Without them, we will see even more outbreaks of measles, mumps, and pertussis and kids will continue to die of rabies, tetanus, and other now vaccine-preventable diseases.
A diphtheria cemetery in Wyoming.
Isolation hospitals and pest houses were commonly used to quarantine folks with smallpox and other now vaccine-preventable diseases.
Even mild smallpox, as depicted on this WHO Smallpox Recognition Card, included flu like symptoms, a few weeks of pustules, and then waiting for the lesions to scab over…
People continued to die of smallpox well into the 20th century, even though an effective vaccine was developed in 1796.
Outbreaks of polio would once isolate entire towns, as parents feared their kids would get sick too.
When was the last time you saw a child with polio?
Before wide use of the Hib and Prevnar vaccines, younger infants with fever would routinely need spinal taps and you would hope for clear fluid (cloudy fluid could be a sign of a Hib or Strep pneumo infection).
In the pre-vaccine era, Hib caused epiglottitis, meningitis, and pneumonia – all life-threatening diseases that are now prevented by the Hib vaccine.
Before the 1990s, when the Hib vaccine available, hospitals had an epiglottitis team on call and always available.
In 1885, several boys from Newark went all of the way to Paris to get Pasteur’s new rabies vaccine, as the disease had always been fatal up until that time.
Even if they survive, kids can lose fingers, toes, or even arms and legs to meningococcemia.
Roald Dahl’s daughter died of measles in 1962, the year before the development of the first measles vaccine.
Nationwide, at least 123 people died in the United States during large measles epidemics from 1989 to 1991, a time when we had good sanitation, nutrition, and medical care, but some folks weren’t vaccinated and we weren’t yet giving a second dose of MMR.
A papilloma caused by HPV on the vocal cords of a child with recurrent respiratory papillomatosis. (CC BY 4.0)
You don’t have to go back to the pre-vaccine era to know that pertussis kills. Ten infants died in 2010 in California from pertussis infections.
We should know that vaccine-preventable diseases were rarely mild, natural immunity comes at a cost, and that those who died from smallpox, diphtheria, measles, and polio aren’t around to talk about their experiences on Facebook (survivorship bias).
We should never forget that vaccine-preventable diseases were once big killers, and the only reason some folks have grown to fear the side effects of vaccines more than the diseases they prevent, is because we don’t see those diseases very much any more. If more people skip or delay getting vaccinated, we will though.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO
Outbreaks of vaccine-preventable diseases belong in the past.
What to Know About Life Before Vaccines
Forgetting the pre-vaccine era and the benefits of vaccines makes folks susceptible to anti-vaccine talking points and scares them away from vaccinating and protecting their kids.
You probably don’t know anyone who ever had polio.
The Last Case of Polio
After all, the United States has been free of polio since 1979. At least that’s when we had the last endemic case or the last case that originated here.
The last case was in 1993. At least that’s when we had the last imported case of polio in the United States.
A 2005 outbreak of vaccine derived poliovirus in 2005 among a group of unvaccinated Amish in Minnesota didn’t cause any symptoms. They had probably been exposed to someone outside the United States that was still shedding after getting an oral polio vaccine, which hadn’t been used in the United States since 2000.
And then there were these following “last cases:”
The last case of VAPP that was acquired in the United States – 1999.
The last case of VAPP that was acquired outside the United States – 2005 – an unvaccinated 22-year-old U.S. college student who became infected with polio vaccine virus while traveling in Costa Rica in a university-sponsored study-abroad program.
And then there is the final last case of VAPP – 2009 – a patient with a long-standing combined immunodeficiency who was probably infected in the late 1990s, even though she didn’t develop paralysis until years later.
Polio Survivor Stories
Since vaccines work and the United States has essentially been polio free since 1979, it wouldn’t be surprising if you don’t know anyone who ever had polio.
Or do you?
“The doctors told my parents that little could be done for me, so my father prepared for my funeral. Fortunately, I recovered, except for the use of my right hand.”
Archbishop Desmond Tutu on Vaccination’s Lifetime of Blessings
You might not have ever have even heard of anyone who had polio?
Or have you?
A few recent news stories highlight just how common polio used to be in the pre-vaccine era:
Mitch McConnell Wouldn’t Meet with the March of Dimes Even Though They Treated His Polio as a Child
Joni Mitchell – after the stuff about Morgellons, you can read about how she battled polio as a child
“When Joni turned 10 years old in late 1953, she woke up one morning paralyzed. It was quickly diagnosed and she was shipped to a polio colony in Saskatoon – similar to a leper colony designed to halt the spread of the disease.”
