Vaccines and proportionate risk

I live in an area where most of the parents I know are college grads.  It is amazing to me how many of them (not the majority, but a significant number) have decided not to vaccinate their children because of the “risk.”  The risk, of course, is the possibility that a child will have a bad reaction.  That risk is real, but small.  Certainly it’s small compared to the number of children who used to die or become permanently damaged because of measles or polio or diptheria, or any number of foul illnesses.  Indeed, if you want a feel for what real risk is about, watch the spread of polio through Islamic countries that have decided for ideological reasons to halt vaccinations, or in Africa, where a combination of poverty, war and ideological beliefs has stopped vaccinations.

In any event, one Marin doctor is trying to turn the tide amongst those people here who have an irrational fear of vaccinations:

I assisted on the autopsy of a 1-year-old boy who had died of hemorrhagic pancreatitis, secondary to infection by an organism called “hemophilus” or HIB. Pancreatitis is one of the most painful conditions that humans can experience. As I looked at this infant’s damaged pancreas, I could not imagine his excruciating pain and his inconsolable distress, not to mention the heart-wrenching loss suffered by his parents.

Aside from causing pancreatitis, this species of hemophilus was also responsible for outbreaks of deadly bacterial meningitis, mostly in children. Until 20 years ago, up to 1 in every 200 children was affected with some illness caused by HIB. Emergency physicians were always on guard against epiglottitis, which could cause total airway obstruction in a child.

Then 20 years ago, a vaccine against this bacteria arrived. Soon, millions of children were receiving it, including my infant son. I have not seen a case of HIB meningitis or epiglottitis since then. The incidence of HIB (that is, the number of new cases per year) has dropped 99 percent since 1985. The current cases occur almost exclusively in unvaccinated or insufficiently vaccinated children.

The same story can be told about rubella. Once a major cause of birth defects, now is all but eradicated in this country. What about polio and smallpox? They’re gone.

I recently attended a meeting of employers trying to gain some control over the skyrocketing costs of health insurance. During our lunch break, we were having an informal discussion of childhood immunizations. One of the insurance executives at the meeting told me his belief that childhood immunizations were required solely in order to make more money for the drug companies.

I said, “Oh, my goodness.” (Actually I didn’t say that, but I cannot print what I really did say.) However, I did proceed to inform him how I felt that he was misinformed.

Dr. Gross explains in his article that vaccines do carry risks, but that they are lower than the risks of doing without vaccinations.  Heck, in this age of biological warfare, whether waged by nations, Non-Governmental Armies, or individual nutcases, I’d happily hie me and my family off to get a smallpox vaccination.

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  • Steve

    While I firmly believe in the right of an individual to elect whether or not to have a vaccine applied to themselves (e.g. the anthrax vaccine issues of the military), I believe that a parent has an obligation to act in the best interest of their child. In a vaccination situation, considering the weight of the alternate risks (of suffering a reaction from the vaccine or the increased likelihood of serious injury if the vaccine is not applied) and the representative costs to the individual or the community (community being the neighborhood, the insurance community, the city at a public clinic, whatever), then I would say that the better course of action is to require the vaccinations in one’s children.

  • Earl

    I’m having to think about this because I’ve got a grandchild on the way….. My bias lies totally with vaccinations, although I believe I’d be cautious about loading a baby up with a whole bunch at the same time. We know little enough about the operation of the immune system in the early months to make me wonder about that.

    I think I’d give the things that are a serious threat to babies for sure….DPT, for instance, at two months (or whenever) for the first one. But perhaps one might depend on Mom’s antibodies in a nursing baby for a while on some of the rest.

    I have some real question about why are some folks pushing hepatitis vaccination for little kids, and maybe we could talk about the realistic risk of actually getting chicken pox, mumps, red measles, and some of the other “childhood diseases” of my youth. Maybe if the kid hasn’t had them by 15 or so, get a vaccination….but what are the real trade-offs earlier? When I was growing up, we all got that stuff because there WAS no vaccine.

    Does anyone have actual data on the risk of these traditional diseases in the young?

  • Joseph Libson

    Comment 1, Steve: I am pro vaccination, but it is not the role of govt to enforce it.

    Comment 2, Earl (“cautious about loading a baby up with a whole bunch at the same time”): In my experience with pediatricians the administration of vaccines is typically done with a great deal of thought and care wrt the schedule of the shots.

    My turn: Has anyone noticed the bizarre connection between anti-vaccine propaganda and chiropractors?

    If you ever go to a chiropractor check out the books on the table. I will be very surprised if you don’t see at least one book talking about the evils of vaccinations (and modern medicine in general).

    BW, my guess is your neighbors have enough disposable income to visit back-crackers. And they might have had a sip of the kool-aid.

    Joe (with 3 healthy vaccinated children)

  • Bookworm

    Joe: you’re absolutely right about my community. The first place people go when they’re ill is their chiropractor. The second, their homeopath. I think both are placebos, and worry that my friends will be deprived of the chance to address serious medical concerns. But it’s a free country, and the market will do what the market does. I’m just grateful that I have access to modern medicine.

    I’m especially bewildered by homeopathy. It arose as a virtuous practice in the early 19th Century when people were being bled for everything and stuffed with poisonous mercury to treat myriad diseases. Homeopathy, which relied on “magic” water, may not have helped, but it didn’t kill, the way the “medicine” of the time did. Nowadays, I struggle to find any justification for homeopaths. (By the way, this is a good skeptic’s article about homeopathy:

  • Ymarsakar

    The only alternative medicine that works is acupuncture and perhaps meditation.

    There’s nothing magical about it, it just allows the body to use its own healing systems better. But as someone who hates and who shots, I’d rather have them available to me than not. I had an immunology shot in my leg, but because the nurse put the bandaid on the wrong spot, somehow my leg got inflamed and it was quite painful for awhile. Or maybe it was an allergic reaction, however I just got a recent shot, 2 in one arm, the other 1 in the other arm, and I didn’t get any reaction.

    I don’t like foreign things sticking in me and I sure as heck don’t like things injected into my bloodstream that burns like hell fire. Heck just talking about it makes my arm phantom ache.

  • erp

    Y, your reaction may have been brought upon by nerves.

    Vaccinations have been such a boon to our society, their use can’t be over emphasized. My kids, now in the 40’s, wouldn’t be admitted to the public schools without proof of vaccination. When did that become optional? Another legacy of the lunatic left’s thankfully now defunct cultural revolution.

    I remember as a kid that every September when school started again, many kids were missing. Victims of polio. So dread a disease was it in the 40’s and 50’s that our summers were ruled by vague rules of what we were and weren’t supposed to do because at that time little was known about polio and the only treatment was to try to keep the patients alive and as comfortable as possible.

    After decades of research, a 100% effective preventative is available for pennies and even given free at clinics. To withhold this life saving vaccine is, I think criminal. The same is true for other preventable childhood diseases. Anyone not familiar with the dangers of childhood diseases to children and adults, should do an internet search before risking all of our health.

    I guess human nature is such that we must continuously re-invent the wheel.