How Denial Caused One Major Health Catastrophe, and How It May Trigger More Crises

Mbeki deferred to a group of dissident—and thoroughly discredited—academics and naysayers in the U.S. With AIDS predicted to wipe out a full 25% of South Africa's population by the year 2010, Mbeki pinned all South Africa’s hopes on containing the disease on the advice of a controversial molecular biologist, Peter Duesberg, who claimed HIV was relatively harmless and that AIDS was caused more by poverty-related conditions such as undernourishment than by unprotected sex. So, instead of administering the cocktail of HIV medications known to be effective, Mbeki had his health minister contrive alternative remedies for AIDS, including beetroot and garlic.

The results were devastating for South Africa. More than 330,000 people died prematurely from the disease between 2000 and 2005 due to Mbeki’s AIDS denialism, and at least 35,000 babies were born with HIV, infections that could have been prevented using conventional medicine, according to a study by the Harvard School of Public Health.

Contagion in the United States

While there is no direct institutional denialism of conventional medicine here in the U.S., the denialist movement is active and spreading nonetheless. Vaccine denialism—especially in states with lax public-health laws—has already shown to have a negative effect on public health in some regional pockets, and it’s leaving those communities open to outbreaks of diseases that had been all but eradicated, including measles, polio, and whooping cough (pertussis).

In 2013, researchers confirmed that a 2010 whooping cough outbreak in California—the worst in the U.S. in more than 50 years—was spread primarily by the children of parents who received non-medical exemptions for school vaccinations from the state. The study showed that the outbreak was found exclusively in clusters where children were not vaccinated. There were more than 9,000 cases of the disease in California in 2010 and 10 deaths. In San Diego County, where there were about 5,000 immunization exemptions, there were 980 cases of whooping cough.

Meanwhile, some states were slashing programs for children's vaccinations. In 2011, the year after the whooping cough outbreak in California, Florida Republican Gov. Rick Scott cut a state program that provided whooping couch vaccines for poor mothers of babies too young to get their first whooping cough vaccines. There has since been a whooping cough outbreak in Florida with a six-week-old boy dying from the disease. 

These whooping cough outbreaks have been followed by a measles outbreak that began in Texas this year, which is now spreading throughout the U.S. Measles had also been declared eliminated, but in recent years it has appeared in areas with low-vaccination rates. The original Texas outbreak affected 21 children who attended the Eagle Mountain International Church in northern Texas, a congregation skeptical of vaccines. The outbreak began after an un-​immunized man visited Indonesia and then the church, which is part of the Kenneth Copeland ministries. None of the children affected had been vaccinated.

"This is a good example, unfortunately, of how birds of a feather flock together," Jason Terk, an infectious disease specialist recently told NPR. "If you have individuals who are vaccine-hesitant or vaccine-hostile, they congregate together, and that creates its own unique situation where a population of individuals is susceptible to getting the very disease that they decided they don't want to protect themselves from."

Overall, measles has infected nearly​ 600 ​people​in 18 localized breakouts across 21 states in the U.S. this year. And despite more than 90% of the U.S. population being immunized against measles, this is the worst measles outbreak in decades, according to the Centers for Disease Control. Nearly three times the number of people have been infected through the end of August than were infected in all 2013.

So far, there are no reported deaths from measles in the U.S. this year, but researchers say it’s all a numbers game. Between one and two of every 1,000 cases of measles are fatal, according to the CDC.

Can Vaccine Denialism in the U.S. Turn Deadly?

One of the scariest facets of vaccine denialism â€‹are those who claim they’re “not anti-vaccine, but pro-safe vaccine.” Thus, they validate themselves as responsible and immunize themselves (pardon the pun) from criticism once outbreaks of measles and whooping cough occur. Thus, those who choose to delay vaccinations or not stick by the prescribed schedule can deny culpability. But their apprehension and ambiguity — whether denialism or not — feeds the doubt that keeps other parents from immunizing their children. And any rhetoric against vaccinations can have a negative impact.

Take the Taliban-occupied areas of Pakistan and Afghanistan, regions where children are being kept from critical vaccinations. This tragedy has nothing to do with denial, but instead anger with the U.S. Leaders of the radical Islamic sect have attacked healthcare workers, killing 61 of them and their escorts in the past two years, and have banned the dispersal of the polio vaccine after they discovered a fake vaccination campaign was used to hunt down Osama bin Laden through his family’s DNA several years ago.

The results of the Taliban’s quasi-institutional embargo on vaccinations have been devastating. Last week, Pakistan reported another 11 new cases of polio, bringing this year’s total to 138, compared with 34 cases of the crippling disease from just a year earlier.

Once nearly extinct, polio’s comeback in the Middle East and northern Africa has elicited a declaration of a global health emergency from the World Health Organization, which has asked these and other countries to ensure their residents are vaccinated before they travel abroad.

Can polio make a comeback in the US? Researchers in Europe are saying that the disease can make a comeback there as regional conflicts are undermining a $10 billion immunization campaign. They’re also concerned about polio’s recent reemergence in war-torn Syria, and the possibility that ​unimmunized refugees who carry the virus may flee to European countries that have been polio-free for decades.​​

Earlier this year, Penn State’s Department of Biochemistry warned that national and global events could combine into some reemergence of polio here, but only for communities that don’t immunize, like the​ 2005 breakout in a Minnesota Amish community. But for the general U.S. population, there’s little risk of polio flaring up, as is happening overseas.

But even as vaccination rates are high in the U.S., the anti-vaccine movement is growing in some states, aided by permissive religious and personal exemptions allowed by state laws. Paul Offit, the noted pediatrician and vaccine advocate, notes that states like Idaho, Michigan, Oregon and Vermont have rates of un​vaccinated kindergartners that are four times the national average. These states could become potential hotspots for infectious diseases, especially in more vaccine-wary communities.

But it’s not only the children whose parents choose not to vaccinate or to delay vaccination that are at risk. Also defenseless are infants and toddlers too young to have their vaccinations, children with immunodeficiencies, and people who, for medical reasons, can't be vaccinated and rely on “herd immunity” from others' vaccinations to keep them protected. So, the denialism of parents who chose not to vaccinate can harm or even kill the small children of parents with every intention of abiding by the vaccination schedule.

"People assume this will never happen to them until it happens to them," Offit told USA Today in April. "​I​t's a shame that's the way we have to learn the lesson. There's a human price for that lesson."​​