Tag: polio eradication

January 18 – This Day in Vaccine History

Would folks be more likely to get vaccinated and protected if they remembered what it was like in the pre-vaccine era?

Since anti-vaccine folks like to make it sound like cancer, heart disease, kidney disease, and everything else are caused by vaccines, will they be surprised to know that in addition to now vaccine-preventable diseases, they were big killers in the pre-vaccine era?
Since anti-vaccine folks like to make it sound like cancer, heart disease, kidney disease, and everything else are caused by vaccines, will they be surprised to know that in addition to now vaccine-preventable diseases, they were big killers in the pre-vaccine era?

A lot of people died of diseases that are now vaccine-preventable, and no, you can’t simply thank better hygiene and nutrition instead of vaccines for saving all of those lives.

A lot of people were still getting smallpox in 1920.
A lot of people were still getting smallpox in 1920.

Since the smallpox vaccine has been around for hundreds of years, can you believe that people were still getting and dying of smallpox 100 years ago?

How about 50 years ago?

January 18, 1970 - everyone was excited about all of the progress that was being made in getting smallpox under control.
January 18, 1970 – everyone was excited about all of the progress that was being made in getting smallpox under control.

That’s hard to imagine, isn’t it, as it was long known how to control smallpox with quarantines and vaccination.

On January 18, 1870, the Chicago Tribune described how Chicago was getting smallpox under control - by getting folks vaccinated.
On January 18, 1870, the Chicago Tribune described how Chicago was getting smallpox under control – by getting folks vaccinated.

Still, it took a long time before smallpox was finally declared eradicated.

And with smallpox under control, fifty years ago, many communities were eager to get kids vaccinated and protected to stop measles.

This paper in Nebraska announced "Stop Measles Day" on January 18, 1970.
This paper in Nebraska announced “Stop Measles Day” on this day in vaccine history – January 18, 1970.

Something changed once we got these diseases under control though.

Can you guess what it was?

Todd Wiley was convicted of manslaughter for shaking his child, but his “DPT defense” made the papers for months, including this article on January 18, 1995.

There were more and more vaccine scare stories in the media. Initially they were about the DPT vaccine and they then moved on to MMR once Andrew Wakefield hit the scene.

The Disneyland measles outbreak was well underway on January 18, 2015.

And even though none of the stories were true, that didn’t stop them from influencing people.

Have we learned our lesson?

Do we need to repeat history?

Vaccines are safe, with few risks, and are obviously necessary.

Anti-vax groups are raising money in Maine and elsewhere to influence parents and politicians and new vaccine laws.
Anti-vax groups are raising money in Maine and elsewhere to influence parents and politicians and new vaccine laws.

Vaccinate and protect your kids. Don’t bring back these deadly diseases.

More on History of Vaccines

Vaccine Cartoons and Caricatures

It shouldn’t surprise anyone that the anti-vaccine movement has long been a good source of material for folks who draw cartoons and caricatures.

Mr. X let everyone know about that flu shots were being used to control people's minds!
Mr. X let everyone know about that flu shots were being used to control people’s minds!

And it still is!

Vaccine Cartoons and Caricatures

Of course The Simpsons, although they are often ahead of their time on things, wasn’t the first cartoon to send a message about vaccines.

Remember the children being fed to the Vaccination Monster?, with John Birch and other anti-vaccination heroes of the day marching to slay it?

John Birch (B) and the other anti-vaccine heroes of the day on their way to fight the vaccination monster.
John Birch (B) and the other anti-vaccine heroes of the day on their way to fight the vaccination monster.

This etching of Charles Williams was made in 1802 as “propaganda against the introduction of vaccination as a preventative measure against smallpox.”

The Cow Pock is an etching by James Gillray.
The Cow Pock is an etching by James Gillray.

That was also the year of the etching by James Gillray of Edward Jenner vaccinating people, who were then turning into cows!

“Dr. Jenner, an excellent portrait, is seen in the exercise of his discovery; a workhouse lad, impressed into the service as his assistant, is holding a milk-pail filled with “vaccine pock hot from the cow.” A second doctor is in attendance, dispensing medicines to promote the effects of the vaccination, which are strongly developed on all sides. Various whimsical results are pictured in the unfortunate subjects with whom the process may be said to have “taken.” A picture in the background, founded on the worship of the golden cadf, represents the adoration of a cow.”

