>> narrator: tonight on frontlinthey're hailed as medicine's greatest triumph, conquering smallpox, diphtheria, polio, and more. >> if you look at vaccines over the past hundred years, they've increased our lifespan by 30 years. >> narrator: but in recent years, some americans have rejected vaccines, afraid they cause chronic disorders, from adhd to autism. >> my kid got six vaccines in one day, and he regressed. you don't have any science that the regression wasn't triggered by the six vaccines. >> narrator: when we investigated the war over vaccines in 2010, there was a growing group of parents choosing not to fully vaccinate their children. now the debate has erupted again. >> a measles outbreak has been linked to the happiest

place on earth. >> ...infected at least 19 people. >> parents here are more scared of gluten than they are of smallpox. >> narrator: are personal choices putting the public health at risk? >> 70 cases of the measles. >> at least 145 in 14 states. >> narrator: tonight on frontlinthe latest chapter in the bitter vaccine war. >> frontlinis made possible by contributions to your pbs station from viewers like you. thank you. and by the corporation for public broadcasting. major support for frontliis provided by the john d. and catherine t. macarthur foundation, committed to building a more just, verdant, and peaceful world. more information is available at macfound.org. additional support is provided by ford foundation, working with visionaries on the front lines of social change worldwide, at fordfoundation.org. the park foundation, dedicated to heightening public awareness of critical issues. the john and helen glessner family trust, supporting

trustworthy journalism that informs and inspires. and by the frontline journalism fund, with major support from jon and jo ann hagler. >> what a cute little face. aw... here we come! >> it's a girl! she's beautiful. >> what's her name? >> rachel.

>> narrator: a new life begins. >> congratulations. >> thank you. >> narrator: out of her mother's womb, rachel murphy is now surrounded by a new world filled with countless germs. modern medicine will do what it can to protect her. >> just a tiny little stick. >> narrator: barely an hour old, rachel gets her first shot, against hepatitis b. this is the first of up to 35 inoculations she will get in the next six years of her life to fight 14 diseases. >> rachel. >> it's okay, princess. >> narrator: public health doctors celebrate vaccines as one of medicine's shining achievements. >> they've increased our lifespan by 30 years. hib would cause 20,000 to 25,000 cases a year. gone. i mean, polio would paralyze, you know, tens of thousands of children every year. gone.

i mean, diphtheria was the most common killer of teenagers in the 1920s. gone. i mean, you know, vaccines... the benefit of vaccines is clear. >> well, there's now 16 diseases that are preventable by vaccination for children. 14 of those are diseases that we vaccinate infants and young children for, and two of them are diseases that we vaccinate adolescents. from my point of view, being able to prevent 16 diseases by vaccination is a really good thing. >> shame on you! shame on you! >> narrator: but this public health miracle has been losing ground. since we first reported on the vaccine war in 2010, more parents across america have decided not to fully vaccinate their children. like all wars, this one has casualties. >> health officials suspect someone who was at the disneyland resort in mid-december had the measles and that's how the disease spread. >> the measles outbreak that began at disneyland in december has now spread to more than 90 people in the u.s. >> narrator: december 2014, the u.s. experienced a major measles

outbreak, a disease that had been eliminated from this country 15 years ago. >> this has gotta be so frustrating for public health officials. >> now it's spread to over 100 infections, to different states around the country. because of that, it's something that's gotten a lot of attention. >> narrator: seth mnookin is a science writer at mit who has reported extensively on the vaccine debate. >> a single person infected with this disease can have implications that are going to go on for months. because it is the most infectious microbe known to humankind, the efforts to contain it, the efforts to track down everyone that the infected person has come in contact with are just incredibly, incredibly expensive. >> narrator: the cdc tracks outbreaks of infectious diseases around the country from its center in atlanta. over the last 15 years they've detected pockets of diseases like whooping cough and measles. the cdc uses forensic techniques to dissect in fine detail how

dangerous pathogens can spread. they analyzed one such event, a measles outbreak that struck an under-vaccinated area of san diego in 2008. like most measles outbreaks, it came from abroad. it began when an infected seven-year-old returned from a family vacation in switzerland on january 15. the child gave measles to two siblings, and collectively, they infected classmates at the san diego cooperative charter school in linda vista. a visit to the children's clinic of la jolla spread the infection to four others. one of these, an infant, flew on a plane to hawaii, where she was intercepted and quarantined. the other 250 passengers had to be contacted and tracked. dr. wilma wooten is san diego county's public health officer. >> this entire process resulted in exposures of almost 1,000 individuals, 90 with no proof of immunization, 73 were

quarantined, 12 additional actual cases of measles in san diego. >> narrator: public health officials determined that what allowed measles to enter the community was that kids were not being immunized because their parents were getting around public school immunization rules by using personal belief exemptions allowed in states like california. school principals have found themselves caught on the front lines. >> the fact is that some families choose not to immunize their children. and then there are families who have children who are particularly medically sensitive, and they're in jeopardy because they could get sick from unimmunized children. so it's a very emotional issue on both sides. >> narrator: across america, the cdc has discovered certain communities with a large population of parents who either do not vaccinate their children or pick and choose which

