Worried About Outbreaks? Vaccinate Your Kids.
“Outbreak” is one of those words you’d think would have an impact on a person’s decision-making.
Much like “avalanche” keeps me from traipsing off on my own around the timber line, and “compound fracture” informs my lifelong aversion to skateboarding, it seems as if reports of numerous new cases of a preventable illness should motivate people to seek out the corresponding preventive measures with all good haste.
That is, sadly, far too often not the reality.
There is no shortage of vaccine-preventable illness these days. Outbreaks throughout the United States and Europe have made the news numerous times over recent years. Yet despite measles breaking out a few years ago—at Disneyland of all places—some people still refuse to vaccinate their kids. Which means outbreaks will keep happening, like the one a couple of weeks ago at a Waldorf school in North Carolina where dozens of kids came down with chicken pox (also known as varicella).
If there is an internet version of shouting oneself hoarse, online discussions over the safety and efficacy of vaccines have had me reaching for the lozenges ages ago. It is a subject to which I am constantly returning. As a pediatrician, there is no phenomenon I find more confounding and infuriating than the persistent refusal of some people to protect their children against potentially devastating illnesses based on groundless concerns about the protection itself.
Something about the recent varicella outbreak particularly resonates with me, however. Perhaps it’s because I’m old enough not only to recall a time before there was an available vaccine, but to have had the illness itself. I vividly remember my totally pox-covered younger brother walking into my bedroom on a morning I was sick with the illness, which I had brought home from school. (It wasn’t pretty.)
When advocates talk about vaccines, we often understandably focus on the direst of the possible outcomes. We mention varicella pneumonia. We bring up subacute sclerosing panencephalitis, a rare but devastating complication of measles that can occur years after the initial infection. We highlight how pertussis (or whooping cough) can be fatal in infants. (Some vaccine-preventable illnesses, like diphtheria, are so devastating even in their typical presentation that their resurgence would be a catastrophe.)
The reason these worst-case scenarios are often discussed is to counter the notion that most of the illnesses we vaccinate against are no big deal, and that preventing them is not worth the nebulous risk erroneously ascribed to immunization. If some parents perceive bygone diseases as unpleasant but otherwise tolerable aspects of childhood, it makes sense to remind them that the outcomes can indeed be incredibly poor.
However, even under the best of circumstances, to get sick with many of these diseases is to be absolutely miserable. Chicken pox commonly causes hundreds of lesions, which can take a week or more to resolve, are intensely itchy, and can leave scars. Even uncomplicated measles usually causes a high fever that can last for several days. And anyone who thinks getting whooping cough isn’t that bad should read this personal account of the illness by Julia Ioffe. (For my part, I’d vastly prefer that neither my patients nor my own kids cough so hard they fracture a rib.)
Again, these are the typical symptoms for some of the comparatively benign vaccine-preventable illnesses. Presumably I don’t have to go to any lengths to convince readers that getting tetanus is horrible?
These are the undisputed facts of these diseases. Unless I have missed something (which, given that the conversation includes a fascinating diversity of beliefs and opinions, is a distinct possibility), not even anti-vaxxers argue that these aren’t the symptoms these germs will inflict on those infected. They’d just rather their kids experience them than accept the well-established fact that vaccines do not cause the various conditions falsely ascribed to them (most commonly autism).
As far as malignant displays of privilege go, this is among the most overt. (I realize few terms are more apt to make people tune out of a discussion than “privilege,” so substitute “social advantage” if that sits easier with you.) The more precarious a person’s situation, the less able they are to withstand the collateral damage of a child’s illness. Lack of affordable childcare, loss of income for missed work days, and/or shared living space with a medically vulnerable relative will have far more impact on some than others, and a blithe willingness to accept those costs signals a relatively cosseted position.
Of course, it’s not only their own children they’re willing to immiserate, or their own schedules they’re willing to throw a monkey wrench into. It’s yours, too. As any honest vaccine advocate will tell you, they don’t work perfectly every time, and some people don’t respond to them as well as others. In addition, some patients are too young for vaccines, or have other medical conditions that preclude their being able to receive them. In order to ensure good protection for everyone within a community, a certain threshold percentage of people within that community needs to be vaccinated. The number of people who must be vaccinated to provide this “herd immunity” varies from disease to disease, with more infectious diseases requiring a higher number than those that are harder to pass on. It’s when a community drops below that threshold (as with the North Carolina Waldorf school) that outbreaks are apt to occur.
Failing to vaccinate your kids threatens this collective immunity. It’s bad enough to leave your kids at risk for (at best) extremely unpleasant illnesses, but this decisions has ramifications beyond any one family. It’s bad for everyone.
If seeing children suffering from highly preventable illnesses in increasing numbers doesn’t motivate people to reconsider their opposition to vaccines, I truly do not know what will. I don’t think I’ll ever be able to fathom it, and have come to accept some minds simply will not be changed. Everyone else, please remember to vaccinate your kids. Their health, and everyone else’s too, requires it.
Daniel Summers is a columnist for Arc Digital. Read more of his work and follow him on Twitter.
Worried About Outbreaks? Vaccinate Your Kids.
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