January 30, 2017
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
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.
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.
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
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
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.)
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
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.
February 2, 2015
<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">I knew that I was going to write this blog post about the news concerning the resurgence of measles and its relationship to the dangerous and misguided anti-vaccination movement. The difficulty was with all the lunacy out there I did not quite know where to start. I grew up in the era prior to vaccination against childhood diseases. I had measles, mumps, rubella and chicken pox. I remember the fear people had of these infectious diseases and even as a child I was aware of how welcome these immunizations were when they became available. It seems absolutely inconceivable that decades later people are advocating against vaccines and placing their children and others at risk of infection with potentially devastating diseases.</span></p>
<p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">There now seems to be a perfect storm of parents making poor choices for their children, a few vocal physicians giving bad advice, a staggering number of ill-informed celebrities saying truly stupid things, and political cowardice and hypocrisy failing to react appropriately. Let’s talk about the history leading to this unfortunate circumstance. Keep in mind that in the year 2000 measles was considered to have been vanquished in the US. There were a few dozen cases all contracted by people who had travelled overseas. However, these few cases were not transmitted to others because the rate of immunization was so high, despite the high level of contagiousness. This circumstance has now changed with people forgoing the vaccinations and like-minded people creating communities with high levels of the unvaccinated.</span></p>
<p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;">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 <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;"> </span></p>
March 12, 2014
<p>Efforts to educate the public are based on the assumption that human beings can be persuaded by good reasons and evidence in formulating their responses to important questions about public health. But are things this straightforward? Are humans really this rational in how they make their decisions? </p>
<p>Think of any social problem that is predicated on how people understand and use information to make good decisions for themselves, especially decisions that have significant social costs. For example, consider the question: does having a gun in one’s home make one more or less safe? A recent piece from the <a href="http://www.nytimes.com/2013/02/03/opinion/sunday/dangerous-gun-myths.html?_=0&_r=1&&gwh=E92C2DA8CA22F33EEDACF3709BE98F83&gwt=regi">New York Times</a> is typical of the clear evidence presented from social science research to show that guns in the home “were fired far more often in accidents, criminal assaults, homicides or suicide attempts than in self-defense. For every instance in which a gun in the home was shot in self-defense, there were seven criminal assaults or homicides, four accidental shootings, and 11 attempted or successful suicides.” Moreover, there is a strong risk factor of having a gun in the home for female homicides and intimidation of women. These data do not prevent gun rights advocates from passionately arguing against any limitations place on guns including assault rifles. In fact some pro-gun advocates falsely claim that any limitation of assault weapons would in fact make women less safe as though that the typical woman would not have the full ability to protect herself. It appears many people view the evidence through the lens of their preexisting set of assumptions, which makes them ignore the scientific evidence or to see it as biased; thus, they continue to believe that having guns in their homes make them safer.</p>
<div><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">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 <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></div>