To really understand the issue, we need to put it into context. Vaccine hesitancy isn`t new. It`s existed since the first vaccine was developed in the late 18th century. However, the cultural context medical developments happen in change over time. So it's not a new social issue; it's an evolving social issue. Mistrust between the public and health authorities has always existed. However, for complex and interconnected reasons, it hasn't been addressed properly. Many tactics in historical anti vaccination campaigns echo those of today`s. Therefore looking at previous anti vaccination campaigns will give insight into the core issue(s). It will also allow us to understand if/how they can be addressed. This will likely involve multiple strategies. There is not, and never has been, uniformity in why people reject vaccines. People are different. The circumstances between any two people can vary to a huge degree. So it's difficult to impossible to predict why any one person isn't vaccinating.
Although the origin of smallpox is unknown, discovery of smallpox-like rashes on some Egyptian mummies leads historians to speculate it dates as far back as 3,000 years. Today, it is the only disease that has been entirely eradicated (since 1980), however samples of variola virus (the virus causing smallpox) are still stored at the CDC and the State Research Center of Virology and Biotechnology (VECTOR Institute) in Koltsovo, Russia.
Smallpox was a devastating disease. It killed 30% of its victims, and those who did survive were often left with scarring. According to the World Health Organisation website, symptoms included ”high fever, vomiting and mouth sores, followed by fluid-filled lesions on the whole body. Death would come suddenly, often within 2 weeks, and survivors could be left with permanent harms such as blindness and infertility, in the most severe forms of disease.”
The earliest smallpox treatment was called variolation. The procedure involved snorting powdered smallpox scabs (medical terms nasal insufflation) , or injecting pustular matter beneath the skin. However, like any medical procedure in the past or today, it had risks. It killed 1-2% of those it was performed on. Therefore, a more effective treatment was needed.
Edward Jenner (1749-1823) was a rural physician in the 18th century. A keen observer, Jenner noted a local theory that those who contracted cowpox were also immune to smallpox. 8 year old James Phipps, was inoculated via two small cuts in his arms with puss from the milkmaid Sarah Nelmes. After developing the milder cowpox, Phipps recovered. Months later, he was exposed to the smallpox virus, and had no symptoms. After Phipps was exposed to smallpox many more times, he did not develop symptoms. Jenner`s theory was proven correct after multiple other studies.
However, one of our greatest fears is fear of the unknown. In any era, a new therapy represents a huge source of uncertainty. We all want to stay safe in the face of potential dangers, so many people became angry and hostile towards the vaccine. For instance,rumours circulated that the vaccine would turn people into cows and other animals, and a caricature of this was even drawn..
On April 19, 1982, the NBC affiliate WRC aired a documentary that sparked the modern anti-vaccination movement. Vaccine Roulette was written, produced, and presented by reporter Lea Thompson. The documentary opens with Lea Thompson looking directly at the camera in the centre of a newsroom. The camera zooms in on a solemn face with a gloomy tone. She explains that they had done over a year of research and found serious questions about the safety and effectiveness of the “P” (pertussis) portion of the DPT vaccine. The documentary then progresses to tell emotional stories of parents who claimed that their children were vaccine injured. It was claimed that the pertussis portion of the vaccine caused “varying degrees of retardation”. It showed parent's emotional faces. It described the sense of loneliness and isolation they felt, dismissed by their community and healthcare providers. This again emphasises the core theme of these movements; trust. While it is absolutely a difficult scenario to be in, no actual evidence is provided that these children's disabilities were linked to DPT inoculations. Following the documentary, local doctor's phone lines were saturated with calls from worried parents. The station received over 2,000 calls from parents, praising the documentary and sharing concerns about their children. In New Mexico, inquiries about the vaccine increased 25%. A group called Dissatisfied Parents together (now the influential National Vaccine Information Centre) was formed. This changed how American families thought about vaccines forever. By the end of 1982, 17 lawsuits had been filed against vaccine manufacturers. Over the next 4 years, they filed 41, 73, 219, and 255.
It's clear that social factors play a huge role in public confidence in healthcare workers and vaccine manufacturers. Vaccine Roulette shows how the media can influence perceptions of vaccines on a large scale . This causes problems because of a key principle. Vaccines, like all public health interventions, don`t work on the individual level. They just work when scaled up. Meaning everyone needs to be on board. It's a collective effort. A team sport. If everyone`s not playing, herd immunity breaks down. So it's important to include everyone in the discussion. It`s key to create a sense of community when discussing vaccines. It makes people more comfortable discussing sensitive issues like this. Which in turn makes them more receptive to information.
Consider that millions of people get vaccinated against the worst infectious diseases each year. Hundreds of millions. Is it not logical that some of them will experience symptoms unrelated to vaccines? This might be related to conditions, medication they night be on, or just simple infection. Regarding childhood vaccinations, vaccines are given at multiple points throughout the first years of an infant's life. Many conditions are also diagnosed within this same timeframe. So doesn't it seem likely that there will be at least some degree of overlap between times of vaccine administration and diagnosis of disease? Despite the two not necessarily being related?
Although this is the truth, it is easy to manipulate people in a stressed state.This is how parents feel when living with disabled children. Enter Andrew Wakefield. He tapped into this loneliness and sense of desperation felt by them. Not just tapped into it. Exploited it for his own financial gain.
One of the most famous vaccine controversies began with a paper published in 1998. It was published in the prestigious medical journal The Lancet. Titled “Ileal lymphoid nodular hyperplasia, nonspecific colitis and pervasive developmental disorder in children”, it implied a link between the triple-dose MMR vaccine and autism spectrum disorder in children. However, it was later discovered that the lead author Andrew Wakefield had altered details about the children's medical histories, manipulated data, and was paid almost half a million pounds plus expenses by a personal injury lawyer called Richard Barr who was representing parents of children who were suing MMR vaccine manufacturers. Further, eight of the subjects in the study were client's of Barr`s. The paper was retracted. Following the longest-ever inquiry by England`s General Medical council, Wakefield was discredited and lost his medical licence. Further, the study itself was discredited with 10 of the authors removing their names from the study in 2004. Also, several large scale epidemiological studies finding no evidence of an association between the triple dose MMR vaccine and a risk of developing autism"
My takeaway from this is that exploiting any patient of any age like this is ethically questionable on its own. However, exploiting vulnerable, disabled children is especially saddening.It is a complete violation of the Hippocratic oath. Being able to trust your healthcare provider is a human right. It's clear that that was violated here. I hope we learn from this and don't allow it again. Thank you for taking the time to read my article.