Vaccine opposition has ebbed and flowed over centuries

NEW YORK (AP) — They're considered one
of mankind's greatest medical
achievements, yet people have balked at
vaccines almost since the time of the first
vaccination — in 1796, when an English
country doctor named Edward Jenner
inoculated an 8-year-old boy against
smallpox.
In the mid-1800s, people protested in the
streets of Victorian England after the
British government began requiring
citizens to get the vaccination. Many
opponents mistrusted doctors and were
wary of a medical treatment they didn't
understand. In the early days, the closely
related cowpox virus was used to
immunize people against smallpox.
"People were afraid that if you got the
cowpox vaccine you would turn into a
cow," said Dr. Paul Offit, a vaccine
researcher at Children's Hospital of
Philadelphia who is an outspoken critic of
anti-vaccination groups.
More than a century and a half later,
there's still an undercurrent of vaccine
dislike and distrust in the United States as
illustrated by the measles outbreak that
started in December at Disneyland — likely
brought in from overseas as has been the
case in recent years. Many of those who
got and spread the highly contagious
illness hadn't gotten the childhood shots.
All this despite medical science's proven
successes in wiping out not only the much-
feared smallpox and polio, but nearly
eliminating other serious illnesses like
diphtheria, German measles, lockjaw and
mumps in the United States. Through it all,
anti-vaccine sentiments have ebbed and
flowed.
"It is fair to say that for as long as we've
had vaccines, governments have worked to
promote those vaccines — and segments
of the population have resisted," said
Jason Schwartz, a medical historian who
studies vaccine policy at Princeton
University.
In the U.S., opposition to vaccines was
most intense in the late 1800s and early
1900s, said Susan Lederer, chair of
medical history and bioethics at the
University of Wisconsin.
That's when organizations like the Anti-
Vaccination League of America and the
American Medical Liberty League led the
charge. Some used photos depicting
vaccinated children with scars and missing
limbs and eyes, claiming immunizations
were to blame.
"For a long time in history, people treated
anti-vaxers as irrational and anti-progress
— kind of a lunatic fringe. But there were
good reasons to be leery of vaccines" back
then, she said.
Vaccines sold at the time were
unregulated, and many were not only
ineffective but also risky because of how
they were made or given. Some were not
sterile and infected children with other
germs, like tetanus.
But opposition faded. Legal challenges to
school-attendance vaccination laws were
shot down by the U.S. Supreme Court.
Vaccine makers came under more federal
regulation, and the shots were better and
safer. And some of the richest and most
influential opponents died off.
By the end of the 1930s, resistance had
declined dramatically. And by the 1950s,
the pendulum had swung. Medical science
was widely respected, doctors were
considered sages, and one of the nation's
greatest heroes was Dr. Jonas Salk —
inventor of the polio vaccine.
Polio — a crippling and potentially fatal
infectious disease — terrified the nation.
In the early 1950s, outbreaks caused more
than 15,000 cases of paralysis each year.
When researchers in 1955 showed Salk's
vaccine worked, the news spurred
jubilation. One medical leader pleaded
with adults not to grab the limited doses
of the vaccine.
"Give the children priority," begged Dr.
Dwight Murray, chairman of the American
Medical Association's board of trustees.
Enthusiasm for the polio vaccine persisted
even after news surfaced — only weeks
later — that some early batches had
caused polio in children.
"If something similar happened today, it's
hard to imagine a vaccination program
going forward," Princeton's Schwartz said.
The anti-vaccine movement overall kept a
fairly low profile until 1998, when a British
medical journal published a now
discredited study in which researcher
Andrew Wakefield and his colleagues
suggested a link between the combination
measles-mumps-rubella vaccine and
autism.
It was a small series of observations in
just a dozen children, not a full medical
study. But it exploded in the media, and
resulted in a big drop in immunization
rates in Britain. The effect was not nearly
as dramatic in the U.S., but researchers
estimate that as many as 125,000 children
born in the late 1990s did not get the
shots because of the report.
The United States then was on the verge
of seeing the end of "homegrown"
measles — health officials declared that
goal accomplished in 2000. Still, the
Wakefield study knocked even prominent
U.S. vaccine experts off balance and
emboldened vaccine skeptics and some
legislators to raise alarms about vaccines.
The years 1998 and 1999 marked a low
point for those who championed vaccines,
Schwartz said.
But the situation soon changed. When
other researchers did larger and well-
designed studies, they found no link to
autism. Wakefield's work was discredited
and his paper retracted. But all this
happened during an era of growing rates
of autism diagnoses, and an array of
parents groups and some celebrities
continued to believe vaccines were the
cause.
Overall, vaccination rates for kindergarten
pupils have held steady across the country,
although health officials have noted
certain communities have seen increasing
numbers of families who have refused to
vaccinate their children.