The term vaccine refers to a form of medical treatment which may be used to preemptively inoculate individuals and populations against infectious diseases. This controversial topic stems from a social phenomenon called vaccine hesitancy, as well as an organized anti-vaccination, or anti-vax, movement. Those who support the use of vaccines point to extensive scientific evidence that vaccines are both safe and effective, whereas those who oppose vaccines believe that vaccines are either unnecessary or unsafe. The COVID-19 pandemic has thrust this debate topic into the spotlight, which has also made it a popular subject for persuasive essays.
The controversial topic over vaccines is framed around two competing views:
Most vaccines are biological preparations which contain agents resembling the microorganisms that cause the disease in question. Vaccines are designed to stimulate an immune system response that can fight off or destroy actual microorganisms associated with the disease. This controversial topic centers on sharp disagreement between the broader medical and scientific communities and segments of the public who either lack confidence or trust in vaccines for various reasons.
The COVID-19 crisis has cast a particularly bright spotlight on this issue today. As public health experts work to distribute an array of COVID vaccines, the anti-vaccination community has grown in visibility and influence. Many of the objections voiced by today’s anti-vaccination movement are similar to those voiced by vaccine opponents over the course of vaccinology’s multi-century history.
Just as long as there have been methods of inoculation in the United States, there have been movements aimed against them. In fact, even prior to the technical development of vaccines, there were individuals and groups who resisted the preemptive treatment methods that ultimately led to the development of vaccines.
The advent of vaccinology in the late 18th Century was actually a breakthrough fueled by prior developments in the area of inoculation. A method called variolation was practiced in China as far back as the 15th century. The method of preventative medicine was first aimed at staving off severe smallpox infections. Subjects were exposed to smallpox using materials taken from a person who was ill with the infectious disease. The preferred method usually involved applying powderized scabs from patients with smallpox to an exposed area on the inoculated individual.
This would typically result in mild symptoms that would subside in a few weeks. Subjects of variolation were found to have developed sufficient immunity to fight off the prospect of severe future infection.
This first method of inducing a prophylactic immune response is also documented in India and Sudan during the next several centuries. The practice made its way to North America by the early 18th Century. Upon its arrival, variolation prompted much of the same concern and hesitancy that are seen in today’s anti-vaccination movement.
1721 marks the introduction of variolation to the colonies of North America. Puritan Reverend Cotton Mather-who previously played a prominent role in the notorious Salem Witch Trials-is otherwise noteworthy as America’s first visible proponent for inoculation. Mather urged Zabdiel Boylston-a groundbreaking Boston physician and great uncle of future U.S. President John Adams-to experiment with variolation. He performed his first inoculations on his 6-year-old son, his slave, and his slave’s son, all of whom contracted mild forms of smallpox before making full recoveries.
Almost immediately, news of this preventative smallpox treatment generated resistance, especially from religious communities. English theologian Reverend Edmund Massey, for instance, delivered a sermon in 1722 entitled “The Dangerous and Sinful Practice of Inoculation.” He claimed that diseases like smallpox were God’s way of punishing sinners, and argued that any inoculation aimed at thwarting God’s will were part of a “diabolical operation.” Massey’s message made its way to the shores of North America, where it took hold with certain religious demographics.
It is also noteworthy that, in the early outset, a prominent set of physicians opposed the use of inoculation, though most relented their position as evidence emerged of its relative effectiveness.
The very first vaccine was both conceptualized and created by Edward Jenner, an English physician and scientist focused on eradicating the smallpox disease by using biological agents found in a bovine disease called cowpox. Jenner is typically recognized as “the father of immunology,” and his work is believed to have saved the lives of more people than that of any other human who ever lived.
Jenner’s work built on the concept of variolation with the goal being to reduce the risk of sickening inoculation subjects or of creating new carriers of the disease. He performed his first vaccination in 1796 and, over the ensuing years, proved that the cowpox-based inoculation produced total immunity from smallpox. At the time of Jenner’s discovery, smallpox was responsible for upwards of 400,000 deaths a year in Europe, as well as for one-third of all cases of blindness.
In retrospect, the infectious disease is estimated to have killed roughly 500 million people in its final century of existence (1880 to 1980). Jenner’s work formed the basis for the eventual development of a modern smallpox vaccine and, by 1980, this deadly illness was designated as having been totally eradicated.
