How We Lived (and Died) Before Vaccines

By Richard Conniff/National Geographic

This piece originally appeared in 2019. I’m republishing it now because it’s part of what motivated

my new book Ending Epidemics: A History of Escape from Contagion (MIT Press).

Like most American children of my generation, I lined up with my classmates in the mid-1950s to get the first vaccine for polio, then causing 15,000 cases of paralysis and 1,900 deaths a year in the United States, mostly in children.  Likewise, we lined up for the vaccine against smallpox, then still causing millions of deaths worldwide each year. I’ve continued to update my immunizations ever since, including a few exotic ones for National Geographic assignments abroad, among them vaccines for anthrax, rabies, Japanese encephalitis, typhoid, and yellow fever.

Having grown up in the shadow of polio (my uncle was on crutches for life), and having made first-hand acquaintance with measles (I was part of the pre-vaccine peak year of 1958, along with 763,093 other young Americans), I’ve happily rolled up my sleeve for any vaccine recommended by my doctor and the U.S. Centers for Disease Control and Prevention, with extra input for foreign travel from the CDC Yellow Book.  I am deeply grateful to vaccines for keeping me alive and well, and also for  helping me return from field trips as healthy as when I set out.

One result of this willingness, however, is that I suffer, like most people, from a notorious Catch-22: Vaccines save us from diseases, then cause us to forget the diseases from which they save us. Once the threat appears to be gone from our lives, we become lax. Or worse, we make up other things to worry about. Thus, some well-meaning parents avoid vaccinating their children out of misplaced fear that the MMR vaccine (for measles, mumps, and rubella) causes autism. Never mind that independent scientific studies have repeatedly demonstrated that no such link exists, most recently in a study of 657,000 children in Denmark.  This irrational fear is why the United States has experienced almost 1200 cases of measles so far this year, almost two decades after public health officials proudly declared it eliminated. About 124 of these measles victims, mostly children, have been hospitalized, 64 of them with complications including pneumonia and encephalitis, which can cause brain damage or death.

And yet autism can still seem like a bigger threat than measles, if only because it appears in countless television shows and movies such as “Rain Man” and “Gilbert Grape.” Meanwhile, you’re more likely to catch measles at a movie theater than see the disease featured onscreen.

And so, parents forget, or more likely never knew, that 33 of every 100,000 people who experienced actual measles ended up with mental retardation or central nervous system damage. (That’s in addition to those who died.)

They forget that an outbreak of rubella in the early 1960s resulted in 20,000 children being born with brain damage, including autism, and other congenital abnormalities.

They forget that, before it was eradicated by a vaccine in the 1970s, smallpox left many survivors