk) 22:56, 21 November 2018 (UTC)

Vaccine controversies - or rather "controversies" - are an artifact of the privileged Western community. The Cutter incident is the best example of the difference between vaccine controversies and problems with vaccines. That was the worst outbreak of iatrogenic disease ever, I think, and it was treated incredibly seriously by the medical profession, and the public remained supportive of polio immunisation. Compare and contrast vaccine-autism bullshit, "religious" exemptions (no major religion has any issue with vaccination), "liberty" isolated from responsibility to the child, and so on. In order for vaccines to be controversial, pretty much by definition, you have to be in a situation where preventable disease is not hat big a concern. In Africa, vaccines are not controversial. Even if there are problems. Actually also in China: there may be outrage about an incident, but vaccination as a principle is substantially uncontroversial despite that. Antivaxers want to pretend that their "concerns" are valid based on things that happen in far-away countries with very much less robust regulatory regimes. This is just part of their decades-long battle to pretend that irrational fears are actually rational scientific objections. Guy (Help!) 23:27, 21 November 2018 (UTC)

I have adjusted the wording to clarify that the CDC's vaccine schedule is safe, without implying anything about other countries, as the source used for this is a US government website. I still think that controversies regarding a specific vaccine (eg the Dengvaxia controversy) or a large number of vaccines made by a specific manufacturers[7] fall under the umbrella term "vaccine controversies", the term "vaccine controversies" means controversies related to vaccines, not just controversies over the concept of vaccination itself. Tornado chaser (talk) 23:52, 21 November 2018 (UTC)

In general, vaccines are safe and effective. More to the point, that is exactly what the source says. So we follow it. We don't open up a chink of doubt as that is to over-egg the risk in a POV way (ant-vax stylee). Pretty much everything is unsafe in some context - even drinking clean water. We must stick to sources. Alexbrn (talk) 07:15, 22 November 2018 (UTC)

I find it ironic that you complained about the thing being US-centric then added a reference to CDC, when in fact the consensus supports the safety of the vaccine schedules of every single developed country. And in fact also China, notwithstanding issues with specific vaccine batches. That's the point the antivaxers are keen to obscure: vaccines are safe and effective, but, like any other manufactured product, errors are possible. The regulatory regime in the developed world is generally very robust, most issues are either in countries with a history of poor manufacturing practice, or in areas where correct storage and handling can be a challenge. And these faulty vaccines still don't cause autism or infertility or any of the other bullshit "vaccine injuries" that antivaxers push. Guy (Help!) 09:23, 22 November 2018 (UTC)

Milk does not say that US milk is safe but other milk might kill you. Johnuniq (talk) 08:44, 22 November 2018 (UTC)

This line Despite overwhelming scientific consensus[1][2][3] that vaccines are safe and effective,[4] unsubstantiated scares regarding their safety still occur appears to be saying that all modern vaccine safety concerns worldwide are bogus. Now I am perfectly well aware of the bogus claims about autism, infertility and all that nonsense about allergies, asthma, and any other possibly immune related disease, and absolutely do not want to lend credibility to those claims, I want to come up with wording that does not imply these concerns have any validity, but without implying that no modern vaccine safety concerns are real. Tornado chaser (talk) 16:52, 26 November 2018 (UTC)

It doesn't say that at all. It says that there is scientific consensus that vaccines are safe and effective, not that all vaccines, administered by everyone, everywhere, in any circumstances, are safe and effective. Bradv 16:55, 26 November 2018 (UTC)

What concerns me is that by saying despite the fact that vaccines are safe and effective, unsubstantiated scares still occur, this implies that all scares are unsubstantiated, which is not true. Tornado chaser (talk) 16:59, 26 November 2018 (UTC)

You're letting your faulty logic lead you into strange imaginings. Alexbrn (talk) 17:04, 26 November 2018 (UTC)

@Alexbrn: saying "your logic is faulty" tells me nothing about what you think is wrong with my argument. Tornado chaser (talk) 17:08, 26 November 2018 (UTC)

