The Anti-Vaccine Movement

The alleged link between vaccines and autism was first published in 1998, in a since-retracted study in medical journal The Lancet. The claim has been repeatedly disproven: there is no evidence that vaccines and autism are related. But by the mid-2000s, the myth was out there, and its power was growing, fueled by distrust of government, misinformation, and high-profile boosters like Jim Carrey and Robert F. Kennedy, Jr. In this episode: the roots of the modern anti-vaccine movement, and of the fears that still fuel it – from a botched polio vaccine, to the discredited autism study, to today. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

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• 0:00Speaker 00

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• 0:18Speaker 01

  Dr. Wakefield, would you like to start this panel?

• 0:24Speaker 02

  Yes, thank you, Mr. Chairman, members of the committee. It's a great privilege to be here. The purpose of my testimony is to report the results of the clinical and scientific investigation of a series of children with autism.

• 0:36Rund Abdelfatah?

  April 6, 2000. Doctors, researchers, and parents of children with autism have been called in front of Congress to testify about a potential link between autism and vaccines.

• 0:53Speaker 02

  Now, nothing in this testimony should be construed as anti-vaccine. Rather, I advocate the safest vaccination strategies for the protection of children and the control of communicable disease.

• 1:04Rund Abdelfatah?

  That's Andrew Wakefield. At this moment, in the year 2000, he's a researcher from the Royal Free and University College Medical School in London.

• 1:14Speaker 04

  A superb scientist who was at a superb institution.

• 1:16Speaker 05

  Sitting just to the left of Wakefield is...

• 1:19Speaker 04

  Paul Offit.

• 1:20Speaker 05

  Paul Offit.

• 1:22Speaker 04

  I am the director of the Vaccine Education Center at the Children's Hospital of Philadelphia and a professor of pediatrics at the University of Pennsylvania School of Medicine.

• 1:30Speaker 05

  At the time, Paul was also part of a committee that advised the CDC about the use of vaccines.

• 1:37Speaker 04

  I was subpoenaed to testify about whether I thought it made biological sense that vaccines could cause autism, and I didn't.

• 1:44Speaker 05

  Paul listens as Wakefield launches into his testimony.

• 1:48Speaker 02

  Just as a little bit of background, this represents 12 years of intensive clinical and scientific research, collaborative research.

• 1:55Speaker 05

  Wakefield is summarizing the results of research he conducted at the Royal Free Hospital. Research that first got the medical community's attention in 1998, when he published a paper in a renowned British medical journal called The Lancet. In that paper, Wakefield hypothesized that the measles, mumps, and rubella vaccine could be connected to the development of autism in children.

• 2:21Rund Abdelfatah?

  When it's Paul's turn to speak, he doesn't waste any time beating around the bush.

• 2:26Speaker 06

  The role in these proceedings is to explore the theories that have arisen due to concerns by the public that autism might be caused by the combination of measles, mumps, and rubella vaccines, known as MMR. No evidence exists that proves this association.

• 2:48Rund Abdelfatah?

  Paul is right. By the time Wakefield landed in front of Congress, his paper had been debunked. And one of the scientists who had debunked it was even sitting on the panel alongside him.

• 2:59Speaker 04

  I think Andrew Wakefield believed this was true. And even after study, after study showed that he was wrong, he believed he was right. But you could see that he was beloved at that meeting. He was, he was godlike, whereas we were the bad guys.

• 3:16Rund Abdelfatah?

  This wouldn't be the last time Wakefield would be called in front of the US government to repeat his debunked findings. Wakefield's paper gave the myth that vaccines cause autism, real traction, and staying power, the consequences of which we're still dealing with today.

• 3:33Speaker 04

  Once you've rung a bell like that, it's very hard to unring it.

• 3:38Speaker 05

  It was a moment that health professionals and the medical field point to as evidence that people who are skeptical of the safety of vaccines are making it all up. But this moment also became a proxy for fears that have been around as long as vaccines have. Fears that in recent decades have intensified as the pharmaceutical industry has grown in size and influence. As the COVID-19 pandemic upended American life. As state mandated vaccination programs have faced backlash. And as a polarized political climate and a deluge of misinformation has made it harder for many people to know who to trust.

• 4:19Rund Abdelfatah?

  Today, those fears go beyond just the MMR vaccine and autism, with some powerful people casting doubt on vaccine safety in general.

• 4:28Speaker 06

  Your president, like Trump, has just announced on his Truth Social account that he is picking Robert F. Kennedy Jr. to be the next Secretary of Health and Human Services.

• 4:38Speaker 02

  This is a highly anticipated confirmation in hearing, in part because the Former presidential candidate's well documented history of spreading false and misleading claims about vaccines.

• 4:48Rund Abdelfatah?

  At the time of publication, the Senate had held RFK Jr.'s confirmation hearing for the role of Secretary of Health and Human Services, but had not yet taken a final vote. Mr. Kennedy, in your testimony today under oath, you denied that you were anti-vaccine. But during a podcast interview in July of 2023,

• 5:08Speaker 04

  you said, quote, "No vaccine is safe and effective." I support the measles vaccine. I support the polio vaccine. I will do nothing as HHS secretary. That makes it difficult or discourages people from taking either of those vaccines.

• 5:24Speaker 06

  Anybody who believes that ought to look at the measles vaccine.

• 5:26Rund Abdelfatah?

  I'm Randa Abdel Fattah.

