Vaccination has greatly diminished death, illness and suffering in the world. But no other medical technology has been so dogged with controversy. The book chronicles the development of the key lifesaving vaccines since the 18th century. It tells the stories of great scientists and their discoveries, of the protests and pain along the stumbling path of progress. This is the first book to tell the whole story of vaccination for a general audience. In light of controversies about flu vaccine and autism, it will be of particular interest to parents, pediatricians, public health workers and anyone fascinated by medical history. Read More>>

Also Available: Table of Contents and Index

Arthur Allen is a Washington DC-based journalist who has written on vaccine issues in The New York Times Magazine, the Washington Post Magazine, The New Republic, Atlantic Monthly, Salon and Slate.


Vaccination and Politics

It took the world about a decade of concerted effort to eradicate smallpox -- the last "wild" case of the disease was in Somalia in 1978 (someone died of the pox in a British lab accident a few years later). The campaign to eradicate polio began in 1988 and will certainly reach the 20-year mark without finishing. To understand why, it's helpful to read this sad Reuters post from Iraq.

Salwa Muhammad, a 30-year-old widow who has been working for Unicef's anti-polio drive for the past three years, says this year's campaign will be her last. In Iraq, everyone is assumed to be working for some ulterior motive. "Some of our colleagues have been beaten," she says, "Some, especially women, have been accused of being government followers and because they go out to work, they are also accused of being prostitutes. There are also allegations that our vaccine drops are contaminated with some poison from the US forces." If we aren't careful, a resurgence of polio could be another consequence of the U.S. invasion of Iraq.

The global polio campaign hit its first big political snag in northern Nigeria four years ago, when some Muslim preachers claimed that the vaccine--a live virus transmitted through drops put in a child's mouth--contained AIDS virus or birth control-inducing hormones. The World Health Organization was only able to convince the mullahs that the campaign was safe by importing vaccine produced in Indonesia, a Muslim country. In the meantime the disease spread to five of Nigeria's neighbors as well as other countries, carried around the world by Nigerian hajjis and their contacts in Saudi Arabia. The expectation that polio could be eradicated in time for the 50th anniversary of the licensing of the original polio vaccine in 1955 proved illusory, and then some.

More recently, Indian villages have been rising up in anger against the campaign because their children keep getting vaccinated against polio yet have crummy healthcare in general. Polio is a crippler, but it causes only diarrhea or other minor illness in about 99 percent of the people it infects. In dirt-poor areas of south Asia and Africa, the polio campaign is often seen as irrelevant when children are dying of other diarrheal diseases in much greater numbers. Recently, global health agencies have begun multi-pronged healthcare campaigns, fighting not just polio but diseases such as malaria and measles simultaneously

The problem with polio vaccine -- the pathophysiological grounds for its political drawbacks, if you will -- is that in tropical countries, where the gut is colonized with many viruses and bacteria, it takes extra vaccinations to protect against the disease. In the United States, three shots of inactivated polio vaccine protect children against the disease. In the Congo, it may take eight or 10 separate oral polio vaccinations to assure complete protection. Endless campaigns make for political unhappiness.

Smallpox was much easier. One poke on the arm with a bifurcated needle, a tiny drop of vaccine trapped between its tines, was generally enough to stop the disease.


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