Science versus No Sense

It's been five years since the whole world was convulsed by Covid. I was extremely fortunate not to lose anyone I knew to this pernicious virus, and I was more than happy to comply with lockdown, social distancing, mask wearing, hand sanitising and absolutely anything and everything that scientists working within public health suggested might keep me and my relatives safe. 

As new knowledge and understanding emerged, so the guidelines shifted, but we were all waiting for that blessed moment when we vulnerable oldies could roll up our sleeves and gratefully accept a vaccination which had been developed at warp speed, and which we knew was the only way we would be able to get back to our normal lives. 

In the last pandemic in 1918 it is estimated that between 20 and 50 million people died of influenza because the only treatment was bedrest. Covid took the lives of around 3.4m people worldwide thanks to over a hundred years of scientific medical advances in both vaccine development and public health. Still a tragedy, but a mitigated one.

My grandmother was born around 1900 and died before her sixtieth birthday, so I have outlived her for around twenty years. Like you, I have many things to thank for my increased longevity besides my personal choices in relation to diet, smoking, alcohol consumption and exercise. These would include improved sanitation, vaccinations against many childhood diseases and the development of antibiotics. For her whole life my grandmother lived without an indoor bathroom or toilet and had no running water in the kitchen lean-to attached to her two up, two down cottage in Norfolk. She contracted rheumatic fever as a child which weakened her heart and most likely, along with her poor living conditions, caused her early demise.

As a result of my personal history, I have always been fascinated by the role a well funded and well developed public health system can play in protecting people from harm. For such protections to work there has to be a high degree of trust and faith in both the institutions offering the solutions and the science which underpins them. Initially we may be resistant or sceptical or see interventions as a kind of killjoy ‘nanny state’ at work, but over time we understand and can measure the benefits of such things as outlawing people from smoking in crowded places or requiring everyone to wear seat belts or improving air quality by levying a tax on highly polluting vehicles.

Perhaps the most important area in which we humans need to have faith and trust in both scientific progress and public health is the one most recently in the spotlight during a pandemic which threatened to kill us in our tens of millions. The fact that a vaccine was developed at such break-neck speed was truly astonishing and the whole history of vaccine development is the perfect example of how intelligent minds and brave souls have both accepted and understood the threat posed by various pathogens and worked out ways either to eradicate them completely or to lessen their impact on our bodies. 

The story of the eradication of smallpox over a two hundred year period is the perfect illustration of that process and it starts with a woman, which is why you may not know about her. Lady Mary Montagu Wortley was herself a badly scarred smallpox survivor when, In 1721, she decided to take drastic action to protect her young daughter during a severe outbreak of the disease in England. She scratched her daughter’s arm and introduced a small amount of pus she’d taken from the pustule of someone with smallpox. She’d learned the procedure in Turkey where it was common practice and where she had successfully inoculated her son.

Thanks to Wortley’s social standing, this procedure was taken up and even used on the Princess of Wales’s children to good effect, but, unfortunately such primitive inoculations held considerable dangers, and many still died thanks to primitive medical practices. 

The development of the first proper vaccine is therefore attributed to Edward Jenner, himself successfully inoculated as a child thanks to Wortley. Jenner developed a much safer procedure using cowpox and as many of you will know, thanks to mass vaccination programmes over two centuries, the scourge of smallpox ended in 1980 when it was declared to be the first human disease to be eradicated globally.

Since that first vaccine many childhood diseases have all but disappeared. Vaccine programmes against typhus, rabies, yellow fever, diphtheria, polio, influenza, hepatitis B, measles, mumps, rubella, whooping cough and, more recently, HPV (human papilloma virus) have all been successfully carried out and millions upon millions of lives have been saved. Unfortunately with widespread protection a space is made for both complacency and conspiracy. If fewer people have their children vaccinated, then childhood diseases like measles can and will erupt again and spread quickly, as is currently happening in the USA where there have been 378 confirmed cases, 17% of which have needed hospitalisation and, to date, 2 deaths, the first for ten years.

