The urge to protect one’s children is one of the strongest known to humans, so when questions are raised about the safety of vaccines, many parents have concerns—and even forego the shots—even though protecting ourselves from serious disease is why vaccines exist. This is particularly true in Marin, so much so that Jon Stewart recently mocked our county as being one “where they practice mindful stupidity.” The comment was spurred by a new report confirming that Marin’s rates of non-vaccination are among the highest in the nation.
In some California schools, the percentage of kindergarteners vaccinated against measles in 2013-14 was lower than rates in the developing world. In Sudan, for example, 85 percent of 1-year-olds were vaccinated against measles in 2013, according to the World Health Organization. That same year, only 54 percent of kindergarteners were immunized against measles at the Bolinas-Stinson School, and even fewer—18 percent—were reported as fully vaccinated. At the Bolinas Children’s Center, 35 percent were fully vaccinated; at the Stinson Beach Preschool, 8 percent. In Marin, 84 percent of kindergartners are fully vaccinated; statewide, the rate is about 90 percent, with our neighbors to the north, Sonoma and Mendocino counties, even higher.
Medicine, like most things, involves risk versus benefit calculations. Virtually nothing is 100 percent risk-free, or 100 percent effective. Vaccines can have risks. But it is clear to us that the benefits far outweigh the risks for individuals of all ages and for the community. This can seem difficult to grasp; due to the success of vaccines over the decades, we don’t see the sickness and death vaccines prevent.
The one disease eradicated by human effort in our time was smallpox, wiped out in Asia by a concerted, intense vaccination campaign. Experts there knew they could not wipe out poverty, hunger, sewage and so forth in India, but the smallpox vaccination could interrupt the transmission of the horrible disease long enough for it to die out. After millions of vaccinations, it worked, even though the other conditions stayed the same. It was a targeted triumph that has prevented incalculable suffering and death since the 1970s. There are other such examples; we saw entire hospital wards in Asia and Africa that had been converted from places of rampant death into much less lethal places following international health programs with vaccination as they key weapon.
Throughout the world, measles kills about 400 children every day, and many more are made very ill, some with lasting problems. Historically it has been one of the most lethal infections affecting humans. But the success of the vaccination has made us forget that. Until recently there were hardly any cases at all in our country—as opposed to a recent and ongoing outbreak of over 50,000 cases and many deaths in the Philippines, for example. So even the relatively small Disneyland outbreak is very concerning to us. Although it may be unlikely that a big outbreak will spread as in times past, it is a frightening reminder.
The vast majority of scientists who have studied vaccines support them. Even most who have questioned some aspects of vaccination still tend to favor vaccines. This is also true for journalists. But research has shown that for some reason, many people give equal weight to nonscientific, unsupportable sources, such as online comments and editorials by self-appointed advocates with little or no scientific background. It reminds us of the climate change debate. More than 95 percent of real experts agree that humans are causing global warming, but a small percentage get “equal time,” influencing policy and behavior. Vaccine denialism seems to arise from mistrust of authority—not always a bad thing—along with a lack of science education and parental instinct. A certain small number of untrained crusaders presume to know more than everybody else.
Regarding autism, the condition that set off this modern episode of denial, even groups that formerly held such a connection existed are backing away from that position, convinced by the evidence. Extensive analysis of all available good studies has not supported the fears that vaccines have contributed to the rise in autism and similar conditions. Autism Speaks, the nation’s leading autism advocacy group, just released a statement saying “Vaccines do not cause autism…We urge that all children be fully vaccinated.” It is what every medical group that has closely examined the issue has concluded, and the researcher who first claimed a vaccine-autism has been wholly discredited and sanctioned.
Rarely, the side effects from a vaccine can be severe. Some people are likely more susceptible to bad reactions, and vaccines carry warnings to evaluate patients for such known risks, though not all can be prevented. Mostly, any reaction is mild. Such statistics are true for most vaccines; and researchers are continually trying to make them even safer.
We wish it were true that optimal nutrition and “natural” foods or supplements could make one and one’s kids immune from disease. But it is not. General immunity might be improved by smart diet and exercise, but the diseases vaccines prevent respect no such robust health. Nor is there is evidence that alternative approaches can make one immune to such infections.
We cannot support the idea that the medical and scientific “establishment” has conspired to hide the ill effects of vaccines for profit or other reasons. First, a bit of thought should make it clear that much more potential profit for drug companies and the medical industry could be derive from sick people than from preventing disease. For even the biggest vaccine manufacturers like Merck, vaccines make up only about 10 percent of their business, and are one of the less-profitable sectors.
For their part, scientists are trained to be competitive and to debunk theories and discoveries; reputation is everything. The idea that thousands of scientists from all over the world would collaborate on such a vast hoax to sell bad vaccines and hide ill effects is less believable to us than most anything else in this debate. Some of the most prominent anti-vaccine figures have been discredited, even convicted, of the very kind of transgressions they have alleged that tens of thousands of others have committed, some trying to profit from the uncertainty they create by selling questionable “cures” for diseases.
On a more philosophical note, effective vaccination requires a form of community solidarity, consciousness and action. Relying on others to make our schools safe by vaccinating, even if you don’t believe in it yourself, is just not in keeping with the spirit of our community. As Dr. Phil Landrigan, one of the best environmental scientists and pediatricians around recently said, “Rather than worry about a vaccine-autism connection that has been proven not to exist, parents should be banding together and writing their elected officials to insist that chemicals be properly tested for toxicity to children before they are allowed to enter the American market. The Europeans have passed such legislation. We should, too.”
We agree. We believe that policies have made it too easy for pollution to affect our health and environment, and for parents to opt out of vaccination due to unfounded fears. There are now proposals to make it much more difficult to opt out, to ban unvaccinated kids from schools, and so forth. Some of these make sense, some less so. We do not believe in taking away parental rights, but parents who do vaccinate, have kids with immune problems have rights, too. We wish all parents would avail themselves of solid scientific information and the sense of communal responsibility public health requires.
We should not go back to the time when now-preventable diseases were prevalent. We hope every parent who is either unvaccinated or has kids who are not fully vaccinated will consider the facts, the health of your kids and the community, and seek advice from your pediatrician. Go in with an open mind, and with the trust you otherwise likely place in them, and you might be surprised; they will work with you to confront your fears and the misinformation you might have heard. And then—vaccinate.
Sadja Greenwood is a retired physician and public health advocate who writes a health column for the Bolinas Hearsay News and the Point Reyes Light. She was an assistant clinical professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco. Steve Heilig is a veteran health advocate trained in epidemiology, medical ethics and environmental and public health, and is an editor of both the Cambridge Quarterly of Healthcare Ethics and the Bolinas Hearsay News. They have no ties to any pharmaceutical or other commercial interests and have long challenged established thought and practice whenever they believed doing so would lead to better health.