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The Free Market 19, no. 4 (April 2001)

One of the modern hero-myths the State has cultivated about itself is that government vaccination programs drastically reduced some common communicable diseases in the twentieth century. For decades, the government has required certain vaccinations for entry into schools, and most parents have passively submitted to the inoculation of their children. Now, in response to increasing evidence that vaccines may not be the boon to our health that has been supposed, opposition to mandatory vaccination programs is building.

In 1900, 11 infectious diseases accounted for over 40 percent of total mortality in the United States. Today only a tiny fraction of total mortality results from these same illnesses. The public health establishment's spin on the data is that its government-funded programs, particularly mass inoculation, are to be credited with the millions of lives saved. "Perhaps the greatest success story in public health is the reduction of infectious diseases resulting from the use of vaccines," the Centers for Disease Control proclaims. However, though vaccines have been developed for many of the diseases prevalent in 1900, most of the reduction in death rates since then came not from mass vaccination programs, but from factors having little or nothing to do with government intervention.

Physician Harold Buttram wrote recently that "from 1911 to 1935 the four leading causes of childhood deaths from infectious diseases in the US were diphtheria, pertussis (whooping cough), scarlet fever, and measles. However, by 1945 the combined death rates from these causes had declined by 95 percent, before the implementation of mass immunization programs." Better living conditions, hygiene, and sanitation--the results of a market economy providing what people need--had much more to do with the decline in mortality than anything government did.

To deny the market's overwhelmingly dominant role in subduing communicable diseases would be blatant chicanery. Yet the CDC maintains, "Vaccines are the best defense we have against infectious diseases."

A similar case can be made for other killer diseases. Neurosurgeon Miguel Faria wrote that between 1923-1953, before the Salk vaccine was discovered in 1955, the polio death rate in the US and England declined on its own by 47 percent and 55 percent, respectively. This is not reported or discussed by the public health establishment but, it seems, only by independent researchers; neither is the fact that European countries, which didn't systematically immunize their citizens, also experienced a precipitous decline in their polio morbidity and mortality statistics.

The same story applies to measles, for which the death rate fell from about 13.3 deaths per 100,000 population in 1900 to about 0.03 deaths per 100,000 in 1955. Mass inoculation became possible when the vaccine appeared in 1963, after measles deaths had practically been eliminated by other factors. Typhoid fever and typhus were also conquered by improved living standards brought about by a market economy, not by government programs. Dr. Faria contends that "the advent of the Industrial Revolution was a formidable event working against most infectious diseases. It brought an improved standard of living, better nutrition, cheap soap, and inexpensive cotton clothing, clothing which could now be washed and rendered free of lice--all of which contributed significantly to the eradication of typhus."

Vaccinations do provide benefits, but they are certainly not the silver bullets that public health services make them out to be. Some researchers are convinced that vaccines were only helpful in eliminating the last few thousand annually occurring cases of certain infectious diseases like polio, diphtheria, and whooping cough.

Now, evidence is mounting that some vaccines, indiscriminately administered to millions of children by government order, are causing severe and even fatal reactions that outweigh the risk of the disease itself. Yet parents are threatened with prosecution for child abuse if they do not get their children immunized.

The most egregious trampling of liberty is the requirement that young children-- even infants--receive a vaccination for hepatitis B. Hepatitis B is a disease that afflicts, for the most part, the sexually promiscuous, needle-using drug addicts, and those on dialysis. It is not a disease of babies and schoolchildren. Out of about four million births every year, only about 50 children will contract hepatitis B before their first birthday, typically because the mother has the virus. For children under the age of 14, the incidence is about 2-6 cases per million, which means that children are three times more likely to die or suffer adverse reactions from the vaccine than to catch the disease itself. Hepatitis B is uncommonly fatal, but so far around five hundred deaths from the vaccine have been reported to the FDA. There are perhaps hundreds of thousands of nonfatal adverse reactions to the vaccine.

Yet from 1991 until recently, the vaccine was recommended for all children within 24 hours of birth. Even now it is recommended by the CDC for all children no later than 6 months, and required by state governments for admission to most schools and many day care centers. Michael Belkin, who attributes the death of his 15-month-old daughter to complications related to her second hepatitis B dose, has no love for the CDC. "[W]hat they are doing is more like a vaccine Gestapo. . . . By the time you get around to going to your pediatrician or going to school, they tell you that you have to have this toxic substance for a sexually transmitted disease--either as one of the first things in life or as the cost of admission to school. It's ridiculous."

Government zealots will go to great lengths to foist "health" on their unwilling subjects. In Utica, New York, last October, middle-school children who had not had their hepatitis B vaccinations were suspended from school. The school district then told the parents that if their children were not vaccinated within two weeks, they would be reported to the state child protection agency for educational neglect.

Another vaccine blunder, courtesy of the CDC, involved a vaccine for rotavirus. Rotavirus is extremely common, infecting almost all children by age 5. The symptom is usually mild diarrhea, but around 55,000 hospitalizations and 20-40 deaths a year do occur. In September 1998, the FDA approved a vaccine called RotaShield. Pre-release trials of the vaccine had shown 30 times the rate of a potentially fatal intestinal blockage, but this was deemed statistically insignificant, and the vaccine was recommended for all infants in June 1999. On July 15, faced with unequivocal evidence that the vaccine was causing intestinal damage, the CDC recommended that the vaccine not be given to anyone. One million children had been immunized with RotaShield over a one-year period, and two deaths and 99 cases of bowel obstruction were reported to the government's vaccine hazard reporting system--a system that is commonly acknowledged to catch only 10 percent or so of actual vaccine-caused injuries.

Plagued by politicization, the vaccine approval and recommendation process is partly to blame for the RotaShield debacle and other, more serious fiascos such as deaths from the swine flu vaccine in the 1970s. Before being licensed, new vaccines must pass the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee. Vaccine "recommendations" for mass immunizations are made by the Advisory Committee on Immunization Practices, members of which are selected by the Centers for Disease Control.

Both committees are, at the very least, potential hotbeds of political corruption. Hearings conducted last year by the Committee on Government Reform give ample reason for concern. One member of the CDC's advisory committee, the hearings revealed, holds a patent on a rotavirus vaccine, receives money from a large pharmaceutical company to develop the vaccine, and is also paid by the pharmaceutical industry to travel around the country telling doctors that their vaccines are safe. He did not recuse himself from voting on rotavirus issues, and recommended to the CDC that the rotavirus vaccine be added to the Vaccines for Children program. Several members of the committees owned stock in drug companies and otherwise stood to gain from government immunization requirements.

The well-being of infants and schoolchildren requires that the vaccination process be depoliticized. While some vaccines clearly can be helpful in preventing disease, they are dangerous in the hands of a government that wants to apply them indiscriminately. Let's keep government out of the medical business, and let parents informed by their doctors decide how to protect their children.

Timothy D. Terrell is assistant professor of economics at Wofford College and an adjunct scholar of the Mises Institute (terrelltd@wofford.edu). Readings: Miguel Faria, "Vaccines: Hygiene, Sanitation, Immunization, and Pestilential Diseases," The Medical Sentinel (March/April 2000). Michael Levin, "All 'Our' Children?" The Free Market 14, no. 4 (April 1996). Geoff Metcalf, "Vaccines that Kill Children?" WorldNetDaily, Sunday, Dec. 3, 2000.