Thursday, October 6, 2011

Dispatches from the vaccine wars

From the Pittsburgh Post-Gazette:
By age 6, children should have vaccinations against 14 diseases, in at least two dozen separate doses, the U.S. government advises. More than 1 in 10 parents reject that, refusing some shots or delaying others mainly because of safety concerns, a national survey found.

Worries about vaccine safety were common even among parents whose kids were fully vaccinated: 1 in 5 among that group said they think delaying shots is safer than the recommended schedule. The results suggest that more than 2 million infants and young children may not be fully protected against preventable diseases, including some that can be deadly or disabling. ...

Kandace O'Neill is a Lakeville, Minn., mom whose views are shared by many parents who don't follow federal vaccine advice. Her 5-year-old son has had no vaccinations since he turned 1, and her 7-month-old daughter has received none of the recommended shots.

"I have to make sure that my child is healthy, and I do not want to put medications in my child that I think are going to harm them," said Ms. O'Neill, who was not involved in the survey appearing in Pediatrics.

Ms. O'Neill said she's not an extreme anti-vaccine zealot. She just thinks that parents -- not doctors or schools -- should make medical decisions for their children.

Parents should make these decisions. Well, at first glance, that sounds reasonable, doesn't it? But on what are they basing those decisions? Are they doctors? Are they medical researchers?

If you don't base these decisions on the overwhelming scientific consensus, then on what are you basing them? Why do you have more expertise than medical professionals? Did you have to get a thorough education in biology and medicine before you were allowed to become a parent?

Study author Amanda Dempsey, a pediatrician and University of Michigan researcher, said vaccine skepticism is fueled by erroneous information online and media reports that sensationalize misconceptions. These include the persistent belief among some parents about an autism-vaccine link, despite scientific evidence to the contrary and the debunking of one of the most publicized studies that first fueled vaccine fears years ago.

Some parents also dismiss the severity of vaccine-preventable diseases because they have never seen a child seriously ill with those illnesses.

But vaccine-preventable diseases including flu and whooping cough can be deadly, especially in infants, said Buddy Creech, associate director of Vanderbilt University's Vaccine Research Program. Dr. Creech has two school-aged children who are fully vaccinated and a newborn he said will be given all the recommended vaccinations.

If you were just putting your own children at risk, I suppose you could argue that that's your right. We don't, as it turns out, let parents recklessly endanger even their own children, and I, for one, wouldn't want to change that. But for the sake of argument, let's give them that.

However, skipping vaccinations doesn't just endanger your own children, but other children, too. Children too young for vaccinations rely on herd immunity for their safety. When too many children skip their vaccinations, infants die.

Also, vaccines aren't magic. They don't always protect every single individual as they should. Your child may have received his vaccinations, yet still be at risk of disease, just because of an atypical response. That child, too, depends on herd immunity, the fact that most people are vaccinated, so the disease can't get established in his community.

Any way you look at it, skipping vaccinations puts your child and other children in danger. It doesn't make any difference if you're a parent or not, your gut isn't a good way to make these decisions. And neither is browsing the internet until you find something you want to believe.

You may, after all, find some video or article that sounds really plausible. But how are you to judge that? Even doctors depend on medical research, and they don't - not if they're smart, at least - choose to believe some lone researcher who disagrees with the consensus.

He could be right, of course, but it's far more likely that the vast majority of scientists are right, instead. After all, that scientific consensus is based on evidence - peer-reviewed and independently-duplicated evidence.

Accepting the scientific consensus is the only rational move in issues like this. The scientific consensus could always be wrong - and all scientists understand that - but you've got to understand that it's far more likely to be right than any other way of making decisions.

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