About Connections: Love it or hate it, history is a map. Those who hate history think it irrelevant; many who love history think it escapism. In truth, history is the clearest road map to how we got here: America in the twenty-first century.
Historically, the first vaccination developed was against small pox. It was produced in 1798 by British doctor Edward Jenner. Small Pox was a dreaded disease: painful, disfiguring, and deadly. It follows logically that the vaccine was welcomed and Jenner acclaimed: not exactly. The vaccine was eschewed and Jenner’s image burned in effigy.
Critics of the vaccine took various positions: religious organizations called the vaccine “un-Christian”; some feared side effects and others were suspicious of the efficacy. They believed the vaccine itself infected people and spread the disease. It might be said that general discontent with the vaccine reflected general distrust in medicine, but that was the eighteenth century; a long time ago, right?
In the nineteenth century, 1882, Massachusetts passed a law making the small pox vaccination legally mandatory. Tension worsened as a result. In the Lenox town meeting they voted to close the schools to prevent spread in case of an outbreak rather than immunize the students. Elsewhere in Massachusetts the New England Anti Compulsory Vaccination League was formed. The League firmly believed mandatory vaccination violated their personal liberty.
In the twentieth century, 1905, a case brought in Massachusetts found its way to the U.S. Supreme Court. The Court found in the state’s favor, ruling that the state could enact compulsory laws to protect the public in the event of a communicable disease. This was the first U.S. Supreme Court case concerning the power of states with respect to public health law. Notwithstanding in 1913, the League was still producing pamphlets on how to avoid mandatory vaccination.
While scholars described vaccination as one of the ten most significant public health achievements of the 20th century, opposition to vaccination persisted and the focus moved from small pox to DPT (diphtheria, tetanus, and pertussis).
The controversy over DPT immunization began after a television documentary (Vaccination Roulette) aired in 1982. It alleged a number of adverse reactions to the inoculation. A book followed in 1991 (A Shot in the Dark) outlining potential risks. The response from the Academy of Pediatrics and the Centers for Disease Control and Prevention was strong but not entirely mitigating. The media storm prompted several lawsuits against vaccine manufacturers but none were successful.
Next on the Anti-vaccination and immunization hit list was the vaccine for measles, mumps, and rubella (MMR). The fight had two prongs: opposition to the use of a preservative called thimerosal that contained mercury, and an accusation that a causal relationship existed between the vaccine and autism.
Research studies were conducted to assess the safety of the MMR vaccine, and none of them found a link between the vaccine and autism. Out of an abundance of caution, the use of thimerosal was dropped or decreased.
It does not seem to matter what the studies report or the experts say. In 2014, measles, a disease that was all but eradicated, reappeared in this country. In 2013 there were 11 reported cases of measles in the U.S. In 2014 there were 644 cases. Hundreds of children were infected, and some died. In the first 23 days of January 2015, there have been 68 cases. The measles have spread from Disneyland and is continuing to rampage.
There is something called “herd immunity.” That means that when a sufficient percentage of the community has been vaccinated, the entire community is protected. That specific percentage of inoculated individuals disrupts the chain of infection; creates a firewall that stops the transmission of the disease. The percentage differs with different diseases, but the CDC calculates it is 83 – 94 percent with measles.
When that percentage was achieved, it served to protect the entire community, and so it was said that “measles was eradicated.” When vaccination rates fall below that percentage the entire community is made vulnerable. We have now fallen below that point with measles, and we are approaching that point with polio.
It is the moment to ask: why? Why has the opposition to life saving inoculations remained relatively consistent since Edward Jenner introduced the small pox vaccination?
Perhaps vaccinations can seem complex even frightening to many, but there are ways to research, study, and establish facts about them. We have evidence and the means to mass communicate the facts. Hypothetically, the majority of people, apprized of the facts, would then act in concert with their best interests. Or not —
Why have the emotions and beliefs underlying the opposition to vaccines remained unchanged in the face of proof to the contrary? Why do we cling to what Paul Krugman calls “zombie ideas,” false ideas that should have died in the light of truth but did not?
We seem to have elevated opinion to the same level as fact. We have allowed hot air to be ranked with research and science. We seem to accept that everything is debatable although a fact should not be seen as one of multiple opinions. We may enjoy that good story – the one truth is never allowed to get in the way of – but there may be consequences. What’s the harm, you ask?
Right now, in six states, it may be killing our children.