This is Democracy – Episode 129: Vaccinations

[0:00:03 Speaker 1] This Is Democracy, a podcast that explores the interracial inter generational and inter sectional unheard voices living in the world’s most influential democracy.

[0:00:16 Speaker 2] Welcome

[0:00:21 Speaker 1] to our new episode of This Is Democracy. This week we’re going to discuss the history and present story of vaccinations in American society. How have we as Americans dealt with the challenges of vaccinations in the past? How have we balanced the imperatives of mass vaccinations with the protections for individual privacy and individual rights? And how do we think about that history in the context of our current covid pandemic and the arrival of at least two now vaccines in our society? How do we think about the history of vaccination in managing the current vaccination challenges and opportunities in our society we have with us? I think easily the foremost historian of history, medicine and American society and politics broadly stated, uh, my good friend and really quite well known historian David Oshinsky. David directs the Division of Medical Humanities in the Department of Medicine at New York University, where he’s also a professor of history. He’s written some of the most important books on Postwar American society and Postwar American democracy. Just to name a few. He’s written what is still my favorite book on McCarthyism. A Conspiracy so immense The World of Joe McCarthy. Also a fantastic book on race, Criminal Justice and the American South. Worse Than Slavery, Parchman Farm and The Ordeal of Jim Crow Justice, which won the Robert F. Kennedy Prize for contributions to Human Rights, a book that I think has gained more relevance as we focus on criminal justice these days. Uh, and David won the Pulitzer Prize for his book on polio, which is most most relevant for our discussion today. Polio and American Story. And he published a few years ago in 2016, A New History of Bellevue, three Centuries of Medicine and Mayhem at America’s Most Storied Hospital. I grew up in New York City, and my parents always threatened me that if I didn’t behave, I’d be sent to Bellevue. David’s book finally explained to me what? That what that meant, what that institution was about and the history of mental health issues in New York City. David, thank you for joining us.

[0:02:29 Speaker 0] My pleasure. My pleasure, Jeremy. Thanks for the fine introduction

[0:02:33 Speaker 1] before we turn to our discussion with David Oshinsky. We have, of course, Zachary Series scene setting poem for us this week and every week. Zachary, What’s the title of your poem today

[0:02:45 Speaker 2] in my defense?

[0:02:47 Speaker 1] Okay, let’s hear it.

[0:02:50 Speaker 2] In my defense, I may have yelled

[0:02:52 Speaker 1] bloody murder to

[0:02:53 Speaker 2] the poor nurse felt my heart lift off my skin like I was watching my own hearse. I may have needed hugs, strong arms and a bucket full of treats. I may have run half naked down the hallway, but I never screamed in the streets. I may have paste the empty office block, blasting rock music and composing elegies for the end of the world. I may have stared stupefied and an endless number of clocks waiting for my own name to be heard.

[0:03:20 Speaker 0] But I knew then that it was all

[0:03:22 Speaker 2] for some unborn. We’s my sinister look, lurking and silent disease. In my defense, I may have screamed, careened, punched the air and steamed. I may have played dead, banged my head, refused to move and wet my bed. I may have composed 1000 different shots for the nose or wine for some Miracle does. But every October, rain or shine, I was there with a grimace, a whale and a wine

[0:03:48 Speaker 1] that brings back so many memories of going to the doctor’s office with you, Zachary and your sister Natalie each each fall for our flu shots and various other things. What is your poem about?

[0:04:00 Speaker 2] My poem is about my experience as someone who

[0:04:03 Speaker 0] absolutely hates getting

[0:04:05 Speaker 2] shots with vaccination, and even though it’s so uncomfortable how important it is to get them

[0:04:11 Speaker 1] well, Zachary, you’ve really set the scene perfectly for us. Uh, David, uh, one of the really interesting questions, it seems to me, is when, as Americans did, did we start vaccinating people in masses in the way that Zachary describes?

