Vaccine eradication of disease

[JMJ]

Do you think it is possible to use vaccines to eradicate diseases?  Do you think it has been done in the case of small pox worldwide and other diseases in certain regions?  If it might be possible, then what makes a disease worth eradicating or a vaccine worth using to eradicate it?

[pers]

Yes, absolutely.  The vaccine played a huge role in eradicating smallpox.  Polio is gone from the US thanks to vaccination, and measles has pretty much been eradicated, only imported cases from countries where they still have a lot of it keep starting off small epidemics, mostly brought in by unvaxed travelers.  

A link to an article titled Smallpox Vaccine: Origins of Vaccine Madness appeared elsewhere. I found it to be a rather strange mix of fact and fiction and wanted to respond to some of the things in it, but my response got rather ridiculously long, and suffered from many interruptions, and now there is this thread, so I guess I will post it here. 

Quotes are from the article.  

The author begins by discussing how unlikely she finds the smallpox vaccine to be and how strange she finds it that doctors such as Stephanie Cave consider it to be based in science.  She then asks:

Did they ever ask themselves how the inoculation of pus from a diseased animal could possibly prevent, rather than create, a disease in humans?

 

That's an easy one to answer: inoculation with the pus of a diseased animal does, in fact, create disease in humans.  If you do it with smallpox, it causes smallpox infection.  If you do it with cowpox, it causes cowpox infection..  Vacination for smallpox also does infect people with the actual disease of vaccinia, the virus in the vaccine.  While it is usually very mild and remains localized to the vaccination site, it can be spread to other parts of the body or even other people, and can be  very dangerous or even deadly to those with compromised immune systems.  

 

While vaccinia, cowpox, andsmallpox are all separate diseases, and two are  very mild while the other quite serious, they are very closely related and have similar structures, so being infected with one and fighting it off helps prepare our immune system to be able to quickly fend off the others. 

 

I'm not sure why all that isn't in the article.  The author may not believe that vaccination is effective, but it is totally bizarre that she would write as if no one had ever thought to question how the smallpox vaccination worked or bother to mention the theory that is behind it.  If she doesn't believe it works, then shouldn't she lay out the ideas and explanations supporting the smallpox vaccine and then counter them, rather than just pretending those widely held beliefs about the vaccine and how it works don't even exist?

 

More from the article:

In this book Creighton says, “The single bond connecting cowpox with smallpox was the occurrence of the word “pox” in each name; it was a case of the river in Macedon and the river in Monmouth. The jingle of the names had the effect that it often has upon credulous people, whose acquaintance with any matter is more verbal than real.” Creighton also goes on to observe: “To a pathologist or epidemiologist, it is as truly nonsense to speak of cowpox becoming smallpox as it is legitimate nonsense to prove that a horse-chestnut is a chestnut horse. "

When Dr. Chreighton died in 1927, DNA research was still in its infancy.  Back then the only evidence of the close relationship between cowpox and smallpox was that someone infected with one was then immune to the other, evidence which Chreighton chose to disbelieve.  But now scientists can get a good look at the virus through electron microscopes, also invented after his death.  They can analyze the DNA and see that yes, the diseases are very closely related.  I don't understand why the author would leave us with only century old speculation and not include any mention of information available since then thanks to modern technology?

 

Cowpox is a disease that occurs on the teats of cows only when they are in milk. The causative virus is said to be orthopox vaccinia; it results in an ugly chancre; it is not infectious; it is, of course, found only in female animals. People who milked infected animals developed pustules on their hands, which in turn, led to swollen glands and general malaise.

 

Cowpox does not just infect cows when they are in milk, but can infect bovines, humans, and cats of either gender.  It is also not the actually the same disease as vaccinia, which is the virus in the vaccine, but the two are closely related members of the same family as smallpox.  And obviously cowpox is an infectious disease – I do not know how she can claim it is not in practically the same breath as she explains that people who milk infected animals become infected by the disease.  

