Up until now, I've just been sitting on the sidelines, reading the facebook comments on posts about the vaccination debate. I'm a fairly calm guy, so it's not often that I'll get angry enough to share that feeling with other people, but I've got to admit that some of the facebooks comments I've read on the subject of vaccination have gotten me angry. Perhaps not "I'm in a rage - I really want to hit something!"-angry, but about as angry as a mellow guy like me can get.
Before I go on, let me say the some of these facebook comments that made me angry were written by friends of mine ( both "facebook friends" who I know casually in the context of facebook, and real life friends/relatives who I feel very close to ). Most of the comments that got me most angry were written by friends-of-friends, but some were written by people I feel close to. I've decided not to single anybody out by name in this blog post, but if in the course of reading this, you find yourself thinking, "Is Rich referring to me?", the answer is almost certainly "Yes, I am referring to you. I care about you a lot, but I think you're wrong about the vaccination issue. Feel free to send me a private message if you want to debate this with me".
Let me also say that I don't want to paint all people in the "anti-vaccination" camp with a broad brush. In fact, I don't even know if "anti-vax" is the right term for most people in that camp. There are many people out there that believe in vaccinating for some diseases but not others, or believe that vaccination is good for society, but promote the idea that it is acceptable for some parents to opt-out of getting their kids vaccinated for various reasons. In general, I think those people are wrong, but I also accept that they are not batshit crazy anti-science people.
That being said, I still find myself getting angry, and it's mostly because I feel betrayed by my tribe. As most of you know, I proudly identify myself as a Liberal. I frequently use whatever limited online influence I might have to speak out about liberal causes, including social issues ( Ex: This, this, and this from my YouTube days, and this, this, this, and this from my blog ) economic issues ( Ex: This and this ), national security issues ( Ex: This and this ), and political issues ( Ex: This and this ). While it's important to understand opposing viewpoints and vigorous debate is a hallmark of any healthy society, I'd be lying if I said I didn't enjoy the community of liberal folks I've connected to on facebook. I enjoy reading the posts of the more active liberal posters on my facebook feed, and I get a visceral thrill when I see that red spot on my facebook screen that indicates that somebody has responded to one of my liberal posts. Whether the liberal person I'm connecting with is across the room or across the globe, I feel like that person is part of my tribe.
So, while I'm a bit disturbed by right-wing Libertarian anti-vaxers, they don't really make me angry, because I expect nothing less than irrational stupidity from those folks. However, when members of my liberal tribe side with the anti-vax forces, I feel betrayed because I feel like those folks are giving the liberal cause a bad name.
I frankly don't understand why liberal people who would certainly tell any right-wing climate-change-deniers to "listen to the the vast majority of scientists" when it comes to to climate-change are skeptical of the vast majority of doctors when it come to vaccinations. Am I missing something here? Isn't medical science - you know - a science?
Yes, I'm sure some of you anit-vax liberal folks have done plenty of research. I've read a lot of what you've had to say in your facebooks post. But do you really think the online research you've done in your spare time is a substitute for years of study and practical on-the-job knowledge that doctors have? I may know a decent amount about how electricity works, but if I want to keep my family safe from electrical fires, I'm going to hire an electrician to wire my home. I may have a degree in Mechanical Engineering, but when our car experienced steering problems a few weeks ago, we let an experienced auto mechanic work on our car to keep our family safe on the road. I really don't care how much research you've done on the internet, if you want to keep you family safe from diseases, you are best off listening to what a doctor tells you.
Full disclosure - I'm married to a doctor ( BTW, she firmly believes skipping/delaying childhood vaccinations is a terrible idea. ). If you want to say that makes me biased regarding doctors, I guess I really can't argue with that. However, it's undeniable that the vast majority of doctors think childhood vaccinations are a great idea. Of course, there will always be a few exceptions, just like there are scientists who are climate-change skeptics, and there were doctors who endorsed cigarettes in the 50's.
I thought about asking why wife to help me refute some of the anti-vax facebook comments I've read, but frankly, she's got better things to do, and there's plenty of people of there who have already refuted many of these claims ( Some examples: This, this, this, and this ).
