The anti-vaccine movement fascinates me. The proof that vaccines prevent debilitating and often mortal illnesses is so well-established and so widely accepted by the scientific community that I just cannot understand how people examining this evidence honestly can fail to see its veracity. However, in every decision not to get the flu vaccine personally, in every decision not to have one’s child vaccinated, we see people carefully considering and rejecting a proven measure to prevent serious illness in themselves or a loved one. I have no doubt that it is the publicity that the anti-vaccine movement has received that has influenced these people. Their influence is so powerful that it even affects healthcare providers. In this report, a well-known Canadian infectious disease specialist recommends against mandatory flu shots because the legal challenges against this challenge “may not be winnable”: http://www.theglobeandmail.com/life/health-and-fitness/health/conditions/doctor-stirs-debate-over-mandatory-flu-shots/article10322395/. This article from the United Kingdom last summer outlined that the majority of doctors and nurses “declined” the flu shot the previous winter: http://www.independent.co.uk/life-style/health-and-families/health-news/health-officials-very-disappointed-that-most-doctors-and-nurses-declined-flu-vaccinations-last-winter-8662483.html
In the first case, it is evident that anti-vaccine ideology has become so mainstream that that the case for mandatory vaccination in a group at high risk for influenza, a serious illness and health workers do know this, is not “winnable” in a legal challenge. Have we all forgotten SARS? Even in Toronto? Toronto, Canada’s largest city, well-equipped, well-resourced, was brought to its knees by SARS. I guess we all assume an influenza epidemic could never be as bad as SARS. The second article is also telling. The article does consider that there may be logistical difficulties to being vaccinated against the flu but both of the hospitals I work in bend over backwards to make it easy to get the vaccination.
As I began my research for the series of blogs I intend to write this summer about vaccines and vaccines, I found this timeline of the history of vaccines from the College of Physicians of Philadelphia: http://www.historyofvaccines.org/content/timelines/all. Each entry has short articles associated with it and, while it naturally focuses on the American and Philadelphian situation, it is a complete detailing of the development of the scientific theories regarding infectious disease and the use of vaccines to prevent disease. The timeline shows us that the benefits of inoculation were understood in China before 1000 CE and, in a letter from the Emperor K’ang to his descendents, we read the following:
“The courage which I summoned up to insist on its practice (inoculation) has saved the lives and health of millions of men. This is an extremely important thing, of which I am very proud.”
We also learn from the timeline that George Washington had the troops of the Continental Army vaccinated against smallpox in 1777. The proof of the efficacy of vaccines is so clear from this history prepared by the doctors of Philadelphia, as is the stark reality of the devastation and personal suffering caused by the diseases they prevented. Today, not only has smallpox been prevented, it has been eradicated – thanks to smallpox vaccination. Vaccination is arguably one of the greatest medical success stories and yet even doctors do not routinely get their flu shot.
Perhaps not enough history is taught in medicine. I hope more doctors than those in Philadelphia will pause to look at timeline developed by the College of Physicians of Philadelphia and take a moment to reflect on the history of vaccines and the diseases they prevent. Otherwise the words of George Santayana may be a medicine’s fate:
“Those who cannot learn from history are doomed to repeat it.”