NOTE: This article was originally published anonymously, in four parts, in a physical magazine in 2019, well before the COVID-19 pandemic. I feel the topic is even more timely now, hence my decision to re-publish the first two parts here.
When was the last time you met a person suffering from Diphtheria? Or a child crippled by Polio? Or someone whose minor wound led to paralysis and death from Tetanus? Most people reading this will probably not even know what Diphtheria is. The eradication of such once common, lethal infectious diseases is one of the biggest success stories of modern medicine, comparable with the advent of good sanitation and the development of antiseptics. Once, we thought diseases were caused by an imbalance of “humours” within the body, now we know that many ailments common to mankind are caused by microscopic living organisms like bacteria and viruses that invade the body and can cause permanent disability or death. As much as antibiotics are wonderful at killing bacterial infections once they start, what could be better than preventing disease in the first place?
Some sobering statistics: Before the advent of modern medicine, the mortality (death) rate of patients who caught Diphtheria was 50% on average, but higher in children under the age of 5 and adults over 40. In the 1920s, around 200,000 cases were reported annually with around 15,000 deaths. Now there is a world-wide vaccination programme and in 2016 only 7100 cases were reported world-wide. In the USA, less than 5 cases have been reported in the last 10 years.
Whooping Cough (Pertussis) is a major cause of infant death world-wide, is 80% infectious amongst unvaccinated individuals and is especially severe if caught by newborns. If a single infected child coughs once in a doctor’s waiting room of unvaccinated people, 80% will catch the infection from such minimal contact. Inexplicably, the disease spikes in prevalence every 3–4 years. In 2008, 16 million cases were reported to the WHO and 195,000 children died. The WHO estimates that vaccination prevented 687,000 further deaths. In the UK, 14 children died from Pertussis infection in 2012, 18 died between 2013–16.
Polio — which although has the potential to kill, more often maims with lifelong physical disability — is on track to be eradicated by 2020 if present immunisation rates are maintained. The last UK outbreak was in the 1970s, the last confirmed case was in 1984 and eradication within the UK was confirmed in 1988. (This does not include cases caught out-with the UK and brought here.) The disease is still prevalent in 125 other countries.
So far, the only disease that we have completely managed to eradicate with vaccination is Smallpox. This shows that it can be done, with enough effort and coordination.
So far in 2019, the preventable disease with the highest media profile has been Measles. Again, think about the last time you knew someone with Measles. It’s just a bad cold, with a few spots, right? Why should we worry about that? Before vaccinations commenced in 1963, the Measles virus killed 2.6 million people a year. That’s 10% of the people who caught it. Up to 30% of the survivors lived with complications, which can include severe pneumonia, permanent brain damage and hearing loss. Even with modern medicine, the death and complication rate of Measles infection has not changed. Measles is the MOST infectious human pathogen, with a 90% infection rate amongst the unvaccinated. In 2000, world-wide Measles deaths reached 545,000. In 2017, this dropped to 111,000.
The important concept to understand about immunisation is that it is not only a medical intervention for the protection of the individual, but for the populace as a whole — what we call “herd immunity”. No medical treatment is 100% fool-proof. Certain vaccines may only have an 80–90% response rate in an individual. However, if the target of 95% immunisation rate is achieved, the mathematics of probability dictate that a virus will be unable to reach a critical enough foothold within a population to multiply into an outbreak. Too many of the people around an infected person will be immune, the virus will be unable to spread.
A drop in immunisation rates triggers a higher probability of infected people meeting unvaccinated people, who meet other unvaccinated people and this snowballs into an outbreak. Then even some vaccinated people are at risk, those whose bodies have been unable to mount a correct immune response to their immunisation.
There will always be people who cannot have vaccines because of chronic illness or immunosuppression. Newborn babies are at huge risk. It is the responsibility of the rest of us to safeguard these vulnerable groups. Christians especially should engage with this responsibility.
So if the above is true, and vaccines have been incredibly successful at preventing the spread of disease, saving lives in the process, what then is the problem in 2019? Why are vaccination rates falling?
The success of vaccines is in one way their weakness. We are no longer so terrified of infectious illness. Smallpox exists only in history books, and to most people, diseases like Polio and Diphtheria may as well also. “Surely they can’t have been that bad,” seems to be the underlying cognition. What we must realise is that in the 21st century, we live in an anomalous period. Most of human history has been blighted by high infant and childhood death rates, the majority of the common people succumbed at the end of their lives to infection. Now, in the western world, our typical bogeymen are Diabetes, Cancer, Heart Attacks and Strokes. It seems strange to us that our ancestors lived in fear of the smallest of wounds or animal bites, as even small breaks in the skin could bring swift death from Tetanus or bacterial cellulitis. Indeed, we are sheltered. And ignorant.
We live through the unprecedented rise of social media and the democratisation of information dissemination. Anyone who can type a tweet or record a YouTube video can find an audience, and a following for their ideas. Evidence is secondary to sensationalism, emotionalism and politics. People naturally associate with their own “tribes”, and whereas that may once have meant family groups or religious organisations, now there has been a mass splintering of mankind into endless ideological minority groups. In a time when various segments of the mainstream media have been shown to be hopelessly biased and partisan (particularly in the USA, but also in the UK), is it any wonder that people seek out voices that echo — and amplify — their own?
More widespread in our culture today is a growing trend towards anti-intellectualism, or “anti-experts”. Fewer children study science, technology, engineering and mathematics (STEM subjects) at school than they used to, and I wonder if in general people are losing the ability to think rigorously about the world around them. If everyone has a voice, and the previously authoritative information sources (doctors, scientists, government, traditional media) now seem untrustworthy, where else will people get their information from than those who reinforce their prejudices and already agree with what they think? Learning is uncomfortable, as with science, often you have to admit to being wrong.
Particularly prominent recently has been the growth of the “anti-vaxxer” movement. They are a widespread phenomenon now — mostly white, well educated, middle-class and very sceptical about the claims of modern medicine. They are backed up by famous actors and personalities, even some politicians (such as in California and Italy). “BIG PHARMA” is one of their enemies-in-chief and they refuse to accept the evidence for the benefits of immunisation, as they see that evidence as somehow tainted or misrepresentative of the truth. One of their prominent prophets is the disgraced UK doctor/clinical researcher Andrew Wakefield whose paper on the supposed link between autism and the combined MMR (Measles/Mumps/Rubella) vaccine was retracted by the Lancet when it was exposed as basically lies. He is now something of a cause celebre because of the way he was “wronged” by the “corrupt establishment” when the General Medical Council stripped him of his licence to practice. Job 13:4 (NIV): You, however, smear me with lies; you are worthless physicians, all of you!
Anti-vaxxers are not stupid, but they are very, very wrong. They inhabit a twilight world where the evil mega-corporations run the puppet governments to ensure that vulnerable children are exposed to dangerous “chemicals” that “weaken their immune systems”, where if only they could be exposed to diseases “naturally”, their immune systems would be “turbocharged” into superiority over everyone else’s. No amount of evidence to the contrary seems to change their minds, made up as they are by a mixture of paranoia, suspicion, good old American rebelliousness and sometimes even misguided biblical justification. Experience suggests that the more anti-vaxxers are presented with otherwise convincing, sensible evidence about vaccines safety and efficacy, the more they dig their heels in and become entrenched in their beliefs. They display a wilful refusal to even comprehend the concept of herd immunity. The existence of pockets of anti-vaxxers in Washington State has led to a state of emergency due to an unprecedented Measles outbreak. How do we protect society (and their own children) from anti-vaxxers?
Look out for answers to this question in part two tomorrow.
