Drinking and driving is a choice -- however, it's an illegal choice because drunk drivers might kill themselves or, even worse, kill others who didn't have a say in the matter. But at least I've never heard of any drunk drivers justifying their actions by arguing that people die in car accidents not involving alcohol, too.
That's the anti-vaccine rationale some parents are using to justify bringing back potentially deadly diseases and putting their children and others at risk, including infants, the elderly and people with immunodeficiencies or on chemotherapy. Where the analogy breaks down, of course, is that serious vaccination injuries are, according to the Government of Canada, "so rare in fact, that the risk cannot be accurately assessed."
However, as revealed in a 2012 study, motor-vehicle crashes are the leading cause of death for 1- to 14-year-olds in Canada. In 2011, this amounted to 63 fatalities, 443 serious injuries and 9,137 total injuries for children 14 and under. Yet, I'm betting these parents who refuse to vaccinate their children wouldn't object to shuttling them around in cars.
Now, the concept of choice seems absurd when applied to drunk driving, but that's exactly how anti-vaxxers defend their illogic. Their willfully misleading websites proclaim Your Child. Your Future. Your Choice and warn vaccine requirements are "a violation of sovereignty over one's body and the right to free choice."
But let's look at where their "free choice" has led us.
Measles were effectively eliminated in Canada by 2002, and that was a good thing because it has a mortality rate of 1 to 2 per thousand in developed countries and 3 to 5 per thousand in developing countries.
Prior to widespread vaccinations in 1980, the World Health Organization estimates measles caused 2.6 million deaths every year. By 2012, with 84 per cent of the world's children vaccinated, that global number was reduced to 122,000 -- which is still 14 deaths every hour. Measles can also cause pneumonia, deafness, blindness and brain damage.
So far this year, there have been well over 450 Canadian cases thanks to outbreaks in B.C., Alberta, Manitoba, Ontario and P.E.I. That's up from 83 in 2013 and 10 in 2012 (though there was a massive 725-case outbreak in Quebec in 2011).
Two more infections of children under two were announced on Monday in Edmonton bringing that city's outbreak up to 13, seven of which are young children. Alberta as a whole is now at 30 cases, with even more if you include last fall.
The vast majority of these 2014 infections, however, have taken place in the Fraser Valley, a region known as B.C.'s Bible Belt and which has traditionally low vaccination rates. The current outbreak, which topped 400 cases began among a religious group called the Netherlands Reformed Congregation (whose pastor warned against vaccines) and spread through a local religious school.
Fraser Health's Dr. Lisa Mu told the Vancouver Sun, "My understanding is that this community feels that natural immunity is what God has intended and that vaccinations would interfere with that." (Interestingly, the hippies on Vancouver's North Shore outdo even the fundamentalists of the Fraser Valley, clocking the province's lowest vaccination rate at 63.5 per cent. The area's immunization and communicable disease coordinator Nicole Roy told CTV, "Definitely many of our parents are going the natural route and in some circumstances that's okay. But when it comes to vaccines, there's not a natural alternative to science.")
About a 95 per cent vaccination rate is required to create herd immunity -- which protects those who can't be immunized for age or health reasons -- and last year the UN rated Canada at 84 per cent (putting us at 28 out of 29 industrialized nations) with some areas falling below 50 per cent. And it's not just bringing back measles.
On April 1, an Ontario mother Facebooked a photo of her five-week-old daughter hooked up to a hospital respirator after contracting whooping cough, which is vaccine-preventable, but not for infants too young to receive the vaccine. "THIS IS WHY YOU IMMUNIZE YOUR CHILDREN!" she wrote. "If you are considering not immunizing your children, think first about the people you put at risk who CAN'T get the immunization."
Her daughter could have died if they hadn't taken her to the hospital in time. In 2010, during an outbreak in California, 10 infants weren't so lucky. This year there's been an outbreak in southern Alberta, with 34 cases, thanks to the area's low immunization rates. The last outbreak happened there in 2012, and killed one infant.
But, y'know, it's about choice.
Which brings us to Manitoba massage therapist Kim Paul, who made that choice not to immunize her son and is "furious" that local school officials won't let him attend school because an older student may have contracted measles. "To me, it almost seems like a bullying situation, you know, get the needle! Get the needle! If you don't get the needle you can't go," she told CBC.
