About Vaccination History

The advancement of science in modern history has allowed for creations of vaccinations for diseases which were fatal and contagious only decades ago. The success of eradicating disease through vaccinations allowed an opportunity for national governments to help play a role in creating a safer and healthier society for their citizens. While the idea of citizens being immune to a wide range of diseases because a country has given access and made it mandatory to have the vaccination sounds appealing, many private citizens take issue with the “mandatory” aspect of vaccinations. The general idea is that they government shouldn’t have a right to make anything mandatory for a person to consume, especially when it involves infants and young children. The rise in this “anti-vaccination movement” and the World Wide Web have coincided in the late 1990s and 2000s. The internet has served as a vehicle for anti-vaccination supporters because of the wide-range of information available to support claim, which can be used to negate a national government’s program. The information found online showing negative side-effects of vaccinations is spread, and it becomes a crisis on the internet. The internet is the backbone of the anti-vaccination movement right now, especially in the context of trying to argue against the government’s national programs because it is the perfect medium to spread one’s own message, research, and beliefs while maintaining a distance from the state.

The best country to examine vaccination history in the context of state versus private citizen is England. There is a history of mandatory vaccination of infants in Britain to learn from, from its introduction in 1853, when a vaccination for smallpox became mandatory for all children. It provoked opposition immediately, not only from middle class radical liberals who are typically the voice behind issues of access, privilege, and arguing with the Crown, but also from working class people. Forty-five years later, in 1898, conscientious objection was given as option for those against vaccinating. During the nineteenth century, other European countries also struggled with smallpox. Bellaby (2003) compared the vaccination policies and its effects in England, Prussia and Imperial Germany from 1835 to 1914. The results shows that mandatory vaccinations led to an earlier control of smallpox in Germany. While Germany controlled and contained the disease earlier, England was able to accomplish the same by the end of the Nineteenth century. This was partially because of disease surveillance and containment in Britain, but was mostly due to another factor. “Active engagement” with the general public at local government levels aided health improvement. The bourgeois middle classes encouraged the “deserving poor” to alter their lifestyles through engagement in their houses, churches, schools and neighbourhoods.

In more recent times, England has maintained the reputation of being distant from state run vaccinations. The most important and damaging hit to the pro-vaccination community was in 1998, when a researcher was the first to make the claim that autism and the MMR vaccine are linked (Bellaby, 2003). The claim was based on a dozen cases of gastrointestinal disorders which developmental regression seemed to be associated. The children in the studies were previously normal. The researchers found that 75% of the parents attributed the onset to autism to the MMR vaccine. On a national population level in England, autism diagnoses increased from 1988, when the MMR vaccine was introduced to the public, and continued into the late 1990s. This did not only occur in Britain but also in the United States and Canada. Still, there have been no studies which have found a reasonable link between the sudden increase in diagnoses of autism and the introduction of MMR vaccine from the late 1980s. Scientific opinion dictates that the risk is insignificant. People are still willing to conform to public health program’s in Britain. After the link of autism to the MMR vaccine, the total amount of vaccinations dropped only 8.6% over six years, but by that time 92% of Brits were already vaccinated, allowing for almost complete eradication of the diseases.

The way the media handled the MMR and Autism crisis contributed to the miscommunication of risk, which could have serious implications. Parents were inclined to act in what they believed to be the best interests for their children. For the MMR vaccination, the Chief Medical Officer refused meet the concerns of parents half-way by allowing access to single disease vaccinations. The Chief Medical Officer’s refusal to get single vaccinations for the children at one time was reasonable: the six doses of vaccination required in all (mumps, measles, and rubella, twice each) would make it more likely that vaccinations would not be completed in their entirety. For example, in the United States children under one and a half years old are given protection against a dozen childhood diseases, which mandates some 15-19 doses of vaccine. As a side effect, healthcare managers are seeking new ways of minimizing infant discomfort, which makes the process more acceptable to parents. Many British parents interpreted the Chief Medical Officer’s argument as insulting because they believed they were acting in their children’s best interests and because the Medical Officer didn’t see the parents as as responsible parents to make sure that individual vaccination courses were completed.

Although the MMR link to autism has been proven to be incorrect and government programs provide information supporting no link, there’s still misinformation being spread on the internet. Anna Kata (2012) argues that vaccinations are a massive public health achievement, contributing to declines in morbidity and mortality from previously unpreventable diseases. However, an internet user might be tricked through reading certain websites to believe the opposite of the truth, that vaccines are useless, ineffective, or even more dangerous than not getting vaccinated. These are just some of the arguments posed by the anti-vaccination movement. The popularity of the Internet today has facilitated the sharing of these beliefs.

