There are two pandemics that pose grave threats to millions of people. One of them (Covid-19) dominates the news, while the other (influenza, or the flu) receives much less attention. A recent clinical trial on an experimental oral antiviral drug called molnupiravir produced promising results1. The fraction of people who received molnupiravir who were hospitalized or died from Covid-19 was 7.3%, compared to 14.1% of the people who received a placebo (sugar pill).
This is important because so many people are being hospitalized and dying from Covid-19. In the USA, from 1 March, 2020 through 31 August, 2021 about 42% were over 65 years of age2.
This includes a very small fraction of people who have been vaccinated. In England, about 0.5% of the Covid-related deaths were people who were fully vaccinated3. Another study showed antibody levels decrease after two doses of the Pfizer/BioNTech vaccine especially among men, people 65 years of age or older and among persons whose immune systems are suppressed4.
Still, healthy children under 14 appear to be at little risk of Covid-19. Unvaccinated children are at less risk of serious Covid illness than vaccinated 70-year-olds5. However, unvaccinated adults are at serious risk. Data from 13 states in the USA showed that about 26 adults per 100,000 vaccinated people had been hospitalized for Covid-19 by late July 20216. That’s compared to about 431 hospitalized people for every 100,000 unvaccinated individuals — a rate roughly 17 times as high as for those who were vaccinated6.
One reason that some people give for not being vaccinated is that the mRNA technology that the Pfizer/BioNTech and Moderna vaccines use is new. This is wrong. Many scientists have worked on this technology for decades7. All the Covid-19 vaccines target antigens that the earlier Alpha variant of the SARS-CoV-2 virus produced, such as the spike (S) protein. Fortunately, they are also effective against the Beta, Gamma and Delta variants8,9. Still, Pfizer and BioNTech have developed a new vaccine that specifically targets the full S protein of the Delta variant. Vaccines based on RNA technologies are being developed and tested for their ability to prevent influenza as well as several types of cancer10.
In the meantime, the same well-tested methods were used to prepare the flu (influenza) vaccines for the current (2021-2022) flu season that were used in previous years11. Each year, the vaccines target the four types (or variants) of influenza viruses that research predicts will be the most prevalent. Routine annual influenza vaccination is recommended for people who are at least six months old months and do not have contraindications12. This includes a history of a severe allergic reaction (such as anaphylaxis) to any component of the vaccine (other than egg), or to a previous dose of any influenza vaccine. People 65 years and over may receive any age-appropriate vaccine (inactivated influenza vaccine, IIV4 or recombinant influenza vaccine, RIV4). Vaccination should not be delayed to find a particular product if an appropriate one is already available. People in isolation for Covid-19 or in quarantine for known or suspected exposures should not be vaccinated if vaccination will pose an exposure risk to others in the vaccination setting. For people who are moderately or severely ill, vaccination should be deferred until they have recovered. People who are mildly ill may be vaccinated, but vaccination may be deferred until recovery to avoid confusing Covid-19 illness symptoms with post-vaccination reactions.
The vaccine will not give you the flu. You might experience some of the symptoms that occur with the flu, but you will not be contagious. Even if you do get the flu sometime after being vaccinated, the vaccine you receive will limit the severity and symptoms. It could even save your life. Unlike Covid-19, the seasonal flu is a deadly threat to young children. Sadly, lies and misinformation are used to sew doubt. A few people with remarkable abilities to convince many gullible people win fame and fortune.
Sadly, there is a long history of conspiracy theories. Some of them claim that physicians, pharmacists, government agencies (such as the Food and Drug Administration, FDA, and European Health Union) and pharmaceutical companies are in a conspiracy to keep people sick. They don’t really try to cure your disease. They only want to treat the symptoms so you will have to spend the rest of your life buying their drugs.
The conspiracy theory is especially harmful when it applies to immunizations and vaccines that prevent many formerly deadly diseases (such as influenza) and even eliminate one (smallpox). The conspiracy theory and general distrust of governments have led some to believe that responsible parents should not let their children be vaccinated – despite the devastating history of communicable diseases such as measles, mumps and rubella (MMR) and polio. One reason for this confusion is that autism spectrum disorders have been and continue to be misunderstood by many people13. Originally, autism was thought to be caused by bad parenting and possibly even exposure to the cold and “refrigerator mothers”. Children with autism were sent to dank institutions. Fortunately, these mistakes were corrected. We now know that autism is not just a single disease, but a spectrum of disorders14. It is not the parents’ fault if they have a child who suffers from autism spectrum disorder (ASD). In addition, physicians are now much better at diagnosing it. Most of the increase in the incidence of ASD is due to better diagnosis, though some is due to the increased average age of fathers and the fact that more premature babies survive infancy. That is, paternal age and premature birth are risk factors for ASD. So, there isn’t an epidemic of ASD and vaccines don’t cause it13.
