TIME Infectious Disease

The Vast Majority of U.S. Kids Are Vaccinated

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Elizabeth Renstrom for TIME

Less than 1% of children received no vaccinations in 2014, but pockets of low vaccination rates put kids at risk

Vaccines are one of the most effective tools for preventing serious diseases in childhood and later in life, and new data from the U.S. Centers for Disease Control and Prevention (CDC) shows most children in the U.S. are vaccinated.

CDC researchers looked at national, regional, state and local vaccine coverage rates and found that overall coverage remains high, and hasn’t changed much between 2013 and 2014. The data shows that the national target of 90% coverage was reached for poliovirus (three or more doses of the vaccine), measles, mumps and rubella (one or more doses of the vaccine), hepatitis B (three or more doses of the vaccine) and varicella (one or more dose of the vaccine).

Overall, children below the federal poverty level had the lowest coverage for nearly all types of vaccinations.

A second report published Thursday from CDC researchers found that most kindergarteners entering the 2014-15 school year were vaccinated, and the exemption rate for vaccines nationwide was about 1.7%.

That’s the national picture at least. The data also shows that state-exemption rates range pretty significantly, with Mississippi at less than 0.1% and Idaho at a high of 6.5%. There were five states that did not meet the CDC’s reporting standards for providing vaccine exemption data. Pockets of children who miss vaccinations exist in our communities and they leave these communities vulnerable to outbreaks of vaccine-preventable diseases,” said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases in a press conference.

Pockets of low vaccination rates have proven problematic this year. In the new report, the researchers write that in 2015, measles outbreak cases included 68 unvaccinated Americans, and among those people, 29 cited philosophic or religious objections to vaccines. The CDC says the U.S. experienced a record number of measles cases in 2014 at 668 cases. That’s the highest number of measles cases since the disease was eliminated in the U.S. in 2000. Between January to August 21, 2015, there have been 188 cases of measles so far.

“We always worry about children and others with leukemia and other similar medical problems who can’t actually receive the [measles, mumps, and rubella] vaccine themselves,” said Schuchat.

The CDC reports in its latest study, that among the 49 reporting states and the District of Columbia (DC), the median vaccination coverage rate was 94% for the measles, mumps, and rubella (MMR) vaccine, and approximately 94% for local requirements for the diphtheria, tetanus, and acellular pertussis vaccine. Varicella coverage was 93.6% among the 39 states and DC that have a 2-dose varicella vaccine requirement.

Some states are strengthening their requirements for exemptions. In 2015, California removed religious and philosophic exemptions for kids in public and private schools and Vermont removed philosophic exemptions. Schuchat recommended parents find out what their states’ vaccination exemption rates are.

Getting routine vaccines in childhood is estimated to prevent 322 million cases of disease and 732,000 early deaths among kids, the CDC points out in its report. The benefits of vaccination are not just for health. Routine vaccination could save $1.38 trillion.

TIME vaccines

Here’s How the Anti-Vaxxers’ Strongest Argument Falls Apart

In session: The vaccine court—like vaccines themselves—stands by to help
Education Images; UIG via Getty Images In session: The vaccine court—like vaccines themselves—stands by to help

Jeffrey Kluger is Editor at Large for TIME.

The anti-vaxxers have been misrepresenting an important, if little-used, law

Scientists have long since learned to roll their eyes at politicians—especially when the topic is vaccines. Chris Christie and Rand Paul have both blundered into trouble with their support of vaccine opt-outs, a position that puts them at odds with virtually every medical authority on the planet. On Aug. 13, Carly Fiorina echoed a similar theme when she questioned “esoteric immunizations” like the HPV vaccine—which is a strange way to describe a shot that can save a woman’s life. All that, however, is just campaign-season noise.

Less noticed but perhaps more damaging was the moment in late July when Florida Republican Bill Posey rose on the floor of the House of Representatives and raised what has long been the anti-vaccine crowd’s biggest argument: the existence of a “Vaccine Injury Court.”

It’s at that point that the conversation often stops. The court—a federal panel that adjudicates payments to what the anti-vaxxers call “vaccine-injured children”—has long been the kryptonite, the dropped mic, the rapped gavel of any rational discussion of vaccine safety.

And no wonder: Since 1988, when the National Vaccine Injury Compensation Program (VICP) began, more than 16,000 claims have been considered and a whopping $3.18 billion have been awarded to families alleging some kind of harm from vaccines. That sounds awfully damning, and in this case, unlike in so many other cases, the anti-vaccine crowd isn’t just making stuff up. The numbers are real and the federal government is the first to admit it.

But the anti-vaxxers are utterly wrong in their interpretation of what the numbers mean. And in fact, the numbers prove that vaccines are as safe as the medical community says they are. Understanding why that’s so means going beyond the tired alarmism and looking at the facts.

The Court, Then and Now

The “vaccine injury court” is more properly known as the Office of Special Masters, which itself is a division of the United States Court of Special Claims. The special masters were created as part of the VICP, an act passed by Congress in 1986 and signed into law by President Ronald Reagan in 1988. It is a fundamental part of the anti-vax canon that the court is a closely held secret, established by Washington but kept as quiet as possible, lest the public catch wise to the fact that hush money is being paid to injured families.

