Ramūnas Bogdanas. Fear of vaccination lives on since the 19th century

Ramūnas Bogdanas

The first electrical lamp in Lithuania was lit on April 17, 1892 in the morning in Rietavas. Only 13 years had passed since it had been invented.

Duke Bogdanas Oginskis was familiar with his fellow countrymen in Rietavas, thus the day was chosen so as to prevent the emergence of rumours about devil's trickery, which could have ruined the electrification of the lumber mill. April 17 was Easter morning and the lamp was lit at church. With the help of God, the fear of the devil was shut out.

Starting from a cow

Another scientific achievement – vaccination – cannot boast of such easy adoption. Edward Jenner is viewed as its inventor, having presented a study to London's Royal Society in 1796 how 13 individuals were safe from smallpox because they had earlier been infected by cow smallpox.

Nowadays, E. Jenner would likely be jailed for his experiments, but back then no one condemned his actions. After noticing that a woman, who milked Blossom the cow came down with cow smallpox, the doctor took some fluid from the abscesses on Sarah the milkmaid's hands and rubbed it on the healthy eight year old son of his gardener. The boy, James, briefly fell ill and got better. Then E. Jenner tried to infect him with the deadly human smallpox, however the gardener's son remained resistant.

This experiment is seen as the beginning of immunology science. In Latin, cow smallpox is called vaccinia from the Latin word vacca, which means cow. Thus, E. Jenner named his method as vaccination. In London University St. George School of Medicine, where the inventor studied, the library still contains a glass case with a brown-white cowhide. That's Blossom, who started vaccinations.

At the end of the 18th century, smallpox was a terrible plague. Every year, 400,000 people would die from it around Europe, a third of those afflicted would go blind. Around 10% of the population would die from smallpox and during epidemics, the casualties would rise to 20%. Children were particularly susceptible – 90% of infected little ones would not survive.

The British parliament honoured E. Jenner with a 10 thousand pound award in 1802 and 20 thousand pound award in 1807. Vaccinations spread further and further, with the UK parliament making vaccination mandatory in 1853.

Mass smallpox vaccinations started in Lithuania in 1930 and already 1936 marked the last case of this terrible disease in our country.

Demonised vaccinations

Alongside vaccinations also spread resistance to them. Activists of the new movement appeared, anti-vaccination publications and organisations. Let me quote an excerpt from an 1807 essay against vaccinations:

"A powerful and terrible monster with a bull's horns, horse's hooves, kraken's maw, tiger's teeth and talons and a cow's tail. In its bowels lies the entirety of the evil of Pandora's Box. Its body is covered by plague, smallpox, purple stains, stinking cankers and wounds overflowing with filth. It is covered by the stench of disease, its appearance in the world is accompanied by pain and death. It kills humanity, particularly the poor powerless children, not just through sores – it eats not hundreds, not thousands, but hundreds of thousands.

The monster's name is vaccination and its growing rampage among the people causes fear and poses a deadly threat."

For part of the 19th century, the public was greatly swayed by such apocalyptic imagery. For example, in Stockholm, the trend to not vaccinate spread so much that in 1872, vaccination levels dropped to 40%. In the rest of Sweden, it reached 90%. However, in 1874, a major smallpox epidemic struck Stockholm and the city came back to its senses and returned to vaccinations.

Similar matters repeated even a hundred years later. 81% of the UK population was vaccinated from whooping cough in the 1970s. Then, the opinion became popular that this vaccination is evil. Over ten years, the vaccination percentage dropped to 31%. A mass epidemic emerged. During it, vaccinations rose to 93% and the outbreak was contained.

The contemporary anti-vaxxer arguments are only different in form to their predecessors in the 19th century. Over two hundred years, nothing new has been thought up and nothing has been dismissed, as if human knowledge and science had remained in place. Resistance continues to be based on four fundamental pillars:

  1. Belief that vaccines do not work.
  2. Belief that someone got ill or died due to vaccines.
  3. Belief that mandatory vaccination is in breach of fundamental human freedoms and rights.
  4. Belief in the exceptional power of alternative medicine, particularly homeopathy and herbs.
  5. No arguments or facts can stand against faith, which does not bow to the passage of time.

The opinion of the poorly educated has a trait of spreading easier than justified explanations. This is because explanations will always take longer, require more time to prepare and will require more effort to understand. It is much easier to listen to a catchy, horrifying slogan and repeat it.

Fake news on vaccination

In 1998, a doctor from the United Kingdom Andrew Wakefield released a study in the scientific journal Lancet that concluded that the combined MMR vaccine, which protects from measles, mumps and rubella, causes autism and digestive tract inflammation in children. This news quickly spread across the world. While surprised scientists reviewed their colleague's findings, many came to believe this.

