Field of Science

Vaccination and the Assault on Health

I had always though that refusal to get a flu vaccination was relatively harmless masochism. Refusal to vaccinate one's own children, on the other hand, should probably be prosecuted as child abuse, but at the least the negative consequences stay close to home.

Yesterday, however, I read two articles on vaccination. One in Slate looks at the risks the unvaccinated pose to people with immunity problems (she's unable to get childcare for her child, who is undergoing cancer treatment, because the risk of being around unvaccinated children is too high). If that seems like a parochial problem ("my kid doesn't have cancer; why should I worry about vaccination rates?"), the other article, appearing in Wired, is feature-length, and focuses on the anti-vaccine movement and the dangers it poses to the health of everyone.

Both note the rise in non-vaccination and the concomitant rise in outbreaks of the scourges of yesteryear. And they were scourges:
Just 60 years ago, polio paralyzed 16,000 Americans every year, while rubella caused birth defects and mental retardation in as many as 20,000 newborns. Measles infected 4 million children, killing 3,000 annually, and a bacterium called Haemophilus influenzae type b caused Hib meningitis in mor ehtan 15,000 children, leaving many with permanent brain damage...
But refusing to vaccinate is more than just a convenient way of decreasing the probability you'll have to pay for college (and that your neighbor's kid with leukemia will survive). This is because the un-vaccinated put the vaccinated at risk.

The Risk to Us All

As told in the Wired article, an unvaccinated 17-year-old Indiana girl picked up measles on a 2005 trip to Bucharest. When she returned, she went to a church gathering of 500 people. Of the 50 attendees who had not been vaccinated, 32 developed measles. Any adults who got measles had at least made the choice to take on that risk, but the children had not.

Even worse are the two people who had been vaccinated but nonetheless got sick. They had been responsible and protected themselves, but this reckless 17-year-old and her parents endangered their lives. First, though, three cheers for vaccines. Of the unvaccinated, 64% got sick. Of the vaccinated and those with natural immunity, only 0.8% got sick.

But still, vaccines don't always work. Sometimes they don't take. Sometimes your immune response may have weakened (for instance, through aging). Or you might just have bad luck. A 2002 study in The Journal of Infectious Diseases determined that you were safer as an unvaccinated person in a well-vaccinated country than as a vaccinated person in a largely un-vaccinated country.

People who refuse vaccines aren't just risking themselves, and parents who refuse vaccines for their children aren't just risking their children, they are risking you and me.


What makes this even worse is that every baby is initially unvaccinated. Children have to reach a certain age in order to get vaccines. What protects babies is that everyone older is healthy (i.e., vaccinated). So adult vaccine-refuseniks made it through infancy partly thanks to everyone else getting vaccinated. But they aren't willing to give other babies the same chance.

Do people have the right to choose for themselves whether they want vaccines? Sure -- as long as they live on top of a mountain or on a deserted island away from contact with anyone else. Mandatory vaccination**, and now!

(**With medical exceptions, of course)


JC said...

1. I don't think you have all of the facts. The use of thimerosal for preservative is very controversial, and possibly neurotoxic. It's not used in all vaccines, thankfully, but is being used in the swine flu vaccine.

Here's some recent research that suggests we shouldn't be using mecury-based additives at all:

2. Secondly, if I had children, I'd consider your call for a mandatory vaccine a direct threat towards them. Many others would too.

josh said...

JC -- the article you cite is pretty skimpy on details. That is, there isn't even enough information to find out whether the study in question was ever done or published. I searched for the article on Google Scholar using several different search terms, but was unable to locate it.

it may well exist, but unfortunately it is an all too common practice by anti-vaccine advocates to simply invent studies to support their arguments. If you can find the actual study, I'd love to see it and even post a link here.

In fact, there is no evidence -- none -- that thimerosal is dangerous in the quantities used in vaccines. It's use is not controversial in the medical community. It is true that it can be dangerous in high quantities, but that's true of everything.

On the other hand, swine flu is incredibly dangerous in exactly the quantities that exist in nature.

AngelaGrace said...

When you can tell me that vaccines are safer for my children than the diseases that they offer 85% protection to (at best!) we'll talk. Same goes for pre-natal ultrasounds and high fructose corn syrup, among other items. When I know based on scientific data that they are 99-100% safe I will expose my children to them. Until then, my children will remain free from them.

I appreciate where you are coming from, however, and I always enjoy reading a person's point of view from the opposing side of a hot button argument.

josh said...


Vaccines *are* 99-100% safe. Negative reactions are very low (so low, that for some vaccines the rate can't even be calculated). Polio, on the other hand, is really, really dangerous. Frankly, even Chicken Pox is more dangerous than your average vaccine.

There are a lot of numbers backing this up in the Wired article I linked to. And there is basically unanimity in the science. Any numbers you read to contrary were almost certainly made up.

weez said...

Indeed, one thing antivaxers conveniently overlook is the harm of the diseases which are prevented by vaccination vs. the actual odds of contracting any side-effect from the vaccine itself. You have a much greater statistical chance (on the order of 5x) of being struck by lightning than you do of developing any serious side effect from any vaccine. Anyone telling you otherwise is gilding the lily for their political opinion's benefit.

@JC: Vaccination for children is already in effect mandatory in many locales- try sending your child to a public school without a complete vaccination record.

Vaccination is actually a victim of its own success. Vaccines are so effective in preventing communicable disease that there's few people around these days who have a living memory of the horrors suffered by now-preventable diseases like polio. Think about iron lungs and permanent mobility disability for a moment and compare that to the temporary discomfort from an injection- and in some cases, vaccines can be administered without a needle stick.

There's a common thread amongst anti-vax advocates; the argument for vaccination is supportable with independently duplicatable science and statistics, while the arguments against are all built on encouraging and spreading fear, misinformation, doubt and unprovable conspiracy theories.

If you oppose vaccination, hit the history books. Sensible parents, who have a complete understanding of the very high risks of contracting preventable diseases vs. the minuscule risks of vaccination side effects would never expose their children to the greater harm of the diseases.

I wrote the bit titled 'Anti-vaccination is child abuse' which coglanglab linked to for a very good reason- because that's what it is. It's completely negligent parenting to allow a child to suffer needlessly, which antivaxers absolutely do inflict not only on their own children, but those of others. Read with horror the story of Dana McCaffery, an infant too young to be vaccinated, who died of whooping cough because selfish, underinformed parents have decided it's trendy to not vaccinate.

If you don't want to vaccinate your children, fine- but you have no right to inflict disease on others' children. There's surely a cave somewhere far away from the general population which you can go live in, where your precious little unvaccinated biohazards can contract their diseases in isolation from responsible society.