It does: it is not logical. But since you're essentially writing about your feelings (essentially, what mood music you hear in the words you read, their weird "implication" to you) it cannot be "disproved". What is suggests is you simply don't like reading that vaccines ar safe and/or that (despite this) there are loads of scare stories about them. Alexbrn (talk) 17:12, 26 November 2018 (UTC)

(edit conflict) Again, it doesn't say that. "Unsubstantiated scares regarding their safety still occur" is not the same thing as "all scares are unsubstantiated". This is classic conspiracy thinking that you've fallen victim to — pick statements apart to introduce doubt, then use those doubts and fears to further a contrary agenda. Bradv 17:13, 26 November 2018 (UTC)

@Bradv: Thanks for your response, I still think that "Despite ... that vaccines are safe and effective, unsubstantiated scares regarding their safety still occur" is basically the same as "all scares are unsubstantiated", but thanks for stating why you disagree. Tornado chaser (talk) 17:25, 26 November 2018 (UTC)

I wrote my comment before you added that nonsense assuming I must be believing in conspiracies and trying to further an agenda, making accusations like this based on ridiculous assumptions in unacceptable. Tornado chaser (talk) 17:25, 26 November 2018 (UTC)

I don't know you nor your motivation for editing this article. I'm just pointing out that this style of logic follows a classic pattern. It's up to you how you want to take that. Bradv 17:32, 26 November 2018 (UTC)

No it doesn't. What it says is that vaccine "controversies" are related to unsubstantiated scares. That fact that conspiracy theories are bullshit doesn't mean there aren't conspiracies. Guy (Help!) 18:54, 26 November 2018 (UTC)

If no one else interprets the wording the way I do, I guess there is no issue, but I am not sure what the second part of your comment is about, nobody ever said that something being bullshit makes it not a conspiracy theory. Tornado chaser (talk) 19:23, 26 November 2018 (UTC)

 Passionate provaxxer here. I agree the wording of that is a bit controversial and perhaps too broad. While I certainly agree that the overwhelming vast majority of current scares (aluminum, thimerosal, aborted babes) are manufactured, there have been plenty of "substantiated scares" over the years such as the Cutter Incident. Jimexcelcs (talk) 19:25, 26 February 2019 (UTC)

ANY debates?

"Vaccine controversies are any debates or ......(etc)"

They are the first six words of the lede, and they bug me.

Why is any debate about vaccines a controversy? Heve there never ever been uncontroversial debates? Doubt it. Moriori (talk) 03:02, 20 January 2019 (UTC)

Debate says "In a debate, opposing arguments are put forward to argue for opposing viewpoints." Controversy says "Controversy is a state of prolonged public dispute or debate, usually concerning a matter of conflicting opinion or point of view."

The main difference seems to be that a controversy is "prolonged". So, are you saying that there could be short debates which ended in consensus? Would it satisfy your concerns to change it to "any prolonged debates"? --Hob Gadling (talk) 07:53, 20 January 2019 (UTC)

No absolutely not. You and I are actually debating right here. Nothing formal. No adjudicators. Nothing controversial. Not prolonged . A reasoned debate -- which can come under any debate mentioned in the lede -- is not a controversy. The subject of the debate might be controversial, but two people discussing opposimg opinions about something is not controversial.I am saying that opinions re vaccine can be controversial, but any debate about them is not automatically controversial. There are some reasonable people in this world. Moriori (talk) 08:32, 20 January 2019 (UTC)

All definitions I've found of "controversy" state that it's usually a "debate" that involves "conflicting opinions": [8] [9] [10]. Which definition would you have us use instead? Merlin^sorca 14:04, 20 January 2019 (UTC)

From the OED, a controversy is

An argument or dispute on a matter of opinion; a (typically heated) discussion involving contrary opinions; esp. one conducted publicly (as in the press) and at length.

It is not relly a debate which suggests formal discussion of some question of public interest in a legislative or other assembly. The word "controversy" is not a very good one to apply to what's gone on with vaccine opposition, and will be addressed by the move proposed below. Alexbrn (talk) 16:55, 20 January 2019 (UTC)

AMA Ethics paper

This paper [11] is very interesting.

