A well-to-do mother resistant to her daughter’s doctor using a vaccine from their neighbour’s child; illustrating the narrow-mindedness of the petty provincial middle classes. Wood engraving by G. Du Maurier, 1872. Wikimedia Commons.
In our Spring 2014 issue, the philosopher Donna Dickenson discussed the rise of personalized medicine in her essay, “In Me We Trust: Public Health, Personalized Medicine, and the Common Good.” Dickenson’s essay considered topics outside of the antivaccination movement, but we’ve excerpted her comments on it here in light of the recent outbreak of measles at Disneyland and the subsequent discussion in the media. You can read the whole article—including her wider analysis of personalized medicine—here.
Consider the antivaccine movement, which is of even greater importance to public health than hostility to communal blood banking. The first and only contagious disease to have been completely eradicated, smallpox, was defeated through vaccination. But as medical historian Arthur Allen notes in Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver (2007), “While vaccination seems to be more efficient and safe than ever before, public ambivalence about the practice has rarely been higher.” A growing body of public opinion appears to view public health programs as no less threatening—and possibly even more so—than the diseases they are meant to protect us from.
It is not so difficult to understand why many people view those diseases as less of a threat than they used to be. In the nineteenth century, all social classes were more or less equally vulnerable to epidemics of maladies such as cholera, smallpox, and typhus. Perhaps those who had their own wells, provided they were clean, were somewhat protected against cholera arising from contamination of the public water supply, but that would mainly apply in rural areas. Whether rich or poor, city dwellers were all at risk. Infectious disease was no great respecter of social hierarchy.
But the very success of public health programs against the mass contagious diseases of the past, at least in better-off parts of the world, now leaves cancer and heart disease as the leading causes of mortality. For example, statistics for the United Kingdom in 1912 listed bronchitis, tuberculosis, pneumonia, and measles among the top ten killers, whereas pneumonia remained the only infectious disease among the ten leading causes of death in 2012. Ischemic heart disease and lung cancer occupied the first two slots in the 2012 figures. With the exception of a few tumors to which there is a viral link (such as Kaposi’s sarcoma, a tumor caused by human herpesvirus 8), heart disease and cancer strike one individual at a time, despite loose talk about “the cancer epidemic.” We die at an older age, but we increasingly die of individualized illnesses. Those are the ones many of us fear most.
Yet that doesn’t entirely explain why so many of us not only seem complacent about infectious disease but fearful of one of the most important mechanisms for preventing it. If anything has reached epidemic proportions, it is the distrust of government vaccine programs. Again, though one might get a different impression from high-profile campaigns in the United States against the vaccines for measles, mumps, and rubella, including appearances on The Oprah Show by prominent vaccination opponents, this sense of beleaguered hostility is not just an American phenomenon. A commenter on a Daily Mail newspaper article about a supposed link between the “swine flu” jab and a “killer nerve disease” wrote,
I find it very interesting that the vaccine does the opposite of what it’s supposed to do. Is anyone open to the thought that this is intentional? That the people in power are using this as a means for population control? And the fact that governments are in the process of making the vaccine MANDATORY?
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