Close to Home: Vaccination battles? They’re nothing new

Breaking news from Sonoma County: As local school districts move to tighten vaccination requirements in the face of a looming epidemic, they’re met with strong and vocal opposition from anti-vaccine groups. Angry debates rattle normally placid school board meetings. An irate father charges that vaccination causes infection rather than preventing it. “Any foreign material introduced into the blood remains there,” he is quoted in a local newspaper, “and will sooner or later appear elsewhere in the body.”

That may sound like a story lifted from today’s Press Democrat, but it’s not. The year was 1907, the issue was smallpox vaccination, and the infection that angry father blamed on smallpox vaccine was leprosy. (The local newspaper was the Santa Rosa Republican back then.)

Vaccination battles are nothing new. Ever since 1818, when the first school mandate was enacted in Germany, health officials and vaccine opponents have clashed over compulsory vaccination. Resistance was particularly fierce in 19th century Europe, even violent.

The passage of the Vaccination Act of 1853, which mandated smallpox vaccine for all British infants, triggered riots in a dozen cities. Anti-vaccine societies became so politically powerful that Parliament was ultimately forced to add a “conscience clause” to the act that granted parents the right to opt out.

Why did so many 19th century parents object to vaccination? The arguments, then as now, were rooted in religious belief, the politics of individual autonomy and parental rights and a deep distrust of science and medicine. The smallpox virus, however, ignored the debates. Wherever vaccine opponents succeeded, smallpox outbreaks followed.

The battles continue today, with measles standing in for smallpox. Opposition to measles vaccine exploded in the late 1990s when Andrew Wakefield, a British physician, linked the combined measles-mumps-rubella (MMR) vaccine with autism. By the time Wakefield was exposed as a fraud, concerned parents had joined pop culture figures, conspiracy theorists and an unquestioning media to push “personal belief exemptions” through many state legislatures.

Vaccination rates fell across the country - dangerously so in areas of Marin and Sonoma counties.

We are now paying the price of that anti-vaccine “success” story. Just as it happened when 19th century vaccination rates fell, a vaccine-preventable infection is on the verge of roaring back.

What can be done?

Strict enforcement of school mandates can help to blunt a measles outbreak, but given current political realities, that may not happen soon.

A key to containing measles in the short term is to appeal to “vaccine-hesitant” parents - those who haven’t yet vaccinated but who may be willing to do so now in the face of a possible epidemic. Higher vaccination rates will make it harder for measles to spread when it inevitably arrives in Sonoma County. An epidemic can be headed off.

Hopefully, hesitant parents will act soon. In Chicago, where I’m visiting family as I write this, the media are focused on a measles outbreak in a suburban day care center. All of the infected children are infants; they were too young to be vaccinated for measles and now, as with all babies, they’re at high risk for complications such as pneumonia.

“There will be more cases,” warns Dr. Terry Mason, the chief of Cook County’s public health department. “We shouldn’t be surprised. The cat is out of the bag.”

That sounds like a warning from 1907.

Dr. Mark Sloan teaches pediatrics and writing at the Santa Rosa Family Medicine Residency.