Recently I had a long discussion with some fellow parents about the merits of vaccinations. I have to confess that when it comes to vaccinations I have drunken the Kool-Aid. I believe that vaccinations have been responsible for saving hundreds of millions of lives and improving the quality of life of billions more. As a kid growing up in New Zealand I received all of the recommended vaccinations. When I was in the process of moving to the United States the immigration service had to have proof of my vaccination history and the easiest way to achieve this was to be re-vaccinated for everything. Also because I have worked in a number of developing countries I have received vaccinations for a range of less well-known lurgies.
In my view vaccinations are a public health issue. We have been lucky in the developed world to not see epidemics of polio, whooping-cough, rubella, measles and the list goes on. Vaccinations have been the major driver of the near eradication of many of these diseases.
It is therefore incredibly worrying to see that diseases like Polio starting to pick up in places like Syria and Pakistan. Polio is a horrible disease that can be fatal and can lead to long periods of hospitalization and lifelong disabilities. Polio disproportionately affects children under the age of five.
You may wonder why we should be concerned here in America about the resurgence of Polio out there in the rest of the world. The reality is that these days – as far as disease is concerned – there are no borders. A person exposed to Polio in Syria today – if they have not been previously immunized could be a unknowing carrier in Seattle tomorrow. What makes matters worse is that in many of the more affluent pockets of America immunization rates for diseases such as Polio have fallen way below the target 90 percent level that is thought necessary to stop epidemics.
So why do parents not get their children immunized. The reasons I heard in the above mentioned discussion are:
- our children are healthy – and can therefore cope with diseases.
- its better for a child’s immune systems to not be immunized.
- there are risks associated with vaccines that outweigh the risks of the diseases.
- there is a link between vaccines and autism.
- there is a link between vaccines and autism for the next generation (i.e. we can pass on susceptibility to autism that we gained through vaccination to our children).
- there is a distrust of western medicine and western doctors.
These views are not extreme. Google “Vaccinations” and within a few hits you will see many of these same ideas being touted. There is also a kernel of truth in some of these items. Vaccines are not risk free. According to the CDC the chance of a serious allergic reaction to the MMR vaccine is about 1 in a million. If you are the parent of that one in a million child then that does not feel like it is a rare occurrence. If on the other hand your child does get measles there is a 15 percent chance of pneumonia, measles croup or convulsions. Two unlucky children in every thousand will on average contract encephalitis, which in turn can lead to brain damage and death. One incredibly unlucky child in every 100,000 may get subacute sclerosing panencephalitis which causes progressive brain damage and nearly always results in death. Catching measles is many times more likely to cause death than being vaccinated – but it is true that vaccinations are not risk free.
On the other hand there is no truth to the myths that there are links between autism and vaccinations. This myth derived from bad research – since disproven and withdrawn – but the myths persist.
The hardest argument to counter is that western medicine and doctors can not be trusted. This is an area that we work on at NWABR. People trust people who are honest, who acknowledge mistakes, who acknowledge that they do not know everything, and who continually strive to improve. At NWABR we are working to both show all of the amazing gains that biomedical research has brought to the world and to also be as honest as we can about areas where things went wrong and where we need to do more work. We believe that there is no other way to rebuild trust – that has so clearly been lost.
I can’t persuade any person to change their mind about vaccinations. But what I can do is really hear their concerns, attempt to distill some clarity from all of the opposing positions and provide data to support conclusions. The parents that I was talking to will do what they will do. Their children are healthy and for them the risks are definitely at the low-end. My only hope and wish is that if their children ever do become sick that they don’t then unwittingly become carriers of their disease. Their children’s robust systems may well be able to cope but the record low levels of vaccinations do mean that many more people will get to share their disease, and some of those people will not do so well.