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Modern medicine has completely changed how humans are able to interact with the world around them and this has in no small part been thanks to the development of vaccines. Many diseases that once decimated humankind have become all but extinct in many parts of the world. Unfortunately, despite all the good vaccines have done, there are many who oppose the use of vaccines often stemming from a fear of adverse reactions and side effects rather than the diseases the vaccines prevent. The anti-vaccination movement has been gathering more steam since the development of the internet and poses major risks to society as a whole.

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The Ancient Chinese had a basic understanding of immunization following exposure to a disease. In the late 1600's, the Chinese emperor K'ang Hsi had his children become immunized using pre-vaccination means. The scabs of smallpox victims were ground up and blown into the nostrils of his children and the matter from smallpox sores were scratched into their skin. While seemingly barbaric, these practices were adopted by people in Europe and survived for centuries due to their effectiveness. The process was later called "variolation."

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2.2 History of Vaccines - Europe and "Variolation"

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2.2 History of Vaccines - Europe and "Variolation"

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In 18th century Europe, when smallpox ravaged society, practices similar to those used by the Ancient Chinese were known as "variolation." This process involved coating a lancet with matter from the pustule of an individual who was suffering from smallpox and insert the virus subcutaneously. Variolation was common and, interestingly, was 10x less fatal than the naturally occurring disease. Eventually, variolation would become decreasingly used with the development of the vaccine by Edward Jenner in 1796.

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In science credit goes to the man who convinces the world, not the man to whom the idea first occurs.

-Francis Galton

For many centuries, smallpox devastated mankind. In modern times we do not have to worry about it thanks to the remarkable work of Edward Jenner and later developments from his endeavors. With the rapid pace of vaccine development in recent decades, the historic origins of immunization are often forgotten. Unfortunately, since the attack on the World Trade Center on September 11, 2001, the threat of biological warfare and bioterrorism has reemerged. Smallpox has been identified as a possible agent of bioterrorism ( 1). It seems prudent to review the history of a disease known to few people in the 21st century.

SMALLPOX: THE ORIGIN OF A DISEASE

The origin of smallpox as a natural disease is lost in prehistory. It is believed to have appeared around 10,000 BC, at the time of the first agricultural settlements in northeastern Africa ( 3, 4). It seems plausible that it spread from there to India by means of ancient Egyptian merchants. The earliest evidence of skin lesions resembling those of smallpox is found on faces of mummies from the time of the 18th and 20th Egyptian Dynasties (1570-1085 BC). The mummified head of the Egyptian pharaoh Ramses V (died 1156 BC) bears evidence of the disease ( 5). At the same time, smallpox has been reported in ancient Asian cultures: smallpox was described as early as 1122 BC in China and is mentioned in ancient Sanskrit texts of India.

Smallpox was introduced to Europe sometime between the fifth and seventh centuries and was frequently epidemic during the Middle Ages. The disease greatly affected the development of Western civilization. The first stages of the decline of the Roman Empire (AD 108) coincided with a large-scale epidemic: the plague of Antonine, which accounted for the deaths of almost 7 million people ( 6). The Arab expansion, the Crusades, and the discovery of the West Indies all contributed to the spread of the disease.

Unknown in the New World, smallpox was introduced by the Spanish and Portuguese conquistadors. The disease decimated the local population and was instrumental in the fall of the empires of the Aztecs and the Incas. Similarly, on the eastern coast of North America, the disease was introduced by the early settlers and led to a decline in the native population. The devastating effects of smallpox also gave rise to one of the first examples of biological warfare ( 1, 7). During the French-Indian War (1754-1767), Sir Jeffrey Amherst, the commander of the British forces in North America, suggested the deliberate use of smallpox to diminish the American Indian population hostile to the British. Another factor contributing to smallpox in the Americas was the slave trade because many slaves came from regions in Africa where smallpox was endemic.

Smallpox affected all levels of society. In the 18th century in Europe, 400,000 people died annually of smallpox, and one third of the survivors went blind ( 4). The symptoms of smallpox, or the "speckled monster" as it was known in 18th-century England, appeared suddenly and the sequelae were devastating. The case-fatality rate varied from 20% to 60% and left most survivors with disfiguring scars. The case-fatality rate in infants was even higher, approaching 80% in London and 98% in Berlin during the late 1800s.