vaccines to permit and how they are scheduled. one such place is ashland, oregon. >> you're walking? >> yeah, well, what am i going to do with a baby... scooter? this is our neighborhood and we love it because we can walk everywhere. ashland is a very safe town compared to almost every place else in america. >> narrator: it's a college town, the home of an annual shakespeare festival, where a well-off, educated population has easy access to alternative medicines, an organic food co-op, and yoga centers. >> go get him! >> narrator: jennifer margulis, a writer with a ph.d. in english, is the mother of four children. >> when my daughter was born in 1999, the nurse bustled in with her tray and said, "okay, it's time for your hepatitis b vaccine." and i looked at my daughter and i looked at the nurse and i said, "isn't hepatitis b a sexually transmitted disease?" and i said, "why am i supposed to vaccinate my newborn baby

against a sexually transmitted disease?" and the nurse got really mad. >> narrator: margulis went on to research and write about vaccines, and in 2009 published a long article about the vaccine debate in mothering magazine, a magazine promoting a natural lifestyle. >> why are we giving children so many vaccines? they get four times the number of vaccines than i got when i was a child growing up in the '70s. as a parent, i would rather see my child get a natural illness and contract that the way that illnesses have been contracted for at least 200,000 years that homo sapiens have been around. i'm not afraid of my children getting chicken pox. there are reasons that children get sick. getting sick is not a bad thing. >> narrator: in common with many other ashland parents back in 2010, margulis had decided not to fully vaccinate her other children according to the officially recommended vaccine schedule. ashland still has one of the lowest vaccination rates in the country.

because of exemptions, some 28% of ashland's kids are allowed to attend public school lacking some or all of their required vaccinations. >> so we're going to need today the d-tap number five, your final polio... >> narrator: pediatrician dr. donna bradshaw-walters worries that these parents may unwittingly bring back diseases that haven't been seen for decades. >> say, "ah." >> ah. >> good job. the possibility of an outbreak is real here in ashland. we are not living in a bubble, especially in this day and age of international travel. our shakespeare festival draws people from all over the world, and it's just a matter of time before someone comes to here from another area who is unimmunized and who has the disease and brings that disease into our community. >> narrator: in fact, ashland experienced an outbreak of

chicken pox in 2014. and given the low rate of vaccination here, the community is at constant risk of other highly infectious and potentially serious diseases like measles or whooping cough taking hold. there are many pro-vaccine parents in ashland, like lorie anderson, whose son, evan, is fully vaccinated. >> it's an outbreak waiting to happen. and so i don't just care about my own child. my child may be well protected because of his vaccination. but i hate to see people get hurt, injured, die, have to be quarantined, isolated because of an outbreak that is preventable with a vaccine. all they have to do is sign an exemption and their kid is exempt from immunization before they go to school. i will try not to be angry. i hope it doesn't get contentious.

it will, though. it will get contentious if there's an outbreak. if vaccinated children start to get breakthrough disease because of the high rate of unvaccinated children, it probably will get ugly. >> narrator: a vast public health infrastructure is committed to preventing such outbreaks: the national institutes of health, the food and drug administration, the centers for disease control and prevention, large vaccine manufacturers. the mainstream medical establishment speaks with one voice: vaccines are a public health miracle far too valuable to put at risk. emilio emini has spent his life making vaccines in america's pharmaceutical companies. he heads pfizer's vaccine operation. >> people haven't seen these diseases in a while, so people become complacent. they don't vaccinate. and what they wind up doing is putting their children and themselves in considerable risk of a severe disease and

infection. polio, even though people aren't worried about it because they haven't seen much of it, is still present in many parts of the world, and it can easily be introduced into a non-vaccinated population. and from what we've seen in other parts of the world, once it's introduced, it will spread very rapidly and cause a lot of disease. >> the fear, my friends, is polio. but soon, perhaps within a year, there may be a vaccine. >> thanks for visiting with us. hey, kids, how about saying good-bye, huh? >> good-bye! >> when i was a child and the big scare was polio, where you would see your friends playing ball outside with you, baseball and basketball, and all of a sudden get sick and be in bed, be in an iron lung, and then come out with a deformity, a serious limp, or a serious physical disability-- that is absolutely frozen in your mind as a very scary scenario.

