Adel Mahmoud, a professor of molecular biology at Princeton, has been involved in vaccine research and development in one form or another since the 1960s both as a researcher and as the former president of Merck Vaccines, where he led the development of the modern measles-mumps-rubella-varicella vaccine. As a member of numerous scientific boards, including the International Vaccine Institute and the National Academy of Science Committee on Science and Technology in the Department of State, he has advised foreign heads of state and the U.S. government on vaccine policy.
But never before has he stood against the president of the United States on the issue of vaccines. Throughout the Johnson, Nixon, Ford, Carter, Reagan, Clinton, both Bushes, and Obama years, inoculation was never a partisan issue. That all changed during the 2016 presidential campaign, much to Mahmoud’s shock.
Mahmoud said he was dismayed to learn that Donald Trump had met with Andrew Wakefield and Robert F. Kennedy Jr., who are both major leaders of the anti-vaccine movement. “Kennedy claims that he’s going to run a commission on vaccine safety,” Mahmoud said. “He has no scientific credibility. He has no scientific knowledge. And he has no idea what he is talking about.”
Kennedy is an environmental activist who wrote an error-filled article for Rolling Stone and Salon in 2005 that alleged vaccines were causing autism and that there was a conspiracy to cover up the evidence. Salon later retracted the article.
Wakefield is an infamous British ex-doctor who wrote a study published in the medical journal the Lancet in 1998 that raised the question of whether the routine childhood measles-mumps-rubella vaccine was responsible for an increase in the number of children diagnosed with autism spectrum disorders. The paper was later discredited by other scientists, the Lancet took the rare step of fully retracting it, and Wakefield was stripped of his license to practice medicine. Wakefield’s study is blamed for helping launch an anti-vaccine movement in the U.S. that has harmed public health.
“There is a significant attack on vaccines in this country, the result of which is decreasing vaccination rates,” Mahmoud says.
Mahmoud will give a talk on Saturday, February 4, at 9: 30 a.m. at the Princeton Plasma Physics Lab. In the free Science on Saturday program, “Imperative of Vaccination Nationally and Globally,” Mahmoud will discuss how vaccines have wiped out infectious diseases, and save millions of lives every year around the world. He will also review the vast evidence that the currently used shots are both safe and effective.
Mahmoud says the program was planned before November 8, when the country elected its first president with a record of anti-vaccine statements. In 2014, a decade after the autism-vaccine link was debunked, Trump tweeted: “Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn’t feel good and changes — AUTISM. Many such cases!”
Mahmoud had already planned to defend vaccines in his talk, but the election results made the issue more timely. “Recently it’s becoming a political issue,” Mahmoud says. “In the background, this has been going on for many years.”
In his defense of vaccines, Mahmoud points to their record as an extraordinarily effective weapon against certain infectious diseases. Smallpox, a disease that once killed millions, has been wiped from the face of the earth. Polio was driven out of the United States and is now nearly extinct throughout the world. Numerous other infections have been driven back dramatically.
In fact, Mahmoud credits vaccines as being largely responsible for the increase in human lifespan in the past 50 or 60 years.
In Mahmoud’s view, the biggest threat to those advances is the anti-vaccine movement, which has sowed doubt in the U.S about the safety of immunizations, leading to declining rates of MMRV shots. If rates decline further, people could start dying. “The decrease in the immunization rate in this country has led to outbreaks of measles and outbreaks of mumps,” Mahmoud says. “It’s one thing to get mumps as a child. It’s a febrile disease, it passes, and there are no complications. But there is major disease syndrome that is related to having measles or mumps in adolescents and young adults. When we have 5 percent of people in the country not immunized, you get some transmission, and then you get young adolescents getting measles, mumps, and rubella, and these are fatal diseases.”
Mahmoud cites a recent outbreak of mumps in Brooklyn, New York, as an example of the danger of allowing too many non-medical exemptions to vaccines. It only took a relatively small number of people not getting the shot to give the disease a window to return to the population. Mahmoud says vaccines protect the people who get the shots, but part of their value is to protect those who are unable, for medical reasons, to get the vaccine. If enough people are inoculated, the disease has no opportunity to spread to the few people who are not immunized. Because mumps is highly infectious, more than 95 percent of people must be immunized in order to guarantee “herd immunity.”
Mahmoud learned to appreciate the value of vaccines early on in his career. He grew up in Egypt, where he was raised by his mother, a housekeeper, after his agricultural engineer father died when he was 10. He earned a medical degree at the University of Cairo in 1963 and in 1968 traveled to England, earning his doctorate in infectious diseases in 1971.
During a 25-year academic career, Mahmoud did research on infectious diseases, immune response, and molecular biology, work that was crucial to developing vaccines. He later became president of vaccines for Merck, where he helped develop the MMRV shot that is currently used as well as the rota, shingles, and human papillomavirus vaccines. He currently teaches at Princeton University where he is a senior policy analyst at the Woodrow Wilson School.
In order to fight the anti-vaccine movement and to assure parents of the safety of the approved schedule of childhood vaccinations, Mahmoud believes healthcare professionals must lead the way. “They have to take a clear position and push the value of vaccines,” he says.
Mahmoud understands why some parents think there is a connection between vaccines and autism. Many of the vaccines are given around the same age that the first signs of autism start to appear.
“I have great respect for parents, who take their child, who is a healthy individual, to get an injection and then something happens, and the kid turns out to be autistic,” Mahmoud says.
“That correlation makes parents believe that there is a causal relationship. But you have to look at the evidence. You have tens of studies that say there is no relationship. You need to be sympathetic with these people, and you need to support them and help them, but it cannot be at the expense of the public health of the whole world.”