MUCH OF THE EVIDENCE ADDUCED FOR VACCINATION IS WORTHLESS
We will now proceed to discuss the alleged value of vaccination by
means of the best and widest statistical evidence at our command; and
in doing so we shall be able to show that the medical experts, who
have been trusted by the Government and by the general public, are no
less deficient in their power of drawing accurate conclusions from the
official statistics of vaccination and small-pox mortality than they
have been shown to be in their capacity for recording facts and quoting
figures with precision and correctness.
In the elaborate paper by Sir John Simon, on the History and Practice of
Vaccination, presented to Parliament in 1857 and reprinted in the First
Report of the Royal Commission, he tells us that the earlier evidence of
the value of vaccination was founded on _individual cases_, but that now
“from individual cases the appeal is to masses of national experience.”
And the marginal reference is, “Evidence on the protectiveness of
vaccination must now be statistical.” If this was true in 1857, how
much more must it be so now, when we have forty years more of “national
experience” to go upon. Dr. Guy, M.D., F.R.S., enforces this view in his
paper published by the Royal Statistical Society in 1882. He says: “Is
vaccination a preventive of small-pox? To this question there is, there
can be, no answer except such as is couched in the language of figures.”
But the language of figures, otherwise the science of statistics, is not
one which he who runs may read. It is full of pitfalls for the unwary,
and requires either special aptitude or special training to avoid these
pitfalls and deduce from the mass of figures at our command what they
really teach.
A commission or committee of enquiry into this momentous question should
have consisted wholly, or almost wholly, of statisticians, who would
hear medical as well as official and independent evidence, would have
all existing official statistics at their command, and would be able to
tell us, with some show of authority, exactly what the figures proved,
and what they only rendered probable on one side and on the other. But
instead of such a body of experts, the Royal Commission, which for more
than six years was occupied in hearing evidence and cross-examining
witnesses, consisted wholly of medical men, lawyers, politicians, and
country gentlemen, none of whom were trained statisticians, while the
majority came to the enquiry more or less prejudiced in favour of
vaccination. The report of such a body can have but little value, and
I hope to satisfy my readers that it (the Majority Report) is not in
accordance with the facts; that the reporters have lost themselves in the
mazes of unimportant details; and that they have fallen into some of the
pitfalls which encumber the path of those who, without adequate knowledge
or training, attempt to deal with great masses of figures.
But before proceeding to discuss the statistical evidence set forth in
the reports of the Commission, I have again the disagreeable task of
showing that a very large portion of it, on which the Commissioners
mainly rely to justify their conclusions, is altogether untrustworthy,
and must therefore be rejected whenever it is opposed to the results of
the great body of more accurate statistical evidence. I allude of course
to the question of the comparative small-pox mortality of the VACCINATED
and the UNVACCINATED. The first point to be noticed is, that existing
official evidence of the greatest value has never been made use of for
the purposes of registration, and is not now available. For the last
sixteen years the Registrar-General gives the deaths from small-pox
under three headings. Thus, in the year 1881 he gives for London (Annual
Summary, p. xxiv.):
Small-pox. Vaccinated 524 deaths.
” Not vaccinated 962 ”
” No statement 885 ”
And in the year 1893, for England and Wales, the figures are (Annual
Report, p. xi.):
Small-pox. Vaccinated 150 deaths.
” Unvaccinated 253 ”
” No statement 1054 ”
Now such figures as these, even if those under the first two headings
were correct, are a perfect farce, and are totally useless for any
statistical purpose. Yet every vaccination is officially recorded—since
1873 private as well as public vaccinations—and it would not have been
difficult to trace almost every small-pox patient to his place of
birth and get the official record of his vaccination if it exists. As
the medical advisers of the Government have not done this, and give
us instead partial and local statistics, usually under no official
sanction and often demonstrably incorrect, every rule of evidence and
every dictate of common sense entitle us to reject the fragmentary
and unverified statements which they put before us. Of the frequent
untrustworthiness of such statements it is necessary to give a few
examples.
In _Notes on the Small-pox Epidemic at Birkenhead_, 1877 (p. 9), Dr.
