I am confused. I am confused about vaccines. When I immigrated with my family to Los Angeles, in order to attend school as an immigrant child, I had to prove that I had all my vaccinations. When my mom produced a hand written paper from Eastern Europe they could not make sense of the weirdness of Hungarian language and instead of trusting my mother (who has two PhD of her own) they gave me ALL the vaccines again. My mom simply said, “Well, it is better to be cautious”. Much later on when I applied for work at a research institute in Seattle where we handled possibly contagious human blood, the first thing the workplace did was send me over to the hospital to review my vaccination record and do a tuberculosis check. Of course I received even more vaccines. All health care professionals have to have additional vaccines against Hepatitis A and B and some other possible infections. During this visit with the nurse I tested positive on the tuberculosis test (of course this was because everyone who had TB vaccine tests positive to the antibody test. It does not mean that I was sick. Since I am from Eastern Europe I had the TB vaccine…) When I looked up the nurse’s face was quite nervous. I calmly pointed again to my wrinkled old piece of paper from Hungary with the stamp indicating “BCG” that is TB vaccine. In the US they are no longer mandating TB and small pox vaccines, both of which I had… Of course this was the same confusing document that got the immigration nurse worked up, and this time again it created the same effect which lead me down a really uncomfortable couple weeks with no work and a few chest x-rays. Finally, after spending much money and time, I was cleared to go to work and deemed infection free. Clearly, possible infections are taken very seriously in this country. I knew this was protocol but I was irritated and frustrated because by now, of course, I knew very well the confusion and the double standards about vaccines in this country. This was also right about the time when I did a lot of travels in South East Asia so there goes even more vaccines: Yellow Fever, Japanese Encephalitis, polio booster, rabies, typhoid and so on… Basically I am vaccinated against practically everything my motto against viruses and bacteria is “bring it on, I can take it”.
The reason I am rambling about all my medical records to you is to say, I don’t get it. It never crossed my mind to not get vaccinated. As a matter of fact, since this country made sure that I had all this protection I was absolutely flabbergasted to learn that American born children don’t have to go through all this rigor to go to school! Why the double standard? What will these unvaccinated children do if there is an outbreak? Or, if they get lucky and there is no outbreak of any diseases in their lifetime, what if they want to travel or become researchers or doctors? I wanted to find out why people are scared to vaccinate their kids. To me this concept was so foreign. Like I mentioned, I am a naturalized citizen of United States. In a lot of ways, I am embedded in the American culture but since I was born and raised in Europe many of my thought processes are still stuck on the other side of the pond… I don’t understand why people are afraid of vaccines. I wanted to find out. Also, in light of the recent outbreak of measles, I wanted to reach out to folks who may be confused about vaccines and they don’t know where to look among so much information.
Since I worked in an immunology research lab, finding a PhD with Immunology background was as easy as opening my contacts and calling my close friend Shannon. Shannon has a PhD in Infectious Disease from Notre Dame University. We both worked in the same institute on autoimmune diseases. Shannon also has 4 children that she raises in the Catholic faith. I hoped she would have the perspective on what is going on with all this confusion. I called her up and she was most exited to help. She asked me to send her some questions so she could prepare, quite typical of Shannon! Of course last minute she texts me that she has to take her oldest to the orthodontist, that she wants to help a lot and would I mind just coming along. Of course I just smiled. I adore her and being a witness to her lovely growing and ever so busy family I learned to be part of her family and roll with the changing schedule. So on a rainy Seattle afternoon we found ourselves huddled up at the orthodontist office full of kids. Somehow that made this interview even more important. Being around children while talking about children’s health was the perfect motivation for this article.
I leaned close to Shannon and asked her almost in a hushing tone as to not be overheard. “Shannon, I am curious to hear your point of view. Why do you think some mothers are reluctant towards vaccinations?”
To this she said, “Dora, the second my first born came out of my belly the only thing I wanted is to protect her against all and every possible harm. From the moment of her birth there was nothing more important than my child. I think mothers everywhere are motivated from this very same instinct. Unfortunately, there is so much information and misinformation out there and it is hard to determine what is right. To compound the problem, the language of Immunology is really difficult. Even well-educated folks struggle with making sense out of the publications since the science is so complicated and is based on a vocabulary that is foreign to most people.”
I smiled because I recalled my own struggle in school making sense of antigens, antibodies, IgM, CD8, T-lymphocytes, CD4, CD28, cytokines and chemokines, oh and the list goes on. Yes, immunology is exciting. It is a micro world that is not visible to the eye. It has many different cells on complex superhighways that navigate this internal world. To understand what goes on in the body in that level you really need at least a few years of university level cell and immuno biology.
“If you look at the vaccination data in schools, it tends to be the well to do districts that have lower vaccination rates”, Shannon continued. “This is quite different from other countries where the poor are under vaccinated and they are willing to walk for days with their child on their back to receive vaccines.”
