By Jo Dean April 30, 2020
Vaccinations have been in the forefront of news in this tumultuous time as we await the development of a Covid-19 vaccine to add to the arsenal of vaccines that have been used to fight illnesses over the last several centuries.
The first use of inoculation, a forerunner of vaccines, is thought to have started around the year 1000 with the Chinese inoculating for smallpox, a disease with a death rate of 30%. In 1777, George Washington ordered mandatory inoculation for smallpox of his troops unless they had already survived smallpox as a child.
Not only smallpox, but numerous other deadly bacteria and viruses ravaged humanity. In 1735, a diphtheria epidemic in New England killed 32% of all children under the age of ten. Many children buried by our ancestors died of diseases that are now preventable with vaccinations.
Locally, Ft. Buchanan, founded in 1856 in the Hog Canyon area of Sonoita, was abandoned in 1865, partially because of malarial diseases and other maladies, many which would have been avoided with vaccines. Every soldier stationed at Ft. Buchanan suffered from mosquito borne diseases, according to an Army Sanitary Report written in February 1859. Of those that survived, some went on to fight in the Civil War where their odds of dying from disease and infection were higher than dying on the battlefield. The Union Army saw 67,000 cases of measles with 4,000 deaths. Of the 660,000 deaths incurred in the Civil War, two-thirds were due to infection and diseases.
People born in 1920 lived their first 20 years during the development of vaccines for tuberculosis, diphtheria, scarlet fever, tetanus, pertussis (whooping cough), yellow fever, and typhus. After 1940 the first vaccines for tick-borne encephalitis, influenza, the Salk vaccine for polio, Japanese encephalitis, anthrax, and adenovirus were developed. In the 1970s the first oral polio (Sabin Vaccine), measles, mumps rubella (German measles), chicken pox, pneumonia, meningitis vaccines became available. In 1980, the greatest global medical success, the eradication of smallpox worldwide, was announced.
Vaccines continue to develop worldwide for diseases that are common in many countries including malaria, Ebola, and dengue fever. Vaccines have been introduced for many diseases common in the United States, including hepatitis A and B, Lyme disease, rotavirus, flu, human papillomavirus (cervical cancer), and enterovirus 71 (hand, foot, and mouth disease).
Just receiving a vaccine for a disease is not enough. There is the term “herd immunity” or community immunity. Herd immunity is the ultimate in social altruism. We are vaccinated not only to protect ourselves but to protect others. Herd immunity is effective only if 80% to 95% (depending on the disease) of the population is immune to the disease either by developing natural immunity or through vaccination. Herd immunity then protects the most vulnerable of the population who cannot be vaccinated such as young babies, young children, the elderly, pregnant women, and those with weakened immune systems.
There are people who are anti-vaccination or ‘anti-vaxxers.’ Many anti-vaxxers are also millennials (born between 1981-1996). In the Patagonia, Elgin, and Sonoita areas most are Caucasian, college educated parents who want to do their best for their children. The current anti-vax movement, started with a vaccine-autism study published 20 years ago in the medical journal “The Lancet” by Andrew Wakefield, a former British doctor who linked the MMR (measles, mumps, and rubella) vaccine to autism. People in the United Kingdom were the first to follow Wakefield’s science. Consequently, the UK suffered 12,000 cases of measles, hundreds of hospitalizations, many serious complications, and three deaths. Wakefield was found to have perpetuated a myth in a world where fabricated science spreads faster than a disease. Wakefield was de-licensed for a “callous disregard for the welfare of children.”
The long-term effects of his study remain today. Many people choose home-schooling to maintain their right of personal exemption from vaccines in public schools. Many private schools do not require vaccinations. It is estimated that only 20% to 40% of the children in Montessori and Waldorf schools are fully vaccinated. Home schooled children in California have a 24% vaccination rate.
In Arizona, private schools have similar rates, way below the safe herd immunity level of vaccinations. Public schools in Arizona, per county, have averages differing according to education and ethnicity. Counties with higher Latino populations have higher vaccination rates, usually above 95%. The lower vaccination rates occur in Mohave and Yavapai counties, Yavapai with a full 10% of student population self-exempt from every vaccine. Santa Cruz County has the highest rate of vaccinations in the Arizona public school population with only 0.5% of the students exempt from all vaccines.
Molly Anderson M.D. from the Mariposa Clinic in Patagonia stated, “This country has a very individualistic culture and people don’t always think about their community when making personal medical choices.” Dr. Anderson estimates 25% of all her patients offered the annual flu vaccine turn it down for fear of side effects.
“What I would say is that Elgin School maintains compliance with state requirements for students to either be immunized or have an exemption form on file,” wrote Annette Koweek, Elgin School science teacher and school nurse. “We are participating in an initiative through the Arizona Department of Health Services for parents to view learning modules about the vaccinations they want to exempt their children from before they sign the exemption form. We are hoping to increase education and promote vaccination for those children who are able to receive the vaccines, in support of herd immunity for all – and especially for babies, and children and adults who are unable to receive them because of medical concerns. Most families who do choose to exempt their children do so for all the vaccines, not just a few. I am happy to report that we are seeing fewer parents opt their children out of any immunizations.”
This feels like an unprecedented crisis that we are dealing with today, but we are not the first generations to experience the devastating effects of a life threatening, highly contagious virus. The suppression of communicable diseases through vaccines and antibiotics has been so successful in modern times that we have perhaps become complacent, but it is important to remember that COVID-19 is only the latest in a long history of pandemics that have exposed us to the harsh reality of a world without vaccines.