Fw: Background [Vaccine History]

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Background [Vaccine History]

> FEAT DAILY NEWSLETTER Sacramento, California http://www.feat.org

> " Healing Autism: No Finer a Cause on the Planet "

> ______________________________________________________

> August 30, 2000

>

> Background [Vaccine History]

>

> [The current Congressional Quarterly Researcher has a collection of

> material looking at current vaccine issues and controversies, one of which

> is the alleged links to autism. It is significant that these topics are

> being addressed in such a politically prestigious publication. We are

> reprinting some of these reports in this newsletter. This article gives a

> history of the inoculation movement.]

>

> Background [Vaccine History]

>

> Early Breakthroughs

> The first vaccine breakthrough in modern times came in 1796, when

> Jenner, an English country physician, noticed that dairymaids

exposed

> to the milder disease cowpox were immune to smallpox. He took some fluid

> from a patient's cowpox sore and later introduced it into a scratch in the

> arm of an 8-year-old boy. Forty-eight days later, when Jenner exposed him

to

> smallpox, he resisted the infection. Jenner named his substance " vaccine "

> after the Latin word for cow.

> Another breakthrough came in the late 19th century, when Louis

> Pasteur, a French chemist, developed chemical techniques to isolate

viruses

> and weaken their effects so they could be used as vaccines.

> Yet vaccination continued to provoke controversy. Pasteur's first

> administration of rabies vaccines to humans was strongly protested by

> physicians and the public, and efforts to immunize British troops against

> typhoid at the turn of the century were bitterly opposed despite the

serious

> risk of typhoid faced by troops serving in the Boer War in South Africa.

> [12]

> By the turn of the century, other scientists had developed " killed "

> vaccines against typhoid, plague, rabies and cholera. By the mid-1920s,

> vaccines had been developed against diphtheria -- an often-deadly

childhood

> disease characterized by a severe inflammation of the throat -- and

> pertussis, or whooping cough, another often-fatal childhood disease

> characterized by a loud " whooping " sound as the victim struggles to get

air

> into the lungs after violent fits of coughing.

> Children and parents of the 1940s and '50s especially dreaded

> paralytic polio, which could paralyze arms, legs or respiratory muscles.

> News stories showed children with metal braces on their legs or encased in

> the so-called iron lungs that helped them to breathe.

> Two teams of scientists led by Jonas Salk and Albert Sabin each

> developed a polio vaccine. The Salk vaccine, using killed viruses, was

> licensed in 1954 and used in mass-immunization campaigns. Within six

years,

> polio cases dropped 90 percent.

> But the Salk vaccine did not provide complete immunity against all

> three polio viruses. By 1961, Sabin had developed an oral vaccine that

did,

> using a live, attenuated virus. It all but replaced the injectible Salk

> version in the United States. But because it used a live virus, about a

> dozen persons a year contracted polio from the vaccine or from being

exposed

> to a recently vaccinated child. Consequently, public health officials

> decided last January to phase out the live, oral vaccine.

> By the 1960s, routine vaccination was no longer controversial among

> the public and the medical community, and live-virus vaccines had been

> developed for measles (1963), rubella/German measles (1966) and mumps

> (1968).

> Mandatory Vaccinations

> To be effective, vaccination depends on universal immunization.

> Otherwise, anyone who is not immunized can contract a disease and spread

it

> to others. State laws requiring immunization date from the early 1800s,

when

> Massachusetts required smallpox vaccinations. Britain established the

> principle of universal free vaccination for smallpox three years later. In

> recent times in the United States, local immunization laws aimed at

schools

> and licensed day-care began with efforts to eliminate measles in the 1960s

> and '70s.

> Opposition to mandatory vaccinations -- largely based on religious,

> legal, medical or safety grounds -- emerged almost as soon as they were

> implemented. In 1905, the U.S. Supreme Court upheld compulsory-vaccination

> laws, but anti-vaccination sentiment prevailed in some states. [13]

> Nonetheless, the incidence of smallpox continued to decline. The

> United States reported its last naturally occurring case in 1949. In 1971,

> routine vaccination for smallpox was discontinued.

> By contrast, the polio vaccine resulted in an immediate push for

> federal action to make the vaccine widely available. After Salk reported

> positive results from his vaccine in 1955, members of Congress from both

> parties urged the government to distribute the vaccine itself or help the

> states.

> The Republican administration of Dwight D. Eisenhower branded a

> Democratic-sponsored bill for universal free vaccines as a form of

> socialized medicine. By August, Congress had drafted a compromise measure,

> the Poliomyelitis Vaccination Act, which provided $28 million to the

states

> for free universal polio vaccines.

