Of the many hardships the pandemic has imposed on America, especially for an infectious disease doctor like myself, the scourge of anti-vaccine sentiment and the resulting preventable deaths is one of the most frustrating.
People hospitalized with COVID-19 rarely refuse treatment, but acceptance of vaccines to help prevent infection is fairly limited. 70% of Americans receive their first complement of vaccine shots, and far fewer receive boosters designed to combat virus variants and provide additional protection. Why are so many people resisting this potential treatment?
Some explanations are peculiar to our time. For example, in the age of social media, the terrible weaponization of science in a highly partisan political environment. But the concept of vaccine hesitation is not new. Such hesitation is, in the larger sense, a rejection of science, a phenomenon that predates the existence of vaccines.
One of the earliest documented disputes of science denial comes from the field of astronomy. In the 3rd century BC, the Greek astronomer Aristarchus on the island of Samos proposed a heliocentric model of the universe. The idea that the earth and planets orbited the sun was so shocking at the time that Aristarchus’ theory was quickly dismissed in favor of models such as those put forward by Aristotle and Ptolemy. that the earth was the center of the universe. The fact that today Aristotle and Ptolemy are better known than Aristarchus demonstrates the power of rejection. It will take about 2,000 years before the concept is seriously reconsidered.
In the 1530s, Polish astronomer Nicolaus Copernicus developed his own heliocentric theory based on astronomical observations. Copernicus is remembered today primarily for this perspective-changing discovery. However, it is noteworthy that he delayed the publication of his findings until 1543, the year of his death, possibly for fear of scorn or religious opposition.
In the early 17th century, Italian astronomer Galileo Galilei, known as the “father of modern astronomy,” suggested that the Earth’s orbit around the Sun was necessary to explain the changes in the positions of the stars and the Sun over time. recognized. Galileo fully and publicly endorsed the Copernican theory of the heliocentric universe, and the condemnation from the Vatican was swift and severe. He was tried by the Inquisition and threatened with excommunication if he did not recant. Rather than incur the Pope’s wrath, he finally agreed that he was wrong and spent the rest of his life under house arrest. It took another 180 years for the church to admit that Galileo was right.
Rejection of scientific progress can be seen throughout the history of medicine. In the last 200 years, he has made four major advances in medicine. Anesthesia, disinfection, antibiotics, and immunity. Not all progress has met resistance. When the benefits of progress are obvious, there is little tendency to hesitate. For example, anesthesia and its cousin analgesia have gained rapid acceptance. They relieved pain and the benefits were immediately appreciated.
Preservatives have had a rocky road to general acceptance. In the 19th century, British and Irish physicians recognized that puerperal sepsis (a dangerous infection of the mother after childbirth) was likely an epidemic spread from patient to patient by medical staff or the community environment. They suggest that improved hygiene reduces the high mortality rate from postpartum sepsis. 1843, Oliver Wendell Holmes Sr., a physician Atlantic) submitted a paper titled “The Contagiousness of Childbirth Fever” to the Boston Society for Healthcare Improvement. Holmes suggested that unwashed hands among medical and nursing staff were responsible for transmission of puerperal fever. This did not sit well with the facilities. Charles D. Meigs, a prominent Philadelphia obstetrician, declared Holmes’ findings to be nonsense and suggested that the increasing number of cases associated with doctors was simply bad luck.
The doctor most often credited with establishing the contagiousness of this infection is Hungarian obstetrician Ignaz Semmelweis. He noted that patients at Vienna General Hospital who were cared for by physicians had a higher incidence of postpartum sepsis than those cared for by midwives. Instead, doctors found that they didn’t wash their hands or clothes before moving from autopsy to delivery. (Coming straight from the autopsy room, they routinely attended deliveries dressed in blood.) When he suggested simple hygiene measures such as hand washing, he was ridiculed and eventually ran out of town. Medical organizations were reluctant to admit that doctors were responsible for the spread of infection and harm to patients, rather than bad air or host weakness.
Science denial can also work in other directions. When antibiotics, especially penicillin, were first introduced, they were rightfully hailed as miracle drugs. The use of antibiotics has been surprisingly successful for many, but not all, childhood ailments. It happened when I asked for a substance. Fifty years ago, telling patients that they had a virus and therefore penicillin would not help led to disappointment, disbelief, and even altercations from patients demanding antibiotics for a simple cold. Many doctors gave up because it was easier than spending time fighting their patients. A consequence of the more indiscriminate use of antibiotics, which represents its own little genre of science denial, is the increase in bacterial resistance.
