October 28, 2009
In light of President Obama’s declaration that the outbreak of the H1N1 virus is a national emergency, Surprising Science is setting this week aside to discuss the history and science of vaccines and their importance in battling diseases, including swine flu. See Monday’s post for part 1, A Brief History and How Vaccines Work, and yesterday for part 2, Success Stories.
It’s kind of startling that the idea of vaccines ever caught on. There is an amazing amount of trust needed: A person—often a complete stranger—is injecting you with a foreign substance. You have to trust that the substance is really what you’ve been told it is, that it has been sufficiently tested and is safe, and that it will work as advertised and not hurt you.
Despite this, most people trust the doctors, science and government and do get vaccinated. A small percentage, however, choose not to be vaccinated (or not to have their children vaccinated). And it’s been this way almost since Edward Jenner first began vaccinating people against smallpox (see the illustration).
Decades after Jenner’s discovery, the British government got involved in vaccination by passing a law in 1840 that provided free smallpox vaccinations to the poor. But later efforts didn’t go over so well. A 1853 law required all infants be vaccinated in the first three months of life and threatened parents who did not vaccinate their children with a fine or imprisonment. Riots soon broke out in several towns. In London, an Anti-Vaccination League was founded. In 1867, after the law was extended to children up to age 14, the Anti-Compulsory Vaccination League was founded. Opposition now focused on the law’s threat to personal liberty. (“As parliament, instead of guarding the liberty of the subject, has invaded this liberty by rendering good health a crime…parliament is deserving of public condemnation.”)
In the late 19th century, anti-vaccination movements spread across Europe and into the United States, where they succeeded in repealing compulsory vaccination laws in several western and Midwest states.
But despite the controversy, protests and pamphlets, the doctors, science and governments eradicated smallpox from the United States by 1950 and from the entire world by 1980.
Along the way, though, anti-vaccination sentiments have resulted in serious harm. For example, when the majority of the residents of Stockholm, Sweden refused vaccination for smallpox in the early 1870s, they were left vulnerable to the disease. The city experienced a major epidemic in 1874, after which vaccination was again popular.
Efforts to eradicate polio—a disease now confined to just a few countries—came off track in Nigeria due to a 2004 rumor that the vaccine “contained birth control drugs as part of a secret western plot to reduce population growth in the Muslim world.” Polio is on the rise again in Nigeria, and more than 100 children have been left paralyzed by the disease this year.
And in places like Europe, Australia and the United States, in communities where parents have stopped vaccinating their children for fear that common childhood immunization causes autism (a fear that is completely unfounded), diseases that had become rare—like measles and pertussis—are making a comeback, as Wired magazine notes in their November issue:
“I used to say that the tide would turn when children started to die. Well, children have started to die,” [pediatrician and vaccine researcher Paul] Offit says, frowning as he ticks off recent fatal cases of meningitis in unvaccinated children in Pennsylvania and Minnesota. “So now I’ve changed it to ‘when enough children start to die.’ Because obviously, we’re not there yet.”
The anti-vaccination movement ebbs and flows over time, with fear of disease fighting mistrust of doctors, science and government. Which will win? If history is any guide: neither. But doctors, science and government will all need to work together to find a way to protect public health. And then, perhaps, they will find more vaccine success stories along the way.
Tomorrow—Vaccine Week, Day 4: Swine Flu Edition
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