By Casey Hurrell
Hackett, Lewis Wendell, “Quince Mil, Yellow Fever vaccination,”100 Years: The Rockefeller Foundation, accessed March 25, 2015.
As the Ebola epidemic winds down in West Africa, the World Health Organization is stressing the necessity of reestablishing routine immunization activities, especially for measles and pertussis (whooping cough). Estimates suggest that the rate of routine immunization against preventable diseases, including measles, plummeted by up to 75% during the Ebola epidemic. Measles outbreaks often follow humanitarian crises, including epidemic outbreaks of other diseases, violence conflict, and ecological disasters. This is due to the sheer virulence of the disease, and the fact that baseline immunization rates tend to be lower than for other EPI vaccines —an outbreak of measles indicates the early stages of health system failure. The inverse is also true; where vaccination campaigns are successful, and there is buy-in from local communities, the entirety of the health system can be strengthened from the ground up. The diseases targeted for immunization efforts have shifted over time, but the message has remained the same: mass vaccination campaigns are among the best ways of lessening the disease burden, and tackling the health problems that affect developing societies head-on. But the story is rarely that simple. History has lessons for global health, as always. [click to continue…]
By Anne Hardy
The declining mortality from infectious disease in Victorian Britain owed little to preventive medical procedures such as vaccination. One thing is certain: the modern anti-vaccine movement has recently brought great attention to the role of vaccines in reducing child mortality during the 20th century. And while this is particularly true for diseases like measles and polio, the reality is that the greatest decline in mortality from infectious diseases occurred well before the introduction of successful and widely used vaccines. It’s therefore important that we look at the history of infectious diseases and vaccines in context so that we can better understand the role of medicine, social change, and public health more generally in explaining how we got where we are today and what role compulsory vaccination might play in the future.
Infectious diseases have been a scourge of humankind at least since the hunter-gatherers formed settled communities, took up farming and domesticated livestock. For much of history the emergence and impact of these diseases on human societies went unrecorded, except in relation to such drastic events as the Great Plague of Athens, the Black Death, or the appearance of syphilis in Western Europe. It was only in the nineteenth century, when public health became a political and economic issue that the problem began to be documented numerically.
Britain was the first, and for a long time the only, country to put into place a dependable official system for recording deaths and causes of death (as well as births and marriages), from 1837 in England and Wales, from 1854 in Scotland. It was soon abundantly clear that infectious diseases exacted a high price in terms of death and morbidity, and that this was principally an urban problem. Britain’s great cities were hotbeds of infection, their death rates far outstripping those of the county boroughs and rural areas. [click to continue…]