By the time they are six years old, most kids in the United States have received 49 doses of 14 different vaccines. This is the standard immunization schedule recommended by the Centers for Disease Control, as well as many pediatricians. But, how did we get to this point? When were the first vaccines developed? Who oversees the research, development, efficacy and safety of vaccinations in the United States? And why have vaccines become such a controversial topic?
Babies and Vaccines: The History of Vaccines
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
KRISTEN STRATTON: When you have a baby, you’ll be asked by your pediatrician to come in for immunization appointment throughout the first year of his life and beyond. You have heard your friends argue passionately in favor and against vaccinations. And perhaps, you have no idea why this debate even exist. What is the origin of this debate? When were vaccinations developed? This is Newbies.
KRISTEN STRATTON: Welcome to Newbies. Newbies is your online on the go support group guiding new mothers through their baby’s first year. I’m your host Kristen Stratton, Certified Birth Doula, Postpartum Doula and owner of Induced Season Doula Services. If you haven’t already, be sure to visit our website at www.newmommymedia.com and subscribe to our weekly newsletter.
You can also subscribe to our shows through iTunes so you’ll automatically get new episodes when they’re released. Here’s Sunny with details on how you can get involved with Newbies.
SUNNY GAULT: Alright, so welcome to the show everybody. Good to have you and a couple things I just want to highlight today. First, have you ever thought about being on Newbies? Would you like to be one of the parents that we have on our show. Today’s episode is a bit different because we’re not gonna have a bunch of parents involved in the conversation but from most of the episodes we do, we love to get feedback from parents on the topics.
So, if that’s something you’re interested in there is a form on our website so you can go to www.newmommymedia.com and fill out a quick form. You can also join our Facebook group where we will post all of the topics that we’re going to be recording and all the times. And this is across all the New Mommy Media shows which include Newbies. So, that’s a great way to get involved in the shows.
I also just got an email the other day from someone who had seen the product reviews on our site and said, “Hey, I really like to be your reviewer”. So I put a link on the site of how you can become a reviewer so if you go to the review section, on www.newmommymedia.com there again, is another form which just gives us some basic information about yourself and it automatically adds you to our newsletter list.
So whenever companies approach us and ask us to review products, then I send out an email to everyone that’s on the list and we have about 600 or so parents that are on the list now and if you’re interested in reviewing the product, then you simply response and we pick the best people to review the product based on what the company wants. So that’s a little bit about our process. If you’re interested in both of those, again, the best place to find out more information is on www.newmommymedia.com .
SUNNY GAULT: So, before we get started with our episode today, I did want to talk about a headline and this is one of those videos that you see online that you simply can’t get out of your head. And I know today’s topic is a little bit heavy so this is one of those just bright shining moments on the internet that I think will really make your day and the video is of this little baby, the baby is four months old, cute but no hair, he does have hair is super blonde and you can’t see it yet but the baby has a rare vision condition, a disorder and he hasn’t really been able to see his mother or anybody for that matter very well his entire life.
So, this video is of the baby first wearing this cute little baby glasses, I mean, really tiny little glasses that they had specially made for this baby and the video is showing the moment where the baby first sees his mom clearly and this huge huge smile just comes over his face and honestly it is just a treat to see and it just warms your heart and his name is Leo by the way.
Little Leo and Kristen did you get a chance to see this video, it's just so adorable.
KRISTEN STRATTON: I did, you know, when this thing go viral and I’m really plugged into social media so I definitely saw it pop up on my newsfeed, its really precious I mean kids who either are hearing someone’s voice for the first time or seeing someone for the first time, its just really precious to see the reaction so I’m sure it must be very satisfying for the mom to have that interaction for the first time with her baby.
SUNNY GAULT: Yeah, it’s so cute his glasses, its purple. Well, I’m not sure why they chose purple but it’s so cute and they’re made specifically out of rubber so there’s no sharp edges of course that could hurt baby. I know its one of those things. I know when and actually and Kristen maybe you can share more knowledge on this but I know when babies first come out their vision is not good, period, right? It takes a while for our eyes to adapt, right?