• 5:28Speaker 05

  And I'm Ramtin Arablouei. On this episode of Throughline from NPR, the roots of the modern anti-vaccine movement and of the fears that still fuel it. From a botched polio vaccine to the 1998 Lancet paper to today.

• 5:47Speaker 02

  This is Dylan calling from Denver, Colorado. Throughline's my favorite show. I listen every week. Stay tuned for the following announcements and messages from our sponsors.

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• 7:13Speaker 05

  Part one. Vaccine roulette. Dr. Paul Offit has been working in the field of infectious disease for over 40 years. His focus on vaccines, like many peoples, began in the shadow of polio.

• 7:30Speaker 02

  This year, the enemy, poliomyelitis, struck with such impact and fury that it shook the entire nation.

• 7:37Speaker 04

  I certainly remember polio.

• 7:39Speaker 05

  When Paul was five years old, he got surgery on his foot.

• 7:43Speaker 04

  When you're in an orthopedic hospital in the mid-1950s, you're in a polio ward.

• 7:47Speaker 05

  Newsreels about polio show kids in wards filled with rows of beds, the kind with the iron headboards that you always see in old hospitals.

• 7:56Speaker 04

  I remember children screaming. I remember the children in iron lungs. It was really like something out of a Charles Dickens novel.

• 8:04Speaker 02

  It spread its crippling tentacles from ocean to ocean and border to border.

• 8:10Speaker 04

  That is not a disease you want to relive.

• 8:12Rund Abdelfatah?

  Starting in the late 1940s, polio outbreaks were just getting worse and worse. This is Elena Connas.

• 8:19Speaker 06

  And I'm a historian of medicine and public health and a professor in journalism and history at the University of California, Berkeley.

• 8:28Rund Abdelfatah?

  She wrote the book Vaccine Nation: America's Changing Relationship with Immunization.

• 8:33Speaker 05

  Polio was a serious threat. A single case could send a community into a panic because polio is really contagious. It can spread through saliva, mucus, feces, contaminated water, or food.

• 8:47Speaker 02

  It has closed the gates on normal childhood. It has swept our beaches, stilled our boats, and emptied our parks.

• 8:54Speaker 06

  Because a single case meant that an outbreak was sure to come, and an outbreak meant that dozens, if not hundreds or thousands of people would be infected. People who were infected with it could end up paralyzed from the waist down, and many, many scores of them would die.

• 9:15Speaker 06

  So when the polio vaccine is approved for use by the federal government in 1955, it is literally this moment where, like, everybody pauses, people run into the streets, church bells ring, sirens go off, and then this massive effort gets underway to distribute

• 9:37Speaker 06

  This vaccine and parents bring their kids and they line up in droves and they get this vaccine.

• 9:45Speaker 05

  The science behind the polio vaccine worked the same way some types of vaccines do today.

• 9:50Speaker 04

  So the goal of a vaccine is to induce the immunity that is typically acquired from natural infection without paying the price of natural infection.

• 9:59Speaker 05

  Vaccines do that by introducing your body to a version of the virus. So your body can learn and recognize it and fight it off. Today, vaccines contain a weakened or dead bacteria or virus or bits of a virus's genetic material. Any of those things can help your body develop immunity.

• 10:18Speaker 06

  The effective polio vaccine contained a version of the polio virus that had been inactivated or quote unquote, killed with chemicals. The problem is, like, that's definitely a way to make an effective vaccine, but you've really got to kill the virus.

• 10:41Rund Abdelfatah?

  So by April of 1955, the polio vaccine was being produced at a mass scale.

• 10:48Speaker 06

  And in this one lab here in Berkeley, there was a batch that went out.

• 10:53Speaker 06

  Nobody realized that the virus hadn't been fully inactivated.

• 10:57Rund Abdelfatah?

  Oh, my God.

• 10:58Speaker 06

  Yeah, so people who believed that they were turning out for a perfectly safe and effective vaccine ended up contracting polio.

• 11:09Rund Abdelfatah?

  Because in that case, they just, they literally injected people with polio accidentally.

• 11:14Speaker 06

  Yes, they did. They did. So this came to be known as the Cutter Incident. And while it caused many, many cases of polio that likely went undetected, it caused 200-plus cases of paralytic polio and led to just under a dozen deaths.

• 11:35Speaker 06

  The federal government stepped in to say, "Okay, there's more we can do in the space of regulation and safety." And we had this relatively new government agency, the CDC, that stepped in and said, "We are going to keep track of all of these vaccines. We're going to work with the FDA and other agencies to make sure that all vaccines are safe."

• 11:57Rund Abdelfatah?

  In May 1955, the government paused all polio vaccinations for over a week while they rechecked the vaccines for safety. The Cutter incident led to a comprehensive investigation and increased federal safety protocols aimed at ensuring that something like this never happened again. The government wanted to send a message.

• 12:18Speaker 06

  You can count on the federal government to ensure your personal safety and this won't happen again. And in the late 1950s, this was a really effective message.

• 12:28Rund Abdelfatah?

  Despite the Cutter incident, polio vaccination continued. By 1961, more than 85% of all school-aged children had received a polio vaccine.

• 12:39Speaker 06

  It's so hard for us to put ourselves in the shoes of somebody living through 1955. They were so terrified of polio. They just might have taken their chances with the vaccine, with a lot of fear in their hearts, but different from how we might react today. Today, something like that, we would never get past.

• 13:06Rund Abdelfatah?

  Cases of polio began to plummet. The polio vaccine became an example of a national triumph.