At present the lede says "Vaccine controversies are controversies around the medical, ethical and legal aspects of the use of vaccines and vaccinations. These controversies have occurred since almost 80 years before the terms vaccine and vaccination were introduced." I think we should qualify this and say that the controversies are primarily not medical or scientific, and that they are maintained by a well-connected international network of people and groups who are fundamentally opposed to vaccines and do not accept the science ont he subject. The AMA article would support this, I will look for others that support or refute it. Guy (Help!) 10:23, 20 January 2019 (UTC)

Yes, and despite the fact those are my words in the lede they're not quite right. The article title is the root problem I think. There are not really any medical "controversies" but mainly wing-nuttery vs reality. Having this article is kind of a POV-fork. Alexbrn (talk) 12:59, 20 January 2019 (UTC)

OK, so what would be a better title? I think Anti-vaccination is simplest and least ambiguous. Guy (Help!) 13:48, 20 January 2019 (UTC)

(edit conflict) I like the lead as it currently is, although I do think the rest of the article is poorly structured. It also seems a bit odd to have an umbrella article for all controversies in any way related to vaccines, how about splitting this into an article on the anti-vax movement to cover the anti-science stuff and moving the legal/ethical/political issues into vaccine policy? "Vaccine controversies" might be better as a category than an article. Tornado chaser (talk) 13:51, 20 January 2019 (UTC)

This is the overarching article that describes the centuries-old anti-vaccine movement. Anti-vaccine redirects here, and that is its principal use. Scientifically, there are no controversies about vaccines as a class of treatment, which is what this article is about, and unfortunately the current tile leads some people to include things that are nothing to do with "controversies" about vaccines, but instead are examples of manufacturing defects and other issues that are rapidly identified and tackled by the medical profession. So it makes sense to move it. That will indeed lead to some of the content being moved elsewhere. Guy (Help!) 13:56, 20 January 2019 (UTC)

I like Anti-vaccination or Opposition to vaccination (both already redirects here) as an article title - though maybe it would be better to consider a map of this whole topic space first (including articles like Thiomersal controversy and MMR vaccine controversy). I'm convinced many editors simply don't grok what the what word "controversy" means. In all, our articles around anti-vax are a bit shit. Alexbrn (talk) 13:59, 20 January 2019 (UTC)

Renaming this to Anti-vaccination or Opposition to vaccination sounds good to me. "Controversy" is a hard word to work around so I'd avoid it if at all possible. Merlin^sorca 14:08, 20 January 2019 (UTC)

Agreed, the other "controversy" articles should also be moved. We are at a point by now that the MMR-autism one could be moved to MMR autism hoax or MMR autism fraud. Guy (Help!) 14:17, 20 January 2019 (UTC)

I like MMR autism hoax, it is clear that it is talking about a specific hoax rather than a general type of fraud (eg Tax fraud). Tornado chaser (talk) 14:21, 20 January 2019 (UTC)

Policy

@JzG: Now that this article is "vaccine hesitancy" not "vaccine controversies", why did you restore the stuff about policy controversies? I would have thought that belongs in vaccine policy. Tornado chaser (talk) 22:49, 2 February 2019 (UTC)

Because the policy is driven by antivaxers. You have edited the articles that describe this. Guy (Help!) 23:32, 2 February 2019 (UTC)

@JzG: On second thought I would support leaving the section on compulsory vaccination in as these policies are made in response to vaccine hesitancy, but the "War" section really seems off topic, and the part that says Hesitancy results from public debates around the medical, ethical and legal issues related to vaccines. Hesitancy and debates have occurred since the invention of vaccination, and indeed pre-date the coining of the terms vaccine and vaccination by nearly 80 years. doesn't make much sense as written. Tornado chaser (talk) 23:41, 2 February 2019 (UTC)

@JzG: Now that the policy issues are discussed in a coherent way in the lead, I see even less need for Hesitancy results from public debates around the medical, ethical and legal issues related to vaccines. Hesitancy and debates have occurred since the invention of vaccination, and indeed pre-date the coining of the terms vaccine and vaccination by nearly 80 years. I also want to know if you would be ok with me removing the "war" section. Tornado chaser (talk) 01:45, 3 February 2019 (UTC)