>> i think we're compelled by our own fears. and certainly my parents, who, you know, who grew up in the 1920s and '30s and '40s, saw these infections. they saw what they could do. for them, vaccines was an easy sell. >> narrator: paul offit is a pediatrician and co-inventor of a vaccine against rotavirus, a pathogen that causes serious fever, vomiting, and diarrhea. >> i grew up in the 1950s and '60s. i saw measles. i had measles. i had mumps. i had german measles. i mean, i knew what those diseases could do. i watched my friends also be sickened by those diseases. and so for me, vaccines was an easy sell. i think for people now, young mothers today not only don't see these diseases, they didn't even grow up with these diseases. so for them, vaccination becomes a matter of faith. >> narrator: but the faith of some parents has eroded. offit, for example, is seen in some quarters not as a hero for inventing a successful vaccine, but as a self-interested entrepreneur whom skeptics have called "dr. profit." >> they all have this guy, paul offit. you guys know him? >> boo! >> and he is the poster child for the term "biostitute."

>> narrator: for such critics, the fact that vaccines have made offit rich is enough to discount what he is saying. but offit, a prolific author, makes no apologies. >> i'm the co-inventor of a rotavirus vaccine, a vaccine that i made in collaboration with merck, and it's a vaccine which has caused a dramatic decrease in this country in hospitalization and has caused already a dramatic decrease in hospitalization and death in some countries in the developing world. i'm enormously proud of that. i would argue that i have an expertise in rotaviruses and... >> but you also financially benefit from that vaccine. >> it's-it's... i know this isn't going to sell. but it doesn't matter. it doesn't matter whether i financially have benefited or not. the only thing that mattered is, did the vaccine that we created at children's hospital of philadelphia do what it was claimed to do? has it prevented hospitalization and suffering and death? and the answer to that question is yes. >> it's a mistake that we have a vaccine against rotavirus, the

vaccine that paul offit helped to develop. in the third world, maybe people are dying of rotavirus, but in this country, you have to do back flips to show a death toll of people from rotavirus. >> well, one of the bitter ironies of vaccination is it carries with it the problems of its own success. >> narrator: author and bioethicist arthur caplan is an expert on the ethical issues surrounding vaccines. >> many parents are not thinking about the risk side of disease because they don't see those diseases. they've never seen any child rendered deaf by the mumps. they've never seen somebody who's had a case of polio. i had polio. i was in the hospital, paralyzed legs and neck, for about a year. so i know firsthand what the polio epidemic looked like. i was sort of at the last outbreak before the vaccines really came online and eliminated it. >> narrator: vaccine-preventable diseases like polio have become

rare in the united states, so rare, in fact, that most younger doctors have never seen a case. (baby crying and coughing) this is one of the few places where you can see what vaccine-preventable diseases look like. this is a case of pertussis, also known as whooping cough. the audience is made up of paramedic students. >> she can't breathe, and that's horrifying for any patient of any age to discover that your airway has closed and you can't inhale. >> narrator: the teacher, dr. cynthia cristofani, is a pediatric intensivist who treats children in need of critical care. she decided early in her career to document the rare cases of vaccine-preventable illness that turned up in her portland, oregon, icu. (baby coughing) she has used the footage to teach other medics how to recognize these diseases. >> i'm old enough to have seen most of the serious life-threatening illnesses that are largely suppressed and some almost eradicated by the modern vaccines.

this baby was a victim of rotavirus. there's major fluid deficiency in this child's tissues. actually kills over half a million humans annually, most of them elsewhere on the planet. the community recollection for these diseases has largely disappeared, and so the parents of younger kids who are of vaccine age are unlikely to have had any personal experience. and unless the grandparents or others can tell them what it was like and happen to have had knowledge of somebody who had a severe complication, it's easy to imagine that these diseases are eradicated. those spots are actually something probably none of you have ever seen. they're chicken pox. this patient had one of the commoner potentially lethal complications of chicken pox. he got strep sepsis from an infected lesion. this child came as close to dying of chicken pox as you can come without doing it. and so i encourage you to remember that chicken pox also can cause fatalities, even though most people used to think of it as a rite of passage in childhood and we all got it. you can do better than that.

there's a vaccine. this one's a scary one. this is haemophilus influenza type b meningitis. and he was actually the last patient i ever saw with this disease. i can tell you it was the scourge of pediatrics when i was in training because there was no vaccine. but beware. it could come back if people stop vaccinating. >> narrator: but critics have argued that while some vaccines may be life-saving, the current vaccine schedule delivers just too many vaccines too quickly. >> why are we giving children so many vaccines? there's no more polio in the united states and there's no more diphtheria in the united states. and no one, no child, has contracted wild polio since 1979 in the united states. so when do we take polio off the vaccine schedule? when do we say, "fantastic. the vaccine worked. we figured it out. we don't have a polio epidemic anymore. let's stop vaccinating against polio." >> the number of antigens in the 14 vaccines, including their

boosters-- which brings it up to somewhere in the 20s-- it's literally a drop in the bucket to the antigens that an infant and a child get exposed to naturally even if they never got vaccinated with anything. >> narrator: officials like anthony fauci have struggled with how to convince parents that the benefits of vaccines far outweigh the risks. >> to say that there is no risk in any vaccine would not be truthful. what is the risk of injecting something into someone's arm? the risk is that a certain proportion of people will get swelling and a little bit of pain, lasting from an hour to a day. that is a very acceptable risk. a very, very, very small percentage of people will get an allergic reaction. namely, there's a component to the vaccine that they didn't realize that they were allergic to. and then there's a subset of a very, very, very, very small