“It is obvious that the government does not want to publicize the existence of the [court],” reads one website that is typical of the conspiracy wing, “because the more Americans learn that there are vaccine injuries and deaths … the more they may start to question the safety of vaccines.”

That, no surprise, is nonsense. The law was well-publicized at the time of its passage and is even better publicized today, thanks to a website set up by the Department of Health and Human Services (HHS), which not only explains the court in depth, but also provides the names and contact information of lawyers in all 50 states and offers detailed assistance in filing a claim.

The purpose of the court is to reckon with the reality that while vaccines are every bit as safe and life-saving as health authorities say they are, no drug or medical procedure is entirely without risks. Since many millions of children get vaccinated every year, even a few bad outcomes could subject the drug-makers to a storm of liability suits. Some claims might be legitimate, but far more could be frivolous or even fraudulent. Either way, the endless litigation could drive up the costs of vaccines.

In order to ensure that vaccines would be as affordable and available as possible, Congress thus created the VICP, establishing a trust fund for awards financed by an excise tax of 75 cents on every vaccine administered. Under the program, cases are adjudicated on a no-fault basis, with attorneys for the government and attorneys for the families arguing before one of eight special masters. The goal is to settle the matter as quickly and fairly as possible, though petitioners (the no-fault system avoids the word “plaintiffs”) who are unhappy with the special master’s ruling are free to take their case to the traditional civil court system.

The standard the petitioners must meet to recover any award is a comparatively low one—the “preponderance of the evidence” rule of civil law, rather than the “beyond a reasonable doubt” requirement of the criminal court system. In practice, that standard has been even more liberally construed in the vaccine court than it is in ordinary civil court, a fact that generally benefits the petitioners. More frequently still, things don’t go that far. In 80% of all cases brought since 2006, the parties settle, meaning that the petitioner recovers an award with no determination being made about whether the vaccine even caused the claimed harm.

“Settlements are not an admission by the United States or the Secretary of Health and Human Services…that the vaccine caused the petitioner’s alleged injuries,” says the HHS website. Claims may be settled for a lot of reasons, including “a desire by both parties to minimize the time and expense associated with litigating a case to conclusion; and a desire by both parties to resolve a case quickly and efficiently.”

Even without blame being established, the billions the government has handed over in payouts since the VICP was created does seem to suggest that a whole lot of people are being harmed. But that is not the case. From 2006 to 2014, approximately 2.5 billion doses of vaccines were administered in the U.S. In that time, a total of just 2,976 claims were adjudicated by the special masters and only 1,876 of those received compensation. Divide that number by the vaccine dose total and you get less than a one in a million risk of harm. Going all the way back to 1988—before the flu vaccine became part of the recommended schedule of vaccines—a total of 16,038 claims have been adjudicated and 4,150 have been compensated, bringing the total payouts up to the $3.18 billion figure.

To the anti-vaxxers, the low number of claimants spells its own kind of trouble. Divide overall payout by the relatively few injured parties and you get $766,265 per petitioner. The government wouldn’t hand over that kind of cash unless the injuries people do sustain are severe, right? Wrong.

Flooded With Injury Claims

The website of the U.S. Centers for Disease Control and Prevention (CDC) is very clear about any possible injury or side-effect that could possibly be caused by a vaccine (giving the lie to yet another anti-vaxxer claim that those risks are being covered up). The large majority of the possible problems are minor and transient—a fever, a short-term allergic reaction, soreness at the site of the injection. There is the possibility of autoimmune reaction too, in which the body effectively attacks itself, though the science is still vague on what role, if any, vaccines can play in that. Other possible problems include simple injury to shoulder, when the vaccine needle penetrates the bursa—the sac of cushioning fluid that protects the joint. For many of these problems, the claimants are adults, not kids.

In rare cases, severe neurological reactions have been observed too, but that very rarity makes it impossible to determine if they were caused by the vaccine or were a mere coincidence in timing. Still, the no-fault rule of the VICP doesn’t seek proof of causation, which means that claims like this are covered—and those are the ones that drive up the overall average.

“In cases in which there is a lifetime injury, the award will be the equivalent of many millions of dollars,” says New York-based attorney Robert Krakow, who has represented petitioners in hundreds of vaccine injury claims. “It could be $20 million over a lifetime.” Just three such claims a year—out of the many millions of vaccines administered annually—0ver the course of the 27 years the VICP has been in effect can account for half of the total dollars spent on awards.

No surprise, since the rise of the anti-vax fringe, the VICP has been inundated. In 1998, the year U.K. physician Andrew Wakefield published his fraudulent paper linking the MMR vaccine to autism, just 325 injury claims were filed, 181 were dismissed and 144 were compensated. In 2010, Wakefield’s fraud was exposed, his paper was withdrawn and he was stripped of his license to practice medicine in the U.K. But the anti-vax hysteria had been unleashed, driven in part by anti-vaccine drum-bangers like Jenny McCarthy. The following year, 1,637 claims were filed. In 2012, that figure rose further, to 2,702. The number of awards granted increased as well, but still remained in the low triple digits—266 in 2011 and 263 in 2012.

