The Democratic Order Cannot Exist Without Vaccines | Opinion

Up until the 19th century, it took all of human history for the global population to reach one billion. By the end of the 20th century, we numbered more than 7.5 billion and will add a billion every 12 years. What's happening? In a word: vaccination.

Vaccines transformed our species' survival statistics and precipitated explosive population growth almost singlehandedly. But beyond saving lives, vaccination dramatically and permanently expanded individual and collective boundaries, injecting safety, stability and, by extension, prosperity into the lives of billions. Vaccination ended millennia of carnage that left survivors physically and mentally maimed. Our modern notions of individualism, liberty, family, society, and history are only possible via a vaccinated populace.

The COVID-19 pandemic has shattered our worldview, limited our freedom of movement, jeopardized our safety, and devastated our prosperity. Our democracy is built on the ability to congregate, to carry out business, to roam the globe. These are safeties hard-won in a war fought over centuries and across every imaginable boundary against an insensate and invisible enemy. In the end, it was vaccination that delivered us from evil and enabled the modern world. We inhabit the Vaccine Age just as surely our ancestors inhabited the Stone Age.

Were we to step back into a world without vaccination, we would encounter reminders of morbidity that our modern senses would find uniquely disturbing. The pre-Vaccine Age adult populace carried with them the overt scars of disease: congenital defects and deformation from Rubella; pock-scarred skin and milky-white, blind eyes from smallpox; paralysis and disfigurement from Polio, to name a few. From ~10,000 B.C. until its natural circulation ended in the late 1970s, the human smallpox virus infected and killed so many people that the precise toll is impossible to know, but is surely numbered in the billions. Smallpox and other now-nearly-forgotten diseases (Diphtheria, Pertussis, Influenza, Measles, Mumps, Rubella, Polio, etc.) were so prevalent and so devastating for our ancestors that they were both the defining feature of life—they were the way nearly everyone died—and just part of the backdrop of pre-Vaccine Age life. John the Revelator had it wrong: there was only one horseman and his name was Pestilence.

It's easy to forget how recent our deliverance has been. About a century ago the Spanish flu ravaged the world in a global pandemic, future President Franklin Delano Roosevelt contracted Polio and was paralyzed for life, and smallpox broke out in Milwaukee. By mid-century the pantheon of vaccines against preventable disease that we know today were developed. When the early 1970s arrived, vaccination had been so successful in controlling smallpox that routine vaccination ended in the US. Gone was the expectation that we lose babies, children, siblings to disease as a matter of course. Our world is not without loss, but in an ironic twist vaccination has made it the mirror image of our ancestors'—liberation from these diseases is a fact simply taken for granted, a defining feature of our world.

That we can be immune to a disease without having to suffer its consequences was a transformative work of abstraction by early medicine. Further, the physical act of inoculation represents a tremendous cognitive disconnect: you receive a treatment while well which prevents you from ever being diseased.

We are geared to experience medicine in the opposite order: treatment is judged by how well it cures the ill. At its heart, this disconnect between disease and treatment combined with the wild success of vaccines in eliminating disease allows space for an insidious thought: that we don't need vaccines. Combined with pseudoscience, misinformation and, at times, ill-will, this is a deadly combination. Here, our earlier timeline belies a troubling new reality: measles and Pertussis outbreaks are resurgent and growing as parents opt not to vaccinate their children, and the drumbeat of emerging diseases continues unabated: SARS, MERS, Avian Flu, Zika, and COVID to name recent examples.

COVID demands a reckoning: the democratic order cannot exist without vaccines. If we are to save ourselves and our descendants from this virus, then we have two requirements: a vaccine and the sense to use it. Anthony Fauci recently described the COVID pandemic as his "worst nightmare" because the disease occupies an dangerous niche: wildly infectious and lethal enough to be a public health catastrophe but benign enough to most individuals to breed complacency. Early indications of a second wave are upon us and Dr. Fauci's assessment was clear: escape from his nightmare requires a vaccine.

During the 2014 West African Ebola Outbreak, I was part of a team working with the WHO in planning how candidate Ebola vaccines could be rapidly tested, produced, and distributed to stem the epidemic. Fortunately, response, contract-tracing, and containment efforts by valiant public health workers made our team's work unnecessary. We will not be so lucky with COVID. The number of candidate vaccines and their success in hitting safety and efficacy milestones gives me hope that medicine will produce the treatment as soon as practical, but that will not be enough: we must remind ourselves to roll up our sleeves. We need to do it now before the battlefield is ceded to anti-scientific, anti-democratic, anti-vaccine forces.

We need to seize this moment to stop treating vaccination as optional, for COVID and for all diseases. A new generation is emerging, one that will now know the pain of losing a grandparent, a sibling, a spouse, or any loved one to an infectious disease. This new generation shares a painful bond with nearly every other preceding human generation since time immemorial. It is a pandemic of pain we can stop from spreading.

Justin Kern earned his Ph.D. in microbiology working to invent vaccines against diseases that are not currently preventable and is an investor within the food and agriculture industry.

The views expressed in this article are the author's own.​​​​​