Do you know who else had polio?
Itzhak Perlman, a polio survivor, now works to end polio.
Alan Alda
Arthur C. Clarke
Francis Ford Coppola – “contracted polio and spent almost a year in bed, his legs paralyzed.”
Mia Farrow
Frida Kahlo
Jack Nicklaus
Itzhak Perlman – has needed crutches to walk since he contracted polio at age 4 years
David Sanborn
Dinah Shore
Donald Sutherland
Desmond Tutu –
Neil Young
Of course, in addition to all of the polio survivor stories, there are stories that aren’t told of the people who didn’t survive polio.
Reading polio stories, from survivors and of those who died, helps reinforce how important it is that we eradicate this vaccine-preventable disease as soon as possible.
We know that vaccines are safe, even if they can have some side effects and risks.
And we know that vaccines work, even if they don’t work 100% of the time.
In fact, vaccines work so well, that they have eliminated or controlled many of the vaccine-preventable diseases that we still get vaccinated against.
Are Vaccines Still Necessary?
So that leaves some people asking themselves – even if the benefits of vaccines far outweigh their risks, are vaccines still necessary?
“So what I did on my schedule is, I took a more logical look at hepatitis B, and I realized that babies have no risk of catching this disease, so let’s not do the hep B vaccine while a baby’s young and small and more vulnerable.”
Dr. Robert W. Sears on Why Partial Vaccinations May Be an Answer
After all, most of us don’t travel to developing countries or do other things to put ourselves or our kids at risk of getting a vaccine-preventable disease, right?
And we probably don’t have conditions that put us at high risk of getting sick either?
So isn’t it safe to just skip or delay many of the shots on the routine immunization schedule?
Shouldn’t some of them just be optional now?
Vaccines Are Necessary
Alternative vaccine schedules? Optional vaccines? No risk of getting diseases? Those are the arguments you will see on many anti-vaccine websites and forums, but they certainly aren’t logical arguments.
“The reason I delay the polio vaccine on my alternative schedule is that we don’t have polio in the United States. We haven’t had it here for over 30 years. We’ve been very fortunate because the vaccination program for polio has been so successful, now we’re reaping the rewards of not having to worry about this disease.”
Dr. Robert W. Sears on Why Partial Vaccinations May Be an Answer
Did you know that an unvaccinated group of Amish children got infected with polio in 2005?
Or that an otherwise healthy, unvaccinated 22-year-old U.S. resident became infected with polio vaccine virus, developing paralytic polio, while traveling in Costa Rica in a university-sponsored study-abroad program in 2005? It turns out that the granddaughter of the host family that she was staying with lived next door and had recently been vaccinated with the OPV vaccine, which does shed, and in this case caused her to develop vaccine-associated paralytic polio.
And did you know that there was a lethal case of vaccine-derived poliomelitis in Minnesota in 2009?
Apparently Dr. Bob didn’t either.
“We know that a disease that is apparently under control can suddenly return, because we have seen it happen, in countries like Japan, Australia, and Sweden. Here is an example from Japan. In 1974, about 80% of Japanese children were getting pertussis (whooping cough) vaccine. That year there were only 393 cases of whooping cough in the entire country, and not a single pertussis-related death. Then immunization rates began to drop, until only about 10% of children were being vaccinated. In 1979, more than 13,000 people got whooping cough and 41 died. When routine vaccination was resumed, the disease numbers dropped again.”
CDC on What Would Happen If We Stopped Vaccinations?
But while polio is now on the brink of elimination, most other vaccine-preventable diseases are not. And that is why we see outbreaks any time vaccination rates drop:
measles – in addition to the outbreaks in the United States, there have been much bigger outbreaks across Europe, with much deadlier consequences
pertussis – yes, some of our pertussis outbreaks are because of waning immunity and occur in fully vaccinated children, but there were even larger outbreaks in Japan, Sweden, Italy, Ireland, Australia, and other countries in the 1970s and 1980s when immunization rates dropped, cases soared, and children died.
diphtheria – few people even know what diphtheria is anymore, but it is still around and causes outbreaks when immunization rates drop.
rubella – want to know what happens when you don’t vaccinate for rubella? just look at Japan – they had 14,357 cases of rubella and at least 31 cases of congenital rubella syndrome in 2013.