The word variola was commonly used for smallpox and had been introduced by Bishop Marius of Avenches (near Lausanne, Switzerland) in AD 570. It is derived from the Latin word varius, meaning "stained," or from varus, meaning "mark on the skin." The term small pockes ( pocke meaning sac) was first used in England at the end of the 15th century to distinguish the disease from syphilis, which was then known as the great pockes ( 8).

VARIOLATION AND EARLY ATTEMPTS OF TREATMENT

It was common knowledge that survivors of smallpox became immune to the disease. As early as 430 BC, survivors of smallpox were called upon to nurse the afflicted ( 9). Man had long been trying to find a cure for the "speckled monster." During medieval times, many herbal remedies, as well as cold treatment and special cloths, were used to either prevent or treat smallpox. Dr. Sydenham (1624-1689) treated his patients by allowing no fire in the room, leaving the windows permanently open, drawing the bedclothes no higher than the patient's waist, and administering "twelve bottles of small beer every twenty-four hours" ( 10).

However, the most successful way of combating smallpox before the discovery of vaccination was inoculation. The word is derived from the Latin inoculare, meaning "to graft." Inoculation referred to the subcutaneous instillation of smallpox virus into nonimmune individuals. The inoculator usually used a lancet wet with fresh matter taken from a ripe pustule of some person who suffered from smallpox. The material was then subcutaneously introduced on the arms or legs of the nonimmune person. The terms inoculation and variolation were often used interchangeably. The practice of inoculation seems to have arisen independently when people in several countries were faced with the threat of an epidemic. However, inoculation was not without its attendant risks. There were concerns that recipients might develop disseminated smallpox and spread it to others. Transmission of other diseases, such as syphilis, via the bloodborne route was also of concern.

Inoculation, hereafter referred to as variolation, was likely practiced in Africa, India, and China long before the 18th century, when it was introduced to Europe ( 9). In 1670, Circassian traders introduced variolation to the Turkish "Ottoman" Empire. Women from the Caucasus, who were in great demand in the Turkish sultan's harem in Istanbul because of their legendary beauty, were inoculated as children in parts of their bodies where scars would not be seen. These women must also have brought the practice of variolation to the court of the Sublime Porte ( 4, 10).

Variolation came to Europe at the beginning of the 18th century with the arrival of travelers from Istanbul. In 1714, the Royal Society of London received a letter from Emanuel Timoni describing the technique of variolation, which he had witnessed in Istanbul. A similar letter was sent by Giacomo Pilarino in 1716. These reports described the practice of subcutaneous inoculation; however, they did not change the ways of the conservative English physicians.

After these first professional variolation procedures, word of the practice spread to several members of the royal family ( 11). Charles Maitland was then granted the royal license to perform a trial of variolation on six prisoners in Newgate on August 9, 1721. The prisoners were granted the king's favor if they submitted to this experiment. Several court physicians, members of the Royal Society, and members of the College of Physicians observed the trial. All prisoners survived the experiment, and those exposed to smallpox later proved to be immune. In the months following this very first trial, Maitland repeated the experiment on orphaned children, again with success. Finally, on April 17, 1722, Maitland successfully treated the two daughters of the Princess of Wales. Not surprisingly, the procedure gained general acceptance after this last success.

THE SPREAD OF VARIOLATION

In Europe, where the medical profession was relatively organized, the new methods of variolation became known quickly among physicians. Since there was also a demand for protection against smallpox, physicians soon began the variolation procedure on a massive scale. Although 2% to 3% of variolated persons died from the disease, became the source of another epidemic, or suffered from diseases (e.g., tuberculosis and syphilis) transmitted by the procedure itself, variolation rapidly gained popularity among both aristocratic and common people in Europe. The case-fatality rate associated with variolation was 10 times lower than that associated with naturally occurring smallpox. In the 1750s more European princes died of smallpox, giving further impetus for the use of variolation ( 3). Among those variolated were Empress Marie-Therese of Austria and her children and grandchildren, Frederick II of Prussia, King Louis XVI of France and his children, and Catherine II of Russia and her son. King Frederick II of Prussia also inoculated all his soldiers. In fact, variolation was widely practiced in Europe until Jenner's discovery.