As I said, the trust between the state and the individual has always been particularly fragile in the realm of public health.  So, it is no wonder that it just takes a few scientifically illiterate and/or malign actors online to seed doubt and suspicion, and to sow disinformation suggesting, for example, the completely debunked theory that vaccines are linked with autism, or that various public health initiatives are infantilising (nanny state), unnecessary or, the ultimate condemnation, ‘woke’.

Which brings me to an article that I have been reading this week in the Financial Times by science journalist and commentator, Anjana Ahuja called ‘An Ominous Shadow Falls Over mRNA Technology.’ The article starts: 

“What a difference a month makes. In February, scientists reported that an experimental vaccine showed promise in a small group of patients with pancreatic cancer, a disease that is often diagnosed late and carries a notoriously poor prognosis. The vaccine - using messenger RNA technology similar to that found in Covid vaccines - activated tumour-targeting immune cells that persist nearly four years after surgery in some patients. Those that produced such an immune response were less likely to see their cancer return.”

An exciting and promising development, you may think. One that merits further research and development, perhaps? However, since January, a new administration has been installed in the USA with a newly appointed Secretary of State for Health and Human Services (budget $1.63tr), Robert F. Kennedy Jr., a well-known anti-vaccine proponent and antagonist when it comes to public health interventions like fluoridating water, which has been proven to prevent tooth decay in children. That and many other such programmes are now under attack.

And it would appear that mRNA vaccines may now be within his sights because on March 16th scientists were reportedly being advised by US National Institute of Health officials to remove references to the technology from grant applications. The reason for this, and the worry is, that such projects are being smoked out via word searches in order to axe them. 

The US National Institute of Health is the world's largest funder of biomedical research, spending around $47bn annually. Dave Weissman, the University of Pennsylvania biologist who shared the Nobel Prize in 2023 for work that led to mRNA vaccines said that curbing such programmes “makes no sense”. It would, he said, delay the discovery of treatments and cures for many diseases and damage the cause of US science. And, make no mistake, if it damages scientific research in the US, it will impact scientific research worldwide.

Another target is Gavi, a global health organisation that helps to provide vaccines and other life-saving care in developing countries for which the current American administration has this week announced a plan to withdraw all US funding. Gavi is estimated to have saved the lives of 19 million children since it was set up 25 years ago with the US as its biggest donor. Janeen Madan Keller, policy fellow at the Center for Global Development said: “Gavi is one of the most impactful global initiatives. We know that vaccinating children is the most cost-effective way to improve health and save lives - which is why, to date, Gavi has enjoyed bi-partisan support. This latest move will turn back years of hard-won progress and stymie Gavi’s efforts to stop the spread of infectious disease across the globe”.

Further breaking news as I read and research more around this: last Friday Peter Marks, the USA’s top vaccine regulator and an architect of the U.S. program to rapidly develop coronavirus vaccine, was given the choice by Kennedy to resign or be fired. He chose resignation, effective April 5th. Marks is leaving his post with a “heavy heart,” he wrote in his (excoriating) resignation letter and added that he is particularly worried about the measles outbreak in Texas which “reminds us of what happens when confidence in well-established science underlying public health and well-being is undermined.”

There may be some cheer for us in the UK in all this. William Hague has this week commented: “Of all the emerging policies of the current American administration, the least rational is the attack on science and aspects of advanced medicine. Severe cuts to America’s National Institutes of Health, hostility to mRNA vaccines and withdrawal of grants for any work relating to climate will make some of the world’s most brilliant minds search for new shores. Britain should be their home.” 

There used to be a saying that if America sneezes the rest of the world catches a cold. It would seem that currently America is not so much sneezing as turning its back on public health protections and scientific research in a way that, to echo both Weissman and Keller’s words, makes no sense and will turn back years of hard-won progress. 

For all our sakes, we’d better all fervently hope that there isn’t another pandemic anytime soon.

Tricia x

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