percentage of those who actually could get a serious reaction. but if you look at that, the risk of that is so minisculely small as to be completely outweighed by the benefit. >> narrator: the cdc's website tries to convey all these risks accurately, even when scientists are not sure the vaccines are, in fact, responsible. here's what it says about the measles vaccine: >> when the cdc communicates risks, they fall into two groups. one is, are those risks that are very rare but in fact are real. >> sometimes, very rarely, can cause a rash later on. >> and the other are those risks that have been reported following a vaccine, but for which we have no evidence that

the vaccine actually caused the problem. those, i would argue, are at best theoretical. >> my son was a bright, precocious, healthy two-and-a-half-year-old child in 1980 when i took him in for his fourth dpt shot. >> narrator: barbara loe fisher runs an independent watchdog organization dedicated to vaccine safety issues. it's an organization she helped found in 1982 after her son suffered a serious vaccine side effect. >> to make a long story short, after that, he regressed physically, mentally, and emotionally, and became a totally different child. he was eventually diagnosed with multiple learning disabilities and attention deficit disorder and had to remain in a classroom for the learning disabled throughout his public school. >> narrator: fisher's organization lobbied successfully for laws that promote vaccine safety. today, a much safer vaccine has replaced dpt. the laws also created a special vaccine court to evaluate and

compensate victims of adverse vaccine side effects. >> vaccines are pharmaceutical products that inherently carry a risk of injury or death. and that risk can be greater for some than others, particularly for genetic or biological high- risk reasons that have... some of which have been identified and some of which have not been identified. >> shame on you! shame on you! >> narrator: one fear had come to dominate the vaccine war, the fear that vaccines were responsible for autism, a mysterious disorder that appears to be on the rise. the theory that vaccines could cause autism became well known partly due to the advocacy of celebrities like jenny mccarthy. >> jenny! jenny! >> today i am not a celebrity. today i am a mom of a child who had autism. >> narrator: mccarthy knew little about autism until her son, evan, received a series of vaccines, including the shot for

mumps, measles, and rubella-- the mmr triple shot. a few weeks later, evan developed seizures and was diagnosed with autism. >> so i left that office devastated, hopeless. the next day, or maybe it was even that night, went on google and typed in "autism." >> narrator: she found the site for generation rescue. >> so i clicked on generation rescue, and i found this community of parents. >> narrator: generation rescue is run by businessman j.b. handley. handley's son was diagnosed with autism following a series of shots in 2004. at the time, he'd also gone on the web and discovered a community of parents with stories to share. >> there were literally tens of thousands of parental reports of children regressing and changing after vaccine appointments.

>> "my child was fine before the vaccine." >> "the vaccine made sam autistic." >> "he completely changed." >> "after the mmr, he wouldn't look at us." >> "cole just stopped speaking." >> "he got the shot. we started losing him." >> narrator: the vaccine most often blamed in these stories was the mmr triple shot for measles, mumps, and rubella. >> then she would get her second mmr... >> few people without kids today realize that when a child goes in for a doctor's appointment-- and they're required to go in at two months, four months, six months, and 12 months to get their initial vaccines-- there are literally somewhere between five and seven vaccines lined up on the table that are all given simultaneously within about 12 minutes. >> your daughter will be protected against five things: diphtheria, tetanus, whooping cough, polio, and hib. >> well, tens of thousands of parents have reported that their kid was never the same after those appointments. the second data point is the knowledge that vaccines cause brain injury in a small segment of the population. we know that. the federal government knows it.

they pay money to kids who've been injured that way. this is something that's been known for years. and then we also know that the number of vaccines given has risen dramatically. so it does not take a rocket scientist to draw a possible correlation between the vaccines being given and the brain injury that our children are suffering because autism is brain injury. >> narrator: combining his resources and her celebrity, handley and mccarthy have been highly effective at organizing a movement of concerned parents. >> hi, i'm jenny mccarthy. i am here today to beg you guys... >> narrator: the science that gave the movement its original impetus was a 1998 article by british gastroenterologist andrew wakefield in the medical journal the lancet. he reported on 12 children with gastrointestinal problems, eight of whom developed symptoms of autism following an mmr shot. wakefield's theory was that the measles vaccine inflamed the intestines, causing harmful proteins to leak into the bloodstream, eventually damaging the brain and causing autism.

