Wednesday, February 04, 2015

"Childhood Diseases" and Vaccination



Science education matters. It is, if you will, an inoculation against the spread of misinformation and fear. Such as the fear of inoculation itself. Vaccines.

Mistrust of authority figures is a different matter - and the mistrust is justified by the conditions under which we live. It is not, however, a reason to make bad medical decisions.

There is a measles outbreak in the United States, a disease declared eliminated in 2000. We had the disease under control due to a very effective vaccine. But the disease existed, fanned by travel and contact with unvaccinated people, as measles has a larger presence in some countries. In other words, by declaring it "eliminated" we were declaring the disease under control. Nonetheless, we now have an outbreak and as political leaders and would-be national candidates weigh in it is apparent that junk science has a great deal of currency. A United States Senator even claimed this week that vaccines lead to mental disorders, which he said on tape and yet tried, lamely, to deny that he said what he said.

A growing "anti-vax" movement is the major factor in the outbreak, but there is also this idea that these childhood diseases are minor, no big deal. Because these diseases have been kept under control for so long - thanks to vaccination - a lot of people forgot, or never learned, that these diseases can lead to complications with long-term damage, permanent damage, even death.

I learned this lesson when I got chicken pox at age 27.

My parents are positive that I had chicken pox as a child and in any case I had had the regular panel of vaccinations. I remember having mumps, as well, during my elementary school years. I don't understand how I could be re-infected, but there was no denying I had chicken pox. It was during my second year in graduate school. I fell ill and broke out, I went to a doctor and got the diagnosis, and he sternly told me to stay in bed. This was in part to contain my disease and also because the complications were extremely serious, including pneumonia and encephalitis. How long should I stay in? Until the pox had dried up and gone.

I was in bed for a month.

And I mean, in bed. I lived alone in an apartment on Candace Street in Providence. My girlfriend looked in on me but didn't stay long. It was easy to stay in because as my body fought this "childhood disease" I was drop-dead exhausted all the time. It kicked my ass. And itched. Oh, the itching. Nothing helped very much.

I did not get pneumonia or encephalitis, but I developed Bell's Palsy, which left half my face paralyzed for several weeks and to this day, 17 years later, my face still goes asymmetrical at times.

We think of childhood diseases as not a big deal. Kids get 'em, they beat 'em, they don't even remember having them. But these diseases are a big deal. Vaccinations don't literally eliminate these diseases. Elimination means "the absence of continuous disease transmission for 12 months or more in a specific geographic area" according to the Centers for Disease Control and Prevention.
 
The media seems to love the question of whether vaccinations should be legally mandatory. This is distinctly a different question than, "Should kids be vaccinated?" The latter is a no-brainer. (We will get to the common objections in a moment.) Yes, vaccinate your kids. Yes. That's an easy question with a correct answer. The answer is yes.

The question the media wants to explore because it makes for good debates on television and lights up the libertarian left and right is "should government require you to do this thing?" Another United States Senator (we are electing some prize turkeys lately) even called question to health codes requiring employees who serve food to wash their hands after using the toilet, completely ignoring what is known - commonly known, in fact - about Eschericia coli bacteria.

What no one has said yet is that making it a legal requirement would not be necessary if we could defeat the misinformation and help people understand that vaccination is, from a medical standpoint, a settled matter and the ethical equation rather simple. We shouldn't need state coercion any more than we need a state to require us to look both ways, and once back again, before crossing a street.

But there is a lot of misunderstanding and fear about vaccines, a lot of strongly prevalent rumors. For heavens sake, we have a prominent and popular television personality insisting absent any scientific evidence that vaccines are linked to autism. At the same time, there is also a lot of mistrust of government and the medical industry, the former being in service to corporations in the latter, and the latter having been willing to push medications and cut corners on safety in order to enhance its profits.

People worried or unconvinced about vaccines should of course be free to make their own decisions - GOOD decisions, sound decisions, decisions based on good information and sensible thought. We have this fallacy that everyone is entitled to hold whatever opinion they like. Some confuse this with freedom of speech. But there is nothing virtuous or helpful in defending the freedom to spread bad medical advice or other false information. True liberty comes when one is free to make good decisions and hold sensible opinions. You don't get there through coercion and you don't get there by calling people stupid.

People aren't stupid for mistrusting experts and corporations and government bodies in a system like ours. Besides human fallibility, and the nature of science (which can be wrong, which is why scientific research is never finished), it is perfectly sane to feel alienated from institutions and authority figures under capitalism. Under for-profit medicine, we are used to be lied to, denied care, and in some areas of medicine overdiagnosed and overmedicated due to profit-driven marketing. What I'm arguing here is that under capitalism, human needs do not come first, and the way we are treated by our medical industry demonstrates this.

Also true, we haven't done a good enough job of educating people about the science behind vaccination. (Or educating people generally about science, starting in elementary education.) For a great many adults, vaccination is as mysterious (and scary) as magic. People hear things about hormones and preservatives in the shots, about mercury this and autism that, and then someone who has been given a platform on television spouts rubbish, and then a pandering senator affirms that rubbish; and large numbers of Americans instinctively trust such figures, even when they are lying or crazy; and the whole fire of ignorance spreads faster with the internet and social media.

Every question about vaccinations, no matter how basic or silly from a scientist's perspective, deserves an answer. If your doctor can't give you a good and informative answer or is not trustworthy, your problem isn't with vaccines, it's with your doctor.

Every question about how vaccines work deserves answers, including questions about the appropriate panel. For example, a lot of parents who are fine with vaccinations still wonder why HPV vaccination is appropriate for their children. There are questions about vaccines, their use, and how they are marketd, that are legitimate and deserve direct answers.

And in a system where medicine and medical care don't have anything to do with profit, some of the experiences that lead to widespread distrust would disappear. It would be "eliminated," in the sense that the CDC uses the term: doctors won't be any more or less fallible, but the context in which we ask questions would be vastly improved.

If good information and reassurance become endemic, you'll see a spike in compliance with vaccination - without coercion.

3 comments:

Kelly said...

The younger generation has not seen how serious these childhood diseases can be, especially for adults or children with underlying health issues. You were wise to heed your doctor's advice when you contracted chicken pox as an adult. A friend of mine's brother caught them from his twins and developed complications and died. It was a real eye-opener for me at the time, so when my doctor recommended an MMR booster before having children, I readily agreed. Oh...and my father caught the chicken pox from me when he was in his 40s, despite having them as a child. My older daughter had a mild case when she was small yet caught them again when her siblings had them. It all seems to hinge on how severe the original case was.

Kelly said...

On another note, your comment at the end about the relationship between medical care and profit really strikes a nerve with me. It's a topic in which I've taken great interest in recent weeks...especially concerning the drug companies, hospital care, and various food industries.

Peter Herman said...

Needless to say, after 30+ years as a working microbiologist I feel pretty strongly about immunizations. Frankly they are one of the 4 things discovered in the late nineteenth century that made remarkable improvements in public health and life expectancy (the others - pasteurization, public sanitation, aceptic technique).

To not immunize your children is like getting into your car drunk with your children in the car without proper restraint and driving. You are a danger to them and anyone else on the road.