Andrew Tyler of the London Evening Standard recently told me that the National Health Service pays a substantial bonus to physicians with documented vaccination rates over 70%, and a still higher increment if the figure tops 90% (13. His drift seemed to be that the overly civilized British need only informal pressures and inducements to obey authority, while the more rebellious, outspoken Americans have to be coerced with laws and penalties. If that is true, I can understand why you wanted to fetch somebody from America, and I shall try not to disappoint you.

My interest in vaccination arose out of a "gut" feeling not to do it that I have devoted a considerable part of my career trying to clarify. In this as in so many other ways, the study of homeopathy has helped me to articulate what my heart and soul already seemed to know. To recognize the organism as a totality of symptoms already implies that any more narrowly defined standards of vaccine effectiveness cannot possibly be adequate. Other glaring inconsistencies include enforcing compulsory vaccination laws in the absence of any public health emergency, and waiving the rules of scientific inquiry in their honor.

These special privileges give some measure of the reverence accorded to vaccines in what can on]y be called the "religion" of modern medicine (2). Its theology was admirably summarized by the French physiologist Claude Bernard well over a century ago:

What we call the immediate cause of a phenomenon is nothing but the physical and material conditions in which it exists or appears. The object of the experimental method and the limit of every scientific research is therefore the same for living as for inanimate bodies. It consists in finding the relations which connect every phenomenon with its immediate cause, or, putting it differently, defining the conditions necessary for the appearance of the phenomenon. When the experimenter succeeds in learning the necessary causes of a phenomenon, he is in some sense its master. He can predict its course and appearance; he can promote or prevent it at will.

As a corollary to the above, neither physiologists nor physicians must imagine it their task to seek the cause of life or the essence of disease. That would be entirely wasting one's time in pursuing a phantom. The words "life" and "death," "health" and "disease," have no objective reality. Only the vital phenomenon exists, with its material conditions. That is the one thing that they can study and know (3).

Precisely as Bernard foresaw, the search for identifiable components of human structure and function and for powerful technologies to control them has obscured the need for and even the possibility of any unifying concept of life or health against which to judge them. To be considered effective by present standards, vaccines need only satisfy two statistical criteria, i.e., reducing the incidence of the corresponding acute diseases as low as possible, and demonstrating measurable titers of specific antibodies in the blood.

Vaccines have become sacraments of our faith in biotechnology in the sense that 1) their efficacy and safety are widely seen as self-evident and needing no further proof; 2) they are given automatically to everyone, by force if necessary, but always in the name of the public good; and 3) they ritually initiate our loyal participation in the medical enterprise as a whole. They celebrate our right and power as a civilization to manipulate biological processes ad libitum and for profit, without undue concern for or even any explicit concept of the total health of the populations about to be subjected to them.