The satirical etchings of James Gillray

Yes, the Cow Pock etching is satire. He was poking fun at anti-vax folks.

And while he was maybe the first, Gillray certainly wasn’t the last to use cartoons to help illustrate the dangers of the anti-vaccine movement.

Or the benefits of vaccines.

Vaccination against small pox, or mercenary & merciless spreaders of death & devastation driven out of society was printed in 1808.

Vaccination against Small Pox. Courtesy of The British Museum.
Vaccination against Small Pox. Courtesy of The British Museum.

The etching by Isaac Cruikshank depicts Edward Jenner driving “three old-fashioned doctors, practicers of inoculation” out of town.

This wood engraving from 1881 shows a crying child getting vaccinated in a room full of people waiting their turn.
This wood engraving from 1881 shows a crying child getting vaccinated in a room full of people waiting their turn. Courtesy of the National Library of Medicine.

In 1838, The Chirurgico Comico Alphabet included this Vaccination cartoon.

The Chirurgico Comico Vaccination.

There wasn’t an entry for smallpox…

How well do vaccines work?

Not well enough to inoculate us against a “Swindling Bank President…

"Now, my friends, step right up and be vaccinated for all forms of disease to which bank officials are liable!"
“Now, my friends, step right up and be vaccinated for all forms of disease to which bank officials are liable!”

The illustration above was made by Joseph Ferdinand Keppler in 1885.

Vaccine Cartoons That Make You Think

Who is most likely to allow misinformation to blindly lead them “off a cliff?”

This cartoon illustrates how misinformation blindly leads people off of a cliff to their getting vaccine preventable diseases.
This cartoon illustrates how misinformation blindly leads people off of a cliff to their getting vaccine preventable diseases.

These cartoons from the 1930s American Public Health Association “Health in Pictures” cartoon booklet can help us see that the anti-vaccine movement hasn’t changed much over the years.

Controlling these diseases is going to take more than just good hygiene and sanitation.
Controlling these diseases is going to take more than just good hygiene and sanitation.

Well maybe they have.

Vaccines are important for people and our pets.

Anti-vax folks today aren’t vaccinating and protecting their animals either!

Let's give them something to think about.
Let’s give them something to think about.

Many of these cartoonists, like Anne Mergen, did indeed give people something to think about.

What would you think about if you saw this cartoon?

The cartoon "Wonder Why My Parents Didn't Give Me Salk Shots?" was published on January 12, 1956.
“Wonder Why My Parents Didn’t Give Me Salk Shots?” was published on January 12, 1956 and “was aimed at parental apathy surrounding the new cure for polio.”

Tom Little won the Pulitzer Prize in Editorial Cartooning in 1957 for his cartoon advocating the use of Jonas Salk’s polio vaccine.

Vaccine Cartoons Today

Unfortunately, the anti-vaccine movement continues to give cartoonists, animators, and writers plenty of material.

Lois and Peter are alone at their anti-vaccine rally, but still manage to trigger a measles outbreak at Stewie's daycare.
Lois and Peter (The Family Guy) are alone at their anti-vaccine rally, but still manage to trigger a measles outbreak at Stewie’s daycare.

Even SouthPark has done an episode about vaccines, as Cartman, who is afraid to get a shot, tries to get a religious exemption to stay in school.

Chicken pox party - The Simpsons did it.
Chicken pox party – The Simpsons did it.

And whether it was in the 1800s or the 21st Century, all of these cartoon images can provide some understanding of how people view public health and the need for vaccines.

“Nuisances and other perceived threats to health were not, of course, seen only in the pointed exaggerations of caricature; they were also available in news drawings and, sometimes, through direct personal observation. But an essential characteristic of the cartoons is their agitational character. They strove for change. To do this, they selected targets, they uncovered less visible problems, and they assigned responsibility for these problems.”

Bert Hansen on The image and advocacy of public health in American caricature and cartoons from 1860 to 1900.

Fortunately, most understand that vaccines are safe, with few risks, and are necessary.

More on Vaccine Cartoons

What Happens if We Stop Using Oral Polio Vaccines?