Certainly, vaccine science is not fixed, and different circumstances lead to different law. The case of Hannah Poling, the 9-year-old Georgia girl who, in 2008, received a $1.5 million award when the court agreed that vaccinations contributed to her later-onset autism, rocked the medical community and only worsened the anti-vax panic. But Poling was a special case; she was suffering from an underlying disorder of the mitochondria, or the energy-processing organelle in the cells. This made her vulnerable to any oxidative stress that could, in theory, be caused by vaccines. Mitochondrial disorders are increasingly being cited in vaccine court claims, but the conditions are not common and are poorly understood. “The belief is that the vaccine triggers a decompensation,” says Krakow, “but this is controversial.”

What’s not controversial is the far bigger picture, which is that medicine has never been about eliminating all risks, but about minimizing and balancing and coolly considering them. Childhood diseases are a manifest danger, capable of sickening hundreds of thousands or even millions of kids each year. Vaccines, which offer powerful—if imperfect—protection, all-but eliminate that peril. Yes, they introduce a tiny bit of their own risk, but they still leave children far safer than they otherwise would be. For the literal one in a million who are harmed, the VICP stands by to help. For the rest, it’s the vaccines themselves that do the helping.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Mental Health/Psychology

Here’s Why People Believe In Conspiracy Theories

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UFO sightings. Hoaxed moon landings. Reptiles who rule the world.

What, in the name of our alleged lizard overlords, convinces a person to believe in conspiracy theories?

According to a pair of new studies published in the journal Applied Cognitive Psychology, conspiracy theorists—and there are a lot more of them than you may think—tend to have one thing in common: they feel a lack of control over their lives.

Jan-Willem van Prooijen, associate professor in social and organizational psychology at VU University Amsterdam, has been studying conspiracy theories and those who believe them for six years. “When I started this research, one of the things that I really found astonishing was how many people believe in certain conspiracy theories,” he says.

MORE: Extraterrestrials on a Comet Are Faking Climate Change. Or Something

Conspiracy theories often crop up during times of uncertainty and fear: after terrorist strikes, financial crises, high-profile deaths and natural disasters. Past research suggests that if people feel they don’t have control over a situation, they’ll try to make sense of it and find out what happened. “The sense-making leads them to connect dots that aren’t necessarily connected in reality,” van Prooijen says.

He and his team showed that the opposite is also true: feeling a sense of control is protective against believing conspiracy theories. In one of the studies, they split 119 people into two groups and told one group to write down times when they were totally in control; the other group was told to jot down a time when they didn’t feel in control. (This gave one group a powerful feeling, while the other felt helpless.)

The researchers then surveyed their attitudes on a building project in Amsterdam that accidentally destroyed the foundations of many houses, and which many people believed was a conspiracy of the city council. But those who had been primed to feel in control were less likely to believe the government was up to something evil. “We found that if you give people a feeling of control, then they are less inclined to believe those conspiracy theories,” he says. “Giving people a sense of control can make them less suspicious over governmental operations.

MORE: What The Jade Helm 15 Conspiracy Theory Reveals About Americans

The Dutch, of course, aren’t the only believers. The second experiment looked at survey data from a nationally representative sample of Americans conducted in the last months of 1999 leading up to Y2K. “The more that people feared the millennium bug in 1999, the more likely they were inclined to believe in other conspiracy theories, ranging from Kennedy to the government hiding evidence of the existence of UFOs,” van Prooijen says. The best predictor of believing in one conspiracy, he says, is believing in another.

This finding backs up data from another group last year, which found that 37% of surveyed Americans believe that the FDA is deliberately preventing the public from accessing natural cures for cancer because they’re beholden to drug companies.

These beliefs can be very hard to change, but giving people a feeling of control could help dispel some conspiratorial beliefs, the new research suggests—a finding that could prove useful worldwide. “There are no doubt cultural variables influencing it,” van Prooijen says. “But the essence of conspiracy theorizing is, I think, universal in human beings. People have a natural tendency to be suspicious of groups that are powerful and potentially hostile.”

TIME vaccines

How to Change an Anti-Vaxxer’s Mind

TIME.com stock photos Health Syringe Needle
Elizabeth Renstrom for TIME

Jeffrey Kluger is Editor at Large for TIME.

It's not easy, but a new study suggests one way to help persuade parents to vaccinate their children

Let’s take a moment and praise anti-vaccine parents. Really. They’re wrong on the science, wrong on the politics, and deeply, morally wrong to deny their own children a simple disease preventive that they themselves likely enjoyed growing up. But like all parents everywhere, they’re acting on a simple, powerful impulse: to keep their children healthy.

That’s a very noble goal, but it’s also one of the things that makes it so bloody hard to change their minds on the topic of vaccines. Public service campaigns don’t work; nor do one-on-one explanations of why the rumors about a vaccine-autism link are wrong. In some cases, there is even a backfire effect: the greater the effort expended to persuade the anti-vaxxers, the more convinced they become that they’re right.

So it’s extremely good news that researchers at the University of Illinois Urbana-Champaign may at last have come up with a way to cut through the misinformation and get the truth across: Don’t just tell parents to vaccinate their children, show them what happens if they don’t.

In a study published in the Proceedings of the National Academy of Sciences, a team led by graduate student Zachary Horne recruited a sample group of 315 people—both parents and non-parents—and first conducted a simple survey designed to measure their pre-existing attitudes to vaccines. The subjects were asked to respond on a six-point scale, from “strongly agree” to “strongly disagree,” to five statements that included, “The risks of side effects outweighs any potential benefits of vaccines” and “I plan to vaccinate my children.”