F. Vacher says: “Those entered as not vaccinated were admittedly
unvaccinated, or without the faintest mark. The mere assertions of
patients or their friends that they were vaccinated counted for nothing.”
Another medical official justifies this method of making statistics as
follows: “I have always classed those as ‘unvaccinated,’ when no scar,
presumably arising from vaccination, could be discovered. Individuals
are constantly seen who state that they have been vaccinated, but upon
whom no cicatrices can be traced. In a prognostic and a statistic
point of view, it is better, and, I think, necessary, to class them
as unvaccinated” (Dr. Gayton’s Report for the Homerton Hospital for
1871-2-3).
The result of this method, which is certainly very general though not
universal, is such a falsification of the real facts as to render
them worthless for statistical purposes. It is stated by so high an
authority as Sir James Paget, in his lectures on Surgical Pathology, that
“cicatrices may in time wear out”; while the Vaccination Committee of the
Epidemiological Society, in its Report for 1885-6, admitted that “not
every cicatrice will permanently exist.” Even more important is the fact
that in confluent small-pox the cicatrices are hidden, and large numbers
of admissions to the hospitals are in the later stages of the disease.
Dr. Russell, in his Glasgow Report (1871-2, p. 25), observes, “Sometimes
persons were said to be vaccinated, but no marks could be seen, very
frequently because of the abundance of the eruption. In some of those
cases which recovered, an inspection before dismission discovered vaccine
marks sometimes very good.”
In many cases private enquiry has detected errors of this kind. In
the Second Report of the Commission, pp. 219-20, a witness declared
that out of six persons who died of small-pox and were reported by the
medical officer of the Union to have been unvaccinated, five were found
to have been vaccinated, one being a child who had been vaccinated by
the very person who made the report, and another a man who had been
twice revaccinated in the militia (_Q._ 6730-42). One other case may
be given. In October, 1883, three unvaccinated children were stated in
the Registrar-General’s weekly return of deaths in London to have died
of small-pox, “being one, four, and nine years of age, and all from 3,
Medland Street, Stepney.” On enquiry at the address given (apparently
by oversight in this one case) the mother stated that the three children
were hers, and that “all had been beautifully vaccinated.” This case was
investigated by Mr. J. Graham Spencer, of 33, Rigault Road, Fulham Park
Gardens, and the facts were published in the local papers and also in
_The Vaccination Inquirer_ of December, 1883.
Several other cases were detected at Sheffield, and were adduced by
Mr. A. Wheeler in his evidence before the Commission (6th Report, p.
70); and many others are to be found throughout the Anti-Vaccination
periodicals. But the difficulty of tracing such misstatements is very
great, as the authorities almost always refuse to give information as to
the cases referred to when particular deaths from small-pox are recorded
as “unvaccinated.” Why this effort at secrecy in such a matter if there
is nothing to hide? Surely it is to the public interest that official
statistics should be made as correct as possible; and private persons
who go to much trouble and expense in order to correct errors should be
welcomed as public benefactors and assisted in every way, not treated as
impertinent intruders on official privacy, as is too frequently the case.
The result of this prejudiced and unscientific method of registering
small-pox mortality is the belief of the majority of the medical writers
on the subject that there is an enormous difference between the mortality
of the vaccinated and the unvaccinated, and that the difference is due to
the fact of vaccination or the absence of it. The following are a few of
the figures as to this point given in the Reports of the Royal Commission:
Death Rate Death Rate
Authority. of of
Vaccinated. Unvaccinated.
Dr. Gayton, in 2nd Report
(Table B, p. 245) 7·45 43
Dr. Barry
(Table F, p. 249) 8·1 32·7
Sir John Simon
(1st Rep., p. 74) 0 to 12½ 14½ to 60
Mr. Sweeting, M.R.C.S.
(2nd Rep., p. 119) 8·92 46·08
Now an immense body of statistics of the last century compiled by
disinterested persons who had no interest to serve by making the severity
of small-pox large or small, gives an average of from 14 to 18 per
cent.[5] as the proportion of small-pox deaths to cases; and we naturally
ask, How is it that, with so much better sanitary conditions and greatly
improved treatment, nearly half the unvaccinated patients die, while in
the last century less than one-fifth died? Many of the supporters of
vaccination, such as Dr. Gayton (2nd Rep., p. 1856), have no explanation
to offer. Others, such as Dr. Whitelegge (6th Rep., p. 533), believe that
small-pox becomes more virulent periodically, and that one of its maxima
of virulence caused the great epidemic of 1870-72, which, after more than
half a century of vaccination equalled some of the worst epidemics of the
pre-vaccination period.