• 13:12Speaker 06

  And at this point, immunization and health professionals were saying, "We are definitely on our way into an era of just biomedical supremacy and freedom from infectious diseases like measles, smallpox, chickenpox, mumps, polio. We're just going to become a dustbin of history."

• 13:33Speaker 05

  But that's not what happened.

• 13:35Speaker 06

  So we get to the end of the 1960s, and what becomes apparent is that nobody's turning out for these vaccines the way they did for the polio vaccine. People feared polio, but they had a very different relationship with mumps, with measles, with rubella.

• 13:52Speaker 05

  They weren't as afraid, so more people skipped the shots.

• 13:56Speaker 06

  And what scientists and epidemiologists start noticing

• 14:00Speaker 06

  Also is that where you have communities that are highly vaccinated, you aren't really seeing outbreaks of things like measles anymore. But where communities aren't highly vaccinated, you're getting outbreaks of polio and measles. So at the end of the 1960s, there's such to be more and more of a push to strengthen the enforcement of mandates.

• 14:23Speaker 05

  Vaccine mandates. Over the next decade, this became a priority. And in 1977, President Jimmy Carter launched a national initiative to increase childhood vaccination rates. States began to enforce mandates that required children to get a set of vaccinations before they enrolled in school.

• 14:42Rund Abdelfatah?

  When we think of the word mandate, right, it's very much sort of top down, right?

• 14:49Speaker 06

  Yes.

• 14:50Rund Abdelfatah?

  And I think especially when it comes to children, that that seems like it could strike a nerve

• 14:56Speaker 06

  Yes.

• 14:57Rund Abdelfatah?

  for for parents in particular, right? That some authority is telling them, I know what's best for your child.

• 15:03Speaker 06

  Absolutely.

• 15:05Rund Abdelfatah?

  More so than you do.

• 15:06Speaker 06

  Absolutely. We were a country founded on libertarian values. Those values shaped the medical landscape of the 19th century and really like the medical landscape up to today. There's a tension between the authority of the parent and the authority of the state. And, you know, this has implications for all different kinds of sectors and questions in society, from, you know, mandatory schooling down to, you know, bike helmet laws and other public health measures. And, yes, vaccination.

• 15:44Speaker 05

  And in 1982, that tension would come to a head around the vaccine against diphtheria, tetanus, and pertussis, known as the DPT vaccine.

• 15:56Speaker 04

  The diphtheria, tetanus, pertussis vaccine had a difficult safety profile when it was first invented.

• 16:05Rund Abdelfatah?

  The vaccine could cause rare but severe side effects, like prolonged crying and seizures in infants. These symptoms were temporary, but claims began to circulate that the vaccine was doing permanent damage to children.

• 16:18Speaker 06

  So in the early 1980s, there is a reporter.

• 16:25Speaker 06

  Lee Thompson.

• 16:26Rund Abdelfatah?

  A reporter at NBC affiliate WRC TV in Washington DC, who catches wind of these claims.

• 16:33Speaker 06

  And she embarks on this reporting project, and it ends up becoming the basis for a 1982 hour-long news broadcast titled Vaccine Roulette.

• 16:45Speaker 05

  DPT Vaccine Roulette.

• 16:48Rund Abdelfatah?

  Just to note here, the people call this vaccine both DTP and DPT. So you'll hear both in the episode, but they're referring to the same thing.

• 16:58Speaker 06

  And what Thompson reports is that scientists have known for some time that there are adverse events associated with this vaccine, but that they aren't disclosing them to parents, and that parents are therefore, as she put it, playing a game of roulette with their children.

• 17:23Speaker 06

  If we kind of keep the Cutter incident in mind, we just marvel at the fact that parents at that moment in time knew that there was this horrible chance that something could go wrong, and yet people still got their kids vaccinated against polio anyway. But a couple decades later, the early 1980s, that's not what the parent population of the US is ready to sign on for at that point.

• 17:49Speaker 05

  Between the Cutter incident and DPT Vaccine Roulette, a lot had changed in the US. There was a string of government cover-ups. Watergate, the Pentagon Papers. These things had put the American people on edge. And there was a series of protest movements, from civil rights to the anti-Vietnam War movement, that changed the attitudes of the country towards their government.

• 18:12Speaker 06

  Their attitude in the wake of the Anti-authoritarian movements is, hold on. There were risks and we weren't informed? Why weren't we informed?

• 18:23Speaker 05

  After seeing the documentary, some parents began to allege publicly that their children had suffered permanent harm after getting the vaccine.

• 18:31Speaker 06

  They organized themselves into a group that they called Dissatisfied Parents Together.

• 18:36Speaker 05

  DPT. They picked that acronym on purpose.

• 18:40Speaker 06

  And they were a pretty formidable group.

• 18:42Speaker 05

  Parents also began to sue pharmaceutical companies.

• 18:46Speaker 06

  The whole issue was like, it was very complicated to determine with certainty whether it was the reaction that a kid had was coincidental with the vaccine. Or was it some underlying condition that was triggered by the fever that they got as a result of this vaccine?

• 19:01Rund Abdelfatah?

  This is Arthur Allen. He's a senior correspondent for nonprofit KFF Health News and author of the book Vaccine: The Controversial Story of Medicine's Greatest Lifesaver.

• 19:12Speaker 06

  You wouldn't really blame the vaccine for that because maybe if they'd had a fever the next week from a regular viral illness, they would, the same thing would have happened to them. So there's the scientific, like, answer to that, and then there's the legal answer to that.

• 19:28Rund Abdelfatah?

