Wolfgang Held: Why is the debate on the topic of vaccination so intense?
Georg Soldner: The topic of vaccination has been polarized ever since there have been vaccinations. As early as 1860, there were statements from vaccination supporters and opponents that sound very similar to those from today. Then, as now, both sides tend to suppress facts that contradict their own view. We also noticed this when we drafted a worldwide position statement on the part of the Medical Section and the IVAA (International Association of Anthroposophic Physicians). Even within the anthroposophic movement, the reactions are contradictory. There were colleagues who welcomed it, and colleagues who feared it would be selling out anthroposophy.
In GA 314, we can read Rudolf Steiner’s statement on vaccination in a concrete situation: “Then you have to vaccinate. There is no other choice. Because fanatical opposition to these things is something that I wouldn’t recommend at all – not for medical reasons, but for general anthroposophic reasons. Fanatical reactions to these things is not what we are striving for; rather, we want to do things differently in general. I’ve always seen this as something to fight against in my friendship with physicians. For example with Dr. Asch, who absolutely did not vaccinate. I always fought against this. Because if he doesn’t vaccinate, someone else will do it. It is completely absurd to be this fanatical in individual cases.”
Obviously, Steiner also said other things about vaccination, and about the importance of acute infectious illnesses for human development and for human destiny.
What makes the topic of vaccination so controversial? Isn’t the victory over smallpox an impressive precedent?
A vaccine is developed for whole portions of the population, so it affects us as a community. At the same time, it intervenes in individual organisms and that creates uneasiness. The vaccine in the last 200 years was the smallpox vaccination. Smallpox has characteristics that it doesn’t share with any of the other infectious diseases that we’re dealing with now. If you are infected with smallpox, you develop the illness with 100% certainty. With polio, only one in a thousand develops paralysis. The other 999 show less severe symptoms, but are also contagious. Smallpox, which is deadly in 30% of cases, always occurs as a full-blown illness.
That means that I can’t overlook a case. This illness is also so dangerous that it makes sense to vaccinate the entire population, because the mortality rate is so high. While the mortality rate for smallpox is approximately 30%, the mortality rate for measles in Germany is 0.1%. Therefore, I can’t mandate measles vaccinations in Germany using the same argument as for smallpox vaccinations. The danger level is a completely different scale of magnitude. But with measles, we also know now that there are mild cases that aren’t recognized as such for quite a while. This is why measles can survive, even if a high percentage of the population is vaccinated. While smallpox’s unique combination of characteristics allowed us to eradicate it, this is not so possible with any of the other infectious diseases we currently vaccinate for. Even polio isn’t eradicated, by the way. The oral vaccination virus can still transform back into its original aggressiveness. We will continue to vaccinate against polio for decades, because dangerous polioviruses continue to surface, some from the oral vaccination that we also used here for many years. But we have nearly eliminated it. There are very few occurrences any more in Europe. But if we stopped vaccinating for polio worldwide, it would probably come back.
With measles, we have three to four times as many cases now in Europe as we did ten years ago. This shows that every illness is different. Eradication of measles is far from being possible. The most we can hope for is that measles outbreaks are limited to only a few people through widespread vaccination of the population and careful care into adulthood. We call this elimination. That is the goal. But based on all that we know, measles cannot be eradicated. The claim is made that it can be, but the claim is false.
So compulsory vaccinations for measles seem useless, right?
There are scientific studies on the question of compulsory vaccinations that show that every compulsory vaccination arouses resistance. In countries like Germany and Switzerland, compulsory vaccination would not be carried out such that children are picked up by the police and forcibly vaccinated. There only a fine would be charged. In point of fact, the vaccination rate increases more through education of the population. This is also the case in Germany for first-time measles vaccinations, which more children entering school have received than in a number of neighboring countries with compulsory vaccinations. We have always advocated that decisions on whether to vaccinate be free, informed decisions by parents or patients wherever possible. I spoke with an Indian colleague yesterday. In her country, there are areas with high child mortality where many parents still cannot read and can’t understand what a free decision on whether to vaccinate means. In areas like these with high child mortality and low levels of parent education— education as we understand it—it is not so simple to tout informed parent decisions on vaccination. Therefore, it is understandable that a country considers compulsory vaccination in some countries with widespread poverty and high child mortality. Measles, specifically, are a very frequent cause of child mortality in such regions. But in countries like Germany, the USA or Australia, the situation is different. Here, we’re talking about diseases with low to no mortality, like mumps. And here, we
insist that parents or the patients themselves should decide what they want to vaccinate for, and when.