The regular practice of variolation reached the New World in 1721 ( 9). Under the guidance of the Rev. Cotton Mather (1663-1728) and Dr. Zabdiel Boylston (1679-1766), variolation became quite popular in the colonies. Mather, a graduate of Harvard College, was always very interested in science and medicine. When a ship from the West Indies carried persons sick with smallpox into Boston in 1721, an epidemic broke out in Boston and other parts of Massachusetts. Mather wrote a cautious letter recommending immediate variolation. However, he persuaded only Dr. Boylston. With Mather's support, Boylston immediately started a variolation program and continued to inoculate many volunteers, despite many adversaries in both the public and the medical community in Boston. As the disease spread, so did the controversy around Mather and Boylston ( 12). At the height of the epidemic, a bomb was thrown into Mather's house.

To make their point, Mather and Boylston used a statistical approach to compare the mortality rate of natural smallpox infection with that contracted by variolation. During the great epidemic of 1721, approximately half of Boston's 12,000 citizens contracted smallpox. The fatality rate for the naturally contracted disease was 14%, whereas Boylston and Mather reported a mortality rate of only 2% among variolated individuals ( 12). This may have been the first time that comparative analysis was used to evaluate a medical procedure.

During the decades following the 1721 epidemic in Boston, variolation became more widespread in the colonies of New England. In 1766, American soldiers under George Washington were unable to take Quebec from the British troops, apparently because of a smallpox epidemic that significantly reduced the number of healthy troops ( 13). The British soldiers were all variolated. By 1777, Washington had learned his lesson: all his soldiers were variolated before beginning new military operations ( 14, 15). The success of variolation in the New World was not without effect on Europe. In fact, the rapid adoption of variolation in Europe can be directly traced to the efforts of Cotton Mather during the Boston smallpox epidemic in 1721. Although many British physicians remained skeptical even after Mather's success, the data he had published were eventually influential. Variolation was subsequently adopted in England and spread from there throughout Western Europe.

In 1757, an 8-year-old boy was inoculated with smallpox in Gloucester ( 4); he was one of thousands of children inoculated that year in England. The procedure was effective, as the boy developed a mild case of smallpox and was subsequently immune to the disease. His name was Edward Jenner.

EDWARD JENNER

Edward Jenner was born on May 17, 1749, in Berkeley, Gloucestershire, the son of the Rev. Stephen Jenner, vicar of Berkeley. Edward was orphaned at age 5 and went to live with his older brother. During his early school years, Edward developed a strong interest in science and nature that continued throughout his life. At age 13 he was apprenticed to a country surgeon and apothecary in Sodbury, near Bristol ( 16). The record shows that it was there that Jenner heard a dairymaid say, "I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face." It fact, it was a common belief that dairymaids were in some way protected from smallpox.

In 1764, Jenner began his apprenticeship with George Harwicke. During these years, he acquired a sound knowledge of surgical and medical practice ( 10). Upon completion of this apprenticeship at the age of 21, Jenner went to London and became a student of John Hunter, who was on the staff of St. George's Hospital in London. Hunter was not only one of the most famous surgeons in England, but he was also a well-respected biologist, anatomist, and experimental scientist. The firm friendship that grew between Hunter and Jenner lasted until Hunter's death in 1793. Although Jenner already had a great interest in natural science, the experience during the 2 years with Hunter only increased his activities and curiosity. Jenner was so interested in natural science that he helped classify many species that Captain Cook brought back from his first voyage. In 1772, however, Jenner declined Cook's invitation to take part in the second voyage ( 4).

Jenner occupied himself with many matters. He studied geology and carried out experiments on human blood ( 17). In 1784, after public demonstrations of hot air and hydrogen balloons by Joseph M. Montgolfier in France during the preceding year, Jenner built and twice launched his own hydrogen balloon. It flew 12 miles. Following Hunter's suggestions, Jenner conducted a particular study of the cuckoo. The final version of Jenner's paper was published in 1788 and included the original observation that it is the cuckoo hatchling that evicts the eggs and chicks of the foster parents from the nest ( 17, 18). For this remarkable work, Jenner was elected a fellow of the Royal Society. However, many naturalists in England dismissed his work as pure nonsense. For more than a century, antivaccinationists used the supposed defects of the cuckoo study to cast doubt on Jenner's other work. Jenner was finally vindicated in 1921 when photography confirmed his observation ( 19). At any rate, it is apparent that Jenner had a lifelong interest in natural sciences. His last work, published posthumously, was on the migration of birds.

