Simone brought up in a…

Simone brought up in a comment one of the concerns I saw a lot in the comments on Dooce's post on vaccination, that she worried we were now vaccinating for things like measles, mumps, and chicken pox, that didn't seem that bad -- diseases that many of us remember having as a child. Irritating diseases, certainly, and inconvenient for families, but not really a big deal. I wanted to address that here, in case it helps clarify for others.

There's certainly a mild risk to vaccinating for those three diseases, but the risk is much greater for not vaccinating. Especially once the population drops below the 95% vaccinated rate you need for herd immunity to work. For measles, for example, hundreds of thousands of children still die every year worldwide. (Interesting piece on vaccination resulting in a massive drop in measles deaths worldwide.

Yes, in the U.S., your kids probably won't die if they catch it, because they'll have access to better healthcare than the kids in third world countries: "The fatality rate from measles for otherwise healthy people in developed countries is 3 deaths per thousand cases. In underdeveloped nations with high rates of malnutrition and poor healthcare, fatality rates have been as high as 28%. In immunocompromised patients, the fatality rate is approximately 30 percent." (Wikipedia)

So let's say measles goes through your kid's partly unvaccinated class in the U.S. Thirty kids catch it, odds are, none of them will have a serious negative result. That's the kind of thing we grew up with. But if it sweeps through an entire school of a thousand unvaccinated kids, even here in Chicago, three kids will die. And some more will be left with brain damage from encephalitis, and blindness from corneal scarring.

Poor kids or those in rural areas in the U.S. might not have as good medical access, and even in the best case scenarios, there's still a higher percentage of deaths and other serious negative results from actual measles than the risks from vaccination. So for your kids, it's safer on average to vaccinate, even leaving aside the social consequences to others. That's why they recommend it, even though there's a slight chance that your kid might have a negative reaction from the vaccine. Most negative reactions are very mild. (I think so far, Kavi has had a mild chicken pox reaction to her vaccination; a bit of a fever and some red bumps.)

"Fever is the most common side effect, occurring in 5%-15% of vaccine recipients. About 5% of persons develop a mild rash. When they occur, fever and rash appear 7-10 days after vaccination. About 25% of adult women receiving MMR vaccine develop temporary joint pain, although this symptom is related to the rubella component of the combined vaccine. Joint pain only occurs in women who are not immune to rubella at the time of vaccination. MMR vaccine may cause thrombocytopenia (low platelet count) at the rate of about 1 case per 30,000-40,000 vaccinated people. Cases are almost always temporary and benign. More severe reactions, including allergic reactions, are rare. About one person per million develops inflammation of the brain, which is probably caused by the measles vaccine virus." (http://www.vaccineinformation.org/measles/qandavax.asp)

And of course, when someone's child does develop inflammation of the brain, that's the case you hear about, over and over, on the internet. I can't blame those parents for their anger and grief. It's very hard to be cold about statistical risk, when you have direct experience of being the one who drew the worst possible hand.

It's tough for parents to make that choice -- if the risk of a serious negative reaction is 1 in 1,000,000, but you know you're risking that when you vaccinate, as opposed to the 3 in 1000 risk of measles death that you'll probably never have to deal with since you live in an area that's close to 95% vaccinated -- well, I can see why individual parents might decide to play the odds and let other families bear the risk. But the more parents who decide that, the greater the risk grows, for everyone. Very very quickly. "After vaccination rates dropped in northern Nigeria in the early 2000s due to religious and political objections, the number of cases rose significantly, and hundreds of children died.[7]" (Wikipedia)

The risk grows especially quickly for vulnerable populations. And you never know -- your kids might be in that group, they might have underlying weakened immune systems that you just don't know about yet. That happens a lot. Those especially at risk are those are those who can't vaccinate: pregnant women and their fetuses, infants, the elderly, and those with compromised immune systems -- kids who already have cancer, or heart problems, or other systemic issues that make it impossible to vaccinate.

Your family's willingness to take on the very slight risk that comes with vaccination, is what saves their lives, every day.

7 thoughts on “Simone brought up in a…”

  1. Great post, Maryanne. The rubella vaccine is very important because rubella causes serious birth defects in fetuses, or death. It is otherwise a mild illness. It turns out that many people lose rubella immunity, and you can’t get the vaccine while pregnant, so it’s a good idea to get a MMR booster before you get pregnant. I didn’t have immunity when I was pregnant (my doc didn’t tell me, just gave me a needle after delivery), and I’m thankful that herd immunity protected my son while we were vulnerable, so that he can grow up to be a productive member of society, rather than needing special care all his life.

  2. Thank you for bringing this up – childhood vaccinations are one of the most important contributions to global health that humans have managed, ever. We forget that in the U.S., because, as you point out, we can more easily weather the diseases themselves through advanced medical care. But as a planet, childhood vaccinations *must* continue.

  3. I wish we had better public information about boosters — I went to my ob-gyn when we were about four months into trying to get pregnant the second time — it would have been the perfect time for her to ask if I’d had a MMR booster. But she didn’t say anything, and I didn’t know about the rubella risks. So now it’s too late, and I don’t know — is my rubella vaccination still active? If not, little baby-to-be is at risk, and we’re relying on others’ vaccinations to keep it safe.

  4. Ummm…In my defense, I don’t have a problem with vaccinations. My kids are up-to-date on their shots. My sister almost died of rubella 46 years ago in Trinidad. If mumps and measles were not lumped with the rubella shot, I might have questioned the necessity of a MM shot. At which point, I’m sure the pediatrician would have explained the benefits to society.

    I really found the Dooce article you referenced in the previous entry great in explaining what happened in California with the exposure and just thinking about what the repercussions were to those on the airplane.

    The bulk of the info I researched back when was regarding the whole autism/vaccination debate. Which, if you’ve ever researched it, can hurt your brain.

    Quite frankly, I don’t know how people manage to NOT vaccinate their child. I couldn’t take him to childcare, Mom’s Day Out, or school (private and public) without proof of vaccination. To get my daughter’s social security number, I needed a shot record, signed by her pediatrician.

    “They” say you can just sign a waiver if your kids are not immunized. I’ve asked about waivers to sign at schools and child care programs and there was no waiver. It was shots or keep your kid home.

  5. The rubella titer is part of the usual prenatal bloodwork. I would assume that your doctor checked this when you had your first baby, and would have given you a booster if you needed it. I was grateful that she didn’t tell me early in the pregnancy so I could worry the whole time, and I’m sorry if I inadvertantly caused you this kind of worry. I assumed since it was your second there would be no surprises. For me there were a bunch of opportunities to be offered a booster before I got pregnant. I don’t know why no one thought of it.

  6. Wow, good entry. I had been thinking (based on stuff people said in that Dooce comment thread, I think) that maybe MMR wasn’t so necessary, but now I’m convinced.

    Simone (re waivers): When I was a kid, in semi-rural northern California in the ’70s, my father sent a note to the school claiming that he had religious objections to vaccination, and I believe that I therefore never had the standard childhood vaccinations. But things may well be different in different places, and may well have changed since then.

    One thing I wish I had asked him at some point is why he made that choice, since he didn’t actually have religious objections. There were no serious negative consequences, as it turned out–but in addition to my getting measles as a kid, there was one minor consequence: a few years ago, my possible exposure to chickenpox led me to not hug anyone at a wedding I attended, because I didn’t know if I was immune. 🙁

  7. Catherine, good to know it’s probably fine. I’ll ask them next time I go in, I think, just to be sure.

Leave a Reply

Your email address will not be published. Required fields are marked *