All of the subjects were then divided into three groups: One group was given material to read about the latest research showing that autism and vaccines are in no way related. The second group was given a paragraph to read written in the voice of a mother describing what it was like when her child contracted measles; three pictures of children with measles, mumps and rubella; and written warnings about the importance of vaccinating children. The third group, serving as a control, read material on an unrelated science topic.

When the three groups’ attitudes to vaccines were tested again, the results were striking. Both the control and the so-called “autism correction” group showed a slight uptick in their approval of vaccines, but in neither case were the numbers terribly significant. The group that had learned about the wages of vaccine denialism changed markedly, however, with increased approval rates five times larger than those in the autism correction group and six times larger than in the control group.

“Rather than attempting to dispel myths about the dangers of vaccinations,” the researchers wrote, “we recommend that the very real dangers posed by serious diseases like measles, mumps and rubella be emphasized.”

As TIME reported in the Oct. 6, 2014 issue, this is precisely the approach that worked during the mumps outbreak in Columbus, Ohio last year. College students were nonchalant about getting vaccinated, but when they learned that the disease can lead to sterility in both men and women, they were a lot more inclined to step up for their shots. “I was pretty freaked out,” one Ohio State University student said. “I didn’t know mumps could lead to any of that.”

The power of the show-don’t-tell approach is nothing new. It’s the reason behind the anti-tobacco shock ads showing people dying of lung cancer, as well as the surgery fund-raising ads showing photos of babies with cleft lips. The trick in all of these cases is getting people to act fast. If too much time elapses between image and potential action, the power of the message is lost.

For that reason, Horne and his co-authors suggest that future research should look at the effectiveness of including the kind of counseling that was used in their study during routine well-baby visits, when vaccinating the child on the spot is an option. After all, the effect of scaring a parent straight may be temporary, but the damage done to a child who contracts a vaccine-preventable disease can be for life.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME medicine

Meet the Heroes and Villains of Vaccine History

A California legislator who faces a recall campaign for his support of a law mandating vaccinations is just one of the heroes in the history of vaccines. Alas, there are villains too

  • Edward Jenner

    Edward Jenner Vaccines
    Popperfoto/Getty Images Edward Jenner

    No one knows the name of the dairy maid 13-year old Edward Jenner overheard speaking in Sodbury, England in 1762, but everyone knows what she said: “I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face.” Jenner was already a student of medicine at the time, apprenticed to a country surgeon, and the remark stayed with him. But it was not until 34 years later, in 1796, that he first tried to act on the dairy maid’s wisdom, vaccinating an 8-year-old boy with a small sample from another dairy maid’s cowpox lesion, and two months later exposing the same boy to smallpox. The experiment was unethical by almost any standard—except perhaps the standards of its time—but it worked. Jenner became the creator of the world’s first vaccine, and 184 years later, in 1980, smallpox became the first—and so far only—disease to have been vaccinated out of existence.

  • Jonas Salk and Albert Sabin

    Albert Sabin Jonas Salk Vaccines
    Mondadori/Getty Images; PhotoQuest/Getty Images Left: Albert Sabin in his laboratory in 1960; Right: Jonas Salk

    Jonas Salk and Albert Sabin didn’t much care for each other. The older, arid Sabin and the younger, eager Salk would never have been good matches no matter what, but their differences in temperament were nothing compared to a disagreement they had over science. Both researchers were part of the National Foundation for Infantile Paralysis—later dubbed the March of Dimes—and both were trying to develop a polio vaccine. Sabin was convinced that only a live, weakened virus could do the trick; Salk was convinced a newer approach—using the remains of a killed virus—would be better and safer. Both men turned out to be right. Salk’s vaccine was proven successful in 1955; Sabin’s—which was easier to administer, especially in the developing world, but can cause the rare case of vaccine-induced polio due to viral mutations—followed in 1962. Both vaccines have pushed polio to the brink of eradication. It is now endemic in only three countries—Afghanistan, Pakistan and Nigeria—and appears, at last, destined to follow smallpox over the extinction cliff.

  • Dr. Maurice Hilleman

    Dr. Maurice Hilleman Vaccines
    Ed Clark—Time & Life Pictures/Getty Image Dr. Maurice Hilleman (center) talks with his research team as they study the flu virus in a lab at Walter Reed Army Institute of Research, Silver Springs, Md. in 1957.

    Around the world, untold numbers of children owe their health to a single girl who woke up sick with mumps in the early morning hours of March 21, 1963. The girl was Jeryl Lynne Hilleman, who was then only 5; her father was a Merck pharmaceuticals scientist with an enduring interest in vaccines. Dr. Maurice Hilleman did what he could to comfort his daughter, knowing the disease would run its course; but he also bristled at the fact that a virus could have its way with his child. So he collected a saliva sample from the back of her throat, stored it in his office, and used it to begin his work on a mumps vaccine. He succeeded at that—and a whole lot more. Over the course of the next 15 years, Hilleman worked not only on protecting children against mumps, but also on refining existing measles and rubella vaccines and combining them into the three-in-one MMR shot that now routinely immunizes children against a trio of illnesses in one go. In the 21st century alone, the MMR has been administered to 1 billion children worldwide—not a bad outcome from a single case of a sickly girl.