>> measles, mumps, and rubella given together may be too much for the immune system of some children to handle. clearly, for the vast majority, it is protective, and we must emphasize that it is just a small cohort of children, we don't know how large, but who appear to have developed the syndrome. >> narrator: news of wakefield's provocative lancet article spread across the world, creating fear that measles shots might cause autism. >> there was a dramatic decline in the coverage of young children with measles vaccines. >> narrator: autism expert eric fombonne was working in london at the time. >> there were areas, like in urban areas, where it was even lower than 80%. and in ireland, in particular, vaccine coverage fell to close to 70%, and there was a big outbreak of measles occurring as a result of that fear. 110 infants were admitted in hospitals in critical conditions, and i think three of them died from measles.

and measles is a preventable disease. >> parents reasonably thought, "my child was fine. they got an mmr vaccine, then they developed the first symptoms of autism. could it have been the mmr vaccine that caused that autism?" that's a perfectly reasonable question. >> narrator: the fact that two events happen close together might mean that they are causally related, but it could also be simple coincidence. >> this vaccination is given at an age where often the first symptoms of autism emerge. and typically, it occurs around 15 or 18 months of age, when these children start to walk, also when we expect them to develop language, which they usually fail to do. >> there are a certain set of diseases that become apparent when children reach a certain age. that's not cause and effect. >> just because one event followed another, it doesn't mean it was caused by the other. i mean, every morning, the rooster crows, the sun comes up. it doesn't mean the rooster's causing the sun to come up. the question is, was it caused by it? ♪ >> isn't the problem here,

jenny, that people sometimes-- casual or listen with one ear-- are going to panic and not vaccine at all? >> probably. but guess what? it's not my fault. the reason why they're not vaccinating is because the vaccines are not safe. what we are saying is that the number of vaccines given, and the ingredients, like the fricking mercury, the ether, the aluminum, the... narrator: vaccine critics question not only mmr, but the many ingredients in vaccines. these historically have included aluminum, formaldehyde, formalin, yeast protein, and a mercury-based preservative called thimerosal used in multidose vaccines. one very influential critic is environmental lawyer robert kennedy, jr. >> so the government scientists are acknowledging that even tiny, infinitesimal amounts of mercury, parts per billion, will

cause profound neurological injury in children. the biggest exposure is coming from our own vaccines. when i was a little boy, we only got three vaccines. but my children, five of my six children, got 22 vaccines, beginning in 1989. that's the thimerosal generation. that's the vaccine generation. >> so the mercury hypothesis had more plausibility than that for mmr because of the nature of mercury, which is known to be a neurotoxicant. but mercury poisoning doesn't resemble autism at all. the fact that mercury is a toxicant is not sufficient to claim that the mercury contained in vaccines can lead to autism. so it was critical, therefore, to follow this hypothesis with properly conducted epidemiological studies. >> narrator: under public pressure, public health agencies decided to act on the side of caution, rather than wait for

the results of such epidemiological studies. in 1999, the fda asked manufacturers to reduce or eliminate thimerosal in vaccines as soon as possible. >> unfortunately, i think it precipitated the notion that the thimerosal was doing harm. and from a parent's standpoint, that again was very understandable. why would you take something out of vaccines in such a precipitous and frightening manner unless there was a problem? >> when i began my crusade for autism, one of the first speeches i gave was, "is it mercury? is it the schedule? is there just too many?" my answer to people, and what i've been telling them, is it's all of the above. we don't know for sure, which is why we keep saying, "study it." but they won't. >> narrator: in fact, around the world, scientists have been studying groups of children, searching for a possible link

between vaccines and autism, using the same epidemiological methods that linked smoking to lung cancer. one country renowned for its epidemiology is denmark. unlike the u.s., danish authorities collect demographic and health data routinely on the entire population in a series of national registers. they know when every child was born, when every child was vaccinated, and when every case of autism was diagnosed. >> it's sort of a paradise for epidemiologists because we don't have to work to collect this data. it is available to us. >> narrator: anders hviid and colleagues at the statens serum institut analyzed data on all the danish children born between 1991 and 1998, over half a million. they compared two groups, those who had received the mmr triple shot and those who hadn't.

then they counted the cases of autism in each group and calculated the autism rate. they found no difference. children who didn't get the shot had the same risk of developing autism as those who did. the team published the findings in the new england journal of medicine. other studies carried out by researchers in sweden, britain, finland, and the u.s. also found no association between mmr and autism. additional evidence came from japan. the japanese changed their vaccine schedule in 1993, replacing the mmr triple shot with three separate vaccinations. but following the change, autism rates did not fall. in fact, they appeared to rise, thus making the triple shot an unlikely cause of autism. the danish team now went on to investigate the second theory,

the mercury preservative thimerosal. it turned out that in denmark, there was a simple way to test this, as well. >> in denmark, since the '70s, only one vaccine has contained thimerosal, and that was a pertussis vaccine. it contained thimerosal until may-june '92. then the same vaccine continued, but without thimerosal. >> narrator: hviid and colleagues found that children who were given pertussis vaccines with thimerosal before 1992 had identical autism rates as children who received mercury-free vaccines after that date. >> we did not find any association between being vaccinated with the thimerosal-containing vaccine and the risk of autism. >> narrator: other studies in the u.s., the u.k., and canada also found no association between autism and thimerosal. in 2004, the institute of medicine carried out its own