  The scientific answer became clear pretty quickly.

• 19:32Speaker 04

  Studies actually fairly quickly showed that, that, that wasn't the vaccine that was doing it. If you looked at children who got the vaccine or didn't, there was no increased incidence of any permanent defects associated with that vaccine.

• 19:43Rund Abdelfatah?

  The legal answer was a little murkier.

• 19:46Speaker 06

  I mean, vaccines are supposed to be really safe and they should be, you know, much safer than almost any medication you can think of. But that doesn't mean that they're completely safe. It doesn't mean that there's no harms.

• 19:58Rund Abdelfatah?

  Parents were winning personal injury lawsuits against the vaccine makers, with the average claim rising to tens of millions of dollars by 1984.

• 20:07Speaker 04

  It really drove vaccine makers from the market.

• 20:10Rund Abdelfatah?

  But the activists powering Dissatisfied Parents Together also wanted alternatives to lawsuits. They wanted a law on the books that would protect children from harm.

• 20:20Speaker 06

  They, over the course of the next four years, Worked tirelessly in the Capitol to introduce new laws that said that the federal government would do even more to ensure that the vaccine supply was safe.

• 20:40Speaker 05

  In 1986, they had a breakthrough, a new law called the National Childhood Vaccine Injury Act, which creates the Vaccine Injury Compensation Program, commonly known as the Vaccine Court.

• 20:55Rund Abdelfatah?

  It was designed to compensate individuals or their families who were injured by certain vaccines. It was a no-fault court, and the compensation money came from a government trust fund, funded by attacks on vaccine manufacturers. But the Vaccine Court also protected those vaccine manufacturers from lawsuits that threatened to hold up their production or even drive them out of business.

• 21:19Speaker 06

  So it's really important to pause here and look at this moment. The parents who came together were from across the political spectrum, and they did something that we'd seen happen before. They turned to Washington, they turned to the federal government, and said, "Do more to ensure that vaccines are safe." This is really distinct in the history of anti-vaccination, and I hesitate to call it that because it does not seem accurate at all. This is a movement that's saying, you know, some of our members actually have real reservations about vaccines, but we are the parents who got our kids vaccinated, and we want future parents to get vaccines for their children

• 22:01Speaker 06

  and feel absolutely confident in those vaccines.

• 22:05Rund Abdelfatah?

  Huh. Oh, see, that's a really important nuance.

• 22:09Speaker 06

  Mm-hmm.

• 22:10Rund Abdelfatah?

  That it wasn't a, "I don't want to vaccinate my child, and you shouldn't vaccinate your child." It's, "We need to demand that we are continuing to improve these vaccines and make sure that they are as foolproof as possible."

• 22:24Speaker 06

  Exactly, exactly. It's a lot easier to tell a story of simple anti-vaccinationism. It, you know, boils everything down to black and white.

• 22:37Speaker 06

  This parent group

• 22:38Speaker 05

  Dissatisfied Parents Together.

• 22:40Speaker 06

  Fractured after a while. There were those who found themselves just absolutely devoted to the cause and stuck with it and kept pushing and pushing and pushing. And then there were parents who said, OK, we got what we wanted, and now I'm moving on.

• 22:56Speaker 05

  Dissatisfied Parents Together would later morph into the National Vaccine Information Center, a group that today has been criticized for spreading misleading information about vaccine safety. The movement spawned by the documentary, DBT Vaccine Roulette, lived on.

• 23:14Speaker 04

  Really, in many ways, that vaccine caused the birth of the modern American anti-vaccine movement.

• 23:19Speaker 05

  Some parents began to draw connections between vaccines and any unexpected diagnoses.

• 23:26Speaker 06

  When Vaccine Roulette aired in 1982, it resonated with parents who feared that we were seeing, as a nation, more and more learning differences and developmental delays and disabilities in children. And they were really struggling to understand like why their kids had disabilities like this when they didn't and nobody in their family did. And vaccines started to suddenly seem like a possible explanation. Concerns about the connection between vaccines and autism were circulating for close to two decades before they were published in The Lancet.

• 24:11Speaker 05

  Coming up, Andrew Wakefield publishes his paper, "Giving the Movement New Life."

• 24:24Speaker 06

  Hello, I'm calling from Milwaukee, Wisconsin. And the only reason I'm calling is to say that I heard the program called "Through Line" last Friday night, and it was the most wonderful program I've ever heard. Thank you. Thank you so much.

• 24:42Speaker 05

  Stay tuned.

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• 25:53Speaker 00

  Part two, The Lancet Paper.

• 25:57Rund Abdelfatah?

  In 1996, a man named Richard Barr approached a doctor named Andrew Wakefield with an offer. Barr was a personal injury lawyer with ties to an anti-vaccine group. He offered to pay Wakefield to research a link between the MMR vaccine and autism so that he could use Wakefield's research as evidence in his lawsuits.

• 26:19Speaker 05

  Wakefield's paper was published in 1998 in The Lancet, one of the world's leading medical journals, sending shockwaves through the medical community.

• 26:28Speaker 04

  Now, his paper wasn't a study.

• 26:31Rund Abdelfatah?

  It was a case series, which is different from a full-blown scientific study. A case series is when doctors notice a trend in their field, maybe like a group of patients exhibiting mysterious symptoms, and they think there could be something more to look into. So they write up a paper on a very limited group of people detailing their findings.

• 26:51Speaker 04

  It was 12 children, eight of whom had developed signs and symptoms of autism.

