Immunization and the American way: 4 childhood vaccines

Were there long-term economic effects of exposure to polio vaccination? An analysis of migrants to Sweden 1946-2003

Recent research showed that exposure to the vaccine against polio in early life had no long-term economic benefits among native Swedes. However, whether this result holds for individuals from other countries remains unexplored. This study explores the relationship between exposure to the vaccine and later-life outcomes, but focuses on individuals who migrated to Sweden (birth cohorts 1946-1971), and constitute a diverse sample in terms of national origin. Using a differences-in-differences approach and register data from the Swedish Longitudinal Immigrant Database, this study explores if being exposed to the vaccine against polio in the year of birth in the country of origin has any impact on adult income, educational achievement, or days or number of hospitalizations. The results are in line with the previous research in showing that there are no statistically significant effects on adult income, education, or health from exposure to the vaccine against polio, regardless of national origin. Furthermore, no scarring effects of exposure to polio epidemics were found on any of the outcomes, reinforcing the hypothesis that polio did not scar individuals in the same way as other contemporary epidemic diseases did, and that the lack of scarring could explain the absence of long-term impact from vaccine exposure.

Human Experimentation in Public Schools: How Schools Served as Sites of Vaccine Trials in the 20th Century

Schools have long been critical partners for public health authorities in achieving widespread vaccination. In the mid-20th century, however, public schools also served as sites of large-scale experiments on novel vaccines. Through examining the experimental diphtheria, polio, and measles vaccine trials, I explored the implications of using schools in this manner, as well as the continuities and discontinuities among the three cases. Common to all of them was that the use of schools brought decision-making into the public sphere, subjecting parents to social pressures and the influences of school officials and community members. However, the effects of using schools varied as well, as their social and institutional significance interacted differently with the narratives surrounding each disease, the public's changing perception of medicine and science, and society's changing values. These insights show not only the power of public institutions to influence opinions and perceptions, but also the subtle forces that one's authority figures, peers, and community members may bring to a seemingly private decision-making process. These considerations are relevant to health interventions today, such as the complex debate over community consent in global health research. (Am J Public Health. 2018;108:1015-1022. doi: 10.2105/AJPH.2018.304423).

Measles vaccination before the measles-mumps-rubella vaccine

At the beginning of the 1960s, it was clear that a vaccine against measles would soon be available. Although measles was (and remains) a killer disease in the developing world, in the United States and Western Europe this was no longer so. Many parents and many medical practitioners considered measles an inevitable stage of a child's development. Debating the desirability of measles immunization, public health experts reasoned differently. In the United States, introduction of the vaccine fit well with Kennedy's and Johnson's administrations' political commitments. European policymakers proceeded cautiously, concerned about the acceptability of existing vaccination programs. In Sweden and the Netherlands, recent experience in controlling polio led researchers to prefer an inactivated virus vaccine. Although in the early 1970s attempts to develop a sufficiently potent inactivated vaccine were abandoned, we have argued that the debates and initiatives of the time during the vaccine's early history merit reflection in today's era of standardization and global markets.

The History Of Vaccines And Immunization: Familiar Patterns, New Challenges

Human beings have benefited from vaccines for more than two centuries. Yet the pathway to effective vaccines has been neither neat nor direct. This paper explores the history of vaccines and immunization, beginning with Edward Jenner's creation of the world's first vaccine for smallpox in the 1790s. We then demonstrate that many of the issues salient in Jenner's era-such as the need for secure funding mechanisms, streamlined manufacturing and safety concerns, and deep-seated public fears of inoculating agents-have frequently reappeared and have often dominated vaccine policies. We suggest that historical awareness can help inform viable long-term solutions to contemporary problems with vaccine research, production, and supply.

Pioneering figures in medicine: Albert Bruce Sabin--inventor of the oral polio vaccine

Over ten years after his death, the Sabin oral vaccine continues its profound influence on public health throughout the world. The annual incidence of polio has fallen dramatically since its introduction, with more than 300,000 lives being spared each year and an annual global saving in excess of 1 billion US dollars. In many ways, the development of an effective oral vaccine and its subsequent regulation by the World Health Organization can serve as a model for medical researchers. Our review describes the contribution of Albert Sabin as a medical researcher, and how his vaccine had a profound impact on the global reduction of polio infections. As many different factors influenced health-care last century, we describe Sabin's involvement with respect to prevailing scientific paradigms and public health issues of the time. Our paper also outlines the basic epidemiology of poliovirus and the historical development of an effective vaccine, both with and without Albert Sabin.

The pertussis vaccine controversy in Great Britain, 1974-1986

This historical essay analyzes the role played by Great Britain in the pertussis vaccine controversy of the 1970s and 1980s. Public backlash against this vaccine not only took place earlier in Britain than the United States, but also was so widespread that a series of whooping cough epidemics soon followed. As with the more recent dispute involving measles-mumps-rubella (MMR) vaccine and autism, the United Kingdom played a primary role in defining, promoting, and ultimately exporting this controversy. This essay seeks to explain this phenomenon by situating it in Britain's long history of suspicion regarding vaccines evident among both the public and the medical profession, a theme dating back to the compulsory vaccination laws of the 19th century. It argues that anti-vaccinationism, far from being simply a new development related to the public's lack of awareness of childhood vaccine-preventable illness, actually represents a revival of a much older movement.

School immunisation certificates--a review over time in a disadvantaged community

OBJECTIVES

To compare proportions of kindergarten children in Auburn presenting School Immunisation Certificates (SIC) or other school-entry immunisation documentation over time, and to examine the immunisation status of these children.

METHODS

Immunisation records of kindergarten children enrolled in all primary schools in the Auburn local government area were reviewed in 1994 and 1998.

RESULTS

Eight hundred and thirty-three and 737 school entry records of children enrolled in kindergarten were reviewed in 1998 and 1994 respectively. There was no change in the overall proportion of children with immunisation documentation and SICs. Sixty-nine per cent (571/833) of children had SICs in 1998, compared with 72% (531/737) in 1994. Thirteen per cent of children had other immunisation documentation in 1998, compared with 11% in 1994. The proportion of invalid certificates fell from 39.2% in 1994 to 12.6% in 1998 (p<0.001). The 1998 survey indicated that 80.2% of children provided a certificate indicating they were completely immunised compared with 56.7% in 1994 (p<0.001).

IMPLICATIONS

Although SICs play an important role in promoting the importance of immunisation among parents and in the school community, there continues to be a substantial number of children whose immunisation status is unknown. In the event of an outbreak, an effective public health response may need to incorporate the use of additional objective measures, such as the Australian Childhood Immunisation Register or personal health records.