analysis of the research and concluded: >> "the body of epidemiological evidence favors rejection of a causal relationship between the mmr vaccine, and autism, and also between thimerosal-containing vaccines and autism." >> the allegations against me are both unfounded and unjust. >> narrator: then something extraordinary happened. on february 2, 2010, the lancet retracted wakefield's landmark 1998 paper, saying it was scientifically flawed. the lancet reported that wakefield's findings could not be replicated and it turned out that some of the kids in his small sample had been referred to his study by a lawyer who was suing pharmaceutical manufacturers on the children's behalf. a few months later, wakefield was stripped of his medical license. but despite these revelations, organizations like generation rescue came out in strong support of wakefield,

continuing to believe in his science. soon after, parents of autistic children who brought class-action lawsuits based on the mmr and thimerosal theories had their hopes dashed by the federal vaccine court. >> and good evening to you. we begin tonight with a ruling that affects millions of parents with children who have autism. families who went to a federal court over these vaccines were told their case was without scientific or legal merit. >> narrator: the vaccine court that barbara loe fisher's organization had helped set up issued a strongly worded ruling on march 12, 2010, denying a link between autism and vaccines. >> scientifically, i think the matter's settled. but i... i don't think that... i think there are a lot of people who don't listen to science and don't understand it. so they're going to be difficult to sway with the scientifical... scientific arguments.

>> i don't give a (bleep) about what the mmr said! my kid got six vaccines in one day, and he regressed! you don't have any science that can show me that the regression wasn't triggered by the six vaccines. what the parents are saying is, "i went in for a vaccine appointment. my kid got six vaccines, and they regressed." we need to ask the question as to why the regression took place-- not whether the regression took place, why the regression took place. the only way to do that is to look at that load of vaccines and compare a group of kids or a group of animals who got the load and who didn't. >> narrator: vaccine critics say many more studies are needed before scientists can rule out side effects like autism-- studies of the other vaccines, studies of multiple additives, and studies to see if certain children are genetically predisposed to a vaccine reaction. but scientists say undertaking dozens of more studies is not only pointless but also unethical. >> we know that vaccines save lives. so, you can't do a traditional study where you take a group of

people and say, half of them we're going to give vaccines to and half we'll give a placebo to because then you're putting the half that you're giving the placebo to at risk of very serious diseases. >> the hypotheses continue to shift. the first hypothesis, which, you know, people bought into long and hard, is that the combination measles, mumps, rubella or mmr vaccine caused autism. 12 epidemiological studies showed that that wasn't true. then the hypothesis shifted to thimerosal, an ethylmercury-containing preservative that was in vaccines, that's no longer in vaccines except for some multidose preparations of flu vaccine, that that caused autism. and that clearly has been shown not to be true. so now this is classic for pseudo-science, is you just keep moving the goal posts. so now the goal post is, "no, we didn't mean actually mmr caused autism or thimerosal caused autism, we just meant vaccines in general cause autism." >> narrator: in the vaccine war, two kinds of knowledge compete for the public attention: the collective but dry conclusions of the scientific community and the personal anecdotes of

parents. >> it's a tragedy that there are kids who are unprotected because their parents are choosing not to vaccinate out of fears that are unfounded. the other tragedy is that the kids who have autism, who desperately need better research into why, and more important, what to do about it now, that research isn't being done, at least to the degree that it should have been, because most of the would-be research, those dollars and hours have been lost. >> narrator: the cdc is involved in a long-term study called seed-- the study to explore early development-- to help identify what might put children at risk for autism spectrum disorders and other developmental disabilities. but it's not clear that such scientific studies will settle the vaccine war. to the contrary, public skepticism of scientific authority seems to be growing, fueled in part by a battleground

where ideas fight for public attention-- the internet. >> i spoke recently at a high school near here. there were about 200 people in the audience, and i asked them how many had gotten the influenza vaccine. and about half raised their hands. of the half that didn't raise their hands, they said that they didn't get it because on youtube, they saw a redskins cheerleader say that she had gotten the vaccine and had a so-called dystonic reaction. >> she's the beautiful cheerleader whose heartbreaking story is shocking the nation. >> narrator: this clip of redskins cheerleader desiree jennings went viral on the web after a local fox news station broke the story. she reported a bizarre neurological reaction to a flu vaccine that caused her to be able only to walk backwards. her story's been viewed and shared more than 2.5 million times. >> desiree can run just fine. it's only when she stops-- you see, that's where the... that's where the spasms start. now, you can walk backwards, though. >> these students who sat in that room were much more likely

to believe something they had seen on youtube from a washington redskins cheerleader than they would have believed something that they would have heard from the centers for disease control and prevention or the american academy of pediatrics. that's a little frightening. >> i think the internet has been fuel on the fire of anti-vaccine fears. there's plenty of websites out there putting out information about people alleging all kinds of complications and problems with vaccines, their own pet theories about what might be dangerous about vaccines, so there are oodles of sources of lousy, dangerous information out there. >> narrator: but advocates like barbara loe fisher see the internet as a democratizing force that has empowered people to challenge medical dogma. >> when i first started this work in the early '80s, i had a selectric typewriter and i had the post office. that's it. today, you have access to the library of medicine on the internet. you can communicate with people all over the world.

