Vaccination: A Backward Excursion for Skeptics

Compulsory vaccination is far from news in mainstream medicine. For centuries, vaccinations have saved lives and have not caused any complaints. Did everyone recognize their necessity, or when did the so-called “anti-axers” appear?

Virginia Mason Franciscan Health is a medical center in the United States where an interesting but predictable event took place. Employees of the center in the US state of Washington, about 6 weeks ago, received a warning about the need to get vaccinated against Covid-19 – to protect patients and colleagues at work, says Air force… At the same time, the administration took a great risk, given the lack of staff and the number of people who categorically do not recognize vaccination.

But “X-day” was a real “surprise” – 95% of staff provided proof of vaccination or a certificate of contraindications for vaccination against covid. That is, only 5% of employees went on administrative leave, including those with the first dose of the vaccine. Charlene Tachibana, who has worked for the company all her life at Virginia Mason, however, is not very surprised:

“We have a long history of vaccination requirements … it has normalized pretty well.”

Back in 2004, Virginia Mason Franciscan Health became the first medical center to require its staff to be annually vaccinated against influenza. The administration then used various interesting measures in order to stimulate the fulfillment of this requirement. The carrot-and-stick method proved to be effective, and in just 2 years, staff flu vaccination rates rose to a record, from 54% to 98%.

This experience was useful to the administration even now, during the coronavirus pandemic. One aspect was to ensure maximum comfort while vaccinating employees. Another was the focus on communication around the new requirement, including information sessions and documents in multiple languages. Tachibana explains:

“We do not take mandates lightly. When there is such a clear scientific rationale behind it, when the vaccine has been proven to be safe and very, very effective, we are moving forward. ”

The company’s experience convincingly shows that vaccination is a powerful tool for protecting public health. But this question can be very controversial. In some ways, attitudes towards current Covid-19 vaccine requirements reflect patterns of past centuries, so it is very important to know and understand the historical lessons about mandatory vaccination. To do this, we will make an excursion into the distant past.

Smallpox was considered the most contagious disease – 85% of people who met the virus died. The disease has mercilessly destroyed entire nations for centuries, only vaccination could stop it. Quarantines were ineffective as they interfered with the development of trade, so the authorities in most countries began to encourage special, “biopolitical” approaches.

In Europe, smallpox appeared in the middle of the first millennium, since the 15th century, epidemics practically did not stop. At the end of the 18th century, finally, a vaccine appears, and over the next two centuries, with the help of universal vaccinations, the disease was completely eradicated. The last outbreak was reported in 1977 in Somalia.

In the 17th century, Chinese doctors discovered that vaccinated on a human wound (that is, when it enters the bloodstream) can induce immunity against the rampant smallpox. The technique quickly spread around the world, and some leaders decided to get such a vaccine. During the American War of Independence in 1777, for example, General George Washington demanded that all troops be vaccinated against smallpox.

The first effective tool of biopolitics was vaccination of the population – variolation (introduction of the contents of smallpox vesicles of patients), then vaccination. There was no scientific explanation for it until the very end of the 19th century (when Pasteur laid the foundations for the concept of artificial immunity), but the remedy successfully coped with smallpox and showed itself well everywhere – from North America to Russia.

The English physician Edward Jenner developed the smallpox vaccine in 1796, and a few years later the compulsory vaccination began. In 1806, Eliza Bonaparte, ruler of the principality of Lucca and Piombino (Italy), introduced mass vaccination – from newborns to adults of all ages. In 1853, the Compulsory Vaccination Act required the vaccination of infants in England and Wales.

But there is a certain pattern. Over time, the population gets used to certain vaccines, and the emergence of new ones scares them. Gavi (Global Alliance for Vaccines and Immunization) Pediatrician and Medical Epidemiologist Lee Hampton says:

“In the United States since the late 1970s. vaccination regulations apply. And many European countries require children to be vaccinated against a range of diseases – hepatitis B, diphtheria, whooping cough, poliovirus, measles, mumps, rubella, chickenpox, and tetanus. And this does not raise any objections. But the change over time of this list, as a rule, becomes the cause of negative attitudes. This was the case with vaccinations against anthrax, hepatitis B and, of course, Covid-19. “