So, what has changed in recent years?
What has changed is the perspective on the measles vaccination. In the last ten years, the measles vaccination has been able to show that it also triggers immunological maturation processes in those vaccinated. Not as strongly as measles itself, but less dangerously, and enough that in countries with high child mortality the measles vaccination lowers mortality more than by simply protecting against measles. Beyond measles, vaccinated children in these countries die less frequently of pneumonia and diarrhea than unvaccinated children. These findings show that the measles vaccination can support a child’s immunological development. For so-called “inactivated” or “dead vaccines”, like early vaccination against diphtheria and tetanus, the opposite is true: They have a negative influence on the immune system of infants and can potentially even raise child mortality rates in poor countries.
On the other hand, the measles vaccination has the effect, today, that in our countries certain population groups that used to be protected are now more endangered. One group is infants. A nursing mother who is vaccinated against measles does not pass her immunity on to her infant like a mother who has had measles herself. The nursing mother who has had measles can give her infant relatively strong immunoprotection (maternal passive immunity), while a mother vaccinated against measles cannot. This means that infants are now at a higher risk of measles. In infancy, measles can leave behind a terrible illness that breaks out approximately seven to ten years later and leads to a mental deterioration and certain death (SSPE).
Is the famous herd immunity turned on its head here?
Herd immunity is a term used to mean that we immunized people reduce the risk of infection for those who cannot be vaccinated because of a weak immune system or extreme youth. But in fact, the opposite is also true: the average age of the few measles cases that we still have here in Germany is now 20 years, and in Switzerland it is similar. The last death due to measles in Germany was of a 40-year- old. The situation is that adults born after 1970, who didn’t have measles as children and who were sometimes only vaccinated once, do not show sufficient immunity to measles. Even adults who were vaccinated twice as children can be so-called “vaccination failures.” The measles vaccine does not protect everyone. At least one percent of twice-vaccinated people does not exhibit sufficient immunity. If we vaccinate against measles already at the age of nine months, this percentage quadruples. If I vaccinate very early, more children remain unresponsive to the vaccine. And once this is the case, it is not easy to correct later. The second measles vaccination is not a booster vaccination – it is meant to fill in gaps for people who didn’t respond to the first vaccination. But it also doesn’t reach everyone – especially those who were vaccinated at very young ages. In such cases, we talk
about vaccination failures. These people can also become ill with measles as adults, for whom measles are much more dangerous than for young children. Once we’re in this situation, the inherent necessity arises that we attempt to vaccinate so widely that the number of those who are not immune despite vaccination or who cannot be vaccinated because of immune disorders remains below five percent, so that outbreaks remain isolated and cannot spread.
Encountering the natural measles virus strengthens my immune system. But in our countries, we have suppressed this encounter to a great extent.
We don’t know, by the way, whether this vaccine immunity, with which we have replaced natural immunity, actually lasts for a lifetime, because it is now so rare to encounter a natural measles virus. Encountering and overcoming the natural measles virus may strengthen my immune system. But in our countries, we have suppressed this encounter to a great extent. With all of the uncertainty regarding long-term consequences, this development creates a certain pressure to take part in measles vaccination, because now more adults or infants could contract measles and be more endangered. In the new GAÄD (German Association of Anthroposophic Doctors) leaflet on measleswe recommend a vaccination at a later age than is generally recommended in Germany and in Switzerland. Scientific studies show that vaccination after the age of 15 months leads to much more reliable long-term protection than vaccinating earlier. Vaccination at 9 months leaves significantly more gaps in immunity than a vaccination at 15 months.
Why don’t such studies penetrate into vaccination practice?
As I said at the beginning, the way scientific findings are handled in day-to-day vaccination practice is not necessarily rational. The social development of day care plays a role. Vaccination of nine-month-old children is only recommended in Germany for children that enter day care early. These days, we even have tiny infants in day care facilities. In the DDR, it used to be quite common for children between the ages of three and six months to enter day care. This is becoming more common again today, leading to higher danger of contagion for infants. This childcare in community facilities means that the age of vaccination has had to be pushed up, contrary to what medical science has determined to be the optimal age for vaccination in terms of long-term immunity.