• 26:57Rund Abdelfatah?

  Wakefield's paper suggested a link to the MMR vaccine.

• 27:01Speaker 04

  For which he had no evidence.

• 27:03Speaker 05

  Again, this is Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia.

• 27:11Speaker 04

  You could have published a paper saying, here's eight children who recently ate a peanut butter and jelly sandwich that now have signs and symptoms of autism, because it was really no better than that.

• 27:21Speaker 05

  But when it was published, people in the medical field took it seriously, because that's how a case series is supposed to work. Someone notices a strange pattern, publishes a paper about it, and it prompts other scientists to look into it.

• 27:35Speaker 04

  Because it's fair enough, right? My child was fine. They got this vaccine. Now they're not fine. Could the vaccine have done it? That is an answerable question. It's a scientific question that can be answered in a scientific venue, and was. And so, study after study after study, more than a dozen studies, done in seven countries, on three continents, involving thousands and thousands of children.

• 27:58Speaker 05

  None of them found any evidence that linked the MMR vaccine to the development of autism.

• 28:05Speaker 04

  So asked and answered.

• 28:11Speaker 05

  But the doubts Andrew Wakefield had sowed were powerful, and that's what landed Paul in front of Congress, testifying opposite Andrew Wakefield in April 2000.

• 28:23Speaker 06

  My concern, Mr. Chairman, is that parents listening to or reading about this hearing might incorrectly conclude that vaccines cause autism. This is not the case. Vaccines are extremely safe and highly effective.

• 28:37Rund Abdelfatah?

  I'd love to get a sense of even more of what it was like to be in that room listening to him.

• 28:42Speaker 04

  It was like the world had turned upside down. In my world, it's always the data that mattered. And it's fair to ask a question, it's fair to have a hypothesis, but if it's a testable hypothesis, which this was, does MMR cause autism, you're not asking how many angels can dance on the head of a pin. This was a question that could be answered in a scientific venue, and was being answered in a scientific venue. And it just... And so I saw this man standing up, ignoring those data, and just declaring his own truths, including scientific truths. And I just couldn't believe it. I wasn't used to that. I'm getting much more used to it now, but I wasn't used to that then.

• 29:17Rund Abdelfatah?

  Did you have any interaction directly with him?

• 29:21Speaker 04

  Yes, as he was walking out, I shook his hand. And he looked at me and sort of kept his eyes parallel, as if he was looking at something behind me, which was unnerving.

• 29:34Rund Abdelfatah?

  In that moment, did you have a sense of just how big this idea that he had launched into the world that vaccines cause autism was going to become?

• 29:44Speaker 04

  No, not at all. I still believed at that time, in a world dominated by logic and reason, that it's OK to ask the question, it's OK to have the hypothesis, but that when that question has been thoroughly answered, that that would end it. And I was just naive. I was wrong. It didn't end it at all. If anything, it's gotten worse over time as we have less and less trust in public health agencies.

• 30:14Speaker 04

  I will never forget that when that meeting was over, and there was an overflow room for parents because parents really wanted to hear this, as parents of children with autism. And afterwards, you know, there were a number of parents that came up to tell me what a jerk I was for sort of standing up for what I thought was the science of vaccines.

• 30:31Speaker 04

  The thing that struck me then and still strikes me is that we were like the scientists, or we were the doctors. But here, he was representing the parents. And, you know, we were parents too. So we cared deeply about vaccine safety.

• 30:46Rund Abdelfatah?

  Wakefield seems like he knew how to command a room. He knew how to shape the narrative. And that seems to have been really important in terms of getting this idea traction.

• 30:58Speaker 04

  He comes off as someone who's speaking truth to power, and that power is pharmaceutical companies who are never going to be seen as sympathetic. So if you're on the other side, I mean, you're just saying, look, this isn't true. I mean, this isn't causing autism, but you don't have anything to offer. You don't have a clear cause or causes of autism. He does. He's offering parents something, and we're not.

• 31:21Speaker 05

  The prevalence of autism diagnoses was rising dramatically during this time. From the 1970s to the 1990s, the US had seen a tenfold increase. Some people attributed the rise, at least in part, to greater awareness and changes in diagnostic criteria, but there wasn't a conclusive explanation.

• 31:42Rund Abdelfatah?

  Wakefield's theory was just one theory. Others started to emerge. Some parents latched onto an ingredient in some vaccines called thimerosal. It's a preservative used to keep germs from growing in some vaccines. It was never used in the MMR vaccine, but it was used in others, and it contains levels of mercury. Some parents believed exposing children to thimerosal could cause autism. This has been studied extensively since then, and there has been no scientific evidence linking the two. Still, the concerns about mercury led to change. There are now thimerosal-free versions of most vaccines available to people.

• 32:25Speaker 05

  Even if Wakefield's theory and thimerosal theory were pretty different, the people who believed in them had a common enemy.

• 32:33Speaker 06

  In the early 2000s, what we have is this moment in which a handful of things have been happening.

• 32:41Speaker 05

  Elena Connis, professor of journalism and history at the University of California, Berkeley.

• 32:47Speaker 06

  There's been growing attention to mercury exposure, growing crackdown on it. There's been growing attention to the abuses of the pharmaceutical industry. And what I mean by that is like very broadly, the practices of the pharmaceutical industry in courting doctors and selling diseases in order to sell drugs, in like concealing data, in turning out-

• 33:13Rund Abdelfatah?

  It's the opioid crisis, right?

