Poor Richard Gives Advice to the Anti-Vaxxers

Ben Franklin has some words of advice for Jenny McCarthy.

Get your kids vaccinated!

Well, not exactly.  Franklin’s advice was actually to get your kids inoculated, since vaccines had not yet been invented by Franklin’s day.  But dead as he certainly is, Ben Franklin thinks he can pretty much settle our controversy over vaccines.

Vaccines, Jenny McCarthy, claims to know from personal experience, cause autism.

No they don’t, say the nearly the entire scientific community.  And there is much scientific literature to recommend their point of view.

But we don’t trust your scientific studies, say the anti-vaxxers.  We don’t trust scientists if we don’t know who is paying them, and we don’t trust big pharma. And there is much recent history to recommend that point of view as well.

And so we are at an impasse.

Franklin helps us see our way out of the impasse.  In his autobiography, the author of Poor Richard’s Alamanac includes some advice about inoculation. He writes, “In 1736, I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way.  I long regretted bitterly, and still regret that I had not given it to him by inoculation.  This I mention for the sake of parents, who omit that operation, on the supposition that they should never forgive themselves, if a child died under it; my example showing the regret may be the same either way; and that, therefore, the safer should be chosen.

A word of historical explanation then.  The vaccine, as we know it, was not invented until 1796.  Its inventor, a physician by the name of Edward Jenner, noticed that milkmaids who had been infected by cowpox could not be inoculated for smallpox; indeed, they didn’t seem to ever catch smallpox at all. So by inoculating them with cowpox, which we now know is similar to smallpox but less virulent, he could give his patients immunity to both diseases.  This, by the way, is where we get the term vaccination (since vaccina is Latin for cow).  This option, alas, was not available to Franklin in 1736.

But Europeans and Americans had been inoculating their children against smallpox for almost a decade, ever since Lady Mary Worley Montague, the pockmarked wife of the British ambassador to the Ottoman Empire, had popularized the procedure in England.   Inoculation was a little different.  It consisted in finding someone with a mild case of the virus, scraping off some fluid from the infected person’s pustules, and then transferring that under the skin of the patient.

The problem with 18th century smallpox inoculation is that it wasn’t so terribly uncommon for the patient to get a case that knocked them down for the count.  And you might also unintentionally pass along other nasty diseases, like syphilis.1 

The worst case scenario here was not autism.  It was death. 

I imagine the decision on whether to inoculate and risk the small, but not infinitesimally small, chance of killing your kid or whether to forgo inoculation and risk having them carried off “in the common way” must have been atrociously, heart-rendingly difficult for 18th century parents. 

Because risking smallpox was no joke.  Small-pox was an all-devouring, all-consuming, death-dealing catastrophe of a disease that left permanent scars on those few who escaped it with their lives.  Modern mortality rates for smallpox are around 30 percent.  Higher for children. It’s quite probable that they were higher in the 18th century.  Franklin’s contemporary Voltaire claimed that 60 percent of people would catch the disease in their lifetime and 20 percent of people would die from it. 

Mortality rates for something like, say, a modern outbreak of measles, are deceptively low by comparison.  This is mostly because measles is not quite as virulent, but also partially because in America, most people are vaccinated. When an outbreak catches hold amongst an under-vaccinated population, the few unvaccinated carriers come into contact with thousands of vaccinated patients, some of whom will catch the virus (since the vaccination is not one hundred percent effective).  Thus, even though outbreaks usually happen when a critical limit of people in a given population are not vaccinated, the outbreak ends up infecting more vaccinated people than unvaccinated people…since there are just so many more vaccinated people around.

But vaccinated people usually get a less severe case.  If, on the other hand, the anti-vaxxers win and nobody gets vaccinated, it would be a different story.  The measles aren’t quite smallpox, but they are no joke either.  The World Health Organization estimates that nearly 100,000 people died of it in 2017, down from more than half a million in 2000 because of a global vaccination campaign.

I think what that means for Ben Franklin and Jenny McCarthy is this.  Even if there is some (likely very small percentage) of kids who get autism from vaccines, and even if it is just a terrible, terrible feeling to think that something you put in your child’s body caused it, in both cases (to vaccinate or not) the worst thing that can happen is that your child dies.  And you will bitterly regret that either way.  So Ben Franklin thinks you should play the odds: vaccinate your children.   

  1. Myron Levine, et al, Vaccines and Vaccination in Historical Perspective