Refusing to vaccinate puts at risk not just your children but the people in our communities who most require our protection. This is a substantial downside for people deciding to protect their kids via star signs and “good vibes” instead of medicine. (Horoscopes are, to be fair, a lot of fun.)
I’m a Taurus! One of our personality traits is not believing horoscopes are real!
Nobody wanted people to be at risk for polio. Not Eisenhower, not Salk, not the people who had lived so long in fear of the disease. Most people were vaccinated immediately. Unfortunately, there were some mishaps. Two batches of vaccine produced at the Cutter laboratories in California did not sufficiently kill the virus, which resulted in the deaths of ten children. This wasn’t Salk’s fault. His vaccine worked. It was the fault of the laboratory. (It used a glass filter rather than an asbestos one when trying to kill the virus, which allowed some of the live virus to seep through.) This incident led to increased federal regulations of vaccines and “better procedures for filtration, storage, and safety testing were developed.”38 In 1955 there were 10 regulators overseeing vaccines employed by the National Institutes of Health. By 1956 there were 150. Today the Food and Drug Administration (FDA) employs 250 people to monitor the production of every vaccine to ensure that there is never a repeat of the Cutter incident. Vaccines are tested tens of thousands of times to ensure they contain exactly what is represented.39
Whew. Good.
Polio was effectively eliminated throughout the world. And then people just … kind of forgot all about polio. This seems to be the human response to any disease. People forget diseases ever existed the minute they are no longer being affected by them. Maybe that’s understandable. Maybe if we all thought about all the potential diseases the world is teeming with, and the extent to which we are, every day, dancing on the edge of a volcano, the world would seem too terrifying to walk around in at all.
Or we’d just vaccinate our kids.
“Our main problem now,” said Thomas Rivers, a leader in viral research who oversaw the clinical trials of Salk’s vaccine in 1956, “is not that anything is wrong with the Salk vaccine, but that something is wrong with the people who won’t take it.”40 People were not necessarily apathetic or foolish. Some of their difficulties stemmed from the fact that three shots a year were required and one booster shot annually for years following. Although efforts had been made to keep the polio vaccine extremely affordable, visiting doctors still costs money. And people living in rural areas far away from a local doctor sometimes couldn’t afford the time to make that many trips, especially since the situation no longer seemed dire.
In 1961 Albert Sabin’s vaccine became available. The American Medical Association recommended that Sabin’s live virus vaccine replace Salk’s killed virus vaccine. Sabin’s vaccine could be taken orally—sometimes hidden in a sugar cube—and once taken, it provided lasting immunity. It does cause polio in very rare cases (one in 2.7 million).41 That said, it’s cheaper to manufacture, which is an advantage. By 1963 it was the vaccine of choice, and Sabin became the new face of the polio fight, although he was never as beloved as Salk.
For some time afterward Salk’s vaccine was forgotten. This haunted Salk for the rest of his life. He hated Sabin’s vaccine. The rivalry and enduring dislike between the two scientists is well documented and would make for a really great movie if anyone wants to produce it.
Today, Salk’s vaccine is used primarily in the United States and Europe, while Sabin’s is more popular in periphery countries. I’d like to say that today Salk and Sabin could take pride in knowing that both vaccines are used, though they really hated each other, so that might be a bit optimistic.
Salk never stopped trying to be of “some help to humankind.” In 1962 he founded the Salk Institute for Biological Studies in La Jolla, California, which he hoped would serve as “a cathedral to science.” The competition to work there was so steep that Salk joked, “I couldn’t possibly have become a member of this institute if I hadn’t founded it myself.”42 Salk continued to work until he died of heart failure in 1993. During the last years of his life he devoted his attention to finding a vaccine for AIDS. He said he knew that many people expected him to fail in his attempts, but he maintained, “There is no such thing as failure. You can only fail if you stop too soon.”43 He never did develop that vaccine, maybe simply because death stopped him. But he never gave up. And he never stopped believing in the fundamental capacity for goodness in people. “What is important is that we, Number one: Learn to live with each other,” he said in 1985. “Number two: Try to bring out the best in each other. The best from the best, and the best from those who, perhaps, might not have the same endowment … the object is not to put down the other, but to raise up the other.”44
Sometimes, as we go about our lives, we’re angry, or other people are angry. We’re idiots, or they are. Maybe it seems a lot to expect that we can lift up our fellow man and bring out the best in everyone. But we’ve done it before. We can work miracles when we come together to help one another. Just look at how we all cured polio.
