The Nuances of Vaccination

anti-vaccine-movement-cartoon-sack
source: Steve Sack and Pat Bagley

Regardless of the issue at hand, there’s a price to pay when we dodge nuances. In recent decades parents have been in the spotlight for refusing to vaccinate their children. In chastising them, we reiterate that they have become suspicious of the “medical establishment” and have been influenced by fiction on the internet. There’s no doubt about the role of such causes, but in trying to change their minds, we also counter with a distorted picture of medical history, as if vaccination programs have placed us on a march towards the elimination of disease, as if modern medicine has enjoyed a record free of blemishes.

Thanks to Gerhard Adam,  I’ve probed into Statistics Canada, which reveals some surprising truths about life expectancy  and have scoured Jacalyn Duffin’s remarkable History of Medicine-A Scandalously Short Introduction. The author, a hematologist and historian from Queen’s,  mentions that in the 1970s Gerald Ford was prompted to start a huge campaign to vaccinate 45 to 50 million people. It was aimed at a flu virus that was perceived to be similar to the one which caused the 1918 pandemic and which claimed 20 to 40 million lives. More details are documented by the Center for Disease Control. Unfortunately, about two hundred vaccinated people contracted  Guillain-Barré syndrome, a rare disorder in which a person’s own immune system damages his nerve cells, leading to muscle weakness and at times paralysis. CDC acknowledged that although some of the cases could have been a coincidence, a small but definite cause and effect relationship was at work. The influenza never materialized either, and the vaccination program was scrapped.

The media at the time portrayed it as a fiasco, harshly accusing the government’s health bureaucracy of acting in self-interest. But there’s an important lesson to be learned, and it’s now included in Annex 11 of DHEW’s (Department of Health, Education, & Welfare) pandemic preparedness plan, which states,

“For policy Asclepiusdecisions and in communication, making clear what is not known is as important as stating what is known. When assumptions are made, the basis for the assumptions and the uncertainties surrounding them should be communicated.”

When such advice is ignored and people are kept in the dark and things go wrong, the ensuing loss of confidence in authority has repercussions far into the future.

Duffin explains the origin of the medical caduceus. In Greek mythology, after Medusa was slain, Athena was presented with the snake-tressed head. She then gave blood to the healer, Asclepios, who used it for cures and to raise the dead. But I learned from Robert Graves’ Greek Myths that Asclepios was given two vials of blood, one from each side of the monster. One vial gave life; the other took it away. It is a somber reminder of medicine’s occasional iatrogenic effects.

The Modern Myth of Life Expectancy

John William Waterhouse (1849-1917), Miranda—The Tempest. 1916.
John William Waterhouse (1849-1917), Miranda—The Tempest. 1916.

We hear it often: life expectancy keeps increasing—but although statistically true, it’s reminiscent of Miranda’s naive declaration of  “Oh Brave New World”!   What got me thinking about the matter was another media battle of dipoles, between McGill educator and author Joe Schwarcz and the scientifically illiterate former actress Suzanne Somers.

He writes in his public Facebook account:

Suzanne Somers is back with another book. Tox-Sick. It seems that our crumbling health (never mind that life expectancy increases every year) is not due to gluten, or GMOs, or cell phones or MSG or exposure to Suzanne; it is due to toxic chemicals (are there ever any others?)

We know Somers is not necessarily appealing to reason, but Schwarcz’s statement about “life expectancy increasing every year” is also misleading. Here’s what few people realize:

“Nearly half of all the gains in life expectancy occurred in the period between 1921 and 1951, when it jumped from about 57 to 70 years of age. But this was largely due to reduced infant mortality.
Reduced deaths from circulatory diseases account for most increases in life expectancy since 1951.” from http://www.statcan.gc.ca/…/2014001/article/14009-eng.htm

A “never mind that life expectancy increases every year” – comment also reflects a kind of complacency.  No sane person would deny or regret medicine’s most significant advances: (1) the germ theory. which strongly motivated sewage treatment, ozonolysis/chlorination of drinking water and antiseptic environments in surgery and childbirth. (2) penicillin, which attacked infections; (3) vaccinations, which abated polio, smallpox and tuberculosis. (4) and anesthetics, which  made dentistry and surgery humane. But since then, aside from CPR and sophisticated bypass surgeries, which have extended the lives of heart disease victims, there have been few comparable landmark-advances in the field of medicine. Great obstacles have been tackled by the what Lewis Thomas dubbed The Youngest Science, but it continues to be impotent against many forms of cancer, Alzheimer’s, autism, diabetes, stress, some viral diseases and increasing antibiotic resistance. Cancer rates seem to have stabilized only because many avoid smoking, drink less and because the statistics are age-adjusted.

Health
http://data.worldbank.org/indicator/ SH.XPD.PCAP/countries/1W?display=map

A “never mind that life expectancy increases every year” comment hides the fact that most of us would sooner die of a heart attack at 70 rather than live one extra decade in extreme pain at the mercy of morphine and harsh therapies or while suffering of senility. In Canada, we spend about $6 000 per capita on health care. This includes public and private contributions. In the United States, that figure was $8233 in 2010, up to $9146 in 2014. This is rendered more expensive than that of other countries having a similar life expectancy due to a combination of over-intensive technology in medicine, excessive bureaucracy, overpriced and over-prescribed drugs and liability insurance. If everyone on earth spent as much as the U.S., $58 trillion would be needed, which is about 77 % of the current combined gross national product of all the countries on the planet! Also bear in mind that the cost of health care increases as populations age. It’s another unsustainable feature of our unsustainable society.

Aside from addressing the issues already raised, we need to focus on prevention. In the last few decades, too much emphasis has been placed on measuring and trying to evaluate the impacts of specific compounds, which often seem to be present at low, innocuous concentrations.  But not only are the thresholds at times debatable, but over-consumption and inadequate regulation expose us to a unpredictable soup of substances in our air, water and indoor environments.

In 2010,  the President’s Cancer Panel reported that “the true burden of environmentally induced cancers has been grossly underestimated” and strongly urged action to reduce people’s widespread exposure to carcinogens.

The panel advised President Obama “to use the power of your office to remove the carcinogens and other toxins from our food, water, and air that needlessly increase health care costs, cripple our nation’s productivity, and devastate American lives.

In trying to prevent heart disease and diabetes, there’s nothing wrong with jogging, sports or indoor gyms. But it’s just as healthy and more ecological to create communities where work, food markets and school are within walking or cycling distance of each other.

When we focus on life expectancy we are prioritizing quantity of life over quality. We know most of what it takes to create quality-education, better health, durable products and a meaningful lifestyle. Why then do we jeopardize so much by focusing on deceitful numbers?

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