Unfortunately, the legal system in the USA and in many other countries has a much lower standard for ‘proof beyond a reasonable doubt’ than do scientists who realize that science can’t prove anything15. Math can prove things, such as the fact that 1+2+3+ … 99 = 4950. You can prove this yourself either by carefully entering each number into a calculator or Excel spreadsheet. Instead, you can realize that 1+99=100, 2+98=100 … 49+51=100 for the first 4900 and then add the 50 in the middle to get 4950. There is no doubt in proof. Unfortunately, much of the public confuses the terms evidence and proof. So, some families with autistic children have pursued legal channels to try to ‘prove beyond a reasonable doubt’ that vaccines were responsible for their children’s condition13. Most of them alleged that the cause was the mercury-containing preservative thimerosal, which was formerly used in many vaccines in the USA and elsewhere. It is not used in any of the vaccines to protect against influenza or Covid-19. Others argued that the culprit was the MMR vaccine itself or perhaps the vaccine in combination with thimerosal. Although most experts have concluded that there is no evidence of a causal tie between autism and thimerosal or the MMR vaccine, some doctors and scientists, some groups representing families with autistic children, and many parents fervently believed there was a connection. Claimants not only wanted to ‘prove’ that the Federal government, the Institute of Medicine, vaccine makers, and mainstream science were wrong. They also wanted money. A child with autism requires very expensive services and will have very limited employment opportunities when they become adults. Besides, many parents of autistic children felt better psychologically when they blamed profit-seeking drug companies for their children’s problems. Over 5000 such families filed claims with the federal Vaccine Injury Compensation Program (VICP). This was created by legislation that was adopted by the United States Congress in 1988 in response to a somewhat similar scare over the pertussis portion of diphtheria–pertussis–tetanus (DPT) vaccine in the United Kingdom.
At least one British researcher fed fears that the vaccine was causing some children to grave neurologic harm - claims that were later widely discredited. Yet the alarm was so great that many British families refused the pertussis vaccine, while many children became ill with pertussis (whooping cough), and about 70 of them died. In the USA, several parents sued the manufacturers of DPT vaccines. Even though most public health officials thought that the claims of side effects were unfounded, some families won large awards from sympathetic, scientifically illiterate juries who were convinced otherwise. As a result, most companies making the DPT vaccine stopped production, and the remaining major manufacturer threatened to do so. Health officials feared the loss of herd immunity, so the US Congress created the VICP. This program provided compensation to children who had serious adverse effects from any childhood vaccine. The compensation covered medical and related expenses, lost future income, and up to $250,000 for pain and suffering. The funding for paying successful claims based on vaccines that were administered before 1988 came from the U.S. Treasury. For claims regarding later vaccinations, funding came from a patient fee of 75 cents per vaccination. To win a VICP award, the claimant did not need to do everything that is required to hold a vaccine maker liable in a product liability lawsuit. But a causal connection had to be shown. This has become much more difficult. An advisory committee helped to amend the list of adverse effects that are recognized because the consensus view changed as the results from new studies were reported. If families try to claim that a vaccine caused an adverse effect that is not on the list, the burden of proof rests with them. ASDs are not on the list of adverse side effects for any vaccine, and the VICP has rejected about 300 such claims outright.
Still, conspiracy theorists have claimed that the British and American (USA) governments supposedly harassed and destroyed the reputation of Dr. Andrew Wakefield, the primary author of the controversial article, “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children”16. It was published in the very prestigious British medical journal The Lancet. His interest in autism was based on observations that there were changes in the types and amount of bacteria in the lower digestive tract of autistic children (from the terminal ileum; ascending, transverse, descending, and sigmoid colons, and rectum). There are important changes in the microbiome in many children with ASD, but it is important to stress a short quote from Dr. Wakefield that many people ignore. It came directly from his article in The Lancet, “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described”16.
So, if Dr. Wakefield did not write that there was a link, why did he have to retract the article and why was his license to practice medicine in England was revoked? The reasons are explained on several websites including Exposed: Andrew Wakefield and the MMR-autism fraud17. In this website, the investigational reporter Brian Deer discovered that Dr. Wakefield had been paid by an anti-MMR lawyer, Richard Barr, “to create evidence against the shot and, while planning extraordinary business schemes meant to profit from the scare”. He was paid two years before writing the controversial article. “The goal was to find evidence of what the two men claimed to be a "new syndrome", intended to be the centrepiece of (later failed) litigation on behalf of an eventual 1600 British families, recruited through media stories. This publicly undisclosed role for Wakefield created the grossest conflict of interest, and the exposure of it by Deer, in February 2004, led to public uproar in Britain, the retraction of The Lancet report's conclusions section, and, from July 2007 to May 2010, the longest-ever professional misconduct hearing by the UK's General Medical Council (GMC)”17.