> Over the next 45 years, the nation would experience a cyclical

> pattern: Disease risk would appear to diminish thanks to immunization;

then

> politicians would cut back on immunization funds; vaccination rates would

> drop, followed by disease outbreaks; then there would be an outcry for

more

> funding for immunizations. [14] For example, polio aid was curtailed in

> 1957, only to be revived in 1960 after outbreaks of the disease in several

> cities. To provide broader assistance, President F. Kennedy asked

> Congress in 1962 to authorize aid to states to buy vaccines against

> diphtheria, whooping cough and tetanus, as well as polio.

> DPT Under Attack

> By the early 1980s, infectious epidemics that killed hundreds of

> children a year had drifted into distant memory, and some parents were

> beginning to start questioning the need for massive inoculations. [15] A

> small number of those parents felt that their children had been damaged by

> vaccines that were not as safe as they could be -- particularly the DPT

> shot.

> Among them was the NVIC's Fisher. In 1980 her toddler suffered

a

> severe reaction after his fourth dose of DPT and an oral polio vaccine.

> After studying the medical literature on vaccine reactions, she learned

that

> he had suffered convulsions and collapsed shock, a rare, adverse reaction

to

> a DPT shot.

> After that, was different -- physically, mentally and

> emotionally. " He no longer knew his numbers or the alphabet, he had poor

> concentration levels, constant ear infections and diarrhea that would not

> stop, " Fisher says. " He became emaciated and stopped growing. "

> Fisher learned that similar adverse events related to the DPT shot

in

> Japan, Sweden and the United Kingdom had led to drops in immunization

rates

> in those countries, and subsequent epidemics of pertussis.

> In 1982, Fisher and other mothers founded the advocacy group that

> evolved into the NVIC. Their goal: get Congress to demand safer DPT

> vaccines.

> By then Japan was already using a safer version of the vaccine,

> produced, ironically, with technology developed by the NIH. In fact, a

U.S.

> company, Eli Lilly, had marketed the safer version in the 1960s and '70s,

> but when Wyeth bought Lily in 1976, it discontinued the product. A 1977

> Wyeth internal document said producing the safer DPT shot would result in

" a

> very large increase in the cost of manufacture. " [16]

>

>

>

> English physician Jenner (top) coined the term " vaccine "

after

> discovering how to protect against smallpox. Jonas Salk (center) led the

> team that developed the first polio vaccine in 1954 in Pittsburgh. Albert

> Sabin (bottom) developed an improved oral polio vaccine in 1961 at his

> University of Cincinnati lab. (Sources: Centers for Disease Control and

> Prevention, Archive Photos and Corbis-Bettmann Photos.)

> " Sure, you can produce a much less toxic product in very low yields,

> and anyone who has worked on pertussis knows this, " Dennis Stainer, an

> assistant director of production and development at Connaught Medical

> Research Laboratories in Canada, told a 1982 symposium sponsored by U.S.

> health officials. " What we are faced with is going from a vaccine that

costs

> literally cents to produce to one that I believe is going to cost dollars

to

> produce. " [17]

> By the mid-1980s, at least 300 lawsuits had been filed against U.S.

> DPT manufacturers. " They knew that the older pertussis vaccine was making

> kids sick, " recalls Ted Warchafsky, a Milwaukee attorney who represented

> parents seeking damages.

> In 1991, Fisher documented the development of the DPT vaccine in A

> Shot in the Dark, explaining how the more toxic whole-cell pertussis

portion

> of the shot was causing so many problems, and why a safer, acellular

version

> had not been widely marketed in the United States.

> " When word went out that I was writing that book, people started

> leaving packages of documents, with transcripts from government meetings,

on

> my doorstep in the middle of the night, " Fisher says. " One physician told

> me, 'You are on the right track, but I will never stand up beside you

> publicly and say that.' "

> Fisher says " it was all about money, " but, in fact, health officials

> and drug firms also wanted to keep the price of vaccines low enough for

> impoverished Third World governments.

> " It's the same for every . . . vaccine, " said Stanley Plotkin,

medical

> and scientific director for Pasteur-Merieux-Connaught, a Paris-based

> pharmaceutical company. " Research costs are recouped in North America and

> Europe, and the vaccines are sold in the developing world at much, much

> lower margins. " [18]

> Stainer went on to ask at the 1982 meeting whether it was right to

> switch to the safe DPT vaccine: " Are we . . . going to have two vaccines,

> one for the wealthy and one for the rest? I don't think any of us want

> that. "

> But that is exactly what has happened. The U.S. government stopped

> purchasing the whole-cell DPT vaccine in 1996 and recommended that doctors

> switch to the acellular DTaP version. Only about 6-7 percent of the

> pertussis vaccines in the U.S. still contain the whole-cell DPT. But it is

> widely used in the Third World.

> But back in the mid-1980s, faced with increasing lawsuits, one of

the

> three DPT producers stopped producing it, and the remaining manufacturers

> found it was increasingly difficult to obtain liability insurance.

