Didn’t Die From Measles? Thank Clean Water, Not a Vaccine

There’s no doubt that vaccines (inoculations) work to protect against infectious disease. They reduce incidence rates dramatically and thus reduce symptoms:

In the above chart, it’s clear that measles inoculation decreased incidence and no doubt its symptoms. But it’s not really clear what impact inoculation has against mortality.

When compared to mortality rate, the introduction of the vaccine looks much less impressive:

And the broader trend across other infectious disease is similar:

It’s clear that there was something else reducing the mortality from infectious disease. Dr. Andrew Weil sums it up:

Scientific medicine has taken credit it does not deserve for some advances in health. Most people believe that victory over the infectious diseases of the last century came with the invention of immunisations. In fact, cholera, typhoid, tetanus, diphtheria and whooping cough, etc, were in decline before vaccines for them became available – the result of better methods of sanitation, sewage disposal, and distribution of food and water.

The 1977 study by John B. McKinlay and Sonja M. McKinlay, titled “The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century,” published in the Milbank Quarterly, extends Thomas McKeown’s thesis—originally focused on England and Wales—to the U.S. context. The authors analyze historical mortality data from 1900 to 1973, arguing that specific medical interventions and the expansion of health services accounted for only a small fraction of the overall decline in U.S. mortality rates.

The primary drivers of this decline to non-medical factors, including rising living standards (particularly improved nutrition), better hygiene, and sanitation.