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The Anti-Vaccination Movement and its Effects on Society. By Anthony Balchin

Vaccination is very topical subject in today’s society. With the resurgence of anti-vaccination groups appearing online, we have to be mindful of the source of the information we are reading. We are at a critical point in which misinformation spreading is causing vulnerable people to become ill or be harmed, and it is important for us to be able to examine facts and differentiate between what is truth and what is not. The truth is that we must all be educated on the science behind vaccination: and through hundreds of years of medical study and scientific scrutiny, vaccinations have proven themselves to be the safest and most effective way to protect the human body from horrifying illnesses such as smallpox, polio, and measles. The opposition has gained notoriety through social media, but the ‘antivaxx movement’ can be dated back to the first ever vaccine of smallpox, in the late 18th century.

Edward Jenner’s smallpox vaccination, first tested on the eight-year-old James Phipps in 1796, has made him a household name. We are taught in schools of the breakthrough method of cowpox inoculation and how this leads to smallpox immunity – a vital development in medicine that tends to only be accredited to Jenner, a well-educated English man. What is often forgotten are the contributions to the development of vaccines from women and eastern culture. Being immunised against smallpox required infecting an open wound with cowpox – a weaker and much milder form of the smallpox virus. The first instance of this method of immunisation by inoculation was initially introduced in the UK in 1721 by Lady Mary Wortley Montagu after learning the technique from physicians in Constantinople. Whilst not introduced in the UK until the early 18th century, the practice dates back as far as the 15th century, where Chinese and Indian scholars of medicine were well advanced compared to European practices. The unfortunate trend of progressive women and ‘minority’ groups being forgotten and overwritten by their male analogue throughout history has led to the history textbooks and school curriculum being a much more British orientated point of view on the advancements of science, which is not always the true picture.

Putting aside historical bias and inaccuracies, it was Jenner who worked hard to spread the vital cowpox cells needed to immunise people against smallpox, arguably the most lethal disease in eighteenth-century Britain. Although Jenner was honoured globally, initially a majority of the public were sceptical and hesitant, and due to smallpox’s abundance, it meant that medical professionals handling the cowpox samples contaminated the sample with smallpox – leading to the belief that cowpox was no safer than smallpox. In a world where germs, viruses, and infections were not understood, the smallpox vaccine was met with resistance from the church, rival doctors, and the very people who needed the vaccine the most. A lot of opposition stems from a lack of understanding, and nothing has changed in over 200 years. Concerns of the ingredients in vaccines, violation of civil liberties, or a lack of confidence with healthcare providers are only a handful of the problems ‘anti-vaxxers’ have with vaccinations. The vaccine hesitancy of these groups has even been identified by the World Health Organisation to be one of the top ten global health threats of 2019.

The science behind vaccination is relatively simple, but it is crucial that we understand why vaccines work in order to educate and inform those who may be unconvinced. Vaccines typically contain a weakened version of the disease they are providing immunity to; this is in order to stimulate the body’s white blood cells to fight off this weakened disease. Once the white blood cells found in the blood have developed a way to fight off the toxin – the body can use its own ‘recipe’ to create similar white blood cells to fight off the full-strength disease if we were to ever come in contact with it. This is called active immunity, and although it can never be 100% effective every time, the efficacy rate of this method is typically 90% to 99%.

A common concern for wary patients is the ingredients present in the vaccine itself. Yes, there are harmful ingredients present in vaccines which, if taken above the safe dosage, could cause severe reactions within the body. Two common ingredient components of vaccines that cause concern are thimerosal (ethylmercury) and formaldehyde. The former is used as a preservative within the influenza vaccine, preventing dangerous bacterial growth, whilst the latter is used as a detoxifier for bacterial toxins. The misconception may stem from differentiating between ethylmercury and methymercury, which is harmful in large doses, whilst ethylmercury has no scientific study that has found a link between the preservative and any harmful effects. Formaldehyde on the other hand is already present in the body, and although there have been studies to show a link between long-term exposure and certain cancers such as leukaemia, the formaldehyde levels in vaccines are so small it is basically negligible, and no scientific studies has shown that the formaldehyde content in vaccines causes any harm.

The infamous reasoning behind anti-vaccination, which has even become somewhat of a joke among internet culture, would be the apparent causation between vaccination and autism. This misconception can be credited to a scandalous study conducted by Andrew Wakefield in 1998, primarily undertaken in Denmark, who since then has been completely discredited and stripped of the title of ‘doctor’. The case study claimed that there was evidence of measles in the digestive systems of children who had shown autism symptoms after the MMR vaccination. The study did not show a relationship between the MMR vaccine and autism, but Wakefield released a supplementary video alongside publication – in which he suggests the combined MMR (an acronym for measles, mumps, and rubella) vaccine was ineffective. Wakefield went on to endorse 3 single vaccinations rather than the combined one. The results from the paper was immediately plastered in news outlets and as a result, vaccination became a malevolent public enemy.