[0:04:27 Speaker 0] That is really 1/20 century phenomenon. Vaccines have been around since Edward Jenner and smallpox in the late 18th century, but mass vaccination is a relatively new phenomenon. There was an interesting case. Jeremy, in 19 oh five, called Jacobson vs the United States, which went all the way to the Supreme Court and involved a minister in Cambridge, Massachusetts, who refused to vaccinate himself or his son to be vaccinated during a smallpox epidemic in Massachusetts. He claimed that aid the vaccine was dangerous, but more important than that it was up to him and his God to determine whether he would be vaccinated or not. It was not the state’s responsibility. The case went up to the Supreme Court, and the court ruled it was a conservative court at this time. But it ruled overwhelmingly that in time of emergency, when there’s a medical emergency, you have to give up some individual rights. In other words, your rights are not absolute, and therefore you could demand that the population be vaccinated in an emergency. What is interesting is that, unlike, say, the Soviet Union, we couldn’t barge into someone’s house and hold someone down and vaccinate the person what

[0:06:01 Speaker 1] parents do

[0:06:01 Speaker 0] exactly. But what the Supreme Court did rule was that you had to pay a penalty for not vaccinating, in other words, that there’d be a $5 fine if you didn’t vaccinate, and that Jeremy is pretty much the way we do it today. In other words, if you refuse to vaccinate your child in most states, you can’t send their child to public school or private school or maybe daycare. The kid can go to the mall and probably play little League Baseball, unfortunately, But in fact, what we do is sort of to penalize. And that’s really what mandatory vaccination means to take your question a little bit further. I was vaccinated as an infant, um, in 1947 and what happened was that there was an enormous, uh, fear of smallpox that a man in New York City had gotten off a bus from Mexico. He had a rash, but he went around the city. He stayed in a hotel, he went to a show. And then he began to show the signs of smallpox. They brought him to Bellevue Hospital, where else, um and it turned out to be a full blown case of smallpox. He died, and one of the attendance at the hospital also died. And what they did at that time was literally to line up the whole city of New York in 1947. And more than five million people were vaccinated in a span of weeks, which is really the first major vaccination of a relatively large area that we have in our own history.

[0:07:48 Speaker 1] It’s extraordinary, David, I have to admit, as a historian myself, I don’t know the story of 1947. It’s not something we

[0:07:56 Speaker 0] often write about. You know, one of the things that’s interesting, Jeremy, is that, as you will know, that medical history often gets short shrift. In other words, 10 times more Americans died in the 19 influence. 18 influence epidemic than died during World War 1, 10 times more American civilians of the age of the soldiers died. And yet you may get a sentence or two in a textbook in American history textbook. You’ll get an entire chapter on World War One, probably a chapter on the Treaty of Versailles. Probably a couple paragraphs on the red scare, and you may get a sentence on an influenza epidemic that killed at least 50 million people worldwide in a span of a year and killed close to a million Americans.

[0:08:49 Speaker 1] It’s so true, and I will plead guilty myself in my own riding in my own teaching. I spend much more time focused on World War One than on the influenza epidemic, and I’m rethinking that today,

[0:09:00 Speaker 0] and I think a lot of historians are rethinking it with you. One of the things that this pandemic has done is really to sort of open the floodgates in terms of what we have been missing in our previous history.

[0:09:17 Speaker 1] So on that note, David in 1947. Uh, when this medical emergency led New York City to inoculate five million people so rapidly, was there resistance was there push back.

[0:09:30 Speaker 0] And that’s a really good question, Jeremy. The answer is no. There was no pushback at all, and the smallpox vaccine is a vaccine with a real kick to it. Um, it’s it does wonders in preventing smallpox. Indeed, smallpox is the only human disease to be wiped off the face of the earth. Um, and it was done through vaccination, but smallpox can have a real kick. In other words, it’s not unusual for a third of the people who take it, maybe to miss a day of work. And yet there was no anti vaccine movement at all. That comes much, much later. It comes in the eighties nineties and is still with us today.

