Vaccination vs. Disease: Which is worse?

It is very reasonable for a parent to worry about vaccines. For one thing, most of them involve sticking the baby or child with a sharp object, thus making the little one cry, and it would be abnormal to not have an automatic reaction to that. For another thing, they are drugs, in a sense. When the little one is ill, and you call in to the health care facility in the hopes that there will be some useful advice, most of the time you hear "No, we no longer recommend giving [fill in the blank with a medicine you thought might work] to children under [one or two months older than your child]. But if [symptom] persists for more than [amount of time that is 12 hours longer than the symptoms ever persist], call back."

[This is a repost in honor of Get Your Flu Vaccination Week. Which is now. Did you get your vaccination yet?]

So, on one hand, health professionals are telling us that our desire to slip the little one a little cold medicine is undesirable, but they, the health professionals, want to stick our babies with needles in order to deliver literally dozens of different concoctions. Indeed, the experience is so traumatic for the babies that the pediatricians will have nothing to do with it. Typically, if your child is seen by a pediatrician at the same visit that s/he would receive a vaccination, the pediatrician will look the child over first, then get the hell out of Dodge before the inoculations nurse shows up with the needles. This way, the child does not learn to hate the doctor. This whole experience is tough for any parent, and it must be especially tough for adults who happen to have Trypanophobia, which is not very uncommon.

When Julia (now a teenager) was an infant, her pediatrician told me that one of the reasons she liked being in that particular sub field of medicine is that, as it turns out, she did not have to see a lot of people who were suffering with terrible illnesses, and her patients, basically, never died. Children who become severely ill are seen by specialists, and such cases are more often than not some form of cancer or other non-infectious disease. But clearly that was not the case in the past in the US and other Westernized countries. Those working with ill children in some parts of the world need to become quite accustom to their deaths. I've had the opportunity to work with those who are ill in non-Westernized places. I've probably seen more babies die than Julia's pediatrician has. A very large percentage of the babies and toddlers who contract malaria in the Congo do not survive. Well, they may survive a bout or two, but eventually, a very large percentage die before their immune system is able to handle the parasite. However, in the past, in the US, babies, toddlers and young children often died of a wide range of diseases that are now routinely treated (like infections) or routinely avoided entirely ... by vaccination.

What a parent has to do when watching their baby getting poked with the needles, or when looking at the very long list of childhood vaccinations that we expect to be carried out on all infants and toddlers these days, is to relate the vaccination to what it is good for. If there is a vaccination that you can honesty, comfortably claim prevents a disease that you would not mind having your child come down with, then ask that needle-bearing vaccinations nurse if it is possible to avoid that particular one. But do make sure you are honest with yourself, and for that, you may well have to reach beyond your own immediate discomfort and look at history.

Paul Offit's new book, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, does this. He begins by going into recent history to look at several cases of unvaccinated individuals picking up a disease and spreading it among other unvaccinated individuals, to cause mini epidemics that give a flavor for what would happen if vaccination was widely rejected. He looks at the history of medicine focusing on anti-vax or vaccine-fearing rhetoric and related events. Again and again, he pits fear of vaccines against the consequences of non-vaccination, and the vaccines, and the practice of vaccination, pretty much win out.

The key message of Offit's book is that the Anti-Vaccine movement harms all of us by producing an increased number of vectors for very nasty diseases that have seemingly disappeared but really haven't, and by decreasing herd immunity.

Offit is well known among anti-Vaxers for his earlier book (Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure). He is a highly qualified expert in the field (I know, to conspiracy loving paranoid people this makes him evil) as an actual vaccinologist and infectious disease expert. In this book, he effectively addresses claims that vaccines cause autism, cancer, and other disorders or diseases. In particular, he analyzes how parents of sick kids have been fed misinformation and developed as anti-vax crusaders by the operatives in the anti-vax movement, as well as how the entire anti-vax message is used as media fodder, and serves as a potential source of income for ambulance chasing lawyers. What makes Offit's book especially interesting is the way in which he brings this discussion well into the past. It turns out that there has been an anti-vax sentiment of one kind or another since there have been vaccines. For instance, when the smallpox virus was first developed, the anti-vaxers of the day made the claim that, since it was derived from a cow-pox source, it would turn people into cows. (As it turns out, that didn't happen!)

Accomodationist medical journalists and celebrities who seem to drive the anti-vax movement are roundly criticized in Offit's book. Even Bill Maher is scathed.

In the end it is not possible for a reasonably intelligent fence sitter to read this book and honestly walk away with anything left of their anti-vax feelings.

During Huxley's pre-natal months and first several months after he was born, the whole vaccination thing came up several times. Other parents in some of the same "classes" we were in, relatives, etc. expressed either concern about vaccines or routine ignorance about things like flu immunity. If Deadly Choices: How the Anti-Vaccine Movement Threatens Us All was available then, I would have been handing out copies. Seriously.