The Return of Measles: Is the Internet to Blame?

Disclaimer: I believe in vaccinations, and my husband and I have chosen to vaccinate our two boys.

This post is not about whether vaccination is right or wrong. It’s about how the current anti-vaccination movement (post-1998) got its legs, and how the Internet may have contributed to it.

From smallpox in the 19^th century to diptheria, tetanus and pertussis in the 1970’s to the current measles, mumps, and rubella controversy, opponents of vaccination (“anti-vaxxers”) have existed for as long as vaccines have existed. The current anti-vaccination movement arose in 1998 when Dr. Andrew Wakefield published the findings of a 12-person study to examine whether there was a connection between the measles-mumps-rubella vaccine and autism. The Lancet, which originally published the study, later retracted, and Wakefield lost his license to practice medicine.

Historically, the anti-vaccination movement has been rooted in specific communities, such as the town of Leicester, England in the mid-1800’s. Today, while there are specific communities with low vaccination rates, we’ve seen much broader reach due, in large part to the Internet.

Flashback to 1998 when the Wakefield study was released.  Just 26.2 percent of American households had Internet access. Two years later, that number grew exponentially to 41.5 percent, (and it now stands at 87 percent, with nearly 99 percent in households earning $75,000 or more). Americans were rapidly adopting the Internet and understanding its power. And, we were learning to use it as a source of health information.

Prior to the “Internet Age,” people simply had to be more reliant on their doctors because health information was not readily available unless you wanted to spend hours in the library of your local medical school. Just as Ford democratized the automobile with the Model T, the Internet democratized health information.

Somewhat ironically, the Wakefield study began to gain traction in the mainstream media in 2001-2002, after labs had demonstrated that they were unable to replicate the results.  But, the power of the Internet had created a monster that was already changing public opinion about the safety of vaccines.

And, this brings us back to 2015, and the Disneyland measles outbreak, which resulted in more than 100 cases in January. How did a disease that was declared eliminated in the U.S. in 2000 make a comeback? Below are three reasons why the Internet may have had a role:

• Dr. Google
  • According to the Pew Research Center’s Internet and American Life Project, 72 percent of Internet users said they looked online for health information within the past year. The same study revealed that 35 percent of U.S. adults have gone online specifically to try to figure out what medical condition they or someone else might have. We like to call it “Dr. Google.”
  • For people seeking information about vaccines, Dr. Google might be WebMD, but it could also be a BabyCenter.com forum or a piece like this one on Vitamin K in the Healthy Home Economist blog. The problem is this – the validity of these sources varies tremendously. WebMD articles are reviewed by a medical doctor and cite sources including the CDC and the Children’s Hospital of Philadelphia. The Healthy Home Economist blogger has, well, a B.A. in Economics; and a commenter on a BabyCenter forum could be ANYONE.
  • While studies do show that people still seek and value information from their doctor, they are increasingly doing their own research. I theorize that people who are more educated (but not necessarily educated in science, biology or medicine) also may feel more comfortable doing their own analysis.
• Finding like-minded individuals
  • A study in The Journal of Pediatrics revealed that social networks play a key role in parents’ vaccination decision-making. The Internet and the rise of online communities and social networking sites have made it very easy for people to solicit feedback from others and find people that share their world view.  For instance, the National Vaccine Information Center’s Facebook page has more than 114,000 “likes” and very strong engagement.
• Information is one click away from you – and everyone you want to share it with
  • The beauty of the Internet is that you are just one click away from finding out more about something.  Suddenly, someone can end up reading a medical journal, or in the case of anti-vaxxers, you might find yourself on oft-cited sources, such as the Vaccine Adverse Event Report System (VAERS) website or reading vaccine package inserts. Whether or not people actually do read these sources, they link to them and they have their key messages nailed. This meme does a great job putting a comical spin on it.

The Internet has connected people to a vast amount of information about vaccines – some true, some untrue, and a lot of opinions. We know that pediatricians overwhelmingly support vaccines, so is the rise of the anti-vaccination movement indicative of people abandoning their physician and turning to other sources (Dr. Google, online communities, family and friends) for health information?  Let us know your thoughts!