I was 12 years into retirement before I began reading about vaccination. For me that was like reading on the topic of whether or not the Earth is flat.
However, a family situation made it quite impossible for me to avoid looking into the issue. Our daughter advised us that, unlike her brother, she would not be vaccinating her children. As everyone learns eventually, there is nothing more beautiful and more precious than grandchildren. And here was our daughter, apparently placing at least one of them at what I thought was terrible risk.
I resolved to do a serious study of the issues. While it seemed to me at first that I could do no better than consult the Centers for Disease Control and Prevention or perhaps the World Health Organization, I realized right away that those sources definitely confirmed the opinion of my son, myself, my family doctor, my most trusted newspaper (at that time the New York Times) and all my friends. I did not know of any authority that I recognized in this area of study who disagreed with my own opinion.
A search on the internet for “vaccine dangers” turned up the CDC (oracularly noting that there are some dangers to vaccines, mostly mild, and nothing like the dangers of the diseases they protect against) and a lot of other places that did not carry any real authority with me. Like: vaccinedangers.com, naturalnews.com, livestrong.com, educate-yourself.org, and mercola.com. Some of the material there made extreme and unbalanced claims in tones of anger or derision. And when the tone was reasonable, the claims still came across to me as extreme and unbalanced.
I might have left it at that, sending my daughter some sober piece of CDC assurance that the hysterical fears about autism and the MMR vaccine were ill-founded and suggesting that she reconsider her decision in that light. But some nagging residue of self-doubt, or perhaps a lingering English-teacher notion of proper research technique, or even (after all) a sense that I owed my daughter more respect for her views than that – something led me to take another step towards… let’s call it the precipice.
My quick look around the internet left me with the Mercola site as rather the most reasonable. True, he was selling his own stuff, but in fact his essays on health topics were always closely reasoned and included links out to sources.
In any case I ended up listening (on his site) to a recorded discussion between Dr. Mercola and Dr. Larry Palevsky, a New York pediatrician. And letting myself listen to this dialog between two obviously very knowledgeable men who spoke conversationally on a topic about which each had come over time to change his mind radically, listening to them explore the reasons for their change of mind with obvious sincerity and ready grasp of support for their position, support challenging the prevailing view that they had themselves once held – this experience gave them a certain authority to my mind.
Not that it convinced me. It just raised serious doubts about my settled opinion. The key thing was that I now had a sense that these two men embodied an authority that I could not simply dismiss out of hand on the basis of what I “knew,” which was, of course, what I believed based on the authority I accorded to the CDC, New York Times, and all the doctors I had ever known. I now had two opposing authorities to deal with. One was older in my experience and much more weighty, but the other was real and also had some weight.
One very peculiar claim stood out in my mind from this interview that I thought could easily settle the conflict of belief I was feeling. This was Dr. Palevsky’s statement that smallpox had not been eradicated from the world by using its vaccine. And when Dr. Mercola challenged him mildly on this point by quoting Dr. Deepak Chopra at a recent conference claiming that the smallpox vaccine was in fact the only one that had worked, Dr. Palevsky stood his ground firmly. (Starts at about the 7 minute mark.) Now I knew from news reports that the World Health Organization had celebrated a great victory over the dread disease exactly by virtue of using the vaccine. Furthermore, I recalled pretty clearly from my high school science days that it was the discovery by Edward Jenner that cowpox could be used to vaccinate against smallpox which had rescued England from a terrible epidemic and thus begun the study of immunology and use of the many life-saving vaccines we now know. This should be easy to check out. The facts in the case must be everywhere to hand.
All the more so as it was along about this time that the New England Journal of Medicine published (in the January 12, 2011 issue) a blistering attack on people like Drs. Mercola and Palevsky. It was called, “The Age-Old Struggle against the Antivaccionists,” and began this way (note my emphasis):
Since the introduction of the first vaccine, there has been opposition to vaccination. In the 19th century, despite clear evidence of benefit, routine inoculation with cowpox to protect people against smallpox was hindered by a burgeoning antivaccination movement. The result was ongoing smallpox outbreaks and needless deaths. In 1910, Sir William Osler publicly expressed his frustration with the irrationality of the antivaccinationists by offering to take 10 vaccinated and 10 unvaccinated people with him into the next severe smallpox epidemic, to care for the latter when they inevitably succumbed to the disease, and ultimately to arrange for the funerals of those among them who would die (see the Medical Notes section of the Dec. 22, 1910, issue of the Journal). A century later, smallpox has been eradicated through vaccination, but we are still contending with antivaccinationists.