KRISTEN STRATTON: It does yeah, actually babies vision when they’re first born is actually limited to basically the distance from mom’s chest or breast and from the breast to mom’s face. And then they also don’t have clarity with all the colors yet as they’re not fully developed at that time. So, its actually pretty amazing that our baby are really designed to see mom’s face and make that connection.
But you know, as much as nice that this baby has glasses is also really amazing how resilient babies are when they do have one of their senses that is not as strong as the other. You know, we have all the other senses for interaction and touch been the most important one. I’m sure that baby got a lot of love and a lot of touches and is still very bonded with his mom.
SUNNY GAULT: Oh, of course. Well, we’ll post videos on our Facebook page, our Newbies Facebook page so if you guys want to check out this adorable video, you haven’t already, you can take a look.
KRISTEN STRATTON: Today on Newbies, we are beginning an in-depth series about vaccinations in the United States. We understand this is a highly controversial topic. The purpose of this series is to educate not pick sides. We are advocates of an informed decision making and throughout this series, you’ll hear the opinions of experts on all sides of the debate.
We’re starting the series today with a look at the history of vaccines from Dr. Elena Conis. Dr. Conis is a professor of History at Emory University and author of Vaccine Nation: America’s Changing Relationship with Immunization. Thank you so much for joining us today, Dr. Conis and welcome to the show.
DR ELENA CONIS: Thank you. It’s a pleasure to be here.
KRISTEN STRATTON: Dr. Conis, can you please tell us what the definition of an immunization is?
DR ELENA CONIS: Sure. An Immunization is something that usually contains either all or part of a micro-organism that in its normal, entire, healthy, wild form causes disease but in an immunization, this micro-organism has been either weakened or killed or kind of reduced to its minor kind of most important part, just to simulate the immune system so that the immune system now is an immune response, it generates antibodies in response to this immunization.
Those antibodies then stay in the body so that when you come in contact with the real micro-organism in its whole live part you already have your body’s defense in place and your body puts that defense into action and combats that micro-organism and protects you from the disease.
KRISTEN STRATTON: When do we first have records of immunization being developed?
DR ELENA CONIS: So to go back to the beginnings of immunizations, you got to go back to a time in history where we had a disease called smallpox around. And smallpox had been a plague of human populations for millennia and for years and years, centuries, in fact, people had tried to protect themselves from smallpox. If you think about chicken pox and then make it a thousand times worst, if not worse than that. That was smallpox, it causes this really painful pox all over the body, sometimes they didn’t stop at the outside, they kind of went inside, on to your mucus membrane, inside your mouth made it difficult to swallow and sometimes, in the worst case you would even hemorrhage or bleed from within.
This is a horrible and often very deadly disease that people try to protect themselves from. There were a number of ways that people in Asia and Africa and Europe try to protect themselves from smallpox for hundreds of years. Many of them realized that, if you had a very mild case of smallpox, just a few pox on the outside of the body and you got better, then you will never get the disease again.
So in Asia and in Africa and in the Middle East, people would intentionally get mild cases of smallpox to “inoculate” themselves so that they got the disease once and then never got the worst case when the worst epidemic broke out.
After some time, some folks of a variety of different people living in England noticed that there were other people who were also protected from really bad epidemics of smallpox and these were milk maids or people who worked with cows and cows had a disease that was similar to smallpox called cowpox. People who work with cows, farmers, milkmaids would sometimes get a mild case cowpox but they would be entirely protected from smallpox.
So, one of the most famous people to make this observation was an English doctor named Edward Jenner. He and a couple of other physicians and farmers in England in the 18th century said, well wait for a second here’s an idea, maybe instead of being deliberately being infected with mild human smallpox, we should deliberately infect people with cowpox and see if that protects them from smallpox. And Edward Jenner did this on the biggest scale and what he showed was it was protected and the reason that we have the word vaccination to refer to immunization is because “vac” comes from “vaca” or “cow” and it was generous observations about cows and cowpox and milkmaids that lead us to the first vaccine.