But of the four great advances, none has helped humanity more broadly or suffered from scientific denial than vaccination. Since the first vaccinations in the 18th century, most, if not all, vaccines developed by scientists have been developed against viruses. Of all viral infections, smallpox was perhaps the most feared. In the 20th century alone, estimated 300 million Died of smallpox. Smallpox is highly contagious and spares no age group or class. The estimated overall mortality for its common form is about 30%, while the mortality for hemorrhagic smallpox (the more serious form of the disease) approaches 100%. Smallpox is also highly contagious, a feature most evident when previously unexposed populations are exposed. Smallpox was unknown in the Americas until European explorers brought cases to the New World. As a result, the disease has depleted the indigenous populations of North and South America.
Early concepts of vaccination to prevent smallpox may have originated in China over 1,000 years ago.History is contested, but some document Shows children being inhaled by uprooting and maturing smallpox lesions scraped from the bodies of infected individuals. This is the level of exposure that can trigger a person’s immune response to smallpox without causing a full-blown infection. The subsequent technique of scratching the skin of an uninfected person with material from another person’s lesion was observed by the wife of the British Ambassador in Istanbul, after which the procedure was brought to Europe. Impressed, I got my children vaccinated. An experiment was then conducted in which six of her prisoners in London were vaccinated. Despite contracting smallpox, no one fell ill.
Like many advances in medicine, smallpox vaccination was accepted by some. resistanceIncluding concerns that vaccination might inadvertently spread the disease to others. This was an understandable response. Live smallpox virus was used, and a small proportion of the inoculated individuals developed full-blown disease and died. In 1721, there was a smallpox epidemic in Boston. Writer and clergyman Cotton Mather advocated for widespread vaccination, but met with only moderate success because of resistance from the local population. (Mother was also an ardent defender of the Salem witch trials.) Years later, a well-known case of vaccination resistance occurred in Philadelphia. When a smallpox outbreak broke out in 1736, Benjamin infected his four-year-old son of Franklin, Francis, and died. Francis had the opportunity to be vaccinated, but he did not.
In subsequent generations, scientists built on these early methods and eventually developed a stable and widely available smallpox vaccine. , one of the greatest achievements in the history of medicine. The last case of spontaneous smallpox was reported over 40 years ago.
Still, vaccine hesitation persists. In America, new vaccines against other diseases continue to provoke a wave of skepticism and hostility. Science denial is not as prevalent as it was centuries ago, but it still rears its ugly head. The advent of the COVID-19 vaccine has put harmful vaccine sentiment into the limelight. There are many reasons for this intensity. For example, some people who might accept the efficacy of vaccines are so afraid of injections that they avoid seeking medical care until absolutely necessary. represents the people of
A more pervasive, more insidious force keeping people away from life-saving vaccines appears to be a growing distrust of expertise, both a political and cultural phenomenon. Vaccine resistance can be propagated by influential people in both liberal and conservative circles, but throughout the pandemic, right-wing rebels and TV personalities in particular have turned into a lavish conspiracy-theory stew about vaccines. Common misinformation is still a problem. Some people continue to believe that the COVID-19 vaccine will infect them and make them sick, but this is not the case. Finally, of course, there are concerns about known and unknown side effects from vaccination. Like many vaccines, COVID vaccination is associated with serious health consequences in very rare circumstances. For example, Moderna and Pfizer mRNA shots are associated with a very low risk of heart inflammation. It is virtually impossible to prove that some side effects do not occur. so far break out. But hundreds of millions of people in the US alone are safely receiving his COVID vaccine.
Perhaps the greatest detriment to vaccination is the fraudulent claim that childhood vaccines cause autism. This claim was originally published in an otherwise respected medical journal in the 1990s and has since been completely retracted. (The author has lost his medical license.) Nevertheless, many still believe this, putting their children at risk of serious illness as a result.
While our scientific progress over the past two centuries has been truly remarkable, our society still suffers from forces that reject reason and hinder our ability to make the most of the discoveries that protect us all. increase. We also need to find opportunities to gain fame or profit from spreading dangerous disinformation and resist those who put others at risk. Until that happens, our species will continue to make sense of the world around us.