This article also came from two doctors (Gregory A. Poland and Robert M. Jacobson) and, of greater importance to me, was published in one of the most prestigious medical journals in the country.
Obviously I would and did begin my investigation with the NEJM article. I thought it would make short work of Palevsky, but its authors were so sure that all their readers would never question the opening claims about smallpox that they didn’t bother to cite sources. Smallpox did not come up in their later arguments.
So I turned to the smallpox section of what looked like a solid book somewhat on the anti-V side of things, Randall Neustaedter’s The Vaccine Guide, Risks and Benefits for Children and Adults. It may be that doctor Neustaedter (OMD) was recommended to me by our daughter. His book was soberly written with lots of detailed explanation and serious footnoting to sources. It did not take an outright stand against all vaccination, either, but instead advised parents to educate themselves and make informed choices.
Curious accident, though – as I was, of course, also looking over the internet for materials at this time, I noticed that Dr. Neustaedter had published an essay exactly on my topic: Smallpox Vaccine: Does it Work? And here I found a direct attack on the anecdotal self-certainty of the NEJM essay. Here are the first two paragraphs, with my highlighting:
The debate over use of the smallpox vaccine has focused on the risks of side effects and deaths caused by the vaccine, as well as the problems associated with the vaccine’s outmoded technology, but these discussions have ignored questions about the vaccine’s effectiveness. Authorities insist that smallpox vaccine was responsible for eradication of one of humanity’s greatest scourges (WHO, 1980). It may therefore come as a tremendous surprise that throughout the nearly 200-year history of smallpox vaccination thoughtful physicians and a veritable army of citizens doubted that the vaccine worked at all.
Four factors have contributed to skepticism of smallpox vaccine’s effectiveness. First is the dubious notion that lesions from cowpox, a disease of cattle, could prevent smallpox, a related but different human disease. Second, during the nineteenth century, which preceded modern bacteriology and the age of refrigeration, it was impossible to know exactly what was in any given dose of vaccine. Third, the reported increase of smallpox disease in communities following the introduction of vaccination seemed to contradict the claims of vaccination proponents. A fourth disturbing fact is the total absence of any carefully controlled efficacy studies of the smallpox vaccine.
The rest of this little essay is filled with facts and figures that on the face of things plainly show that the vaccine was worse than doing nothing and also that the disease was successfully addressed, eventually, by improving sanitation practices and facilities as well as by isolation. The three non-controlled efficacy studies Neustaedter finds fall out 2 to 1 against efficacy.
The British expression “gobsmacked” captures well how I felt after reading that essay. A lot like, I suppose, Richard Dawkins waking up one morning in Heaven.
But enter now another instructive accident into my life as vaccine controversy explorer. My daughter’s mother-in-law, whose other belle fille is an ER doctor, having heard of my research and having noticed what must at the time have been a New York Times best-seller on vaccines, sends me the book – Vaccine (The Controversial Story of Medicine's Greatest Lifesaver) by Arthur Allen. And Wow! is this ever a good attack exactly on Randall Neustaedter’s thesis. Allen is reasonable, thorough, well-footnoted and, above all, concessive in his balanced support of the smallpox vaccine’s efficacy and safety. Unlike any of the pro-vaccine writers I had come to before, he not only knows of the excellent arguments from the end of the nineteenth century against the vaccination, he even does a good job of making them clear to the reader, and then rejecting them.
If I had happened to read Allen’s book before the Neustaedter piece, I almost certainly would have ended my research right there. As it was, I had a head-on collision of arguments. It was very clear to me that there were questions of fact that needed to be and could be answered by some additional research. And the potential health of my grandchildren was at stake.
What I discovered I give in the right hand column of this page. The daughter was right. I was wrong. About vaccination in general and smallpox in particular. Anyone interested in following me as I chase down the facts is welcome to do so. Click here.