Measles

Measles is in the news right now.  An outbreak has hit California and dozens of people have gotten sick with it -- some sick enough to require hospitalization.

Into this fray have ridden pro and anti-vaccine advocates, explaining why vaccines would or wouldn't have helped prevent this outbreak.  I read a recent blog post by a Christian doctor detailing a story of a child under his care who died of measles and I have read other stories of children who have suffered terribly after vaccines.  I believe that all of these people are being honest, but there are other things to remember.

Temporality does not equal causality.

This is the sort of thing that leads to superstition.  A black cat walks across my path and then later in the day I have a bad accident.  Did it have anything to do with the cat?  Just because one event comes before another doesn't mean it caused the later event.

In the medical world it seems to be tougher to analyze the situation.  If I started coughing two days after I got a flu shot it is easy for me to believe that the flu shot gave me a cold.  But, maybe someone at Walmart coughed on me or, maybe I shook hands with someone who had a cold.  Most of the time when I get sick, I never know who was the generous soul who shared with me -- maybe a patient, maybe someone at church.  Identifying the cause is not as easy as remembering what happened right before I got sick.

Anecdotes are both the weakest and the strongest type of evidence.

People tell stories -- hopefully true stories -- about vaccines and plenty of other things in their life.  In many ways, these stories influence us the most because they hit home.  We can picture in our minds the sick child dying of measles or, the paralyzed nonverbal child, suffering because of an unneeded vaccine and our hearts melt in sympathy or, shake in anger.  And yet, these stories tell me nothing about the overall risks of a vaccine or the illness it is intended to fight.

Much more useful are statistics.  If I know that twenty-five percent of those who caught measles in the Disneyland measles out break have required hospitalization or, that the rate of serious complications with the MMR vaccine is 4 per 10,000 children vaccinated (mostly fever fits), although ten percent of children get fevers and joint aches after the shot, then I can compare risks and benefits of the vaccine and the illness.

Everything has risks and benefits.

If your doctor diagnoses you as having carotid artery blockages (narrowing in the arteries in your neck), he will send you to a surgeon who will then tell you that the risk of no surgery is a 20 percent chance of stroke over the next two years, while your risk of having surgery done is 2.5 percent chance of stroke or, infection.  I think in this setting, most people would elect to proceed with surgery, even understanding that there is a significant risk to the surgery.

In the same way, everything we do (or don't do) has a risk.  Taking any vitamin, supplement or, antibiotic contains within it a possibility of reaction to some ingredient in it.

The problem is that for the most part the risks of the activities we do every day are unknown.

With vaccines, they are clear and are published in numerous scientific papers for those who choose to know.

Choose wisely who you believe.

Everyone thinks they are an expert.  Unfortunately, in the internet age, everyone's voice is the same volume (usually shouting).  It is more important to have good data backing up opinions than to be an "expert" in the field.

The tendency is to look for views that mirror our own and to collect those, rather than investigating all possibilities.

Vaccination protects others.

There are plenty of people who cannot get vaccinated.  They have cancer and are receiving chemotherapy, or are immunosuppressed, or have a history of a serious reaction to a vaccine, or an allergy to the vaccine.  The way to protect them is to be certain that they don't get exposed to these illnesses. 

I believe the loving thing to protect these unvaccinated children and adults is to do my best to make sure that neither my children or me will be the vehicle by which they get exposed to a preventable illness.  There may be some risk to my children, but it is worth it.  My children have decent immune systems, they would probably do OK with many of these illnesses, but there are plenty of folks around who wouldn't.

Vaccines protect the "least of these" even more than they protect the strong in our society.

Distance makes the heart grow fonder.

The fact that most of us in the United States have never seen any of these once common illnesses makes us think that they were no big deal.  Yet, every one of these illnesses has a rate of serious complications.  Unfortunately, for viral infections like Measles, German Measles, and Mumps, there are no treatments, only supportive care.  A certain number of the cases, even in a developed country like the United States, will lead to long term problems like neurologic symptoms or, sterility.

Honestly, it isn't just the risk of serious illness that leads me to vaccinate my children, although those risks are real for unvaccinated children.  Even if my children didn't get seriously ill, the idea that they would have multiple week long illnesses throughout their childhood, during which they were miserable and I could do little to help them is something I would rather not experience.

In the end, I am sure I can do nothing to change the minds of those who are convinced that some vaccine company has paid me under the table, or brain washed me into mindless belief in vaccines.  I have looked at the statistics and they aren't even close.  The risks of vaccines (which are real) are far out weighed by the morbidity of these diseases.

That's why I recommend vaccinations.

That's why I vaccinate my children.