 

Some writers claim that James Phipps died from tuberculosis at the age of twenty-one but one source states that he recovered and lived until 1853.15 Jenner’s son, who was also vaccinated more than once, died at twenty-one from tuberculosis. Tuberculosis is a condition that some researchers have linked to the smallpox vaccine.16 In fact, Dr. A. Wilder, Professor of Pathology and former editor of The New York Medical Times, went so far as to say, “Consumption (TB) follows in the wake of vaccination as surely as effect follows cause.” 

 

This is just really strange.  At the very least, the “surely as effect follows cause” is a wild exaggeration considering the millions who were vaxed and did not get TB, but the only evidence she puts forth that there is even a relationship between the smallpox vaccine and a disease that was infecting and killing people for thousands of years before the vaccine's invention and continues to do so decades after mass vaccinationfor smallpox ended is a quote from the editor of a publication which only existed for a few short years in the 1800s?  And she doesn't even provide a citation?  Is that really the best she can do?

 

Toward the end, the article talks about other pox viruses, specifically monkeypox for which it is true that the symptoms and treatment are pretty much the same as smallpox and claims that it is just smallpox renamed.  

 

The difference between the smallpox virus and the human monkeypox virus is a difference in protein structure. As health authorities have never worried about the difference between cowpox virus and smallpox virus, why should they be concerned now? Concerned enough, that is, to say that monkeypox is not smallpox. They can’t have it both ways: saying the cowpox virus prevents smallpox but then denying that the monkeypox virus can cause smallpox.

 

But guess what, the smallpox vaccine (so, being infected with vaccinia) can be used to prevent monkeypox too!

 

Again, the very basic idea behind all of this is that fighting off one of the diseases can prepare the immune system for when it encounters the other closely related diseases, enabling it to fend off the virus before the individual actually comes down with the illness.  I still do not know why the author is not even bothering to mention the very basics of the theory behind the smallpox vaccine, why she is pretending these ideas don't even exist.  There is no contradiction between saying that experiencing one disease helps the immune system be ready for similar disease and saying that infection with one virus can not cause an illness that has a separate virus as its cause, even if the two viruses are closely related.  That is not having it both ways at all.  

 

Smallpox are monkeypox are closely related, and they are very similar.  But as the article pointed out, the protein structures are a bit different.  One of the other main differences between them is that, thankfully, monkeypox is quite a bit less contagious from person to person, and thus much slower to spread and easier to control. 

 

This page has more information on various pox viruses, as well as discussing the strategies used in eradicating smallpox:  http://virology-online.com/viruses/Poxviruses.htm It is not any sort of official site, and it is a bit out of date as there was a small outbreak of monkeypox in the US in 2003 which is not included, but it is interesting and the information seems accurate, from what I can tell.

[caned & able]

Smallpox has been wiped out? Someone needs to tell the CDC!

http://www.cdc.gov/eid/content/17/4/730.htm

Apparently the best way to get smallpox is to get the vaccine ...

http://jama.ama-assn.org/content/297/23/2579.full

 ... or have sex with someone recently vaccinated against smallpox.

[BeckyBird]

When a vaccine spreads almost as much disease as, well, the original disease.....what's the point of the vaccine again? (OPV)

[WildKingdom]

Yes, smallpox is eradicated. Vaccinia is not smallpox. A fact of which I'm sure the CDC is well aware.

[pers]

Originally Posted by caned & able 

Smallpox has been wiped out? Someone needs to tell the CDC!

http://www.cdc.gov/eid/content/17/4/730.htm

Apparently the best way to get smallpox is to get the vaccine ...

http://jama.ama-assn.org/content/297/23/2579.full

 ... or have sex with someone recently vaccinated against smallpox.

You might want to give these articles a bit of a closer reading.  They are talking about vaccinia cases, not smallpox.  There has not been a case of smallpox in over thirty years. 

