Map of life expectancy at birth from Global Education Project.

Thursday, May 05, 2005

Immunization

Robert Rinsky, editor of Public Health Reports, is happy! And, with a bit more reservation, I share his ecstasy. Says Bob, in the new issue, "I have one of the most amazing documents of modern times in front of me. An indescribably huge triumph of Public Health. Almost incomprehensible. It is the March 21, 2005 Morbidity and Mortality Weekly Report announcing the elimination in the United States of rubella and congenital reubella syndrome. . . "

Okay, he could use a thesaurus. But he's right. When I was a child, a family close to us had a child born deaf, blind and retarded because of rubella, who spent his life in an institution. I'm not old enough to remember when the country was terrorized by polio, but my aunt had it and suffered some lifelong effects. I had a schoolmate who wore heavy braces and walked with crutches, and I have already written about my friend and mentor Irving Kenneth Zola. Smallpox, one of the great scourges of humanity, has been eradicated from the earth. This is a case of humanity coming together, cooperating at the highest levels of national power, to eradicate a biological species, but I've never heard even Earth First! objecting. (They probably do, but it's not likely to be a winning issue for them.)

People younger than 60 or so can scarcely imagine existence before the modern vaccine era. Life was far less certain. Any child could be snatched away at any time in a random harvest, or maimed for life. We take for granted now that children will become adults. Believe it or not folks, that is a luxury our grandparents did not know.

I am not sure why, but immunization has always been shadowed by skepticism. Ever since Jenner developed vaccination to prevent smallpox, there have been popular movements against the practice. Many people are simply determined to believe that immunization is dangerous, ineffective, of an active conspiracy of some kind against their ethnic group or their religion. Recently, a polio outbreak in Indonesia is believed traceable to a traveler to a region of Nigeria where religious leaders have opposed polio vaccination as a plot to render Muslim women infertile. In the U.S. and the U.K., a determined movement of parents has insisted that their children's autism was caused by the Measles-Mumps-Rubella vaccine, or more specifically a preservative used in some doses that contained mercury. (Very careful study has absolutely ruled this out.)

Many people in the U.S. continue to refuse to allow their children to be immunized based on religious ideas or pseudo-scientific beliefs. There are principles of civil liberties at stake of course, and most states allow conscientious objection to immunization requirements. It is easy to permit this because of herd immunity -- if most children are immunized, an epidemic cannot take hold, and even those children who are not immunized are protected. But that is a matter of percentages. Too many objectors would find their children at risk of dangerous diseases.

Opposing immunization is not progressive, populist, or liberating. It's just a mistake. There have been a couple of incidents in which vaccines that turned out to have unacceptable side effects, and needed to be withdrawn. For most, there may be rare adverse effects, usually mild and transient, or more common mild side effects such as a one day fever. But believe me, these are well worth the benefits. It's a lot easier to be a Christian Scientist nowadays, when you can take a free ride on everybody else's sensible choices.

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