Epilogue
Sometimes people ask me when I believe America is due for another plague. I invariably reply, “Well, we literally just had one.” People who talk about the possibility of a pandemic that kills millions as though it is somehow unlikely seem to forget that. Perhaps that’s because it just didn’t look like what television shows about plagues depict. There were no government officials in hazmat suits sweeping into neighborhoods to quarantine people during our last plague. But then, as we’ve seen, the response to plagues rarely looks like that. People, more than anything, want to go about life as normal, even during a plague.
But AIDs is not less horrific for that.
Indeed, the shadow of the mishandling of the AIDS crisis hangs over this entire book.
I did not want to write a chapter on AIDS. That is because I think it is my role to tell the stories of people who are already dead and cannot speak for themselves. You may have lived through the AIDS epidemic of the 1980s yourself. If not, you know someone who did. I am certain that individuals can tell the story of those terrible times much better than I.
That said, I must conclude this book by writing at least a little about the extent to which AIDS was mishandled, because this plague seems a perfect case in point of what happens if you ignore every single one of history’s lessons regarding disease.
Let’s look at some of those lessons.
One of the interesting takeaways from both the Antonine plague and polio is what a difference a strong leader can make during an epidemic. Marcus Aurelius’s swift response to the Antonine plague—and his attempt to help cover expenses for the general populace and rebuild the parts of the army decimated by the disease—staved off the fall of the Roman Empire, at least temporarily. When FDR took up polio as a cause, America followed his lead and went to work eradicating it. Although his role may not have been as significant, Eisenhower is also to be commended for trying to ensure that cost did not prohibit any child from receiving the polio vaccine, and that the vaccine was shared with the world. Those men each acknowledged the seriousness of their crises and went about bravely confronting the disease in their midst head-on. They did not ignore it or glamorize it or shame people for having it, because that never works. That strategy just gives diseases more time to multiply and kill people. Diseases are delighted when you refuse to take them seriously.
When members of the Ronald Reagan administration first heard about AIDS, they laughed about the blossoming epidemic. Mark Joseph Stern described the infamous episode in this Slate account:
On October 15, 1982, at a White House press briefing, reporter Lester Kinsolving asked press secretary Larry Speakes about a horrifying new disease called AIDS that was ravaging the gay community.
“What’s AIDS?” Speakes asked.
“It’s known as the ‘gay plague,’” Kinsolving replied.
Everyone laughed.
“I don�
��t have it,” Speakes replied. “Do you?”
The room erupted in laughter again. Speakes continued to parry Kinsolving’s questions with quips, joking that Kinsolving himself might be gay simply because he knew about the disease. The press secretary eventually acknowledged that nobody in the White House, including Reagan, knew anything about the epidemic.
“There has been no personal experience here,” Speakes cracked. The room was in stitches.1
After those in the administration had a good laugh, they proceeded to, at least publicly, ignore AIDS. President Reagan didn’t address the disease in any capacity until September 17, 1985. When a reporter asked him about the terrifying spread of the disease, Reagan replied:
We have $100 million in the budget this year; it’ll be $126 million next year. So, this is a top priority with us. Yes, there’s no question about the seriousness of this and the need to find an answer.
Q: If I could follow up, sir. The scientist who talked about this, who does work for the Government, is in the National Cancer Institute. He was referring to your program and the increase that you proposed as being not nearly enough at this stage to go forward and really attack the problem.
