Readers familiar with the novelist Roald Dahl will know that, beneath the literary façade of mischief and intrigue, there lies a tragedy. His eldest daughter Olivia was just seven in 1962 when she died from the complications of measles. As Dahl himself wrote: “As the illness took its course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning… I noticed that her fingers and her mind were not working together and she couldn’t do anything. In an hour she was unconscious. In 12 hours she was dead”. 

Once herd immunity is established, our society tends to forget very quickly the devastating effect that some infectious illnesses can have on countless people – out of sight, out of mind. Yet it is a little over two centuries since British physician and naturalist Edward Jenner used scrapings from a cowpox rash on the finger of a dairymaid named Sarah Nelmes to inoculate a young boy, James Phipps, with the cowpox virus. Later, he attempted to inoculate the boy with smallpox and, despite repeated attempts, was unsuccessful. In 1798, Jenner published his case studies under the title: An inquiry into the causes and effects of the ‘Variolae vaccinae’, a disease discovered in some of the Western counties of England, particularly Gloucestershire, and known by the name of cowpox.

Perhaps less well known are the efforts of Catherine the Great, Empress of Russia, in promoting widespread inoculation against smallpox, and predating Jenner by several decades. At least half-a-dozen reigning monarchs including Queen Mary of England and Peter II of Russia had already succumbed to the disease, while her own husband (Peter III) suffered a particularly severe bout, leaving him with ugly scars and little hair. In 1768, Catherine invited Scottish physician Thomas Dimsdale to Russia to inoculate her and her 14-year-old son, the Grand Duke Paul. Unlike Jenner’s later method of vaccination, Dimsdale’s technique was to introduce a trace amount of smallpox (rather than cowpox) into the body, a method ultimately quite dangerous and often resulting in the very illness they were trying to avoid. However, the procedure worked for Catherine and her son and thus it was made available to over two million Russians by 1800. 

Vaccination is one of many subjects covered in David Robert Grimes’s fascinating book, The Irrational Ape: Why flawed logic puts us all at risk, and how critical thinking can save the world.¹ Grimes (through radio, print and social medial) has long been an advocate of evidence-based logical reasoning in relation to societal problems; indeed, he has a unique ability to explain to the average person the potential pitfalls of bad science. One such example in his book is the aftermath of Andrew Wakefield’s false claims that the MMR vaccine is linked to autism.

Despite The Lancet conceding that Wakefield’s work was “fatally flawed”, and despite a General Medical Council finding of serious professional misconduct against Wakefield, an entire anti-MMR (indeed, anti-vaccine) movement persists to this day. In the words of Prof Fiona Godlee, editor of the BMJ, this is “fuelled by unbalanced media reporting and an ineffective response from government, researchers, journals and the medical profession”. 

With a decline in MMR uptake, measles cases have skyrocketed in Europe in recent years, reaching 82,596 in 2018. A proportion of these children died, just like Olivia Dahl did in 1962. Those who forget history are destined to repeat it.

Reference

1. Grimes DR. The Irrational Ape: Why flawed logic puts us all at risk, and how critical thinking can save the world. Simon and Schuster (2019): 90-92