Wednesday, February 11, 2015

Advancing Modern Healthcare to the 1700s

1796...AD.  Edward Jenner develops the world's first vaccine for Smallpox.  For most of us, smallpox is as described here - ancient history.  This horrific disease terrorized the world for most of recorded human history by blanching its victims with a gut-wrenching outer appearance in addition to internal trauma.  Smallpox claimed the lives of over 20% of those who contracted the disease, including 5 European Monarchs and a Pharaoh.  Yet, smallpox was not limited to the Egyptians, the Renaissance, or even the Victorians.  To illustrate the recency of Smallpox devastation, the World Health of Organization estimates that smallpox was responsible for 2 million deaths in 1967, only 20 years before many of you reading this were born.  After a herculean effort, Smallpox was eradicated in 1980, one of man's greatest achievements.  After Jenner's success, vaccines were developed for Cholera (1879), Tetanus (1890), Tuberculosis (1925), Whooping Cough (1927), Polio (1952), Measles (1963), Chicken Pox (1974), and many others.  Despite the success of the development of these vaccines, only Smallpox has been eradicated and many of these diseases present a serious health issues in many of the world's undeveloped countries.

Typically just a checkbox for children and those entering high school and college, vaccines have anchored themselves in the news cycle because some parents are choosing not to vaccinate their children.  These decisions have been spurred by a myriad of fallacies, the foremost of which is the spurious notion that vaccines cause autism.  This false movement was started in part by Andrew Wakefield, a British physician who lost his medical license after the paper he submitted to the Lancet linking vaccines to autism was discredited.  Others have attacked some of the ingredients included in vaccines, which can include Mercury and Formaldehyde, which on the surface can appear disconcerting, but are safe in small quantities and serve a purpose.  Regardless of the reason, once a critical mass of people has become inoculated, herd immunity is established, which protects those who are unable to receive vaccines due to other pre-existing conditions (yes, my girlfriend has a public health degree :)).  Once this herd immunity breaks down, the risk of infection for those with immunodeficiencies skyrockets, as was recently evidenced in Disneyland.

Many others have provided their take on this ...bizarre? change of opinion in parents' health policies.  I do not have the technical background to provide a unique take on this from a scientific perspective.  Instead, let's look at this from an emotional perspective and how offensive this is to those who came before us.

My grandmother passed away a few months ago.  She was born in 1919, and in addition to living through the Great Depression, several wars, and the invention of the television, modern air travel, nuclear power, all things stemming from the integrated circuit, and gogurt, she could bake a mean chocolate cake and fried apricot pie.  But, she was also born before vaccines had been developed for all of the above diseases except for Smallpox, Cholera, and Tetanus.


It is difficult for our generation to fathom the anxiety associated with exposure to these diseases.  For those who have never seen an iron lung (<-- an incredible story), or are unaware of how extremely contagious Measles was and still is, neither bit of knowledge is particularly positive.  While every parent frets over the health of their young children, early 20th century parents must have felt like their children had to crawl through a minefield of infectious disease. Imagine telling a mother in 1900 that in 75 years, virtually all concern of exposure to these viral diseases would be eliminated.  Imagine first her disbelief and then her desire to do anything in her power to provide that immuno-defense for her children.  Yet, here we are in 2015, saving our nose to spite our face as we comb through statistics to showcase the literally one-in-a-million instance where vaccines could present serious consequences to gloss over the wonderful benefits they have afforded us.  How many of us would have volunteered for an Ebola vaccine if we knew it had the same success rate as vaccines for Measles, TB, and Whooping Cough?  What about a vaccine for HIV?

For those who would like to point out that science can reverse itself, you are correct. It has perhaps most famously occurred in the fields of astronomy and physics.  The earth was the center of the universe.  Then it was the sun.  Now we are pretty damn insignificant.  Newton was right...until Einstein was.  The data supported these transitions in scientific theory.  It is entirely feasible that a medical breakthrough could produce a treatment more robust and more safe than vaccines, but at this point in human history, vaccines present the best option for the overall health of humanity.


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