"Avoid!" One of the most common bits of advice heard these days. Avoid tap water. Avoid bottled water. Avoid butter. Avoid margarine. Avoid the sun. Avoid sweeteners. Avoid genetically modified foods. Avoid plastic bags. Avoid paper bags. Avoid preservatives. Avoid dairy. Avoid meat. Avoid soy. Avoid..ahh..never mind. I could go on and on with a litany of such “avoids”. There are some valid points to be made with some of these, but there is one “avoid” that is particularly troublesome. That is the advice to avoid vaccination.
I can understand some hesitancy about COVID-19 vaccines. After all, these have been rolled out in an amazingly short time, far shorter than any other vaccine ever. That raises the question of shortcuts having been taken, an accusation that is not borne out by evidence. The theory behind the vaccines is sound, the trials have been well designed, and the early results better than expected. Much of this is due to unprecedented scientific cooperation and lots of researchers putting their backs to the wheel. It is true that the trials so far have been short and that long-term evidence is lacking. However, there is no way to get around this, you cannot have long term results before a long term has passed. Mired in a pandemic we just cannot afford to wait. Our best bet at getting back to some semblance of normalcy is widespread vaccination.
What do we say to people who don’t trust the science, who believe the research has been rushed and think that mRNA vaccines mess with our DNA? I doubt they can be convinced, so I say, nobody is forcing you, if you choose not to get vaccinated, so be it. This, though is not what I say to people who choose not to give their children the time-tested childhood vaccinations. That is a different story.
Vaccination just may be the most significant medical advance in history. It is difficult to estimate the number of lives saved, but it is in the many millions, to say nothing of the countless number of people who have been spared the misery of mumps, measles, whooping cough, and polio. I can vouch for the agony of whooping cough myself. Feeling as if you are going to cough your lungs out is a memory that doesn’t leave you easily. I survived, but one of my grade two classmates did not. And how often can one say that a disease has been completely wiped off the face of the earth by a medical intervention? The last case of smallpox was recorded in 1978. The World Health Organization estimates that in the twentieth-century smallpox killed as many as 500 million people and that as recently as 1967 it was responsible for two million annual deaths.
Other vaccines may not have eradicated diseases, but they have curbed their incidence very significantly. Whooping cough cases in North America have declined from a pre-vaccination peak rate of about 300,000 per year to 10,000. Measles from a million cases annually to one hundred. Diphtheria and polio are almost non-existent today in developed countries. The incidence of hepatitis B and tetanus have been reduced by a factor of 40, rubella by 200 and mumps by 400. The effectiveness of immunization is simply beyond argument. How can there be an issue here? How can some parents choose not to vaccinate their children? It really is a conundrum. But the answer likely lies in a growing distrust of the “medical establishment,” a discredited but widely publicized scientific study, inaccurate information being spread on the Internet, and a lack of understanding of the difference between an association and a cause and effect relationship.
Although we may not think of it in such terms, the decisions we make in life often come down to a risk-benefit analysis. Whether it is flying in airplanes, eating smoked meat, taking cholesterol-lowering medication or vaccination, there are always plusses and minuses to consider. There is no denying that immunization does come with some risk. Rashes, joint pain, fever are well documented, as are occasional lapses in the speed with which safety issues concerning vaccines have been addressed. Oral polio vaccines, which were more convenient to administer than the injected form, were responsible for actually causing the disease in rare cases. Yet, some twenty years were allowed to pass before switching back to the safer, injectable form. An infant vaccine against an intestinal infection striking roughly four million babies a year in North America was found to cause an increase in life-threatening cases of bowel collapse and had to be abandoned. Although there is no scientific evidence linking the mercury-containing preservative thiomerosal to any disease, it probably should have been removed from vaccines more speedily when ill effects attributed to mercury in other contexts became apparent.
Vaccines in a sense are becoming victims of their success. As memories of the horrors of the original diseases that they prevent fade, more attention is being focused on possible harmful side effects. Indeed, one can judge the progress of society by looking at its worries. Instead of having to be concerned about millions dying from smallpox or coming down with measles or whooping cough, we worry about the possibility of vaccination being linked with some cases of autism. That suggestion was raised in 1998 by a paper published in the British medical journal, The Lancet. Andrew Wakefield and twelve colleagues claimed that the measles, mumps and rubella vaccine (MMR) caused a bowel disease which then caused autism.
The report received extensive publicity and triggered public demonstrations against mandatory vaccination. Most scientists were skeptical of the Wakefield study, and their skepticism was borne out by the results of an investigation published in 2002 in the New England Journal of Medicine. Danish researchers had examined immunization records and autism diagnoses for all children born between 1991 and 1998 and found that unvaccinated children were just as likely to be diagnosed with autism as those who had received immunizations. The Lancet study was further discredited when it was revealed that Wakefield had failed to disclose receiving a large grant from a group of lawyers who were looking for ammunition in a lawsuit against vaccine manufacturers. In the end, ten of Wakefield’s co-authors retracted their support of the original research, saying that in retrospect the results as reported were not valid.
Other studies around the world also refuted the link between vaccines and autism but a vocal group of anti-vaccine advocates maintains that a witch hunt has been organized against Wakefield to protect vaccination interests. Humbug. The fact is that autism commonly shows up roughly at the same age that vaccines are given, and an association can readily be mistaken for a cause and effect relationship. But even if there really were a link between autism and vaccination, the anti-vaccine movement would still not be justified. The benefits overwhelm the risks.
In Britain, the consequences of the vaccine scare are already being seen with rising rates of mumps, rubella and measles. And Britain faces another problem. Homeopaths are recommending that tourists traveling to malaria laden destinations use homeopathic remedies instead of well-tested prescription prophylaxis. This is ludicrous. Homeopathic products contain no active ingredient of any kind, so it comes as no surprise that a number of travelers have already paid for their folly with their health. Many homeopaths also advise their patients to avoid vaccines in lieu of a cacophony of implausible homeopathic medications. If indeed you are looking for something to avoid, how about this silly and dangerous advice?