[0:10:15 Speaker 1] It echoes one of my favorite parts of your book on on polio you describe in the book once Jonas Salk, the creator of one of the vaccines and the most famous I think, once it’s the trials are completed in 19 early 1954. You describe the excitement people saying the vaccine works and the hankering to get it. You quote one person at our desks. We cheered as if the Orioles or the cults had won a big game. Outside, we could hear car horns honking and church bells chiming in celebration. We had conquered polio. This was only seven years after the 1947 smallpox inoculation that you describe. What was it similar then, in the 19 fifties, the same excitement and generally positive view of very,

[0:11:03 Speaker 0] very positive in the 19 fifties, Jeremy Science was kind of that. It’s high tide. Um, antibiotics were rolling out of factories, you know, penicillin stripped of mice and the smallpox vaccine was there and had been in use. And then suddenly this vaccine arrives that really takes care and prevents the most insidious childhood disease we’ve ever seen, which is paralytic polio. So there was just a sense of euphoria, Um, and with my parents and all other parents, it was simply a matter of risk versus reward. In other words, they saw every year what polio did, and they were just hungry for a vaccine today. Vaccines work so well that we really have very little evidence of what they stopped. And that is a big problem.

[0:11:58 Speaker 1] Wow, that’s a very important point, right? We we the counterfactual is hard to imagine for us. Um, David, when then did this resistance or hesitation toward vaccines? Where did that come from? And when

[0:12:14 Speaker 0] I think that’s a That’s an interesting question. If I had to, uh, sort of lay it out, I would say that Watergate played a role. And the reason Jeremy, as you well know, is that it really was a time when people began to question what police were telling them whether it was the government, whether it was public health experts people, I think became much more cynical. Then you have the growth of the Internet in which everyone is his or her own expert, and there are just endless vaccines, anti vaccine sites that creep up. If I had to say, what was the watershed moment? Um, it really was when, um, there were certain people physicians who began to publish kind of bogus, uh, results involving the alleged dangers of vaccines. There’s a man named Andrew Wakefield, who I think lives in Austin. At this moment, Um, Andrew Wakefield wrote a very, very influential and turned out to be completely fraudulent paper in which he claimed that basically vaccines caused autism. There were a major cause of autism. Um, it was published in The Lancet, which is the most important medical journal in England and one of the most important in the world. And and it finally was retracted after virtually everyone else who has signed off on that particular paper said that they couldn’t go along with it anymore. But what Andrew Wakefield did and he was stripped of his medical license in Great Britain is he came to the United States. He was not allowed to have a medical license here, But he moved to Austin and became a kind of anti vaccine guru, Um, telling many, many people, giving them an explanation for why their Children had autism, for example, and claiming that it was vaccine related. And you have so many parents who were sort of looking for any answer to this incredibly important and confusing problem. And Wakefield really essentially became their guru, and he’s not alone. If you look on the Internet. You’ll see all of these extremely sophisticated, uh, anti vaccine websites that have all the bells and whistles but are just handing out information that is completely erroneous and anti scientific. It’s it’s really, um it’s really a shame. And, you know, they’ve done study after study after study that showed there is absolutely no link between autism, um, and vaccination. And yet that myth continues to circulate.

[0:15:19 Speaker 1] And, of course, you know, it’s not the first time in our history at all we’ve had myths like this, but I think it’s it’s particularly corrosive to public health. Is the point right?

[0:15:28 Speaker 0] Absolutely. Um, we are really at a stage now where science is under attack. Uh, not not just science in terms of vaccination, but in terms of climate and and a whole lot of other vital issues issues that will really determine as a human race how we face the future. I really think we’re at a crossroads at this moment

[0:15:56 Speaker 1] and and and as a historian in what, what have we learned from past moments when science came under attack? That’s relevant for right now. If we want people to stay healthy, we want them to get these vaccinations when they’re available. What can we learn from you? Know, for example, debates in the early 20th century over the teaching of evolution. The famous,

