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Posted on January 30, 2017 at 8:54 AM

A curious confluence
of events unfolded Tuesday night. Just hours before President Obama uttered the
powerful “science and reason matter” in his farewell address, Robert F. Kennedy
Jr. announced that the incoming president had tapped him to head a committee on
vaccine safety.

RFK Jr. is not a
pediatric immunologist nor an epidemiologist, but a vocal
“vaccine
skeptic.”
 Although the
PEOTUS dialed back on the purported appointment shortly after social media
erupted, a 
tweet from March 28, 2014 makes his analysis
of the history and science of vaccines clear: Healthy young child goes
to doctor, gets pumped with massive shot of many vaccines, doesnt feel good and
changes – AUTISM. Many such cases!

As a child I devoured
books on the history of medicine. One of my favorite stories was how
Edward
Jenner
 developed the
first vaccine, testing an approach that had been used for centuries. Knowing
his story made me understand why my little sister had to shriek her way through
shots for the “childhood diseases,” while I’d suffered through chickenpox,
mumps, and both types of measles. My pediatrician predicted I’d end up deaf and
brain damaged after a month with measles.

Now I think the tale
of Edward Jenner needs retelling, for those who may not have heard it.

VACCINES 101

A vaccine is a
pathogen, or part of one, whose presence in a human body is sufficient to evoke
an immune response, yet not complete or active enough to transmit the illness.
When the vaccinated person encounters the wild pathogen, the protective
antibody response is immediate, thanks to immune memory. Conquering polio
provides a dramatic vaccine story, which DNA Science covered 
here.

Vaccines aren’t just
biomedicine, but bioethics too. The herd immunity that arises at the population
level protects us all, illustrating the principle of beneficence: action that
is done for the benefit of others. Vaccinate enough people against a particular
pathogen, and it can’t find enough sensitive people to rampage through a
population. In practical terms, when parents refuse to vaccinate their
children, other children can die. Yet vaccines are not entirely risk-free; no
medical treatment or procedure is. Most reactions are due to allergy or the necessary
revving up of the immune response —
here’s
a list
 from a reliable
source, the CDC.

THE DISCREDITED DR.
WAKEFIELD

The vaccine-autism
link arose from a paper published in The Lancet in 1998, in which
English physician Andrew Wakefield described “a pervasive developmental
disorder” in 12 children. The large, red word
“RETRACTED” appears on the first page. The study had
no controls and a tiny sample size, but case reports are ok in the medical
literature given appropriate caveats. What wasn’t ok (among many other
problems) was that Dr. Wakefield was being paid by attorneys representing allegedly
harmed children. When this news surfaced, The Lancet, in February
2010, again fully retracted the paper — in case anyone missed the earlier
discrediting.

Apparently the
president-elect did not get that memo.

But he’s certainly old
enough to remember how polio vanished after kids started lining up at school to
receive vaccines. Maybe they didn’t do that at the military school his parents
sent him to (see “Confident. Incorrigible. Bully: Little Donny was a lot
like candidate Donald Trump”
from the
Washington
Post
.)

And so in the interest
of educating the new administration on the history of vaccines, here is the
story of Edward Jenner and his testing of the smallpox vaccine that has rid the
world of this terrible disease. (It’s from my first textbook, with apologies to
McGraw-Hill. I plagiarize myself for the greater good.)

JENNER’S STORY

“Vaccine technology
dates back to the eleventh century in China. Based on the observation that
those who recovered from smallpox never got it again, people would collect the
scabs of infected individuals and crush them into a powder, which they inhaled
or rubbed into pricked skin.

Dr. Edward Jenner

In 1796, the wife of a
British ambassador to Turkey witnessed the Chinese method of vaccination, and
mentioned it to an English country physician, Edward Jenner. Intrigued, Jenner
had himself vaccinated the Chinese way, and then thought of a different
approach.

It was widely known
that people who milked cows contracted a mild illness called cowpox, but did
not get smallpox. The cows became ill from infected horses. Since the virus
seemed to jump species, Jenner wondered, would exposing a healthy person to
cowpox lesions protect against smallpox?

Wrote Jenner of the
horse ailment that farmers transferred to cows: ‘It is an inflammation and
swelling in the heel, from which issues matter possessing properties of very
peculiar kind, which seems capable of generating a disease in the human body …
which bears so strong a resemblance to the smallpox that I think it highly
probably it may be the source of the disease.’

A physician inspects
the growth of cowpox lesions on a milkmaid.

A slightly different
virus causes cowpox than smallpox, but Jenner’s approach would prove
successful, leading to development of the first vaccine (from the Latin vaca
for “cow”). Unable to experiment on himself because he’d already taken the
Chinese vaccine, Jenner instead tried his first vaccine on 8-year-old James
Phipps. On May 14, 1796, he dipped a needle in pus oozing from a small sore on
a milkmaid named Sarah Nelmes, then scratched the boy’s arm with it.

Young James survived,
and the smallpox vaccine was born. Eventually, the vaccine would completely
eradicate the disease, although several nations maintain the virus in storage
for research purposes.”

THE BIGGER PICTURE

Smallpox lesions had a
characteristic central dimple, and if a person survived for awhile, the lesions
grew together, covering the body. Instead of that horrific and painful
disfigurement, I have a scar from my smallpox vaccine on my upper left arm. My
kids didn’t even need smallpox vaccines, for the last case in the US was in
1949, and the last in the world, in Somalia, in 1977, according to the 
CDC.

The success of vaccine
campaigns is a vivid reminder that, as President Obama said, science and reason
matter. Can someone please invent a vaccine against willful ignorance? Stat.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website.

 

 

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