Vaccination: give me your evidence.

[jedusor]

From what I've seen, the process of altering controversial beliefs (religious, political, moral, etc.) tends to follow a pattern: kids fervently uphold their parents' views when they're young, then start to listen to enough of the counterarguments to become agnostic on the issue, then pay no attention to it for a while, and then finally decide to actually focus on the question and make a decision about it. I've seen this happen with the change from conservative to liberal, the change from religious to atheist, the change from atheist to religious, the change from omnivorous to vegetarian or vegan, and a host of others. The final perspective isn't always in opposition to the original--my opinion on abortion followed these steps from knee-jerk blind acceptance of one side (of course abortion should be legal, and you're just wrong if you think otherwise) to ambiguity and active ignorance (I'm not sure what I think, and I'd really rather not talk about it) to a period of careful consideration, after which I settled on my original opinion, but with actual reasons and a new capability of discussing it on a rational level. That period of indecision and not thinking about it is, I think, important to the process, and I've discovered through interactions with a lot of people that pressing the issue when someone's in that stage is about as pointless and frustrating as trying to argue with someone who's knee-jerk convinced that they're right.

My mother is--surprisingly, for someone normally so adamantly in favor of scientific progress--against vaccination. None of her kids, including me, were vaccinated when she had control over the decision. I believe Clayton and Lincoln have still never been vaccinated; Cordell had to get his shots before he could go to Japan, and I had to get mine before I could come to Clark. I've been in the "ignoring the decision" stage for a few years on this. I thought about it a little when I got jabbed for Clark, but I think I was still not quite ready to attack the issue.

I just read an article about it in Wired, and now I'm ready to take a look at the science and make a decision. So: tell me what you think, and back up your position with links and names and studies that I can look into. I suspect most of my flist is pro-vaccination; if you aren't, and you're afraid of getting jumped on, feel free to contact me privately or delete your comment immediately (I'll get it e-mailed to me).

EDIT: Please be civil.

Comments

[linaelyn.livejournal.com]

I'm not anti-vaccination. I'm not pro-vaccination. I'm pro-careful, thoughtful, case-by-case vaccination, rather than blanket application to all.

When we understood less about immunology, in the early days of vaccination, it made sense to just give the polio vaccine to everyone, and hope for the best. As our knowledge has increased, we can better understand the factors that might create bad reactions in certain individuals. Knowing that a specific individual has a family history of life-threatening reaction to a vaccine is a good reason to postpone or perhaps avoid entirely, vaccination with that particular thing.

I had a great aunt die within 24 hours of receiving her first tetanus shot, somewhere back in the 1950's. My mother was hospitalized after having a life-threatening reaction to her first tetanus shot, in 1959. For this reason, I postponed giving my kids tetanus shots until they were old enough to talk to me about how they were feeling. I wanted to be able to ask them about specific symptoms, and not guess if the infantile crying was sadness, tummyache, or "I feel like my skin is burning all over."

I haven't vaccinated the kids for chickenpox. Neither would I choose to take them to "a chickenpox party." I feel that giving the vaccinated or infected person a lifelong Herpes zoster infection that can flare into shingles whenever their immune response is reduced? NOT a positive result. It's just anecdotes, but I've watched several 12-18 year olds, stressed by their overscheduled, underslept lives, fall to a very painful, weeks-long case of shingles - and these are kids who were vaccinated, so they wouldn't be missing any school due to chickenpox.

I'm absolutely THRILLED about the possibility of a widely effective vaccine for HIV. That's where I think science should focus its efforts - vaccines for diseases transmitted by the unsuspecting asymptomatic human carrier, which later turn out to cause DEATH in most of the infected. Likewise, if we can eliminate most cervical cancer with a vaccine for HPV? Sign me up for that bandwagon.

The thing that throws vaccination into the realm of "wow, what were we thinking, when we did that?" is, quite frankly, the fact that it's a profit-driven industry. There is money to be made on vaccines, and huge sums of money to be lost as well. When scientific data unexpectedly show that the thing we thought was *going* to make a lot of money, suddenly has a setback where it's not effective or has poor outcomes? There's huge financial pressure to hide the data, and protect the stock value of the corporation. That's bad for public health.

All of this is just me spouting my personal opinions, here. I should back it up with data, and will try to do so... after I get through soccer, costume sewing, trick-or-treating w. the kids & their friends, and more soccer tomorrow! *hugs* thanks for the chance to stand on my soapbox, here.

[mh75.livejournal.com]

Apparently there is money to be made on the other side of the argument as well, as people are out peddling not only their convinctions against vaccines, but a myriad of unproven, and sometimes down right dangerous, 'cures' for autism, or, right now, flu-prevention medications.