Components used to make vaccines have been criticized for centuries. Some of them contained minimal amounts of animal products, such as squalene, shark liver oil. The polio vaccine previously used cells from monkey kidneys, while others used calf lymph. These ingredients have caused rejection by vegetarians. Sylvia Valentine, who is writing her Ph.D. thesis on the topic at the University of Dundee, points out that there were various reasons for the vaccine refusals:

Some believed that the human body should not be contaminated with animal materials. The anti-vivisection movement was also associated with anti-axers, and many opponents opposed many other things, including government interference in their lives. Anti-vivisectionists objected, for example, to the methods used to produce calf lymph, which were pretty gruesome to be honest and concerned about animal welfare.

Pork tissue ingredients have also made some Muslims worry about halal (anything that is allowed and acceptable in Islam) vaccinations. For example, if porcine gelatin is used as a stabilizer for vaccines. This factor has called into question the measles vaccination in Indonesia in 2018. Recently, Indonesian Muslim clerics said Covid-19 vaccines are legal, as the manufacturers have assured they do not contain pork products.

Another controversial component is post-abortion fetal cells that were legally produced decades ago. These cell lines continue to be used to test some vaccines and develop others. However, the Vatican declared the Covid-19 vaccines “morally acceptable.”

In fact, throughout the history of vaccination, religious leaders have played an important role in promoting and administering vaccination – in their own interest to protect the health of their congregations. But along with spiritual opponents, there were others who opposed vaccination. During the Victorian era, English employers introduced the requirement for smallpox vaccinations, which met with fierce working class opposition. University of Utah historian Nadia Durbach denies claims by today’s vaccine opponents about the magnitude of the phenomenon:

“It was also more common than anti-vaccination today. There was more unknown in terms of vaccination science, and due to lack of sanitation, this process could easily lead to infection. “

Likewise, in 2004, union nurses challenged mandatory influenza vaccinations at Virginia Mason Franciscan Health. Parallels can still be drawn between today’s and historic vaccine protests. Anti-vaxx effigies are even burned from time to time in the US, like this May in Utah. But there is one important difference – the form of protests. Victorian protests often resembled a gay carnival. According to Nadia Durbakh:

“A common anti-vaccination demonstration involved driving a newly released anti-vaccination prisoner, often still in prison clothes, on a cart decorated with ribbons and banners and accompanied by a brass band.”

Childhood vaccinations are now mandatory in most US states and many European countries. We see now with regard to Covid-19, as before with smallpox, that vaccination requirements are increasing coverage – number of vaccinated children increased significantly compared to previous periods. There is no doubt that compulsory vaccinations can save many lives. Research has tirelessly proven that mortality among the unvaccinated is significantly higher. For example, in countries with compulsory measles vaccination, the incidence was 86% lower than in countries without it.

A general tension arises between commitment, which can increase public hostility, and voluntary vaccination, which can increase transmission. Some experts are worried about compulsory vaccinations, as such a policy could diminish the credibility of medical authorities in the long term. As an example, vaccination pledges sparked violent unrest in Brazil and fueled a vigorous anti-vaccination movement across Europe. A significant minority remains hesitant to get vaccinated, which indicates the importance of monitoring and strengthening relationships between health care providers and the public. Gavi Pediatrician and Medical Epidemiologist Lee Hampton says:

“Vaccination requirements are something to be handled with care, with the lowest possible level of enforcement. Its conditions of use should include the presence of a life-threatening disease, especially a highly contagious, life-threatening disease, and [безопасное] effective intervention to reduce transmission of this disease. This is usually a pretty good combination. It helps that the Covid-19 vaccines we have are really safe. Used carefully and wisely, the benefits of these mandates outweigh the harm. ”

So far, however, it is not entirely clear whether this is enough to convince skeptics. As you can see, the statements and actions of modern opponents of vaccination (in this case from the coronavirus) are not a new phenomenon, as history shows. At all times they have existed and were firmly convinced of their righteousness. However, reality proved the opposite, unfortunately often – at the cost of their own lives. Fortunately, they constituted an insignificant minority among the population, which helped humanity to defeat with the help of vaccines many terrible diseases that claim millions of lives.

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