Vaccines vs malaria, Michele Bachmann, other diseases

There was great medical news for the world this week, with the announcement of the successful trial of a vaccine for malaria (The RTS,S Clinical Trials Partnership, “First results of phase 3 trial of RTS,S/AS01 malaria vaccine in African children”, The New England Journal of Medicine, October 18, 2011, 10.1056/NEJMoa1102287).

This trial, involving 15,460 babies and children, found the vaccine known as RTS,S gave 50% protection against the disease. Given that malaria kills about 800,00 people annually – mostly small children in Africa – that’s an incredible number of lives that could be saved.

It’s an incredible scientific achievement too, given that this is the first time a vaccine has been effective against a parasite, rather than a virus or bacteria.

And of course, given the number of other diseases that have already been tackled by vaccines, millions of lives have already been saved since Edward Jenner’s first smallpox vaccination, in 1796.

But right from the start, campaigns to vaccinate – and especially to make it compulsory – have been met by campaigns against vaccination.

Anti-vaccination movements have many motivations, ranging from concerns about individual liberty to, famously (and famously discredited), fears that they cause autism.

Recently, would-be Republican presidential candidate Michele Bachmann climbed aboard the anti-vaccine bandwagon. Her specific target was Gardasil, vaccine for the human papillomavirus, which is a major cause of cervical cancer.

Her claim, that it causes “mental retardation”, was typical of anti-vaccinationists, and is largely based on confusing coincidence with causation (with any mass-vaccination campaign, bad things are bound to happen to people just by mere chance, but it’s all too easy jump to the conclusion that the events must be connected – call it the human tendency to discern patterns where there are none).

This is not to deny that vaccines need scrutiny; they are usually derived from the pathogen or toxin that causes the disease, so rigorous testing has to be done to ensure their safety. And we rely on government bodies, like the US Food and Drug Administration (FDA), or Australia’s Therapeutic Goods Administration (TGA), to monitor and enforce safety standards.

Of course, this itself is not without controversy: recently there has been a lot of criticism of the TGA for being slow to act on a flu vaccine produced by CSL that caused adverse reactions like fevers and seizures.

The trouble is that these things affect people’s lives, but the science involved isn’t always clear to those people. And so we have to hope that those making decisions are better informed. The lifesaving potential of discoveries like the malaria vaccine is all too easily scuppered by people in power giving in to non-scientific ideas.

And there’s not much more power you can get than the President of the United States…

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