The smallpox vaccine does not contain any smallpox virus and so can not cause smallpox.  It does contain live, unaltered vaccinia virus, and so vaccinating someone for smallpox is actually deliberately infecting them with vaccinia.  Vaccinia is a very close relative of smallpox, close enough that the antibodies created in fighting one are protective against the other.  But while smallpox is a serious and often deadly disease, vaccinia is typically extremely mild, and usually remains confined to the point of vaccination and clears up quickly.  People vaccinated with vaccinia are supposed to keep the vaccination site covered for a while and use careful hygiene to help keep it confined, but sometimes still it can spread to other parts of the body or even other people as happened in those cases.  And while  vaccinia is generally very mild, it can be dangerous, or in very rare cases even deadly, to those with weakened immune systems.  It is for sure a dangerous vaccine, but one that did make sense when smallpox was a serious risk.  But because of how dangerous the vaccine is, they stopped vaccinating for smallpox in the US, where there had not been a case in decades, even before it was completely eradicated from the world.

Unfortunately, while the virus has been wiped out to the point that it can't come back on it's own, samples still live on in labs, and so it is possible that smallpox could return through human means.  The CDC and a similar agency in Russia are both known to have highly guarded samples, but it is also possible that other nations and labs have secretly kept virus samples as well.  The September 11th attack followed by the Anthrax attacks brought about a greater concern of terrorists getting their hands on smallpox and using it in biological warfare, and as a result they started vaccinating military personal and some civilian doctors and medical staff who would be called on to respond to suspected smallpox cases/attacks.  This was pretty controversial due to the dangers of the vaccine and the known risk of vaccinia spreading to others beyond those deliberately vaccinated with it.  The vaccine was not offered to the general public, but they did start increasing the amount of stored vaccine to ensure the ability to vaccinate everyone who may need it in case it ever became necessary.  

[Chamomile Girl]

Originally Posted by WildKingdom 

Yes, smallpox is eradicated. Vaccinia is not smallpox. A fact of which I'm sure the CDC is well aware.

'Cmon people are we seriously going to waste our energy wondering if smallpox has been eradicated? I'll tell you what, if anyone is wondering whether or not to vaccinate their child and they stumble across a discussion like that they are going to think anti-vaccinationists are a bunch of loons.

Now, back to the original question: There is no doubt in my mind that the smallpox vaccine did indeed help to eliminate smallpox. There is also no doubt in my mind that it was worth it...but this may be because of my constant exposure (pun ) to what people who contracted smallpox had to endure both in terms of the illness and its treatment before the vaccine (my husband's area of study is smallpox in victorian london). Smallpox was no "simple disease to be treated easily at home" although as it became more rare people freaked out about it more and more (just like we see today with measles and chicken pox).

BTW pers great post upthread.

Other diseases are a more difficult call. I do think the the medical profession is a bit too gung-ho over the idea that vaccines are some sort of panacea. They clearly are not. Doctors got lucky with the smallpox vaccine because they discovered a similar, very mild disease that worked for smallpox immunity. Before this was discovered people were getting innoculated with actual smallpox pus, often with disastrous results (the idea behind that being you would still get ill but a more mild case would result...so most people lived). If other diseases worked in the same way doubtless the vaccines would be more effective.

For me the big issue I have wit vaccines is all the crapola they include as preservatives and whatnot. And of course the fact that they want to inject all that sludge into newborns and other babies who do not yet have mature immune systems. Add to that the fact that vaccines are the cash cow for big pharma and it all adds up to something truly fishy.

But I DO think that vaccines can be very helpful given certain circumstance...like if they ever manage to create an effective vaccine for malaria it would completely change the world.

[JMJ]

caned & able, vaccinia is slightly different than smallpox, so small pox may be wiped out, but vaccinia can still be caught from the vaccine.  Yes, I have no clue why they are still vaccinating people against a disease that no longer exists using a disease that exists only because of the vaccine.  Strange.  Back the question of what did wipe out small pox?

[pers]

Originally Posted by JMJ 
 Yes, I have no clue why they are still vaccinating people against a disease that no longer exists using a disease that exists only because of the vaccine.  