Jenner’s work would lay the groundwork for the development of future vaccines and inform the initial scientific approach to confronting infectious disease epidemics including tuberculosiss (1920s); Influenza (1930s-40s); Polio (1950s); Measles, Mumps, Rubella (MMR) (1960s); Chickenpox (1980s); HPV (2000s); and COVID-19 (2020s).
In each of the above-noted instances, scientific evidence denotes that vaccines have prevented unnumbered infections, illnesses, and fatalities. Likewise, little verifiable evidence exists that the distribution of these vaccines has produced widespread negative side-effects.
Religious opposition combined with economic imperatives to produce a cross-section of vaccine opponents from the earliest stages of Jenner’s discovery. Just as with variolation, vaccines generated moral opposition from some religious leaders and congregants even as other religious leaders played a direct role in espousing vaccine usage. Also among those who objected to the development of vaccines were those practitioners who based their medical careers largely on the soon-to-be-outmoded practice of variolation.
One other complicating factor was the relative infancy of pathogenic science at this point in history. It wasn’t until the late 19th and early 20th Century that the scientific community developed the capacity to identify potential pathogens. This means that various diseases which might have been caused by contaminations in the vaccine (rather than actual components of the vaccine) were instead conflated with vaccine side effects.
In one prominent instance, an estimated 750 of 100 million smallpox vaccine recipients contracted syphilis. Though the illness was likely caused by contamination, a prominent medical opponent of vaccines named Charles Creighton seized on this occurrence and advanced the claim that syphilis was a side effect of the vaccine. Though not founded on scientific evidence, his writing on the subject did have the effect of eroding public confidence in vaccines.
While there were groups who opposed vaccinations for religious reasons or concerns over their medical implications, there was no organized ideological resistance to vaccines until the latter part of the 19th Century. One notable influencer-a British businessman named William Tebb-opposed vaccinations on the grounds of individual liberty. As Britain began to establish compulsory vaccination laws to contend with continued smallpox outbreaks, Tebb became a vocal opponent.
Tebb paid a visit to New York in 1879, helping to lay the groundwork for formation of The Anti-Vaccination Society of America. This was followed in 1882 by the formation of the The New England Anti-Compulsory Vaccination League, and in 1885, the Anti-Vaccination League of New York City. As cities and states in the U.S. faced localized smallpox outbreaks, individual states began to impose their own compulsory vaccination rules.
The push and pull between public health agencies and medical professionals on one side, and an increasingly organized anti-vaccination movement on the other side, would reach a crescendo (and also establish a far-reaching legal precedent) in 1905.
In 1901, the cities of Boston and Cambridge faced another surge in smallpox cases and fatalities. Both cities responded by imposing compulsory vaccinations. Those who refused were subjected to modest fines. A pastor named Harlan Jacobson was a noted critic of compulsory vaccinations, and attributed his own lifelong afflictions of illness and pain to a smallpox vaccine received in his native Sweden at the age of six.
As smallpox outbreaks grew in Massachusetts, public debate raged between members of the medical community and segments of the public who openly opposed vaccines. Anti-vaccination groups claimed that vaccines were “the greatest crime of the age,” and that forced inoculation “slaughter[s] tens of thousands of innocent children.”
A New York Times article from 1902 responded to this position by describing anti-vaccination advocates as a “familiar species of crank,” calling their arguments “absurdly fallacious” and ultimately dismissing the movement and its adherents as “ignorant” and “deficient in the power to judge [science].”
In the midst of this charged atmosphere, Jacobson argued his right to refuse vaccination all the way up to the U.S. Supreme Court. In a 1905 ruling, Justice John Marshall Harlan recognized that while personal freedom is a matter of critical importance, “the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand.”
This majority opinion introduced the “reasonableness” clause which provided far-reaching powers to the U.S. government to impose limits on personal liberties when it may be reasonably concluded that this is essential for public safety and health. The clause would go on to have its own long and controversial history, including its invocation to justify forced sterilization of institutionalized women during the 1920s, its application to warrant widespread lockdowns during the COVID-19 crisis, and the eventual reversal of this application in 2020.
However, most germane to this discussion is the far-reaching and repeatedly sustained finding that public health agencies can legally impose compulsory vaccination for the benefit of public safety.
In the mid-20th Century, America experienced a growing mistrust of its own government and institutions, especially in the area of public health. As noted above, the 1920s saw a growing acceptance of a practice called eugenics, which among other now widely-condemned practices, aimed at improving long-term population genetics by sterilizing women deemed unfit for procreation. Tens-of-thousands of women who were institutionalized with learning and developmental disabilities, as well as women from impoverished communities and communities of color, were subjected to forced sterilization.
