Hygiene, not vaccine
Vaccinations are given a lot of credit for eliminating childhood diseases. But good hygiene, sanitation and nutrition have much more to do with it.
False. For example, in the first three-quarters of the 20th Century, over a quarter of a billion people died of smallpox worldwide. The combination of an effective vaccine and a determined effort by the medical community eliminated the disease in the wild. There has been no reported case of smallpox in the wild since 1977.
Nobody has died of smallpox due to a natural infection in over thirty years.
The American satirist Mark Twain famously said there were three kinds of untruths: lies, damned lies, and statistics.
Abuse of statistics is indeed a plague. Let’s see if we can spot any abuse of statistics in this story.
As if to prove his point, the UK’s Department of Health regularly produces its immunization handbook—more popularly known as the ‘Green Book’—which is sent out to doctors and healthcare workers. The Green Book provides all the latest information about the effectiveness and safety of the major vaccinations.
Naughty. This is characterising the green book as lies. As we will see in a moment, that is a precise reversal of the truth.
Reading it, you’d have to agree that vaccinations are a good thing as they’ve eradicated most of the major diseases that afflict us, especially when we’re young.
Take, for instance, measles.
Protection is offered by the MMR (measles–mumps–rubella) shot, which has certainly attracted more than its fair share of controversy over the years, but the Green Book confirms its positive effect on our health.
As does every reputable scientific study.For example, the first two decades of MMR vaccination in the US prevented an estimated 52 million cases of the disease, 17,400 cases of mental retardation, and 5,200 deaths (source). In five years from 1999-2004 initiatives by UNICEFW and the World Health OrganizationW improved measles immunisation coverage and averted an estimated 1.4 million deaths. A Cochrane review in 2012 confirmed that the evidence still supports mass MMR immunisation.
To make the point, the book’s compilers have produced a handy graph that clearly shows the vaccine has saved lives.
Bait and switchW alert!
The graph begins in 1950, 18 years before the first measles vaccine was introduced and 38 years before the MMR jab was introduced. For the first 16 years up to 1966, the number of cases of measles varied between 160,000 and 800,000 each year before suddenly dropping to around 100,000 cases annually. Today there are just a few thousand cases a year.
The disease claimed around a hundred lives every year from 1950 to 1968 before falling to 13 deaths a year—until 1988,
when the MMR vaccine was introduced. After that, measles claimed its last life in 1992 in the UK, except for one case in 2006 of a 13-year-old boy with a failing immune system.
But wait: “measles claimed its last life in 1992 in the UK, except for one case in 2006 of a 13-year-old boy with a failing immune system”.
This is 2013. The current statistics show:
- 2 deaths in 1992
- 4 deaths in 1993
- 1 death in 1995
- 3 deaths in 1997
- 3 deaths in 1998
- 3 deaths in 1999
- 1 death in 2000
- 1 death in 2001
- 1 death in 2004
- 1 death in 2006
- 1 death in 2007
- 2 deaths in 2008
And what about poor Gareth Colfer-Williams? He died of pneumonia, a common and historically deadly complication of measles.
So it looks as if the claim that “measles claimed its last life in 1992 in the UK, except for one case in 2006 of a 13-year-old boy with a failing immune system” is A BIG FAT LIE
But push the start date of the graph way back—to 1850 in fact—and a different picture emerges. From 1850 to 1910, measles was responsible for around 1,200 deaths every year.
Did you spot it? The relevant words are highlighted in the captions to the two graphs.
Yes, this is the classic antivax trope of comparing measles deaths with vaccination uptake. It’s usually combined with the have-your-cake-and-eat-it claim that measles isn’t that dangerous anyway.
Death is not the only adverse effect of measles. There’s also measles encephalitis and blindness, diarrhoea and pneumonia – and herd immunity is vital because it’s extremely contagious (90% of unimmunised people who share living space with an infected person will be infected in turn) and immunocompromised individuals are at particular risk.
Then, year on year the death rate plummeted. By 1920, it was down to 650 deaths a year; by the start of the 1930s, deaths had fallen to 250 and down they continued to go until 1950—the year the Green Book takes up the story—when around a hundred deaths were recorded.2
Reference 2: Donegan JLM. Vaccinatable Diseases and Their Vaccines. Self-published online, 2004
Why don’t doctors tell you to check this source? Because it’s a worthless piece of anti-vaccination garbage by a doctor who was described by judges as using “junk science” and admitted to the GMC that she had selectively used only those sources that support her beliefs, described by the GMC as “deeply held”
The decline in death rates is well understood and is largely down to improvements in the management of pneumonia (up to 30% of measles pneumonia patients died in the 1920s, before antibiotics).
And all of this happened long before vaccines were introduced.
For reasons which are well understood and do not undermine the reasons for continuing to immunise against measles, because, as the Green Book graph shows, however much you try to hide the fact, measles cases plummeted after the MMR was introduced.
The idea that measles is a relatively benign disease and only deaths should concern us, is a poisonous bit of anti-vaccination propaganda.
What had happened were better sanitation and public hygiene, better living conditions and improved nutrition.
So it could be argued that mass MMR vaccination reduced the death rate from 13 to zero—but good sanitation had already reduced it from 1,200 to 13 deaths.
And antibiotics, curing the pneumonia that was the largest cause of death, but not the largest cause of permanent harm.
Perhaps vaccination shouldn’t take all the credit after all.
And perhaps they should. The one person whose judgement cannot be trusted on that, is an anti-vaccinationist.
Why don’t doctors tell you that hygiene protects against infectious disease and vaccines don’t?
Because it’s a big fat lie.