  • Pearl Kendrick and Grace Eldering

    Pearl Kendrick Vaccines
    University of Michigan School of Public Health Pearl Kendrick

    It was not easy to be a woman in the sciences in the 1930s, something that Pearl Kendrick and Grace Eldering knew well. Specialists in public health—one of the only scientific fields open to women at the time—they were employed by the Michigan Department of Health, working on the routine business of sampling milk and water supplies for safety. But in their free time they worried about pertussis—or whooping cough. The disease was, at the time, killing 6,000 children per year and sickening many, many more. The poor were the most susceptible—and in 1932, the third year of the Great Depression, there were plenty of poor people to go around. A pertussis vaccine did exist, but it was not a terribly effective one. Kendrick and Eldering set out to develop a better one, collecting pertussis samples from patients on “cough plates,” and researching how to incorporate the virus into a vaccine that would provide more robust immunity. They tested their vaccine first on mice, then on themselves and finally, in 1934, on 734 children. Of those, only four contracted whooping cough that year. Of the 880 unvaccinated children in a control group, 45 got sick. Within 15 years of the development of Kendrick and Eldering’s vaccine, the pertussis rate in the U.S. dropped by 75%. By 1960 it was 95%—and has continued to fall.

  • Dr. Richard Pan

    Sacramento California News - June 30, 2015
    Madeline Lear—Sacramento Bee/Zuma Press Senator Richard Pan speaks during a press conference at William Land Park Elementary School in Sacramento on June 30, 2015 on Senate Bill 277, which eliminates personal and religious belief exemptions for vaccines.

    The work that’s done at the lab bench is not the only thing that makes vaccines possible; the work that’s done by policymakers matters a lot too. That is especially true in the case of California State Senator Richard Pan, a pediatrician by training who represents Sacramento and the surrounding communities. Pan was the lead sponsor of the recently enacted Senate Bill 277, designed to raise California’s falling vaccine rate by eliminating the religious and personal belief exemptions that many parents use to sidestep the responsibility for vaccinating their children. For Pan’s troubles, he now faces a possible recall election, with anti-vaccine activists trying to collect a needed 35,926 signatures by Dec. 31 to put the matter before the district’s voters. Pan is taking the danger of losing his Senate seat with equanimity—and counting on the people who elected him in the first place to keep him on the job. “I ran to be sure we keep our communities safe and healthy,” he told the Sacramento Bee. That is, at once, both a very simple and very ambitious goal, made all the harder by parents who ought to know better.

  • Dr. Andrew Wakefield

    Dr. Andrew Wakefield Vaccines Autism
    Shaun Curry—AFP/Getty Images From right: Dr. Andrew Wakefield and his wife, Carmel arrive at the General Medical Council (GMC) in central London on Jan.28, 2010.

    Not every conspiracy theory has a bad guy. No one knows the name of the founding kooks who got the rumor started that the moon landings were faked or President Obama was born on a distant planet. But when it comes to the know-nothing tales that vaccines are dangerous, there’s one big bad guy—Andrew Wakefield, the U.K. doctor who in 1998 published a fraudulent study in The Lancet alleging that the MMR vaccine causes autism. The reaction from frightened parents was predictable, and vaccination rates began to fall, even as scientific authorities insisted that Wakefield was just plain wrong. In 2010, the Lancet retracted the study and Wakefield was stripped of his privilege to practice medicine in the U.K. But the damage was done and the rumors go on—and Wakefield, alas, remains unapologetic.

  • Jenny McCarthy and Jim Carrey

    Jenny McCarthy Jim Carrey Vaccines Autism
    Brendan Hoffman—Getty Images Jim Carrey (center) carries Evan McCarthy, son of actress Jenny McCarthy (left) during a march calling for healthier vaccines on June 4, 2008 in Washington.

    If you’re looking for solid medical advice, you probably want to avoid getting it from a former Playboy model and talk show host, and a man who, in 1994’s Ace Ventura: Pet Detective, introduced the world to the comic stylings of his talking buttocks. But all the same, Jenny McCarthy and Jim Carrey are best known these days as the anti-vaccine community’s most high-profile scaremongers, doing even the disgraced Andrew Wakefield one better by alleging that vaccines cause a whole range of other ills beyond just autism. None of this is true, all of it is shameful, and unlike Wakefield, who was stripped of his medical privileges, Carry and McCarthy can’t have their megaphones revoked.

  • Rob Schneider

    Rob Schneider Vaccines
    Richard Shotwell—Invision/AP Rob Schneider in 2014.

    What’s that you say? Need one more expert beyond Jenny McCarthy and Jim Carrey to weigh in on vaccines? How about Rob Schneider, the Saturday Night Live alum and star of the Deuce Bigalow, Male Gigolo films? Schneider has claimed that the effectiveness of vaccines has “not been proven,” that “We’re having more and more autism” as a result of vaccinations, and that mandating vaccines for kids attending public schools is “against the Nuremberg laws.” So, um, that’s all wrong. A vocal opponent of the new California law eliminating the religious and personal belief exemptions that allowed parents to opt out of vaccinating their kids, Schneider called the office of state legislator Lorena Gonzalez and left what Gonzalez described as a “disturbing message” with her staff, threatening to raise money against her in the coming election because of her support of the law. Gonzalez called him back and conceded that he was much more polite in person. Still, she wrote on her Facebook page, “that is 20 mins of my life I’ll never get back arguing that vaccines don’t cause autism with Deuce Bigalow, male gigolo.#vaccinateyourkids.”

