Immunisation and the anti-immunisation movement

Unfortunately, while unaware of the lead author’s subsequently-revealed conflicts of interest, the same editor published hugely influential but now comprehensively discredited research linking Measles-Mumps-Rubella vaccine to autism. Publicity about this research has been credited with causing a significant reduction in measles immunisation, thousands of excess cases and at least two deaths. Trust nobody, perhaps?

Immunisations are possibly the commonest drugs prescribed to healthy people. We even avoid giving them to the unwell. Given the influence of drug companies over health care, it is not surprising that some people believe that immunisations are drug company scams.

We are currently experiencing a pandemic of swine flu which, in most people, causes symptoms similar to seasonal flu. If the virus becomes more virulent then immunisations could potentially prevent millions of premature deaths. They might also cause a few.

In 1976, fear of a swine flu epidemic in the USA resulted in a now-notorious mass vaccination program that medical authorities acknowledge killed at least two dozen people. This might have been justifiable if the anticipated swine flu epidemic had occurred. It did not. The virus is thought to have only claimed one victim.

On this specific occasion, it was probably safer to risk catching the disease than to risk getting the immunisation. This was, however, an unusual circumstance.

I am no fan of drug companies and I am aware that over the years I have innocently poisoned various patients. Despite this, I think immunisations are the most effective life-prolonging medicaments ever invented.

Smallpox was dreaded for most of human history. In many regions, an epidemic would infect more than half the population and kill up to a third of those afflicted.

People generally do not catch smallpox twice. By some accounts, this allowed tiny doses of smallpox-infected material to be used as immunisations in India and China as early as the 11th century. This probably killed about 1 per cent of recipients. A thousand years ago that represented good odds during an epidemic.

Half a millennium later, similar practices were adopted in the West. This was condemned by some theologians. In 1722, a lengthy sermon titled The Dangerous and Sinful Practice of Inoculation was published. It argued that diseases were punishment for sin and interference with God’s will was diabolical.

The eventual recognition that the milder disease cowpox conferred smallpox immunity allowed development of relatively safe vaccines (vacca is Latin for cow). Edward Jenner usually gets the credit but assorted peasants beat him to it.

For instance, two decades before Jenner’s experiments, a farmer immunised his family with an infected cow’s pus. This worked but the good news was not greeted as Good News. Many locals thought the family would grow horns or turn into cows.

Despite the deadliness of smallpox and the effectiveness of vaccination, there were ongoing campaigns against immunisation. One well-documented epidemic of smallpox in Stockholm in 1873 was attributed to vaccination rates of about 40 per cent due to an anti-immunisation movement. Elsewhere in Sweden the immunisation rate was about 90 per cent. This epidemic faded with mass vaccination and became Sweden’s last.