While I should probably just end this blog post by saying, "listen to what doctors are saying about vaccinations", there are a few issue that I want to tackle specifically.
I'll start with some low-hanging fruit, because this particular "fruit" has gotten me more angry than anything else. As the father of two children on the autism spectrum, few things get me more angry than the completely discredited claim that childhood vaccinations can lead to Autism. As most of you should know by now the scientist who sounded the alarm about vaccines causing Autism ( Dr. Andrew Wakefield ) has been completely discredited. I'm not going to go into details here, but click on this link, you'll see what I mean. The most illuminating section of that link is the following:
An investigation by journalist Brian Deer uncovered the fact that two years before the 1998 Wakefield group report was published, Wakefield had begun receiving money from lawyers, led byRichard Barr, wanting to file lawsuits against vaccine manufacturers. Of £3.4m distributed to doctors and scientists recruited to help build their case, Wakefield received £435,643 in fees, plus £3,910 expenses.* Deer also discovered that in 1997 Wakefield had applied for a patent for a measles vaccine on behalf of the Royal Free hospital medical school and the Neuroimmuno Therapeutics Research Foundation, a private company of unconventional immunologist Professor H. Hugh Fudenberg of Spartanburg, South Carolina. (Fudenberg claimed in a 2004 interview with Deer that he cured autistic children with his own bone marrow.) Wakefield's vaccine would be a potential competitor to the MMR and single-shot measles vaccines. The final blow to whatever credibility Wakefield had left was delivered in 2009 when it was discovered that he had fixed his data.I'm well aware of how hard it is to raise kids on the autism spectrum. My boys are a joy, and I'm generally hopeful, but I also have moments of despair when I feel that my boys might never be able to handle the social interaction needed in the real world, and I worry about what will happen when my wife and I are gone. I think that kind of despair makes some parents of autistic children yearn for some explanation for their child's condition. I think some parents want somebody or something to blame, but there is absolutely no evidence that vaccines are to blame. It's true that children first start to show that signs of autism after they are vaccinated, but that's because children start getting vaccinated at an age far too early in a child's development to tell if a child has autism. Just because vaccinations happen at an age before children start to show signs of autism, doesn't mean that vaccinations cause autism. Saying the vaccinations cause autism because kids get vaccinated before they show signs of autism is as valid as saying diapers cause autism because kids wear diapers before they show signs of autism.
I know that some people will point to the rising rates of children diagnosed with Autism, but consider the following.
1) Until my kids were diagnosed, no one in my family had ever been diagnosed with Autism.
However ...
2) I used to rhythmically rock myself to sleep each as a child. My mom told me I used to grab the bars of my crib and rock it back and forth rather hard.
3) My younger brother didn't really start speaking until he was 4. I was only 7 at the time, but I remember my parents being really worried about him.
4) My Dad's older brother was valedictorian of his High School, but had such severe social issues that he dropped out of college with a nervous breakdown, endured shock therapy, and was never able to hold any job other than manual labor. He also wasn't able to manage his life effectively after my grandparents died and had to be in assisted living long before his physically abilities deteriorated to a significant extent. After I became more educated on the subject, I had strong suspicions that he must have been on the autism spectrum.
The point I'm trying to make is that autism simply wasn't diagnosed aggressively in the past. Just because autism wasn't being diagnosed as often in the past doesn't mean it wasn't prevalent in the past. Also, while my own's family's history certainly isn't a large enough sample size to prove anything, it gives me the distinct impression that the root cause of autism is genetic, especially when I consider that the younger's brother's first daughter is also on the autism spectrum.
Now that's I've gotten that off my chest, let me get to the concerns/objections that some of my liberal friends may have if they've read this far. The majority of "anti-vax" liberal folks commenting on facebook have indicated that they "believe in science", and are generally in favor of vaccinations, but have indicated either that ...
1) Some vaccinations ( such the MMR for measles, mumps, rubella ) are not really necessary, because certain diseases are not serious enough to risk the potential environmental impact of vaccines.
