Реферат: The Role of Smallpox Vaccination in Mortality Decline in the Great Britain through Eradicating the Disease
Late Dr. Gryzanovski noted the strange fascination in numbers: “Not only the mathematician, and the mystic philosopher, but the artists, the physicist, the economist, all feel it alike, and even those who are unable to comprehend the real nature of numbers, have an instinctive appreciation of their conclusiveness”. Below is a good example how numbers can be misleading if used improperly. During an agitation in favor of compulsory vaccination in Germany at the end of 19th century, the learned Professor Kussmaul went into great details by citing the occurrence of 3330 cases of smallpox in Marseilles in 1828. According to the statistics that was presented by him to prove the necessity of mass vaccination, 2289 of the 3330 persons had not been vaccinated. Out of these unvaccinated folks 420 or 18.3 per cent died, whereas the mortality among the vaccinated 1041 was only 17 or 1.7 per cent. At first sight, it seems obvious that vaccinated folks were luckier and through saved lives smallpox vaccination caused an invaluable amount of economic gain, but that is only if we presume that data is correct and calculation is without any fault. But now we have Dr. Lorinser’s data on Marseilles’ population in 1828, and proportion of vaccinated, 133000 and 33000 respectively. And if now we recalculate using the correct denominators, we come up with a completely different picture. In fact, it is the opposite of the initial finding that supported efficacy of the smallpox vaccination. Mortality level among the vaccinated comes up to be 32 per thousand, while mortality level among the unvaccinated is 23 per thousand. This recalculation of the data at hand not only disproves the initial claims of the efficacy of smallpox vaccination, but also shows that it was dangerous. So who is right in this case? Maybe both men’s conclusions were wrong, but Dr. Lorinser’s statistical methods seem to make more sense. (Gryzanovski, 1906).
Hence, the role of smallpox vaccination in eradicating the disease in Britain seems to be exaggerated. The first medical tool in preventing smallpox disease, inoculation, was pronounced illegal after being carried out on mass level for more than 120 years. It is interesting to note that from the date of mandatory smallpox vaccination law in Britain in 1853 till the complete eradication of the disease in 1979, almost the same amount of time had passed as in the previous case. One thing is different though – this time, with vaccination, medical men decided to end smallpox vaccination on a good note… After 1979, smallpox cases were spotted in a few LDCs (less developed countries) of the world, but the WHO did not re-initiate mass smallpox vaccination.
Conclusions and Directions for A Future Research
Without a doubt, eradication of smallpox disease was one of the greatest achievements of mankind. It must be emphasized that this was the merit of combined forces of various factors, such as economic, sanitary, technological, and educational. Arduous endeavors of certain groups to continue with inoculation long after it had been banned in 1840 were mentioned (NAVL, 1910), and this leads one to think that these groups probably had huge economic and/or political interests at stake. Estimation of economic benefits derived from smallpox immunization, both inoculation and vaccination, would shed light on the special interests behind this practice. In case of inoculation that preceded vaccination, it seems to be a very low-cost (both start-up, and operations) and highly profitable field: all kinds of amateurs (from farmers to custom-officers) carried out inoculations throughout towns and villages, with little or no regulation; overseers of the poor paid for their parish to be inoculated. For instance, the statement that “many gentlemen paid for inoculation of the children of the poor in their own neighborhoods” does signal huge economic spending on inoculation, but does in no way quantify the amount (Razzel, 1965). The above description of smallpox inoculation resembles the current day Internet get-rich-instantly recipes, which also boast low-cost, huge potential markets, and little regulation.
Vaccination replaced the arsenal of medical profession against the infectious diseases, but little has changed. Many vaccine batches are found to be contaminated even during our days, and there is still no sure way to inspect their quality, few vaccine manufacturers work as a monopoly. Vaccine manufacturers and doctors who carry out the vaccination practice are legally freed from liability on any consequent damage caused by vaccines (NVIC.COM).
I was not able to economically compare the weight of smallpox vaccination compared to other forces, mainly not due to the lack of data on smallpox mortality or economic and other developments in Britain between 18th and 20th centuries, but due to impossibility to measure things with he same units. How would you compare sanitation, increased knowledge of safe food preparation, better economic standards of living, higher levels of vaccination, and lower mortality rates? How much is the worth of one human being’s life? If just one child died after vaccination, and it turns out he was a potential new Einstein, how does that change economic calculations of losses due to post-vaccine mortality? I tried to avoid going deep into analyzing mortality rates alone, because it would become a simple body count, not economics. However, with little surprise, I discovered that among all the forces that are believed to have played role in eradicating smallpox, smallpox vaccination remains to be the most controversial to the date.
Список литературы
1. Helleiner, Karl. “The Vital Revolution Reconsidered”. The Canadian Journal of Economics and Political Science, Vol. 23, No. 1. February 1957.
2. M. Greenwood. “The Vaccination Problem”. Journal of the Royal Statistical Society, Vol.93, No.2. 1930.
3. Scott, Susan. “The Dynamics of Smallpox Epidemics in Britain, 1550-1800”. Demography, Vol. 30, No. 3, August 1993.
4. Milnes, Alfred. “Statistics of Smallpox and Vaccination, with Special Reference to Age-incidence, Sex-incidence, and Sanitation”. Journal of the Royal Statistical Society, Vol. 60, No. 3. September, 1897.
5. Gryzanovski, Ernest. “On Collective Phenomena and the Scientific Value of Statistical Data”. Publications of the American Economic Association, 3rd Series, Vol. 7, No. 3. August 1906.
6. Encyclopedia Britannica online. http://www.britannica.com/
7. Krause, J. T. “Changes in English Fertility and Mortality, 1781-1850”. The Economic History Review, Vol. 11, No. 1. (1958).
8. The National Anti-Vaccination League. (NAVL) “For and Against Vaccination”. London, 1910.
9. National Vaccine Information Centre. NVIC.COM
10. World Health Organization: Smallpox Vaccination. WHO.ORG