Ladies and gentlemen, according to the Center for Disease Control and Prevention, there were 104 cases of measles between Jan. 1 and Jan. 31 of 2015. Why is that news you ask, why I am bothering to write a post about two high school football teams worth of people? Because the disease they contracted was declared eradicated within the United States back in 2000. I am writing this post because this is only the latest wave of a growing medical crisis that must be confronted now, lest it decimate our nation. And no, ladies and gentlemen, that is not an exaggeration.
Where did this outbreak start you ask? In one of the best (or worst, your call) places for it to, Disneyland in California, where hundreds of thousands of people rub elbows everyday, only to return to their homes with whatever microbial passengers they might have picked up. Two of the people responsible for the initial spread of the outbreak I consider innocent in this matter. Two small children, under the age limit of a year old, were among the first cases, and thus had not yet had their MMR (measles, mumps, and rubella) vaccine. Many of the rest, however, were among a dangerous, and growing, population in America, activists against vaccination, or more colloquially anti-vaxxers. We’re going to run through a short sweep of the scientific consensus and basis of vaccination of herd immunity, and go into why this is the gravest threat to our nation poised to very badly damage us sometime this century.
Before we get into the controversy of vaccinations themselves, let’s start with the science of vaccinations. How exactly do they work? Well I’m glad you asked. Vaccines are careful laboratory cocktails designed to help the body develop defenses against diseases without getting sick. One of the neat things about the human immune system is that once it has encountered a disease type, special cells in the immune system called B-cells remember the characteristics of that disease and remember the necessary antigens to more effectively battle the virus, bacteria, etc. This happens with all regular diseases you catch, but also applies when you are given a vaccine. Vaccines include a small dose of the microbe to be immunized against, and a small, carefully selected group of other chemicals to induce a limited immune response. It is essentially intended to give a small, short version of the disease without actually infecting you. This way, you have the defenses without the risk of the actual illness.
Now, vaccines are not wonder weapons against illness. Having had a vaccine does not mean that you can always never get sick whenever you exposed to that particular disease. For an immediate time after being ill, your body’s immune system is in maximum overdrive. You really can defeat truly staggering amounts of germs. However, in the downtime between illness your immune system goes through a drawdown. Its defenses are still up, and it’s still battling foreign matter and germs everyday. However, these are limited engagements, needing only limited amounts of the full power of the immune system which is held in reserve. The same is true of diseases you’ve been vaccinated against. Your body is prepared to fight that microbe, but only in a limited quantity. If you are exposed to enough, you will fall ill, although you might recover a tad faster than a non-immunized person. So why are vaccines so effective? Two words: Herd Immunity.
We discussed a moment ago your body can fight off a limited attack from diseases it knows. We also discussed that this limited defense can be overwhelmed. The only practical way for this to happen is if you are exposed to a sickly person. There are other situations, but they are few and far between. As practical rule that is the only way. What herd immunity does is negate the opportunity for such an instance.
We are all exposed to literally hundreds, if not thousands, of different invading microorganisms every day. Most our body easily defeats. Others would infect us, if not for the vaccine that you have preventing it with that limited immunity. Congratulations, you are now not infected with polio, which can lame you, or measles, leaving you blind, or whooping cough, with a lung disability for the rest of your life. But what if you can’t get the vaccine?
Here’s where herd immunity kicks in. The vast majority of cases during an outbreak of anything are from people to people transfer of the disease (yes there are exceptions like foodbourne illnesses, but that’s not our focus here). Usually only a handful of people are infected by that original outbreak of the virus. They will, because of the social nature of human beings, continue to interact with other people, and unfortunately run a chance of infecting other people by accident. Many diseases, measles in particular can have infected, infectious persons (those with the disease able to spread it to others) who display no symptoms yet, or any more. In the case of measles, it is yet. Herd immunity means that the vast majority of the people they come in contact with will have the limited immunity to the microbe, and thus will not become ill from the exposure. Epidemics spread when infectious people come into contact with vulnerable people, who are then infectious themselves, etc. etc. Herd immunity means there are few to no vulnerable targets, vastly decreasing the chance that a disease can spread. Without larger numbers of infected persons, the chances of an epidemic reaching truly vulnerable people, young, the elderly, those with compromised immune systems, etc., is vastly decreased.
This is how the vulnerable people are protected. Yes, there is a truly infinitesimal fraction of the population who cannot be vaccinated due to medical conditions. There is also the larger number of young children who have not yet reached the age for the appropriate vaccine, the people for whom in old age the vaccine is wearing off, and the still larger number of people who are not vaccinated for any discernible scientific reason whatsoever. All of these people are protected by herd immunity, which reduces the chance that infectious persons during a minor outbreak can reach them and begin a more rapid growth.