• 33:15Speaker 06

  Yes, but like long before the opioid crisis. Like, you know, we even have like the editor of the esteemed New England Journal of Medicine writing a whole book about things that Big Pharma had done wrong. It has become like a national punching bag. There are these- Myriad concerns that parents and others have been raising about vaccines. The fact that autism rates were just skyrocketing in a mind blowing way. Like it just in the early 2000s, everywhere you looked, every classroom, there were kids with autism diagnoses. They were all across the spectrum.

• 33:56Speaker 06

  The statistics coming out of the CDC were absolutely terrifying and they just went higher and higher, like the rate of-

• 34:04Rund Abdelfatah?

  With no good explanation.

• 34:05Speaker 06

  No explanation at first and gradually like partial explanations coming together. But you can kind of start to see the issues here overlapping, like, hold on, mercury exposure, hold on, more and more vaccines and these mandates and autism. And this very active group of parents kind of join forces with some of the extant vaccine critical groups and start bringing attention to, again, as they called it at the time, vaccine safety issues in a way that hadn't happened in a full 20 plus years.

• 34:49Speaker 06

  Like, things had gone really quiet after the passage of the 1986 law.

• 34:57Speaker 06

  All of this is kind of like coming to a boil at the same time. Like, imagine a stove with all of these pots and they're all hitting like the boiling point.

• 35:08Speaker 05

  Soon, the pots on the stove would boil over and concerns about vaccines and autism would spread much further.

• 35:16Speaker 04

  Around 2004, RFK Jr. called me.

• 35:21Rund Abdelfatah?

  That's coming up.

• 35:27Rund Abdelfatah?

  Hello, this is Steve from Tampa, Florida, and you're listening to Throughline from NPR.

• 35:35Rund Abdelfatah?

  Stay tuned for the following announcements and messages from our sponsors.

• 35:39Speaker 00

  This week on Wait, Wait, Don't Tell Me, panelist Paula Poundstone shares a hot tip for saving money this Halloween. I used to have my kids go out early enough that I could take their candy and give it out. That's so smart. Don't miss our full conversation and the rest of our games. Listen to the Wait, Wait, Don't Tell Me podcast in the NPR app or wherever you get your podcasts. The number one issue in America right now is the economy, whether it's the high price of gas, a potential AI bubble, or the unsteady job market. At NPR's The Indicator, we've got you covered. Understand the economy in 10 minutes or less each day. Listen to The Indicator from Planet Money on the NPR app or wherever you listen to

• 36:21Speaker 00

  podcasts. Support for this podcast and the following message come from the Southern Environmental

• 36:31Speaker 05

  Law Center. No one voted for a dirty air. No one voted for polluted water. That's why S E L C is fighting back to defend the healthy environment everyone depends on, just as they've done for 40 years. Because clean air, clean water, and a healthy climate aren't political, they're fundamental. Learn more at selc.org.

• 36:53Speaker 05

  Part Three: Deadly Immunity.

• 36:57Speaker 05

  June 2005. Dr. Paul Offit wakes up to an article from Rolling Stone titled,

• 37:06Speaker 04

  Deadly Immunity.

• 37:07Speaker 05

  The author is a well-known environmental lawyer named Robert F. Kennedy Jr., who'd called him up while researching the article a year earlier.

• 37:16Rund Abdelfatah?

  For years, RFK Jr. had been concerned about mercury and the environment. He'd pushed back on the coal industry to clean up rivers, where the mercury and fish had been found to have a harmful impact on humans who ate them. So when he learned there was mercury in vaccines, he decided to investigate, and he called up Paul.

• 37:35Speaker 04

  It was a good conversation. We talked for about an hour.

• 37:39Rund Abdelfatah?

  At least, that's what he thought before he read the article.

• 37:43Speaker 06

  Although the vaccination industry insists that ethyl mercury poses little danger because it breaks down rapidly and is removed by the body, several studies suggest that ethyl mercury is actually more toxic.

• 37:55Speaker 04

  He just said that mercury is in vaccines at a level that's toxic. He had misstatement after misstatement after misstatement in that article.

• 38:03Speaker 05

  Paul had developed a vaccine for an illness called rotavirus. And as he says, he told RFK on that call, "Study after study had shown that a child would ingest more mercury from breast milk than from any vaccine. There was no evidence that such small quantities caused damage."

• 38:22Rund Abdelfatah?

  So back to the article. In it, RFK Jr. also repeated a claim from a scientific paper published in the late 90s by a doctor in England named Andrew Wakefield, the claim that vaccines are linked to autism.

• 38:36Speaker 05

  We should quickly note, RFK Jr. and Andrew Wakefield did not respond to our request for comment for this episode.

• 38:44Speaker 06

  He was arguing another thing, namely that the pharmaceutical industry was aware of something and was concealing it.

• 38:52Speaker 05

  This is Elena Connas.

• 38:54Speaker 06

  And that corporations like that actually needed more regulation and oversight than they were getting. The scientists and researchers, many of them sincere, even idealistic, who are participating in efforts to hide the science on the Marisol, claim that they are trying to advance the lofty goal of protecting children in developing nations from disease pandemics. They're badly misguided. Their failure to come clean on the Marisol will come back horribly to haunt our country and the world's poorest populations. Deadly immunity, Rolling Stone, June 2005. And coming from an environmental lawyer, that argument had a lot of traction.

• 39:36Speaker 05

  RFK Jr.'s article reignited debates over vaccines, and Andrew Wakefield started to get noticed in the US.