> " Shortages of the vaccine occurred in some areas of the country, and

prices

> escalated dramatically, " Duke University's Katz recalled. [19]

> But instead of selling the safer Japanese vaccine, Warchafsky says,

> U.S. manufacturers asked Congress to limit their liability for adverse

> reactions to any vaccine mandated by the government, hinting they might

stop

> producing children's vaccines without it.

> " And then the industry started buying up the experts, " he contends,

> citing the example of Cherry, a widely recognized pertussis expert

who

> has served on both the ACIP and the AAP's vaccine advisory committee.

> Cherry was a principal author in a 1978-79 study sponsored by the

FDA

> and the University of California at Los Angeles (UCLA), which found that

an

> alarming number of children receiving the DPT shot, one in 1,750, was at

> risk of suffering from " collapse shock " and an equal number of having

> convulsions.

> Yet by 1990, after having received a $400,000 grant from Lederle, he

> declared in the Journal of the American Medical Association (JAMA) that

> severe brain damage caused by the vaccine was a " myth. " By 1993, Lederle

had

> given Cherry and UCLA an additional $834,000 for pertussis research and

> expert testimony in lawsuits brought by parents of injured children. [20]

> Meanwhile, Congress in 1986 limited the liability of manufacturers

of

> mandated vaccines and health practitioners who administer them. The

National

> Childhood Vaccine Injury Compensation Act also:

> Established a " no-fault " system of compensation for injuries or

deaths

> reasonably associated with the administration of childhood vaccines;

> Ordered CDC to set up a centralized system for reporting adverse

> reactions to vaccines; and

> Required periodic independent reviews of the scientific evidence on

> adverse events.

> Immunizations Lag

> By the late 1980s, immunization rates were slipping again. Then, in

> the first years of Bush's presidency, the nation got a wake-up call

> on the dangers of incomplete immunization: A major measles epidemic in

> 1989-91 killed at least 132 persons.

> Concentrated in Chicago, Houston, Los Angeles, New York and

> Philadelphia, the outbreak had infected 18,000 people by 1989. More than

> three-fourths of the cases involved unimmunized preschool children, mostly

> blacks and Hispanics.

> " Everyone knows that when immunization levels drop, it is just a

> matter of time before you get an epidemic, " said Philip A. Brunell, former

> chairman of the AAP Committee on Infectious Diseases. [21]

>

> The U.S. military's push to inoculate all service members against

> anthrax spread by germ warfare has been highly controversial. Many service

> members quit rather than take the vaccine or were court-martialed for

> refusing to take it. (KRT Photo/Kim )

> p>In recent years, concern about vaccines has deepened as officials

> have begun adding new vaccines for non-epidemic diseases to the mandatory

> schedule, and as enforcement of mandatory vaccinations has begun to

tighten.

> Some doctors, rewarded by managed-care companies for achieving high

> inoculation rates, won't treat patients who refuse vaccination. States,

> which receive federal grants for achieving high inoculation rates, are

> pressuring local health departments to improve inoculation rates. And

> welfare mothers in some states are having their checks reduced if their

kids

> don't get vaccinated.

> The Clinton administration has won legislation to extend vaccination

> programs to the poor and has recommended new legislation to improve

> vaccination levels. Since 1994, the Vaccines for Children program has

> allowed the government to provide free pediatric vaccines for low-income

> children.

> In addition, the federal government is overseeing establishment of a

> network of state electronic vaccine-tracking registries. So far, 22 states

> have set up or are in the process of establishing such registries, whereby

> all children are enrolled at birth. One state is using the database to

> contact parents of children who have not received all their federally

> mandated vaccines.

>

> [12] From S. Ellenberg and T. Chen, " The Complicated

Task

> of Monitoring Vaccine Safety, " Journal of the U.S. Public Health Service,

> Public Health Reports, January/February, 1997; Vol. 112, No. 1; pp. 10-20.

> [13] son v. Massachusetts 197 U.S. 11 (1905).

> [14] For background, see Jost, " Childhood Immunizations, "

The

> CQ Researcher, June 18, 1993, pp. 529-552.

> [15] For background, see H. , " Combating Infectious

> Diseases, " The CQ Researcher, June 9, 1995, pp. 489-502.

> [16] Rock, op. cit., p. 153.

> [17] L. Coulter and Barbara Loe Fisher, A Shot in the Dark

> (1991), p. 209.

> [18] " Industry Perspective: An Interview with Dr. Stanley Plotkin, "

> IAVI Report, June 1996. p. 7.

> [19] Katz's comments were made in testimony Aug. 3, 1999, before the

> House Government Reform Committee.

> [20] Rock, op. cit., p. 153.

> [21] Jost, op. cit., p. 540.

>

> From the CQ Researcher of Aug 25, 2000

> © 2000 Congressional Quarterly Inc. .

>

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