so it has changed everything. >> narrator: in this new world, many parents are no longer willing to take the word of their doctor on faith, or to accept the conclusions of the medical establishment, frustrating public officials charged with protecting the health of the community. >> i'm the mother of a two-and-a-half-year-old, and i haven't done any vaccines at all. and i feel very safe and very comfortable with my decisions. >> i'm a midwife, and i'm also the co-leader of the rogue valley holistic moms network. >> narrator: ashland's public health officer, dr. jim shames, has met with parents to talk about their responsibilities for the public health. >> do you feel that when you say "no, thank you," that you might be putting anybody else at risk besides your child? >> this is the major thing that we're always up against. public health officials are looking at the good for all. mothers are looking at the good for their one child. and that's very important for them. it's the most important thing. it's their world. >> when you make that decision for your child, which you have a right to do, do you think you may be affecting other children?

>> do i believe that i'm causing harm by not vaccinating my child? no, i don't, because if the vaccines work, who am i putting at risk? >> so let's talk about that. now, not everybody can get immunized. that child right there is probably too young to get immunized against pertussis. if your child gets pertussis by not getting the vaccine and your child passes it on to a delicate newborn... >> i really don't believe it. i feel like... first of all, i feel like it would be responsible to then quarantine my child and not expose them to other, you know, potentially fragile populations. >> a lot of diseases are transmitted before you even know you're sick. >> it's my responsibility as a parent to keep my child safe, i think, and i don't think it's your responsibility to take a vaccine because i might be at the same party with you and you might cough on her. honestly. i think your job is to protect your own health. and i mean, maybe i sound... i really don't mean to be sounding selfish in that way.

>> there has to be some step beyond just "i take responsibility for me and my kids" because there's things that happen in the best of intentions that diseases do get transmitted. >> narrator: for these ashland mothers, health is a private affair, not a public responsibility. for them, refusing a vaccine is no more significant than refusing any medication for your child. but ethicists say vaccines are special. >> vaccines have an odd power that drugs don't have. if i take a drug, it doesn't help you. but if i get vaccinated and some others get vaccinated, then you may be benefited by so-called herd immunity. >> in other words, if a certain percentage of the population is vaccinated, that will stop infections from spreading because most of the people around that child are vaccinated, so therefore the virus can't really spread. however, when a critical number of people aren't vaccinated, when there's a critical drop in herd immunity, then the viruses can spread. and not only are those children who aren't vaccinated at risk,

but those who can't be vaccinated are at risk. >> narrator: when enough people don't vaccinate, herd immunity begins to crumble. the first to suffer are vulnerable populations, those who because of age or illness can't be vaccinated. when vanessa was six weeks old, too young for most vaccines, her only protection was from the herd. then she came down with a severe cough. >> she turned totally blue. she stopped breathing, and we didn't know what to do to have her breathing back again. i took her outside, you know, bring her back. she wasn't responding. >> narrator: an ambulance brought her to the pediatric icu in her hometown of portland, oregon. fortunately, the intensivist on call that night was dr. cynthia cristofani. this was vanessa. (coughing) >> i look at the video and i keep saying, "vanessa, take a breath, please" because we knew that a child of that age with an already narrow airway baseline,

who's not inhaling well, could easily lose consciousness from lack of oxygen and perhaps die. >> they're giving her oxygen. >> narrator: dr. cristofani opened the infant's airways and sucked copious secretions from her mouth. vanessa had pertussis, whooping cough. her status was so dire, a chaplain was brought into the er. >> vanessa was 40 days old when she was diagnosed with whooping cough. so we were probably a week away from having her vaccine for whooping cough. so the only thing that will protect a kid like that will be the herd immunity. and in that case, it failed. i mean, somebody in the community didn't vaccinate or, you know, got vanessa infected with it. >> narrator: vanessa survived, and the cdc traced her pertussis to an infected student at her brother's high school. for the very young and for the very old, scientists say herd immunity matters.