Because while the virus has been eradicated from the human population, it does still exist stored in laboratories.  See my last post just a little up the thread. 

[cappuccinosmom]

Yep.

I'm watching dh's country with interest.  Polio had been a problem.  And people still live (in terms of hygiene) pretty much like they did 50 and 100 and 150 years ago in rural areas.  Infrastructure is spotty at best, and the majority do not have running water and indoor toilets etc.  Even in the big cities and the capital, sanitation leaves something to be desired, outside of the fanciest hotels and richest homes.

The major change that preceded the near-eradication of polio cases there was....<drumroll>...a huge vaccination campaign.  It would be nice if health and hygeine would follow, and that's being worked on, but the quickest and most efficient way was vaccination.  IMO, polio is worth eradicating.

[cappuccinosmom]

Also, the TB "link" is interesting.

TB has been a killer in dh's country since long before vaccines arrived.

It is often contracted through animal contact--cows, for instance, are major carriers, and it goes direct from their fresh milk to humans--cows aren't being vaccinated, I'm pretty sure. ;)

TB also killed many people in Europe and America before the advent of vaccines.  It's a nasty disease, but I am pretty sure not caused by vaccination.

[Bokonon]

Originally Posted by cappuccinosmom 

Also, the TB "link" is interesting.

TB has been a killer in dh's country since long before vaccines arrived.

It is often contracted through animal contact--cows, for instance, are major carriers, and it goes direct from their fresh milk to humans--cows aren't being vaccinated, I'm pretty sure. ;)

TB also killed many people in Europe and America before the advent of vaccines.  It's a nasty disease, but I am pretty sure not caused by vaccination.

We don't vaccinate for TB in the US.  And TB rates continue to decline.

Cows most definitely do get vaccinated, just like dogs and cats.  Perhaps not for TB, but they do get vaccinated.
 

[cappuccinosmom]

I'm referring to the idea that vaccines cause TB.

Yes, it certainly can decline in other ways.  I'm just saying there is no link between vaxing and contracting TB.

[cappuccinosmom]

And cows in Ethiopia most defnitely do *not* get vaccinated, unless they are very special cows, lol  Likewise, it seems unlikely that cows were widely vaccinated at the time when vaccines were just being invented and tested.

Thusly, we can be fairly sure that vaccination does not cause TB, seein' as TB was around and killing long before anybody was vaccinating either people or cows.

[Bokonon]

Originally Posted by cappuccinosmom 

And cows in Ethiopia most defnitely do *not* get vaccinated, unless they are very special cows, lol  Likewise, it seems unlikely that cows were widely vaccinated at the time when vaccines were just being invented and tested.

Thusly, we can be fairly sure that vaccination does not cause TB, seein' as TB was around and killing long before anybody was vaccinating either people or cows.

Smallpox and polio were "around and killing long before anybody was vaccinating either people or cows" too, but that doesn't mean that the vaccines never caused the disease.  And yes, the TB vaccine has caused TB.

"In the summer of 1930, in Lubeck, Germany, 240 infants were vaccinated with BCG; 72 of the vaccinated infants developed tuberculosis and died…."

http://insidevaccines.com/wordpress/2010/11/08/tuberculosis-vaccine-use-based-on-blind-faith/

[Bokonon]

Originally Posted by cappuccinosmom 
 I'm just saying there is no link between vaxing and contracting TB.

Have you researched this?  

[Chamomile Girl]

Can we stick to the original question posited by the OP please? It is an interesting question.

[miriam]

[QUOTE]
VACCINIA VACCINE

Dryvax,® the vaccinia (smallpox) vaccine currently licensed in the United States, is a lyophilized, live-virus preparation of infectious vaccinia virus (Wyeth Laboratories, Inc., Marietta, Pennsylvania). Vaccinia vaccine does not contain smallpox (variola) virus. Previously, the vaccine had been prepared from calf lymph with a seed virus derived from the New York City Board of Health (NYCBOH) strain of vaccinia virus and has a minimum concentration of 108 pock-forming units (PFU)/ml. Vaccine was administered by using the multiple-puncture technique with a bifurcated needle. A reformulated vaccine, produced by using cell-culture techniques, is now being developed. [/UNQUOTE]

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5010a1.htm

If smallpox is eradicated, why are we reformulating the vaccine against it?  