As we occasionally hear reports of vaccine derived polio, it shouldn’t be surprising that anti-vaccine folks are calling for the end of all use of the oral polio vaccines that can trigger these cases.

Do you recognize the NVIC and ICAN? Think Barbara Loe Fisher and Del Bigtree... and ask them why they want to bring back polio.
Do you recognize the NVIC and ICAN? Think Barbara Loe Fisher and Del Bigtree… and ask them why they want to bring back polio.

Got any idea of what would happen if anyone listened to them?

What Happens if We Stop Using Oral Polio Vaccines?

Believe it or not, a plan is already in place to stop using oral polio vaccines.

So why haven’t we done it yet?

“In April 2016 a switch was implemented from trivalent OPV to bivalent OPV in routine immunization programmes. Following WPV1 and WPV3 eradication, use of all OPV in routine immunizations will be stopped.”

OPV Cessation

It is obviously because we haven’t yet eradicated wild polio!

“The GPEI’s achievements are evident not just in the retreat of WPV to geographic corners of the world, but also in the successive elimination of WPV types. In 2015, WPV type 2 was declared eradicated; WPV type 3 has not been seen since 2012; and while WPV1 has yet to be interrupted, its incidence has been reduced by over 90% since 2014.”

Polio Endgame Strategy 2019–2023

We are very close though.

“In impoverished communities with substandard sanitation and living conditions, vaccine strain poliovirus can contaminate water sources used for bathing and drinking, which can lead to more cases of vaccine strain polio paralysis,” said Barbara Fisher, co-founder and president of the National Vaccine Information Center. “Until polio eradication campaigns stop using live oral polio vaccine, the vaccine strain polio virus will continue to cripple children and adults.”

Vaccination-wary groups call for halt of oral polio vaccine

But if we stopped using oral polio virus vaccines before polio was eradicated, we would simply start seeing more cases of wild polio. And they would be at much higher levels than the vaccine derived cases we are seeing now.

“While over 18 million people who would have been paralysed by polio are walking today as a result of the eradication programme, we have not yet reached zero – and our mission to reach every last child remains as urgent as ever. If we stop our efforts now, within ten years we could see as many as 200,000 new cases each year, all over the world. Simply put, children everywhere remain at risk until polio is eradicated.”

Polio Endgame Strategy 2019–2023

Is that what Barbara Loe Fisher is proposing?

The Endgame Plan 2013-2018 succeeded in certifying South-East Asia (SEARO) as polio-free, brought the African Region closer than ever to eradication of wild poliovirus,  possibly eradicated two out of three wild poliovirus strains, set the world on the path of phased Oral Polio Vaccine (OPV) removal, stopped outbreaks in Syria and Horn of Africa, and cornered wild poliovirus circulation to a joint cross-border reservoir between Afghanistan and Pakistan.
The Endgame Plan 2013-2018 “succeeded in certifying South-East Asia (SEARO) as polio-free, brought the African Region closer than ever to eradication of wild poliovirus, possibly eradicated two out of three wild poliovirus strains, set the world on the path of phased Oral Polio Vaccine (OPV) removal, stopped outbreaks in Syria and Horn of Africa, and cornered wild poliovirus circulation to a joint cross-border reservoir between Afghanistan and Pakistan.”

What if instead of just stopping oral polio vaccinations, we went ahead and switched to IPV now, before wild virus interruption?

Would that be so bad?

Well yeah, it would, since IPV doesn’t stop the transmission of the polio virus.

IPV does prevent you from actually getting paralytic polio, but not from getting a polio infection and spreading it to others. So if we switched to IPV now, we would never actually eradicate polio.

OPV, on the other hand, prevents both paralytic polio and the spread of infection. Unfortunately, it can also rarely mutate and cause paralytic polio. And when vaccination rates are low, these mutant strains can even cause outbreaks.

Why do the outbreaks of mutant strains of polio only happen when vaccination rates are low? Because in addition to preventing infection from wild strains, the polio vaccines can prevent paralytic polio that is caused by the mutant strains!

But why use a vaccine that can mutate like that? It’s simple. The risk of wild polio is so much greater before OPV gets wild polio virus strains under control.

Don’t Spoil the Polio Endgame

There have been some hiccups, but we are very close to eradicating polio.