The President: I think with our budgetary constraints and all, it seems to me that $126 million in a single year for research has got to be something of a vital contribution.2
In reality, Reagan slashed the AIDS budget by 11 percent in 1986. It went from $95 to $85.5 million.3
The president did not hold a major public address to discuss the disease until 1987, after 20,849 Americans had already died of it. The Gay Men’s Health Crisis was founded in 1981. An Early Frost appeared on television in 1985. The Normal Heart was staged at the Public Theater in New York by 1985. The actor Rock Hudson would die that same year. The surgeon general was sending reports endorsing condom usage in 1986. What was Reagan waiting for?
I do not know if medical progress on the disease could have been accelerated. But I certainly know that a leader can change the way the public responds to an outbreak of disease. Reagan was called “the great communicator.” He was, perhaps, one of our most charismatic presidents. He was beloved, and he was personally friendly with gay people. Imagine what it would have meant, right from the beginning, to have had a leader who said, “Americans do not let other Americans be struck down in the prime of their lives by a plague. It doesn’t matter who they are or how they live their lives. We are a courageous people, and we are going to come together to fight this dreadful disease.”
I am always trying to rewrite the scripts for history, the way some people must mentally rewrite the scripts for disappointing episodes of their favorite television shows. I admit I have not succeeded in changing anything, yet.
A more compassionate, humane response might not have halted the spread of the AIDS epidemic, but it surely would have been better than laughing at it.
By 1987 the prominent conservative William F. Buckley Jr. suggested that everyone with AIDS should be “tattooed in the upper forearm, to protect common-needle users, and on the buttocks, to prevent the victimization of other homosexuals.”4
This stance had nothing on California congressman William Dannemeyer’s statement that if he could identify everyone with AIDS, he would respond by “wip[ing] them off the face of the earth.”5 The Arkansas senator and later governor Mike Huckabee took an infinitesimally more moderate view in 1992: “It is the first time in the history of civilization in which carriers of a genuine plague have not been isolated from the general population … we need to take steps that would isolate the carriers of the plague.”6 We keep considering this man as a presidential candidate, and he basically said that everyone with AIDS should be rounded up and shipped off to an island.
Whenever someone casually refers to “the history of civilization” in a way that does not jibe with the history of civilization as I extensively, constantly, read about it, I like to research their favorite books to see where they are getting their information. In most of these cases all their favorite books have titles like Christmas, Guns, and Integrity.
Huckabee’s statement was ill informed. As you know from reading this book, it is not the first time in civilization that carriers of a plague were not forced into isolation. It seems most likely he was thinking of lepers, and in that case quarantine wasn’t a good thing. It was a disaster. The nightmarish conditions on the island of Molokai required a man of Father Damien’s rare compassion and courage to bring order and welfare. And that disease wasn’t even especially contagious.
Meanwhile, carriers of the highly contagious tuberculosis were off at the opera and hunting alligators for fun and profit. It is telling that, historically, quarantines extended primarily to those who had less wealth, power, and social clout.
In instances during the AIDS epidemic when nonsufferers—modern-day Father Damiens—came together to rally for more federal funding for AIDS, Huckabee complained: “An alternative would be to request that multimillionaire celebrities, such as Elizabeth Taylor … Madonna and others who are pushing for more AIDS funding be encouraged to give out of their own personal treasuries increased amounts for AIDS research.”7 It is worth noting that the bulk of proceeds from the auction of Taylor’s $150 million jewelry collection did indeed go to AIDS research.8 So in the end she gave about as much as the government did in 1986. That said, relying on a single woman, even one as generous and generally magnificent as Elizabeth Taylor, to take care of a national health crisis is not realistic.