The study was riddled with improper scientific conduct. Arguably, the most important transgression was the involvement of only 12 patients, an absurdly low number of participants for a medical study. For reference, the follow up study of Wakefield’s study used over 650 thousand children born in Denmark between 1999 and 2010, and with that study came the unequivocal scientific conclusions that the MMR jab had no link with the development of autism. But the damage from media outlets had already been dealt, and there still remains scepticism within groups of anti-vaxxers.

More controversy developed as investigations began. An important detail was that Wakefield had filed for a patent for singular measles vaccination before the controversial paper was released – which would’ve resulted in financial gain for Wakefield. An even more significant financial gain than the bribery Wakefield already profited off from lawyers who allegedly wanted to sue vaccine manufacturers. It was in 2011 when a British journalist named Brian Deer provided thorough insight into Wakefield’s study, and found conclusive evidence of research fraud and falsified data. It is said without doubt that this paper should have never reached the public eye, since anti-vaxxers provide evidence that suggest the public are not responsible enough to look at studies objectively, and with enough rigour to determine its validity. Besides the horrific implication that a child has a lesser quality of life due to a diagnosis of autism, the choice to not vaccinate a child due to the fear of having to care for someone with special needs is extremely selfish. No matter the reasoning behind an anti-vaxxer’s belief, their choice to not vaccinate provides good footing into understanding that person’s character.

Although vaccines have repeatedly shown to be mostly over 90% effective at preventing disease, and no credible study has proven a link between vaccines and severe harm, vaccines are not perfect. Some side effects of vaccination are a swollen point of entry, potentially a fever, and since gelatine is present in some vaccines as a stabiliser and a preservative, this could lead to an allergic reaction. Overwhelming scientific evidence has shown the benefits of vaccination far outweigh the symptoms of any disease. Knowing this, there are still people who are unable to be vaccinated due to medical reasons, such as; nervous system problems, hereditary or congenital immune system problems, or are simply too young to receive the needed vaccines. These group of unfortunate individuals rely on ‘herd immunity’ to protect them against diseases for which they are not able to get vaccinated for. Once a certain amount of people obtain immunity to a disease, the immunisation threshold, the disease begins to die off, in a process called elimination. A global effort to eliminate a disease results in its eradication. The World Health Organisation (WHO) declared smallpox eradicated in 1977, 181 years after the crude but revolutionary vaccination against the deadly disease.

So far, the WHO only recognises two diseases that have been eradicated by human effort – smallpox and a disease that infected cattle and livestock, rinderpest. However, a lot more diseases are on their way to being wiped from the face of the Earth, such as polio and malaria.

Measles, a disease that kills the cells that create antibodies – the very things used by the body to destroy disease, has the impact of weakening the body for many years after. As horrible as measles is, reoccurrences in the form of outbreaks have made a resurgence – primarily in America. These unfortunate events have been credited to the population not reaching the immunisation threshold for elimination or eradication to occur. Not only does this impact already struggling healthcare systems common in certain first-world countries, but for third-world countries, measles can be fatal – the death rate can go up to 10% in particularly poverty-stricken parts of Africa.

Vaccinations are only effective as long as everyone is on the same side, the side governed by facts and hundreds of years of medical study. Herd immunity is the only defence some people have - the choice to not vaccinate yourself or your children is fundamentally selfish and detrimental to medical progression. The human race already has so many more pressing matters to deal with, like climate change, that we shouldn’t have to concern ourselves with diseases that are easily preventable. The argument to not vaccinate on the basis of ‘free speech’ and the ‘first amendment’ is idiotic as the people who cannot be immunised because of medical reasons are affected by those people’s choice to not get vaccinated. Those people that are immunocompromised did not choose to contract measles or meningitis or whatever preventable disease, but because of anti-vaxxers making uninformed decisions and believing in the pseudo-science of essential oils and multi-level marketing schemes, we are putting vulnerable people in danger, and are regressing within a society that needs to be advancing. We have enough problems to deal with without vaccination-refusal being added to our list.

The anti-vaccination movement is terrifying as it has a much greater impact on humanity as a whole than most people give it credit for. There absolutely should be legislation that promotes vaccination, or rather makes it mandatory for those who can have it. Some progress has been made in this regard, as stricter rules on the admittance of non-vaccinated children into childcare is being put in place, once again primarily in America. Although this does reduce exposure and transmission of contagious diseases, there is still a lack of trust between anti-vaxxers and medical professionals. Misinformation spreading on social media makes it hard for some people to differentiate fact from fiction: strict and proper education on the science behind vaccination needs to be put in place, otherwise the anti-vaccination movement may continue to grow, and become a pandemic of its own.

Credits:

Created with an image by CDC - "Created in 2003, this historic image depicts Centers for Disease Control and Prevention (CDC) Clinic Chief Nurse, Lee Ann Jean-Louis, extracting a dose of Influenza Virus Vaccine, Fluzone® from a 5 ml. vial. In this particular view, you see a close view of her hands, holding the vaccine vial with her left hand, and using a syringe, extracting the vaccine dose, with her right."