KRISTEN STRATTON: You mentioned Dr. Jenner, but who are some of the other vaccination pioneers? And what was significant about their advancement?
DR ELENA CONIS: Sure, so Jenner generally gets all the credit for coming up with the first vaccine, but its important to know that he actually didn’t really know what he was doing, he would take a pus from a cowpox blister and use it to immunize or vaccinate people and that became the practice throughout the 19th century in Europe and also in the United States and elsewhere.
Part of the reason why nobody really knew why this worked was because there was no understanding at that time that diseases were caused by germs. There were all these other ideas about what causes disease. People thought it was bad air or weakness in your own constitution, they didn’t have the idea that we have today that there are specific micro-organism germs and bacteria that cause disease and that idea doesn’t really gain kind of scientific popularity until the late 19th Century.
One of the pioneers of that idea that is one of the pioneers of the germ theory of disease was Louie Paster who probably most people know of his name because Paster came out of the pasteurization of milk and his name lives on in that work. But before Paster did his work on milk, he showed that the causes of disease were tiny, tiny little micro-organism or germs. And he was aware of Jenner’s smallpox vaccine and so he thought, maybe we can take other germs and weaken them in the laboratory, make them so that they look more like cowpox then like smallpox and use those to immunize against other diseases.
So Jenner inspired Paster and Paster came up with a whole handful of other vaccines. In the late 1800s, he came out with vaccine primarily to protect livestock and chickens from things like influx and cholera but he also came up with the first rabbis’ vaccine as well.
So, Paster’s contribution in the late 19th century is the kind of next major leap in the development of vaccine, and then we have pretty much a quiet period. There are hands full of new vaccines that come out in the late 19th and early 20th century. But it isn’t until several decades into the 20th century that scientist primarily lead by Harvard scientist named John Enders figured out how to cultivate viruses in particular in the lab and what this meant was once you could grow viruses in the lab, you had lots of virus to work with and so you could cultivate lots of virus and do lots of testing with different types of weaken virus to come up with new vaccines.
So, once those techniques were developed the first vaccine we got were the new polio vaccine. It was developed in the 50s and 60s and then a whole host of other vaccines that followed the polio vaccine including the vaccines against measles, mumps and rubella in the 1960s and the 1970s. So these are some of the major milestones that lead to vaccination development over pretty much two hundred years of history.
KRISTEN STRATTON: Who were often the recipients of vaccinations when they were first developed?
DR ELENA CONIS: So what’s so interesting about the early history of vaccination, is that before we had the first smallpox vaccine that is, that contains cowpox, people who practice inoculation were pretty much anybody who wanted to avoid a really serious case of smallpox.
So in Asia, Africa and the Middle East, where inoculation was practiced, there were a variety of different ways of going about this. Sometimes an inoculator would go village to village and inoculate everybody. Sometimes some families inoculate others didn’t. By the time the inoculation reaches Europe in the 1700s, it ends up being really popular among the upper classes and it’s the upper classes who go kind of crazy for inoculation and things stayed that way throughout the 1700s until Jenner came out with the first vaccination using cowpox.
I think the thinking at that time was, oh everybody would want to use this new vaccine, to protect themselves and their families. But one of the first things that happen was that governments –state governments or national governments saw this as a powerful way to protect the entire populations. So what you see in the early 1800s after the development of that smallpox vaccine is a handful of governments or sometimes just the national army saying okay, everybody has to get vaccinated against smallpox, because it’s in the interest of national security. That is if our whole army is protected against smallpox, that’s one disease that we won’t succumb to and if our whole population is protected against smallpox then we are overall will help the population that can grow and treat and carries on all our normal activities without ever fearing the threat of serious epidemic disease.
