Figure: From my old Pharmacognosy text by Evans, ca. 1940s. The first vaccine ever developed used “kine pox” (the serum extracted or scraped away from a cow with pox infection in the skin.) This process for manufacturing vaccines for the Pox maintained the use of the cow into the mid 20th century. This is how the pox was extracted from cattle during the 1940s. Whether the cow in this picture was bred to be “hairless” (reduced hair) or is just very cleanly shaven is uncertain.
Reading the news story about the Harvard Mumps outbreak in the dorm–there is really just one line you have to walk away remembering from this story:
[Quote] ” . . . people in college dorms often share living spaces with dozens of people, giving them more opportunities to be exposed to the virus, either on surfaces or through contact with other people, Adalja said. Although being vaccinated against mumps can prevent a person from getting sick if he or she has been exposed to lower levels of the virus, for people living in dorms, vaccination may not be enough to ward off an infection, he said.
“The exposure that they have to mumps is so high in these situations that it overcomes the ability of the vaccine to protect them,” Adalja told Live Science. “It may be that, in these special situations, a much higher level of antibodies [against mumps] is needed to keep the virus at bay,” Adalja said.”
Wait a minute . . . wasn’t being vaccinated supposed to have a “herd effect”? This would mean that if all the college students in the dorms are vaccinated, we needn’t worry.
A portrait of a past mentor of mine, Dr. Daniel Fox. An MD at SUNY Stony Brook and expert Medical Historian, he was a major influence on much of my work. He removed from SUSB around 1989 for a Chief Editor position with the Milbank Quarterly, a medical journal devoted to the federal programs that define the healthcare system and provide rules and regulations in the establishment of the current managed care system, the development of HMOs, and the establishment of many of the Federal programs devoted to health, such as Medicare and Medicaid.
The “HERD EFFECT” provides a very false sense of security to people in medicine, in particular those who contest my past three years of reminding people that 1) theories are perceptions, not facts or truths, 2) theories are good some of the time, not all of the time, and area based on the culture of the places they are born, where the definitive observations are made, and 3) theories in medicine are, in many cases, just as good now as they were back then (remember the lancet?).
The purpose of theory is guide us into understanding a phenomenon we are observing. A person into innovation and change works with multiple theories, multiple options, multiple routes to take in the analysis. A genius is a skeptic of theories, because all theories require skeptics. In medicine, it was the skeptics who decided the theory of four humours was off, or that the alkaline theory of blood and disease so common around 1790, did take into account the chemistry of the blood, but made some false conclusions.
We should be thankful that theory got replaced, right? It was replaced by the nervous energy based theory of the body, which enables scientists to argue sensibly about how life was an process totally derived from natural energy, and the “medical electricity” was the panacea of the future. And in a few years it was the future, people changed their minds about older ideologies in medicine, decided the old time teachings were out of date, and that the theory of disease and how to cure it had to somehow be replaced by more welcoming philosophies.
The discovery of the vaccination using kine pox serum, and the nearly synchronous discovery of the magical powers of homeopathy is not coincidentally proven around the same time as vaccines for any different reasons. The two were derived from the same theory, and took different paths in the philosophical synthesis and use in medicine. Franz Anton Mesmer would be steadily arguing with Volta and Hahnemann, each contesting the other “experts'” claims, not realizing in a decade too, they too would not longer completely correct, that their ideology would have to be changed to be practiced, again and again and again, until doctors finally got it right.
Allopathy’s gate theory of pain still remains a basic idea that we are taught in introductory nervous system courses. The herd effect is taught as a lesson and a rule, but it should be hypothesis, less in value than a theory, and in today’s classes used as a reminder of a theory that this ideology or philosophy medicine relied so heavily upon is failing. It is not a theory any more, and to mention it as your guiding lines of reasoning in the discussion of the failure of infectious disease vaccination programs, enables those who see failure happening to point to you as the cause–you and your old, out of date theory.
Medicine is no longer like it used to be when the philosophy of “Herd Effect” was born. We are more observant, and needs to use the imagination less to know when the events that ensue and the theory that supposed explains them, are a mismatch.
The above statement – – – “The exposure that they have to mumps is so high in these situations that it overcomes the ability of the vaccine to protect them,” – – – is an excuse for a failed theory. It demonstrates lack of acceptance of being wrong. Physicians and medicine are not humble. They hate to admit they are wrong when they are. But in the end, such a stubbornness only embarasses the profession further.
The younger generations, going to college as premeds, are either with you or against you in allopathy when your theory fails to hold its ground once changes happen. Patients, students, shouldn’t be assumed to be part of some great Pavlovian experiment that medicine is engaged in, mesmerizing you until you either given up and accept what is claimed, or are somehow tricked into believing that the gold leaflet they wrote this “Truth’ upon has to be correct, because of who wrote it, not the work and evidence developed to prove it is still true.
It is very easy to eliminate this problem. Open the gate and let the new theories in.