Wednesday, March 11, 2009

Tithonus and the rubella vaccine

I routinely inoculated children in my practice. My children were vaccinated. I love vaccines!
This is just one tiny discussion about one small aspect about vaccines.

Coldly thy rosy shadows bathe me, cold
Are all thy lights, and cold my wrinkled feet
Upon thy glimmering thresholds, when the steam
Floats up from those dim fields about the homes
Of happy men that have the power to die,
And grassy barrows of the happier dead.
Release me, and restore me to the ground;
Thou seest all things, thou wilt see my grave:

Thou wilt renew thy beauty morn by morn;
I earth in earth forget these empty courts,
And thee returning on thy silver wheels.

from Tithonus, Alfred Lord Tennyson

At 14 weeks, a developing human has toes. The heart beats. She pees, she swallows. Conscious? No way to know.

In July, 1962, I was just learning to talk, a bit late. During that month, a fetus conceived by a married Swedish couple had the misfortune of falling late in the birth order. She was not wanted. 3 months after conception, she was scraped from the womb. She still exists, at least as cells derived from her lung.

Her name is WI-38.

When I was 7 years old, back in 1966, a 14 week's mother induced his abortion because of psychiatric issues. We know that the fetus was a "he"; we know that his mother was an otherwise healthy 27 year old woman.

His name is MRC-5.

I am aging now--bodies fall apart. Modern medicine promises me big things on the horizon--soon I will be able to regenerate brain tissue, synovium, marrow. If I can hang on long enough, I may never have to die.

WI-38 and MRC-5 are immortal. They live as cell lines perpetually propagated, and are used in the development of many childhood vaccines. They help protect us from rabies, polio, and hepatitis A.

Oh, yes--and rubella. My mother taught in elementary school in 1958, back when I was a fetus. She was exposed to rubella, before a vaccine was available. I am lucky. A little hard of hearing, perhaps, but otherwise OK.

In 1994, Britain required rubella immunizations for its youth, a vaccine developed from MRC-5's cell line. A few conservative Catholics objected.

No alternatives for the vaccine were available. The Catholic bishops left it up to individual families whether to accept the vaccine.

(Bonum ex integra causa, malum ex quocumque defectu. "Goodness arises from an integral cause, evil arises from any defect whatsoever." Roman Catholicism has flaws--I left the Church long ago, when I may have been too young to know better. Underneath the dogma, however, wisdom survives.)


Rubella virus causes "German measles"--children get a relatively mild illness with fever, rash, and swollen glands. It goes away in a few days.

Infection early in pregnancy, however, often results in severe disease to the fetus. Congenital rubella syndrome (CRS) can cause severe birth defects--cataracts, deafness, heart defects, and mental retardation. It still occurs. I have seen one case.

(Case is a way to deflect the reality--it was not a "case"--it was a child.)



American physicians are predicting we will soon see CRS eradicated in the Western hemisphere.

MRC-5 will not be unemployed, though--his cell line has many other uses.

Tithonus was condemned to a uselessly aged body, MRC-5 to a uselessly young one. When cloning becomes possible, MRC-5 deserves to be in the front of the line.

This week President Obama lifted the Bush administrations restraints on using new embryonic cell lines. The issue had become a political football. Still, it is not enough to be "on the side of science" or "on the side of God." Many quick to dismiss Bush's objections do not know a stem cell from a daffodil.

Where do I fall? Ask me over a Guinness. You will get an honest answer, but maybe not a straight one.

This was written a few years ago, when I still practiced medicine. I am not an "anti-vaxxer," but I am an anti-dogmatist.
The cells are WI-38, from here.


John Spencer said...

Despite the fact that I practically swim in gray, I have a strong sense of justice. I'm pro-life, which means I'm against war, against the death penalty, against rednecks shooting immigrants trying to get a better life, in favor of health care, but also against abortion and against doctor-assisted suicide and I'm not crazy about the stem-cell idea (though it can save lives - after all, "saving lives" was justification for using the atomic bomb).

I rarely share my thoughts on these, especially when it's all in one laundry list like that. But when, too my core, I believe we are all broken and beautiful at the same time, I can't help but think everyone should get a chance to live.

doyle said...

Dear John,

Never figured you for the black-and-white crowd.

I think Wes Jackson said it best--"we ought to stay out of the nuclei."

Bet a Guinness would taste extra good chatting with you.

John Spencer said...

I'm really pretty gray despite this. For example, I'm personally pro-life, but politically I believe in legal abortion, because I'd rather save one life in the process. Still, the thought of it really makes me sad.

I never used to believe that until I had my own kid. It wasn't the ultrasound that did it. To me, the ultrasound was like a fuzzy cartoon. It was the kicking and moving that I swear responded to my voice (bad science I'm sure, but not bad for someone who believes in poetry)

The older I get the stronger and fewer my convictions become. I'm more pro-life than ever, but I can also see the complexity of the issues.