Herd immunity can be broken. If the number of people immune is not a high enough proportion, the disease can slip through the cracks to the unprotected, and eventually spread to the infected as continuous exposure slowly overwhelms the limited defenses. And, as the infectiousness of a disease rises, so does the appropriate portion of the population to confer proper herd immunity. Measles is one of the most infectious diseases known to modern medicine, with an ability to remain viable for long periods both airborne and on non-antimicrobial surfaces. This is why small communities like Marin County, California, are experiencing such rapid outbreaks. Well, measles infectiousness and their own lack of protection. For a cartoon repeat of what I just went over, as well as an estimate of the population proportion required for immunity to measles, please feel free to consult http://imgur.com/a/MqpkY?gallery.
Now, let’s discuss why you might not want to vaccinate yourself or your child. Please be aware, I will deal with the moral ramifications of the autism debate, and the the insistence of parents over control of their children’s medical care in a moment. For now, I am concentrating on the science. The science is that since the turn of the century, the CDC has logged 69 incidents of possible vaccine adverse reactions. Let’s check that number again, 69. The requirements for a case to be logged: a serious adverse reaction to SOMETHING has to occur after the vaccination in a reasonable time span. Causation is not required to get on this list, just correlation. Consider this, every child in the United States, between when they are born and when they turn 18, provided their physician uses the CDC’s guidelines, gets about 36-40 shots. Multiply that by the number of children in this country in that time period and I won’t bore you with the scientific notation to display the percentage chance. Suffice it to say it is near machine precision.
Now, you may remember that there was once a study published in a scientific journal theoretically linking vaccination to autism, 1998 in the Lancet to be specific. Here’s the real story. Andrew Wakefield falsified data, paid little children for blood samples at his son’s birthday party, was paid thousands of dollars for expert testimony in an anti-vaccine class action lawsuit, filed his own patent for a variant of the above vaccine he discredited, and has since has had his paper retracted and his medical license revoked. Are you sure you want to listen to him, instead of the CDC? If yes, why are you reading my blog? Honest question.
But what about the mercury in the vaccines? Well for starters, the mercury you’re taking about was in a compound called thimerosal, which contained ethyl mercury, a specific mercury compound. Toxic mercury is methyl mercury, subtly but critically different. The latter is a neurotoxin, the former is a preservative and antifungal agent, helping to preserve the vaccine, which is good for everybody. You can actually easily get the bad mercury; a lot of it is in the oceans from pollution and concentrates in measurable quantities in some stocks of tuna, yeah that fish a lot of sushi uses. Further, to sate the public bloodlust the CDC ordered thimerosal removed anyway back in 1999, driving up the price and driving down the availability, harming vaccination efforts in the Third World, to no great effect on the medical health of everyone.
But, but, chemicals! When’s the last time you had salt? Should be fairly recently, humans need salt to survive. Would you happen to know what salt is made of? Sodium and chlorine, two of the most reactive elements on earth, the former explosive and the latter a deadly gas. Together they make French fries worth eating. Chemicals are a part of your every day existence, and the chemicals in vaccines have been so rigorously tested I thoroughly doubt that there is much at all about them not known to the medical community.
Now, let’s consider some of the morality to vaccines. First, yes, it is, for now, your choice on whether or not you can be vaccinated, or when you were a child, your parents’ decision. For all of you reading this, if/when you have children, that power will be in your hands. What do you need to consider? Well, you should consider the risks and benefits to yourself. Risk of not taking the vaccine: Potential to catch a life-threatening illness which can easily kill you, maim you, leave blind and deaf, etc. Benefit of not taking the vaccine: You don’t get poked. Risk of taking the vaccine: The mind-bogglingly insignificant chance that you have one of the handful of disorders making you allergic to vaccines and that to date it has magically gone undetected. Guaranteed sting of needle. Possibility of soreness, light fever for day, etc. Benefit of taking the vaccine: Not playing chicken with a deadly disease. But there is another avenue to consider, as if the case was not already ironclad. Herd immunity only works if everyone is immune. If everyone is responsible to choose concerning the vaccination conferring immunity, then we all share responsibility for maintaining this immunity. So when you don’t take the vaccine, not only are you taking your life, or the life of your child into your hands and playing microbial roulette, you are playing microbial roulette with everyone.
There is now a chink in the herd immunity. News flash, you (or your child, you is much less wordy) are not the only one who is not immune. Chances are, you are part of a group of such people, who are a gigantic microbial target. Case in point, Marin County, California. And when you are infected, you are at risk of spreading enough pathogen to infect another person despite their immunity. So really, at the end of the day, if you choose to not vaccinate yourself, you then fall ill and get another person sick, not only is it your fault, but everything that happens to them, and everyone they infect, and what happens to them, ad infinitum is your fault. And there are people that rely on herd immunity to protect themselves. The immune systems of the elderly for example are often compromised by old age and cannot deal with booster shots and must rely on this protection for their own safety. You aren’t just compromising yourself when you don’t vaccinate, you’re compromising everyone.