  • Robert F. Kennedy, Jr.

    Robert Kennedy, Jr. Vaccines
    Rich Pedroncelli—AP Robert F. Kennedy, Jr. speaks against a measure requiring California schoolchildren to get vaccinated during a rally at the Capitol in Sacramento, Calif., on April 8, 2015.

    If you’re looking for proof that smarts can skip a generation, look no further that Robert F. Kennedy, Jr., son of the late Bobby Kennedy. RFK Jr. has made something of a cottage industry out of warning people of the imagined dangers of thimerosal in vaccines. An organomercury compound, thimerosal is used as a preservative, and has been removed from all but the flu vaccine—principally because of the entirely untrue rumors that it causes brain damage. But facts haven’t silenced Kennedy who, as a child of the 1950s and ‘60s, surely got all of the vaccines his family doctor recommended. Children of parents who listen to what he has to say now will not be so fortunate.

TIME vaccines

Seattle Flunks Vaccine Science

Northwest nonsense: Vaccine rates in Seattle are dangerously low
Edmund Lowe Photography; Getty Images/Moment RF Northwest nonsense: Vaccine rates in Seattle are dangerously low

Jeffrey Kluger is Editor at Large for TIME.

In the same week Nigeria frees itself from polio, vaccine rates continue to fall in the Pacific northwest

Nothing says First World city like Seattle does. Come for the cachet, stay for the Seahawks, and give a nod to the Starbucks and the Amazon and the mothership that is Microsoft just to the east. There’s nothing this so-hip-it-hurts town lacks, it seems—except perhaps for common sense. If you’re looking for that, the developing world is a far better bet.

That’s the inescapable conclusion on what should be a very good week for public health—and childhood health in particular—with the World Health Organization and other groups announcing on July 24 that Nigeria has gone a full year without a single reported case of polio. Pending further certification, the country will be removed from the dwindling list of countries in which the disease is endemic, leaving just Pakistan and Afghanistan. If Nigeria’s caseload remains at zero for two more years, it will be officially declared polio free.

How did the country that as recently as 1988 saw 30,000 children—a stadium’s worth—paralyzed or killed by polio every year achieve such a stunning turnaround? No surprise: vaccines—the same vaccines that have saved the lives and health of millions of children around the world, and the same vaccines that saw polio eradicated entirely in the U.S. in 1979.

So it came as a head-slapping development that earlier this month, Seattle news outlets reported that polio vaccination rates in their city have hit a low of just 81.4%, or worse than the rates in Rwanda, Zimbabwe, Algeria, El Salvador, Guyana, Sudan, Iran, Kyrgyzstan, Mongolia and Yemen, according to the WHO. Why? Because Rwanda, Zimbabwe, Algeria, El Salvador, Guyana, Sudan, Iran, Kyrgyzstan, Mongolia and Yemen may have a lot of problems, but they don’t have the anti-vaccine crazies.

Vaccine denialism is a perverse affliction of people who should be smarter than they act—the well-educated, high-income folks who know just enough to know too much, and to assume that simply because they haven’t seen a disease in a long time it’s gone away. And hey, if it does turn up, they’ve surely got the resources to deal with it.

That’s the reason that in the U.S., anti-vaxxers tend to cluster in wealthy, blue-state communities like Silicon Valley, New York City, Columbus, Seattle and it’s down-coast little sister Portland. It’s the reason too that the nonsense that animates the anti-vaxxers—the idea that vaccines are toxic or overprescribed or nothing more than a cash grab by big pharma and big government—is a lot likelier to gain traction in other wealthy countries around the world than in ones that have only recently done away with scourges like polio or are still struggling with them, and either way have images of sick or dying children still fresh in their minds.

“Polio is nonexistent in the states, so if you’re going to travel, it makes sense to do it,” said one Washington State resident interviewed by Seattle’s KUOW radio station on July 14. “We are doing vaccines based on our family’s needs, not based on what doctors say we need to follow.”

Never mind how abjectly ridiculous that thinking sounds if you shift its frame even a little: “We are fire-proofing our home based on our family’s needs, not based on what the fire department say we need to follow,” or “We are fastening our seat belts during turbulence based on our family’s needs, not based on what flight attendants say we need to follow.”

Never mind, too, that that the very reason polio is non-existent in the states is because people have been good about getting vaccinated and that, as an outbreak in an unvaccinated Amish community in 2003 showed, there is no virus in the world that isn’t just an incoming airline flight away. If it lands in a community where vaccine rates are low, it will find plenty of people to infect.

What’s more, while polio may indeed have been KO’ed in the states years ago, measles, mumps, rubella, whooping cough and more are all very much still at large, and outbreaks of those diseases have been on the rise thanks to the anti-vaxxers. The vaccination rate for measles, mumps and rubella specifically is below 90% among Seattle kindergarteners, dangerously short of the 95% rate needed to keep communities as a whole protected.

