This is a fascinating history of vaccination and its troubles, with a less convincing conclusion about the declining take-up of vaccination.
Vaccination started with diseases like smallpox, which killed millions. Then it was discovered that, even in the case of very infectious diseases, if only 90 per cent or so of a population were vaccinated, there would be too few hosts left for the microbe to survive and “herd immunity” would result. After a time, the whole programme could be shut down because the terrible disease would have been eradicated from our planet.
Blume makes it clear that he is all in favour of triumphs like this. Attempts to eradicate polio are dealt with at length, complete with the early arguments over the best kind of vaccine to introduce – live or dead – and the suspicion that, in the first years of the campaign, some children were damaged or killed by vaccines that were not fully understood. Yet this model of disease eradication survived, to everyone’s benefit.
Then came the 1980s stress on free market ideology, when vaccination became the prerogative of the private sector. Inevitably, there followed a profit-driven trend for vaccination against relatively mild childhood diseases such as mumps. Measles seems to be on the cusp for Blume – a killer in developing countries but far less serious in developed countries.
According to Blume, the causes of “vaccine hesitancy” are multi-faceted, and nationally specific, from protest against state authority to suspicion of the drug companies. The medical profession prefers to blame the anti-vaccine campaigners, because this is simple and they would not know what to do if they had to face up to the true causes. But Blume does not say what should be done and sometimes seems to champion parents’ suspicions about vaccination. After all, the drug companies are after profit and mumps doesn’t do much harm; when the drug companies use advertising to convince everyone that it does, they can make a lot of money from vaccination.
My touchstone for analyses of debates over vaccination is the scientifically baseless revolt over the mumps, measles and rubella vaccine (MMR) and I don’t think Blume handles it clearly. He helps us understand parents’ doubts but not that panics like this can be based on trivial suspicions (what about a panic over consumption of kiwi fruit?) when the news media amplify the fears in the way they did in the case of MMR. Parents are justifiably fearful for their children – plenty of parents are quoted – but vaccination is special because my next-door neighbour’s refusal to vaccinate puts my own child at risk.
Blume does not ask who, in the world we live in, should make the decision to vaccinate widely. While he condemns the drug companies’ highly effective use of the media to advertise the dangers of mild diseases, anti-vaccination campaigns, amplified by what we now know are frighteningly effective social media, are treated as only a superficial problem. Please, governments, for the sake of my grandchildren, counter anti-vaccination movements and their media amplifiers with official information campaigns, irrespective of any deeper, historical, causes of resistance. Even in developed countries, measles is deadly dangerous for the weak and undernourished.
Harry Collins is distinguished research professor in the School of Social Sciences at Cardiff University.
Immunization: How Vaccines Became Controversial
By Stuart Blume
Reaktion Books, 272pp, £25.00
Published 28 July 2017