Because of the integration into daily lives, many people use the internet for health information, and because of this the information impacts decision-making for patients. This creates the need to know what is shared online, arguments like the MMR case in Britain, to know how to combat the claims. Anna Kata (2012) discusses how Web 2.0 has been a double edged sword for medicine. While paternalism through the government is on a decline, medicine is moving in a direction of a model of “shared decision-making” between the patient and physician. This process is and will only be available because of high quality information about health on the web. The double edged sword idea comes into play when that information can easily be redirected by the dark side of the internet. The power of the internet to educated patients is also the ability to confuse and misinform. Kata points out that postmodern attitudes, where science-based results are just “another way of knowing” is integrated with new “expert systems” where people without advanced training come to think themselves just as much “experts” as the real experts. Kata identifies most of the common tropes and tactics of the anti-vaccine movement.

The verbage and classic tropes that anti-vaccinators use on the internet are typically recycled, and common themes seem to develop because of it. Anna Kata (2010), in an older article, discusses the tropes used. There’s the argument of “civil liberties”, in which no doctor, school, or government has any moral or ethical right to vaccinate their children against the parents’ own judgement. Kata’s study showed that seventy-five percent of arguments about civil liberties and vaccinations was in regards to parental rights, like with the Chief Medical Officer in England, when parents feel violated because the state doesn’t deem parents knowledgeable in caring for their own children and making their own decisions. Since the state and government put themselves in control of vaccinations, sixty-three percent of websites discussing anti-vaccination made statements where governments are viewed as totaliarn. Twenty-five percent of these websites complained about the government monitoring citizens who chose to not vaccinate, so they could be harassed into vaccinating or for other reasons. An ever-present theme on the internet is conspiracy theories. Almost ever website Kata researched had some claim of conspiracy on it, with a popular theory being a government cover-up in which bodies showing the negative effects of vaccines are hidden from the public. Another common conspiracy theory was the idea that vaccines are solely used as a tool for profit, and the idea of collusion between government officials, pharmaceutical companies, and physicians, all benefited financially. The most popular individual doctor who is cited on these websites is the doctor from England who showed the false link of autism and MMR, Andrew Wakefield. He’s often celebrated as a martyr to the anti-vaccination community, although there is no mention of doctors discrediting him and his professional career and reputation being ended shortly after his claim was proven to be false. Personal testimonies and emotive appeals were found on eighty-eight percent of the websites. Majority of these testimonies were narratives from anti-vaxx parents who believed their children were truly damaged by vaccines. The conversation of “us versus them” was also extremely prevalent, in which parents and vaccine deniers were shown as fighting with physicians, governments, or the scientific community.

A plan to combat the anti-government, post-modern arguments of anti-vaccinators has been discussed by Thomas May (2005). He believes to beat the internet, we must reconsider our packaging of information for the audience intended on receiving it instead of becoming more sensationalized like the internet. Redesigning the packaging, or creating an effective campaign like our group intends to do so, will increase the chances of communicating the intended message. Thomas May argues that a healthy attempt to package vaccines shouldn’t include spinning of information or a misrepresentation of the fact. If implemented correctly, it would be showing the facts in an easy-digestible manner that is also retained by a large amount of people. By doing this, the shared decision-making model discussed earlier becomes more attainable and beneficial because the information the patient finds will be accurate. Public communication has to consider the underlying theories which the public uses to process information. Packaging for health policy communication is important because a large gap may exist between speaker and the audience. Politically-minded health policy creators fail in recognizing that a message might fail to resonate with an audience if it doesn’t have an explanation that correlates the information to existing public perceptions. May discusses this mispackaging occuring, “people of lower socioeconomic status tend to receive health information from a few local, community-based sources. Conversely, scientists tend to communicate in ways that provide greatest benefit to members of the highest socioeconomic”(2005). The result is a gap in information, both with the source and with the interpretation. We must also streamline communication to the general public. Streamlining communication requires that primary sources of information be made available early. This need was illustrated by Thomas May (2005) in the recent case of Terri Shiavo, where “confusion over her condition was caused by reporting that conflated comatose, brain dead, and persistent vegetative state conditions”. Eventually, the confusion was cleared up, but occurred too late to help alter public opinion. Streamlining communication can occur if efforts are first taken to change the ‘packaging’ between speaker and audience. It can be understood that people of a lower socioeconomic status receive health information from local doctors and organizations that incorrectly ‘package’ the information, which has been relayed by authoritative sources and it fails to resonate.

The anti-government, anti-authoritarian, and anti-big pharma protests have grown momentum over time with the internet, which shows the presence and relevance of social and political tensions in the world today. The history of vaccination shows that the debates centred on civil rights and government distrust was in relation to mandatory vaccination. These arguments are still made but are less common than other themes. The current most prevalent topics are critiques of science, medicine, and authority. This debate can only occur in a postmodern society, which is beneficial to such protests. This is because the characteristics of postmodernism include concerns about values, prioritizing risk over benefit, and promoting the well-informed patient. An analysis of the MMR crisis, partnered with an understanding of how the internet influences intercultural interactions through anti-government and anti-science tropes to dissociate people from vaccinations were the largest takeaways, that’ll be used in the future campaign. The focus of the internet as a tool to rise above governments and authority is especially lucrative, in terms of having to decide how to package vaccinations attractively but also accurately. The most difficult issue is going to be trying to create a campaign that can defeat post-modernism.