Monday, April 6, 2009

Vaccines

How about another measles outbreak? This one took place in Washington state. Eight kids in one household all got sick. They did not visit the pediatrician because of the rash, but rather due to complications of measles infection. Two developed pneumonia and one thrombocytopenia.

Nineteen cases altogether were associated with the outbreak. Of these, 16 were school-aged. All of these were unvaccinated due to philosophical exemption. Eleven of the children were homeschooled and 5 attended a faith-based private school.

The cases were linked to a large religious event held in a neighboring city. Four of the cases attended this event. Unfortunately, a month past before public health learned of the first cases which left lots of room for transmission. They believe the outbreak was stated by a Japanese national who also attended the event. She developed a rash while at the conference, and her brother had been clinically diagnosed with measles prior to her arrival to the US. She had received an MMR due to the exposure to her brother. There is not definitive evidence of this connection, however.

I feel compelled to out my stance on philosophical vaccine objections. As a public health worker and infectious disease epidemiologist, I should be hard core pro-vaccine. I am not. I understand parental concern over vaccines and I disagree with my colleagues who seek to demonize vaccine objectors. The scientists say one thing, the parents whose children have been inured by vaccines say another. How do you decide what is best for your child?

Vaccine preventable diseases can be devastating. In his autobiography, Benjamin Franklin wrote: “In 1736 I lost one of my sons, a fine boy of 4 years old, by the smallpox… I long regretted bitterly and I still regret that I had not given it to him by inoculation; this I mention for the sake of parents, who omit that operation on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that therefore the safer should be chosen.” The dilemma for parents today is that we are much more likely to be confronted with examples of vaccine injury than illness and/or death from vaccine preventable diseases. As such it is rational for parents to avoid the injury.

Nonetheless, at present, science does not validate the levels of anxiety about vaccines.

1 comment:

  1. Tough question...especially when we hear such things in the news like the flu vaccine not being geared towards whatever strain of influenza is the flavor of the month.
    That being said, it seems that certain vaccines are very low-risk and critical to keeping preventable diseases from being epidemic, especially as our cities/schools/daycares become ever more crowded.

    ReplyDelete