When specialists carefully analysed the study, it turned out that the author based his research on 12 children and lacked a control group. It is clear that a sample size such as this is far too small to make any conclusions. After reviewing the researched cases, it was found that of the twelve, three were not even autistic and five had signs of autism already prior to their vaccinations.

Following a global reaction, research was performed involving a million children worldwide and no links between the MMR vaccination and autism were found.

Furthermore, A. Wakefield's motives were uncovered: he himself had made an application regarding a new vaccine for measles and sought for MMR to be removed from the list in order for his medication to replace it. For such behaviour, the doctor lost his license.

Mandatory or voluntary?

Currently, vaccination is mandatory in 11 European states of 31 (35.4%), while in the remaining 20 countries, it is recommended. Our neighbouring Latvia has 10 mandatory vaccinations, Poland – 9.

Following a rise in anti-vaxxers, which was crowned by a demonstration numbering one hundred thousand, the UK parliament made amendments to the vaccination act in 1898, including into British law the concept of decision based on religious and moral beliefs.

When answering an inquiry by members of European Parliament on the effectiveness of mandatory vaccinations, the European Commission responded on the basis of an ASSET report performed for EU money and which included the situation up to the year 2013. The Commission specified to the MEPs that public vaccination levels do not depend on the mandatory nature of the vaccinations.

Upon reading the report, we will find that in the Baltic States, the levels are even despite the vaccinations being mandatory in Latvia. The vaccination levels are near the same in Poland, where vaccinations are mandatory and in Finland, where they aren't.

However, the authors of the report concede that their research includes too little data to decide on the influence of mandatory vaccinations. Indeed, the researched time periods without epidemic outbreaks do not consider cultural differences between the countries.

In Italy, the fabricated news about MMR causing autism influenced politicians so much that in 1999 they abolished the mandatory vaccination. Vaccination levels particularly fell in 2012 when populist political movements supporting anti-vaxxer moods spread. These did everything to attract more votes to their own side.

For example, the leader of the Five Star Movement, current Italian Prime Minister Matteo Salvini posted on Twitter in 2013 that he took his daughter for vaccination and she was completely unafraid. In 2017, however, he now claimed that all these vaccinations are nonsense because people wanted to hear it.

The government at the time was facing a measles epidemic and implemented a further six mandatory vaccinations, this including from measles, to complement the existing four.

Children going to school in Italy had to bring a doctor's note that they are vaccinated. Populists won the elections and allowed children to attend school as long as they bring a note from parents regarding vaccination.

Australia has two brief rules: "No jab, no play" and "No jab, no pay". Based on them, unvaccinated children are not admitted to education institutions and their parents do not receive grants for their children. The Homeland Union is proposing a similar solution in Seimas at the moment.

Measles outbreak in Europe

The greatest outbreak of measles is in Ukraine. From the start of the war with Russia, the vaccination levels fell there, only reaching 31% in 2016. An epidemic broke out.

In 2018, over 53 thousand cases of measles were recorded in Ukraine. Second place went to Serbia, which had around 5,000 cases. Next is Israel where many do not receive vaccinations due to religious belief. There are many cases in Russia.

In the EU, most cases are found in France (2913), Italy (2517), Greece and Romania. In 2018, over 82 thousand citizens were infected with measles in Europe, with 72 deaths caused by it.

Willing vaccinations begin when epidemics begin to rage. Until they do, there is excessive trust in Doctor Google, while real doctors' recommendations are ignored.

I believe in Lithuania it is also linked to thriving corruption in the healthcare sector. If a doctor takes bribes from a patient, is it hard to imagine that they wouldn't be on the take from, say, the pharmacy industry to encourage consumption?

Now, with people rushing to check if they are immune or not and beginning to vaccinate, we face not the Oath of Hippocrates, but the spirit of business – a service that recently cost just 6 euro now costs 40 euro with the epidemic rising.

We would face no epidemics if the country had 95% public immunity, which prevents them. When discussing the clash between mandatory vaccinations and core human rights, I would propose to consider whether mandatory education for children does not breach and limit their and their parents' rights to choose?

Children would rather play computer games or with friends than study and potentially would grow up happier. Parents would let their children out to herd geese or would leave them at home to care for the younger ones, thus saving money on nannies and kindergartens – the family's economic welfare would improve, emotional bonds would strengthen. But it was decided that it benefits society more to have similarly educated members.

Can you compare the removed right to blow tobacco smoke into the eyes of a non-smoker with the right to remain an unvaccinated potential host for an infection?

Is it not more beneficial for a society to have members protected not only from illiteracy, but also from epidemic? Or perhaps the intervention of a vaccine into a body is a greater breach of rights than the intervention of education into the mind?

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