Vaccines and autism are in the news... again. This time, Melinda Gates' recent remarks at Davos got me thinking about a strange vaccines analogy. Often, the lack of widespread vaccinations leads to unsettling news headlines. As an example from 2014, a record high number of measles cases (667) was uncovered since the disease was considered eliminated in 2000. This did not transpire in one of the African countries that the Gates Foundation targets for funding vaccine campaigns, but in one of the most developed countries in the world and in the history of time.
Before I demystify my analogy, let me ask a question:
How can a celebrity hide in plain sight in a place you normally don't find them? Let's say in downtown Berkeley, California where I went to college, a colorful place where tight-jean-wearing hipsters and hippies abound. You would think they could blend in as normal people, given that stranger things can be spotted near fraternity row, like tutu-wearing EDM concertgoers sporting Cookie Monster's carcass for shoes (read: furry rave leg warmers). You would think that... but no.
Usher once tried to get one of Top Dog's famed hot dogs in Berkeley, and my entire FB newsfeed just about imploded. Like a normal guy, he was wearing a t-shirt, jeans and sunglasses -- the typical MO for any celebrity trying to blend in. But the attack was immediate. It was like the hipster kids on the street could smell the "mainstream" on him. They all rebelled by outing him on social media and closing in on him until he was forced to moonwalk out of there. Or, at least, that's how I imagined the scene transpiring.
What if he was wearing the same outfit in N.Y.C.? Now, that's a whole different story. I've heard native New Yorkers say celebrities walk in plain sight all the time. They dress like us lesser mortals and pop on some shades to go. So why don't they get the same reaction on the streets? Because everyone wears shades in New York.
It's called herd immunity.
When a celebrity wears sunglasses and everyone else in a 5 mile radius is also wearing them, he/she will be safe from recognition. But, when you try to go to a place full of lovable weirdos like in Berkeley and try to be normal... well, then you will be spotted.
And there's the neat little vaccines connection I'm trying to draw here. The effectiveness of vaccines in a population operates just like donning sunglasses in New York. A certain percentage of the population must be wearing them for celebrities to be safe from their adoring fans. In the same way, a certain percentage of the population must be vaccinated for us to be safe from adoring germs.
The CDC publishes these thresholds called Herd Immunity Thresholds (HITs), and they vary by disease. For measles, 83-94% of the population must be vaccinated; for mumps, 75-86%; for rubella, 83-85%. Not many people know about that.
In our class studying the diffusion of innovation in society, my professor Dr. Tim King told us about the Wakefield/McCarthy anecdote to shed some light around what causes some innovations to be adopted and others to be discarded. On mass airwaves, Jenny McCarthy gave credence to the fraudulent study by Andrew Wakefield that tried to paint a causal link between the MMR (Measles, Mumps, Rubella) vaccine and autism. And why did Dr. Wakefield do that? Because he was getting ready to peddle some bogus test kits to doctors to diagnose "autistic enterocolitis" (i.e. vaccine-induced autism, an entirely fictitious condition) and sell a counter-vaccine for MMR. And you thought Martin Shkreli was shady.
Anyhow, many public health experts blame this incident for propagating the mistaken notion that vaccines are dangerous. Given the influence of celebrity opinion leaders in America, endorsing such claims and worse, failing to condemn them upon further evidence, is extremely irresponsible.
In this case, you also uncover the two traits that prevent vaccines from being adopted at greater rates:
(1) Observability: If people don't see visible results, slow adoption rates ensue. When you have a product like a vaccine, where success is defined by a non-event, people are just a lot less likely to believe its efficacy, especially if they see a neighbor who didn't get vaccinated remain healthy.
(2) Complexity: If people don't understand how something works, they may not adopt it. Vaccines sound like paradoxes: "So you're telling me that you're going to inject potentially lethal bacteria into my blood, and I'm letting you...why?" As much as you want to go into the details of how small doses don't do harm and that vaccines in fact create antibodies that protect you from the disease, people won't get into the minutiae. Smartphones are easy to use thanks to Steve Jobs and brilliant UX designers, but does the lay person really understand the circuitry behind them? (For more information on how products or ideas are adopted by society, read Diffusion of Innovations by Everett Rogers).
Dr. King's words during that lecture were haunting: "It's safer to be unvaccinated among a vaccinated population than to be vaccinated among the unvaccinated." With the latter, there is a much greater likelihood for disease outbreaks to happen.
So next time you hear of a highly publicized measles outbreak (hello April 2015 Disneyland!), don't blame The Mouse. Don't blame vaccines. Don't even blame your neighbors who didn't get their kids vaccinated. Educate them. The only person you can probably blame this all on with some immunity (hehe) is Jenny McCarthy.
Follow Kiron Chandy on Twitter @kironchandy.