Vaccines (Part I): Jenner, Pasteur, and the Dawn of Scientific Medicine
Article Type:Editor's Corner
With the issue of mandatory vaccination programs for infants and children, lines have been drawn in the sand. On one side, we find concerned parents, increasingly being supported by dissenting physicians and scientists troubled by the serious side effects of vaccines, which have, in fact, been reported with greater frequency, including serious neurological deficits and even death. Physicians on this side of the line have not only asked for more open data and information to the public, but question the statistics as it regards specifically risks versus benefit studies, the need for adhering to the individual-based ethics and admonition of Hippocrates (photo, right) of first doing no harm, and allowance for more parental involvement and freedom of choice --- that is, the right of parents to refuse to give their children certain vaccines; and full informed consent for parents --- that is, complete disclosure of all pertinent information relating to vaccine safety and efficacy.
On the other side of the line, we find government bureaucrats, public health officials, central planners, and much of the organized medical establishment militating for a greater role of government in "developing immunization strategies," developing tracking databases, increasing medical surveillance, and accelerating the pace of vaccine development, as well as enlarging the scope of mandatory vaccine programs already in place, particularly for infants and pre-school children. This group is bolstered not only by the coercive power and financial coffers of the federal government but also by the new collectivist, utilitarian ethics of population-based medicine. Recently, this group has even invoked history and the past necessities of medical authorities for using a variety of public strategies which may at times infringe on individual liberty. On August 3, 1999, U.S. Surgeon General David Satcher reminded chairman Dan Burton (R-IN) and his House Government Reform Committee of the benefits of mass immunization in protecting society from such historical scourges as poliomyelitis, measles, tetanus, meningitis, and other pestilential diseases once dreaded by man. He reassured the committee that "serious side effects are rare and that the benefits of immunization more than outweigh any potential risks." He added that vaccines are to be considered among the safest and most effective medicines in man's armamentarium in the fight against diseases.
And so, with this introduction, perhaps we should take a retrospective look at the history of vaccination and touch upon the development of the germ theory of disease to which it's necessarily entwined.
For full paper:
Vaccines (Part II): Hygiene, Sanitation, Immunization, and Pestilential Diseases
Article Type:Feature Article
Vaccines --- Kill or Cure?
As the controversial debate over mandatory vaccine policy heats up igniting passions, it is perhaps appropriate we summarize what is known about the manifest benefits of modern vaccines, not forgetting the tremendously salutary impact on health and longevity wrought about by better living conditions, hygiene and sanitation, in general, and the introduction and subsequent widespread use of antibiotics, in particular.
In Part I of this essay, we discussed the history of vaccinations, the advent of the germ theory of disease, and the ushering in of the dawn of scientific medicine.(1) In Part II, we will weave into this historic tapestry the more contemporary history behind some of the many infectious illnesses of the 20th century and revisit the story as to how they were eradicated. Only then can we arrive at today's reality over vaccine policy and reach the truth as to the best possible advice that should presently be given to individual patients.(2,3)
Officials at the CDC tell us vaccines are "90 percent safe and effective." And according to UNICEF, vaccines save the lives of at least 1.5 million children every year. Yet, parents are concerned, and increasingly, dissenting physicians are asking questions and breaking away from the heretofore monolithic medical ranks. Let's look at the big picture to avoid missing the forest for the trees.
Growing up, I thought deadly infectious diseases had been conquered long ago. Yet, in Cuba, I knew of a girl who died of diphtheria, and my father as a country doctor, diagnosed and treated a case of anthrax and another one of typhus. When I visited Haiti in 1975 as a medical student, I saw cases of tetanus and congenital syphilis. In 1982, while I was chief neurosurgical resident at Grady Memorial Hospital in Atlanta, Georgia, we had in our service, simultaneously, patients with Pott's Disease, miliary TB with renal involvement and cerebral tuberculoma (for which we were consulted as to possible removal), and tubercular meningitis (for which we were to implant a Rickham reservoir for CNS chemotherapy). Scrofula was the only "classical" TB case missing in our clinical service!
And with the advent of AIDS and other immune deficiency and immunosuppressed states, we have seen in the 1990s a resurgence of tuberculosis and other opportunistic, infectious diseases, e.g., toxoplasmosis, cytomegalovirus (CMV), etc. In my own practice, I treated patients with chronic fungal meningitis and bacterial subdural empyemas requiring surgical evacuation. So, infectious diseases are still with us, and so taking preventive public health measures is prudent in many circumstances when the public is at risk. With this in mind, let's look at some of these diseases that are specifically salient to our discussion, and try to separate the wheat from the chaff in the debate.
For the full paper: