Tag: smallpox

How Misinformed and Irresponsible Parents Led to Outbreaks of Smallpox

In our age of social media, we have gotten used to hearing from the Surgeon General and most everyone else in our government.

The Surgeon General had to address misinformation and propaganda about vaccines nearly 100 years ago.
The Surgeon General had to address misinformation and propaganda about vaccines nearly 100 years ago.

Folks likely weren’t as used to this back in the early part of the 20th Century.

Surgeon General Letter to All State Health Officers

At the time, because of a return of smallpox, H.S. Cumming wrote this letter:

To all State Health Officers:

The neglect of vaccination in many districts of certain sections of the United States has led to a recrudescence of smallpox, with the corresponding suffering experienced by its victims and a wholly unnecessary sacrifice of human lives in the years 1922 and 1923 amounting to 967 known deaths from smallpox and possibly a number of others which were not reported. During the first six months of 1924 an additional toll of at least 200 human lives has been taken every one of which deaths could have been prevented by vaccination and revaccination.

The increasing number of cases of smallpox and the continued spread of this disease from city to city and from State to State will, if not checked, not only augment the number of victims but may bring about a condition which would seriously interfere with the movements of passengers on trains steamers, automobiles, and other carriers. It is conceivable that this interference might be of a degree that would involve the expenditure of hundreds of thousands of dollars in quarantine, a contingency which might easily be avoided provided our people can be induced to protect themselves by vaccination and revaccination.

The Public Health Service is being importuned at the present time to exercise its authority in enforcing interstate quarantine to prevent the migration of the unvaccinated when there is danger that these persons may have been exposed to smallpox.

It is particularly desirable that the Federal Government may not be forced to interfere in interstate travel and it is earnestly hoped that the authorities of all States, counties, municipalities, or other units of government will immediately begin campaigns to secure the vaccination or revaccination of all persons who have not been recently successfully vaccinated particularly in those States where smallpox is prevalent.

Vaccination and revaccination being a perfect protection against smallpox it might be argued that protection against the disease is a matter which should be left to the discretion of the individual, but there is no more reason for leaving the defense against an enemy of the State, such as smallpox is, to the discretion of the individual, than there would be in leaving the defense of the State against an armed invading force to the individual. These enemies are equally dangerous. Furthermore there are a large number of persons who are otherwise good citizens who because of indifference, carelessness, and lack of information, and oftentimes because of having been deceived by false propaganda and deliberate misinformation, either fail or refuse to protect themselves and their trusting but helpless children until it is too late. These same children of misinformed or irresponsible parents being too young to judge for themselves are entitled to the protection of the State and certainly the State is derelict in its duties if it allows such unprotected children to be exposed to smallpox.

Respectfully HS CUMMING Surgeon General

The response to the foregoing letter has been very gratifying. At the same time, much still remains to be done in the way of vaccination and revaccination of our nonimmune population if a recrudescence of this disease is to be forestalled.

Does any of that surprise you?

Talk of “enforcing interstate quarantine?”

People being deceived by “false propaganda and deliberate misinformation?”

Folks skipping vaccines and allowing a vaccine-preventable disease to return?

Unnecessary sacrifice…

Why?

What were they worried about?

It wasn’t autism!

And it couldn’t have been that they were getting too many vaccines

But they were still led to believe that vaccines were dangerous and they let that misinformation influence them, putting their kids at risk, with tragic results.

One hundred years later, folks shouldn’t still be making these same mistakes.

More on Misinformed and Irresponsible Parents

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

Can You Go to Jail for Not Vaccinating Your Kids?

Believe it or not, parents have been jailed for not vaccinating their kids.

In a recent Michigan case, a mother was jailed for refusing a court order to vaccinate her son. The court had agreed with the boy’s father that the child should be vaccinated and protected.

So this case was not just about vaccines, but about divorced parents who disagreed about how to care for their child…

Can You Go to Jail for Not Vaccinating Your Kids?

Although it isn’t common, historically, there have been other stories of parents going to jail for not vaccinating their kids.

Parents in Maryland were surprised that they might face jail time for not vaccinating their kids.
Parents in Maryland were surprised that they might face jail time for not vaccinating their kids.

Recently, in 2007, parents were warned that they might be sent to jail for not vaccinating their kids. The problem wasn’t just vaccines though, as these parents could have gotten exemptions. And they had several months to do so before the Judge gave his warning…

No one went to jail in Maryland in 2007.

Have you ever heard of John (Jack) Marsh?

Going to jail for not vaccinating his kids became routine for John Marsh.

In 1946, he was put in jail and his daughter, Betty Jane, was taken by child welfare services so that she could get a smallpox vaccine. His son Marlin was also to be taken, but couldn’t be found.

What happened next? We don’t know. That was the last report about John Marsh and his family.

We do know a lot about what happened before this though…

John Marsh was first jailed in 1937 for not vaccinating his kids.

John Marsh’s story started nearly 12 years earlier!

In 1934, he spent 7 months in jail because he wouldn’t vaccinate his children Daniel and Lorna. As in 1946, those children were taken and vaccinated and Marsh was released.

John Marsh was again jailed in 1937 for not vaccinating his kids.

He was also put in prison in 1937 over getting his son Eugene vaccinated.

John Marsh was jailed over and over from 1937 to 1940 because he wouldn't vaccinate his kids.

Why was he against vaccinating his kids?

John Marsh believed that his nieces were vaccine injured.
John Marsh believed that his nieces were vaccine injured.

He believes that a smallpox vaccine caused two of his nieces to go blind. One of them became blind about two weeks after getting her smallpox vaccine. Two weeks later, her sister also became blind. And then another.

What could have affected these girls in 1925 besides Mildred’s smallpox vaccine? Trachoma was once a common cause of blindness in the United States and it was quite contagious.

Even though two weren’t even vaccinated, the family still thinks that they all suffered from some kind of vaccine injury.

“The infrequency of eye involvement following vaccination is very striking when we consider the number of vac­cinations, the doubtful handling that many receive, and the ease with which infection may be transferred.”

Arthur J. Bedell, M.D., F.A.C.S. on Multiple Vaccination of the Eyelids

Interestingly, ocular vaccinia is a known, rare complication of getting a smallpox vaccine. It could occur if you touched the site of vaccination and then touched your eye, and so could also occur if you were in close contact with someone who was recently vaccinated, as the Marsh sisters.

Unlike these girls though, the infection typically only involves one eye, would cause lesions suspicious for vaccinia in or near the eye, which were never mentioned, and often leaves obvious lid deformities.

And doctors did not believe that those girls had a reaction to the vaccine.

John Marsh never won any of his cases and his kids always ended up getting vaccinated...
John Marsh never won any of his cases and his kids always ended up getting vaccinated…

Are there any other cases of parents going to jail instead of vaccinating their kids?

In 1899, apparently there wasn't a religious exemption to getting vaccinated.
In 1899, apparently there wasn’t a religious exemption to getting vaccinated.
Yes, we had anti-vax chiropractors way back in 1926.
Yes, we had anti-vax chiropractors way back in 1926.
In 1942, Bowser's two children were admitted to a county Children's home and vaccinated, as they had never been to school.
In 1942, Bowser’s two children were admitted to a county Children’s home and vaccinated, as they had never been to school.
This was in 1924, but just like today, these parents didn't win their court case.
This was in 1924, but just like today, these parents didn’t win their court case.

Could any of this happen now?

We still have truancy laws and laws about kids getting vaccinated…

Jack Marsh had an alternative to going to jail over not vaccinating his kids...
Jack Marsh had an alternative to going to jail over not vaccinating his kids…

But no one wants parents to go to jail over vaccination decisions.

And no one wants kids to be forced to get vaccines.

Vaccination laws were being strictly enforced to try and control outbreaks and epidemics of smallpox, which still occurred in the 1920s and 30s.
Vaccination laws were being strictly enforced to try and control outbreaks and epidemics of smallpox, which still occurred in the 1920s and 30s.

We also don’t want kids to get sick and disease to spread because of ignorance and unnecessary fear of vaccines.

Who is scaring these parents in the first place?
What is scaring these parents in the first place?

Unfortunately, anti-vax folks create a viscous cycle.

As they scare more and more parents, they create pockets of susceptible children, and larger and larger outbreaks of vaccine-preventable diseases, which eventually require stricter vaccine requirements and mandates to control.

More on Jail and Vaccines

How Much Shedding Would a Vaccine Shed…

Are you still confused about vaccine shedding?

You should be worried about wild diseases, not shedding from vaccines.
You should be worried about wild diseases, not shedding from vaccines.

As this infographic describes, it really isn’t that complicated…

What Does Vaccine Shedding Really Mean?

To clear up some things:

  • yes, some vaccines do actually shed, but it is rarely a reason to avoid getting vaccinated and protected
  • of the vaccines that we use routinely, shedding is limited to the rotavirus vaccines, FluMist, and the chickenpox vaccines
  • some other vaccines that can shed include the oral polio vaccine and the smallpox vaccine
  • the rubella component of MMR may very rarely shed, but only in breastmilk

If vaccines do shed, why shouldn’t we be more concerned about it?

Well, for one thing, most vaccines don’t shed.

DTaP, hepatitis A, hepatitis B, Hib, flu, IPV, HPV, meningococcal, pneumococcal, and Tdap shots – none of them shed.

And then there is the fact that:

  • when a vaccine sheds, it is the weakened or attenuated vaccine strain, not the wild strain that would cause more serious disease. Putting it another way, if the vaccine strain doesn’t make the person who is getting immunized sick, then why would it get someone else sick if they got it through shedding? Of course, there is a situation in which even a vaccine strain could be dangerous, and that’s for those who are severely immunosuppressed. Still, natural disease would be bad for these kids too!
  • even with oral polio vaccines, the problem isn’t really shedding, which actually provides a type of passive immunization in areas where polio is still not well controlled. The problem is that very rarely, the attenuated virus in the oral polio vaccine can revert to a form that can cause the person who was vaccinated to actually develop polio (VAPP). Now, shedding of this strain would be a problem, but only if the other person wasn’t immune.
  • rotavirus vaccines only shed in stool. You can avoid it by washing your hands when you change your child’s diapers, which you hopefully do anyway.
  • FluMist is attenuated and cold-adapted, which means that it won’t replicate well in our warmer nasal passages and respiratory tracts.
  • you have to actually get a rash, which is rare, for the chickenpox vaccine to shed.
  • it is only kids with eczema that usually get sick if they are exposed to someone who recently had the smallpox vaccine. Since the smallpox vaccine causes skin reactions, even the attenuated vaccine strain can cause severe reactions if a child’s skin is already broken down, like with eczema.

Are you still concerned about shedding?

Can a Vaccinated Person Transmit Measles Through Shedding?

To put your mind at ease, understand that you are not going to get measles from shedding.

“In this systematic review, we have determined that there have been no confirmed cases of human-to-human transmission of the measles vaccine virus.”

Greenwood et al on A systematic review of human-to-human transmission of measles vaccine virus

Well, at least not from someone who was recently vaccinated shedding a vaccine-strain of measles

If you aren’t vaccinated and protected, you could easily get it from someone who has measles and who is shedding the wild type virus though. Measles is so contagious, you just have to be in the same room as someone with measles and you will likely get sick. In fact, you can enter a room a few hours after they have left and sill catch measles!

And in theory, if someone developed vaccine-associated measles – they got sick with a vaccine-strain of measles after getting vaccinated – then they could spread the virus to someone who wasn’t immune. That’s just because they would be contagious though, not anything specific to vaccines and shedding. Also, it is basically unheard of for this to happen.

Dectecting vaccine strain measles in urine isn't something to be concerned about because it can't lead to an infection. Measles is spread through respiratory secretions, not urine.
Dectecting vaccine strain measles in urine isn’t something to be concerned about because it can’t lead to an infection. Measles is spread through respiratory secretions, not urine.

What about all of those folks who test positive for vaccine-strain measles during an outbreak?

That’s not about shedding either.

They aren’t even people with measles. Instead, they typically have a vaccine reaction, a rash and/or fever after getting their MMR and they test positive for the vaccine strain of measles because they just got a live virus vaccine.

Is Vaccine Shedding a Threat?

Shedding isn’t the threat that anti-vaccine folks make it out to me.

Think about it. If it really was a big problem, then why don’t more intentionally unvaccinated kids with exemptions get sick when they are around kids who are vaccinated?

“Health officials should require a two-week quarantine of all children and adults who receive vaccinations. This is the minimum amount of time required to prevent transmission of infectious diseases to the rest of the population, including individuals who have been previously vaccinated.”

Sally Fallon Morell, president of the Weston A. Price Foundation

We don’t actually quarantine anyone after they are vaccinated, so why don’t more kids with immune system problems get sick via shedding?

Or just think about what happens in a typical daycare or school. All of the kids don’t get vaccinated on the same day, so if shedding was an issue, wouldn’t the kids who had gotten their vaccines first shed on the ones who weren’t yet vaccinated, getting them sick?

Of course, this doesn’t happen. Again, shedding isn’t the threat that anti-vaccine folks make it out to be.

More on Vaccine Shedding