Of course, government representatives and wealthy celebrities aren’t the only ones who can make a difference when it comes to the fight against disease. By looking to Father Damien’s treatment of the lepers, or Reverend Henry Whitehead’s support of John Snow’s cholera research, we can see the difference religious figures can make. Perhaps it seems only natural that they, more than anyone else, would devote themselves to relieving the pain of those suffering. But during the AIDS crisis the religious right claimed that homosexuals should burn in hell and that the disease was God’s punishment. The popular pastor Billy Graham pondered before an audience, “Is AIDS a judgment of God? I could not say for sure, but I think so.”9
Graham, I am pleased to say, at least eventually apologized for this statement. The Reverend Walter Alexander, of Reno’s First Baptist Church, who stated that, to combat the epidemic, “we should do what the Bible says and cut their throats,”10 did not. In 1989 Catholic bishops strongly objected to the use of condoms specifically to stop the spread of AIDS.11 This stance was, obviously, both dumb and deadly.
I am sure there were religious groups that were kind and compassionate and behaved in a Christian fashion. I would love to hear stories about the pastors and priests and others drawn to religion because they wished to help their fellow men. I know there must have been many who helped fight this scourge. I am certain they exist. But they do get overshadowed by the “Burn in hell, fags” signs from this period. I suppose God could be an intolerant God. I have never met God. But if he is as cruel as these people made him out to be, then, like that sixteenth-century Cuban, I’d rather take my chances in hell with the devil.
The stigma around AIDS rivaled that around syphilis. Remember that character who said that you wouldn’t even want to share a room with someone with syphilis, let alone shake hands with him? People were equally afraid to touch people with AIDS, likely because it took a monstrously long time to get information on how the disease actually spread. As late as 1985, Reagan wasn’t exactly sure whether children with AIDS should be in schools.
In some cases, even the families of those with AIDS forsook them. Ruth Coker Burks, who cared for thousands of people dying of AIDS, recalled in The Arkansas Times the number of families who abandoned their children in the early days of the epidemic. She recalled her first experience calling a mother who hung up on her:
“I called her back,” Burks said. “I said, ‘If you hang up on me again, I will put your son’s obituary in your hometown newspaper and I will list
his cause of death.’ Then I had her attention.”
Her son was a sinner, the woman told Burks. She didn’t know what was wrong with him and didn’t care. She wouldn’t come [to see him], as he was already dead to her as far as she was concerned. She said she wouldn’t even claim his body when he died. It was a curse Burks would hear again and again over the next decade: sure judgment and yawning hellfire, abandonment on a platter of scripture. Burks estimates she worked with more than 1,000 people dying of AIDS over the years. Of those, she said, only a handful of families didn’t turn their backs on their loved ones.
Burks hung up the phone, trying to decide what she should tell the dying man. “I went back in his room,” she said, “and when I walked in, he said, ‘Oh, momma. I knew you’d come,’ and then he lifted his hand. And what was I going to do? So I took his hand. I said, ‘I’m here, honey. I’m here.’”12
This parental rejection reminds me of the children dying of bubonic plague who cried: “Father, why have you abandoned me? Do you forget I am your child? O, Mother, where have you gone? Why are you now so cruel to me when yesterday you were so kind? You fed me at your breast and carried me within your womb for nine months.” But at least parents during that earlier plague did not feel righteous about abandoning their children.
Those who had AIDS survived because they, like Mr. Crumpton’s No Nose’d Club for syphilitics, founded groups like the Gay Men’s Health Crisis and ACT UP to fight for their right to live. They supported one another. They protested. They yelled. They made people extremely uncomfortable.
Good for them.
There should be a statue to the leaders of those groups who fought to exist in a time of almost unrivaled hatred and foolishness in the United States.
The horrible mismanagement of the AIDS crisis makes me want to grab those people by the shoulders and shake them and say, “Why haven’t you read about what worked or did not work every time a plague cropped up before this one? Why aren’t you paying attention? Do not do the same stupid stuff people did before! We know what works and what doesn’t! Be smarter, please, please, be smarter, be kinder, be kinder and smarter, I am begging you.”
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