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"Protecting the health and informed consent rights of children since 1982."

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Anti-Science Activists Label Pro-Vaccine Safety Advocates "Antivaccine" in June 26 JAMA Article

A Response

Barbara Loe Fisher, Co-founder and President

National Vaccine Information Center

In the latest efforts by anti-science activists to label pro-vaccine safety advocates "anti-vaccine," a trio from Northwestern University have published an article in the June 26, 2002 Journal of the American Medical Association (JAMA) entitled "Content and Design Attributes of Antivaccination Web Sites." In what must surely be a lull in the careers of Robert M. Wolfe, M.D., Lisa K. Sharp, Ph.D., and Martin S. Lipsky, M.D., these three have spent a lot of time and effort pouring over the content of what they have dubbed "antivaccination" websites in order to come up with an analysis purporting to get to the heart of the thinking and motives behind organizations and individuals who operate websites questioning the safety and efficacy of vaccines.

The National Vaccine Information Center (NVIC) which operates the oldest and largest vaccine safety advocacy website, offers the following observations about the content of the article and the thinking and motives of its authors:

1. This is not science, it is an op ed piece.

2. The information on the internet, thank goodness, is not peer reviewed by

doctors like these authors or we wouldn't be able to believe what is on the internet anymore than we are able to believe what is published in JAMA.

3. They need to include a dictionary in their article. What exactly is their

definition of "antivaccination?" Is it the label they apply in the second sentence of the first paragraph to those challenging "the safety and effectiveness of recommended vaccines?" If that is the definition of anti-vaccine, we can label these authors anti-science for suggesting that challenging and testing existing knowledge in science be abolished in favor of protecting the status quo.

4. The hallmark of good science is replication. We call for a public release

of the names of all the websites these authors have labeled anti-vaccine so their analysis can be independently analyzed.

5. In just one of the many examples of intellectual bias, the authors

perseverate about the internet access the public has to personal and emotional experiences of families with vaccine injured children. They, however, apparently have no problem with the use of visual images of children who were injured or died from polio as an incentive to the public to get vaccinated.

6. This article is a sophomoric attempt to label the vaccine safety and

informed consent movement as "anti-vaccine" in order to deflect attention from the very real gaps in scientific knowledge about the biological mechanisms of adverse responses to vaccination. Should the Institute of Medicine be labeled anti-vaccine for repeatedly publishing reports over the past decade calling for increased scientific research into outstanding questions about vaccine safety? Instead of analyzing websites which are pointing out and asking for answers to outstanding scientific questions about vaccine safety, these doctors should be pulling their microscopes out of storage and finding out why some children are not able to handle the 36 doses of 11 vaccines they are now getting. They could work to develop genetic and other biomarkers to identify and screen out high risk children. That would go a long way toward re-instilling trust in national vaccine policies and eliminating some of the nagging doubts about vaccines that parents of learning disabled, hyperactive, epileptic, autistic, asthmatic, diabetic and mentally retarded children talk about on the internet.

7. History shows that challenge to the status quo, which is embodied in much

Finally, this kind of pretentious posturing by doctors who claim that they engaged in "critical revision of the manuscript for important intellectual content" did not remove the responsibility from JAMA editors to exercise a little self discipline and pass on this one. What the publishing of this kind of junk science does is fuel the suspicions of parents that those in power are determined to silence the voices of people suffering because science will not listen and does not care. It is a sad commentary on an even sadder reality that faces many families with vaccine injured children.

Content and Design Attributes of Antivaccination Web Sites

Robert M. Wolfe, MD; Lisa K. Sharp, PhD; Martin S. Lipsky, MD

Context Individuals searching the Internet for vaccine information may find antivaccination Web sites. Few published studies have systematically evaluated these sites.

Objectives To examine antivaccination Web site attributes and to delineate the specific claims and concerns expressed by antivaccination groups.

Design and Setting In late 2000, using a metasearch program that incorporates 10 other search engines, we reviewed and analyzed 772 links to find 12 Web sites that promulgated antivaccination information. Analyzing links from these 12 sites yielded another 10 sites, producing a total of 22 sites for study. Using a standardized form, 2 authors (R.M.W., L.K.S.) systematically evaluated these sites based on specific content and design attributes.

Main Outcome Measures Presence or absence of 11 Web site content attributes (antivaccination claims) and 10 Web site design attributes.

Results The most commonly found content claims were that vaccines cause idiopathic illness (100% of sites), vaccines erode immunity (95%), adverse vaccine reactions are underreported (95%), and vaccination policy is motivated by profit (91%). The most common design attributes were the presence of links to other antivaccination sites (100%of sites), information for legally avoiding immunizations (64%), and the use of emotionally charged stories of children who had allegedly been killed or harmed by vaccines (55%).

Conclusion Antivaccination Web sites express a range of concerns related to vaccine safety and varying levels of distrust in medicine. The sites rely heavily on emotional appeal to convey their message.

JAMA. 2002;287:3245-3248

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