Hib – a 2008 outbreak in Minnesota during a temporary vaccine shortage likely reflected “increasing carriage and transmission affecting those with suboptimal primary series vaccination coverage, or a weakening of herd immunity”
tetanus – although tetanus isn’t contagious, we are seeing more cases in kids and pregnant women who aren’t vaccinated, as the bacteria which causes tetanus is present in spores in dirt and dust almost everywhere
polio – although polio is now endemic in only three countries, Afghanistan, Nigeria, and Pakistan, there are other countries where outbreaks can still occur, including the DR Congo and Syrian Arab Republic and many other high risk countries. This includes outbreaks of circulating vaccine derived polio virus, which increased this year in non-endemic countries, especially Syria because of years of poor immunization rates because of war.
Vaccines are necessary to avoid these kinds of outbreaks.
What Happens When We Don’t Vaccinate?
It should be very clear that everyone can’t try to hide in the herd.
We know what happens when too many people don’t vaccinate their kids.
At least those of us who understand herd immunity know what happens…
In Ukraine, for example, there was a “massive epidemic” of diphtheria and other vaccine-preventable diseases in the Newly Independent States of the former Soviet Union in the early 1990s.
“This epidemic, primarily affecting adults in most Newly Independent States of the former Soviet Union, demonstrates that in a modern society diphtheria can still spread explosively and cause extensive illness and death.”
Diphtheria in the Former Soviet Union: Reemergence of a Pandemic Disease
In Ukraine alone, there were 17,387 cases of diphtheria and 646 deaths from 1992 to 1997. Also high, were cases of measles (over 23,000 cases in 1993) and pertussis (almost 7,000 cases in 1993).
Vaccine preventable diseases are just a plane ride away.
Need a more recent example?
Just look at the tragedy unfolding in Venezuela. In addition to all of the hardships the people are facing, because of a weakened health system, poor surveillance, and a lack of preventative measures, including immunizations, they are seeing a rebound of diphtheria, measles, and other infectious diseases.
After being eliminated in 1992, there have been at least 450 cases of diphtheria in Venezuela since 2016 and at least 7 deaths.
Vaccines are necessary.
Vaccine-preventable diseases will come back if we stop vaccinating our kids.
And tragically, they aren’t yet gone in many parts of the world, even those that are well controlled in more developed countries. That’s why we often say that these diseases are ‘just a plane ride away.’
Just remember that the planes travel both ways. It isn’t just you traveling to high risk areas. Sometimes folks who are sick with vaccine preventable diseases bring them home and start outbreaks.
Polio is caused by one of three wild-type polio viruses.
Of course, anti-vaccine folks like to push misinformation about polio being caused by a lot of other things, from poor hygiene and eating too much white bread to having a tonsillectomy or being exposed to pesticides, like DDT.
“Williams describes the many blind alleys and false leads of the early days of polio research, when doctors, scientists, and public health officials were convinced that the disease was transmitted by bedbugs, budgies, cats, and flies, or caused by seafood, cow’s milk, jimson weed, fruit, vegetables, and DDT…”
If the polio virus doesn’t cause polio (germ theory denialism), then you can’t really expect the polio vaccine to prevent polio, now can you?
The DDT-Polio Connection?
There actually is a bit of a connection between polio and DDT, but not the one anti-vax folks think.
Wait, what?
No, DDT didn’t cause polio.
“Between the end of World War II and the early 1950s, researchers, municipal officials, and individuals from Georgia to California employed DDT to stop polio by killing flies, a suspected but debated actor in the disease’s transmission.”
Conis on Polio, DDT, and Disease Risk in the United States after World War II
Yes, many towns would routinely spray with DDT after a polio epidemic came to town because they didn’t yet know what did cause polio.
For example, in May 1946, “sections of the city were blanketed” with DDT as they sought to stop the source of a polio epidemic in San Antonio, which they thought might be a “tropical mosquito.”
Even the schools were closed in San Antonio when polio came to Texas in 1946. And they stayed closed for the last few weeks of the Spring term!
See the connection now?
Polio first. DDT spraying after.
This idea is especially easy to see when you understand that there were many polio outbreaks and epidemics in the late 19th and early 20th century, well before DDT was discovered to be an effective insecticide in the early 1940s.
And the spraying mostly stopped before the polio outbreaks stopped.
In 1951, although he wasn’t yet sure how the polio virus spread, Dr. Sabin did know it came from “human feces derived from patients and healthy carriers,” and he declared that there was “general agreement that there is no justification for initiating emergency insect control measures in the hope of stopping a poliomyelitis epidemic.”
“It is perhaps an established epidemiological principle that epidemiological probability must be compatible with bacteriologic (or virologic) possibility, particularly when the epidemiological probabilities lend themselves to several alternative explanations.”
Albert B Sabin, MD on Transmission of Poliomyelitis Virus
And even before that, the Editorial Board for the American Journal of Public Health, in 1946, said that “While municipal cleanliness and sanitation are always highly desirable, there is no reason to believe that improved methods of sewage treatment and disposal, more rigid standards for the purification of water supplies, or the dusting of DDT over a city from aeroplanes will have any measurable effect on the incidence of infantile paralysis.”
Also remember the other big reason that we saw DDT spraying in the United States – the elimination of malaria.
“The National Malaria Eradication Program, a cooperative undertaking by state and local health agencies of 13 southeastern states and the CDC, originally proposed by Louis Laval Williams, commenced operations on July 1, 1947. By the end of 1949, over 4,650,000 housespray applications had been made.”
CDC on Elimination of Malaria in the United States (1947 — 1951)
Did the spraying of DDT to eliminate the flies that transmit malaria in the southeastern United States correlate with extra cases of polio?
No.
There were big outbreaks in New York, Indiana, Ohio, and many other parts of the country that didn’t spray DDT to help fight malaria.
“The peak year for use in the United States was 1959 when nearly 80 million pounds were applied. From that high point, usage declined steadily to about 13 million pounds in 1971, most of it applied to cotton.”
EPA on DDT Ban Takes Effect
Did we stop spraying with DDT in the early 1950s because it was banned and is that why we stopped seeing so much polio?
No.
The peak year for DDT use was in 1959. Surprisingly, we don’t see that peak on any anti-vaccine graphs in 1959…
What was the peak year for polio cases? It wasn’t 1959 or 1960, as you would expect if there was a link between DDT and polio.
Although the use of DDT decreased after 1959, it was used until it was “banned” in 1972, and even then, there were exceptions for public health uses.
Explaining Polio
The polio virus causes polio.
But why?
Or at least why did we start seeing so many more cases in the late 18th through the mid 19th century, until it was controlled with our polio vaccines?
“…contrary to the prevailing “disease of development” hypothesis, our analyses demonstrate that polio’s historical expansion was straightforwardly explained by demographic trends rather than improvements in sanitation and hygiene…”
Martinez-Baker et all on Unraveling the Transmission Ecology of Polio
One rather simple and elegant explanation is that we started to get too clean, the “disease of development” hypothesis.
Improved hygiene and sanitation helped delay when kids would get polio. Remember, polio is spread by contaminated food and water through fecal-oral transmission.
So instead of routinely getting it when they were newborn babies or young infants, when they still had some protection from maternal antibodies, they got it later when they had no immunity. So polio essentially changed from an endemic disease, or something that everything got, to an epidemic form.
DDT is a pesticide that was widely used after World War II and was sometimes sprayed in a vain attempt to keep polio outbreaks from getting out of control. That is the only connection to polio though.
At least it is well known by the people who understand that vaccines are safe, vaccines are necessary, and that vaccines work.
If you are on the fence or hesitant to vaccinate your kids, you might not be so sure and might not know who to trust when it comes to getting information about vaccines.
That’s why it is important to get educated, be skeptical, and do your own research.
How Quickly Can You Debunk Anti-Vaccine Propaganda?
What do you think about the following photo description that is making the rounds on anti-vaccine websites and on Facebook?
How quickly could you figure out if the information is true or not?
Is this a photo of kids in iron lungs because of the Cutter Incident?
Of course, the Cutter Incident is actually true and plenty of folks ended up in iron lungs, mostly because of natural polio infections though, not because of the polio vaccine.
“In 1952 alone, nearly 60,000 children were infected with the virus; thousands were paralyzed, and more than 3,000 died.”
Jason Beaubien on Wiping Out Polio: How The U.S. Snuffed Out A Killer
Let’s start doing some research…
The first clue that this isn’t real is that the cases from the Cutter Incident would have been spread out over the five Western and mid-Western USA states where kids got this particular polio vaccine. With about 200 of them severely affected, they almost certainly would not have had such a large group of people in iron lungs, enough to fill a gymnasium, in just one area.