In addition, the children in the Lancet study were not what they appeared to be. According to the website:17 “In The Lancet, the 12 children (11 boys and one girl) had been held out as merely a routine series of kids with developmental disorders and digestive symptoms, needing care from the London hospital. That so many of their parents blamed problems on one common vaccine, understandably, caused public concern. But Deer discovered that nearly all the children (aged between 2½ and 9½) had been pre-selected through MMR campaign groups and that at the time of their admission, most of their parents were clients and had contacted a lawyer, Barr. None of the 12 lived in London. Two were brothers. Two attended the same doctor's office, 280 miles from the Royal Free. Three were patients at another clinic. One was flown in from the USA. The investigation revealed, moreover, that the paper's incredible purported finding - of a sudden onset of autism within days of vaccination - was a sham: laundering into the medical literature, as apparent facts, the unverified, vague - and sometimes altered - memories and assertions of a group of unnamed parents who, unknown to the journal and its readers, were bound to blame MMR when they came to the hospital because that was why they had been brought there. Wakefield, a former surgeon, denied this. But the true number of families accusing MMR wasn't eight, as the paper said: it was 11 of the 12 (later all 12) and in most cases, records noted parents' compensation claims before the children were referred. "If my son really is Patient 11, then The Lancet article is simply an outright fabrication," said the father of the penultimate child in the series - admitted to the Royal Free, at age 5, from northern California and whose history was falsely reported in the paper”17. In conclusion, the MMR and other vaccines are safe and effective. They prevent a multitude of diseases and have saved many lives.
One of the obstacles to communication is that most scientists and mathematicians think differently than many non-scientists. Scientists and mathematicians realize that science can’t prove anything with the certainty that math can. We also realize that mathematical certainty is not always very useful. At a conference of biologists and mathematicians, a mathematician gave a talk that only half of the audience understood. After the speaker ended, a biologist asked if the topic had any practical applications. The speaker said no and half the audience laughed with delight. Still, math is fundamental to society. Science, engineering and technology are impossible without it. However, scientists seldom feel the need for certainty. Experiments test hypotheses or ideas to see if they are right or wrong. The results may answer the original question but then raise ten more questions. We discover that there were many things that we didn’t know. There are often things that were right in front of us all along, but we only recently detected them by using better tools of observation. We make decisions about whether to be vaccinated, take a prescription drug or a dietary supplement, as do all people. However, we know that our decision could be wrong. There was a time when margarine was considered to be healthier than butter and smoking tobacco was recommended to lose weight. Scientists and even physicians thought that the data that existed in the 1950s supported those ideas. As more data emerged, we realized that olive oil is much healthier than butter, but butter is better than margarine. We don’t need to be certain. We simply feel that we are being as safe as possible. Still, we keep reading scientific and medical journals and modify our ideas when appropriate.
In contrast, many people find uncertainty to be intolerable. In a world seemingly gone mad, they long for safety and certainty. If a website, blog, radio talk show host, a major news agency or even a well-paid scientist tells an audience what they want to hear, they can sell doubt, just like they did with tobacco and global climate change18. It has been and remains very popular and a powerful tool used by much of the global elite and by Donald Trump’s Republican Party.
1 Fischer, W. et al. Molnupiravir, an oral antiviral treatment for Covid-19. medRxiv preprint, 17 June, 2021.
2 CDC, Laboratory-confirmed Covid-19-associated hospitalizations. 2 Oct., 2021.
3 Quinn, B. Fully vaccinated people account for 1.2% of England’s Covid-19 deaths. The Guardian, 13 Sept., 2021.
4 Levin, E.G. et al. Waning humoral immunity response to BNT162b2 Covid-19 Vaccine over 6 months. The New England Journal of Medicine, 6 Oct., 2021.
5 Leonhardt, D. Covid and age. An unvaccinated child is at less risk of serious Covid illness than a vaccinated 70-year-old. New York Times, 12 Oct., 2021.
6 De Jésus, E.G. These charts show that Covid-19 vaccines are doing their job. Science News, 31 Aug., 2021.
7 Dolgin, E. The tangled history of mRNA vaccines. Nature, volume 597, pp. 318-324, 16 Sept., 2021.
8 Cevik, M. et al. Covid-19 vaccines: keeping pace with SARS-CoV-2 variants. Cell, volume 184, pp. 5077-5081, 30 Sept., 2021.
9 Tregoning, J.S. et al. Progress of the Covid-19 vaccine effort. Nature, volume 21, pp. 626-636, Aug., 2021.
10 Smith, R.E. Vaccines based on modern RNA technology. This technology's potential for vaccines and other diseases. Wall Street International, 24 December, 2020.
11 CDC. Seasonal flu vaccines, 2021.
12 CDC. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2021-22.
13 Donovan J, Zucker C. In a Different Key: The Story of Autism. New York: Crown Publishers, 2016.
14 Rosen, N.E. The diagnosis of autism: from Kanner to DSM-III to DSM-5 and beyond. Journal of Autism and Developmental Disorders. 24 Feb., 2021.
15 Capra F, Luisi PL. A Systems View of Life: A Unifying Vision. Cambridge University Press, Cambridge, UK, 2014.
16 Wakefield, A. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet, volume 251, pp. 637-641,1998.
17 Deer, B. Exposed: Andrew Wakefield and the MMR-autism fraud, 2021.
18 Oreskes, N. and Conway, E.M. Merchants of doubt: how a handful of scientists obscured the truth on issues from tobacco smoke to climate change. Bloomsbury Press, New York, 2010.