February 17th, 2012
As the number of parents who refuse to vaccinate their children grows in the US, so does the number of pediatricians who refuse to treat them. Over at the inevitable comment thread at Metafilter, one pediatrician explains the realities of vaccination and the risk your children run if they’re not vaccinated:
Sometimes I work with families for whom the reality of the morbidity and mortality of these diseases is extremely limited. In my education, I do focus on morbidity because families will not hear that they are putting their children at risk to die. The injuries from these diseases are often more concrete, even minor injuries like the significant scarring of varicella, or persistent airway disease from pertussis. Refusing MMR exposes male children to infertility risk, all children to acquired heart defects. Refusing HiB, even if your child does not die from meningitis, will surely result in acquired neurological, cognitive, vascular, and extremity injury once heroic efforts have saved the child from meningitis death. In the case of HiB, many currently practicing providers lived through the complete horror of internship and residency in children’s hospitals’ meningitis wards where babies were dying all around them that could not be saved. My current attending talks about the weeks when HiB vaccine was, then, introduced and the wards closed up, one by one. And he gets freaking teary-eyed about it, even now. Refusing pneumococcal vaccines like Prevnar opens all of us up for more of the same–the current Prevnar 13, for example, covers for 48% of invasive meningitis.
Families do not believe they are accountable to their own children–that they answer for their scars and acquired disabilities. But they do. Injury from actual vaccine is an incredibly small and fully reported risk. Any parent can go to the CDC site, at any time, and monitor vaccine injury. But the risk of acquiring a preventable childhood disease by refusing to vaccinate is nearly certain in that child’s lifetime. It’s as if a family made the decision to let their infant lay across the backseat, unbuckled, without a carseat, because they decided they would simply just drive very carefully.
My sympathies all lie with the doctors, though I can spare some pity for those parents who, genuinely wanting the best for their children, are taken in by one of the bullshit merchants preying on their fears and insecurities, their greed masqueraded as concern. But vaccination is not new, not controversial and has been used for a long long time, has slain some of the greatest childhood killers: smallpox is gone completely, polio almost, measles in rich countries is an inconvenient childhood disease, nothing to be worried about. That very same success ironically now makes continuing vaccination programmes vulnerable to indifference as parents wonder what the point is, if these disease are gone or under control. But they are still necessary and not vaccinating doesn’t only put your own child at risk, but other people’s children too…