• 39:49Speaker 06

  This high-profile individual, he had been one in England.

• 39:52Rund Abdelfatah?

  And he inspires other high-profile supporters.

• 39:56Speaker 06

  We do not need that many vaccines. A number of celebrities start talking about their own concerns about vaccines, going on nationally televised talk shows.

• 40:08Rund Abdelfatah?

  Among the most vocal were.

• 40:09Speaker 06

  Jenny McCarthy and Jim Carrey.

• 40:12Rund Abdelfatah?

  Without a doubt in my mind, I believe vaccinations triggered Evan's autism. Actress Jenny McCarthy and comedian Jim Carrey were dating at the time, and Jenny's son had been diagnosed with autism.

• 40:25Speaker 06

  So I think they need to wake up and stop hurting our kids.

• 40:29Rund Abdelfatah?

  Together, they organized a rally in the nation's capital called Green Our Vaccines.

• 40:34Speaker 06

  I just want to start by asking the CDC one question. How stupid do you think we are?

• 40:41Rund Abdelfatah?

  RFK Jr. spoke at that rally. They've removed the thimerosal from the vaccines and autism rates have not gone down. How many times have you read that, repeated by these people from the press?

• 40:54Rund Abdelfatah?

  That is an industry talking point that the industry knows is a lie. Everybody knows. National news outlets turned out story after story about vaccines.

• 41:04Speaker 06

  Local newsrooms were closing down and there was increasing competition for news consumers. And the vaccine story was one of these stories that resonated broadly.

• 41:20Rund Abdelfatah?

  And meanwhile.

• 41:20Speaker 06

  Social media is taking off. The public can actually weigh in. And so this thing really snowballs and it's really creating a mass movement.

• 41:36Speaker 05

  So as this mass movement continued to make headlines in the 2000s, it also began to face more scrutiny.

• 41:44Speaker 06

  A lot of really critical media attention then starts to focus on the kind of characterization of vaccine skeptics as ignorant.

• 41:58Speaker 06

  Selfish, uninformed, and worse. And it's become kind of a moral position that many in media and politics have become comfortable taking vaccines save lives. If you don't get vaccines, you don't care about people and you don't believe in science without including any of the vast context around the question.

• 42:26Speaker 05

  Yesterday, a respected British medical journal retracted a study that said the MMR vaccine may trigger autism. CBS News correspondent Richard Roth. With more eyes on the movement, the Wakefield paper came under more scrutiny. The Lancet retracted it in 2010, and a British journalist named Brian Dear published an investigation revealing that it wasn't just flawed, but omitted key facts. Dear had already confirmed that Wakefield was paid to conduct his research by people with an interest in its outcome. His new work revealed that some children in the study had already exhibited signs of autism before getting vaccinated. RFK Junior's article in Rolling Stone was also removed.

• 43:11Rund Abdelfatah?

  You went through the sort of fallacies of the Wakefield paper. Do you remember when it was retracted and what your reaction to the retraction was? And what happens to Wakefield?

• 43:25Speaker 04

  My reaction was, it's too late. It should have never been published. You can't say anything about causality because there's no control group.

• 43:32Rund Abdelfatah?

  But were you surprised that even after the retraction, the narrative continued?

• 43:38Speaker 04

  I'm not even sure if they'd retracted it a month later, it would have mattered. I think the cage door got open and the devil came out.

• 43:47Speaker 05

  After the retraction, Wakefield lost his medical license in the UK, but he had already moved to the US and gotten involved in the anti-vaccine movement. Eventually, he made a documentary which controversially reiterated the claims in both his paper and RFK Junior's article.

• 44:06Speaker 05

  As for RFK Jr., he launched an organization called the World Mercury Project that was committed to, quote, "exposing the government and corporate corruption that has led to increasing exposures to neurotoxic mercury in foods and medicines."

• 44:23Speaker 06

  And in the meantime, vaccine-preventable diseases are starting to break out in really troubling numbers.

• 44:32Speaker 05

  Health officials fear thousands

• 44:34Speaker 04

  may have been exposed to the measles at Disneyland and Disney California Adventure last month.

• 44:39Speaker 06

  And in 2014, there's this measles outbreak that starts at Disneyland.

• 44:45Speaker 04

  I think the original case may have come in from outside of this country because measles is still prevalent in the world.

• 44:51Rund Abdelfatah?

  Measles had been eliminated in the US by the year 2000, which meant enough people were vaccinated that even if someone came into the country with measles, it wouldn't be able to spread. Think of it as like a bunch of people holding up umbrellas in a group. So even if a few people don't have an umbrella, they're still shielded from the rain.

• 45:10Speaker 04

  There was essentially a moat around them.

• 45:12Rund Abdelfatah?

  But that protection wouldn't last forever. For decades, California had allowed some people to opt out of vaccines for non-medical reasons. The state actually created that exemption when it started mandating that kids get the polio vaccine before enrolling in school, back in the 1960s.

• 45:29Speaker 04

  California had a philosophical exemption to vaccination.

• 45:34Rund Abdelfatah?

  And vaccination rates had begun to fall.

• 45:36Speaker 04

  Once vaccination rates fray, that moat disappears. Eye fever, aching eyes, hacking cough, and after a week, every square inch of you covered by red dots. Measles. Tonight, the CDC warns it's back and it's spreading. So Oregon is now the latest state

• 45:53Speaker 06

  to have a case of measles traced back to that outbreak that started at Disneyland. As health officials try and contain the virus. From late 2014 into 2015, health professionals and lawmakers come together in California and elsewhere and say, like, enough is enough. We have had enough vaccine skepticism. We have had enough use of vaccine exemptions. And so they start cracking down on exemption clauses.

