The sceptics would do well to study the history of their movement.
The relatively disease-free, low infant-mortality world we’re used to today was not always so, and vaccines played a pivotal role in granting us our modern, healthy childhoods. In 1796, Edward Jenner used material from a cowpox lesion to innoculate an 8-year-old subject, James Phipps. Ignoring the ethical implications of experimenting on children, Jenner observed that Phipps was protected from the deadly smallpox virus due to his immune system being exposed to the mild, closely-related cowpox. Following further experimentation on more children, including Jenner’s own 11-month old son, the vaccine (Vacca means cow in Latin) was born.
Within 200 years, smallpox was eradicated by a global vaccine drive, and several other diseases, from polio to measles, have been eliminated in many countries and reduced considerably in others. Vaccines have been one of the greatest public health accomplishments of the 20th century, but they have been met with repeated resistance throughout their history — resulting in multiple disease outbreaks that would otherwise not have occurred.
Birth of the anti-vaccine movement.
In 1840, the United Kingdom made vaccines for smallpox freely available to the poor, and by 1867 vaccination was mandatory with ‘cumulative penalties’ for non-compliant parents. Although there was some anti-vaccine sentiment prior to the 1867 legislation, the encroachment of the state in the name of public health resulted in the formation of several anti-vaccine journals and mass protests, with childhood vaccination rates plummeting to 3% in Leicester.
The anti-vaccine mood spread to other parts of Europe, resulting in a major smallpox epidemic in Stockholm. The British government, under pressure from anti-vaccinationists, instituted a royal commission to investigate vaccine effectiveness. The commission came out in favour of vaccines but allowed parents to conscientiously object against vaccination in the future.
Continuation into the 20th century.
- Vast improvements in vaccine development and research.
- Increases in public awareness of disease outbreaks (including polio, measles, rubella and others), along with the desire to protect children from future epidemics.
- Increased levels of scientific literacy alongside a post-war baby-boom.
- Public acceptance of vaccines resulting in publicised decreases in disease rates, reaffirming the necessity of vaccine use.
The above resulted in a period of wide-scale vaccine promotion between 1940 and 1970, within which disease occurrence dropped significantly. However, the golden age of public opinion regarding vaccines was short-lived. With decreases in disease threats to the public, similar to that of the diminished presence of smallpox in late 19th century Europe, anti-vaccine sentiment began to rise once more.
The DTP controversy.
The Diphtheria-Tetanus-Pertussis (DTP) combined vaccine was widely used from the 1950s, with the aim of preventing disease caused by the three bacterial pathogens in its name. Whooping cough (pertussis) is a respiratory disease which is potentially deadly to infants and young children. In the UK, cases of whooping cough dropped from over 100 000 per annum in the 1940s to a few thousand in the early 1970s, with similar trends observed in other countries which actively utilised the vaccine.
The DTP vaccine had remained mostly unchanged from the 1940s, raising concerns over the vaccine’s safety. In 1974, a paper was published in the UK detailing the cases of 36 children with a neurological illness that, the authors believed, was caused by the DTP vaccine. A media frenzy ensued, and vaccination rates plummeted in the face of growing medical uncertainty. Vaccine opposition spread to many other countries, facilitating whooping cough outbreaks in the UK, Sweden and Japan— eventually resulting in a return to vaccine use.
Although the claims against the DTP vaccine weren’t completely unfounded (there was a very low risk found), the controversy was a taster of the damage that can be caused by a combination of sensationalised mass-media coverage and medical uncertainty.
The 90’s and beyond: a movement grows.
It was in 1998, following the publication of a paper linking the Measles Mumps and Rubella (MMR) vaccine to autism, that media-fuelled anti-vaccine fervour rose once again. Although the paper was later retracted by The Lancet, due to major flaws and the finding that Andrew Wakefield (an author on the paper) had vested financial interest in the autism-MMR link (read more about the investigation here), the damage to public opinion was complete. A new anti-vaccine era had begun.
On top of the vaccine-autism theory (which has been thoroughly debunked, with a recent study on nearly 700,000 children over 10 years finding no association), several other vaccine concerns have since proliferated:
- Thimerosal, an anti-bacterial preservative used in multidose vaccines, was thought by anti-vaccine campaigners to contribute to the proposed vaccine-autism link, due to its mercury content. However, thimerosal breaks down into 50% ethylmercury (not hazardous methylmercury); and although there was no basis to the claims, the FDA phased out thimerosal use in many vaccines, further fuelling conspiracy theories.
- Aluminium salts are utilised in vaccines as adjuvants (for a stronger immune response). Due to the well documented toxic nature of aluminium, campaigners highlighted it as a toxic substance. However, it is utilised in extremely low amounts, well below the established safe limits.
- Many campaigners believe that global disease reduction is due to greater levels of public hygiene and that vaccines are an unnecessary arm of a grand government conspiracy. This is simply false, with much research showing the efficacy of vaccine use, not to mention historical precedent. Other debunked theories include the risks of vaccines outweighing the benefit and the overloading of the immune system, which you can read about here.
So where do vaccines stand today?
Anti-vaccine campaigners are no longer confined to the fringes of society. From Donald Trump’s lacklustre grasp of basic scientific concepts to Robert De Niro’s vaccine-sceptic push — we find ourselves in a period of pseudoscientific prevalence amongst societal elites. With declining rates of vaccine use in developed nations, whooping cough has made a comeback in the US and measles cases tripled in Europe between 2017 and 2018.
History appears to be repeating itself once more.
The historical role of scientific critique.
The anti-vaccine movement has resulted in the repeated study of vaccine safety, including unanticipated secondary effects — which has, rather than working against vaccines, added to the backing of their use. However, this has been mostly superfluous, and the consequences of not vaccinating have been severe. Critique is always important, but it should be done in a manner which doesn’t result in unfounded outcry and panic, for it is the youngest in our society who end up paying the price.