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Blogs Coffee House From the archive

Celebrating the death of smallpox – and a short history of vaccination

25 May 2014

10:06 AM

25 May 2014

10:06 AM

The World Health Organisation is voting on whether to destroy the last few remaining samples of the smallpox virus.

Smallpox is the only virus that affects humans that’s ever been eradicated, but it took nearly 200 years from the discovery of the smallpox vaccination in 1796 to eradication in 1979. In the 19th century the British government hesitated about bringing in mandatory vaccination, proposing an amendment to the law that would make allowances for conscientious objectors. The Spectator thought that was a terrible idea.

‘Because these people have the sincerity to sacrifice their own children, we are to let them spread the disease everywhere. We are to make a law for the general good, but allow every man to have his own opinion as to the policy of enforcing it…It is impossible that such a principle can be followed, unless we are prepared to make vaccination an open question. We cannot admit that the benefits of it are so doubtful as to justify a parent in refusing it to his child, and at the same time maintain that its benefits are so great as to require its adoption under a penalty.’

The debate was still going on nearly 30 years later when Arthur Balfour again proposed to give some leeway to the conscientious objectors. All medical experts had warned that compulsory inoculation was the only way to stop the disease spreading, an editorial pointed out.

‘They yield to a craze for the sake of votes…Their clear duty, if they held vaccination to be an indispensable precaution, and compulsion, therefore, to be just, was to resist any effort to impede the former or abolish the latter, and endure the consequences at the voting places as best they might. Otherwise they gave up all pretensions to be leaders, and became mere funnels for the prejudiced and ignorant will of the community, or, rather, of a section of the community…The distrustful are now informed that, in the opinion of the highest State authorities, their distrust is a natural manifestation of their consciences, and, as such, entitled to every respect.’

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In those days, the magazine had no truck with public mistrust of vaccinations. In 1885, after an outbreak of smallpox, a decree making vaccination compulsory was issued in Montreal. It sparked a riot.

‘The French, furious at this invasion of their right to spread death, rose in insurrection. They invaded the Health Office, wrecked the store of lymph, and even attacked the Sisters of Mercy who attend the sick, and who, being as experienced as doctors, have a prejudice in favour of vaccination…The riot is a curious evidence of the close relation between ignorance and cruelty. The fanatics were ready to commit murder, and do endure a deadly epidemic rather than accept a scientific preventive, which, it would appear, is urged upon them by their own priests. The anti-vaccinators of Leicester are as foolish as those of Montreal, but we imagine they will be found more practical. When they begin dying in heaps, as they will die whenever the epidemic strikes them—a mere question of time—they will, we venture to predict, instead of murdering the doctors, run to them for lymph, which should be carefully kept ready. Otherwise the Leicester people may lose half their children, which is too severe a penalty for prejudice, however obstinate.’

With other vaccines, though, The Spectator has been less dogmatic. Louis Pasteur’s scheme to try out a cholera vaccine on Siamese villagers in Siam sounded a bit dodgy. In the 1950s, the British health authorities were cautious about bringing in Dr Jonas Salk’s polio vaccine. Many of the children injected with it in America developed paralytic polio and some of them died. It turned out that Dr Salk had miscalculated the time it takes for the polio virus to die, so some of the vaccines contained the live virus.

‘Several of the manufacturers licensed to make the Salk vaccine have had the daunting experience of finding active virus—in one instance, in four out of six batches tested—in the vaccine, when it should have been safe and ready for use…If the British health authorities had been as impulsive as their American counterparts this recent American tragedy could have been reproduced here. Thank God for British phlegm!’

In the 1970s it emerged that a whooping cough vaccine had given some children brain damage. The health minister at the time, David Ennals, said that the vaccine should still be given to all children and that parents of children who had been affected wouldn’t receive any compensation from the government. In an article with the headline Suffering and the Little Children, Patrick Cosgrave gave him hell.

‘Each of these children is not merely the victim of an unfortunate and unpredictable side-effect of a drug. He or she is also the victim of a massive and sustained propaganda campaign by the Department of Health, and by ministers in that department in successive governments. To claim, as Mr Ennals does, that the mounting of such a campaign in no way involves his department in responsibility for any of its results is outrageous in a way that Pilate’s washing of his hands never was…The inescapable fact is that unless enough good men and true can be found in Parliament who are willing to compel Mr Ennals and the Government to behave with minimal decency, children with wrecked minds and their stricken parents must content themselves with their tragic lot. Many bad and hard things have been done by governments in recent years; but I know of nothing as bad as that.

Doctors have spent generations trying to persuade superstitious populations of the benefits of inoculation. Psychologically, it makes sense when medical professionals can’t admit to the dangers of a jab, but may have had disastrous consequences for Sally Clark. She was accused of killing two of her children, who died in mysterious circumstances. Professor Sir Roy Meadow told a court she was suffering from Munchausen’s Syndrome by Proxy and the jury was told to discount the fact that her baby had been given a DTP injection hours before he died. After Sally Clark died at the age of 42 (friends said of a broken heart), Neville Hodgkinson analysed the case.

Deaths and major injuries from vaccines are rare, but if professionals take an ostrich-like attitude towards those that do occur — and instead blame the parents — the scene could be set for a major disaster….Clearly, Professor Meadow is much respected and has made a distinguished contribution to medicine. But was it really such an innocent mistake? Or was the professor in common with his paediatric colleagues avoiding facing up to a reality, unpleasant for professionals who have for years defended a controversial vaccine: that when a tiny baby dies five hours after being injected, a link between the two events might be more probable than that the mother was a murderer?’

Andrew Wakefield’s now discredited research that linked the MMR vaccine to autism hit the same nerve in the medical establishment. Thousands of parents refused to have their babies vaccinated because of his paper. The evidence might have been flawed but it was peer reviewed and published in The Lancet. Wakefield’s mistake was no reason to strike him off, said Rod Liddle.

‘This is not a whine about the inexact nature of science, which is obviously a given; in a way it is the reverse. It is a whine about scientists not accepting the inexact nature of science — and dragging the rest of us along in their monomaniacal wake. Striking Andrew Wakefield off the medical register will not convince me that the MMR is safe.’

Bruce Aylward, who runs the WHO’s polio eradication programme, talks about polio as if he’s talking about a human enemy – one strain is low, sneaky and cunning, the other brash and bullying. He describes how polio exploits ignorance and prejudice, as well as geography, hiding itself in the remotest parts of the world. When the CIA admits to using a vaccination programme as a cover for spying or an Islamic preacher speaks out against inoculation, that’s a point to polio. In the agonisingly slow process of eradicating a disease, it’s easy to see why the doctors come out fighting – just as long as they’re right, all the time.

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