Sunday, January 26, 2014

Crunchy Confessions: The V-word That Isn't Vagina

 

   I was working on a completely different post to start off the Crunchy Confessions series, but then I found dumb on the internet and got side-tracked. So this is my vaccine post. Spoiler alert: we don't vaccinate. I haven't been vaccinated since 2000 (though I still show titers), Joey since 2005, and Perrin not at all. Commence your judging. This post was supposed to be a simple explanation of why we made this decision, for the benefit of those who are curious. But then this happened:

http://www.latimes.com/business/hiltzik/la-fi-mh-antivaccination-movement-20140120,0,5576371.story#axzz2rHWps5hT

  So now I feel the need to address this article and unpack the misunderstandings that it represents before explaining our choices. Somethings I want to make clear- I think it's great that people are writing articles on this subject, even ones that are "pro-vaccine". I'm not anti-vaccine in any way. I just don't find them appropriate for our family. I think it is important that people openly discuss the subject and seek out as much information as possible to make their own decisions. That being said, I think those people who wish to present information should do their best to make sure it is accurate and not misrepresent it in anyway or rely on fear mongering to "win" the debate. Why is it even considered a debate, anyway? To me, a debate is a competition where someone comes out right. But that's not how this works. What is right for you may not be right for me. In fact, even when presented with the exact same information, you and I may come to different conclusions about what is appropriate. And that's ok- we are different people. That is part of this wonderful human experience. What's more is that this "us vs. them" mentality is incredibly inaccurate. There are people who vaccinate fully, including all the little extras like flu and HPV. There are people who get everything required for school and work, but nothing more. There are people who get everything required, but delay and separate on a modified schedule. There are people who selectively vaccinate getting some but not all that are recommended. And there are people who don't vaccinate at all. This isn't Westside Story; it's not about picking sides. So the reason that above article irks me is not because it is in favor of vaccines but because I feel it is poorly written and presented to purposefully misrepresent a few things.

   For starters, let's talk about that awesome map. This "devastating graphic" is supposed to show the toll of the "anti-vaccination movement." I'm not really sure there is a movement. I've never been invited to meetings or anything, but whatever. But if you take two seconds to read the map, you will realize that this depicts measles and whooping cough outbreaks across the globe. You know what it doesn't show? Which of these outbreaks occurred in non-vaccinated people. The whooping cough outbreaks in the U.S. for instance have largely been in vaccinated individuals. You know what else it doesn't show? The reason people were not vaccinated. The author later talks about the unavailability of the MMR vaccine in Africa. How exactly is my decision not to vaccinate my child responsible for drug shortages on the African continent? I am all for making vaccines available in African countries and I agree that they will save millions of lives. I would never argue for restricting anyone's access to vaccines. I understand that the decision not to vaccinate is a truly privileged one dependent on access to excellent medical care. So showing a map of disease prevalence and then blaming parents in the U.S. in one grand swoop just makes absolutely no sense and is incredibly inflammatory.
   Next we have one of my favorites- "But in the developed world it's an artifact of the anti-vaccination movement, which has associated the vaccine with autism." I have never met anyone who made the decision not to vaccinate because of autism. This is one of the most rampant misconceptions about parents who choose not to vaccinate. Are there people out there who do believe this? Sure. But that is in no way representative of everyone who makes that decision. Our reasons not to vaccinate, which I will address shortly, have nothing to do with autism. You may not agree with the decision I have made, but trying to make me out as a crazy conspiracy theorist is just rude. 
  And then we have the part that really pisses me off- "The lesson of all this is that vaccination is not an individual choice to be made by a parent for his or her own offspring." Excuse me...what? You really want to open that can of worms? Who exactly will be making the decision about what will be injected into my body against my will? What is worse is that this argument seems to be predicated on the idea that unvaccinated people are a threat to the total population, which is nonsense. This plays back to the theory of herd immunity, or the idea that once 95% of the population is vaccinated against a disease, the disease will not longer be able to exist. The only problem is that this theory has never been proven. Even if it had been theoretically viable in the past, the size of the global population and the ease of travel would make this impossible to achieve. If vaccines work, the vaccinated have nothing to fear from the rest of us. 
  Another common error that this author is making is that he seemingly uses "unvaccinated" to refer only to those individuals who actively decline vaccination. What few people realize is that a large portion of adults are "unvaccinated" without being aware of it. Unlike natural immunities, vaccines wear off overtime and require boosters. If you have not had regular boosters and haven't been checking your titers, there is a possibility that you are unvaccinated. 