It is, however, a most suggestive fact that, considering small-pox
mortality _per se_, without reference to vaccination—the records of which
are, as have been shown, utterly untrustworthy—we find the case-mortality
to agree closely with that of the last century. Thus the figures given
in the Reports of the Hampstead, Homerton, and Deptford small-pox
hospitals at periods between 1876 and 1879 were, 19, 18·8, and 17 per
cent. respectively (3rd Report, p. 205). If we admit that only the
worst cases went to the hospitals, but also allow something for better
treatment now, the result is quite explicable; whereas the other result,
of a greatly _increased_ fatality in the unvaccinated so exactly balanced
by an alleged greatly _diminished_ fatality in the vaccinated is not
explicable, especially when we remember that this diminished fatality
applies to all ages, and it is now almost universally admitted that the
alleged protective influence of vaccination dies out in ten or twelve
years. These various opinions are really self-destructive. If epidemic
small-pox is now much more virulent than in the last century, as shown
by the greater mortality of the unvaccinated now than then, the greatly
diminished or almost vanishing effect of primary vaccination in adults
cannot possibly have reduced _their_ fatality to one-fifth or one-sixth
of that of the other class.
Again, it is admitted by many pro-vaccinist authorities that the
unvaccinated, as a rule, belong to the poorer classes, while they also
include most of the criminal classes, tramps, and generally the nomad
population. They also include all those children whose vaccination has
been deferred on account of weakness, or of their suffering from other
diseases, as well as all those under vaccination age. The unvaccinated
as a class are therefore especially liable to zymotic disease of any
kind, small-pox included; and when, in addition to these causes of
a higher death-rate from small-pox, we take account of the proved
untrustworthiness of the statistics, wholly furnished by men who are
prejudiced in favour of vaccination (as instanced by the declaration
of Dr. Gayton, that when the eruption is so severe as on the third
day to hide the vaccination marks, it affords _primâ facie_ evidence
of non-vaccination (2nd Report, Q. 1790)), we are fully justified in
rejecting all arguments in favour of vaccination supported by such
fallacious evidence. And this is the more rational course to be adopted
by all unprejudiced enquirers, because, as I shall now proceed to show,
there is an abundance of facts of a more accurate and more satisfactory
nature by which to test the question.[6]
One more point may be referred to before quitting this part of the
subject, which is, that the more recent official hospital-statistics
themselves afford a demonstration of the non-protective influence of
vaccination, and thus serve as a complete refutation of the conclusions
drawn from the statistics we have just been dealing with. Dr. Munk
stated before the Hospital Commission, that the percentage of vaccinated
patients in the London small-pox hospital had increased from 40 per
cent. in 1838 to 94⁶⁄₁₀ per cent. in 1879 (3rd Report of Royal Comm.,
Q. 9090). This evidence was given in 1882; but Mr. Wheeler stated that
according to the Reports of the Highgate hospital, the vaccinated
patients had long been over 90 per cent. of the whole, and are now
often even 94 or 95 per cent. The hospitals of the Metropolitan Asylums
Board, which take in mostly pauper patients, give a lower percentage—the
Homerton hospital 85 per cent., the Deptford hospital 87 per cent., and
the Hampstead hospital 75 per cent.—in the two latter cases adding the
“doubtful” class to the vaccinated, as the facts already given prove
that we have a right to do and still probably give too high a proportion
of unvaccinated. As the proportion of the London population that is
vaccinated cannot be over 90 per cent. (see Minority Report, pp. 173-4),
and is probably much lower, and considering the kind of patients the
unvaccinated include (see back, p. 29), there remains absolutely nothing
for the effects of vaccination. We have already seen that the total
case-mortality of these hospitals agrees closely with that of the last
century; the two classes of facts taken together thus render it almost
certain that vaccination has never saved a single human life.