But what about rising autism rates, you say? Well, funny thing there, autism rates have been rising for a very interesting reason, a reason that says much about the upcoming generation and their parents. A 2013 study determined the vast majority of the growth in reported autistic cases is due to a vast increase in diagnoses. Children and adults brought before doctors and psychiatrists are being diagnosed with points along the autistic spectra at rates never before seen. And its categorization is so wide, the vast majority of the people I consider close friends, and myself for the that matter, register on the low to medium end of the spectrum. (That ought to tell you plenty about the crowd I run with.) Fundamentally, it’s similar to one of the reasons cancer diagnoses have also shot up, the greater success of diagnosis, both in life and in autopsy. What was once “Ailment” or “Sickness” is now all manner of diseases identified by the medical community, and autism is no different. (The associated conclusions about social perceptions of normal I shall save for another time.)
Now, let’s say you hold that your only concern can be yourself, that you can’t help others until you help yourself and somehow that logic follows through to not being vaccinated. Let’s consider something else. Let us consider that you are a parent with a child, and you are refusing to vaccinate over a fear that your child might develop autism, despite the lack of any inclination displayed by your child towards the known allergenic conditions. If such is the sum of your case, then firstly, I must denounce you as a close-minded fool, unable to listen or consider reason, as the science says you’re completely off the wall and on the other side of the room.
Second, let us truly consider what you just said. You took a stance where you said autism is undesirable. Without considering the implications for people with autism at the moment with that stance, let us consider further what your logic actually means. You mean that you are more willing to risk the permanent scarring, blindness, deafness, maiming or even death of your child from a preventable disease than the infinitely lesser risk of your child developing a social and learning disorder. Let that sink in for a moment.
You would rather risk your child’s life, than the damage to your image of your social reputation for having an autistic child. You would rather risk someone else’s life, than let them run a lesser risk of a condition that would mean you would need to have a greater role as a parent and supporter of your child. You find death to be a better fate than autism for your child.
I have no words for my disgust. Your entire role as a parent is to bring your child up in the best way you can, your entire priority should be them, but you are more willing to let them die than allow them to suffer a social disability and the associate damage you think your social standing would take. And let us truly consider this, because you are not worried about the child’s ability to succeed with autism but how that will deviate your life from your perfect plan and what it will do to you. On behalf of those on the autistic spectra, including myself at the very edge, and my younger brother well within it, you are hereby held in utter contempt.
This is what is wrong in America. This is the shot in the arm we need. The average adult holds the theoretical equivalent of the 10th grade science education, and that is before accounting for the sad state of public schooling in America these days. We need to get our heads on straight. When there is this much confusion between the medical professionals and the scientific community and the public at large, action must be taken. Not only should scientists make even greater efforts to clearly and simply convey their findings to the general public, but the public should listen. Politicians and celebrities would do well to promote the real science, rather than seek publicity with “controversial” stances that are misinformed at best and dangerous at worst.
One of the great dangers of the American breed of democracy is the belief that my ignorance is as good as your knowledge, and the media’s effort to present a “debate”, and raising pseudoscientific quacks and uptight nobodys to “debate” medical professionals does no one any good. There is no debate on the subject, the science is clear. Should the understanding change, so will the opinion of the scientific community and the governing medical bodies, and new policies will reflect that. In the meantime, these are the facts of the situation as best we all understand them.
To those of you out there touched in some way (probably not the warm and fuzzy way) by my comments about autism, consider my words. Consider where our society stands that that is our opinion, and how we managed to fall so far. Consider what we can do to rise from our folly, and how to move forward. Educate each other on the facts of vaccination, and counter this societal trend of perfection where you find it. That we can consider some lives less preferable than death is not a wise position to be in, and one we must confront at every turn. Please, take action. That is the only way any of this will ever change.
For a very blunt reading on the autism component of my post, this is the article that inspired me to write on the subject. It is not an easy read. http://www.addictinginfo.org/2015/02/03/autistic-woman-destroys-anti-vaxxers-theyd-rather-have-dead-children-than-children-like-me-screenshots/
Straight facts on measles in the US from the agency responsible for America’s health: http://www.cdc.gov/measles/cases-outbreaks.html
An amusing (sarcastically) read on the ongoing science and science education crisis around the world, please consult this well thought-out piece from the newspaper The Economist: http://www.economist.com/blogs/democracyinamerica/2015/02/politics-and-vaccinations?fsrc=scn/fb/te/bl/ed/whatexpertssaywhatpeoplehear
As always, thanks for reading and feel free to comment below. – GP