No. I strongly suggest you stop trying to edit article in this area, as you admit you know nothing about the history or politics of it. Guy (Help!) 01:48, 3 February 2019 (UTC)

@JzG: Where do I "admit" that? Tornado chaser (talk) 01:49, 3 February 2019 (UTC)

Whenever you are trying to excuse your naive edits. Guy (Help!) 02:15, 3 February 2019 (UTC)

@JzG: If my arguments are so bad that they constitute an admission that I "know nothing about the history or politics of it" why don't you just point out the obvious flaw in the edits I've proposed, rather than act like all my edits to vaccine articles can be reverted just because I'm the one who made them. If you explain why you want to keep material that I want to remove, maybe we could agree on wording that satisfies both of our concerns rather than spending our time having arguments that aren't even about the article content. Tornado chaser (talk) 02:25, 3 February 2019 (UTC)

War

@JzG: Why do you believe the "war" section should stay? Tornado chaser (talk) 18:42, 20 February 2019 (UTC)

Infobox

I would like to aim for a navbox primarily for anti-vaccination, as at right. However, a general vaccination navbox might be preferable, with links to article son people like Paul Offitt, Dorit Reiss and Peter Hotez. I think there is definite scope to cover specifics like Chiropractic and anti-vaccination, which is definitely a thing. I don't know if anyone else thinks this is worth doing? Guy (Help!) 21:57, 3 February 2019 (UTC)

I like it but would it be in addition to or replace the pseudoscience infobox? Could it go where we now put Further Reading?--Akrasia25 (talk) 12:32, 4 February 2019 (UTC)

I would put it in place of {{infobox pseudoscience}}, because pro-disease bullshit is not just pseudoscience, there's also politics and propaganda in there, and a small amount of gross distortion of legitimate fact. Guy (Help!) 12:50, 4 February 2019 (UTC)

Sure makes sense. How does it work with three redlinks, and no category made yet? Are these the right articles to put in the box? BTW, there is also a that should be looked and maybe the category name changed as well. --Akrasia25 (talk) 14:59, 4 February 2019 (UTC)

"Eventually" is how. There's work to do. See Draft:Chiropractic and anti-vaccination for a starting point. Guy (Help!) 22:00, 4 February 2019 (UTC)

• Created Vaccine contamination with SV40. Guy (Help!) 22:22, 5 February 2019 (UTC)

Category

Three vaccine"controversy" articles have now been renamed to remove the word "controversy", which gave undue weight to fringe ideas.

• In line with the renaming of MMR vaccine controversy to MMR vaccine and autism, I have proposed renaming category:MMR vaccine controversy to category:MMR vaccine and autism to match the parent article. See Wikipedia:Categories for discussion/Log/2019 February 5 § Category:MMR vaccine controversy.
• In line with the renaming of vaccine controversies to vaccine hesitancy, I have proposed renaming category:Vaccine controversies to Category:Vaccine hesitancy, to match the parent article. See Wikipedia:Categories for discussion/Log/2019 February 4 § Category:Vaccine controversies.
• In line with the renaming of Thiomersal controversy to Thiomersal and vaccines, I have proposed renaming category:Thiomersal controversy to category:Thiomersal and vaccines , to match the parent article. See Wikipedia:Categories for discussion/Log/2019 February 5 § Category:Thiomersal controversy,

I put this through CFD rather than simply move them so that the bot will do the spadework. Guy (Help!) 21:22, 5 February 2019 (UTC)

Common themes

I think I can spin out Common themes into a separate article, as these are not about hesitancy but more about blatant antivax propaganda. Any suggestions for a title? I am thinking maybe List of anti-vaccination tropes or some such. Guy (Help!) 00:24, 7 February 2019 (UTC)

These are common reasons used by people to justify their decisions not to vaccinate themselves or the children, thus they seem relevant to this article. - Bilby (talk) 00:43, 7 February 2019 (UTC)

List of anti-vaccination tropes sounds like a reasonable title to me. TylerDurden8823 (talk) 19:24, 7 February 2019 (UTC)

@Bilby: Obviously, but the level of detail is bloating this article out, hence the thought of spinning it out into a separate article, as we usually do when a subsidiary topic starts to overwhelm the primary topic. Guy (Help!) 20:07, 7 February 2019 (UTC)

