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If Vaccines Work...?

by Richard Gant

March 3, 2017

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I... I can't even believe I'm writingthis.

That image up there showed up in my Facebook feed, posted by a smug JAQer who"I assume"hates the idea of health and not dying of horrible diseases. And who possibly hates children as well. Thankfully, I saw it because a friend of mine who does notpine for the glory days of 16th-century medicine had laid into the JAQer with a will and a vengeance.

Distressingly, this is a trope. It's a common tactic used by people who hate health and children and science and reason (also known as "antivaxxers," the term I used is longer but probably more accurate) to sow confusion and spread misinformation about the benefits of vaccines by "just asking questions." Questions that have answers, mind, but JAQers are often too intellectually dishonest to bother acknowledging those answers. It gets in the way of the soundbite.

Ifvaccines work?

If vaccines work?

This... this will require more than one article. Because there's a coupleof questions to address here: "Do they work?" and "How are unvaccinated children a threat?". And answering a JAQoff's questions takes time and effort. So, let's just jump into the first question.

"Do vaccines work?"

Yes they work, you primitive screwhead.

The Center for Disease Control provides the following list of vaccines used in the United States: adenovirus, anthrax, diphtheria, hepatitis A and B, Haemophilus influenzaetype b, human papilomavirus, seasonal influenza (flu), Japanese encephalitis, measles, meningococcal, mumps, pertussis, pneumococcal, polio, rabies, rotavirus, rubella, shingles, smallpox, tetanus, tuberculosis, typhoid fever, varicella, and yellow fever. That's vaccines for 25 different illnesses. And yes, they work. It's not just me saying that, either. The Journal of the American Medical Associationalso says it, along with the Centers for Disease Control.Let's look at some numbers, shall we?

From 1936 to 1945, there was an average of 21,053 cases of diphtheriareported each year in the United States. An average of 1,822 of those cases resulted in death. The diphtheria vaccine first went into widespread use in the late 1940s. From 1970 through 1979, an average of 196 cases per year were reported, and from 1980 through 2011 a totalof 55 cases were reported. Not an average. A total. According to the CDC, "Of 53 reported cases with known patient age since 1980, 34 (64%) were in persons 20 years of age or older; 41% of cases were among persons 40 years of age or older. Most cases have occurred in unimmunized or inadequately immunized persons."

From 1953 to 1962, there were an average of 530,217 cases of measlesreported in the United States, with an average of 440 deaths per year. The measles vaccine was introduced in 1963. By 1982, only 1,497 cases were reported"although there was a "measles resurgence" from 1989 through 1991, in which a total of 55,622 cases were reported that resulted in 123 deaths. "In 2011, CDC reported 16 outbreaks of measles and 220 measles cases, most of which were imported cases in unvaccinated persons. Among the U.S. measles cases in persons 16 months through 19 years reported in 2011, 62% were in persons not vaccinated for a nonmedical reason."

From 1963 through 1968, there were an average of 162,344 cases of mumpsreported in the United States, resulting in an average of 39 deaths per year. The first mumps vaccine went on the market on March 30, 1967 and the number of mumps cases declined dramatically, falling to an annual average of 3,000 in 1983 " 85. There was a resurgence in 1986 " 87, with a total of 12,848 cases reported. The next worst post-vaccine resurgence was 3,502 in 2009, but in 2011 only 404 cases were reported and in 2012 only 229 cases were reported. So, even at its worst, the post-vaccination resurgence was less than 10% as bad as the average in the five years before the vaccine came into use.

Pertussis, also known as whooping cough, averaged 200,752 cases per year from 1934 to 1943, and killed an average of 4,034 people each year. The first pertussis vaccine went into widespread use in the mid-1940s. By 1960, reported cases declined to 15,000, and by 1970 the US was down to less than 5,000 cases per year. From 1980 " 1990, an average of 2,900 cases were reported per year.

Depressingly, the number of pertussis cases has been on the rise recently, for interesting reasons. See, the original pertussis vaccine was a "whole-cell" vaccine, calling for four separate vaccination doses with intact but inactivated Bordetella pertussiscells. These vaccinations were 70% " 90% effective, but the protection degraded with time and left the recipient unprotected after five to 10 years. The average age of pertussis victims has been increasing, indicating that recipients of the older vaccine have not been receiving booster shots (something not required by recipients of the acellular pertussis vaccines that went into use in the 1990s).

So, clearly they do work

Clearly. And I could keep going"JAMAcovers polio, rubella, smallpox, and tetanus as well, and the CDC Epidemiology And Prevention of Vaccine-Preventable Diseases"pink book"covers literally every disease for which we have a vaccine in use in the United States. Or if you want a simplified view, you can look at Max Roser's vaccination article on Our World In Data. Regardless of which you look at, though, they all show the same thing: the average number of cases of these diseases have decreased dramatically, sometimes by multiple orders of magnitude, since the introduction and widespread use of vaccinations for the disease. They work. They're not perfect, but they work.

They aren't perfect?

No, of course not. Nothing is. Which is why, in my next blog post, we'll look at why an unvaccinated child is still a threat even though vaccines dowork.

by Richard Gant

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