[0:16:17 Speaker 0] I think, uh, you know, that’s again. It’s a very, very difficult question. Um, uh, basically, I think we have to present a message that is as effective to the public as the message of those who are questioning science. And I don’t think we’ve done a particularly good job of it. And I think that to some extent, our media plays a role in this and what I what I mean is in the 19 eighties nineties and going into the 20th century, um, you would have a show. I won’t use Oprah’s an example. But that that kind of show where you would basically have, um, someone who is on the anti vaccination side and a scientist on the on the pro vaccination side and they would the host would say, Okay, we have these two people. One is going to be pro vaccine. One is going to be anti vaccine. I’m not taking sides this up for you, to the audience to decide, and to me it would be the same thing as saying Okay, we have two people here. One is going to talk about. The earth is flat, the other is going to talk about The earth is round. I’m not taking sides here. It’s up to you to decide and what you generally have would be, say, a parent whose child had gotten very sick after a vaccination. But in fact it had nothing to do with the vaccination itself. And then you would have a scientist preventing presenting hard, cold facts, and it was clear that the audience felt much more sympathy for the parent. And I think what we have to do now and particularly in minority communities, because what we’re seeing is that when you look at those who are questioning vaccines now and say they will not be taking this particular covid vaccine, it’s much more powerful that sentiment in the African American community in the Latino community than it is in other communities. It’s much more potent among people who are less educated. Um, so you have all of these things where you are going to have to really put out a message, and I think you need more than scientists. I think you need celebrities. You need athletes, you need actors and actresses. You need people with credibility to various generations and types of different communities. Who will tell them that this vaccine is safe and effective? And what I am hoping, Jeremy, is that as we go on and we see that this vaccine is really, uh and there are more than one as you noted, that these vaccines are really basically doing their job in preventing further cases of covid and they are safe. I think you’ll begin to see that the boy public opinion will turn in a much more positive direction. What do you think

[0:19:20 Speaker 2] of our efforts? Uh, with the covid vaccine so far, And and not just the covid vaccine reaction to Covid in general has this sort of emphasis on people like Tony Fauci and others. Expertise. Has that made science cool again? Or do you think it’s sort of caused a new a new outgrowth of of anti science?

[0:19:40 Speaker 0] I think, uh, excuse me. I think that depends on whom you ask. Um, I know that I know numerous people who say when Tony Fauci says, Take the vaccine, I’ll take the vaccine, and he’s already said take the vaccine. But he has been turned into, um uh, you know, a kind of pin cushion for those who are hesitant about the vaccine or for those who think that he is questioning the present administration. Um, so I think I think it has really cut both ways. What we’re going to do is historians is to look back on this 10 years from now, 15, 20 and longer, and I think we’ll see that Tony Fauci will come out glowingly. Um, and that’s that, like so many people. Um, he didn’t get it right at the beginning. Almost no one got it right at the beginning. We didn’t know what was what was coming. We didn’t know how quickly it would spread. Um, but over time and rather quickly, we began to see what this virus was about and how to begin to prevent it and also taking, uh, non therapeutic measures of social distancing and masks and the like, and that has split the country. But I think that what we’re going to find in the future is that science was absolutely correct about this, And and Jeremy, one of the things I’ll mention that is that is really interesting is that a lot of information has now come out from the Southern Hemisphere. In other words, they have gone through their winter, the winter that we are entering now, and what they found out is that amazingly, this year, in places like Australia and Chile and parts of Africa, there was virtually no influenza and covid rates began to fall dramatically. And that was because people were not only getting their flu shots at much higher numbers, but they were also using the social distancing from covid and clearly translated into into many fewer influenza cases. So we certainly have evidence that social distancing works that masks works, that not that doing away with parades and mass gatherings work. All we have to do is basically to do the best we can, either through mandates or just persuasion, to have people hold on longer. And that’s the problem

[0:22:31 Speaker 1] that but it makes a lot of sense and and certainly I think about my own routine and how, how less frequently, how infrequently. Now I interact with anyone outside of my family within 6 ft and of course that means that there’s less germ exchange, so I’m less likely to get a variety of

[0:22:48 Speaker 0] agree. And I am just like you, Jeremy. I mean, I’m doing everything virtually, but you and I and so many others are really privileged and that we we don’t have to drive a bus. We we we don’t. We’re not a policeman on the beat or a firefighter or someone working in a store. Uh, you know, uh, those are the people who are most at risk and those are the people the rest of us must protect.

[0:23:15 Speaker 1] Right? Right, David, if if and when President Elect Biden’s team comes to you and asks you for advice as a historian on what they should do, what would you say or what will you say?