No, you're not being bullied; you're being stupid and contagious. As is your patron saint Jenny McCarthy, whose claims that vaccines cause autism (based on a discredited U.K. study) somehow became so influential that Ontario Health Minister Deb Matthews called her out as "outrageously irresponsible."
On April 12, McCarthy attempted to backtrack in an Op/Ed in the Chicago Sun-Times claiming she's not anti-vaccine at all, but simply "embarked on this quest not only for myself and my family, but for countless parents who shared my desire for knowledge that could lead to options and alternate schedules, but never to eliminate the vaccines."
There are, of course, countless examples of her arguing just that. But McCarthy no longer matters -- in an ironic twist, the anti-vaxxer movement she put a pretty face on has gone viral.
Google "vaccine" and there are countless quack sites filled with pseudoscientific claims intended to put the fear of God into anxious parents. I get why it works -- nobody wants to risk putting their child in any danger, no matter how infinitesimal. (Except when it comes to driving, I guess.)
But we've passed the point of politeness when convincing arguments filled with peer-reviewed scientific studies can't compete with unprovable anecdotes. So let's be clear: Refusing to vaccinate your kids is not a personal choice.
As an editorial in the Canadian Medical Association journal noted this week, "one unimmunized person puts the well-being of greater society at risk."
The CMA editorial, which emphasized that "there is absolutely no scientific controversy about the effectiveness or safety of childhood vaccines, particularly the MMR (measles-mumps-rubella) vaccine," is calling for a national strategy to deal with the highly infectious disease as it doesn't respect provincial borders.
Author Dr. Gordon Giddings also called for a national vaccine registry to track who has and who hasn't had their shots, as well as a national program to address vaccine-hesitant parents affected by the "dangerous, incomplete information and misinformation" on the Internet.
Unfortunately, a recent study actually confirmed that no amount of reason is going to convince anti-vaxxers. Maybe we can't convince all parents to vaccinate their kids, just as we can't convince all drivers not to drink -- but we do try to keep them off the road.
So let's apply the same logic here: No vaccinations, no public school. That's already the case in Ontario (alongside New Brunswick and Manitoba) where the provincial government recently strengthened the Immunization of School Pupils Act by adding three new vaccines. But the so-called "mandatory" policy still allows exemptions for religious, ethical, or philosophical reasons.
And yet viruses don't care about motivation any more than they care about borders -- and we shouldn't, either. No more exemptions -- if you don't get the needle, you can't go. I also think unvaccinated kids also should be kept out of parks-and-rec activities, pediatrician offices, walk-in clinics, and daycare.
Living in a civilized society requires certain obligations -- you know, like not killing people and not stealing. And another crucial part of that social compact is not wantonly bringing back vaccine-preventable diseases. There's simply no choice when it comes to saving children's lives.
Your newborn should get this shot even before leaving the hospital, and receive another dose at one to two months and a third at six to 18 months. The vaccine protects against an incurable, liver-infecting virus, hepatitis B, which can be passed to a baby during childbirth if the mother is infected. This virus spreads through contact with blood or other body fluids (sharing toothbrushes and utensils can put you at risk). Soreness at the site of the shot, or a slight fever, is the most common side effect, according to Gabrielle Gold-von Simson, M.D., assistant professor of pediatrics at NYU Langone Medical Center in New York.
The DTaP vaccine protects against diphtheria (a germ that can form a gray or black film in the throat), tetanus (an infection that can cause muscle spasms so strong they can break bones), and pertussis (a highly contagious disease that causes a severe, uncontrollable cough, known as whooping cough). Five vaccine doses are given to children at two months, four months, six months, 15 to 18 months and four to six years. (And boosters at age 11 or 12 and then every 10 years.) DTaP may be combined with other vaccinations to reduce the number of shots needed. "Now, it's DTaP with hepatitis B and the polio vaccine. So, it's five in one," Dr. Gold-von Simson says.