Anyway, there is a good reason to vaccinate against chicken pox, which can be very very very bad in older people. My husband's chicken pox as an adult was very different than mine as a kid. (And the two people i know who have had shingles lately had chicken pox, not the vaccine.) I won't say that kids need it at 2, but, i wouldn't rule it out entirely. (For Katje, too, if she is reading this. Since it came up in her journal.)

[linaelyn.livejournal.com]

Apparently there is money to be made on the other side of the argument as well, as people are out peddling not only their convinctions against vaccines, but a myriad of unproven, and sometimes down right dangerous, 'cures' for autism, or, right now, flu-prevention medications.

Absolutely true. Two wrongs do not make a right. The fact that there are unethical folks on both sides of the equation should increase the care and vigilance with which one makes informed-consent decisions about medical procedures.

I definitely understand the dangers of adult primary chickenpox infection. My own sister caught chickenpox as a 24 year old adult and was hospitalized for a week. (This was years before the vaccine was developed.) She had to be fed via a tube, because her mouth was too full of blisters to swallow. She had blisters in her vagina. It was nothing short of horrific, lemme tell ya.

I've known probably around two dozen adults and teens who have had shingles, and some of those infections have caused pain and debility for months. Two of my elderly acquaintances have gone blind in one eye due to the infection. "Mary" lost her driver's license because she couldn't see well enough to drive anymore. My point is, chickenpox can be serious, shingles can be serious, and if you're trading the risk of serious illness in your 20's for risk of blindness in your 70's, then that tradeoff should be made clearer to the parents who are making the vaccination decision.

[vito-excalibur.livejournal.com]

I recommend this link (http://www.wired.com/magazine/2009/10/ff_waronscience/) to everyone.

If you don't believe in vaccination because it's a profit-driven industry, then I certainly hope you also don't get any other sort of medical care, and definitely that you never buy food or drink from others. Those are profit-driven industries too. That's how we get things, in capitalism.

And even so, please understand that in medicine, the real profit is in things like diet pills and insulin shots: things that people take every day or week for the rest of their lives. Anything for which the demand is one time per lifetime or at the most once every ten or twenty years, is just not going to be the huge money-maker that gets pushed for profit.

[linaelyn.livejournal.com]

I think you may be replying to a comment *I* did not make.

I am not anti-vaccination. I am not pro-vaccination. I am absolutely in favor of informed consent and case-by-case medical care for every individual.

I am not making my choices based on whether there's profit involved or not. I try to purchase *all* products and services with care, most especially when my main source of information regarding whether a product or service is safe and effective is the corporation or individual who will be financially affected by that information. Thankfully, the FDA regulates pharmaceutical companies who make vaccines and meat-packers who produce ground beef. In each of those industries, there have been instances where the FDA's oversight was insufficient to prevent human tragedy from occurring, due to ethical violations driven by corporate greed.

I read the Wired article the day is came out. It has many very good points. And it's not the whole picture. I repeat my original premise: I am absolutely in favor of informed consent and case-by-case medical care for every individual. Not everyone is suited to blanket vaccination,.

[imagines.livejournal.com]

Thanks for this post, because I'm right smack in the "not sure yet, rather not talk about it" stage, and maybe reading comments to this will help me out too.

[uncanny-npl.livejournal.com]

I'm generally, though not militantly, pro-vaccination, based on my own little, casual inference from history. That is, I find myself unable, quite, to take for granted the fact that my family and I don't have to live in fear of polio, smallpox, etc., the way my mother's family did. The whole debate, such as it is, makes me really curious to see what anti-vaccination parents will do once an HIV vaccine becomes available.

FWIW: Here's an article from slate.com that might add some nuance to your inner debate:

http://www.slate.com/id/2232977/

And here's another, not quite on-topic, but something I'm pretty sure you'll be interested in:

http://www.slate.com/default.aspx?id=3944&qt=vaccination

Good luck in figuring it all out. (Also, said the old woman who will be the first to let you know if she ever figures *anything* out for sure, you might want to become a little more wary of using a phrase like "the final perspective.")

[uncanny-npl.livejournal.com]

Actually, that second address should be:

http://www.slate.com/id/2232537/

And I actually think *this* is a much more interesting and provocative controversy than the anti- vs pro-vaccine thing. Lots of really big issues here. If I were your age, *this* is the sort of thing I'd be debating with my friends. As it is, I've got a 16-year-old daughter who just got her first HPV shot, so I'm about ready to saddle up my *own* high horse.