• 46:23Rund Abdelfatah?

  But there was a backlash.

• 46:25Speaker 06

  Jim Carrey is really upset with California Governor Jerry Brown for signing a new vaccination law this week. The rule

• 46:33Speaker 02

  Six vaccines mandatory for all schoolchildren regardless of their religious and personal beliefs. Carrie went off on Twitter and called Governor Brown a corporate fascist who must be stopped.

• 46:49Speaker 06

  In 2017, you started to have these Republican-led legislatures that were very skeptical of vaccination.

• 46:58Speaker 05

  Arthur Allen is a senior correspondent for KFF Health News.

• 47:02Speaker 06

  Republicans had always been as pro-vaccine as anybody else. It was a reaction to this effort to sort of crack down on vaccine exemptions that were causing this measles outbreak. And it created incredible power in the anti-vaccine movement.

• 47:18Speaker 05

  The Disneyland outbreak led to 147 people being infected with measles across seven states, Mexico and Canada. No one died, but Paul Offit says if vaccination rates continue to decline, outbreaks like that could be much worse in the future.

• 47:36Speaker 04

  So I just, I just fear this. I think we're just so blasé about this. We, we don't remember these diseases and I guess having lived in a polio ward for six weeks, it's, that's still with me.

• 47:51Rund Abdelfatah?

  Let's, let's play out the scenario. What are we looking at if vaccination rates for these different diseases fall?

• 47:59Speaker 04

  Then you'll see children start to die from measles again because that's always the first one to come back. It's already starting to come back. Measles is the single most contagious vaccine-preventable disease. The contagiousness index for viruses like influenza or SARS-CoV-2, the cause of COVID, is like two to four, meaning you'll infect two to four people. The contagiousness index for measles is 18. It's much, much higher. You just have to be in the person's airspace within two hours of them being there. And sadly, that may be what it takes that we have to see children suffer this, but I'm not even sure that will do it. I think we have lost trust. I think a lot of that happened during the COVID pandemic.

• 48:42Speaker 04

  In part because we weren't always right, because we were learning as you go,

• 48:50Speaker 04

  because you're building the air paneling while it's still in the air.

• 48:55Speaker 04

  And we're sort of dictating things and that really rubbed people the wrong way.

• 49:04Rund Abdelfatah?

  Yeah, I have to say, I kind of, I feel that I had my first kid last year. And, you know, you're getting vaccines basically from the time they're, what, like, two months old. And I have a new kind of empathy for that kind of fear that many parents have because you have this desire to sort of control everything, you know, about their well-being and health and care and all of that.

• 49:28Speaker 04

  I think it's perfectly reasonable for a parent to be skeptical of anything that they put into their child's bodies, vaccines certainly among them. I mean, we ask parents to give as many as 25 shots in the first few years of life to prevent diseases most people don't see, using biological fluids most people don't understand. I think it would be surprising if parents weren't skeptical of vaccines. But I think that there's a difference between skepticism and cynicism. And when you cross the line to cynicism, now you just don't believe what people are telling you. You don't believe the data, you don't believe the science, and that's different. All you have that separates truth from superstition are excellent scientific studies, and if you're throwing those out, then you feel like there's no hope.

• 50:11Speaker 06

  I will say that when you sit down to get a vaccine, you're placing an enormous amount of trust in a long chain of people and institutions that you may not know, you may never see, you may never understand. That trust is fundamental to that story of success. But that trust has been eroded across the board. Getting a vaccine is not just this simple, cut-and-dried medical or political act. Like, it's a human act, and it can be painful.

• 50:55Speaker 06

  And when we do it to children and our little babies, it's emotional, too. All of that is part of the reality of getting vaccinated. So, yes, vaccines save lives, and I wish that could be the end of the story, but the entire reason why I study the history of vaccination is because it's not.

• 51:33Rund Abdelfatah?

  That's it for this week's show. I'm Rund Abdelfatah.

• 51:36Speaker 05

  I'm Ramtin Arablouei, and you've been listening to Throughline from NPR.

• 51:41Rund Abdelfatah?

  This episode was produced by me.

• 51:43Speaker 05

  And me, and. Lawrence Wu. Julie Kane. Anya Steinberg.

• 51:48Speaker 01

  Casey Minor. Christina Kim. Devin Kadyama. Irene Noguchi.

• 51:55Rund Abdelfatah?

  Voiceover work in this episode was done by Devin Kadyama.

• 51:58Speaker 05

  Thank you to Greta Pittinger at RAD, Brett Neely, Scott Hensley, Johannes Dergi, Jonette Oakes, Keandre Starling, Tony Cavan, Nadia Lancy, Edith Chapin, and Colin Campbell.

• 52:12Rund Abdelfatah?

  Fact checking for this episode was done by Kevin Vocal. This episode was mixed by Jimmy Keely. Music for this episode was composed by Ramtin and his band, Drop Electric, which includes.

• 52:24Speaker 01

  Navid Marvi.

• 52:25Speaker 05

  Cho Fujiwara. Anya Mizani. And finally, if you have an idea or like something you heard on the show, please write us at [email protected] or hit us up on Twitter at Throughline NPR.

• 52:38Rund Abdelfatah?

  Thanks for listening.

• 52:48Speaker 00

  Stay tuned for the following announcements and messages from our sponsors.