[0:23:30 Speaker 0] What I would do, Jeremy, is to take them back to the great influenza epidemic of 1918. There was a major study published in the American Medical Association Journal JAMA about 10 years ago, and what that study showed was that cities across the United States that began these non therapeutic social distancing measures earliest that kept them going the longest, and that did things like doing away with parades and public gatherings and demanding that people stop spitting on the streets and wear masks. Those cities had far lower mortality rates than cities that did not have these practices. This works. It’s a stop gap measure. And the other thing I would tell them is that we have got to spend a ton of money to convince people to get vaccinated. You know, we’ve done this at warp speed, which is both in a way of good and bad type of terminology. I think the term whoops free scares people because they think we went to quickly. We cut corners, we cut no corners. We did phase three trials. They were done very carefully. We’re still evaluating the results. That’s what the Biden administration has to do. Social distancing. There is evidence on that side and persuasion

[0:25:09 Speaker 1] that makes a lot of sense and ostensibly also more money for the distribution of the vaccine, particularly to poor communities.

[0:25:15 Speaker 0] Absolutely, that I think will be done. I I think my gut feeling is that certainly by the spring of 2021 we will have enough vaccine. The question is how do we convince people to take it

[0:25:33 Speaker 1] right, right and so I guess that that will be our last question. We always like to to close on a hopeful note, and you’ve already given us one. But it does seem to me that one of the key messages that comes from your your vast scholarship is the role we all have as individuals in setting a model for others. I mean, the story you tell of 1947 you went or your parents took you for your vaccination not simply because they understood the science, but because they knew everyone else was doing it and it was the right thing to do.

[0:26:02 Speaker 0] Exactly exactly

[0:26:04 Speaker 1] How can we make that? How can our listeners as individuals, how can they contribute to this?

[0:26:10 Speaker 0] I think what you’ve got to understand about vaccination and herd immunity is that when you are taking a vaccine, Jeremy, you’re not only taking it to protect yourself, you’re taking it to protect others. And someone said, Well, what’s the big deal? You know they can get the vaccine themselves. It’s their choice. There are lots of people in this country who cannot be vaccinated if they have an immunodeficiency. If they are undergoing chemotherapy, these people have to be protected. And I think it is our obligation as citizens to make certain that we get vaccinated not just to protect ourselves and our family, but to protect the vulnerable and the community at large.

[0:27:02 Speaker 1] Very powerful statement and very well founded. Statement to Zachary Is this persuasive to you and other young people like yourself who might understand the science but still don’t like to get vaccinated? I know we go through this debate every year in our household. Zachary. How do you respond to

[0:27:19 Speaker 2] this? Well, I think I think it is very, very powerful, but I honestly don’t think it’s going to be an issue of young people being willing to take the vaccine or not. I I think that in many ways, young people are at least the people I interact with are more akin to issues of science and are much more aware of the ways in which people distort the real science that’s going on in the background. But I think it’s really about setting good role models for for young people, but also for for the rest of the population and getting people out there that everyone trusts to really put forth this message that we all need to get vaccinated. We all need to take social distancing measures,

[0:27:59 Speaker 0] beautifully said.

[0:28:01 Speaker 1] And I think it’s It’s so practical, too. I mean, all of us as educated individuals, listening to this podcast, thinking about these issues. We all have a role to play. I think that’s what David and Zachary are saying. I mean, we have to. We have to go out and and not only get vaccinated ourselves, but continue to advocate for this and and make it part of our democratic civic responsibility. David, your work embodies this so well. And and as you said in the podcast, also, you you embody the importance of bringing an understanding of science to history and understanding of history, to science. And thank you for sharing your your wisdom with us today. David.

[0:28:37 Speaker 0] It was my pleasure. Thank you. Jeremy

[0:28:40 Speaker 1] and Zachary. Thank you for your poem. And most of all, thank you to our listeners for joining us for this episode of This Is Democracy. This podcast is produced by the Liberal Arts Development Studio and the College of Liberal Arts at the University of Texas at Austin. The music in this episode was written and recorded by Harrison Lemke. And you can find his music at Harrison Lemke dot com. Subscribe and stay tuned for a new episode every Thursday featuring new perspectives on democracy. Mm. Uh huh. Mhm