Is there a need for immunization in Canada? An echo from a darker past reminds us the answer is unequivocally yes!

One of the latest "trends" that most amazes me is the astonishing and profoundly harmful numbers of people in Canada who pass around total conspiracy thinking nonsense about immunizations and vaccines for children and whose willful ignorance undermines enormously successful efforts that were made to eradicate many devastating and horrible conditions in the 20th century.

"Anti-vaxxers", as they are known, prey on people's credulity and lack of scientific knowledge to perpetuate falsehoods that fly in the face of the actual and clear historical record that shows directly the hugely beneficial impact widespread immunization programs have had.

Recently I came across a leaflet from 1951 that was published for the "Seventh National Health Week" and that looked at the progress modern medicine was making on a number of fronts as well as at the distance there still was to go in combating preventable illness.

The leaflet is interesting in a number of areas, but where it is most illustrative from a present day perspective is in the area of immunizations.

At the time vaccines for conditions like diphtheria were available but still were not nearly as widespread in their usage as they needed to be. Even so, despite a lack of universality they were already having a significant positive impact when used and available.

This is nothing compared to the incredible impact they were to have over the coming decades with widespread public health campaigns in schools and more broadly.

Before we go into the numbers here, please note that in 1949 Canada's population was 13,177,00 and that today it stands at 36,433,000.

Between 1943 and 1949 there were 9,856 cases of polio in Canada (the overwhelming majority of which would have been among children and youth) leading to 605 deaths as well as what would have been a lifetime of health issues for those who survived. At the time this leaflet was published there was still no vaccine against it. 

What about today? "Thanks to immunization, Canada has been polio free for the last 20 years." Yes, that is right, not a single case of polio. Seems pretty clear cut to me.

Between 1943 and 1949 there were 14,595 cases of diphtheria resulting in 1,399 deaths. This was, in fact, actually a huge decline from previous years thanks to immunization as can be seen above. In Toronto they had even eliminated diphtheria. 

People have forgotten how horrific diphtheria is. Here are a couple of images to serve as a reminder:

This child has severe neck swelling due to diphtheria. 

From Health Canada:

Respiratory diphtheria affects the mucous membrane of the upper respiratory tract. Symptoms include a mild fever, sore throat, difficulty swallowing, malaise and loss of appetite. Sites of infection can include the anterior nose, pharynx/tonsils or the larynx. The most common manifestation that leads to systemic infection is pharyngeal/tonsillar diphtheria. It can progress to acute respiratory distress, upper airway obstruction and asphyxia in young children. An adherent, asymmetrical, greyish-white membrane is visible on the tonsils and oropharynx typically within 2 to 3 days of illness.
Patients with severe disease may develop notable swelling in the neck area giving the characteristic bull neck appearance. Systemic complications such as myocarditis and central nervous system effects (such as muscle paralysis) can occur. This happens if the toxin produced at the site of infection is absorbed into the bloodstream. The case-fatality rate is about 5% to 10%.

and:

Localized infection of the skin (cutaneous diphtheria) may occur. It manifests as various types of lesions which can be indistinguishable from impetigo. Cutaneous diphtheria is rarely associated with systemic complications.

Why have people forgotten? Because, thanks to immunization basically no one in Canada gets diphtheria anymore! 

In Canada: "Since 1993, a total of 19 cases have been reported with a range of 0 to 4 cases annually...The last death due to diphtheria in Canada was reported in 2010."

In the case of "Whooping Cough" (pertussis), immunization has led to a dramatic decline in incidence. Whereas between 1943 and 1949 there were 76,679 recorded cases of it in Canada resulting in 2,047 deaths, now, with a far higher population, we see between 1,000 and 3,000 cases a year with few deaths.

However pertussis has made a bit of a comeback with periodic outbreaks directly due to people either not immunizing their children or delaying immunization. Given that the inoculation for pertussis "is included in a vaccine that typically also protects against diphtheria, tetanus and polio", this is very alarming.

The 1951 leaflet asks, "Is there a need for immunization in Canada?" and the answer both then and now is a resounding Yes! There is no serious case against immunization that is not predicated on ignoring the evidence or on distortions and misrepresentations of the scientific record. It is a peculiar and disturbing form of privilege and scientific illiteracy that would lead people in a society that has so obviously and dramatically benefited from public, mass immunization to turn their backs on it as some kind of bizarre, internet fed fad.

 Immunize your kids! It is your responsibility to both them and to society, and the historical evidence of its efficacy is absolutely, unequivocally clear. 

See also: Health Insurance Now! - A look back to before universal health care in Canada