In the later 1800s, this idea is more popular in some governments than others and there are some nations that have taken a different approach and both France and England for instance, experiment with just vaccinating the poor and other countries do this as well. So there are varieties of approaches that you see from one country to another. And in the United States interestingly, we kind of come back for the entire 19th century; we didn’t rely too heavily on compulsory vaccination. It was mostly seen as a local issue so if a local town or city, thought that it was facing an epidemic, they might say, Okay now everybody has to get vaccinated but it was usually only in response to the threat of imminent disease.
KRISTEN STRATTON: When did vaccination become the standard for the United States for access to public education?
DR ELENA CONIS: That’s really interesting and in fact, it is probably later than most people think. Throughout the 19th century as I mentioned, and this is true for the earlier part of the 20th century, vaccination is only compulsory on fairly rare occasion in the threat of an outbreak. There are a couple of places that experiment with requiring vaccination for enrollment in school. I think one of the earliest examples of that is actually in Massachusetts which tries that in the 1800s but it isn’t until the 1970s that, that approach really takes off in the United States.
There are a couple of reasons why. The polio vaccine that was developed and actually there were two polio vaccines developed in the 1950s and 60s, those were by and large really popular vaccine. The public was really, really afraid of polio. Really eager to protect themselves and their children. So when those new vaccines came out, people got vaccinated and those new vaccines were based on the new virus culture capability that I mentioned that was developed by John Enders.
So after the polio vaccine, all of a sudden we had these new vaccines coming quickly out of new pharmaceutical companies like Merck who were able to use these virus culture techniques to make vaccines against measles for instance and then later rubella and then later mumps. The public health community thought that when these new vaccines came out, the public would be just as eager to get them and they thought in particular that the public would be eager to get vaccinated against measles but in-fact that wasn’t the case. In-fact mostly middle and upper-middle-class children would be vaccinated against measles because they were the ones who have the most kind of regular frequent contact with their pediatricians. And people at the lower income level, most were not getting vaccinated.
So school laws were seen as a way of ensuring that everybody got vaccinated regardless of class or income or family ability or access to healthcare. They became really popular in the late 60s and early 70s, the school vaccination laws that is because public health experts and epidemiologist, in particular, began to show that in states where there were laws requiring kids to get vaccinated in order to enroll in school there were far fewer outbreak of disease.
So those types of laws became more popular once they were proven to be a way of vaccinating everybody regardless of class, and once they were proven as a means of reducing outbreaks and infectious disease.
KRISTEN STRATTON: Can you explain more in depth the history of vaccination oversight by the government?
DR ELENA CONIS: Sure. In this country, we have several different aspects of government that are responsible for overseeing the safety of vaccines and the FDA is the big one. The Food and Drug Administration approves new vaccines and reviews all the safety data that has been submitted with a new vaccine application and the FDA is the agency, that kind of gives the rubber stamp to a new vaccine to come on to the market.
In addition to the FDA, the Centers for Disease Control which is in Atlanta, not Washington which is my hometown. The Centers for Disease Control oversees the safety of vaccines once they are already being widely used. So, once the vaccine is approved by the FDA then the CDC plays the role in keeping track of who’s getting that vaccine and what their adverse reaction or undesired consequence or side effects might be.
So you have this kind of two of the very basic level, different tiers of safety and oversight. This came in to being more than a century of I would say struggle in the United States to figure out what exactly the government’s role should be. Throughout the entire 19th century, the Federal government was completely uninvolved in ensuring vaccine safety and it was, in fact, the outbreak of a number of cases of tetanus that was transmitted with vaccines in the late 19th century.
This was tetanus that was contaminating vaccines. It wasn’t supposed to be in there and it ends up leading to hundreds of cases of illness and a number of deaths. And that was the first thing that prompted the Federal government to say, Okay, we need to keep an eye on this because now vaccines are being produced in a variety of different States. They’re being shipped all over the place, they’re being used widely and there is no one body responsible for making sure that all those vaccines are safe.
