Immunisation - some thoughts for hesitant parents
At MMC we strongly believe that immunisation is a hugely effective preventive health measure, second only to the availability of clean water. Millions of lives have been saved by immunisation, and diseases such as smallpox have been eradicated from earth. Polio is tantalisingly close to eradication, with decreasing numbers in Pakistan and Afghanistan. Africa has had no polio cases for over a year (August 2015) thanks to an enormous effort by many, many passionate people, against all sorts of obstacles. For example, Unicef trains thousands of volunteers to promote polio vaccination. "“Being a parent myself makes me want to protect all the children of the world,” said Suzan, a mother of three and a Unicef volunteer in Dar’a, Syria.
When the global polio eradication drive began in 1988, more than 350,000 children around the world were paralysed by the virus each year. Polio serves as a case study for us to reflect on many of the most important principles around immunisation. Firstly, it reminds us that we all live together on this beautiful planet, and unless a disease like polio is eradicated from every last pocket on the globe, it will come back, spread, and remain a risk to us all. In the end, we are all dependent on each other, or as Martin Luther King wrote: “We are caught in an inescapable network of mutuality, tied in a single garment of destiny. What affects one directly affects all indirectly." Secondly, the problems with polio eradication in Pakistan and Afghanistan are largely due to incorrect beliefs (myths) about polio immunisation, with conspiracy theories about the CIA and Western governments having a strong hold in sections of society, especially in areas controlled by the Taliban.
Closer to home, we have a similar example: measles. We know that measles can be easily prevented and could even potentially be eliminated, like smallpox. But, if vaccination levels drop in a community to below 95%, measles can easily spread. Imagine for a moment if you were the parent of a child who has been treated for a life-threatening illness like leukaemia, and can’t receive measles immunisation because of his compromised immune system. You don’t need to imagine what it would be like to see your child go through an illness like that, and the treatment. Just think how it would feel if your child was faced with the prospect of getting measles (with potential serious or fatal complications) during a measles outbreak. And so we see that independent choice about measles immunisation is an illusion: if you decide not to vaccinate your child, you are placing others at risk as well. Some of those others will be especially vulnerable. “Immunity is a shared space—a garden we tend together.” (Eula Biss, “On Immunity”).
Measles also highlights the role of myths in health beliefs in western societies like ours. A huge body of research has conclusively shown that there is no relationship between measles vaccination (MMR) and autism, but the myth persists. We know that myths thrive when people need an explanation for a deeply troubling condition like autism (the causes of which remain controversial and poorly understood). Read what Roald Dahl wrote about the death of his daughter Olivia from measles.
We also know that we are all susceptible to the “post-hoc” fallacy - the tendency to attribute cause to an event which occurs shortly before another event. For example: malaria was for centuries a baffling plague. It was observed that persons who went out at night often developed the malady. So, on the best post hoc reasoning, night air was assumed to be the cause of malaria, and elaborate precautions were taken to shut it out of sleeping quarters. A long series of experiments eventually proved that malaria was caused by the bite of the anopheles mosquito, which bites at night. The same incorrect assumption is often made about events which occur after a vaccination.
We recognise that many people question the advice they receive from doctors and government departments. We live in a cynical age. It’s easy to find opinions which support our world view, especially in an Internet and Twitter-connected globe. “A man hears what he wants to hear and disregards the rest” sang Simon and Garfunkel in “The Boxer”. Some people believe that the medical profession colludes with drug companies to push vaccinations onto people for the sake of money, while concealing side effects. In an extension of this thinking, governments and even bodies like the WHO are included in this analysis. If this way of thinking appeals to you, we ask you to reflect honestly on whether this is plausible, likely, and fair.
The central problem for people who do not have experience of infectious diseases is that they have trouble visualising the risks of the illnesses they are being asked to protect their children against. In that context, the perceived risks of the protection (immunisation) loom large. And so immunisation has become a victim of its own success - we no longer see most of the illnesses children are vaccinated against. Stories of parents whose children have been damaged by vaccine-preventable infections typically highlight the fact that they had no idea what the illness could do (until their child got it!).
Any vaccine contains some potential for side effects, as well as benefit, but modern vaccines are rigorously tested and monitored to ensure that benefits far outweigh potential harm. Concerns about overloading the immune system, or exposing children to toxic additives in vaccines are widespread. These concerns can be readily answered with sound information, which is easily available - and we can help provide that information if needed. Good starting points include IMAC and Childrens Hospital of Philadelphia. Dr Ari Brown has a great summary of common questions and answers.
