|Anti-vaccination poster from the late 1800s|
Historical Medicine Library, Phila.
My blog post on the History of Vaccination proved so popular, and the Covid pandemic is still so immediate, that a good look at the history of anti-vaccination is warranted. And a paper in the London Review of Books for 20 January 2022 provides lots to think about.
In the cute way of LBR, the headline is an attention-grabber -- Whack-a-Mole! - and the paper was penned by Rivka Galchen.
It begans with an evocative anecdote. One hundred and eighty years ago, a Hungarian obstetrician by the name of Ignaz Semmelweis oversaw a couple of free maternity clinics in Vienna. One was the training ground for midwives, and there the maternal mortality rate was very low. Despite the generally high rate of puerperal (childbed) fever, only about four percent of the patients died. The other clinic was a school for medical students, and there the mortality rate was high -- about 10%.
Naturally, the word got around. Expectant mothers went to great pains to be delivered at the midwives' clinic, even to the extent of giving birth on the road outside. But what was it that made the difference? As Herr Ignaz found, it was very simple. The midwives washed their hands. The medical students did not.
But when Semmelweis reported this logical conclusion, he was dismissed as a madman. He was fired, and returned to his native Budapest. He wrote a book about it, which got bad reviews. He was known as the crazy fellow with an obsession with dying women. He took to drink, and died in nasty circumstances at the age of forty-seven.
The book where this story is told is Heidi Larson's Stuck: How Vaccine Rumours Start, and Why they Don't Go Away.
When Larson was Unicef's strategy and communications director for new vaccines, polio vaccine was boycotted in northern Nigeria. Someone with a political agenda had started off a rumor that the vaccine caused sterility in children, and all the scientific persuasion in the world could not stall the spread of this misinformation. The boycott surged through Africa and as far as Indonesia, causing the loss of an unknown number of lives, and the crippling of many others.
Because of this, Larson has devoted her career to the "ecology" of anti-science propaganda. And it is surprising how much of this is focused on girls. In a province in Columbia the HPV vaccine that prevents cervical cancer came under attack, leading to a great deal of teenaged hysteria. In 2014 the same happened in Japan, meaning that vaccination among girls fell from 70% to 0.3%. The Bandim Health Project, founded in 1978 by Peter Aaby in the very poor Guinea-Bisseau region of Africa, claimed that measles vaccine was causing an increase in the mortality of girls, but not, mysteriously, in boys. This has led to a rethink of the issuing of vaccines in very poor countries.
And so it goes on. In 1998 the French temporarily suspended a vaccine for hepatitis B, because of false rumors that it was linked to multiple schlerosis. Rightwing governments have become notorious for tagging onto populist anti-science claims. In 2018, with a new government in Italy, the health minister fired all thirty members of the scientific advisory board. Since then the current government has reversed this, imposing some of the toughest vaccination mandates in the world.
The second book reviewed in this paper is Anti-Vaxxers: How to Challenge a Misinformed Movement, by Jonathan Berman. His focus is on the role of the internet, with predictable but shocking conclusions. While both scientific evidence and anti-science messages appear on the web, the anti-science ones spread faster and further than the rest.
He also delves into the history of vaccination. Interestingly, I learned that it was not Jenner who first took advantage of the milkmaid/cowpox story. Instead it was an English farmer by the name of Benjamin Jesty (not a joke) who in 1774 decided to test the cowpox theory by scratching himself, his wife, and his children with a needle polluted with lymph from a cowpox pustule. It could have led to the demise of a whole family, but instead they all survived the current smallpox epidemic with no illness at all. There was just the temporary soreness about the scratch that we all associate with vaccination injections.
With Jenner, as we have seen, vaccination against smallpox became very popular. The trouble started when vaccination against smallpox became compulsory in England, in 1853. All sorts of people rioted. The unionists barked about freedom, and medical professionals (and non-professionals) were unhappy at the loss of the good income that had come from smallpox epidemics.
Alternative -- and often very dangerous -- remedies were (and still are) touted. In the US, as Berman demonstrates, dietary supplements -- which cover a lot of so-called folk remedies, and which in 1994 the US Congress exempted from the requirement to prove safety and efficacy -- has boomed from an industry worth four billion a year to one with an annual profit of just about two hundred billion.
There is a lot of money there to fund anti-vax propaganda, and to support the right politicians. And, interestingly enough, Berman reveals that the most fervent anti-vaxxers in the US are usually middle-class white women.