Vax On

Lately I’ve been poking the vaccination debate beehive on social media sites. Mostly, this comes from my own auto-response to reading non-scientific nonsense – it bugs me when I read or hear someone basing the argument for their irresponsible behaviour on bad science, conspiracy theory or freedom of choice.

Why is it that we allow people to choose to not vaccinate their children, while at the same time prohibiting peanut butter in school lunches? Food allergies are just as real and dangerous as mumps and measles – and potentially more deadly, when you consider that viruses can be spread much more widely than peanut butter – but we allow one to be a matter of parenting philosophical choice and the other to involve the suspension of a 1st grader and public pillorying of a parent because of a cookie.

Unless someone cannot – for real medical reasons, such as being immuno-compromised – be vaccinated, it is irresponsible to not be. The benefit to others far outweighs any perceived risk or infringement of personal choice. Good hygiene has taught most of us to cover our mouths when we cough or sneeze; immunization is a systematic extension of a handkerchief, protecting us and those around us from the spread of germs.

The science is clear – immunization works to prevent disease. It prevents it by training the immune system to recognize, respond to and wipe out the virus before it can take hold, thus protecting the individual (I know this is a significant over-simplification). A concomitant – and arguably much more important – benefit is that, by reducing or preventing the illness in one person, it reduces or prevents the infection of others. This is science, and is based on a preponderance of peer-reviewed evidence, both of the biology itself as well as 50 years of epidemiology.

Does it work 100% of the time? Of course not. Biology being biology, there are always anomalies – sometimes people who are vaccinated still get ill. But it does work the vast majority of the time. One thing that can assure that it doesn’t work: not getting vaccinated. Unless there is a medical reason to not get vaccinated, everyone can and should be vaccinated. Don’t believe me? Ask the families in developing nations who trek many miles to receive immunizations; they can tell you that measles are, in fact, that bad (as are whooping cough, mumps, and smallpox).

And the connection to autism? In the first place, it’s complete bunk. But also, autism is neither deadly nor completely debilitating. To use bad science as a reason to avoid a risk of autism is saying you prefer a disease that is potentially deadly to you and others over a potentially difficult but not life threatening disorder that plenty of people live with daily. Also, it’s complete bunk.

Regarding conspiracy theory and Big Pharma, I’ve yet to hear a cogent outline of what the evil corporate end-game is for pushing harmful vaccines. Yes, they are corporations and have to (and do) make money, and yes, they have made errors in the past about safety and efficacy. Which is why it’s important to get the facts, but to get the facts and say, “well, I still don’t trust them because they’re big corporations and so must be bad” is foolish. Want to stop using other Big Pharma offerings such as analgesics and anesthetics and chemotherapy? It’s still foolish but go ahead – the only one you’re hurting is yourself. But immunization is about more than you – it’s about everyone you may come in contact with, which in today’s global world is EVERYONE. So that’s foolish and irresponsible. And did I mention that it’s complete bunk?

As for freedom of choice, freedoms also come with responsibilities and with costs. Responsibilities include making your choices knowledgeably and considerately. Costs include the potential impact on others. One person’s choice to not get vaccinated or to not vaccinate their children, when that choice is based on misinformation, can have considerable cost to others and to an already burdened health care system.

I recently had a discussion about how the different the world would be without interventions such as vaccines or other modern medical advances. The premise was: given that not everyone who gets measles/smallpox/ebola dies from it, are those survivors the fittest among us? Considering Darwinism, are we interfering with survival of the fittest by preventing the deaths through medical intervention? My answer was yes, we are interfering with it, but that that’s a hallmark of mankind – we mess with things, ideally for the betterment of the species. The downside (and the reality) is that, in doing so, we enable population growth without managing the other impacts (environment, economy, food supply, to name a few).

But where would one draw the line in terms of acceptable intervention (such as washing vegetables or cooking meat before eating it, or setting a broken bone) and disturbance of natural order (penicillin, ibuprofen, insulin for diabetics, birth control, and vaccines)? So yes, interventions are interference, but defensible as for the greater or public good. Those who opt out of immunization are undermining that public health good, exercising their freedom of choice to the risk and detriment of others.

The harsh reality is that some parents may lose their children because of the choices others make with theirs. This is the entire basis of the no-peanut-butter rule, so why shouldn’t it also apply to immunizations? Part of being a society is that our actions should consider the impact on others as well as ourselves. The negligible risk and cost of immunization are far outweighed by the benefit to other individuals and to the population-at-large.

Disclosure statements:
1. I am neither a parent nor a teacher, but I know several of each.
2. I have been vaccinated – MMR, Hepatitis, and influenza. Current immunization is a requirement in my workplace, where I may contact patients who are immunocompromised or just generally have enough to deal with without adding the flu or whooping cough to their problems.
3. I am have no food allergies that I’m aware of. I occasionally have peanut butter in my lunch.

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