The next clue is that the iron lungs aren’t plugged in.
That led me to a quick search for ‘iron lung photos’ and an article on Understanding Historical Photos that features the iconic “Iron lungs in gym” photo.
“At first glance, this image shocks and saddens from the enormity of the problem of sick children in need of iron lungs. On closer examination, it is clear that the equipment that usually accompanied people using iron lungs, such as tracheotomy tubes and pumps and tankside tables, is not present (compare the picture to photographs in the section on the iron lung). This scene was staged for a film. It is not historically accurate as a respirator ward, but is an example of an established photographic technique (famously used, for example, by WPA photographers in the 1930s) of directing the viewer’s response by creating a shot that would not naturally occur. ”
Smithsonian National Museum of American History on Understanding Historical Photos
A little more research helped me discover that the photo was taken:
for an informational film that was being produced by the March of Dimes
in the auditorium of the Rancho Los Amigos National Rehabilitation Center in Downey, California USA
in 1953
So it took less than a few minutes to figure out that the folks who claim to be “exposing the truth” about vaccines are pushing pure propaganda.
Remember, the Cutter Incident happened in 1955, two years after this photo was taken…
So, a staged 1953 photo for an informational movie for the March of Dimes does not show kids in iron lungs from the Cutter Incident!
How long would you have believed this or other polio myths?
How long would it take you to debunk them?
What to Know About Debunking Anti-Vaccine Propaganda
Learn just how quickly most anti-vaccine misinformation can be debunked if you simply practice being a little skeptical and do your own research.
So far this year, there have only been 11 cases of wild polio in the world – 6 in Afghanistan and 5 in Pakistan.
“In 1952 alone, nearly 60,000 children were infected with the virus; thousands were paralyzed, and more than 3,000 died.”
Jason Beaubien on Wiping Out Polio: How The U.S. Snuffed Out A Killer
Robin Cavendish was born and raised in the pre-vaccine era though, before we had the polio vaccines that have controlled, and will hopefully soon eradicate, polio.
Who Is Robin Cavendish?
Breathe is the story of Robin and Diana Cavendish.
Robin Francis Cavendish was born on March 12, 1930 in Middleton, Derbyshire, England.
After an early career in the Army, he helped start a tea-brokering business in Africa and made frequent trips to Kenya.
It was in Kenya that he developed paralytic polio in December 1958, just over three years after Jonas Salk‘s polio vaccine was found to be effective in field trials (April 1955).
Although he was initially given just three months to live after his diagnosis, with the help of his wife Diana, he was able to survive for another 36 years!
And they did a lot with those years, including:
using a specially adapted van to travel around England
developing a wheelchair with a built-in respirator with their friend, Oxford professor Teddy Hall and his company Littlemore Scientific Engineering. Their first prototype of their portable respirator was released in 1962 – the Cavendish Chair.
helping scientists develop the Possum, a device that helped severely disabled people electronically control their environment, including answer the phone or turn on the TV
becoming an advocate for other polio survivors
co-founding the charity Refresh with Dr. Geoffrey Spencer, which started as a way for families who needed extra help because of the need for a respirator to go on vacation together
The story of his remarkable life is told in the new movie Breathe.
And while it is also a great reminder of what life was like before we had vaccines, we shouldn’t forget about all of the other polio survivors, some of whom now have to deal with post-polio syndrome.
Nor the fact that we are so close to ending polio. Or at least new polio infections.
What to Know About Robin Cavendish
Robin Cavendish was a respirator dependent polio survivor whose life story is told in the new movie Breathe.
Some can even help you understand why you are afraid of vaccines.
Unfortunately, if you simply search Amazon for books about vaccines, you are going to be hit with a list of anti-vaccine books. These are books that push their own made-up, so-called alternative immunization schedules and misinformation about vaccines to scare you away from vaccinating and protecting your kids.
Best Vaccine Books
Which books about vaccines have you read?
Did you even realize you had so many choices?
These books about vaccines and vaccine-preventable diseases can help with your research about vaccinating and protecting your family.
Some of my favorite vaccine books that can help you with your research on vaccination and making the right decision for your child include:
Your Baby’s Best Shot. Why Vaccines Are Safe and Save Lives
How many of these books about vaccines have you read?
What To Know About Vaccine Books
If you were scared away from vaccinating your kids because of a book you read or something you saw on the Internet, consider reading a few of these vaccine books that are based on evidence, not fear.
