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Anti-Vaxxers” Or Vaccine Mt Carmel-Like Challenge to Any Ten Was Not Exactly Safe – the Mortality Hesitancy Unvaccinated Priests of Baal

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Anti-Vaxxers” Or Vaccine Mt Carmel-Like Challenge to Any Ten Was Not Exactly Safe – the Mortality Hesitancy Unvaccinated Priests of Baal INSIGHT Text by Dr Hsu Li Yang Origin of vaccination Others before Dr Jenner had refers to “delay in acceptance or refusal observed that cowpox infection of vaccines despite availability of The term “vaccination” describes the protected against smallpox, and it vaccination services”,5 and this issue administration of a vaccine, which is is widely acknowledged that farmer has been around probably for as a “biological preparation that improves Benjamin Jesty from Dorset, England long as there has been vaccines. Rev immunity to a particular disease.”1 was the first to inoculate cowpox Cotton Mather, a preacher who had This term was coined by Dr Edward into his wife and two sons in 1774, advocated variolation in Boston, had Jenner after “variolae vaccinae” (Latin protecting them from the smallpox a bomb hurled through his window for “smallpox of the cow”), a story outbreak that occurred in his region.2 in November 1721 with the following that is reasonably well known.2 However, this does not in any way note: “Cotton Mather, you dog, dam Dr Jenner, however, was neither the reduce Dr Jenner’s achievement on you! I’ll inoculate you with this; with a first person to discover vaccination 14 May 1796 and afterwards, as he was pox to you.” The bomb fortunately did nor even the first to use cowpox to the first to study the phenomenon not detonate.6 protect against smallpox. Grinding scientifically and to publicise the up the dried scabs from smallpox Sir William Osler, who is still results. Many – most notably the great survivors and inoculating these into venerated today as a father of modern Louis Pasteur – have stood on his uninfected persons (variolation) had medicine, issued a challenge to “anti- shoulders to pave the way for the study been practised for centuries in China, vaxxers” that bears recounting, and of immunology and the discovery of India and the Middle East; Lady Mary which also hints at the shape and scale even more vaccines. Wortley Montague is credited for her of the anti-vaccination movement advocacy in establishing the practice of his day: “I would like to issue a of variolation in England.3 Variolation “Anti-vaxxers” or vaccine Mt Carmel-like challenge to any ten was not exactly safe – the mortality hesitancy unvaccinated priests of Baal. I will go was estimated to be 2%, which was The World Health Organization (WHO) into the next severe epidemic with nonetheless approximately seven listed vaccine hesitancy as one of the ten selected, vaccinated persons and times lower than the fatality rate top ten threats to global health for the ten selected unvaccinated persons – I of smallpox.2 first time in 2019.4 Vaccine hesitancy should prefer to choose the latter – 18 APR 2019 SMA News three members of Parliament, three The ease of access to information Local context anti-vaccination doctors (if they can via the Internet and social media In Singapore, at this time, we are be found), and four anti-vaccination appears to have made matters worse fortunate that the anti-vaccination propagandists. And I will make this rather than better, as confirmation movement is not as organised as in promise – neither to jeer nor jibe when bias has led to the formation of online other countries, with our vaccination they catch the disease, but to look after communities and “echo chambers” rates for the mandatory childhood them as brothers, and for the four or where selective sharing of scientific measles and diphtheria vaccines five who are certain to die, I will try to research and experiences have created holding out at 95% of the eligible arrange the funerals with all the pomp greater uncertainty around the safety population yearly. It is important today and ceremony of an anti-vaccination of vaccines.9 What is new today, relative to have an effective communication demonstration.”7 to the past, has been the exploitation strategy involving mainstream and of this issue on social media by Vaccine hesitancy has at its core social media channels around the malignant “state actors” (to borrow conflicts within the relationships topic of vaccines, even though it a recently popularised local term) to between humans, science, the is understood that the most rabid amplify social discord, which in turn power of the state and public health “anti-vaxxers” will not be swayed by erodes public trust and consensus on practice. Two primary themes have any amount of scientific evidence. On vaccination.10 threaded through the “anti-vaxxer” a perpetual basis, we should continue movements of the past and present: Unfortunately, the way forward to publicly commit to the safety of firstly, vaccines cause more harm is not straightforward. WHO did our vaccines (and drugs), as well as to than the diseases they are supposed not find a single intervention that implement the vaccination programmes to prevent; secondly, the issue of addressed all instances of vaccine – particularly the mandatory vaccines freedom of choice (conscientious hesitancy, recommending instead for children – in an even-handed and objections) versus compulsory multi-component strategies that responsible manner. vaccination.8 There have always been target specific under-vaccinated doctors, unfortunately, that are part groups, including interventions that of the “anti-vaxxer” movements, the enable vaccination behaviour.5 One most infamous of recent times being recent tragedy of vaccine hesitancy Dr Hsu is currently Head of the Dr Andrew Jeremy Wakefield who is the ongoing measles epidemic in Infectious Diseases published a fraudulent Lancet paper Philippines that began at the start Programme at the in 1998, claiming to link the measles, of this year, with more than 20,000 Saw Swee Hock mumps and rubella (MMR) vaccine cases and 300 deaths as of March. The School of Public Health and Clinical to autism and gut disease. His work Filipino authorities have attributed Director of the has been discredited multiple times this outbreak to the loss of trust in the National Centre for and he has been struck off the UK country’s immunisation programme Infectious Diseases. medical register, but his “alternative following the Dengvaxia scandal facts” have not come unstuck and he in 2017, with a steep plunge in remains very much a hero to the anti- vaccination rates of measles and other vaccination movement. diseases as a consequence in 2018.11 References 1. World Health Organization. Vaccines. Available at: https://www.who.int/topics/vaccines/en/. 2. Riedel S. Edward Jenner and the history of smallpox and vaccination. Proc (Bayl Univ Med Cent) 2005; 18(1):21-5. 3. Boylston A. The origins of inoculation. J R Soc Med 2012; 105(7):309-13. 4. World Health Organization. Ten threats to global health in 2019. Available at: http://bit.ly/2TXET6u. 5. World Health Organization. Report of the SAGE working group on vaccine hesitancy. Available at: http://bit.ly/2Yo4nZi. 6. Best M, Neuhauser D, Slavin L. “Cotton Mather, you dog, dam you! I’l inoculate you with this; with a pox to you”: smallpox inoculation, Boston, 1721. Qual Saf Health Care 2004; 13(1):82-3. 7. William Osler. Man’s Redemption Of Man; A Lay Sermon. Paul Hoeber, 1910. 8. Schwartz JL. New Media, Old Messages: Themes in the History of Vaccine Hesitancy and Refusal. Virtual Mentor 2012; 14(1):50-5. 9. van Schalkwyk FB. New potentials in the communication of open science with non-scientific public: The case of anti-vaccination movement. 2019. Available at: http://bit.ly/2TAF966. 10. Broniatowski DA, Jamison AM, Qi S, et al. Weaponized health communication: twitter bots and Russian trolls amplify the vaccine debate. Am J Public Health 2018; 108(10):1378-84. 11. Republic of the Philippines Department of Health. DOH identifies vaccine hesitancy as one of the reasons for the measles outbreak. Available at: https://www.doh.gov.ph/node/16721. APR 2019 SMA News 19.
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