In addition to his training and experience in biology, Jenner made great progress in clinical surgery while studying with John Hunter in London. Jenner devised an improved method for preparing a medicine known as tartar emetic (potassium antimony tartrate). In 1773, at the end of 2 years with John Hunter, Jenner returned to Berkeley to practice medicine. There he enjoyed substantial success, for he was capable, skillful, and popular. In addition to the practice of medicine, he joined two local medical groups for the promotion of medical knowledge and continued to write occasional medical papers ( 4, 18). He also played the violin in a musical club and wrote light verse and poetry. As a natural scientist, he continued to make many observations on birds and the hibernation of hedgehogs and collected many specimens for John Hunter in London.

In 1797, Jenner sent a short communication to the Royal Society describing his experiment and observations. However, the paper was rejected. Then in 1798, having added a few more cases to his initial experiment, Jenner privately published a small booklet entitled An Inquiry into the Causes and Effects of the Variolae Vaccinae, a disease discovered in some of the western counties of England, particularly Gloucestershire and Known by the Name of Cow Pox ( 18, 10). The Latin word for cow is vacca, and cowpox is vaccinia; Jenner decided to call this new procedure vaccination. The 1798 publication had three parts. In the first part Jenner presented his view regarding the origin of cowpox as a disease of horses transmitted to cows. The theory was discredited during Jenner's lifetime. He then presented the hypothesis that infection with cowpox protects against subsequent infection with smallpox. The second part contained the critical observations relevant to testing the hypothesis. The third part was a lengthy discussion, in part polemical, of the findings and a variety of issues related to smallpox. The publication of the Inquiry was met with a mixed reaction in the medical community.

Jenner went to London in search of volunteers for vaccination. However, after 3 months he had found none. In London, vaccination became popular through the activities of others, particularly the surgeon Henry Cline, to whom Jenner had given some of the inoculant ( 4). Later in 1799, Drs. George Pearson and William Woodville began to support vaccination among their patients. Jenner conducted a nationwide survey in search of proof of resistance to smallpox or to variolation among persons who had cowpox. The results of this survey confirmed his theory. Despite errors, many controversies, and chicanery, the use of vaccination spread rapidly in England, and by the year 1800, it had also reached most European countries ( 10).

Although sometimes embarrassed by a lack of supply, Jenner sent vaccine to his medical acquaintances and to anyone else who requested it. After introducing cowpox inoculation in their own districts, many recipients passed the vaccine on to others. Dr. John Haygarth (of Bath, Somerset) received the vaccine from Edward Jenner in 1800 and sent some of the material to Benjamin Waterhouse, professor of physics at Harvard University. Waterhouse introduced vaccination in New England and then persuaded Thomas Jefferson to try it in Virginia. Waterhouse received great support from Jefferson, who appointed him vaccine agent in the National Vaccine Institute, an organization set up to implement a national vaccination program in the United States ( 20).

Although he received worldwide recognition and many honors, Jenner made no attempt to enrich himself through his discovery. He actually devoted so much time to the cause of vaccination that his private practice and his personal affairs suffered severely. The extraordinary value of vaccination was publicly acknowledged in England, when in 1802 the British Parliament granted Edward Jenner the sum of £10,000. Five years later the Parliament awarded him £20,000 more. However, he not only received honors but also found himself subjected to attacks and ridicule. Despite all this, he continued his activities on behalf of the vaccination program. Gradually, vaccination replaced variolation, which became prohibited in England in 1840.