>> the more immunity we have in a community, the better it is. 50% is better than nothing, and 100%-- it's like building a brick wall around a city and protecting it against an enemy. it's excellent protection against something entering our community that could cause illness. >> narrator: five years ago when we last reported on the vaccine war, public health officials were struggling. it was a challenge to explain the importance of herd immunity. but now the political landscape has changed because of the rapidly unfolding measles outbreaks like the one that started at disneyland in california. (horn blares) the outbreak there, public health officials say, is a sign of poor herd immunity caused by parents using the personal belief exemption to opt out of the mandatory vaccine schedule required for attending public

schools. >> there are essentially two types of non-medical exemptions in this country: religious exemptions and personal belief exemptions. the way those two types of exemptions are administered around the country vary widely. in some places, you essentially just need to say, "it is my personal belief that i should not vaccinate my child" and sign a piece of paper and that's that. >> narrator: reed elementary school in marin county has traditionally made it easy to obtain such exemptions. but now some parents have pushed back, saying that such policies put certain kids at risk. this is seven-year-old rhett krawitt. he's lived with leukemia for most of his young life. he has endured multiple medical procedures and over 50 surgeries. >> made it! >> narrator: 90% of such cases are eventually fully cured, but the treatment wipes out the immune system, making

vaccinations impossible. >> okay, you ready to go, rhett? >> i've been ready. >> when he was first diagnosed, he was pretty much pulled out of society. we avoided highly concentrated groups of people. when we went out we wore a mask. i mean, we really did limit his exposure and we just were so excited for the day when he could start kindergarten so he could have that sense of socialization and community and learning. >> narrator: a year into remission and back in school, rhett will soon be healthy enough to be fully vaccinated, but until then, his life depends on herd immunity. and marin's high rate of non-medical exemptions therefore puts kids like rhett at risk. that's what this school board meeting is all about. >> so at this point in the meeting, what we're going to do is turn it over to public comment. >> narrator: rhett's family has come to argue that reed

elementary should bar unvaccinated kids who don't have legitimate medical exemptions. >> the story isn't about rhett anymore, it's about the hundreds of kids currently with suppressed immune systems that rely on the science of herd immunity. please eliminate the personal belief exemption as a condition of attendance at reed. >> my name is rhett krawitt. leukemia is cancer in my blood. >> narrator: rhett has become a poster child for the pro-vaccine camp, which is now on the offensive, with california politicians considering new legislation to repeal personal belief exemptions. >> my name is dr. richard pan. i'm a state senator representing district six in sacramento. and i really have made extraordinary efforts to be sure that our children are safe. >> narrator: and there are similar plans in other states. >> what do you want the board to do? >> to make sure everybody gets vaccinated.

>> have you talked to your pediatrician? >> narrator: but vaccine watchdogs like barbara loe fisher oppose such legislative attempts to limit parental choice, turning again to the internet. >> the battle lines are clearly drawn. now americans have a choice to make. will we stand up and fight to protect our freedom to make voluntary decisions about which vaccines we buy and use, or will we permit liability-free drug companies and government health officials to take that freedom from us? >> madame chair and members of the committee, thank you. >> narrator: jennifer margulis has also joined the fight, testifying against a new oregon bill to ban personal belief exemptions. >> for me this is a debate about freedom and parental choice. oregon should be educating parents about vaccines and vaccine safety. there is no place for forced vaccination in a free society. >> thank you. >> narrator: and some politicians are being asked to weigh in on this divisive issue. >> parents need to have some measure of choice in things as

well. so that's the balance that the government has to decide. >> did you really just say that you think most vaccines in this country should be "voluntary"? >> the state doesn't own your children. parents own the children, and it is an issue of freedom. >> hillary clinton tweeting, "the science is clear: the earth is round, the sky is blue, and vaccines work." adding, "grandmothers know best." >> parents don't have unlimited rights with respect to the welfare of their children. you can't put them at risk of fatal disease. you can't put them at risk of devastating disability. you know, the ethics isn't just on the side of the critics. the ethics is also on the side of those who say, "do good in the name of children. do good in the name of public health." >> narrator: one thing both sides can agree on: there's a lot at stake in the vaccine war-- on the one hand, the fear that american communities will be exposed to serious diseases; on the other, something equally compelling: every parent's wish to do what's best for her child.

>> i'm going to race you there! >> narrator: next time, a frontline/ propublica exclusive investigation. a string of murdered journalists. >> somebody knows who's responsible for each and every one of these acts. >> for them to pull that off in such a quick time, that takes money. that takes support. >> do you think the bureau should reopen the investigation? >> if new information's developed, oh, yeah. >> narrator: 30 years later, why is it still a secret? "terror in little saigon." >> go to pbs.org/frontline for more on the vaccine war. >> it's a tragedy their kids were unprotected because their parents are choosing not to vaccinate. >> learn more about the vaccine exemption laws in your state.

visit our watch page, where you can stream more than 200 documentaries. and connect to the frontline community, tell us what you think on facebook and twitter, and sign up for our newsletter at pbs.org/frontline. >> frontlinis made possible by contributions to your pbs station from viewers like you. thank you. and by the corporation for public broadcasting. major support for frontliis provided by the john d. and catherine t. macarthur foundation, committed to building a more just, verdant, and peaceful world. more information is available at macfound.org. additional support is provided by ford foundation, working with visionaries on the front lines of social change worldwide, at fordfoundation.org. the park foundation, dedicated to heightening public awareness of critical issues. the john and helen glessner family trust, supporting trustworthy journalism that informs and inspires. and by the frontline journalism

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