We hope that you put your children in a car seat when they go in the car, and use a life jacket if they go in a boat. Vaccinating your children is just the same: protecting them as much as possible from the dangers of a hostile world of infections.
All of us working at MMC believe strongly in immunisation and we and our children are fully vaccinated.
When the global polio eradication drive began in 1988, more than 350,000 children around the world were paralysed by the virus each year. Polio serves as a case study for us to reflect on many of the most important principles around immunisation. Firstly, it reminds us that we all live together on this beautiful planet, and unless a disease like polio is eradicated from every last pocket on the globe, it will come back, spread, and remain a risk to us all. In the end, we are all dependent on each other, or as Martin Luther King wrote: “We are caught in an inescapable network of mutuality, tied in a single garment of destiny. What affects one directly affects all indirectly." Secondly, the problems with polio eradication in Pakistan and Afghanistan are largely due to incorrect beliefs (myths) about polio immunisation, with conspiracy theories about the CIA and Western governments having a strong hold in sections of society, especially in areas controlled by the Taliban.
Closer to home, we have a similar example: measles. We know that measles can be easily prevented and could even potentially be eliminated, like smallpox. But, if vaccination levels drop in a community to below 95%, measles can easily spread. Imagine for a moment if you were the parent of a child who has been treated for a life-threatening illness like leukaemia, and can’t receive measles immunisation because of his compromised immune system. You don’t need to imagine what it would be like to see your child go through an illness like that, and the treatment. Just think how it would feel if your child was faced with the prospect of getting measles (with potential serious or fatal complications) during a measles outbreak. And so we see that independent choice about measles immunisation is an illusion: if you decide not to vaccinate your child, you are placing others at risk as well. Some of those others will be especially vulnerable. “Immunity is a shared space—a garden we tend together.” (Eula Biss, “On Immunity”).
Measles also highlights the role of myths in health beliefs in western societies like ours. A huge body of research has conclusively shown that there is no relationship between measles vaccination (MMR) and autism, but the myth persists. We know that myths thrive when people need an explanation for a deeply troubling condition like autism (the causes of which remain controversial and poorly understood). Read what Roald Dahl wrote about the death of his daughter Olivia from measles.
We also know that we are all susceptible to the “post-hoc” fallacy - the tendency to attribute cause to an event which occurs shortly before another event. For example: malaria was for centuries a baffling plague. It was observed that persons who went out at night often developed the malady. So, on the best post hoc reasoning, night air was assumed to be the cause of malaria, and elaborate precautions were taken to shut it out of sleeping quarters. A long series of experiments eventually proved that malaria was caused by the bite of the anopheles mosquito, which bites at night. The same incorrect assumption is often made about events which occur after a vaccination.
We recognise that many people question the advice they receive from doctors and government departments. We live in a cynical age. It’s easy to find opinions which support our world view, especially in an Internet and Twitter-connected globe. “A man hears what he wants to hear and disregards the rest” sang Simon and Garfunkel in “The Boxer”. Some people believe that the medical profession colludes with drug companies to push vaccinations onto people for the sake of money, while concealing side effects. In an extension of this thinking, governments and even bodies like the WHO are included in this analysis. If this way of thinking appeals to you, we ask you to reflect honestly on whether this is plausible, likely, and fair.
The central problem for people who do not have experience of infectious diseases is that they have trouble visualising the risks of the illnesses they are being asked to protect their children against. In that context, the perceived risks of the protection (immunisation) loom large. And so immunisation has become a victim of its own success - we no longer see most of the illnesses children are vaccinated against. Stories of parents whose children have been damaged by vaccine-preventable infections typically highlight the fact that they had no idea what the illness could do (until their child got it!).
Any vaccine contains some potential for side effects, as well as benefit, but modern vaccines are rigorously tested and monitored to ensure that benefits far outweigh potential harm. Concerns about overloading the immune system, or exposing children to toxic additives in vaccines are widespread. These concerns can be readily answered with sound information, which is easily available - and we can help provide that information if needed. Good starting points include IMAC and Childrens Hospital of Philadelphia. Dr Ari Brown has a great summary of common questions and answers.
We hope that you put your children in a car seat when they go in the car, and use a life jacket if they go in a boat. Vaccinating your children is just the same: protecting them as much as possible from the dangers of a hostile world of infections.
All of us working at MMC believe strongly in immunisation and we and our children are fully vaccinated.
To see information on Travel Vaccinations please click on the More Tab, then click on the Information tab.