For most people, living in the developed world is a mere accident of birth and geography—a demographic freebie that gets you started in life far ahead of people born in less lucky places. Privilege can be part of that first world birthright, as can wealth and freedom and the opportunity for good heath. But smarts, it seems, have to be earned. That, clearly, is something Nigeria and Rwanda could teach Seattle.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME vaccines

This Is How Nigeria Beat Polio

Goodbye to all that: Computer-generated model of a poliovirus
Calysta Images ;Getty Images/Tetra images RF Goodbye to all that: Computer-generated model of a poliovirus

A quarter-century campaign brings the world tantalizingly close to eradicating a disease

It’s easy not to notice a negative. A house burns down on your block and it’s all you can talk about. But a house doesn’t burn down? Where’s the news?

Still, absence can be the stuff of headlines, and that fact has rarely been truer than it is in Nigeria today—where health officials are celebrating a full year without a single case of polio. A polio-free Nigeria means a polio-free Africa, since it was the only country left of the 47 on the continent where the crippling disease was still endemic. The virus, which as recently as 1988 was endemic in 128 countries, crippling 350,000 children per year, has now been cornered in just two places—Afghanistan and Pakistan, and it’s barely hanging on there. Wipe polio out in those last two redoubts and it will become only the second disease in history—after smallpox—to have been vaccinated out of existence.

“We are celebrating the first time ever that Nigeria has gone without a case of polio, but with caution,” said Dr. Tunji Funsho, who leads Rotary International’s anti-polio campaign in Nigeria. “Surveillance takes place in every nook and cranny of this country, even in those areas that have been free for years.”

The victory in Nigeria did not come easy—and it almost didn’t happen at all. For more than a generation, it has been Rotary that has led the drive to eradicate polio, administering vaccinations to 2.5 billion children in 122 countries at a cost of $1.4 billion. With the help of UNICEF, the World Health Organization (WHO), the U.S. Centers for Disease Control, the Bill and Melinda Gates Foundation and other groups, the effort paid off comparatively fast. As long ago as 2003, the virus had been chased out of all but six countries and the global caseload was down to just 732. There was talk of eradication by as early as 2005.

But Nigeria scuttled those plans. In the summer of 2003, Muslim clerics in the country’s northern regions halted all vaccinations, spreading the fiction that the vaccines contained HIV and were designed to sterilize Muslim girls. Quickly, the poliovirus did what all viruses do when they’re given that kind of running room: it spread, and fast. By 2005, cases consistent with the Nigeria strain were appearing in a 16-nation band that stretched as far away as Indonesia, before the outbreak could finally be contained.

“This is a disease that can’t be controlled,” said WHO spokesman Oliver Rosenbauer at the time, “it has to be eradicated.”

While the current victory in Nigeria was a huge milestone, things remained dicey right to the end—again due to politics—when Boko Haram fighters killed nine polio workers and abducted three others earlier this year. But the vaccine program was already too far along for the attacks to reverse things, and as the July 24 anniversary arrived, victory was at last declared—albeit tentatively.

Nigeria is now officially off the list of endemic countries, but the poliovirus can lurk in sewage and elsewhere, and since there can be up to 200 asymptomatic cases of the disease for every paralytic one, there is no telling how many human virus reservoirs are still at large. Only after two more polio-free years pass will Nigeria be declared officially done with the disease.

That leaves Afghanistan and, most troublingly, Pakistan. Currently, there have been only 33 cases of polio recorded worldwide in 2015—28 in Pakistan and 5 in Afghanistan. At the same point last year, those two countries had already had 107 infections, and the Pakistani strain had turned up in at least six other countries.

Progress has been slowed in Pakistan by often-deadly attacks on polio field workers carried out by local Taliban fighters. Since 2012, however, the government has been providing help, committing its military to protecting the vaccinators and recruiting religious leaders to speak out on the moral imperative of ensuring the health of children.

National pride plays no small role too. India—Pakistan’s mortal rival—has not had a case of polio since 2011 and was declared officially free of the disease last year. That the Indians accomplished this in a country with four times the landmass and seven times the population of Pakistan has been galling to many Pakistanis. The dramatic reduction in new infections in Pakistan from 2014 to 2015 has been a point of national pride.

Protecting children should not, of course, be a matter of international bragging rights. It should just be something human beings do. We’re a species smart enough to have invented a vaccine and brave enough to go delivering it in very dangerous places. The effort to eradicate polio has been a halting thing, and we have too often gotten in our own way. But at last, sometimes despite ourselves, we appear to be on the brink of winning.

TIME vaccines

Why Science Is Winning the Vaccine Wars

Nothing to fear: More and more babies are being protected as more and more parents smarten up
Miodrag Gajic; Getty Images Nothing to fear: More and more babies are being protected as more and more parents smarten up

Jeffrey Kluger is Editor at Large for TIME.

A new survey shows that common sense is trouncing fear-mongering

You can’t poll a scientific fact. The speed of light is the speed of light (186,282.4 miles per second) whether 90% of people believe it, 25% believe it or 100% have no opinion. The same is true for the heaviest element, the size of the Earth and the number of cells that make up the average human body (37.2 trillion, in case you’re counting).

And the same is true, too, for the safety and efficacy of vaccines: They’re extraordinarily effective and extraordinarily safe, no matter what the folks in the anti-vaccine fringe have been saying. But in this case, popular opinion makes a difference—potentially a life and death one. That’s because parents who have bought the anti-vax line are far less likely to vaccinate their children, putting those kids at risk as well as anyone in the community who can’t be vaccinated due to age or a medical problem.