Another incident, more singular and less nefarious but nonetheless damaging to public confidence in the medical community, involved a disastrous error by a pharmaceutical company engaged in distribution of the polio vaccine. In 1955, Cutter Laboratories accidentally produced 120,000 doses of the polio vaccine that contained some amount of live polio in addition to the inactivated form of the disease.
The incident resulted in 40,000 new polio cases, 53 instances of paralysis and five fatalities, as well as sparking a new outbreak that contributed to 113 further paralyzations and five more fatalities.
And in what is now among the most widely recognized cases of human rights abuse in modern American history, the Tuskegee Experiment was carried out by the United States Public Health Service (PHS) and the Centers for Disease Control and Prevention (CDC) from 1932 to 1972. The subjects, 600 impoverished African-American sharecroppers from Macon County, Alabama, were told that they were receiving treatment for syphilis (a condition which was readily treatable with antibiotics by the late 1940s). Instead, they were given placebos and merely observed in the interest of gathering data on the long-term effects of untreated syphilis.
128 subjects died from untreated syphilis, and the experiment was only discontinued when it was leaked to media outlets in 1972. The incident ranks as a dark chapter in America’s public health history. For members of America’s Black communities, this incident is only a root event in a long history of health disparities, discrimination, and deception, all of which help to feed ongoing mistrust.
Incidences like those cited above are part of the subtext to America’s anti-vaccination movement. Darker chapters like these have helped to fuel the modern surge in anti-vaccination sentiments. However, this surge can also be readily traced to an academic article by a former British physician named Andrew Wakefield.
In 1998, Wakefield published an article in Lancet claiming that his research had identified a direct link between the Measles, Mumps, Rubella (MMR) vaccine and incidences of autism. The article received a great deal of attention, much of it in the form of negative pushback from the scientific and medical communities. When other researchers were unable to reproduce his findings, an investigation into Wakefield’s methods revealed that he had falsified much of his research, that he had misled the subjects of his research, and that he appeared to be motivated by financial conflicts of interest.
According to a British court ruling on the issue, “[t]here is now no respectable body of opinion which supports [Dr. Wakefield’s] hypothesis, that MMR vaccine and autism/enterocolitis are causally linked.” Lancet retracted Wakefield’s article and he was subsequently removed from the medical registry.
In the aftermath of this controversy, Wakefield emerged as among the most prominent and influential proponents of the anti-vaccination movement. He would go on to produce the also influential 2016 film, Vaxxed: From Cover-Up to Catastrophe.
Wakefield’s continued visibility on this issue has proven influential. While the medical and scientific communities have rejected his findings, Wakefield’s hypothesis regarding the connection between vaccines and autism remains widely accepted within various anti-vaccination communities.
Using our own backstage Ranking Analytics tools, we’ve compiled a list of the most influential figures concerning the issue of vaccines in the U.S. between 1900 and 2020. Our rankings produced a list of influencers that is dominated by notable vaccinologists and virologists, those who have played a direct role in creating and distributing vaccines, and prominent anti-vaccination figures and celebrities.
Rank | Person |
---|---|
1 | Andrew Wakefield |
2 | Albert Sabin |
3 | Maurice Hilleman |
4 | Jonas Salk |
5 | Jenny McCarthy |
6 | John Franklin Enders |
7 | Paul Offit |
8 | Hilary Koprowski |
9 | Alison Singer |
10 | Joseph Mercola |
Using our own backstage Ranking Analytics tools, we’ve compiled a list of the most influential books on the topic of vaccines in the U.S. between 1900 and 2020. This list is composed of texts by both those who argue in support of vaccination education, and those who believe vaccines are dangerous, ineffective, or part of a conspiracy waged by pharmaceutical companies. Also included on this list are several references published by public health agencies in the U.S. and U.K.
Back to TopToday, the vaccine controversy is an issue that can generate highly charged emotions. Some regard vaccinations as a matter of privacy and individual liberty, whereas others view vaccination as a matter of public health, in which the decisions of one can impact many. For this reason, the debate over vaccinations is highly susceptible to disinformation, conspiracy theory, and mistrust of the government.