[all-ephemera.livejournal.com]

Personally, I am pro-vaccination. I think that some vaccines have been put on the market too early and/or without enough research, but I also think that I never contracted smallpox whooping cough or any other of a number of things I was vaccinated against. I feel like the reason some people are against vaccines now is because they seem irrelevant because who gets smallpox now? Because the vaccines work. I sometimes worry about what happens if too many people stop getting vaccines - do we start seeing a resurgence of these previously-nearly-extinct diseases?

I have no studies to present to back up my opinion, sorry. It's all opinion.

[rubrick.livejournal.com]

I apologize in advance for not following your "links and names and studies" directive, so this will mostly be just another rant. My view is that those who reject vaccines are ignorant, selfish, or both.

They're ignorant if they believe that more people have been harmed by vaccines than hurt by them; this belief is false by a bogglingly large margin. Vaccines have probably saved more human lives than any other scientific advance with the possible exception of antibiotics and awareness of the importance of sanitation.

They're selfish if they reject the vaccine because they've decided (based on valid or invalid evidence) that the risk to their own children from the vaccine is greater than from skipping it. The reason vaccines are such a public health boon is not just that they prevent individuals from getting a disease; it's that they eliminate vectors for the disease to spread. This is how diseases are eradicated; they run out of available hosts. Now, a certain number of individuals can get away with opting out, because they're unlikely to run into others who are also unvaccinated and carry the disease. Thus, Clay has probably never had rubella. Those who opt out are basically saying "I'm going to let others pay the expense an assume any risks there might be and I'll still receive the benefit of their efforts."

Now, in the case of specific vaccines, the calculus might change; there can certainly be diseases not worth vaccinating against. But to be anti-vaccine in general is to say "I think things were just swell when millions of people were dying of smallpox."

[vito-excalibur.livejournal.com]

...Yeah.

With the caveat that I totally understand people being selfish about their kids. And that vaccines are not risk free. And that it must be very, very difficult to accept that if everyone else gets their kids vaccinated then your kid is at very low risk if you vaccinate him and there is a risk if you do and you still should anyway.

And yet you still should anyway. Because things were not swell in the days of smallpox and polio and rubella.

But hey, pertussis is coming back as the anti-vaccine people get more of a foothold, so is meningitis...I guess eventually the connection between vaccinations and kids not dying will become less abstract and easier to understand, right?

[misterajc.livejournal.com]

I would suggest you look at the web sites run by the CDC, the WHO and the AMA.

Vaccination is actually a non-zero sum game with an interesting payoff matrix. If there are vary minor risks of side effects associated with vaccination and a few people don't do it they will benefit, as they avoid the risk of side effects, but enough other people are vaccinated that they don't get the disease. However, if you go past a critical threshold that would allow the disease to spread, everyone suffers - the people who did not get vaccinated because they are likely to get the disease, and the people who did because the vaccine may not be 100% effective and because of the economic and social consequences of a epidemic.

[mamagotcha.livejournal.com]

My mother is--surprisingly, for someone normally so adamantly in favor of scientific progress--against vaccination. None of her kids, including me, were vaccinated when she had control over the decision.

Cordell had his first round of shots at the age of 4 months, and had a pretty serious reaction to them. It was then that I started my research into vaccines (and none of it was done online). I'd also like to say that I don't think I'm a knee-jerk reactionary... I've come to my conclusions very, very carefully and with a LOT of research, and am constantly revisiting the decision.

I'll be interested in seeing what kind of responses you get.

[jedusor.livejournal.com]

I didn't call you one! I was saying that my agreement with you wasn't thought out, not that your decisions weren't. I'm asking for evidence from both sides here, and I'd appreciate hearing more about your reasoning. I've asked you before, and the answer has been different every time, but I don't think you've ever offered support for your position (beyond the autism link, which seems to have been pretty thoroughly debunked). Do you have any suggestions for me to read up on?

[mamagotcha.livejournal.com]

Sorry, you're right. You didn't. I've just been feeling kinda picked on and extrapolated your words.

I wrote more about it on my LJ, not wanting to clutter yours.

Oh, and I don't think the autism link has been debunked...

[jedusor.livejournal.com]

Pretty sure it has. (http://pediatrics.aappublications.org/cgi/content/full/114/3/793%29)

[mamagotcha.livejournal.com]

I'm combing through this, and not finding anything that shows the rates of autism in vaccinated vs. unvaccinated populations. Do you know where that is? Or can you help me find it? Thanks! It would help a LOT!

