Anti Vaxxers caused the death of children by measles in 2019 Guest post

Smallpox was a dangerous, scarring and often fatal disease and before the C18th, treat­ments were painful and hopeless. Then Lady Mary Mon­tagu, wife of the British ambass­ador to the Otto­man Empire, obser­v­ed inoculation by var­iol­­at­ion. The doctor insert­ed cells tak­en from a smallpox pustule, into the skin of a healthy sub­ject; the res­ulting infection was mostly mild and granted life­long imm­unity. Lady Mary’s brother had earlier died of smallpox and she survived the disease in 1715, so she needed to protect her child­ren. But back in Lond­on, many British doctors scoffed at the prac­tice as “Or­ient­al folk treatment practised by peasant women”.

Protesting against a proposed bill that would remove parents’ ability to claim a philosophical exemption to the MMR vaccine, Feb 2019

Olympia, Washington. Guardian 

Yet as the practice of inoculation by variol­ation successfully spread through UK and the Empire, new opposition emerged. Espec­ially in Boston during a 1721 smallpox epidemic. Local Congregat­ion­alist minister Cotton Mather (1663-1728), who’d studied medic­ine, vig­or­ously advocated in­oculations. But some Boston physic­ians condemn­ed inoculation as an affront to God’s will; only God could determine who might be exposed to small­pox and survive, or die.

Swiss physician Théodore Tronchin (1709–1781) att­racted international patients to his clinic. The Duke of Orleans, Louis-Philippe I (1725-85), sum­m­oned Tronchin to Paris to treat his children; a tiny amount of the smallpox virus was taken from the pustule of a smallpox patient. Tronchin’s success in sav­ing the royal children sparked excitement about inoculation among Paris’ ar­ist­ocracy. But his success inevitably led to a campaign of hatred against him, by scientists, clerics and University of Paris scholars.

Edward Jenner (1749-1823) was a doctor practising in his Gloucest­ershire village where variolat­ion was a part of his duties, using the arm-to-arm system. Then in 1796 Jenner discovered that milk­maids showed no side effects when they were inoculated, yet they still acquired immun­ity. He knew the maids had caught cowpox from milking diseased cows, and suggested it would be possible to use milder cowpox material for arm-to-arm inoculation. Jenner was successful.

Like Tronchin, Jenner’s ideas were met with immed­iate public crit­ic­ism, based on religious, scientific and political protests. Yet in 1802, Jenner’s supporters in­vited him to join the American Academy of the Arts and Sciences.

Wide­spread vaccination dramatically red­uced mortal­ity rates. Smallpox’s mortality rate in non-inoculated infants reach­ed 80% by the late 1800s; inoculated children had a 0.5–2% mortality rate.

Britain ad­opted state-sponsored vac­c­ination camp­aigns: the first Vaccin­at­ion Act (1853) mandated vac­cinat­ion of infants. If parents refused, they were prosecuted and fined. When small­pox mortality rates re-rose in the 1860s, the second Vaccination Act (1867) ex­tended the age requirement to 14 years.

Andrew Wakefield was struck off in the UK, but feted in the USA 

flanked by supporters ahead of an appearance before the GMC. 

Guardian, 2007 

The laws were met with immediate resist­ance from citizens. The Brit­ish Anti-Vaccination Leagues arose, anti-vaccination journals sprang up and mass dem­onstrations started. In Leicester in 1885, c90,000 people marched to prot­ect the parents of unvacc­in­ated children from fines. In response, a royal commission in­ves­t­igated ev­id­ence both for and against vaccination. The commission sat for 7 long years, leading to a third Vaccination Act (1907).

In the USA, in 1855, Mass­achusetts became the first state to req­uire public-school children to be vaccinated. And by the 1890s, most states had adopted com­pulsory policies. But the Anti-Vacc­in­ation Society of America quickly mobilised using pamphlets, court cases and state legisl­at­ur­es, opposing compulsory vaccin­ation laws and protecting civil liber­ties.

In the landmark Jacobson v Massachusetts (1905), the Supreme Court ruled that the state may be justified in restricting indiv­idual liberty, to protect the general public. So pen­alties could be im­posed on parents who refused to vaccinate their chil­dren.

Relig­ious American communities continued to demand the right to claim exemption from man­dat­ory vaccinat­ion. 45 states allowed moral or philosophical ex­emp­t­ions from mandatory vaccin­ation for enrol­ment in schools, while 5 states only allowed medical ex­empt­ions. Did/do any states allow Distrust Of Science as a reason?

Mandatory vaccination must have worked. There is no evidence of naturally occur­ring smallpox transmission anywhere in the world today.

Smallpox patient with the characteristic late-stage confluent maculopapular scarring, 

Italy, 1965. Wiki 

Now measles, whose symptoms included high fever, cough, watery nose and eyes, with a rash appearing days later. Comp­licat­ions included pneumonia and encephalitis of the brain. As a highly contagious virus with no direct treatment and a notable mortality rate, measles rem­ained a major public heal­th concern. The first measles vaccine was tested in Oct 1958 in Enders’ Boston lab by Drs Samuel Katz and John Enders when 20 children were given an experimental vaccine. When they discov­ered that a killed-virus vaccine did not create the desired immunity, they success­fully tested a safe, live, att­en­uated measles vaccine.

In 1971 Merck Pharmaceuticals developed a vacc­ine that could safely combine measles, mumps and rubella ie MMR. For those parents who could not afford childhood vaccines, public funding programs were quickly established and measles was totally eradicated!

Anti-vaxxer resist­ance to vaccinat­ion had long emerged on both sides of the Atlant­ic, and elsewhere. Even in 1998, a British doctor Andrew Wakefield pub­lish­ed a paper in The Lancet reporting that the Meas­l­es-Mumps-Rubella vacc­ine was linked to 12 cases of autism. So Dr Wakefield call­ed for the susp­en­sion of MMR-linked vaccines! The paper was entire­ly fraudulent and fraught with conflicts of inter­est, but the link with autism is still believed.

To protect mass immunity, the In­fect­ious Diseases Society of Am­erica requires a 95% anti-measles vaccination rate. At that level, the efficacy of vaccin­ation as a public health tool is irref­ut­ab­le, against many highly infectious dis­eases.

Australian anti vaxxer cartoons by Michael Leunig,
Age Newspaper, 2015

So why is measles suddenly resurging? The BBC reported that in 2018 there were 9.8 million cases of measles and 142,000 deaths, the worst-affected countries being D.R Congo, Liberia, Madagascar, Somalia and Ukraine. In Aug 2019 alone, the US Centres for Dis­ease Control reported 1,215 cases of measles across 30 states, 75% of them in New York state. And around the world, WHO reported 364,808 new cases by July 2019 - a 150% increase in cases.

In Feb-March 2019, a measles outbreak hit the Philippines with 31,056 measles cases including 415 deaths. 83% of all deaths were children under 5. Measles appeared in the Pacific island of Samoa in Sept 2019 and by Nov, the Government had declared a state of emergency; schools were closed and vaccinat­ions mandated. In Samoa, where the nat­ional immunisation rate had fallen to a low of 30%, 72 precious children died from measles in late 2019!

See Origins for photos, medical texts and critical cartoons.

Dr Joe