To jab or not to jab

Is that still a question ??

I remember going to buy the HiB vaccine in 1998 for my daughter, before we travelled to the UK. The chemist shop—apparently the only one that even stocked the vaccine– was madly busy, but after much hand waving and shouting I managed to communicate with a salesman (there were never any women in chemist shops in those days. Not even these days).

He heard/ lip read me saying ‘HiB’ ‘HiB’ and waving the prescription, which he glanced at just cursorily, as though this was all beneath him, and opened the freezer door of a large fridge. A dozen different vials tumbled out and fell down. He gathered them and just shoved them in anyhow and rummaged a bit before handing me a slightly cold package over the waving hands of other customers. It said Hep B vax.

So then I had to shout and wave some more while he looked at me with an annoyed expression at not accepting what he was handing out. He took the HepB back and gave me the HiB. I still have no idea if there was anything in that vaccine that could have genuinely protected my 5 month child since the temperature of the cold chain seemed to be ridiculous to believe in. For all I know they even switched off the freezer at nights.

So, clearly, the vaccine delivery systems can have some grey zones.

Vaccines have been the cutting edge of preventive medicine for a while now. Evidence exists that the Chinese employed smallpox inoculation (or variolation as it was called) as early as 1000 CE. Apparently “the Chinese would take scabs from healing vesicles, grind them up, and snort them up their noses. Those Chinese sure knew how to party.” http://www.ofmicrobesandmen.com/pretty-milkmaid/

It was practiced in Africa and Turkey as well, before it spread to Europe and the Americas. But Edward Jenner’s innovations, begun with his successful 1796 use of cowpox material to create immunity to smallpox, quickly made the practice widespread. It eventually resulted in the eradication of smallpox.

The reasons why milkmaids were always being referred to as beautiful in poems was that they rarely contracted smallpox and the subsequent severe pockmarking of the face.https://blogs.scientificamerican.com/observations/how-a-young-boy-a-cow-and-a-milkmaid-helped-to-conquer-smallpox-video/

Disturbing image warning: Child in Bangladesh with small pox

Jenner took material from a sore on a milkmaid’s hand and inoculated his gardner’s eight year old son. After a mild fever and discomfort, the boy recovered. When exposed to smallpox a few months later, he was found to have complete protection against the disease. While today this experiment would be considered illegal at best and wildly unethical at worst, it was the first documented case of what would eventually be called vaccination.

Louis Pasteur’s 1885 rabies vaccine was the next to make an impact on human disease. Rabies has a 100% fatality and at least 10 million lives have been saved by this vaccine so far.

And then, at the dawn of bacteriology, developments rapidly followed. Antitoxins and vaccines against tetanus, anthrax, cholera, plague, typhoid, tuberculosis, and more were developed through the 1930s. Since then we now have a long list of vaccines that can protect us from many of the diseases that used to be common around the world, including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps, rotavirus and Haemophilus influenza type b (Hib).

In India we have some free (and compulsory) vaccines on schedule. https://www.nhp.gov.in/universal-immunization-programme-uip_pg and then there are the optional ones made available. We have managed to successfully eradicate polio. It was a mammoth undertaking and Atul Gawande has written a very interesting account of his observations while accompanying a Pulse Polio field worker. https://www.newyorker.com/magazine/2004/01/12/the-mop-up. But one reads about illegal immigrants crossing over from Nepal and Bangladesh every day and one really has to wonder…..

How are vaccines tested for safety and efficacy ? Well, first on animals and then mostly on fit and healthy adults   (probably mostly men since it would be unethical to ever try out vaccines on pregnant women). Some people are against the use of animals for testing. I loved the War of the planet of the Apes and it raised some very dark questions about humans and our sense of ownership of this planet and how we treat animals but then an image like this makes you question that again…

Meanwhile there comes news from Siberia that, despite Trump not believing in global warming, the permafrost has started to melt. This would open up the graves of those who died from smallpox so many decades ago and possibly the virus could spread again, against an entirely unprotected generation who was never vaccinated since small pox was eradicated in 1977! “Spores of potentially fatal anthrax from dead people and reindeer that had been entombed in the permafrost are already thought to have infected 24 patients currently in hospital in Salekhard near Russia’s north coast.” http://www.independent.co.uk/environment/smallpox-siberia-return-climate-change-global-warming-permafrost-melt-a7194466.html

If this cute looking tardigrade can survive 30 years of being dried out and all kinds of extremes of temperature, who knows what else is out there ? https://www.theverge.com/2017/7/15/15971918/tarigrade-earth-space-astrophysics-asteriod-apocalypse-survival

Of course the story of vaccines also includes the story of Henrietta Lacks, whose immortal cell line ( HeLa), used without her consent, also led to breakthroughs in the study of herpes, leukemia, influenza, hemophilia, Parkinson’s disease, certain types of genetic diagnoses, cancer, AIDS, cloning, the effects of radiation and toxic substances, and in vitro fertilization. This made many pharmaceutical and biotech companies into billionaires many times over, while her family has yet to receive anything in compensation! https://thatwhichiam.wordpress.com/2017/07/21/in-the-medical-garden-of-good-and-evil/comment-page-1/

There are some people who are against vaccines. Though the claims that vaccines cause autism have been dismissed, repeatedly, (https://www.autismspeaks.org/science/science-news/no-mmr-autism-link-large-study-vaccinated-vs-unvaccinated-kids) now some people do question if the ingredients (such as thiomersal ) used in vaccines , could affect babies since they are vaccinated with fairly large volumes compared to their body weight.

Bill Nye (the Science Guy) hosted an episode on this which we saw recently. From their debate I agree that one thing is true –those who have never seen the harmful effects of the actual disease can start doubting if the benefits really do outweigh the risks. It’s almost the same argument one makes for ensuring that women must have access to safe abortion. Those who have seen the wards filled with women dying of septic abortions understand how precious this right is.

Maybe the current Indian  government is sponsoring this anti-porn vaccine, using holy cow serum mixed with peacock tears…….hahaha

If vaccines are meant for public health, then should they not be government owned/ subsidized like nationalized banks? Well, those in the list of universal vaccines are but plenty of vaccines are part of the ‘for profit’ industry. https://www.theatlantic.com/business/archive/2015/02/vaccines-are-profitable-so-what/385214/. In India the trials for the Human Papilloma Virus (HPV) vaccine had some serious ethical concerns raised as did the unexpected enthusiasm with which everyone was pushed into taking the vaccine, especially since simple screening is as effective in preventing cervical cancer.

So— prevention, profit, ethics, public health…. and it’s the same dance that the medical fraternity is constantly engaged in. You put your right foot in. You put your right foot out. Step to the public, step to the private, swing around and back again. That’s what it’s all about …..

There are so many new vaccines being developed– to protect from Alzheimer’s, HIV, malaria and much more. http://www.immunizeforgood.com/vaccines/new-vaccines-on-the-horizon There are even DNA vaccines being developed which could provide better immunity than the conventional ones. http://www.medscape.com/viewarticle/715527_8

But sadly, there is no vaccine against stupidity yet………