So we got that, that first bit of government oversights that was called the Biologics control Act 1902 and ever since then, we’ve really been expanding government‘s role in overseeing vaccines safety right up essentially until the present.
KRISTEN STRATTON: When we come back we will continue our discussion with Dr. Elena Conis about the history of vaccinations.
KRISTEN STRATTON: Welcome back to the show, we are talking with Dr. Elena Conis, about the history of vaccinations. Dr. Conis, has vaccinations always been a controversial subject or is this a recent shift in our culture to be in questioning vaccine?
DR ELENA CONIS: That’s such a good question. And I think it’s so important to take note of the fact that from the moment that we have the very first vaccine, the smallpox vaccine, vaccination has always been controversial. And people had always expressed fears and worries about vaccines. And that first smallpox vaccine, for instance was something that represented people’s pre-existing fears about the state of society so, working-class people who saw vaccines being recommended by the elite or royal class distrusted vaccines for that reason because they didn’t really trust the motives of these classes of society.
They also worried about the safety of vaccines because they knew that it was an animal-based product and this wasn’t a worry limited to people of specific classes, this was a worry that was shared widely in response to the first vaccine.
The other most important objection that people have voiced about vaccination has been a religious objection, in other words, there have always been people who had felt that to vaccinate against disease as akin to playing God. And this shaped by some particular religious beliefs.
So from the very first moment that we have the very first vaccine, there have been people objecting to vaccines based on religious beliefs, based on fear of what’s in them, and based on questions about the motives of the people promoting those vaccines. In this country, especially in the latter 20th century to the present, we’ve been relying to an unprecedented extent really on compulsory vaccination and that introduces a whole level of objection that people who have all kinds of vaccine worries might not care if they’re not forced to get those vaccines.
But we require vaccines for enrollment in school in this country and so we have another form of objection which is an objection to in-force vaccination. That has always been with us, all those objections to vaccinations have been with us since the beginning of vaccination but what I do want to point out is that, every time the state or the government, increases its involvement in saying who must get vaccinated that tends to always be matched with resistance so as the state power increases and says okay more people must get vaccine against these diseases under these conditions you have more people saying hold on hold on, we have specific reservations we want to be heard. So we are seeing I think in the recent decade an uptake in that kind of push against government power.
KRISTEN STRATTON: What cultural shifts over the several hundred years have each significantly influence the development and implementation of mass vaccination?
DR ELENA CONIS: So I think what’s so wonderful about the study of history when thinking about vaccination is that you can see precisely how our cultural changes and cultural trends and also our political trends all influence how the public response to vaccination. And historians have shown wonderful examples of this, after world war II there was the threat of smallpox outbreak in New York City and all the New Yorkers eagerly lined up to get their smallpox vaccines. It’s something that you probably won’t necessarily see today, but maybe if there were saying Ebola or Zika outbreak today in a place like New York City, and there were effective vaccines, you would see people scrambling to get those.
That’s because of course, there’s a lot of cultural fear around those two diseases. So cultural fear can definitely influence how people fear about getting vaccinated. Examples of New Yorkers getting vaccinated after World War II is a nice example of how patriotism and trust in government and a kind of devotion to working with everybody to protect the commons that can increase acceptance to vaccination as well.
If you look at the kind of flip side of it, what are the cultural trends or norms or patterns that have increased skepticism towards vaccines, that’s where you can start to see that in the 1960s and 70s as we were just beginning to produce new vaccines for children, as we were beginning to use compulsory approaches to encouraging the use of that vaccines, in other words, we were implementing school laws to an unprecedented extent. We were doing that in the 60s.
A time when lots of people were questioning the authority and signing on for the new social movements like the Women’s movement, the Environmental movement and those movements were all about pushing back against experts rethinking the advice that you’ve been given about how to live your life, questioning technology and science and political authority and all of that had a tremendous impact on how people perceive vaccines and the people who were promoting their use.