“Yes, exactly! I shouted, I just had to interrupt her. “This is what I don’t get! I had many conversations with other immigrants, for example my friend from South Africa, he is just as lost as I am. He told me, if you don’t get your vaccines you get sick and die it is simple as that. So people take vaccinations very seriously.”
“Yes, but in this country people rarely ever get sick, and hardly anybody dies” At this point Shannon was clearly trying to lower my excitement with her voice since folks started looking at us. My laser vision could tell from the quality of stares who was ‘pro’ and ‘anti’ vaccine in a single glance. Or at least my vivid imagination made people walk around with signs on their forehead for brief minute.
“OK” I said, “So just for the record, are your kids vaccinated?” To this Shannon gave me a broad smile: “Of course. I think as a parent, it is a matter of who you put your trust in. Do you trust the American Academy of Pediatricians to make safe recommendations for kids ‘health, or do you trust people outside the Academy, who in my opinion, have questionable backgrounds and don’t have the training required to make recommendations for or against vaccines. ”
“But what about possible side effect?” I asked.
“All medications can have possible side effects. Nobody is arguing against that. But the ratio of possible harm due to vaccines versus the possible harm of the disease that we are vaccinating against is so astronomically favoring vaccination that it is simply hard to put it in words.”
“Some people question the ingredients in vaccines, can you talk about that?”
“Yes, a lot of folks worry about the ingredients found in vaccines like aluminum. This makes sense because you don’t want to be injecting your child with something that might damage them, or in the most extreme case, cause them autism. However, there are great resources from the CDC that clearly list the various ingredients found in all the vaccines used in the United States with the latest information on safety. “
“Thanks Shannon, these are really great websites. I did not know that aluminum was found even in breast milk! There is some really useful information here”:
Next, I asked Shannon what other concerns she hears from parents. She said: “Vaccination schedule. They are worried that it is too much, too fast and the child’s system is not able to handle it.”
“HA” I thought, I was used as a pin cushion by immigration and work immunization nurses. I scratched my head. “But wait, if I remember well I think the human body is built to handle a lot more than just a few ‘invaders’ at the time.”
“You are right Dora, imagine all of the antigens or germs that a child is exposed to crawling around on the ground, or playing at the playground. Our Immune System is highly capable of handling a large dose of germs at any given time. There are good resources for this too.” This is a great handout by American Academy of Pediatrics on the most commonly asked questions on vaccine schedules:
“It has been said from some folks that these vaccine preventable diseases are not necessary anymore in the United States because these diseases are eradicated. But with the new measles outbreak, nature is here to prove otherwise.”
“Yes, unfortunately. This following website has personal testimonial about the consequences to diseases. These testimonials are heartbreaking and worthwhile to read:
At this point I took a deep breath. “The herd is breaking down” I said. I remembered learning about ‘herd immunity’. It is the idea that if enough people are vaccinated than the few that are not vaccinated can be protected just by being surrounded by folks who are vaccinated and thus will not pass the disease. Since the disease is relying on human to human jumps, if it jumps mostly to humans with vaccines where it is destroyed it cannot continue jumping.
So far in United States, those parents who were afraid of vaccines were protected from the disease by the other people who were willing to get vaccinated. The World Health Organization recommends vaccination of 95% of the population to ensure “herd immunity” and prevent outbreaks of measles. As long as the number of people not getting vaccinated is very low it sort of works because the herd of vaccinated folks can form a thick barrier. This is why all of us immigrants are vaccinated to porcupine state. In essence what the CDC is doing is trying to isolate the USA as much as possible to protect its citizens from itself. But now more and more children and not getting vaccinated, so the herd is breaking down. This is all compounded by the fact that global travel is easy and fast, countries are no longer isolated. Once the herd is not thick enough for protection these illnesses will jump around again killing and injuring children.
So it comes down to common sense. Even if we suppose that there are side effect to vaccines, if we don’t vaccinate the morbidity and death rates of infants and children will rise significantly. Maybe we have forgotten how few children survived into adulthood without vaccines. So the choice is either take vaccines that may or may not have side effects that we have not determined yet, or to allow people to not vaccinate and guarantee that an epidemic will make many children die and suffer.
We are fortunate enough to be the first generation in the United States that has not experienced a horrible outbreak. This places us into a false sense of security. Vaccines protect us against horrible diseases but we no longer see these diseases. We see autism is on the rise so mothers are asking what to do. On one hand mothers have an illness that they have seen face to face such as autism and on the other hand they have a bunch of illnesses that they only hear about in the doctor’s office.
With vaccines we are fighting conceptual evil while there are other more touchable problems in our current society. But these conceptual evils are very much real, the only thing that keeps them away from us is mass vaccinations.
I wonder just how much ‘thinning of the herd’ is necessary before people start getting really-really sick….
Below is a list of some additional information sites on vaccines that I received from Shannon:
Specific vaccine handouts: