Pasteur and his work : from an agricultural and veterinary point of view
Pasteur’s research on microscopic organisms that led to the discovery of the processes of fermentation and pasteurization have been celebrated in the history of medicine and public health, but his work had an impact on the field of agriculture as well. The nineteenth century saw the beginning of the mass movement of people into cities in Europe and the United States. Some city dwellers kept animals – pigs and chickens especially – close at hand in their new homes. Dairies, shepherds, and other animal farmers expanded their stock in order to provide more butter, milk, cheese, wool, and meat for urban dwellers who had to buy these items in the market. The result was that animals were coming more in contact with each other and epidemic diseases in animals devastated larger numbers and affected human beings both directly – as sources of disease to humans – and indirectly, as shortages affected the food supply. Pasteur’s development of vaccines for rabies and anthrax were key developments in stemming epidemics: rabies was frequently transmitted from dog bites to children in cities, and anthrax killed hooved livestock and could make humans sick as well. The above image demonstrates how to effectively inoculate a sheep against anthrax; according to the directions, two men working in this way could vaccinate up to 150 sheep or goats per hour.
The Preparation of Diphtheria Antitoxin and Prophylactics
While anti-vaccinationists in the early twentieth century liked to point to the cultivation of cowpox virus in cows and its transmission to humans as a source of contamination and impurities [link to the “What is Vaccine lymph” document in anti-vax docs], scientific authorities in later decades documented processes such as these in order to demonstrate to the public the safety and cleanliness of animal facilities. In this film, produced for British audiences at the end of World War II, we find out first how diphtheria toxins and antitoxins act on the body, then are taken on a tour of a laboratory where the virus is purified and attenuated for use in medicine. The narrator provides details on how frequently and under what conditions the antitoxin is harvested from the horses, to show the reader that everything is done in accordance with the strictest principles of hygiene. Finally, as proof of the safety of this process, statistics on falling diphtheria rates since 1894, when the vaccine was first used, are shown.
Mobile Vaccine Clinics, c. 1955
This image, captured in 1955, was published in a 1994 exhibit catalog celebrating nearly 200 years of the United States Public Health Service (USPHS). Originally established by Congress as the Marine Hospital Service in 1798 to assist and quarantine sick and diseased seamen, this federal organization evolved over decades to promote the public’s health both domestically and internationally. In the 1950s, as more vaccines became available for more communicable diseases – notably polio – the PHS took on the duty of distributing vaccines widely, especially in rural areas and populations underserved by doctors.
The 1962 Vaccine Assistance Act
This Kennedy Administration policy was passed by Congress in 1962 to provide federal funding for local and state immunization programs. At this time, vaccines were available for diphtheria, poliomyelitis, tetanus, and whooping cough, and national surveys showed that these diseases were most prevalent among preschoolers in impoverished areas, which also had the lowest vaccination rates. Not all doctors agreed, however, on whether a federal program for vaccination assistance was necessary, as evidenced by the following series of medical journal editorials.
Kansas
The editor of the Journal of the Kansas Medical Society urged his readers to consider the reasons why the bill had been passed before they jumped to conclusions about government interference in the practice of medicine.
South Carolina
The editor of the Journal of the South Carolina Medical Association questioned whether mass vaccination was important enough to divert patients from their doctors’ offices to receive them.
Kentucky
In Kentucky, the public health department chose to take advantage of federal funds to institute a state-wide immunization program, and kept doctors appraised of what the program would be doing with its funds.
In 1977, the US Department of Health, Education, and Welfare put out this pamphlet for parents, to inform them of the recommended childhood vaccines and to explain their importance. By the late 1970s, smallpox had been effectively eradicated in the United States, [see smallpox-specific documents] and with the death of such a virulent threat, many parents began to wonder whether the other diseases for which vaccines were available – measles, polio, rubella (German measles), mumps, diphtheria, pertussis (whooping cough), and tetanus – were all that dangerous. In particular, adherents of natural living and the Holistic Health Movement, were convinced that immunity obtained “naturally” – that is, through catching the disease itself in childhood – would more effectively convey lifelong immunity to the disease.
The pamphlet produced by DHEW includes several images of healthy children, but only two pictures at the beginning depict the vaccination process. One shows the more typical syringe injection, but the second introduces a new piece of vaccine technology (shown above). The invention of the jet injector increased the rate at which vaccinations could be distributed: this device could vaccinate up to 1000 people in an hour. Jet injectors worked by using high pressure to force vaccine material under the skin without the use of needles, which though not painless, was relatively less painful than a needle stick, reduced the risks from needle-stick injuries, and was thought to be easier for individuals who feared needles.
Changing notions of risk and disease prevalence in the late 1970s did change how parents and government officials understood vaccine risks and benefits. One event especially gave the public pause when it came to immunizations: the 1976 swine flu “affair.” Reports in early 1976 that an influenza virus similar to the one that caused the 1918 global flu pandemic had stricken soldiers at Fort Dix, New Jersey, prompted President Gerald Ford to announce a national campaign to vaccinate 95 percent of the US population. But the epidemic never came, and to make matters worse, several dozen cases of Guillian-Barré syndrome had occurred among the 40 million people who did receive the vaccine. As part of the public law implementing the vaccine program, Congress had ordered the Secretary of Health, Education, and Welfare to investigate the range of adverse side-effects attributed to various vaccines and the rate at which they occurred, with the goal of determining the potential cost to the government should claims be made against it as a result of vaccine injuries. Later, in 1986, Congress passed the National Vaccine Injury Compensation Program, a no-fault system in which claimants who felt they had suffered adverse effects from a covered vaccine could file a claim against the federal government, thus providing a streamlined alternative to traditional malpractice lawsuits.
Vaccine-Preventable diseases in Pre-school children
Government attempts to mitigate the risks associated with vaccination – whether through increased surveillance and investigation under the FDA or by the Vaccine Injury Compensation Program – did not automatically result in 100 percent compliance with immunization guidelines for children. This report and plan of action, set out by the Indiana State Department of Health, found that only two-thirds of children under the age of two had been given all of the vaccines deemed appropriate to their age group in 1993. The data generated by their study and the Department of Health’s proposed course of action to bring more families into compliance, is representative of the problems public health officials have faced in trying to ensure compliance with vaccination requirements and what they have felt to be the best course of action in response.
Talking to Patients about New Vaccine Guidelines
In the early 2000s, highly publicized findings – later proven untrue – alleged that a link existed between the MMR vaccine (for measles, mumps, and rubella) and autism. Fearful that this could be true, many parents in the United Kingdom and United States opted to have their children receive the vaccines as single doses (rather than the combined shot), skipped booster shots, or declined to have their children vaccinated at all. In response, many medical professionals tried to address these fears and assure their patients that the vaccines were safe. This issue of Chemist and Druggist, a trade magazine for pharmacists and pharmacy owners in Britain, featured as one of its continuing education modules information on new vaccine guidelines put out by the National Health Service in 2007. The pharmacist is not only educated on what the then-current medical advice was, but is also given a hypothetical scenario in which a client with small children expresses fears about a link between autism and vaccines. By completing the exercise, the pharmacist is meant to learn effective techniques for convincing the patient that it is safer to have her children vaccinated.