Jenner married in 1788 and fathered four children. The family lived in the Chantry House, which became the Jenner Museum in 1985. Jenner built a one-room hut in the garden, which he called the "Temple of Vaccinia" (Figure ​(Figure4 4 ), where he vaccinated the poor for free ( 10, 17). After a decade of being honored and reviled in more or less equal measure, he gradually withdrew from public life and returned to the practice of country medicine in Berkeley. In 1810, his oldest son, Edward, died of tuberculosis. His sister Mary died the same year and his sister Anne 2 years later. In 1815, his wife, Catherine, died of tuberculosis ( 17). Sorrows crowded in on him, and he withdrew even further from public life. In 1820, Jenner had a stroke from which he recovered. On January 23, 1823, he visited his last patient, a dying friend. The next morning Jenner failed to appear for breakfast; later that day he was found in his study. He had had a massive stroke. Edward Jenner died during the early morning hours of Sunday, January 26, 1823. He was laid to rest with his parents, his wife, and his son near the altar of the Berkeley church.

CONCLUSION

Jenner's work represented the first scientific attempt to control an infectious disease by the deliberate use of vaccination. Strictly speaking, he did not discover vaccination but was the first person to confer scientific status on the procedure and to pursue its scientific investigation. During the past years, there has been a growing recognition of Benjamin Jesty (1737-1816) as the first to vaccinate against smallpox ( 21). When smallpox was present in Jesty's locality in 1774, he was determined to protect the life of his family. Jesty used material from udders of cattle that he knew had cowpox and transferred the material with a small lancet to the arms of his wife and two boys. The trio of vaccinees remained free of smallpox, although they were exposed on numerous occasions in later life. Benjamin Jesty was neither the first nor the last to experiment with vaccination. In fact, the use of smallpox and cowpox was widely known among the country physicians in the dairy counties of 18th-century England. However, the recognition of these facts should not diminish our view of Jenner's accomplishments. It was his relentless promotion and devoted research of vaccination that changed the way medicine was practiced.

Scientific advances during the two centuries since Edward Jenner performed his first vaccination on James Phipps have proved him to be more right than wrong. The germ theory of disease, the discovery and study of viruses, and the understanding of modern immunology tended to support his main conclusions. The discovery and promotion of vaccination enabled the eradication of smallpox: this is Edward Jenner's ultimate vindication and memorial.

References

3. Hopkins DR. Chicago: University of Chicago Press; 1983. Princes and Peasants: Smallpox in History. [ Google Scholar]

5. Lyons AS, Petrucelli RJ., II . New York: Abradale Press, Harry N Abrams Inc; 1987. Medicine-An Illustrated History. [ Google Scholar]

8. Moore JC. The History of the Smallpox. London: Longman; 1815. [ Google Scholar]

12. Beall OT, Shryock RH. Cotton Mather: First Significant Figure in American Medicine. Baltimore: Johns Hopkins University Press; 1954. [ Google Scholar]

13. Bardell D. Smallpox during the American war of independence. ASM News. 1976;42:526-530. [ Google Scholar]

16. Parish HJ. Victory with Vaccines: The Story of Immunization. Edinburgh: E & S Livingstone; 1968. [ Google Scholar]

19. Scott EL. Edward Jenner FRS and the cuckoo. Notes and Records of the Royal Society. 1974;28(2):235-240. [ Google Scholar]

20. Underwood EA. Edward Jenner, Benjamin Waterhouse and the introduction of vaccination into the United States. Nature. 1949;163:823-828. [ Google Scholar]

22. World Health Organization. The Global Eradication of Smallpox: Final Report of the Global Commission for the Certification of Smallpox Eradication. Geneva: World Health Organization; 1980. Global Commission for Certification of Smallpox Eradication. [ Google Scholar]

Articles from Proceedings (Baylor University. Medical Center) are provided here courtesy of Baylor University Medical Center

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Edward Jenner and the history of smallpox and vaccination

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In science credit goes to the man who convinces the world, not the man to whom the idea first occurs. -Francis Galton For many centuries, smallpox devastated mankind. In modern times we do not have to worry about it thanks to the remarkable work of Edward Jenner and later developments from his endeavors.

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Edward Jenner was an English physician and scientist who became interested in the tales he had heard that milkmaids had somehow become protected against smallpox after contracting cowpox. In order to test this, Jenner inoculated an 8 year old boy with cowpox, who developed the disease, and waited for the boy to recover. A few months later, Jenner inoculated the boy with smallpox...and the boy never developed the disease. Thus the first vaccine was created. While Jenner's discovery was already well known amongst dairy farmers, he ultimately brought this to the attention of the scientific community.

