The Vaccine Narrative

I just finished the book "The Vaccine Narrative" by Dr. Jacob Heller.  I feel it is a good idea to post a review of it on here, since it fits all of what I am trying to do with this blog.  Fair warning, if you intend to read this book without spoilers, this review does have spoilers a plenty.

Dr. Heller looks at the narrative through history of the pro-vaccination side of the public argument we all know about.  He opens with the sentiment that yes, he is pro-vaccination, but he also feels the need to correct misconceptions which are prevalent in the narrative propagated by his side of the public debate.  The best way to convince those with legitimate concerns about vaccines (not those who are anti-vax conspirators, but those who have questions as a result of those conspiracy theorists) is to be completely open and honest about all aspects of vaccines, not just those aspects which are positive.  The first step in being honest to concerned parents is to be honest with ourselves.

The book begins with the creation of the smallpox vaccination, and how it's creation was more out of luck than out of scientific rigor.  Most of us know the story of how Edward Jenner noticed that the milkmaids who milked cows with cowpox were seemingly immune to smallpox, and used this apparent fact to use the non-deadly cowpox as the basis for the vaccine for the very deadly smallpox.  Dr. Heller describes correctly that this was a lucky hunch more than anything, as there weren't enough cases of cowpox producing immunity to warrant risking the masses.  This was also before the development of the germ theory of disease, so he had no theoretical means for testing the biological effects of one on the other.  We are all glad that this happy accident happened, but it was just that; an accident.

Heller then goes into the Diphtheria vaccine, and how this is the beginning of the modern vaccine and the narrative behind them.  This vaccine was developed using something other than luck and chance of being in the right place at the right time.  The researchers not only had the basis for the germ theory of disease, they used it for the development of the vaccine.  While the germ theory was still more hypothesis than anything at the, this vaccine was still developed using it.  Since the germ theory which was the backbone of the development of the vaccine, the researchers had to perform more rigorous trials in order to get it approved for mass usage.  When this vaccine was released to the public for use, is was a victory for both vaccines and the germ theory of disease.  The lucky break here is that they used an incomplete hypothesis for the vaccine development, one where some aspects were not entirely correct.  The development of the vaccine helps fill in some blanks and correct some of the misconceptions in the hypothesis, but it was lucky that the hypothesis brought about the vaccine.

In the second chapter, the Rubella vaccine is brought up as the first major vaccine which deals with a disease which is not fatal at all.  The major issue of the disease is a small increase in the likelihood of birth defects.  In an era before Roe v. Wade made abortion legal and before World War II began to change the role of women in the household (and our cultures sexist tendencies), the rubella vaccine was developed as a tool of sexism to keep women barefoot and pregnant in the kitchen.  All of the scientific concern with the rubella disease was that it may ruin the foundation of the Working-Man/House-Wife paradigm which drove American Culture.  The same arguments against feminism today (not misandry, or as misogynists call them, feminazi's) were arguments for developing the rubella vaccine in the 1940's.  This is a hole in the vaccine narrative in America which anti-vaxxers could very well fill with their vitriol.  The opposition to this one vaccine in particular came in the form of whether the side-effects were worth the minor gain of the vaccine.

Next comes the Pertussis Vaccine, which had it's own issues.  there were side-effects of the vaccine which were wholly in the realm of non-fatal, and the vaccine used killed versions of the disease in the vaccine.  These two facts, combined with the Cutter incident (a different vaccine, but the mentaility of lumping all vaccines together was strong), helped convince some parents to create Dissatisfied Parents Together, a group which demanded much safer vaccinations.  They were a group who used legitimate science to say that the vaccines need to be made safer for use on the masses.  They bring up the concept that the absolute across the board requirements for safety of vaccines are too lax, especially when vaccines are not all equally effective or are used against equally deadly diseases.  This group is not completely anti-vax, for they completely understand the need for them and do not demand not vaccinating children; they are merely calling for a more stringent legal definition of safety for vaccine research and vaccine production.

The final disease talked about in this book is HIV/AIDS.  While there is no vaccine for this disease, here in 2017, it does fit in the vaccine narrative.  When it was first detected in 1981, researchers thought that a vaccine for it would be easy enough to manufacture, so long as they could convince a government who wanted to steer away from condoning sexual deviance (unprotected gay sex) and supporting drug use (what the war on drugs would eventually go against) help finance the search for a vaccine.  In short order, it was obvious that developing a vaccine for HIV would be exponentially more difficult than for other diseases.  Soon, it would be obvious that vaccines may not be a viable option for all dangerous diseases, despite what the pro-vaccination narrative might want to believe.  There are some diseases which are immune enough to vaccines that a development of a vaccine would legitimately bankrupt big corporations before it gets on the market.  For all practical purposes, vaccines cannot be developed for all diseases, or even for all deadly diseases.

This book does well in being both pro-vaccine and pro-honesty.  Yes, vaccines are vital for eradicating disease, especially of the deadly variety, but we on the pro-vaccine side need to be more honest about the realities of vaccines.  Some of them were developed from luck, others from incomplete hypotheses, others still from sexist tendencies, and some vaccines do not have a strong enough of an efficacy to warrant it's widespread use as is given the non-fatal nature of the disease.  We must also accept the notion that vaccines may not be able to be developed for every disease.  These truths we must admit to ourselves, because we must also admit them to parents in order for them to provide fully informed consent.

So until next time, take that as you will.

K. "Alan" Eister Δαβ