I write about vaccines quite a bit. The reasons are legion, though perhaps best is that vaccines are one of the greatest medical triumphs in history, potentially saving hundreds of millions of lives. Unlike some medical procedures, the risks are very small versus the very large benefits. And in general the cost to the patient is very low as well.
Despite this, the number of people getting vaccinated remains dangerously low in many areas. Some people outright deny the benefits of vaccinations and instead grossly distort risks and trumpet fictional problems. Others simply donât know the facts about vaccination; they are not anti-vaccination outright but may not be getting the best information.
This was brought home to me again, quite literally, twice over the past 24 hours.
First, on Sunday, I took my daughter to the local grocery store pharmacy to get our annual flu shots. As I did last year, I had her take my picture so I could tweet it and promote a little health safety to my Twitter followers.
When I did, I got a predictable response: a lot of folks supporting me (saying they had, or would soon, get their shots) and a few saying they wouldnât.
Of those who refused, some used slippery logic, and some claimed a previous shot gave them the flu, which is simply impossibleâitâs far more likely it was either a coincidence (it takes about two weeks for your immune system to respond to the vaccination, during which time you can contract the illness) or they got some other infection (a bad cold is commonly mistaken for influenza).* Only a handful seemed like out-and-out anti-vaxxers.
Of all the replies I got, this was my favorite:
It says, âAs someone who can't get all vaccines and relies on herd immunity, I thank you for getting yours.â
Yes. Thatâs the whole point, in fact. If I got the flu, it would suck for me, but I can handle it. Iâm a healthy person, and a few days of misery is survivable, plus it would give me an excuse to lie on the couch and watch a Stargate: SG-1 marathon. But for someone who has a compromised immune systemâpeople undergoing cancer treatment, people with autoimmune disorders like rheumatoid arthritis, and infants who havenât yet developed a strong immune systemâor people with other medical conditions like heart disease, diabetes, or asthma, the flu is a lot worse. It can kill them. As in, dead. A jab in the arm is a small price to pay to help prevent that and to boost herd immunity.
The second incident was on Monday, less than a day after my daughter and I got our shots. I received an email from the principalâs office of my daughterâs high school telling me that three students at the school had been diagnosed with pertussis: whooping cough.
Three cases in one school is shocking and possibly due to low vaccination rates. If you know much about Boulder, Colo., that may surprise you: Itâs one of the best-educated cities in America. Yet education is not the same as wisdom, and in many cases cities with a better-than-average level of education in the public have lower vaccination rates. I suspect this is because people with a college degree are educated enough to know they should seek evidence for a claim, and when they do, they tend to confirm their own biases. If a friend says he heard vaccines cause autism (say), then he goes online and searches on the terms vaccines and autism. They are far more likely to see an anti-vaxx site than one like mine. This confirms their pre-existing bias, and a pocket of lowered immunity begins.
I'll note that there is some concern that the pertussis vaccine is not as efficacious as it once was. This may be true, but it's also true that children who are vaccinated are still less likely to get pertussis, and if they do, the symptoms tend to be less severe. Either way, given this, it makes more sense to get it than not. Last year, we had an outbreak of pertussis in Boulder. (Rates have skyrocketed very suddenly, which makes me think it's not due to a weakened vaccine; we would've seen rates climb many years ago.) During this outbreak, pertussis nearly killed Natalie Schultz, a 6-week-old infant, and there was one fatality. Pertussis is not a disease you want to screw around with.
My wife, my daughter, and I are fully vaccinated against pertussis and several other preventable diseases; we have all recently had our TDaP booster. Iâm not worried about my daughter getting whooping cough from her fellow students, but I hope a lot of the parents in Boulder are. This is a very difficult and nasty disease, and my heart goes out to the children who have it. But I hope very, very much they donât come into contact with any infants while contagious, becauseâlike what I said about the flu aboveâan otherwise healthy teenager getting it is bad but generally survivable. The same may not be true for the most helpless among us.
The letter I got from the school was quite good, giving excellent information and advice about pertussis and vaccinations. But I want to note that it said parents should see their "health care provider" and get advice about vaccinations. This being Boulder, I know that for some parents, that means seeing a naturopath or homeopath. My opinion on those fields of nonsense is on record. Many, many times.
Instead, my advice is: Go see a board-certified doctor and ask about vaccinations. They will have actual evidence, facts, and medical research to back up their advice. When dealing with potentially deadly but easily preventable diseases, science is the best way to go.
Correction, Oct. 16, 2013, at 16:00 UTC: This post originally stated that antibodies develop "a few days" after a flu injection. It takes two weeks, according to the CDC. (Thanks to Todd W of Harpocrates Speaks for the fix.)