According to a recent article in The New York Times, “the United States is helping to lead a large study of two vaccines against Ebola.

 

By Paul Hicks

According to a recent article in The New York Times, “the United States is helping to lead a large study of two vaccines against Ebola. But as researchers try to compress a clinical process that can take a decade into a fraction of the time, they are confronting the same volatile mix of skepticism, fear, false rumor and understandable mistrust that helped spread Ebola in the first place.”

A few days earlier, the Times reported: “Legislative efforts to increase pressure on parents to get their kids vaccinated failed in Oregon and Washington State Wednesday amid stiff opposition as a handful of other statehouses consider similar bills prompted by a measles outbreak at Disneyland.”

The controversy started with the 1998 publication of a fraudulent research paper in the medical journal The Lancet that lent support to the later discredited claim that colitis and autism spectrum disorders are linked to the combined measles, mumps, and rubella (MMR) vaccine.

Meanwhile, the government of Pakistan is said to be increasing efforts to eradicate polio from the country, despite the murders of numerous health workers by the Taliban. Parents in a northwestern province were sent to jail following their refusal to let their children be vaccinated because they believed that vaccinations were a plot by the West to make Pakistanis infertile.

These current examples of anti-vaccination opposition around the globe are just the latest in a long history of fear and resistance that dates back to experiments in the eighteenth century by physicians seeking a cure for smallpox. The name of the infectious disease, also called variola, derived from the sac-like marks (pocks), was distinguished from the Great pox, which was the common name for syphilis.

The method first used for the immunization of an individual against smallpox, called variolation or inoculation, involved inserting material taken from a smallpox victim into superficial scratches made in the skin of an individual. The patient would develop pustules identical to those caused by naturally occurring smallpox, usually producing a less-severe disease than naturally-acquired smallpox but followed by future immunity to the disease.

The introduction of variolation in North America is credited to promotion of the procedure by Cotton Mather and Dr. Zabdiel Boylston during a smallpox epidemic in Boston during 1721. Use of variolation spread slowly throughout the colonies because of fears and, in some cases, fundamentalist religious opposition. Among those who survived without being inoculated was George Washington, who endured a bout of smallpox in 1751.

In his 1871 history of Rye (“Chronicle of a Border Town”), the Rev. Charles W. Baird describes the trouble that smallpox inoculation caused among Rye residents in the 1760s when “It awakened the liveliest fears of the ignorant everywhere. In some places inoculation was absolutely forbidden and physicians performing it were liable to severe penalties…”

Baird quotes from a notice of April 4, 1763 from James Wetmore in Rye, who “‘acquaints all persons that are disposed to be inoculated, that they may be well accommodated at his house, where constant attention will be given by Dr. Nathaniel Downing…who has inoculated a number of persons there that have had Small-Pox uncommonly light.’ But the inhabitants watched these proceedings with an evil eye. Their alarm and displeasure found vent before long at a lawful town meeting, which was held at the school-house in Rye, April 2, 1765.”

The meeting resulted in a Town regulation that imposed a penalty of five pounds on anyone who took any person into their home to be inoculated unless they had obtained permission from two Justices of the Peace and the Town Supervisor that it is “at a convenient place and from a public road not nigh to neighbors.”

Despite support from Washington, Franklin and Adams, widespread public resistance to inoculation still persisted in the early years of the Revolutionary War, causing the Continental Congress to issue a proclamation in 1776 prohibiting inoculation by military surgeons. Smallpox was rampant among the Continental army, but most of the British troops had been inoculated. Then in 1777, Washington ordered a mass inoculation of his troops, which some historians believe played an important role in winning the war.

A safer vaccination procedure was introduced by an Englishman, Edward Jenner, in 1798. After observing that milkmaids who had caught cowpox (a milder related disease) did not later catch smallpox, he was able to prove that vaccinating a patient with fluid from cowpox lesions would provide protection against smallpox.

Louis Pasteur’s 1885 rabies vaccine was the next to make a major impact on human disease. It was followed by the development of vaccines against diphtheria, tetanus, cholera, typhoid, tuberculosis, polio and other diseases. But despite all the successes, the fears about vaccinations today echo those voiced two hundred fifty years ago when the people of Rye feared the effects of variolations. For an excellent summary of the concerns, look online for the World Health Organization’s “Six Common Misperceptions about Immunization.”