Even further clouding the issue is the reality that certain demographics-particularly Black and brown Americans-have long experienced discrimination and inequality within America’s healthcare system. This condition has sown historical mistrust and, for some, a consequent tendency toward vaccine hesitancy.
Today, the World Health Organization (WHO) characterizes vaccine hesitancy as one of the gravest threats to global public health. To their perspective, this threat is acutely visible in the midst of COVID-19 crisis.
As COVID-19 forced the world into a state of lockdown and medical crisis during 2020, scientists and pharmaceutical companies raced to develop a vaccine. By the end of 2020, numerous vaccines were moving toward fast-track approval for use in the United States. However, during a politically-charged time in the United States, mistrust of the government is particularly high.
This mistrust has dovetailed with a rapidly growing anti-vaccination movement to produce a broad cross-section of Americans who are either hesitant to receive the COVID-19 vaccine, or who are refusing the preemptive treatment altogether. For some, the hesitancy is couched entirely in the rapid speed with which the vaccine gained approval. Others have been moved to reject the vaccine based on a broader-and often politically-motivated-skepticism over the danger or severity of the COVID crisis.
For instance, according to the March 2021 NPR/PBS NewsHour/Marist poll conducted in 2021, 30% of all American adults said they would refuse the COVID-19 vaccination, whereas 47% of those who specifically identified as supporters of former President Donald Trump said they would refuse the vaccine. Today, the COVID-19 vaccination is ground-zero for the ongoing debate between advocates for, and opponents of, vaccines.
Back to TopOur goal in presenting subjects that generate controversy is to provide you with a sense of some of the figures both past and present who have driven debate, produced widely-recognized works of research, literature or art, proliferated their ideas widely, or who are identified directly and publicly with some aspect of this debate. By identifying the researchers, activists, journalists, educators, academics, and other individuals connected with this debate-and by taking a closer look at their work and contributions-we can get a clear but nuanced look at the subject matter. Rather than framing the issue as one side versus the other, we bring various dimensions of the issue into discussion with one another. This will likely include dimensions of the debate that resonate with you, some dimensions that you find repulsive, and some dimensions that might simply reveal a perspective you hadn’t previously considered.
On the subject of “vaccines,” this requires us to consider groups, such as “vaccinologists” and “virologists,” who have played a direct role in the development and distribution of vaccines, as well as those in the “anti-vaccination” or “anti-vax” movement who have helped to proliferate public “vaccine hesitancy” and resistance.
Our InfluenceRanking engine gives us the power to scan the academic and public landscape surrounding the vaccine issue using key terminology to identify consequential influencers. As with any topic that generates public debate and disagreement, this is a subject of great depth and breadth. We do not claim to probe either the bottom of this depth or the borders of this breadth. Instead, we offer you one way to enter into this debate, to identify key players, and through their contributions to the debate, to develop a fuller understanding of the issue and perhaps even a better sense of where you stand.
For a closer look at how our InfluenceRankings work, check out our methodology.
Otherwise get started with a look at the key words we used to explore this subject:
The key term in this controversy refers directly to a form of medical treatment, typically used as a preventative public health measure, that introduces a dormant biological component of an infectious disease as a way of stimulating an immune response. This response helps prepare the body to fight off introduction of the actual disease. Influencers include scientists and physicians who have made groundbreaking discoveries in this area.
Vaccinologists are those scientists and physicians who engage in the research, experimentation and deployment around vaccinations.
Virologists are scientists and medical professionals who conduct research on infectious diseases, and therefore, produce important findings that contribute to the development of vaccinations.
The phrase “anti-vax” and “anti-vaxxer” are widely used to describe the current public movement, and its adherents, who speak publicly on what they perceive as the dangers of vaccination, as well as the violations to personal liberties implied by compulsory vaccination laws. Though many of these influencers are not a part of the medical community, many do have highly visible public platforms that they have used to drive influence on this subject.
Whereas “anti-vax” is a frequently employed term in the modern public debate surrounding this issue, anti-vaccination sentiment has a long history. Alternative health proponents, religious leaders and activists who identify with this movement have assembled through Anti-Vaccination leagues dating back to the late 19th Century.
This term refers to the sentiment which prevents members of the public from seeking vaccination, and can refer to both those who reject vaccines on an ideological basis and those who refuse vaccinations based on fear or mistrust of the medical community. Influencers in this area include both those who speak out against vaccines and those who have worked to reduce vaccine hesitancy by educating members of the public about what they perceive as vaccine safety and efficacy.
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