Vaccinations and Machinations

It’s about the data; but it’s not all about all the data.

The continuum we call medical science has been affronted in recent years by a fairly heated debate surrounding the treatment protocol known as “vaccination.” Medical scientists have long theorized that, by becoming vaccinated, a person develops immunity from various diseases, both bacterial and viral, including those deemed contagious. That theorization has been tested over hundreds of years, has established consensus, and warrants merit. The process of becoming vaccinated is called inoculation, whereby a disease antigen is introduced into an organism such as a plant, or a human body, for the purpose of producing antibodies resistant to that disease. The bodily processes by which that happens are now settled medical science.

During the stumbling centuries since Hippocrates’s time, Western medical science has evolved slowly but significantly, taking a giant leap forward between the sixteenth and eighteenth centuries during the so-called Scientific Revolution. In the seventeenth century, Sir Francis Bacon formalized the rudimentary scientific methods of the ancients with his 1620 treatise Novum Organum, which focused on inductive reasoning and experimentation. Various beliefs were questioned and often disproved, such as that “bad humors” were the cause of disease; leeching and the bleeding of patients was deemed barbaric and potentially deadly; and concoctions of various remedies, including snake oil and sugar water, were exposed as fraudulent. The scientific method revealed these and other medical treatments to be, at best, ineffective; but they also spurred additional experimentation and discoveries. The slow walk which had characterized medical treatment until the mid-nineteenth century is evidenced by American physician Oliver Wendell Holmes, Sr.’s successfully arguing that washing one’s hands before treatment—especially surgery—was necessary to reduce the risk of doing harm. Also during the nineteenth century, Hungarian doctor Ignaz Semmelweis mandated such handwashing at Vienna General Hospital, where he pioneered antiseptic procedures—to which there was resistance at the time.

As is often the case, popular music added colorful background to the notion of therapeutics. In the 1870s a classic popular sailor’s song of Irish origin, “What Shall We Do with a Drunken Sailor,” contained an imperative, therapeutic answer to that query in one of the ditty’s refrains which—while avoiding scientific jargon—got the point across: “Give ’em a hair of the dog that bit ’em,” i.e., when he has a hangover, “give him a shot of the whiskey that inebriated him the night before.” The idea is one summarized succinctly in the Latin phrase similia similibus curator: “like cures like,” making the point sans couleur musicale. It was at one time believed that a hair, ingested or placed on a bite wound made by a rabid dog, would cure rabies. Simply put: a little bit of the cause can cure the effect. Unfortunately, in the case of rabid dog bites, only mythology and learned quackery—not data—supported that belief.

The study of viruses was begun in 1798 by British scientist Edward Jenner, who observed that farmers who contracted cow pox were immune to smallpox. The result: production of an effective vaccine for smallpox. However, it wasn’t until 1880 that Louis Pasteur’s use of the scientific method theorized that certain bacteria cause disease; Pasteur’s pathogen of choice to study was rabies—which is actually a virus. It was not until 1892 that Dmitri Ivanovsky made the discovery, using the scientific method, that diseased tobacco plants contained a substance infectious to healthy tobacco plants. Co-discoverer Martinus Beijernick called this living infectious fluid a “virus.”

Today, a two-dose vaccination by injection of human rabies immune globulin, given prior to being bitten by a rabid dog, will prevent someone from being one of the fifty thousand humans killed worldwide each year by rabid dogs; four doses of it, during the two weeks after such a bite, will cure it. The difference between “hair of the dog” and the human rabies immune globulin protocols is found in one word: data—plural of the Latin word datum. Medical science uses data as the basis for calculations to determine statistical risk—not a guarantee of cure, but a useful metric representing desire and intent.

Other vaccines—notably against poliomyelitis, measles, mumps, rubella, and many other diseases—have been shown by data to prevent or slow the spread of those diseases. Every single time? No. Anecdotes and one-off reports of serious adverse impacts exist, but are statistically rare and involve other factors. However, the longer the data stream of consistent positive results—coincident with fewer negative results—the more effective a vaccine containing a live virus antigen is trusted to be. This is one of the many factors making the current boisterous debate over vaccinations somewhat amusingly curious—and its outcome crucial.

The number and sequencing of vaccines administered to young children are now under closer scrutiny by parents—which is a good thing, provided parents are willing to take the time to educate themselves, particularly about the data. More importantly, the right of informed choice is again under both subtle and overt pressure, because responsible adults want to trust our systems of medicine, which more or less govern our systems of thought regarding health. It is noteworthy that—given a choice—people wanted to “trust the science” during the global pandemic which broke out in 2019; but there wasn’t much science to trust: there were essentially no data based upon which both medical and non-medical people alike could make intelligently informed choices. In the middle of this data desert, many governments, influenced by various scientists and business interests espousing sometimes conflicting theories, decided to make the choice for them, and the planet’s general populations became the experimental sample for study. Data collection continues, with boosters and initial vaccinations leading—sooner or later—to a larger sample size, and to more definitive results.

In the meantime, it’s about the data; but it’s not all about all the data…yet. In a conversation with a very bright friend—a urologist—in 1973, I asked about the data for a drug then being prescribed for patients. After sharing some available statistics revealing about a 50/50 indication of effectiveness, and seeing my quizzical expression, he looked me straight in the eye and stated quite sincerely, “if a patient doesn’t believe in any drug…it won’t work.”

In a truly free marketplace of ideas, and of medical treatments, examination of data is essential; and the warning, caveat emptor, is infinitely more important than ever it was to the drunken sailor of yore.