Lingering uncertainty over vaccines
The journey of regaining confidence in vaccination
Vaccination is a bone of contention of today. Social media and (pseudo)scientists are feeding us with an enormous amount of information. We often do not recognise whether the information is bona fide or we are being hoaxed — by either a greedy person or a clueless activist. The lack of trust when it comes to vaccines became a major concern of public health professionals, as the vaccination rates dropped significantly in the past years. But why exactly are they concerned? Let the start be with an explanation of a ‘thing’ that vaccines were actually invented for. Contagious Disease. Further, I will explain the terminology associated with vaccines and explore why they should not be a bone of contention. Vaccines indeed have side effects, but the benefits are much higher than the risks. Parents who are confident vaccines are safe, have happy and healthy children.
A contagious is a disease that one person can get from contact with another. Diseases vary — some of them are more contagious than others. Epidemiologists study disease behaviour — what can cause or prevent the disease. They answer questions such as: where and how often it occurs, how and how quick it spreads and whom it affects. Scientists in epidemiology fields use a ‘basic reproduction number’ or ‘basic reproductive ratio’ abbreviation as R0 to describe how contagious the disease is. It is one of the fundamental concepts in mathematical biology. The larger the value of R0 the more likely the epidemic is to happen and it is harder to control it. Measles is often reported as the most contagious human disease.
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body’s immune system to recognise the agent as foreign, destroy it, and “remember” it so that the immune system can more easily recognise and destroy any of these microorganisms that it later encounters. — WHO.
Scientists and healthcare professionals often call vaccination a miracle of modern medicine that has saved more lives worldwide than any other medical procedure. Vaccines have an interesting history. It all goes back to ancient Greece where Thucydides discovered that people who survived the smallpox plague in Athens did not get infected again — they became immune to smallpox causing variola virus. But Thucydides’s observation ended on observation only. In the History of Vaccines timeline, the first mention about vaccination we are familiar with today happened to be in the year 1000 in China. There is some evidence showing that the Emperor K’ang Hsi who had survived smallpox as a child had his children inoculated. However, it still has not resembled the present vaccine. The preferred inoculation method (or variolation in the case of smallpox) was to apply powder or pus from a smallpox pustule under the surface of the skin. The wound had to be made, so the pus could be rubbed into it.
This method was introduced to Europe in the early 18th century. It was familiar to Edward Jenner, who later conducted the first scientific investigation of smallpox prevention. He experimented on humans in 1796. It was known to him that the prior infection with cowpox virus protected from potential smallpox infection. His trials proved that. The beginnings of vaccinology and immunology had their place. Then, during the 19th-century cowpox vaccination became a worldwide practice. Especially in Europe and North America.
The period of a great awakening lasted for forty years. The most prominent names of that time were Koch, Pasteur, von Behring and Ehrlich. In this period the central place of the research held bacteria, medical applications and empirical immunologic discoveries relating to antibodies. Louis Pasteur first worked on anthrax but later on, he put his interest into fowl cholera. Experiments led to the discovery of how to make vaccines by weakening the microbe responsible for the disease. Robert Koch developed ways of staining bacteria which improved the microbe’s visibility under the microscope. He was then able to identify the bacterial causes of tuberculosis and cholera. Other German scientists Emil Adolf von Behring and Paul Erlich developed so-called diphtheria antitoxin. With their work, they hoped to fully eradicate diphtheria.
The modern era of vaccines after 1985 was divided into whole and subunit bacterial, viral recombinant subunit, and live and killed whole virus preparations using virus grown in cell culture. Most of the vaccines from the modern era were licensed as safe to be practised with.
Measles, mumps and Rubella are known as MMR. The vaccine which started the speculation whether autism and immunisation are linked together. In 1998 in Royal Free Hospital, London a young gastroenterologist, Andrew Wakefield presented a paper which later would be appearing in The Lancet. The paper postulated that there might be a link between MMR and autism. But it was not confirmed, and the author himself never confirmed that MMR causes autism. In his work, Wakefield described twelve children he had seen in the previous year as exhibiting autistic behaviours and suffering from severe intestinal inflammation. He reported he had found traces of measles virus in children’s intestinal tracts. Based on that discovery Wakefield and his team started speculations whether measles virus, intestinal inflammation and autism comprised basis for a single syndrome.