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Ever since Jenner vaccines have blown up. Experiments performed by Louis Pasteur led to the development of the cholera vaccine and the anthrax vaccine. Two vaccines for Polio have been developed, one live-attenuated and one inactivated. There has also been the development of a vaccine against Measles, Mumps and Rubella (MMR). And of course the influenza vaccine. Modern immunology has even been looking to develop vaccines against HIV and even cancers with some promise.

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List of Vaccines Used in United States | CDC

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Vaccines used in the United States (list of)

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3.2 History of the Anti-Vaccination Movement - Autism and Vaccines

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3.2 History of the Anti-Vaccination Movement - Autism and Vaccines

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In 1998, Andrew Wakefield, a former British Doctor, and 12 of his colleagues published a case series study in a journal called The Lancet. The study suggested that the MMR vaccine may predispose children to developing autism. This, of course, led to major controversy and a widespread drop in MMR vaccination rates. Quickly after it was published, numerous studies were conducted and ultimately refuted Wakefield's speculative conclusions. It was later found that Wakefield cherry-picked his data and also had financial interest in getting the results his paper presented. Wakefield was stripped of his medical license and was proven to have committed scientific fraud. But unfortunately, his influence can still be felt in society today.

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4.1 Arguments and Misconceptions About Vaccines

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4.1 Arguments and Misconceptions About Vaccines

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"The majority of people who get disease have been vaccinated."

This statement itself is not wrong, but it does not support the anti-vaccination movement. The phenomenon can be explained by 2 factors:
1. There is no vaccine that is 100% effective and therefore not every vaccinated individual will develop full immunity.
2. A vast majority of people have been vaccinated.

This makes it a numbers game.
Example:
Total people = 1,000
Vaccinated = 995
Unvaccinated = 5

Vaccinated individuals that develop disease = 7
Unvaccinated individuals that develop disease = 5

7/1000 (<1%) of vaccinated individuals develop disease.
5/5 (100%) unvaccinated individuals develop disease.

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3.3 History of the Anti-Vaccination Movement - Thimerosal

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3.3 History of the Anti-Vaccination Movement - Thimerosal

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The controversy surrounding thimerosal has been around since the early 2000s. Thimerosal is a mercury containing compound that has been used as a preservative in vaccines, and thanks to Wakefield, became controversial as a possible link to vaccines and autism. This again has been refuted by many studies; however, in order to appease people's worries, thimerosal was removed or greatly reduced in many vaccines including influenza.

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3.1 History of the Anti-Vaccination Movement - Early Criticism of Immunization

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3.1 History of the Anti-Vaccination Movement - Early Criticism of Immunization

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Criticism against the various forms of immunization have been around since their development. Prior to Jenner, advocates for variolation often had to defend the immunization practice against charges that the practice was more harmful than the diseases it was intended to prevent. This is certainly understandable as both variolation as well as Jenner's initial smallpox vaccine involved scoring flesh and inserting lymph from a blister of someone with disease. In many cases, however, contention came from religion, believing vaccination was "unchristian" as the vaccine came from an animal. Contention also came from a distrust in medicine.

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History of Vaccines - A Vaccine History Project of The College of Physicians of Philadelphia | History of Vaccines

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The History of Vaccines explores the role of immunization in the human experience and examines its continuing contributions to public health

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4.2 Arguments and Misconceptions About Vaccines

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4.2 Arguments and Misconceptions About Vaccines

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"Vaccines cause many harmful side effects, illnesses, and even death - not to mention possible long-term effects we don't even know about."

Vaccines are generally very safe and a vast major of adverse events following vaccination are minor and temporary, i.e. a sore arm, mild fever. The vaccines themselves go through a rigorous testing process that takes several years before they are licensed and approved by the FDA and recommended by the CDC.
The more severe adverse reactions, such as anaphylaxis or seizures, are very rare (on the order of 1/1000 to 1/1000000). Those who are unable to receive vaccination because they are susceptible to such a reaction, rely on others to get vaccinated.

