The Triple Helix @ UChicago

Fall 2018

"The Anti-Vaccination Movement Returns, With a Modern Addition" By Rose Cytryn

 

Among those in the medical world, there have been few – if any – inventions or discoveries which have been more impactful and influential than vaccines.  Despite the advantages of vaccines and early vaccination, there have been many critiques and fears regarding the practice. There are those who are fearful of contracting the disease through vaccination, those who do not understand the intention or practice of vaccination and those who are simply complacent about vaccinating.  Additionally, there are growing fears of and resentments towards what are believed to be profit-hungry pharmaceutical companies and financially-minded medical establishments. 

Though it was present in the first settlements in Africa and was recorded in Egypt and Eastern Asia before 1000 BC, smallpox did not reach Europe until sometime between the 5th and 7th centuries: where it was known to decimate populations.[1]  It was also known that the few who survived the contraction of smallpox were the only ones immune to the disease.  This somewhat counterintuitive observation led to the practice of inoculation - the introduction of antigenic substances into a body to produce immunity - which began around the 17th century.  Despite the increased frequency of inoculation as a preemptive cure, there were still criticisms as people continued to die from smallpox.  

It was, in fact, the process of inoculation that was of interest to Edward Jenner, a Gloucestershire-born biologist, in 1796.  It was a popularly known myth in Europe that milkmaids, young women who worked in close quarters with cattle all day long, were immune to smallpox.  Despite the falsity of the specific statement, Jenner focused on the deliberate contraction of not smallpox, but cowpox, as a means of immune protection.[2]  On May 14th, 1796, Jenner inoculated a young boy with matter from the lesions of a milkmaid who had cowpox.  Two months later, Jenner inoculated the boy with matter from a smallpox lesion observing that now, the boy was immune.[1] 

As in 1796 when Jenner first made the connection between inoculation with cowpox and the prevention of smallpox, the manipulation of the immune system to prevent contemporary diseases is the same.  Vaccines imitate an infection to set off the production of T-lymphocytes in the body. T-lymphocytes, white blood cells which mature in the Thymus, differentiate into various T cell subsets, the most common of which, alpha beta T cells, rearrange chains on the cell receptors and take part in the adaptive immune system response.  The antigens are fragmented, attenuated, or dead versions of the infection and are ingested by an antigen-presenting cell which travels to a lymph node where lymphocytes are produced. These memory cells are then primed and sent out when the matching antigen from the active infection is introduced during contraction of the natural infection.[3]  

The practice of introducing the body to vaccines as a means of preventing infection is only one part of the protection vaccines can provide.  While vaccines are made of attenuated or dead strains of an infection, there are those within a community who are too young or too sick to receive a vaccine at all because the introduction of even an attenuated infection could hurt them.  It is for this reason that collective vaccination, also known as herd immunity, is important. Herd immunity is predicated on the understanding that members of the community may be unable to be vaccinated but that these people can still be protected if the infection cannot spread to those around them who are vaccinated.[4]  It is these two ideas, the importance of memory antibody production and the presence of herd immunity, which are at greatest risk because of the critics of vaccinations. 

Despite the evolution of vaccinations and the prevalence of herd immunity, the criticisms of these practices have remained relatively stagnant.  Various hesitancies and larger and more intense anti-vaccine groups cite that vaccines contain toxins, are too strong for the immune systems of children, and are not preferable to the natural course of immunity.  Anti-vaccination support puts a more modernized blame, largely, on pharmaceutical companies as groups looking to profit off of causing harm to children as well as the believed lack of testing of vaccines.[5] 

Often, it is physicians who promote these ideas, and that is why so many people choose to find distrust in the medical and vaccine system.  In 1998, former doctor Andrew Wakefield linked the vaccine against measles, mumps, and rubella (MMR) to autism.[6] Though the paper and its contents were redacted, the thought was released, and many in the public latched onto it because it came from the mouth of a prestigious doctor.  In the wake of Wakefield’s paper, there were over 12,000 cases of measles in the United Kingdom resulting in hundreds of complications and three deaths. In the United States, in fact, measles was eradicated in 2000, but due to lack of vaccination there have been over 2,200 reported cases of the measles, all this prior to the measles outbreak in Minnesota in 2017.[7]  

The hesitancy of one parent, of one family, is harmful enough; however, professionals in the medical community are now faced with an even larger-scale problem: the generation which grew up at the very beginning of Wakefield and his predecessors’ ideas are now, in larger numbers than ever, not vaccinating their children.  This not only puts the individual children in harm’s way but poses a threat to herd immunity for other children and people in the community who cannot be vaccinated and rely on those around them for immune protection. It is these clusters, the groups of people who live physically near each other and who are often like-minded, who erase herd immunity and put not only their own children and family members in danger, but also the society at large.  The carelessness and the mistrust of vaccinations and the medical community which works hard to produce and distribute them continues to undermine laws, organizations, and politicians which work to make these exact practices illegal. 

References

[1] Tulchinsky, Theodore H. "Edward Jenner, Vaccination and Eradication of Smallpox." Case Studies in Public Health, 2018, 17-33. doi:10.1016/b978-0-12-804571-8.00010-x.

[2] Barquet, Nicolau. "Smallpox: The Triumph over the Most Terrible of the Ministers of Death." Annals of Internal Medicine127, no. 8_Part_1 (1997): 635. Accessed November 27, 2018. doi:10.7326/0003-4819-127-8_part_1-199710150-00010.

[3] CDC. "Understanding How Vaccines Work." Center for Disease Control, July 2018, 1-2. Accessed November 27, 2018. https://www.cdc.gov/vaccines/hcp/conversations/downloads/vacsafe-understand-color-office.pdf.

[4] Hussain, Azhar, Syed Ali, Madiha Ahmed, and Sheharyar Hussain. "The Anti-vaccination Movement: A Regression in Modern Medicine." Cureus, 2018. doi:10.7759/cureus.2919.

[5] "What's Behind the Fear of Vaccines?" Scientific American. September 05, 2017. Accessed December 26, 2018. https://www.scientificamerican.com/custom-media/whats-behind-the-fear-of-vaccines/.

[6] Smith, Tara C. "Vaccine Rejection and Hesitancy: A Review and Call to Action." Open Forum Infectious Diseases4, no. 3 (2017). doi:10.1093/ofid/ofx146.

[7] MPH, Jonathan D. Quick MD, and Heidi Larson. "The Vaccine-Autism Myth Started 20 Years Ago. Here's Why It Endures Today." Time. February 28, 2018. Accessed November 26, 2018. http://time.com/5175704/andrew-wakefield-vaccine-autism/.

 
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