   I would love to discuss the risks associated with vaccines and the negative externalities that can occur, but I really don't have the time right now and I would hate for people to think this is simply a vaccine-bashing post. So instead, I am going to explain the main reasons why we choose not to vaccinate and I will discuss this in terms of Perrin, since he is the only one of us who is completely unvaccinated. 

1. The eradication of diseases in many parts of the world has nothing to do with vaccines. Instead, many diseases disappeared because of improvements in sanitation and general health.
2. The mortality of many diseases was more a result of the inability to treat secondary infections such as pneumonia. The measles for instance is generally harmless in people with healthy immune systems. If by chance a patient does experience complications, modern medicine now has appropriate ways to treat them. Varicella is one of the most mild illnesses. The decision to vaccinate for varicella wasn't even due to public health- it was money. The push for the vaccines was to prevent parents from having to take time off to be with their kids, thereby loosing productivity for businesses.
3. Many diseases haven't been present in the U.S. for decades. Polio is a good example- add in that it is transmitted through fecal matter and there is almost 0% chance of Perrin ever coming in contact with the live virus.
4. Many diseases aren't even a risk to certain populations. Take Hep B for example. The first shot given to babies in the U.S. You know who is at risk for Hep B? Intravenous drug users and prostitutes. Seriously, the CDCs decision to administer Hep B at birth was based solely on the fact that it's hard to convince promiscuous drug addicts to schedule yearly exams. It was a decision made out of convenience, not necessity.
5. Common reactions to vaccines are fever, aches, and chills. The same, if not more, symptoms that present for young children had they actually contracted the disease. Why not just get the natural, life-long immunity?
6. The immune system is not fully functioning until after two years of age. There is reason to believe that in children under two, the immune system is not able to effectively integrate the vaccine and it may be damaging to overall immune development.
7. Breastfeeding reduces the risk of most vaccine preventable diseases.
8. You can always choose to vaccinate later on. Perrin can make the choice for himself when he is older. I can always change my mind. You can never unvaccinate. I am not comfortable injecting foreign substances into an unconsenting individual.

    So there you have it. There is not one vaccine preventable disease that I feel we have a reasonable chance of encountering that also presents a large enough threat to justify vaccinating for. Does this decision come with risks? Absolutely. So does the decision to vaccinate. Or drive a car. Or do any number of things. We make risk-analysis decisions everyday. Do people still die from these diseases in the U.S. ? Yes. You know what even more people die from? Heart disease. Cancer. But no one is up their neighbor's ass picking apart the different carcinogens they have in their home and what they are serving for dinner tonight. Maybe you aren't comfortable with the same risks that I am comfortable with, and that is ok. You want to get every vaccine in existence? Go for it! But don't get offended that I don't make the same decision. And for the love of God, don't blame me for a case of measles in Ethiopia.

Here are two other opinions that I feel explain the above pretty well.
This one is a blogger that also does not vaccinate, and she breaks down the risks of each disease and the corresponding vaccine.
http://blindedbythelightt.blogspot.com/2013/12/a-specific-approach-to-question-why_3.html?m=1

This book, though the title sounds a bit juvenile, is actually not an "Anti-vaccine" book. In fact, the author's suggestion is a selective and delayed vaccine schedule. That being said, after reading it I still felt comfortable with our decision.
http://www.amazon.com/What-Doctor-About-Childrens-Vaccinations/dp/0446555711

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