Immunization

“ Immunization with safe and effective vaccines can greatly reduce the tragic loss of life and reduce the massive costs associated with health care. The Surgeon General of the United States has repeatedly urged adults to use appropriate preventive healthcare practices, including vaccination for diseases preventable through immunization. We can all do our share in making sure we ourselves and members of our families know about and receive immunization, and that our neighbors and communities have the same opportunity. ”

“ We know from sampling that no new disease has been introduced by either side in over ten years now. Against all the known ones, we have immunization techniques, anti-sera, antibiotics, and so on. I suppose you get your shots every six months like all the rest of us; we should all be very hard to infect now, and such infections as do take should run mild courses. ”

“ America does well to hold a national week of observance to remind citizens that the need for immunization does not stop with childhood. Vaccine-preventable diseases continue to kill grown-ups in our Nation; as many as 70,000 adults die each year because they do not take advantage of vaccines for influenza, pneumococcal pneumonia, hepatitis B, tetanus, and other preventable infectious diseases. ”

“ This Nation has always been committed to fostering the health of its people, and particularly of its children. Immunization against disease has been an exciting chapter in that effort. The United States can take pride in the dedicated research which has produced safe and effective vaccines against polio, measles, rubella, and other childhood diseases. ”

“ IMMUNITY.
It is evident, however, that it will take a long course of education and almost revolution in the sentiment of the people, to establish a system of segregation and quarantine as rigid and as perfect as that which is outlined. What then is the next best resort? I answer immunization. If we cannot keep the infectious organism from contact with the human body, we should endeavor to make the body immune from its ravages. ”

“ But now a flareup had occurred. The Lancet brought in supplies of the antibiotic, and Tiger Martin spent two days showing Singallese physicians how to control further outbreaks with modern methods of immunization and antisepsis. ”

“ Nor is it as easy to immunize a human being over many years of life, subject to so many conflicting influences, as it is to immunize a guinea-pig living in a cage.
To lessen the dangers and enable the patient to keep up his immunization for many months and years, Goodale borrowed an idea from Schloss, who fed his egg-oat-meal-almond anaphylaxis patient minute doses of these foods until he so raised his resistance that he was able to eat them in [Pg 106] ordinary quantities without harm. ”

“ For previous generations, diseases were a deadly shadow hovering over every new birth. Thanks in large part to medical advances and improved public health practices, most of today's children are no longer threatened by these afflictions. Childhood immunizations alone have saved countless American lives in the past decade, and today we are increasing our efforts to identify and immunize children who need this protection. ”

“ Even among people at greatest risk for complications-the elderly and the chronically ill fewer than one in five routinely receive annual influenza vaccination and fewer than one in 10 have been vaccinated against pneumococcal pneumonia. ”

“ The process by which passive immunity is acquired depends upon the fact that as a result of the reaction between the specific virus of a particular disease (the antigen) and the tissues of the animal attacked, certain substances—antibodies—are produced, which when transferred to the body of a susceptible animal protect it against that disease. The most important of these antibodies are the antitoxins. From the study of the processes by which immunity is secured against the effects of bacterial action the serum and vaccine methods of treating certain infective diseases have been evolved. ”

“ From a careful analysis of the results of this inoculation, it is shown that the efficacy of the prophylactic depends upon the virulence of the bacillus culture from which the vaccine is prepared, and upon its dose and ability to produce a well-marked febrile reaction. It appears to be more effective in the prevention of deaths than of attacks.
The anti-typhoid vaccination is another example of inoculation to secure active immunity. It is needless, perhaps, to point out that all these vaccinations, except rabies, are prophylactic, and not curative. ”

“ To be able to resist the invasion of any species of bacteria, one is said to be refractory to or immune against that variety of germs.
Serum therapy is based on the demonstrated fact of immunity, and of the possibility of producing it by injecting the serum of immunized animals. In many infectious diseases, one attack protects an individual for a lifetime and one form of disease may protect against even a more virulent form, as vaccination protects against smallpox. ”

“ If these three defensive processes given us by Nature are in working order, that is to say, if we are "healthy," they should secure to us a sufficient "immunity"—at [Pg 244] at any rate, "recovery"—from any attack of disease-producing microbes. But they are not in "unselected," widely ranging mankind always equal (in their unaided natural state) to their task.
The attempts to produce immunity by vaccination with weakened or localised disease germs is really an attempt to train and develop to a high point the activities of the phagocytes or eater-cells of the blood. ”

“ Fig. 6. Vaccination on the tenth day, showing a severe type of infection in a little child. Note wide-spread inflammation over the arm at the “areola” around the vaccine pustule and the bad eruption on the face which sometimes spreads all over the body. This is, of course, a clear case of pus infection and septicemia in which lockjaw, meningitis, pneumonia, or other diseases may find their essential conditions for producing their deadly work in killing the child as a direct or indirect result of the vaccination and the double infection caused by it. ”

“ It is admitted in later reports that the disease can be conveyed to animals or man by ordinary skin inoculation or scarification provided some blood is drawn in the operation, which is, of course, a common occurrence in ordinary vaccination. This rather doubtful statement as to infection in man by ordinary vaccination I will therefore prove to be an evident error and will give, further on, the most convincing proof that foot and mouth disease—or what is in every way equivalent to and identical with it—is frequently conveyed to mankind by vaccination, with fatal effect! ”

“ The theory of the vaccine treatment of disease is that if you infuse into the blood the [Pg 416] products of the germs of certain diseases, the individual in whose blood the vaccine has been put, will wholly resist that particular disease, or if he acquires it, it will be in a mild and more modified form. If a family for a number of generations has had various members die of tuberculosis, the blood stream of the family will have become so impregnated with the toxins, or poisons, of the disease, that, in time, a certain immunity will have been established. ”