It’s the reason there was an outbreak of vaccine-preventable measles earlier this year triggered by a single unvaccinated visitor to Disneyland, and an outbreak of vaccine-preventable mumps in and around Columbus, Ohio. And it just might be the reason an immune-compromised woman—who relied on the protection that a well-vaccinated community ought to provide its few unvaccinated members—recently died of measles in Washington state, the first U.S. measles death in over a decade.

So it’s the best possible news that a new poll conducted by doctors at the University of Michigan’s C.S. Mott Children’s Hospital found that across the country, parents’ views on vaccines are changing fast—and for the better.

Assembling a sample group of 1,416 randomly selected parents with at least one child 17 years old or younger, researchers posed a series of questions about the benefits of vaccines, the risks associated with vaccines, and the wisdom of laws, like the one Gov. Jerry Brown of California signed last month, requiring nearly all children attending schools in the state to be fully vaccinated. They also asked about the parents’ perception of the risks of measles and whooping cough.

In all five categories, the parents seemed increasingly to be aligning themselves with the sense and safety of the basic science camp and less with the misinformation and fear-mongering of the anti-vax camp. Overall, only 7% of parents thought vaccines were less safe than they did a year ago, while 25% thought them more safe than they once did; 68% were unchanged. Similarly, only 6% of parents were less supportive of vaccine requirements for students than they used to be, while 35% were more supportive. And 40% and 37% of all parents believed the risk of measles and whooping cough, respectively, have risen for U.S. kids in the past year, while only 15% in both cases thought the danger has decreased.

“For a quarter to a third of parents to say that their views on the safety and benefits of vaccines have shifted in just a year’s time is quite remarkable,” Dr. Matthew Davis, the director of the poll, said in a statement.

Actually, it’s more than remarkable. It also confirms what a lot of health-policy experts have been saying for a long time—that once parents started seeing the consequences of vaccine denialism in the form of flash-point epidemics like the Disneyland and Columbus outbreaks, they would come rushing back for the protection vaccines offer. An epidemic of any illness may be a terrible way to learn a lesson, but it’s a decidedly effective one.

Davis partly credits media coverage of the epidemics for helping parents wise up. That’s not just because of the reasonably responsible way news outlets reported the outbreaks, but also because of they way they’ve been edging away from the nonsense coming from anti-vaccine celebrities like Jim Carrey. Yes, Carrey got more press attention than he deserved after the vaccine law was approved in California, when he called Brown a “corporate fascist” and proceeded to recycle old myths about the dangers of mercury in vaccines. But he was also blow-torched for his know-nothingism in both mainstream and social media—a sign that the popular consensus is changing. The same kind of global opprobrium has at last caused Jenny McCarthy—the anti-vaxxers’ Earth mother—to go dark on the topic of vaccines altogether.

None of this means the vaccine fight is over—and it never will be as long as there is an Internet and an anti-vax community willing to fill it with silliness. But as the new poll suggests, that community is steadily growing smaller, and a larger community of parents committed to protecting the health of their children is taking its place.

Science, which has never sought to be a popularity contest, is winning this one all the same.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME health

This Is What Happened to the First Person to Get the Rabies Vaccine

Joseph Meister
Apic/Getty Images Joseph Meister, who received inoculation of the rabies vaccine from Pasteur in july 1885

He received his inoculation directly from Louis Pasteur, on July 6, 1885

Rabies is among the most terrifying viruses to get. According to the Centers for Disease Control, “once clinical signs of rabies appear, the disease is nearly always fatal.” (Really: there have been fewer than 10 documented cases of survival once symptoms appear.) Luckily for us—and our pets—Louis Pasteur developed a vaccine that can stop things from getting to that point.

The first time the vaccine was ever administered to a human being–on this day in 1885–was by Pasteur himself. Knowing that the disease was otherwise fatal, both doctor and patient (or, rather, patient’s mother) were willing to risk whatever harm might come from the injection, which had only been tested on dogs.

As TIME recounted in 1939:

One hot July morning in 1885, feverish little Joseph Meister was dragged by his frantic mother through the streets of Paris in search of an unknown scientist who, according to rumors, could prevent rabies. For nine-year-old Joseph had been bitten in 14 places by a huge, mad dog and in a desperate attempt to cheat death, his mother had fled from their home town in Alsace to Paris. Early in the afternoon Mme Meister met a young physician in a hospital. “You mean Pasteur,” he said. “I’ll take you there.”

Bacteriologist Louis Pasteur, who kept kennels of mad dogs in a crowded little laboratory and was hounded by medical criticism, had never tried his rabies vaccine on a human being before. But moved by the tears of Mme Meister, he finally took the boy to the Hotel-Dieu, had him injected with material from the spinal cord of a rabbit that had died from rabies. For three weeks Pasteur watched anxiously at the boy’s bedside. To his overwhelming joy, the boy recovered.

By that fall, when his nation’s Academy of Sciences acknowledged the success, “hundreds of persons who had been bitten by mad dogs rushed to his laboratory.”

As for Meister? He ended up working as a janitor at the Pasteur Institute. There, TIME reported, Meister regaled visitors with tales of his time as the pioneering doctor’s patient: “I shall see always Pasteur’s good face focused on me,” he told them. He committed suicide in 1940, shortly after Germany invaded France—though, contrary to a prevalent myth, there is no evidence that he did so because he would rather die than allow the Nazis into the Institute.

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