In the coming decades it will be a growing problem that individual adults have no reliable protection. Measles will not disappear in the next few decades. If an adult without protection travels to a country where there is still measles, for example as part of a development aid project, he or she can become infected and severely ill, and also pass on the infection to others. These are the risks. This is why it is for us Anthroposophic physicians of especially high priority—and we are pioneers in this area—to pay very careful attention to the immunity of young adults. When young adults leave my practice, I check whether they have measles immunity. This is best done with a blood test, so that vaccination failures can be identified. Just because
you’ve been twice vaccinated doesn’t always mean you’re immune. In the 2015 Berlin epidemic, we saw that some of those infected had been twice vaccinated. And they sometimes exhibit less typical disease progressions that are not immediately recognized while they infect others. So the vaccinations have caused new problems. It is not the case that any given vaccination can inject eternal health, even if this is sometimes suggested.
Rudolf Steiner turns that thought on its head with the description of how it is the disease itself that at some point releases the vaccine, possibly because it has fulfilled its task.
Rudolf Steiner often characterizes the situation from different perspectives. A famous example of how we can look at something from different perspectives is the disappearance of polio. Vaccination proponents can point out that with the introduction of the polio vaccine, the number of infections fell drastically. Anyone who denies this is going against the facts. But we also know the fact that many diseases have retreated before medical measures could affect them. Even polio was certainly already retreating through improved hygiene and overcoming the period of misery after WWII. It is especially clear in the case of tuberculosis, which has by and large disappeared here, independent of possibilities for medical treatment. The disappearance of tuberculosis is rather due to the fact that people began to expose themselves to the sunlight in bathing suits and to take in sun, thereby counteracting the pathogen. Rudolf Steiner himself specifically pointed to this significance of sunlight. Improved diet and sunlight undermines tuberculosis, while, for example, the extreme veiling of Muslim women today can lead to a significant increase in the frequency of tuberculosis. We can see that the appearance of a disease follows its own laws, which do not have a one-to-one relationship with our actions. This is currently the case with scarlet fever, for example, whose aggressiveness has significantly decreased.
A perspective that I have represented for twenty years is based on long-term observation. I notice that the intervening feverish illness in childhood—taking hold of one’s own body’s destiny—doesn’t necessarily have to be measles – it can also be for example pneumonia. And over half of all childhood pneumonia is caused by viruses. Now, interestingly, we are being able to develop joint projects with pediatrician colleagues, including in Germany, around dealing differently with fever in acute infectious diseases: not suppressing fever anymore with medication, and not prescribing antibiotics for every feverish illness. My colleague, Professor David Martin in Witten/Herdecke, has received nearly 2 million Euros as a research grant from the government in order to develop and evaluate an app for parents that is intended to help parents overcome their fear when their child has a fever, and will give clear instructions for appropriate care for the child. How they, in generally understandable words, can help this acute intervention of the child’s being in its body within the framework of the fever.
This is also the aspect that Rudolf Steiner meant. It is not about contracting the measles illness – it needs to be about allowing a child in its first years to take hold of its body, to individualize its body within the context of feverish illnesses. About overcoming predispositions to illness that have been inherited from the parents, such as tendencies to allergies, through feverish illnesses. Within Anthroposophic Medicine, we have been able to prove that acute feverish illnesses, when not suppressed, contribute to a lower occurrence of allergies, for example.
If all pediatricians assume a favorable attitude toward acute feverish illnesses, we will have done much more for childhood development than if we fight for the opportunity to get the now rare measles virus.
Of course, measles is one of these illnesses, but I don’t need to cultivate measles – there are enough other feverish illnesses that occur in childhood. If all pediatricians and general practitioners take a different attitude toward acute feverish illnesses, we have perhaps done much more for the good of children and for child development than if we, a small group of Anthroposophic physicians, fight for the ability to contract measles, now a rare illness.
What positive effect can this discussion have?
First of all, I am very glad that we in the anthroposophic movement are bringing a process of clarification, if we want to affect the development of civil society. For example, the majority of parents in Germany are afraid of measles and don’t want the disease to continue to occur. But we can influence the thinking of these young parents, for example, in regards to acute fever. David Martin has the support of the Chair of the Professional Association of German Pediatricians, and our guidebooks for parents are widely purchased. On a broad front, we can change the way people think about acute fever. We approach the public and consciously participate in the now unavoidable global control of measles, by becoming more open to early measles vaccination. Before, we more often advised vaccination at the end of childhood. We approach the public. But on the other hand, we want to share our central thoughts on fever and the individualization of the child’s body with the public. When that is understood, we are not isolating ourselves in a niche. Rather, we become the seed of change in society.
Dr. Georg Soldner is the Deputy Head of the Medical Section, School of Spiritual Science, at the Goetheanum in Dornach, Switzerland.
Translated from German by Tascha Babbitch, firstname.lastname@example.org.