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4.3 Arguments and Misconceptions About Vaccines

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4.3 Arguments and Misconceptions About Vaccines

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"Vaccine-preventable diseases have been virtually eliminated from my country so there is no need for my child to be vaccinated."

Those in many developed countries have been fortunate enough to have had access to vaccines causing many diseases to be brought down to very low levels. These diseases, however, still exist around the world and are especially prevalent in less developed areas. It is very easy for travelers to bring diseases across borders where they can spread quickly in communities that are not vaccinated.
So it is important to vaccinate not only to protect yourself but also to protect those around you. Those who either cannot be vaccinated or do not respond to vaccines, rely on those around them to be immunized in order to stop the spread of disease. This is a concept known as Herd Immunity.

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4.4 Arguments and Misconceptions About Vaccines

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4.4 Arguments and Misconceptions About Vaccines

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"Giving a child multiple vaccinations for different diseases at the same time increases the risk of harmful side effects and can overload the immune system."

Parents will, of course, worry about the risks posed by vaccines. However, as evident by all the ridiculous things children stick in their mouths, children are exposed to an enormous number of foreign antigens on a daily basis. Vaccines really aren't much different. Studies have also shown that there is no increased risk or burden on the immune system when given multiple vaccines.
Despite this, many parents look to space out vaccinations due to their worries. But it must be noted that immunization schedules that have been put in place for children are carefully designed to maximize their effectiveness and keep those children healthy during some of the most vulnerable years of their life.

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Whilst living in a modern society free of horrible diseases that once decimated civilizations, it is easy to forget how far we have come and how fortunate we are today. Unfortunately, the influence of misinformation like that of Andrew Wakefield's paper, fuels individuals innate biases and continues to dissuade people from vaccinating. This has led to problems such as the resurgence of measles. Its incidence is climbing every year with more cases occurring in the first 3 months of 2019 than in all of 2018. Hopefully, this spread of misinformation can be halted by correct information and vaccination rates can be increased around the world.

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Health and Human Services. (2017). Vaccine Safety. Retrieved from https://www.vaccines.gov/basics/safety/

Kluger, J. (2019). Measles Is Returning to a Range of Places - But Not for the Same Reasons. Retrieved from http://time.com/5375687/measles-return/

Lord, A. (2015). Anti-vaccination in America. Retrieved from http://americanhistory.si.edu/blog/anti-vaccination-america

Merriam-Webster. (n.d.). Inoculate. Retrieved from https://www.merriam-webster.com/dictionary/inoculate

Miller, B., MD. (2017). Risks of spacing or delaying vaccines in children. Retrieved from https://chw.org/newshub/stories/risks-of-spacing-or-delaying-vaccines-in-children

NBC News. (2019). Measles count in U.S. this year already more than all of 2018. Retrieved from https://www.nbcnews.com/storyline/measles-outbreak/measles-count-us-year-already-more-all-2018-n989581

Sadarangani, M. (2016). Herd Immunity: How does it work?Retrieved fromhttps://www.ovg.ox.ac.uk/news/herd-immunity-how-does-it-work

Phadke, V., Bednarczyk, R., Salmon, D., & Omer, S. (2019). Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007135/

Rao, T., & Andrade, C. (2011). The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/

Riedel, S. (2019). Edward Jenner and the history of smallpox and vaccination. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/

Schwartz, J. L. (2012). New Media, Old Messages: Themes in the History of Vaccine Hesitancy and Refusal. Retrieved from https://journalofethics.ama-assn.org/article/new-media-old-messages-themes-history-vaccine-hesitancy-and-refusal/2012-01

The College of Physicians of Philadelphia (2018). History of Anti-vaccination Movements | History of Vaccines. Retrieved from https://www.historyofvaccines.org/index.php/content/articles/history-anti-vaccination-movements

The College of Physicians of Philadelphia (2019). Timeline | History of Vaccines. Retrieved from https://www.historyofvaccines.org/timeline#EVT_1

The Immunisation Advisory Centre (2017). A brief history of vaccination. Retrieved from http://www.immune.org.nz/vaccines/vaccine-development/brief-history-vaccination

World Health Organization (2019). WHO | Six common misconceptions about immunization. Retrieved from https://www.who.int/vaccine_safety/initiative/detection/immunization_misconceptions/en/index2.html