V for Vaccines: Making a Convincing Case
The prevalence and rise of anti-vaccine campaigns in Trump era got me thinking about the fraudulent anti-vaccine claims that thrive today, despite the magnificent success of vaccinations against formerly fearsome diseases. I looked at scientific data that unambiguously demonstrates how effective vaccines are at preventing the most devastating diseases. However, the anti-vaccine adversary plays an unfair game and does not follow logic or evidence. As a scientist, I consider it my moral imperative to combat the claims of the anti-vaccine lobby.
In the spirit of World Immunization Week, I decided to explore the history of vaccines, from the first rudimentary forms inoculation to modern day vaccines.
The story of vaccines begins with smallpox. In the 20th century, smallpox killed an estimated 300 million people, making it one of the worst diseases known to humankind. Before doctors knew how to prevent this highly infectious disease from spreading, Dr. Edward Jenner carried out one of the most pivotal experiments in the history of medicine. Jenner had observed that milkmaids who suffered the mild disease of cowpox never contracted smallpox. He then hypothesized that by exposing a patient to inoculated cowpox, he could protect them from contracting the similar but deadly smallpox. In 1796, Jenner injected an eight-year-old boy with pus taken from a cowpox lesion. A year later, the boy was proven to be immune to smallpox. Dauntless, Jenner then performed the experiment on several other children, including his own 10-month-old son. In 1798, he finally published his results and coined the term “vaccine” from “vacca,” the Latin word for cow. The widespread embrace of smallpox vaccine in the 19th century led to the worldwide eradication of the deadly disease by the late 1970s.
The 19th century also saw Louis Pasteur develop vaccines against fatal diseases like anthrax and rabies. In the 20th century, Jonas Salk was first to develop a vaccine against polio. By the early 2000s, the World Health Organization declared the complete eradication of polio in the Americas, Europe, and Western Pacific. Likewise, other severe viral infections such as measles, mumps, and rubella were nearly eradicated through extensive vaccine campaigns. Since the introduction of measles-mumps-rubella (MMR) vaccine in 1963, reported cases of these diseases, and congenital rubella syndrome (CRS) have decreased by more than 99%. The first 20 years of licensed measles vaccination in the U.S. prevented an estimated 52 million cases of the disease, 17,400 cases of intellectual disability, and 5,200 deaths.
As science and technology progressed, vaccines became more effective, and the number of vaccines that are available and required by law has grown significantly over the years. Time and again, vaccines have immensely benefited humankind by providing a multitude of short- term and long-term benefits. WHO reports that vaccination greatly reduces disease, disability, death and inequality worldwide. Vaccines not only provide protection against the targeted diseases, but also against related diseases. For instance, the influenza vaccination has been found to protect against ear inflammation in 30% of cases in Finland and the USA. Vaccination against human Papilloma Virus (HPV) has been associated with the drastic reduction in cervical cancer. The increased life expectancy from the use of vaccines translates into long-term cost savings that promote economic growth.
On one hand, the pro-vaccine argument stands on firm ground today with the undeniable success of vaccines. On the other hand, the prevalence of the anti-vaccine movement has been a persistent problem since the time of Jenner. At the time, the British clergy widely ridiculed Jenner’s idea, claiming that it was ungodly to inoculate someone with material from a diseased animal. For the most part, the anti-vaccine movement persisted more on a religious ground than on any firm scientific basis. While governments across the globe were proposing, and implementing mandatory vaccine acts, many people continued to object that vaccination violated their personal liberty and religious beliefs.
A large wave of the anti-vaccine movement was unleashed in 1998 with an article published in The Lancet, a prestigious U.K. medical journal, by British doctor Andrew Wakefield, who claimed that vaccines cause autism. But an inquiry by the British General Medical Council found the research to be fraudulent, and the journal retracted the paper, later stating that that the article never should have been published
Still, the media seized on the discredited anti-vaccine claims, igniting public fear over the safety of vaccines. And even after two centuries, skeptics remained opposed to vaccination on deep-rooted religious or political grounds.
The public misgivings, whether for safety or philosophical reasons, led to relaxation of mandatory vaccine acts in many parts of the world. Consequently, several diseases have been making comebacks in recent years, as increasing numbers of parents decide that vaccination is dangerous. California recently endured the largest whooping cough outbreak since 1950, infecting almost 9500 people.
One reason scientists think this might be happening is a phenomenon called “herd immunity” or “community immunity.” If you live in a neighborhood where every child except yours is vaccinated, there is hardly any risk of your child contracting the disease. You are relying on everyone else’s child being immune and incapable of spreading infection. But in the event that your child does become infected, many others are put at risk, including those who cannot be vaccinated for medical reasons or those who are not old enough to be vaccinated.
Classic examples of the principle of herd immunity at work are pneumococcal conjugate vaccine and the polio vaccine. After American children began receiving the pneumococcal conjugate vaccine in 2000, the incidence of pneumococcus caused by the strains of bacteria in the vaccine fell by 55% among adults ages 50 and older. This group didn't even receive the vaccine, but they clearly benefitted from the reduced spread of the bacteria. Similarly, polio was virtually eliminated in the U.S. after about 70% of the population got the polio vaccine.
Vaccines have consistently maintained an excellent safety record. Vaccination may cause a local reaction, such as pain, swelling, redness, and fever, but there is no scientific evidence of them causing autism or other long-term side-effects.
Ultimately, it is far easier to prevent these diseases rather than cure them. The evidence for the safety and benefits of vaccines is stunning, and I challenge you to arm yourself with these facts in a dialogue with anti-vaxers. In this Vendetta, the savior of humankind is V for Vaccine.