So again, throughout time, you can kind of take the cultural temperature of our nation and see things that in all likelihood would influence either positively or negatively people’s attitude towards vaccination.
KRISTEN STRATTON: What is significant about the changes in the relationship between medical professionals and their patients which makes this particular time in our history significant?
DR ELENA CONIS: Well, I think that there are a couple of important changes and again I think that it's important to think across lines of class when talking about this. I think that there’s a lot of attention to the fact that since the 1960s, 1970s American healthcare consumers tend to go into encounters with their doctors or medical professionals not necessarily always looking for advice, but coming in armed with their own pre-existing knowledge and coming in prepared to asked questions or question be [inaudible] about the advice or guidelines that their doctors would lay out.
I think that is probably true to some extent in particular middle-class consumers but I think that often gets lost in conversations about how vaccinations attitude are influenced by people’s relationships with doctors is the fact that our healthcare system has been really really fractured and really broken and just a couple of examples, if you live below a certain level of income you might find it really hard to have a regular “family doctor”.
Maybe if you don’t have steady employment you might go from one doctor to another doctor or only seek your healthcare at clinics or be covered by state-level Medicaid programs that it can be challenging to form an on-going relationship with one provider group. I also often see with my student and I have taught Public Health graduate student for years now and they often tell me the story of how as adults they go to college they want to be a doctor. They graduate college, they get a job they have another doctor and they maybe go to graduate school, have yet another doctor. Finish graduate school get another job, have another doctor. By the time they reach their childbearing years, they’re just forming a whole new relationship with the new doctor. So that lack of continuity, with the healthcare provider is something that’s really a feature of the modern age.
KRISTEN STRATTON: Thank you so much Dr. Conis for joining us today and sharing just a piece of your extensive knowledge of the history of immunization. And for our Newbies club members, our conversation will continue after the end of this show as Dr. Conis will share about her book Vaccine Nation: America’s Changing Relationship with Immunization. For more information about the newbies club, please visit our website at www.newmommymedia.com .
SUNNY GAULT: Alright, we have a question from one of our listeners. This comes from Heidi and Heidi lives in New Mexico. And Heidi says: I’m a first-time mom with a one week old newborn, is it possible for an infant this young to develop diaper rash even when I use ointment with every change to prevent it. What should I do if this problem persists?
DR. TARA ZANDVLIET: Hello, Heidi, this is Dr. Tara Zandvliet, yes it is definitely possible for your newborn to have a diaper rash in the first week. Its often the time where they get the most diaper rashes, the newborn skin is super sensitive and everything from the diaper, the cream, the wipes and even their own urine can irritable the skin to the point of seeming like a burn. As they get older, their skin became much less sensitive and diaper rash happens less often.
So keep the skin clean and dry, change the diaper often and don’t rub a lot with those wipes, it is hard with the thick black meconium at the beginning but by now it should be easy to gently wipe off the stool. Consider using just a soft cloth with water instead of a wipe or use hypoallergenic wipes with aloe. You can use aloe creams, zinc creams like Zeferten or vitamin cream like A&D, they all help as a barrier between the wetness and the skin.
If you use a zinc cream use the original one, not the creamies. One favorite where I trained was called Happy Hiney which was a mixture of a zinc cream and anti-fungal women’s vaginal cream like Monistat and Crotect anti-itch cream which was hydrocortisone 1% and it was the ointment not the cream and we mix that up in equal parts it on at each diaper change. It worked like a charm. If you continue having problems, then consider changing the diaper brand. I hope that helps.
KRISTEN STRATTON: That wraps up our show for today. We appreciate you listening to Newbies.
Don’t forget to check out our sister show:
• Preggie Pals for expecting parents
• Parent Savers for moms and dads with infants and toddlers
• The Boob Group for moms who breastfeed and
• Twin Talks for parents with multiples.
Thanks for listening to Newbies. Your go-to source for new moms and new babies.
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified healthcare provider.
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