About the Book
Vaccine: the Controversial Story of Medicine’s Greatest Lifesaver relates the history of the development of vaccines–killed, weakened or fragmentary forms of a microbe that are injected or inhaled or ingested in order to produce immunity to the germ’s naturally occurring form. But Vaccine is more than a medical history, because the changes vaccination has wrought in society are profound. The story of vaccination also tells a lot about the human experience of modern times. It’s the saga of epidemics and how people faced them, the fear of God that disease once inspired, and the fear of the government that grows out of medical errors. It’s about what it’s like to live at a time when disease could suddenly sweep into your home and steal your child, and about the changing face of human faith at a time when infectious disease has, in great measure, been conquered, or at least tamed. It’s the story of the very human scientists–Pasteur, Salk, Sabin, Hilleman, and others—who dedicated their lives to assuring that families would never again be at the mercy of germs. It’s also about the struggle between personal autonomy and national goals, about allowing individuals to live their beliefs while still protecting the public health.
The tale begins in 1721 in Boston, then a town of 12,000, where Cotton Mather, epitome of the Godfearing minister, seeks to enhance his political standing by introducing a Turkish medical practice he has just read about. With the assistance of a surgeon named Zabdiel Boylston, Mather brings variolation, the most primitive form of vaccination, to America, and in time this practice drastically reduces the mortality of smallpox. In 1798 the story shifts to England, where a gentleman farmer named Edward Jenner, noting that milkmaids are frequently immune to smallpox, successfully tests the hypothesis that human exposure to the trifling pox disease that infects cows will protect the human against smallpox. The next 180 years witness the gradually eradication of smallpox thanks to Jenner--as well as to naturally occurring shifts in smallpox’s virulence. Along the way, the frequently dangerous smallpox vaccine becomes a point of furious debate, often causing riots and other protests pitting governments and the medical establishment against a variety of anti-vaccine groups, medical apostates and individual freethinkers.
Starting in the 1880s, scientists begin attacking other diseases–first rabies and anthrax, and then the scourges of childhood–diphtheria, typhoid fever, whooping cough and measles, among others. The 1955 announcement that Jonas Salk’s polio vaccine is safe and effective leads Americans to ring church bells and hug one another in the streets. It marks the threshold of an era of near-total confidence in the U.S. medical establishment. But slowly, toward the end of the 20th century, vaccines threaten to become a victim of their own success. Since they are only given a few times to any individual, and are extremely difficult and expensive to make, the number of vaccine makers in America has shrunk from 26 in the 1960s to only a handful. Everyone expects vaccines to be cheap, and perfectly safe. With all our children fully vaccinated (and protected by clean water and antibiotics, to be sure), our life expectancy has expanded by 30 years. Now that the grave diseases of childhood are mostly gone, mistrust muddies the waters. Vaccines are blamed for chronic diseases whose causes are unknown–epilepsy, asthma, and above all, autism–although there is little evidence that vaccines cause such problems. Yet vaccines do carry some risk, like any medical procedure. They are also imperfect medicine, as the yearly struggles to come up with a good influenza, or flu, shot demonstrate. As the nation prepares for a possible flu pandemic, Americans are increasingly being urged to get ordinary flu shots, in order to build up the public health commons–and to keep the flu vaccine manufacturers healthy.