1 Anti-Vax Culture of Conspiracy: Where Does it Begin and Where Does it End? Abigail Beach (Biochemistry), Destri Eichman (Biochemistry and Spanish), Jacob Hansen (History), Missy Rolseth (Political Science), and Stacia Schollmeyer Education Alpha Chi, Missouri Delta Westminster College March 2, 2020 We began researching in December, assigning each group member a specific perspective with which to look at the anti-vax culture of conspiracy. We reconvened in January, forming an outline to better direct our research. We conducted a survey in early February and put a rough draft together in mid-February. For the last two weeks, all team members have been extensively reading, editing, and commenting on other members’ sections. We are very proud of the interdisciplinary investigation we present. 2 Anti-Vax Culture of Conspiracy—Where Does it Begin and Where Does it End? According to the CDC, up to 30% of children in the United States are not properly vaccinated every year. Although vaccines have been produced and distributed to improve public health and safety since the 1800’s, some parents make the decision to not vaccinate their children. Why do parents make this choice? Throughout history, conspiracies have been rampant in human civilization. From ill-placed blame during the Black Plague to claims of U.S. government involvement in the 9/11 terror attacks, conspiracy theories have made a significant impact on society. The anti-vax culture of conspiracy has been growing tremendously over the last two decades. What began as whispers alluding to bad medicine has exploded into a social movement that has been heard throughout the Western world. While other modern cultures of conspiracies lead to books, online threads, and heated discussions, the anti-vax culture puts the health and lives of children at risk. Anti-vax culture began with an irresponsible publication, was followed by misplaced celebrity advocation, blossomed into deadly epidemics, and is now at the one of the most significant political questions of the twenty-first century. As the echoes of affected children are heard throughout the United States, this culture of conspiracy is perhaps the most significant of the 21st century to date, requiring a resounding chorus of education and reason, leading to trust in science, responsibility of those with influence, and laws to prevent the unthinkable. Before February of 1998, most people believed that vaccines were safe, effective, and had positive health outcomes (Assessing the State of Vaccine Confidence, 2015). After the eradication of polio and smallpox, individuals who lived in countries in which vaccines were readily available understood, or had even witnessed, their life-saving capabilities. But in February of 1998, Andrew Wakefield and ten co- authors published an article titled “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children” in The Lancet that has had reverberating consequences across the Western world. However, papers published in scientific journals are, by construct, supposed to be peer- reviewed under strict guidelines (Björk & Hedlund, 2004). Thus, scientists were right to want to study Wakefield’s topic further and see if his results could be replicated. 3 The premise of the research was to investigate symptoms and the possible causes of illness for children who had gastrointestinal conditions and had lost acquired skills. Through their investigation, Wakefield et al. (1998) proposed possible correlations between the Measles, Mumps, and Rubella (MMR) vaccine and the observed symptoms through both parental accounts and previous research on the subject. Given the article’s scientific nature and publication in a well-known research journal, readers who lacked an understanding of science quickly began to view the research as fact, allowing it to guide the medical decisions made for their children. However, upon further academic review, the article was found to have many fundamental flaws, as the paper presented data and correlated speculations that were problematic for the scientific community. Scientific experimental design has long had an implied model to which scientists can look in order to construct analyses that are conclusive, unbiased, and clearly defined within the scope of their research field. An analysis into the article published by Wakefield et al. shows that while the authors adhered to the basic fundamentals of this type of research given the study’s structure and associated testing, they ultimately disregarded the principles that lay the groundwork of research (Seethaler, 2009). First, this research has an integral fault in the sample size. In this study, only twelve children within one specific pediatric hospital unit were observed and examined. In order to feel confident making generalizations about populations and ensuring that those generalizations are not due to random chance, scientists are less likely to trust data collected from few participants. Given this, these researchers should not have drawn sweeping conclusions from such a small sample size. Further, among the twelve participants, only one was female. To ensure the most definitive data, almost all scientific studies include participants only of one sex or a comparable number of participants from each sex. Those studies that do not choose participant sexes in this way typically do so for a specific reason related to their research questions. Additionally, there were significant issues with data collection and presentation. Wakefield et al. (1998) attempted to claim that the MMR vaccine was the cause of a variety of symptoms that the authors claimed were associated with its exposure: fever, delirium, self-injury, rash, repetitive behavior, 4 loss of self-help, convulsion, gaze avoidance, diarrhea, disinterest, lack of play, vomiting, and recurrent viral pneumonia. The authors went further to discuss behavioral diagnoses—some definite, others not— of the 12 participants: autism, autistic spectrum disorder, “post-viral encephalitis?,” “post-vaccinial encephalitis?,” “disintegrative disorder?,” and “autism?” (1998). A tenant of scientific research and statistics is that correlation does not equal causation. Thus, even if Wakefield et al. could statistically show a correlation between the MMR vaccine and the smorgasbord of symptoms and inconclusive behavioral diagnoses, it still would not show that MMR causes these things, particularly with the small number of participants. In other words, there is no evidence that shows that vaccines cause autism or any of the other ailments that Wakefield et al. claim. In fact, there are studies that directly refute the results of Wakefield and his co-authors. Taylor et al. (1999) published a paper one year after the publication of the Wakefield et al. article titled “Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association.” In this paper, Taylor et al. examined children born since 1979 who had been diagnosed with autism and charted that trend against the introduction of the MMR vaccine. Taylor et al. had 498 participants from eight different health districts in the United Kingdom. They found no discernable change in the rate of children diagnosed with autism, even across the time period during which the MMR vaccine was introduced, thus disproving any correlation between the two. While there were many issues with the way that Wakefield et al. conducted their research, what many considered to be the biggest issue was the blatant conflict of interest involved in the study and its findings. In 2004, the editor of The Lancet (the journal in which the Wakefield paper was originally published), Richard Horton, published a statement saying that an investigation into the ethics, data collection, and results of the Wakefield et al. article revealed that the Wakefield study was funded by the Legal Aid Board, who were in the midst of a legal battle with a pharmaceutical company that produced vaccines. Despite all the evidence against it, the Wakefield et al. study was not retracted by The Lancet 5 until 2010. Furthermore, even though the article was retracted, it is still the influence for a chorus of anti- vaxxers heard throughout the nation. The vibrations of the Wakefield et al. article, despite the research’s innate issues, penetrated developed societies throughout the world. This prompted an array of reactions that have agitated not only health outcomes in relation to vaccine preventable diseases, but also the healthcare systems as a unit itself. Conspiracies give way for believers to stake tangible blame on someone for their perceived predicament. Most of the time, especially in this instance, believers place this blame on the ‘establishment’ which tend to be figures of the government or scientific communities. Science has long been linked to conspiracy theories, as many associate its inner-workings with militaries, government, and large corporations like pharmaceutical companies (Goertzel, 2010). Although this can very rarely be the case for some medical researchers, a majority of those within the healthcare system who are proponents of vaccination are family physicians and pediatricians whose entire careers are dependent on the health and safety of their patients. In fact, a majority of healthcare distrust stems from the overplayed media attention of outlying doctors who have been caught gaming the system (Girgis, 2017). This is not the first time that scientific inquiry has been disregarded in favor