'The natural benefits of vaccines'

VIEWPOINT Adam Finn Professor of paediatrics, University of Bristol

http://news.bbc.co.uk/1/hi/health/7947863.stm

One of the arguments given by those who feel uncomfortable about giving children vaccinations is that they are "unnatural".

But in this week's Scrubbing Up health column, vaccine expert Professor Adam Finn argues that they are in fact a very natural idea.

With increasing evidence of the damage we are doing to our precious little planet, the urge to curb the ravages of modern life has an even much more powerful resonance with today's younger adults.

Linked to this is an urge to classify our habits and all the things we make, buy and use - to define them as good or bad, or more often as natural and unnatural.

There can scarcely be a more widely used, understood and applied word in Britain today than "natural". But pause for a moment to try and define what it means and it will slip through your fingers as nimbly as a wet fish or a wisp of smoke.

Artificial - or not?

Of course this will-o'-the-wisp quality is what makes the word useful. People do think they know exactly what it means.

Actually they feel very comfortable with it and this is reinforced by a very broad consensus on whether things are natural or not.

For example, quickly look at the following list and decide which of them is natural:

• 1 - toilet rolls made from recycled paper
• 2 - supermarket plastic bags you chuck away after one use
• 3 - flying first class to New York to go shopping
• 4 - walking to the top of a Welsh mountain
• 5 - eating an apple you just picked in your garden
• 6 - eating a microwaved preprepared dinner

You picked 1, 4 and 5, didn't you? All of you. It's easy. The trouble is that it isn't.

If natural means "the way it used to be before modern civilisation came along" then, depending a bit on when your personal date for the start of the modern era falls, none of those things are natural, not even the apple.

A number of things we use whose "natural" qualities are sometimes heavily marketed, like clean water, were certainly not available prior to the modern era (and unfortunately still aren't in many places).

While its health promoting benefits are manifest and universally appreciated, clean water is entirely artificial and we certainly did not evolve imbibing it.

Wrong side of the fence?

I could now start taking pot shots at the health foods and natural medicines industries.

But that is not my theme. My thing is vaccines.

I reckon that if I'd popped a vaccine into the list above, maybe alongside a vitamin pill, a good proportion of you, perhaps nearly all of you, would not have included it among your "natural" selections.

Imagine scores of empty seats that would be there if all those whose lives had been saved by vaccines were suddenly to vanish     Read your comments

If I've done a good job, you'll finish reading this column and when you do you'll revise your opinion.

About 14 years ago, when I was a parent of young children, as preparation for a talk at a doctors' meeting about vaccines, I surveyed (rather informally) parents - mostly mothers of course - waiting in the playground of our local primary school.

Without exception, of the vaccines given to their children over the first 15 months of life, the one they felt most comfortable with was the oral polio vaccine. Given as drops into the mouth, it felt more "natural" than the others given by injection.

The irony of this is that this (and not, for example MMR) was the one vaccine then used which was known to carry a small risk of very serious neurological side effects - it could, very rarely, actually cause polio, the disease it is designed to prevent.

As a consequence we now use an injected vaccine instead.

So the main reason that vaccines seem to fall down the wrong side of the fence when it comes to deciding if they are "natural" may simply be about needles.

This cultural norm is reversed in some African countries I have visited, where a healthcare visit which does not result in an injection of some description is generally judged by the patient or parent to have had a failed outcome.

Of course, neither viewpoint is rational.

More broadly, the principle upon which immunisation is based - namely, exposure to a non-harmful version of the naturally occurring infection in order to induce a natural and protective immune response - can be seen to be a far more natural process than the drug- and surgery-based therapies most widely venerated as the main achievements of modern medicine.

'Vast armies'

Perhaps the other main reason that vaccines get so much bad and so little good press these days is that their beneficiaries don't know who they are and nor does anyone else.

Look around any room crowded with young and middle-aged adults - next time you go to see a film for example - and imagine scores of empty seats that would be there if all those whose lives had been saved by vaccines were suddenly to vanish.

Imagine all your family and friends and then, arbitrarily, remove or cripple one in 20.

It's hard to do it and rather scary.

If, somehow, we could all conjure up an imagine of the vast armies of people who would not be healthy and here if it were not for immunisation, I reckon we would not hesitate to put it on our personal lists of good, "natural" things to be embraced and celebrated - along with renewable energy and muesli bars!