[mh75.livejournal.com]

I don't have bibliographical information, but i believe that there have been some pretty big European studies on the issue. Also, at least one of the big CDC cited studies has looked at that.

[mamagotcha.livejournal.com]

Danged if I can find any of 'em.

[mh75.livejournal.com]

*sigh*, and i'm crap at quoting real detail even when it comes to my research that i keep bibliographical information sitting around in, and i don't tend to keep the stuff i read on this subject. You could probably hyjack Bill's university library to look for something - perhaps a 'meta-study' would yield better results (as the skew in population size is problematic for this type of analysis).

[jedusor.livejournal.com]

It's difficult to find an unvaccinated population without a host of third variables to think about. You can't just grab a few hundred babies and randomly assign them to vaccinated and non-vaccinated conditions, and that's really the only way to come up with good data.

I can offer this (http://jama.ama-assn.org/cgi/content/full/290/13/1763), which is a study comparing autism rates between children whose vaccines contained thimerosal and those without. So if it's the mercury you're worried about, there's that.

[mamagotcha.livejournal.com]

No, mercury isn't an issue any longer. It's that it seems that autism is virtually unseen in unvaccinated populations, at least by anecdotal information. And while I was an art major, I *know* that anecdotal information is not terribly dependable... but it CAN be a source of "hmm, maybe we should look at this" before any studies are finally generated. And that might be where we are in this situation... enough anecdotes are building up to show interest in a large scale study of vaccinated vs. unvaccinated populations.

[mh75.livejournal.com]

My evidence right now is no better than anecdotal, and i'd like to go to bed, however, autism is not un-seen in an unvaccinated population. I don't know if the numbers match up precisely, but there are certainly cases of autism that develop in unvaccinated kids.

Perhaps you would find a starting point at the following:
http://www.cdc.gov/ncbddd/autism/documents/vaccine_studies.pdf

If you read the study descriptions you will notice that they are looking at kids that have been diagnosed with autism, and comparing whether they have been vaccinated, and when they were vaccinated to kids without autism.

[kaberett.livejournal.com]

It has - certainly MMR is known to have nothing to do with it.

www.badscience.net has a lot of details on vaccination, and the fact that vaccine scares tend to be confined to a single country or single language-group (MMR in the UK and the States; something different in France a decade ago which I've already forgotten).

Bad Science I recommend to you in general, actually, Julia; and for my part I'm largely pro-vaccination because I value herd immunity highly (looking at the measles/mumps/rubella rates in the UK post-MMR scare is pretty scary, particularly given life-threatening illnesses etc) and, looking at metastudies, the risks tend to be much lower than that of the illness.

Having said all which, in the case where a person has an adverse reaction to a vaccine that isn't due to how it works (e.g. 'flu - where most of the symptoms of the 'flu are your body going wrong, but it's still better to not get it) then I'd agree that not giving them any further vaccines unless it's possible to establish a reason and avoid it is probably sensible.

... and I'm still dithering over whether or not to get the swine flu jab, particularly given doc_spod's comments on it - he's pushing me from "can't be arsed" to "um, actually"...

[jedusor.livejournal.com]

What are his arguments in favor?

[mh75.livejournal.com]

People your age are being hit hard with complications, including bronchial problems, high fevers, mental confusion, brain inflammation, etc.

Also, herd immunity.

All of which could be prevented by a vaccine that has been tried and tested, and which is highly unlikely to cause even mild side-effects.

[misterajc.livejournal.com]

What were the shots that Cord got at the age of four months? How did the reaction that he got compare with the effects of actually catching the diseases he was inoculated against?

[mamagotcha.livejournal.com]

He was given the first round of injections recommended for his age... DTaP, probably MMR, possibly polio also. Unfortunately, there is no way I can answer that second question, because I can't say what the long-term effects of the reaction were... I suspect the high fever contributed to some damage of his tooth enamel, but other than that I have no way to find out what else would have been different.

He's the only child I have who has certain Asperger's syndrome symptoms, but again, I have no way to determine if he would not have developed those without being vaccinated.

He's also the only child I had with ear infections at a young age, but I was encouraged to wean him at an early age (6 months) and I suspect that this contributed more than his reaction, but I have no way to know for certain.

I wrote more on this on my own LJ, not wanting to hijack Julia's discussion... please feel free to check it out.

[mh75.livejournal.com]

I suspect that if you read my lj at all regularly you know both my considered opinion, the amount of effort i've put into developing it, and have seen links to various articles on the subject.
I tend to go to the CDC to get basic statistics when pressed, but, beyond that, i'd refer you to the librarian at a medical or science library. I'm afraid i don't keep links or bibliographies around to give you a lot of hard evidence.

