in Editorial , 392 references
There's a meme flying around the last few days that has managed to "snag" a few people I know on Zuckerpig's site related to vaccinations.
I've seen two variations of it. One "features" a kid (but not an infant) who cannot be vaccinated because she's immunocompromised and a "attenuated" live vaccine could kill her. The other features an infant too young to have been vaccinated against the evil (in this case, whooping cough.)
Both are attempts to shame people who are "anti-vaxxers", and take a shot at the autism claims.
Let's start there.
There is no evidence that vaccines in fact cause autism. Zero. There are a lot of claims that said occurs, but there's no scientific evidence for it.
The "meme" is basically a my kid got screwed because of you evil bastards who didn't vaccinate your kids.
The problem is that the meme is false.
Let's deconstruct it because down this road lies a dangerous and false set of beliefs.
First, there's the explicit claim that "if your kid was vaccinated mine would not have gotten sick."
This is false unless every single kid is vaccinated with vaccines that are 100% effective.
But most of these memes include a kid who can't be vaccinated either due to age (too young) or immune compromised. Therefore if exposed they are likely to get ill.
Second, no vaccine is 100% effective.
Behind the dangerous falsity of these memes is a blatantly false claim about how "herd immunity" works. It does not prevent disease from being transmitted, in short.
What herd immunity does is attempt to prevent transmission from turning into epidemic.
That is, let's say you have measles. It doesn't matter why you have measles. Maybe you didn't get vaccinated whether for "conscious objection" reasons or not (e.g. you're a refugee) or maybe the vaccine failed (and yes, they do!) It doesn't matter why you have measles, all that matters is that you do have measles.
Measles happens to be extremely contagious. That is, if you have it and come close enough to someone to transmit it, and they are not immune (either from vaccination or previous exposure) the odds are extremely high they will get it. Different diseases have different efficiency of transmission; some like chicken pox and measles are very easy to transmit, others like HPV or HIV require direct intimate (bodily fluid) exchange.
Herd immunity has exactly nothing to do with the singular event of someone who has a disease coming into contact with the unprotected person. If that happens and the vector is completed then the odds of infectious transmission are extremely high.
What herd immunity does is make the percentage of people who are immune high enough that the probability of the infected person contacting a susceptible person and transmitting the disease falls below the infectious percentage (that is, what percent of those who come into contact will get it.) So long as that number is <1.0 for anyone who has the disease then you have what is called "herd immunity" because the infection cannot reproduce at a rate sufficient to nail everyone who is susceptible.
You'd think that herd immunity would make a disease eradicated because with an insufficient transmission rate it would quite-quickly wind up disappearing. You'd be right about that except for one problem: For it to work you must reach that level for all populations that can serve as both reservoirs and impacted entities (which may include species other than humans.) If you do that the disease literally disappears.
So why do Whooping Cough, Chicken Pox and Measles still exist?
Because there are populations where that level of immunity was never achieved.
Who are those people?
Do you really want the bad news?
They're largely illegal immigrants and refugees -- that is, people from third-world shitholes where there is no vaccination and thus those diseases are still common.
So if you actually want to reduce the risk of your little kid getting Whooping Cough then you want to kick out every single illegal immigrant and every refugee, and prevent any from coming into the country until they are both vaccinated and quarantined for a sufficient time to know their immunity is good.
The fact is that we have "herd immunity" for most common diseases for which vaccines are available today in the Untied States and other western nations, despite the few "objectors." The exceptions are nearly all traceable to not those scared of autism but rather to refugees and illegal immigrants, both of whom come in without any documentation as to their immunization status and in many cases with not only no immunizations but latent disease as well!
That's where the problem is but what you have to understand is that the random risk of someone, even if we kick all those people out, getting past the screening or simply having a vaccination failure -- and it does happen -- still exists.
In short if your kid is either incapable of taking the vaccines or is too young to have done so herd immunity does not protect them from the singular infection that could hose them. If someone who has failed immunity to said disease for whatever reason, including not of their own fault, is shedding the virus (or whatever) and manages to meet the transmission requirements to your kid they're going to get sick -- period.
Vaccines are also not without risk. The HPV vaccine, for example, has a record of occasionally causing Guillian-Barre syndrome. Some cases of this "side effect" are fatal and many cases that are not fatal produce permanent partial paralysis. Since HPV is a sexually-transmitted disease and cannot be transmitted by casual contact to claim that everyone "must" have said vaccine is an outrage -- that is a matter of personal choice where one must weigh the risk (very small, but real) of a severe adverse event against the risk of transmission of the condition through voluntary or violent sexual encounter.
Frankly, I don't think anyone has the right to make that decision for someone else and thus it's a decision that should be made by adults at the time of turning 18. That's my view and others may differ; one of the pleasures (and pains) of being a parent is that you get to choose in that regard for your kids -- but not for mine.
There are, however, some states that have tried to mandate it for anyone in schools and from my perspective what that amounts to is an admission that the school cannot manage to keep kids from fucking one another in the buildings and on the school grounds, which says a lot about their level of competence in running said school!
So let's not conflate "vaccines" into one bucket, because they're not. There are those that I believe you can make a very clean argument for -- DTaP, MMR and Polio being the poster children for that group. Why? It has nothing to do with "herd immunity" but everything to do with the fact that if you contract these conditions they are dangerous and can kill or permanently and severely harm you and the vaccines, while not 100% effective, are extremely good at providing lifetime protection against the disease in question. Here the balance of risks and benefits are clearly on the side of choosing the vaccination. If you draw the "short straw" and get harmed by the vaccine that's awful but you are far more-likely to get injured or killed by the disease itself and remember -- herd immunity does not prevent you from getting sick -- it only prevents your illness from turning into an epidemic!
Then there are those vaccines that have a less compelling argument: Varicella (Chicken Pox) is in that category. That's a live (attenuated) vaccine. Further, in up to a third of the people vaccinated it fails to provide complete protection -- that is, if exposed you will get the chicken pox and can transmit it anyway, although it will likely be a milder case! Whether that one's worth the risk (and there are some risks, but not terribly severe ones) is an open question. Chicken Pox almost never produces any permanent harm in someone who gets it, which makes the balance much harder to accurately estimate -- but since the vaccine itself is an attenuated virus the risk of taking the vaccine is rather low too. Note that one of the "memes" circulating relates specifically to Chicken Pox exposure to an immunocompromised person and the vaccine has a 30% failure rate. So much for the claim in the meme that the transmission was "preventable" -- the truth is that it probably was not as the odds are much higher that the person who gave the kid the pox was vaccinated but had a partial failure than someone who wasn't vaccinated at all. (Note that the zoester vaccine, given to older adults for shingles, is even harder to evaluate -- shingles sucks but since the vaccine for it too is attenuated the risk of it giving you shingles if you have an un-diagnosed immune problem is quite real and, if it happens, you're hosed.)
Finally, in the next (and last) bucket we have the HPV vaccine (and others that are similar and undoubtedly will be developed in the future.) That vaccine only protects against some strains of HPV, not all and thus might lead someone to engage in riskier behavior than they would otherwise believing they are immune from that condition. Since virtually all cases of HPV transmission are a result of voluntary intimate contact anything that causes people to believe they're immune from a potential bad outcome but is less than 100% effective might actually increase, rather than decrease, the risk of disease. In addition there is a small but non-zero risk of a severe or even deadly side effect.
In short you cannot take all of these different immunizations as a "package"; they each have individual risks and benefits and must be evaluated on that basis.
Finally, the bottom line when it comes to vaccination is that, to nearly a 100% degree, they are all about personal benefit in the form of immunity (partial or complete) conferred in the person vaccinated. The side effect of "herd immunity", if achieved, prevents transmission of the disease in question from turning into an epidemic but does not, in any case, prevent one infected person from infecting a second susceptible person.