Nursing Clio

This week, Nursing Clio is featuring posts written by undergraduate students. The following post was written by a student in Carolyn Herbst Lewis’ course on the history of medicine. Lewis’ students spent the semester writing a longer research paper, and then had the added challenge of sharing the contents of that paper with a broader audience through a blog post. The Nursing Clio editors selected two to share, but you can read the rest of Lewis’ students’ posts here.

by Natisha Robb

In “When the Personal Really is Historical (and Scary!),” Jacqueline Antonovich, a gender and medicine historian, described her 21st-century experience with pertussis, a.k.a. whooping cough, an extremely contagious “good old-fashioned Oregon Trail disease” that recently reemerged since its near eradication in the 1970s. Antonovich inquired:

So who or what is to blame for the rising tidal wave of whooping cough misery? Are the non-vaccinating, yuppie/hippie parents to blame? After all, the anti-vaccine movement among parents has been gaining momentum for over a decade now, ever since British doctor, Andrew Wakefield used faulty science to allege a link between immunizations and autism.

While Antonovich suggests a recent surge in the anti-vaccine movement, records unveil a history fraught with ongoing controversy. Before vaccinations became a childhood rite of passage, every family knew someone who lost a child to a now vaccine-preventable disease. Yet despite the magnitude of casualties from smallpox, measles, polio, rubella, diphtheria, tetanus, and pertussis in populations lacking herd immunity, vulnerable communities did not always welcome vaccination campaigns with open arms.

The controversial roots surrounding vaccinations originate in debates regarding religious beliefs, safety and efficacy, corruption fears, personal liberties, and public health. Religious objectors believe that vaccinations defy the healing power and will of God. These objectors also claim that injecting foreign substances into the sacred body defiles it. Not too far afield, parents with an incomplete understanding of the immune system and the creation of antibodies necessary to combat disease question why they would knowingly inject their healthy children with potent, biologically active disease-causing agents.

While some uninformed parents question the efficacy of vaccines, others doubt the governmental and scientific safeguards aimed at protecting children. Following the 1982 NBC airing of DTP: Vaccine Roulette, mothers with disabled children alleged that pharmaceutical companies, in cahoots with government officials, collectively concealed the dangerous nature of vaccines. These mothers “compared vaccination laws to the practices of oppressive, communist regimes . . . [and called the] cover-up of vaccination risks ‘an American holocaust . . . a modern day Auschwitz.’”[1]

This invasion of personal liberty in the name of public health illustrates the contentious conviction that “epidemic disease, like war, is the health of the state.”[2] After state power officially penetrated the skin following the initiation of the first American compulsory vaccination laws in the 1850s, opponents hollered medical oppression and an invasion of parental authority and bodily sovereignty. The question had become: should the government intrude upon an individual’s right to choose vaccinations or should officials ultimately ensure the well-being, health, and safety of the entire nation?

Clearly, the anti-vaccination movement flourished long before Wakefield’s unsubstantiated claim challenged the integrity of the scientific community and triggered a renewed worldwide scare over vaccine safety. Perhaps the most important factor to consider when noting the reduction in vaccination rates in the twenty-first century is the relative disappearance of once epidemic diseases. After scientists gained an understanding of immunology, bacteriology, and virology, vaccines allowed nations to proactively protect themselves. Today, many parents, pediatricians, and vaccine opponents lack first-hand experience with the crippling diseases vaccinations almost completely eradicated in America. Thus, vaccines became victims of their own success. An ‘out of sight, out of mind’ mentality appeared as childhood diseases disappeared. This attitude allowed the growing concern over vaccine side effects to flourish.

In “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All,” Amy Wallace introduces readers to Paul Offit, a Philadelphia pediatrician and coinventor of a rotavirus vaccine. Since the rotavirus kills approximately 600,000 children per year, this vaccine saves hundreds of innocent lives each day. Recognizing the rhetoric of risk and freewill that propels the anti-vaccine movement, Offit empathically defends the risks involved in protecting children. Wallace noted:

He [Offit] wants Americans to be fully educated about risk and not hoodwinked into thinking that dropping vaccines keeps their children safe. “The choice not to get a vaccine is not a choice to take no risk . . . It’s just a choice to take a different risk, and we need to be better about saying, ‘Here’s what that different risk looks like.’”

Yet getting parents and vaccine opponents to understand the horrific, harsh, and ugly reality of these childhood diseases remains incredibly difficult. Before vaccinations emerged as one of the top public health advancements of the twentieth century, smallpox killed 500 million people, polio paralyzed 16,000 Americans each year, and measles killed 3000 people annually.[3] Infant mortality was high and life spans were cut short. Today’s third world problems ran rampant in first world nations. How many outbreaks and innocent lives must now be claimed in vulnerable communities lacking herd immunity before vaccination rates rise again?

ABOUT

• Natisha Robb, an Iowa native and biological chemistry major at Grinnell College, wishes to pursue a career in medicine or youth development following graduation in May 2014. Natisha serves as a student development representative and genetics research assistant at Grinnell and tutors incarcerated students through the Liberal Arts in Prison Program. Natisha also volunteers as a fundraiser and advocate for Grinnell Public Health and Medical Global Brigades while leading a small group and coordinating outreach efforts for Grinnellians Seeking Christ.

Notes and References

[1] Conis, Elena, “A Mother’s Responsibility: Women, Medicine, and the Rise of Contemporary Vaccine Skepticism in the United States,” Bulletin of the History of Medicine 87, no. 3 (2013): 430.

[2] Willrich, Michael, “The Least Vaccinated of Any Civilized Country: Personal Liberty and Public Health in the Progressive Era,” Journal of Policy History 20, no. 1 (2008): 76.

[3] Ibid.

“VACCINATIONS – Your KIDS – what do YOU do ????,” Truthology.

“Latest H1N1 Swine Flu News,” Fluscam.com.

Heidi Stevenson, “The Coming Push to Give HPV Vaccines to Infants,” January 20, 2014 Health Impact News Daily, from Gaia-Health.com.