“ We developed a live vaccine, not on the basis of our own experiences and research, but we made use of the experiences of others. I should like to mention primarily the work of the French typhus research scientists, Blanc, Baltasar, and assistants Legrer and Lecolle. When vaccinating, a vaccine must be used which gives anti-infectious protection, and in general, in the case of virus diseases, successful vaccination is also achieved only with live virus. Let me mention the examples of smallpox, influenza, and yellow fever. ”

“ You can immunize a guinea-pig or a patient to almost anything now-a-days by giving him minute doses gradually increased but the immunity passes off quite rapidly when the treatment is stopped. We have still something to learn from Nature in this respect. Nature can give us one dose of yellow-fever or scarlet-fever or small-pox or measles and make us immune for life but your artificially produced immunity may last for a few weeks or months only. Our closest imitation of natural immunity is vaccination [Pg 93] against small-pox. Here we produce an actual disease, cow-pox ”

“ All immunological studies are based on the known fact of the reinforcement of natural resistance to disease, as illustrated by serum therapy in diphtheria and by vaccine therapy in anthrax. The attempts to elucidate the principles underlying these two methods have led to the development of many fruitful hypotheses and theories, and many diagnostic and curative procedures of great value. It was early evident that the explanation of resistance to infection, either natural or acquired, must be sought in the cells or fluids of the body and especially of the blood. ”

“ No instance of the transmission of foot and mouth disease to man through vaccine virus has been recorded, and it is considered doubtful, in view of the tests made, if it is possible to reproduce the disease in him by the cutaneous inoculation commonly used in the process of vaccination. ”

“ At the end of twenty days’ injections they found they could obtain such a large quantity of anti-rabic substance in the serum of an animal, that even 1 part of serum to 25,000 of the body weight would protect an animal. This process differs from that of Pasteur in so far as that in place of promoting the formation of the antidote within the body of the patient, by a process of vaccination with progressively stronger and stronger virus, this part of the process is carried on in an animal, Babes using the dog and Centanni the sheep, the blood serum of which is injected. ”

“ What is the cause of this difference if it is not that extraordinary medical practice, or malpractice, which deliberately impregnates the bodies of these exceptionally healthy and “hand-picked” men with a whole series of the worst type of disease infections known—that is, septicemic infections, like the typhoids and the variolas, etc.? And should anyone wonder, therefore, if the death lists of the army should show plainly in the blood poisoning diseases of pneumonia, meningitis, etc., which are known to follow frequently after vaccination? ”

“ The circumstances attending this reintroduction of an original vaccinia, which I have recently detailed elsewhere, [5] strongly impressed me with the idea that the vaccine virus became "tempered" (so to speak) by passing through the human body, its original potency suffering diminution with the increase in the number of subjects through which it had been transmitted; while, at the same time, the proportion of subjects in whom the vaccination "took," which had been small with the original "vaccine," increased when it had (so to speak) become "humanized." ”

“ The taking of virus from a child, or an adult, should never be allowed, as constitutional diseases are often transmitted in that way. Vaccination is performed by making a small incision in the skin and introducing the virus on the point of a lancet or needle. On the third day, if the desired result has been attained, a small red spot may be seen. This increases in size, becomes elevated, and, by the sixth day, is filled with a clear, yellow liquid. About the eighth day, the pustule is fully formed, when symptoms of small-pox are usually felt,—headache, shivering, loss of appetite, etc. ”

“ By immunity is meant non-susceptibility to a given disease, or to experimental inoculation with a given bacterium or toxin. The term must be used in a relative sense, and account must always be taken of the conditions present. Immunity.An animal may be readily susceptible to a disease on experimental inoculation, and yet rarely or never suffer from it naturally, because the necessary conditions of infection are not supplied in nature. That an animal possesses natural immunity can only be shown on exposing it to such conditions, this being usually most satisfactorily done in direct experiment. ”

“ Vaccination consists in introducing vaccine into the blood of a healthy person, usually by making an abrasion of the skin. The vaccine is obtained from health laboratories, where it is produced from the blood of artificially-infected cattle. Inoculation of the human blood is also widely used nowadays in order to prevent or to mitigate diphtheria, typhoid, pneumonia, and rabies. All members of the American expeditionary forces during the World War were given the anti-typhoid inoculation. ”

“ The question of the value of preventive inoculation is, however, still an open one. So also are other applications of the principles of immunity, as the production of anti-sera for snake-venom, and for the irritant (and perhaps intoxicating) vegetable agent causing hay fever.
I have earlier in this lecture referred to methods of serum diagnosis depending on agglutination or solution of bacteria or on the precipitation of protein. Immunology has recently contributed to medicine another diagnostic method of great value. ”

“ When a moist eczema is present there may be auto-inoculation of the pock on the affected area and a general confluent vaccine eruption appear.
Immunity.—The immunity against smallpox, or vaccinia, produced by vaccination is of gradual growth, and is not complete until the period of suppuration, about the beginning of the second week. Natural immunity is said to exist, and is probable, but it is exceedingly rare. Vaccination of a pregnant woman rarely, if ever, confers immunity on the fœtus. ”

“ There may be no exact and absolute demonstration of this fact, for no vaccinated person willingly associates with a small-pox patient, or has himself inoculated with matter from a small-pox sore, in order to determine his immunity toward that disease. The vital statistics of this century answer the question regarding the utility of vaccination. Whether those of the coming century will answer that regarding the utility of inoculation as a preventive not only of cholera, but of other infectious or contagious diseases, remains to be decided. ”