“In 1988, when the World Health Assembly declared its commitment to eradication and the Global Polio Eradication Initiative (GPEI) was formed in pursuit of this goal, there were 350 000 annual cases of WPV in 125 countries. By the end 2018, only 33 cases were identified – all from two neighbouring countries (Afghanistan and Pakistan).”

Polio Endgame Strategy 2019–2023

And while there are plenty of challenges ahead, including:

  • Ongoing conflicts in the last remaining polio-affected regions.
  • Weak or fragile health systems and extreme poverty in both endemic and non-endemic countries.

Let’s not add to those challenges and let anti-vaccine folks bring back polio.

“The medical establishment repeatedly claims that the science regarding vaccines is settled,” said Del Bigtree, CEO and founder of Informed Consent Action Network, adding that the outbreak of vaccine-derived cases “highlights the danger of eliminating the human and civil right of informed consent with regard to vaccines — a right available for all other medical products and procedures.”

Vaccination-wary groups call for halt of oral polio vaccine

Let’s not let them scare parents away from vaccinating and protecting their kids, which would lead to even more cases of both wild polio and vaccine derived polio.

More on the Polio Endgame

Are More Polio Cases Now Being Caused by the Vaccine Than by Wild Polio Viruses?

Why would people think that more polio cases are now being caused by the vaccine than by wild polio viruses?

More polio cases are now being caused by the vaccine than by wild polio viruses.

Well, it’s true…

Are More Polio Cases Now Being Caused by the Vaccine Than by Wild Polio Viruses?

Wait, what?

“It is no exaggeration to describe it as a crisis. Even worse, looking more widely at the current state of polio eradication, the crisis has three peaks: the first is the level of wild polioviruses in Pakistan; the second is the way that the escalating restrictions in access in Afghanistan have created a huge immunity gap; and the third peak is the widespread occurrence of vaccine-derived polioviruses.”

Independent Monitoring Board 17th Report

Yes, as we are getting close to eradicating polio, we had been seeing fewer and fewer cases of wild polio in the world.

“In rare cases, the live virus in oral polio vaccine can mutate into a form capable of sparking new outbreaks.”

Report raises concern about rare polio cases caused by oral vaccine

And we have been seeing more cases of vaccine-derived polio, which is rarely caused by the oral polio vaccine.

Fortunately, something that most folks miss is that the polio vaccine protects against both wild polio and vaccine-derived polio.

“As recently as 30 years ago, wild poliovirus paralysed more than 350,000 children in more than 125 countries every year. In 2018 there were fewer than 30 reported cases in just two countries – Afghanistan and Pakistan.”

“Zero polio transmission and health for all”, WHO Director-General gives new year’s wish to the people of Afghanistan and Pakistan

And of course, if we weren’t using these polio vaccines, while that would solve the problem of vaccine associated polio, we would simply be seeing lots more wild polio.

More polio cases are now being caused by the vaccine than by wild polio viruses.

Even though cases of wild polio are up this year, after years of decline, they are still tremendously below what they were in the pre-vaccine era.

Remember, we are comparing about 300 cases of wild and vaccine-derived polio that we see today with more than 300,000 of wild polio that we used to see!

“Global efforts to immunise children with the oral polio vaccine (OPV) have reduced wild poliovirus cases by 99.9% since 1988.”

Fact Sheet: Vaccine-Derived Poliovirus

And even those 300 cases of wild and vaccine-derived polio cases can be eliminated if more kids get vaccinated.

“Today, global leaders convened at the Reaching the Last Mile (RLM) Forum in Abu Dhabi to affirm their commitment to eradicate polio and pledge US$2.6 billion as part of the first phase of the funding needed to implement the Global Polio Eradication Initiative’s Polio Endgame Strategy 2019-2023.”

Global leaders pledge US $2.6 billion to eradicate polio at the Reaching the Last Mile forum in Abu Dhabi

And we will get those kids vaccinated.

“Fourthly, rumours and deliberate social media seeding of misinformation about the polio vaccine has had a big impact on refusal rates. Fifthly, organised boycotts of the Polio Programme to gain political concessions have reduced some communities’ acceptance of the polio vaccine.”

Independent Monitoring Board 17th Report

And we will eradicate polio.

More on Polio Eradication