It is a natural reaction of a parent to question vaccination. And this is what is the basis of the controversy around vaccines: fear and lack of knowledge. As of today, the internet provides a platform for nearly anyone who wants to raise their voice. The message about vaccine harmfulness went VIRAL.
But MMR vaccine is a good vaccine as says Michael Fitzpatrick in his MMR and autism: what parents need to know. He also assures that the vaccine is safe. The evidence against MMR is weak and the risks associated with it are drastically low. Every medicine has side effects, Fitzpatrick gives an excellent example:
This is not the only source that proves the safety of the MMR. A Danish study of more than half a million children showed that there is no link between the MMR vaccine and autism. Dr Kreesten Meldgaard Madsen who is an epidemiologist and expert on infectious diseases at the Danish Epidemiology Science Centre in Aarhus informed The British Medical Journal (BMJ) that the study showed that the risk of autism is nearly the same in children who were vaccinated and in children who were not. Dr Marsden stresses that the MMR vaccine is safe and it protects children against disease:
Villain. A toxin in tuna cans which kills us.
People had to find a scapegoat. An ingredient in vaccines that potentially was responsible for all horror. They found it, it was mercury. It had to be something. David Gorski in his analysis Mercury in vaccines as a cause of autism and Autism Spectrum Disorders (ASDs): A failed hypothesis says that it is one of the most pernicious medical myths of recent years that thimerosal used in vaccines is responsible for autism and ASDs. Much of the debate about thimerosal and its malignancy hinges on the assumed similarity of ethylmercury to methylmercury. The two compounds sound nearly the same, and the popular press tends to use them interchangeably. It is crucial to understand that methylmercury differs from ethylmercury — the compound present in vaccines. Studies comparing ethylmercury with methylmercury claim that they are processed differently in the human body. Ethylmercury is excreted from the body much more rapidly than methylmercury. Hence it is much less likely to cause any side effects or harm as it does not accumulate in the body.
Because the popular press used the names interchangeably it caused confusion among the public and led to anxiety. Scientists stress that the public seeks information from medically accredited sources.
It all happened more than two decades ago. Scientists released a lot of evidence proving that vaccines are safe and are one of the best developments in medicine. However, there are groups of people who still question their effectiveness and safety. That is why it is critical to look for information from scientific sources. Fears over the safety of vaccines are understandable, however, research shows that the public’s biggest fears about vaccination are unfounded. Not vaccinating is a contribution to a collective danger and opening up opportunities for bacteria and viruses to establish themselves and spread. Vaccines are one of the greatest inventions of modern medicine, contagious disease used to wipe out entire populations before. As science progresses and tackles new challenges, the public should not forget how many deaths vaccines have prevented, and how many deaths they continue to prevent.
Other Sources
History of Vaccines. Chinese Smallpox Inoculation
University of Oxford Vaccine Knowledge Project
Children Hospital of Philadelphia. Vaccine Education Center
Bower, Hilary. “New Research Demolishes Link between MMR Vaccine and Autism.” BMJ 318, no. 7199 (June 19, 1999): 1643. https://doi.org/10.1136/bmj.318.7199.1643a.
Kirkland, A. (2012). Credibility battles in the autism litigation. Social Studies of Science, 42(2), 237–261. https://doi.org/10.1177/0306312711435832
Rooney, James P.K. “Mercury Levels in Newborns and Infants After Receipt of Thimerosal-Containing Vaccines.” Pediatrics 122, no. 4 (October 1, 2008): 902. https://doi.org/10.1542/peds.2008-1926.
Smeeth, Liam. “MMR and Autism. What Parents Need to Know. Michael Fitzpatrick. Routledge, 2004, Pp. 218, ISBN: 0415321794.” International Journal of Epidemiology 34, no. 3 (June 1, 2005): 716–716. https://doi.org/10.1093/ije/dyi067.
Lingering uncertainty over vaccines
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