If smallpox was eradicated by the vaccine, obviously the old vaccine worked well enough.  

Why re-invent the vaccine that did the job?

...And why are we reformulating a vaccine for a disease that has supposedly been eradicated?  :scratch

[Chamomile Girl]

Originally Posted by miriam 

[QUOTE]
VACCINIA VACCINE

Dryvax,® the vaccinia (smallpox) vaccine currently licensed in the United States, is a lyophilized, live-virus preparation of infectious vaccinia virus (Wyeth Laboratories, Inc., Marietta, Pennsylvania). Vaccinia vaccine does not contain smallpox (variola) virus. Previously, the vaccine had been prepared from calf lymph with a seed virus derived from the New York City Board of Health (NYCBOH) strain of vaccinia virus and has a minimum concentration of 108 pock-forming units (PFU)/ml. Vaccine was administered by using the multiple-puncture technique with a bifurcated needle. A reformulated vaccine, produced by using cell-culture techniques, is now being developed. [/UNQUOTE]

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5010a1.htm

If smallpox is eradicated, why are we reformulating the vaccine against it?  

If smallpox was eradicated by the vaccine, obviously the old vaccine worked well enough.  

Why re-invent the vaccine that did the job?

...And why are we reformulating a vaccine for a disease that has supposedly been eradicated?  :scratch

Because there is fear that "terrorists" are going to get hold of test tube smallpox and use it as a bio weapon. That is why the only people who are currently vaccinated against smallpox are those associated with the military or other anti-terrorist organizations.

[JMJ]

I think the fact that diseases can be perpetuated by vaccination is something to consider when looking at the worth of a particular vaccine. It seems to me that a lot of the vaccines out there work by infecting the person with an illness that is at least supposedly safer than catching the wild disease itself. I think in a lot of cases of vaccines that are approved for wide usage, the statistical risk for the general population of developing a severe form of the disease that is vaccinated against is lower for people who are vaccinated than people who are not.

I see two difficulties with this. First of all, there is very little research on the risk of contracting another disease or dying after a vaccine, and as diseases become more rare, it becomes more likely that an individual will develop a complication from vaxing than that an individual will develop a complication from the disease in question.  For example, smallpox is eradicated, and the vaccine may still be protecting people who are working with it in a lab, but vaccinia can still be caught by members of the public due to the vaccine, and a member of the public getting the vaccine would be at greater risk for developing problems from the vaccine than problems from smallpox itself.

Second, the risk to an individual (of getting the disease or the vaccine and developing complications with either one) may or may not be the same as the statistical risk for the general population.  For example, it is well known that giving the OPV to an immune compromised individual is a bad idea.  They are more likely to get VAPP, and they are more likely to be contageous for a long period of time, getting others around them sick as well for many years.  The last thing you want in a polio epidemic is somebody who is contageous with polio for years.  Most people have no complications with measles and many other diseases if they are well nourished and have healthy immune systems, and therefore, having a vaccine would only serve to disrupt the natural immunity and prevent a few days of not feeling well.  A difficult thing to consider is the act that people who are immune compromised are the most likely to have a problem with the vaccine and the most likely to have a problem with the disease in question and therefore, best off if they can be in an environment where the disease is rare and they are unvaccinated.

When I look at something like measles or polio, where it seems like in the US, the risk of actually getting the disease is so low, and the risk of getting the disease and having it cause a complication is tiny while the risk of problems with the vaccine is low but maybe more than we understand, it is easy to question the risk/benefit analysis for individual vaccines.  Are there diseases, though, that it's not as much about whether or not I think my child will have a problem with the disease, it will be a problem for enough people that we should try to make it so nobody ever gets it again and then halt the vaccine for everybody?