Nov 28 2009
Chiming in on the Vaccination ‘Debate’
I don’t have children, and the jury is out on if that will happen. But i have read a little about having babies and raising children. I have a few ideas about how i want to do things. In the course of my reading, i stumbled onto the idea that vaccinations are not something you should blindly succumb to. “Vaccinations are risky…the big medical companies are just out to make a profit…” etc, etc.
These are easy things to believe because there’s a big bad guy out there that you can point a finger at, and you can save yourself by taking action, or in this case, not taking action (not getting vaccinated, or not having your children vaccinated). My mind was open to this line of thinking.
Not anymore. An article from Wired Magazine called An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All really got through and changed my mind. (It’s not a short article, so be prepared for a lengthy read.) Their most convincing argument was simply to make me realize that i have no idea what i am talking about. I am not a doctor, nor are the parents who want to end mandatory vaccinations. The second most powerful argument comes from a psychology perspective - the idea that we are or should be or can be in control of our own safety, and how that idea affects us.
Ah, risk. It is the idea that fuels the anti-vaccine movement — that parents should be allowed to opt out, because it is their right to evaluate risk for their own children. It is also the idea that underlies the CDC’s vaccination schedule — that the risk to public health is too great to allow individuals, one by one, to make decisions that will impact their communities. (The concept of herd immunity is key here: It holds that, in diseases passed from person to person, it is more difficult to maintain a chain of infection when large numbers of a population are immune.)
That actually makes sense to me. I’m all for individual power, but the idea that individual persons may end up jeopardizing the community at-large is a little bit scary. To be a part of a community, i think we have to allow certain decisions to be made for us that are in the best interests of all.
In 2005, a 17-year-old Indiana girl got infected on a trip to Bucharest, Romania. On the return flight home, she was congested, coughing, and feverish but had no rash. The next day, without realizing she was contagious, she went to a church gathering of 500 people. She was there just a few hours. Of the 500 people present, about 450 had either been vaccinated or had developed a natural immunity. Two people in that group had vaccination failure and got measles. Thirty-two people who had not been vaccinated and therefore had no resistance to measles also got sick. Did the girl encounter each of these people face-to-face in her brief visit to the picnic? No. All you have to do to get the measles is to inhabit the airspace of a contagious person within two hours of them being there.
OK - that’s a lot scary. Who wants to volunteer to forgo the measles vaccine after reading that?
The article anchors itself around Paul Offit, a pediatrician and a proponent for vaccinations who has even developed a vaccine himself. He’s taking a very public stand in what has become a controversial debate about whether vaccines can cause autism. He adamantly says no.
And he <Paul Offit> wants Americans to be fully educated about risk and not hoodwinked into thinking that dropping vaccines keeps their children safe. “The choice not to get a vaccine is not a choice to take no risk,” he says. “It’s just a choice to take a different risk, and we need to be better about saying, ‘Here’s what that different risk looks like.’ Dying of Hib meningitis is a horrible, ugly way to die.”
That’s an important point. Is it possible that we are forgetting how awful these diseases are?
…by a 2002 study published in The Journal of Infectious Diseases. Looking at 3,292 cases of measles in the Netherlands, the study found that the risk of contracting the disease was lower if you were completely unvaccinated and living in a highly vaccinated community than if you were completely vaccinated and living in a relatively unvaccinated community. Why? Because vaccines don’t always take. What does that mean? You can’t minimize your individual risk unless your herd, your friends and neighbors, also buy in.
Perceived risk — our changing relationship to it and our increasing intolerance of it — is at the crux of vaccine safety concerns, not to mention related fears of pesticides, genetically modified food, and cloning. Sharon Kaufman, a medical anthropologist at UC San Francisco, observes that our concept of risk has evolved from an external threat that’s out of our control (think: statistical probability of a plane crash) to something that can be managed and controlled if we just make the right decisions (eat less fat and you’ll live longer). Improved diagnostic tests, a change in consumer awareness, an aging society determined to stay youthful — all have contributed to the growing perception that risk (of death, illness, accident) is our responsibility to reduce or eliminate. In the old order, risk management was in the hands of your doctor — or God. Under the new dispensation, it’s all up to you.
That last paragraph is something that really hit home for me. I am a bit of a control freak (Lance is nodding his head at that!), and i do tend to think that i can become informed about the choices i have to make and thus make better ones. To a degree, this is true. But at some point i have to stop and admit that i can’t out-think people who have made a life’s work out of something i’m trying to google in 15 minutes.
It’s a very interesting article, and i would encourage reading it if you have the time. Share with me what you think.