I support creating this article, List of vaccine myths would be a good, neutral title, similar to less contentious articles like Tornado myths. "List of anti-vaccination tropes" has a bit of a "we're out to bash the antivaxers" feel, while List of vaccine myths has a better "here are the facts" neutral tone. Tornado chaser (talk) 20:39, 7 February 2019 (UTC)

Chemophobia

I think this article could use a bit more discussion about the role of chemophobia in vaccine hesitancy. I do see that we have a decent amount of content on the anti-vaccine groups' concerns about aluminum, but I frequently see various other chemicals thrown about as concerns. I think that deserves mention (and then should be thoroughly debunked). TylerDurden8823 (talk) 00:14, 9 February 2019 (UTC)

I don't think it's chemophobia as such (that does play a role, just a different one). The ever-shifting "which chemical is it that causes this Vaccine Injury™" is motivated primarily by the need to compete with science they don't like. Homeopaths do the same, e.g. Dana Ullman's "nanomolecules", aiming to fill the yawning chasm where plausible mechanism should lie. Guy (Help!) 00:46, 9 February 2019 (UTC)

I don't know. I've read a lot of comments from anti-vaccine folks who specifically try to invoke the dreaded "ingredient list" and point to specific chemicals/ingredients as "bad", "dangerous", "toxic", "poisonous", etc. It seems to be a major driver for many of their nonsensical arguments. I think that definitely contributes to vaccine hesitancy when parents and other people who are confused on the issue of vaccine safety read that nonsense online and are influenced by it. TylerDurden8823 (talk) 04:36, 9 February 2019 (UTC)

That's just good old fashioned motivated reasoning. They will point to anything that supports their delusions. Guy (Help!) 19:39, 20 February 2019 (UTC)

I'm not disagreeing with you that anti-vaxxers point to a variety of things to support their misconceptions. All I'm saying is that they frequently invoke chemophobic arguments (chemicals are bad ahhhh!) to support their point of view. It's a common trope used in those circles (at least from what I have observed). TylerDurden8823 (talk) 06:21, 21 February 2019 (UTC)

A product to be injected is assumed non-toxic until proven toxic. It has to be tested on the population at large, preferably as a mandate by law. Is that the philosophy of the pro-vaccine crowd? Sorry, but I stick to the precautionary principle, maybe I'm old fashioned.145.64.134.242 (talk) 13:37, 22 March 2019 (UTC)

CNN

Parents were protesting compulsory vaccinations 150 years ago. Some are still angry Might have something useful for non-MEDRS stuff. Gråbergs Gråa Sång (talk) 13:15, 17 February 2019 (UTC)

It's a remarkable fact that the anti-vaccination movement is actually older than vaccination. What's even more remarkable is how little the rhetoric has changed over time. The same basic arguments, with elements switched out as they are recognised as bogus (e.g. the switch from mercury to aluminium as the ingredient that "causes" autism). The base claims - Vaccines Are Not Natural and therefore squicky, and You can't Make Me Do That, have been stable for nearly two centuries. Guy (Help!) 14:05, 23 February 2019 (UTC)

More CNN: MMR vaccine does not cause autism, another study confirms. Well, that's good. Gråbergs Gråa Sång (talk) 10:55, 5 March 2019 (UTC)

Effectiveness

The article claims under this heading that "Scientific evidence for the effectiveness of large-scale vaccination campaigns is well established. The reference in support of this is the paper "Effects of a large-scale intervention with influenza and 23-valent pneumococcal vaccines in adults aged 65 years or older: a prospective study". First, older people do not represent the target population of mass vaccination campaigns, which are younger children. Second, the flu vaccine is not representative of childhood vaccines. To make matters worse, the flu vaccine for adults has been proven apallingly ineffective by Cochrane Research, see "Vaccines for preventing influenza in healthy adults." which also found "widespread manipulation of conclusions" (sic) in the studies funded by industry. So the "effectiveness" statement is unsupported and largely contradicted by the reference given in this heading. 145.64.134.242 (talk) 08:52, 22 March 2019 (UTC)