[xthread.livejournal.com]

Herd immunity is your friend. It's my friend, too, which is one of the reasons I'm inclined to commend it to you.

If I had kids, there would need to be some really strong showings of harm for me to consider not vaccinating them. I managed to catch chickenpox as a near-adult, and had I been properly vaccinated, not only would I not have gotten it, I wouldn't have given it to the friend that I did. So, I think you can chalk me up into the strongly pro camp.

On the flip side, I've never gotten a flu shot, because I've never really had a particularly bad reaction to flu. (Unlike pneumonia, which nearly killed me when I was two). So that putative flu shot I might get is one that someone else would probably be better served by. Although I did pay careful attention when the first H1N1 reports were coming out - so far it appears that H1N1 really is as virulently transmissable as we were afraid, but it is not as lethal as we were afraid it might be, so we're coming out ahead. But there's definitely an epidemic on.

[(Anonymous)]

My kids are 14, 6 and 2. They've all had "wild" chickenpox but if they had not I would consider getting them vaccinated at puberty, mainly because I had chickenpox as a teenager and it was really, really bad. I'm a cervical cancer survivor but I'm not getting the girls that stupid "cervical cancer" vaccine because I believe that it was put on the market without enough testing, and the vaccine is really only for a few strains of hpv, which are not the only causes of cervical cancer. I had to get over 30 vaccines when I was in the Army, including a mandatory annual flu shot, and some of them made me very ill. The flu shots were the worst.

All that to say that even though my information is only anecdotal, it's enough for me to have rejected vaccines for my kids. I've read all your friends' arguments both for and against vaccination and I always try to keep an open mind...I generally do not try to convince people to do what I've done, but I don't mind telling them my own experience if asked :)

[jillcook.livejournal.com]

oops, that "anonymous" post was from my, I didn't realize that I wasn't logged in on my netbook

I had whooping cough

[tapati.livejournal.com]

and man was it a bitch! I thought I would suffocate. I've had various respiratory things over the years but this was in a class all by itself. I lived in a high percentage anti-vaccination town (Santa Cruz, CA) and we had an outbreak. My immunity had worn off from childhood vaccinations. I got to see exactly why it was so feared. If I, with adult level strength, could barely get air back into my lungs to cough again and try to clear my airway, trying as hard as I could, how could a small child or infant succeed? It took every ounce of strength I had. The eerie whooping sound for which it is named is caused by the tiny opening through the thick mucus as you are drawing a breath to cough once more. It takes several such coughs to finally breath more freely. I don't ever want to go through that again! Whooping cough has been making quite the comeback with so much fear about autism.

I also had a very severe case of chicken pox and was astonished to hear about chicken pox parties coming back into vogue. Of course while it's being incubated it is unlikely that every parent is quarantining their child, thus causing outbreaks of chicken pox to unvaccinated children or adults who never had it as children.

Then I have a pregnant friend who was made to feel guilty for getting the H1N1 vaccine and was in tears, worrying about her baby--for no good reason, just pressure from people who read all the anti-vaccination pseudoscience web sites.

So I wrote the following post (http://tapati.livejournal.com/489500.html) about vaccination hysteria as a result.

I also recommend this article. (http://www.wired.com/magazine/2009/10/ff_waronscience/)

Quote:

Twelve epidemiological studies have found no data that links the MMR (measles/mumps/rubella) vaccine to autism; six studies have found no trace of an association between thimerosal (a preservative containing ethylmercury that has largely been removed from vaccines since 20011) and autism, and three other studies have found no indication that thimerosal causes even subtle neurological problems. The so-called epidemic, researchers assert, is the result of improved diagnosis, which has identified as autistic many kids who once might have been labeled mentally retarded or just plain slow. In fact, the growing body of science indicates that the autistic spectrum — which may well turn out to encompass several discrete conditions — may largely be genetic in origin. In April, the journal Nature published two studies that analyzed the genes of almost 10,000 people and identified a common genetic variant present in approximately 65 percent of autistic children.

[rozasharn.livejournal.com]

There is no autism epidemic. (http://www.slate.com/id/2157496/) Also, there is autism in unvaccinated populations.

My general rule is vaccinate, vaccinate, vaccinate. The vaccines recommended for normal use are mostly long-established, well-tested, and safer than going for a ride in a car. The only times I would reccomend against vaccination are if there's a specific medical reason, such as egg allergy if the vaccine is egg-cultured.

You cannot rely on herd immunity because you can't know in advance who you'll be around or whether they've been vaccinated.

And the diseases we immunize against are horrible; that's why they were targeted.