2) Parents with concerns about the perceived dangers of vaccines should have the choice to opt out of vaccines because herd immunity offers enough protection.
Let's me tackle these one at a time ...
1) I honestly don't know what kind of environmental risk was being referred to in the facebook comments I read, but it's certainly nothing the vast majority of doctor's are concerned about. There's certainly no risk of autism, and if anyone reading this has other kinds of concerns about environmental risk, send me the details and I'm confident that my wife and her large number of doctor friends will be able to help me refute them. More importantly, I don't think anyone should be promoting the idea the measles/mumps/rubella are not serious illnesses. Just check what the CDC has to say about measles, and then consider what measles could potentially do to a baby too young to be immunized. The CDC also says here that mumps can cause deafness in one out of 20,000 infected children. That may seem like long odds, but if I were told that an average of 2 people in the crowd would go deaf at each at sold-out Mets game, I would stop going to Mets games. OK, I'll admit the rubella symptoms in children do not seem that serious, but considering what it can do to a pregnant women's unborn child, why run the risk of a child with rubella giving rubella to a pregnant women picking up a kid at a day care center.
2) The clear problem with the "opting out of vaccines and counting on herd immunity" strategy is that if enough people adopt that strategy, herd immunity will go bye-bye. I'm not trying to say that nobody should opt out of vaccines. It's a scientific fact a small percentage of children ( such as children with compromised immune systems ) are better off not getting that vaccines, and I have no problems with parents of those children opting out of the vaccines and counting on herd immunity. However, science also suggests that the percentage of children who are better off not getting vaccines is extremely small ( 1.8 per 1,000,000 according to this study ), so we should not be in a situation where 13% of children in California child care centers are not vaccinated ( You're embarrassing the hell out of me liberal California, you really are. Are you really gonna let most of the conservative states out-science you when it comes of vaccinations? ). I'm fine letting some parents opt-out of vaccinations for their children, but it has be really rare, and I'd like the opt-out to be signed off on by a doctor.
As a parent, I can understand the fears some parent have about vaccinations. One my friends indicated in a facebook comments that she stopped her child's vaccination schedule after her child developed a "mild case of measles" after getting the MMR shot. I don't really know enough about that situation to comment further ( I've frankly been a little afraid to ask ), but I can understand why parents in general can be fearful of vaccinations. As I said, I'm all for medical exemptions when absolutely necessary, but I would strongly encourage most people to try to get over their fear and get their children vaccinated. If 13% of parents in the largest stare in the US are opting out vaccinations and science suggests that only 0.00018% of parents really need to, there are clearly a lot of people acting on irrational fears.
And look, I know a lot about irrational fears; I've got all sorts of them when it comes to my children. Some of you may be aware that I'm the worst kind of helicopter parent when it comes to leaving my children alone ( and my wife is the same way ). I never leave my children alone in a public place under any circumstances. Even though my oldest son Michael is just about as tall as my wife, far stronger than my wife, and will soon be getting his brown belt in jujutsu, I still won't let him go into a restaurant bathroom alone, even if I can see the bathroom from my table. I know that's completely irrational, but my fear overcomes my rationality ever time, and will probably continue to do so until I'm sure my kids are bigger and stronger than me ( which will almost certainly happen in a few years, considering the way they are growing ).
However, as crazy as my helicopter parent irrationality is, it doesn't really put anyone else at risk. The fact that I'm overprotective with my children doesn't put anyone else's children at risk. However, opting out of vaccinations due to irrational fears does put other people at risk by weakening herd immunity.
I can't really deny that if herd immunity is very strong ( as it still is for most diseases we give vaccines for ), and the chances of catching a given disease are practically zero, then it opting out of the vaccine might be a slightly safer course of action than getting the vaccine, assuming the odds of being harmed by vaccine complications are slightly higher than the chances of being harmed by the disease when you are protected by only herd immunity. However, you shouldn't damage herd immunity by opting out of vaccinations for your children, because as we learned from this fellow who passed away this week ....
( "The needs of the many outweigh the needs of the few." )
I think I'll leave it at that. If Spock's logic can't convince you that herd immunity is important, I don't know who can.
Rich
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