Commentary
The announcement by Moderna of a vaccine against COVID-19 that is “95 per cent effective” understandably raises spirits (and the stock market) for a second time, more even than did the announcement by Pfizer of the previous successful vaccine.
The Moderna vaccine is not only slightly more successful, but—very importantly—will be much easier to administer to a population on a large scale.
The duration of the protection that it confers is not yet known, and the numbers immunized were too small to exclude the possibility of rare but serious side-effects.
But it is possible that the immunity produced by the vaccine will be lasting, or lasting enough, that it will be very safe, that it will prevent transmission of the virus, and that it will work very well in the most vulnerable people.
Unlike the Pfizer trial, the Moderna trial included a fair sample of the very people who most needed protection, those over the age of 65. So there is room for hope without premature rejoicing. Some things cannot be known or decided in advance of all experience.
What is almost certain is that, whatever vaccine is produced and used (and there are several under development), it will be the object of suspicion and even paranoia, however effective it might be.
I know of no other medical procedure that has produced so much and so prolonged mistrust as immunization, against whatever disease the immunization might have been. Why this should be, I am not quite sure, but it is so.
Shaw on Medicine
I recently happened upon a book, published in 1969, about the medical opinions of George Bernard Shaw, by far the most famous playwright of his day, and (deservedly) a winner of the Nobel Prize for Literature.
“Shaw and the Doctors” by Roger Boxill is a far too-sympathetic account of Shaw’s combination of good sense and crankiness. He was led to the latter, which the author of the book denies, by his love of paradox, by his almost a priori determination to go against received opinion merely because it was received and not because it was wrong, and by his preference for a bon mot over the strict and literal truth.
Shaw, writing at the end of the nineteenth and beginning of the twentieth centuries, believed that general living conditions were more important for health than any medical procedures, either preventive of curative, could ever be.
In a very broad, general way, this is correct: but it is so general that it needs to be qualified rather than solidified into an orthodoxy of its own, an orthodoxy that would inhibit medical research as being pointless.
Amongst another things, Shaw was opposed both to vaccination (against smallpox) and the germ theory of disease, according to which germs by themselves cause specific diseases. It is true that in the early days of germ theory there was overenthusiasm for the notion that germs were the source of all human ills, and it is also true that infection by germs is seldom a sufficient cause by itself for disease.
Shaw was much impressed by the fact that Max von Pettenkofer, an eminent German scientist who did not believe in Robert Koch’s discovery of a germ causing cholera, publicly drank a flask of cholera germs and did not get the disease.
From this kind of evidence, Shaw concluded that infection with germs was the result of disease rather than the cause of disease, a startlingly simplistic confusion between a necessary and a sufficient condition. It is possible to be infected with the tubercle bacillus without contracting the disease, tuberculosis; but it is impossible to contract the disease without infection with the bacillus.
Shaw was deeply opposed to vaccination, and we have forgotten that anti-vaccination was one of the great socially-mobilizing causes of the nineteenth century, with mass-circulation publications devoted to the cause for at least seventy years.
It is a little startling to read Shaw’s views so strongly defended in a book published only 8 years before the elimination of smallpox as a disease from the entire world. Had Shaw’s view of the question prevailed, smallpox would still be with us.
Progress and Resistance
My best friend when I was young, from whom I was almost inseparable, was one of the last children in the country to suffer from polio, which left him paralysed from the waist down. Not surprisingly, my parents were frightened that I would be next, which fortunately I was not.
A year or two later, immunization became general, and the disease practically eliminated. No parent would ever again have to suffer the anxiety that my parents suffered—though this is not to say that there would be no other causes of anxiety or suffering.
It is perfectly possible, though not likely, that any future vaccine against Covid-19 will be only partially effective, even totally ineffective in the long-term, or that it should have rare and serious side-effects not immediately apparent to offset against its benefits.
There is, as I said, much that cannot be known in advance of all experience. And yet it is more probable that a safe and effective vaccine will be found, as safe and effective vaccines have been found before.
Nevertheless, whatever the empirical results, there will be (if the past is anything to judge by) a movement, possibly even a strong movement, that will deny the evidence through thick and thin, and magnify contrary evidence, trivial or specious as it might be.
From the practical point of view, it won’t matter very much, provided only that the movement is not so large that it compromises the development of herd immunity. If it is not sufficiently large, it will itself benefit from the very procedure that it excoriates and opposes.
Reading—or re-reading, in my case—about Shaw’s views on medicine, which were fundamentally nihilistic about the prospects of technical advance, and also paranoid about the motives of those who tried to bring it about, one realizes how contemporary a figure Shaw was. And I do not mean that as a compliment.
Theodore Dalrymple is a retired doctor. He is contributing editor of the City Journal of New York and the author of 30 books, including “Life at the Bottom.” His latest book is “Embargo and Other Stories.”
Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.
