meganursula | (no subject)

I think this article is well worth reading.

http://www.wired.com/magazine/2009/10/ff_waronscience/

For the record, i think there is room for people to evaluate their vaccination approach. Something i like about this article is that is discusses many of the details in the debate which i think are too often poorly understood or just plain ignored by people.

There are a number of things i would quote from it, but perhaps the most salient for today is “The choice not to get a vaccine is not a choice to take no risk,” he says. “It’s just a choice to take a different risk, and we need to be better about saying, ‘Here’s what that different risk looks like.’

While people are wondering about flu vaccines, and novel H1N1 vaccines, i think we should keep this in mind. I do fall prey to the tendency to want to avoid the vaccines - both of them - because it is an unknown, and because i am currently healthy under the status quo. Why take a risky action when i can avoid it? The answer, of course, is that inaction is also a decision that carries some risk*, and all the current evidence suggests that for me, and my family, at this time, inaction is far more dangerous than the actual action. But, while my head can accept that, my gut still gives me trouble.

My out, of course, is that H1N1, the vaccine that i, particularly, should have this fall, but which is also more frightening because i haven't had it before, isn't available. So i have to hope that no one with exposed symptoms of swine flu rides the bus with my pregnant self, but i'm saved from a decision so far.

* complete aside - this, of course, applies to other areas in my life. Like my job.

Flat | Top-Level Comments Only

I think I told you once about the friend of mine who didn't vaccinate her child. I'd always supported her, and looked up to her as this kind of brave hippie mama for bucking the status quo. Then, while I was pregnant with Beth, I was notified by her that her pediatrician and some county official strongly suspected her kiddo (whom I loved dearly) had rubella, after we'd all been playing together for a few days. I was told to be on standby basically, that I could have contracted it, and that Beth could end up deformed or miscarried. That changed the whole debate for me.

Thankfully, her kid turned out fine, but it took me a long time to overcome a private resentment I had toward her, that she had put me and my unborn child in that position. I don't think I could have forgiven her had I contracted the disease and Beth suffered complications. I don't know how she could have forgiven herself if her child had gotten sick and suffered permanent damage.

I think Katje is very right; that you choose the risks you're willing to be accountable for. And I think you're right when you say that people today no longer have the social memory of what these diseases can do, and certainly right now we have a lot of distrust around the government and whatever they recommend to us. I am happy to vaccinate my kids for their childhood diseases, but I find myself balking every time I sit down to schedule flu shots for all of us.

I thought the article was right on when it said that throughout history, it's rationality that's the anomaly. It bothers me deeply that this guy is getting death threats from people for basically being a scientist, but that's another issue altogether.

And yet, flu is probably more likely to actually cause problems than many of the standard childhood diseases, and getting all adults vaccinated seems like it would feel safer than getting your infant vaccinated. I often end up with it because of my asthma, but i've never really been sure that it was necessary. Weird, isn't it?

I think some of the reason that the whole vaccine thing has grown into such a huge issue is that we see a threat to our kid - either way we perceive the threat to be - and respond completely animalistically. But, jeesh, yeah, i find it hard to sympathize with someone who would threaten someone who was really doing their best to do something great.

I'm not sure about that. I mean, would you rather contract the garden variety flu as a pregnant mom, or Rubella? Would you rather M got the flu, or polio? I'd go with flu, personally. I agree it would make more sense to vaccinate adults, but logistically that's a much bigger nightmare than vaccinating kids.

I should do my own research about the regular flu vaccine. You guys say above that there is ample evidence of its effectiveness, but I've always heard very mixed things. Which means anecdotes, which means I should actually look up some studies. Whereas, with the childhood disease vaccines, we have years of proof that they work, so I'm much less concerned. Beth has a lot of bronchial problems in the winter (I hear her coughing right now, in fact), so I'm thinking we should go with getting the vaccine this year. :\

Well, right now, far more people get the flu than get these childhood diseases. Also, because of the symptoms at the onset of contagion, and people's general awareness, it feels like you're much more likely to catch the flu than some of these other diseases. Additionally, you have a renewed risk for flu complications every year. I mean, i don't want the other diseases running rampant, either. I guess i was just thinking that we could really limit the spread of flu just by vaccinating every adult at work, without exposing kids at a sensitive time in their development.
And, in another sense, while i'm perfectly sure that i see value in vaccinating kids against whooping cough (one of the more realistic current concerns), i don't see how i wouldn't extend that conviction to vaccinating myself against the flu? If i want my neighbor to be vaccinated against rubella, shouldn't i vaccinate myself against flu, which could kill my immune compromised neighbor?

eh, maybe something to think about.

As to studies of safety in the flu vaccine - despite the fairly large number of people who don't bother with it, large portions of the population (percentage depending on year) have been getting vaccinated for decades. Evidence shows that it is 70-90% effective in preventing flu, and can reduce complications in those who do get the flu, depending on the year and composition. (The vaccine takes about two weeks to take effect, is less effective if it is the first year it has been received, and occasionally faces a mismatch between which strains of flu are included and which are present in the wild, which is why it is imperfect.) Rates of severe complications are shown to be much lower than rates of complications from flu.

If you do get the flu vaccine you can discuss with your doctor activated vs. inactivated (which have different statistics and uses). If you get your kids vaccinated you can request a single dose (mercury free) version. (You can do that for yourself, too, but, they usually limit who can have them due to manufacturing limitations, and there is compelling evidence that it doesn't matter anyway.)

Aren't all US vaccines mercury-free at this point? Or this is one of the (few, and I thought now zero) exceptions where they really need a powerful preservative?

Seasonal flu vaccines in a multi-dose vial have a mercury preservative in them. The also manufacture the vaccine in a single-dose vial, but because it is harder to produce those in large numbers, they tend to reserve them for children.