Cleaveland: Vaccinations and the public's health

The SafeSEAL(TM) antimicrobial soft diaphram slips onto any stethoscope effortlessly. Changed only once a week, SafeSEAL(TM)  helps provide protection against harmful bacteria commonly found on stethoscopes. Available in adult, pediatric and infant sizes. (PRNewsFoto)
The SafeSEAL(TM) antimicrobial soft diaphram slips onto any stethoscope effortlessly. Changed only once a week, SafeSEAL(TM) helps provide protection against harmful bacteria commonly found on stethoscopes. Available in adult, pediatric and infant sizes. (PRNewsFoto)

Vaccination represents a milestone in mankind's fight against numerous infectious diseases.

Smallpox, a viral illness, attacked vulnerable populations for centuries, killing many victims and severely disfiguring survivors. In China, India and Turkey many children were "inoculated" with material taken from sores of persons suffering from a milder form of the disease. The technique protected most of the recipients from subsequent smallpox. A tiny fraction of inoculated children died.

photo Clif Cleaveland

In 1796, British physician Edward Jenner observed that milkmaids in his rural district did not contract smallpox, a disease that frequently swept the countryside. He learned that the milkmaids developed temporary sores on their hands, similar to lesions on the cows' udders. Surmising that "cowpox" protected against smallpox, Jenner injected 8-year old James Phipps with material taken from a pustule on the hands of an infected milkmaid. The boy had minor symptoms, which quickly subsided. Six weeks later Jenner injected the boy with material from a smallpox lesion. He published his findings, launching "vaccination" as a means of protection against specific, infectious diseases.

Resistance to both inoculation and vaccination came from some religious leaders who stated the treatment interfered with God's will. During an epidemic of smallpox in Boston in 1721, Rev. Cotton Mather promoted inoculation. Violent opposition arose from some religious and medical spokesmen. Mather prevailed, and the epidemic subsided.

Vaccination spread. The last case of smallpox occurred in North America in 1952. After an intensive, worldwide campaign, the World Health Organization certified the global eradication of smallpox in 1980. Several countries maintain weaponized smallpox as potential tools in future wars.

Louis Pasteur proved the effectiveness of a rabies vaccine in 1885. The first half of the 20th century saw the development of vaccines against pertussis (whooping cough), diphtheria, tetanus and typhus.

For the general public, the development of a polio vaccine represented a universally acclaimed triumph. Largely unknown in epidemics before the 20th century, the viral disease could afflict thousands of children and young adults within a city or countryside during summer months. The majority recovered completely. A small percentage suffered varying degrees of paralysis, which was often permanent. Some spent months or years within "iron lungs" which sustained their breathing. Some died.

More than 2,000 polio-related deaths were recorded in New York City in 1916. The most severe polio epidemic in the U.S. occurred in 1952, resulting in more than 57,000 cases, which included 3,100 deaths, and 20,000 victims with varying degrees of paralyzed or weakened muscles.

Communities responded to outbreaks with closure of swimming pools, movie theaters and public venues. Fear was widespread and blame for outbreaks sometimes was directed to poor people and racial minorities.

For years, a nationwide campaign, the March of Dimes, raised money for research, treatment and rehabilitation of victims. President Franklin Roosevelt, paraplegic from probable polio in 1921, publicized the annual fund and awareness raiser.

Dr. Jonas Salk became a national hero upon the release in 1955 of an injectable polio vaccine whose development he had led. Six years later an oral vaccine, developed by Dr. Albert Sabin, was released. Except for a few pockets of disease in Pakistan, Afghanistan and Nigeria, polio has been eradicated. When asked who owned the patent for the polio vaccine, Dr. Salk replied, "Why the people, I would say. There is no patent. Could you patent the sun?"

Numerous other vaccines followed, providing protection against measles, rubella, mumps chickenpox (varicella), bacterial meningitis, influenza and common strains of pneumonia. The vaccine for hepatitis B protects against liver cancer associated with infection by that virus. The vaccines for human papilloma viruses prevent many cases of cancer of the cervix. Work continues to develop vaccine for dread diseases such as HIV, malaria and Ebola virus.

Despite those accomplishments, an aggressive, anti-vaccination movement persists in the U.S. That will be addressed in my next column.

Contact Clif Cleaveland, a retired physician, at ccleaveland@timesfreepress.com.

Upcoming Events