This combo shot protects against three viruses: measles (which causes high fever and a body-wide rash); mumps (which causes face pain, swelling of the salivary glands, and sometimes scrotal swelling in boys); and rubella or German measles (which can cause birth defects if the infection occurs during pregnancy). The first shot is given at 12 to 15 months of age and once again between the ages of four and six. MMR is sometimes combined with the chickenpox vaccine into one shot (brand name ProQuad). "All these different preparations are designed to reduce the amount of shots the pediatrician has to give," says Dr. Gold-von Simson.
Chickenpox, a highly contagious rash that many people remember from childhood, is caused by the varicella virus. A varicella vaccine was first licensed in 1995 and now spares future generations this itchy misery. Chickenpox infections can be especially dangerous in adults who don't have immunity from the vaccine or haven't had it in childhood, and can also lead to shingles, an extremely painful blistering rash. The shot is given to children at 12 to 15 months and again between four and six years. The vaccine can cause soreness at the site of the shot, fever, and, in some cases, a mild rash.
"Haemophilus influenza type b is the bacterium that causes meningitis," says Dr. Gold-von Simson. Meningitis, an inflammation of the membranes surrounding the brain and spinal cord, is particularly dangerous for kids under the age of five. Hib vaccines are generally given at two, four, six, and 12 to 15 months of age. Depending on the vaccine used, the six-month shot may not be needed. Fever, swelling, and redness at the site of the shot are potential side effects.
Polio vaccine is "such a success," says Dr. Gold-von Simson. "Because of the vaccine, there are no more cases (of polio)." There are no more in the United States that is. The virus hasn't been eradicated worldwide, so kids still get the IPV, or inactivated polio vaccine, which is a shot containing killed virus. Polio is bad news, and can cause paralysis and even death. Children are given the IPV at two months, four months, between six to 18 months, and then again between the ages of four and six years.
This vaccine, known as PCV13 (brand name Prevnar), protects against 13 types of Streptococcus pneumoniae, which are bacteria that can cause all sorts of mayhem, including meningitis, pneumonia, ear infections, blood infections, and even death. A total of four shots are given to kids (at two, four, six, and 12 to 15 months of age) to protect them against the germs, known collectively as pneumococcal bacteria. The most common side effects of the vaccine include drowsiness, swelling at the site of the shot, mild fever, and irritability.
Flu vaccinations are given each year starting in the fall. The Centers for Disease Control and Prevention recommends them for kids ages six months or older, although they aren't required for school attendance. (Connecticut and New Jersey require the vaccine for attending child-care centers and preschool.) Common side effects from the vaccine include soreness, redness, or swelling at the site of the shot. Fever and aches may occur too. "If you have an egg allergy, you shouldn't have the influenza vaccine," says Dr. Gold-von Simson.
The rotavirus vaccine (RV) (brand names RotaTeq, Rotarix) is given to children at two and four months of age. (RotaTeq is also given at six months.) The vaccine protects against a virus that is the most common cause of severe diarrhea and vomiting in young kids worldwide. About 55,000 children in the U.S. were hospitalized each year due to rotavirus before the vaccine was licensed in 2006. It is not required for school attendance. The vaccine is in liquid form and given by mouth to babies. It may make them a bit more irritable and can also cause mild diarrhea or vomiting.
Kids can catch hepatitis A from sharing food or drinks or by putting contaminated food or objects in their mouths. It's a viral infection that affects the liver, and can cause a number of symptoms, including fever, tiredness, jaundice, and loss of appetite. Children ages 12 through 23 months generally get two doses of the Hep A vaccine, with a minimum interval of six months between shots. Some states require the vaccine for school attendance. Soreness where the shot was given, headache, and loss of appetite are the most common side effects of the vaccine.
This vaccine, known as MCV4 (brand name Menactra), protects against meningococcal bacteria, which can infect the membranes surrounding the brain and spinal cord. MCV4 is recommended for kids at 11 or 12 years of age, and anyone between ages two and 55 who is at increased risk of infection (people with certain health conditions, military recruits). Teens starting college should be vaccinated with MCV4 before going to school if they didn't previously get the shot. (Freshman living in dorms are at increased risk of infection.) A little pain at the site of the shot is the most common side effect.
Human papillomavirus (HPV) vaccine (brand names Gardasil, Cervarix) is given in three doses over a six-month period, and is approved for girls between ages nine and 26. While there are over a hundred types of HPV, this vaccine protects against two sexually transmitted types that are the most common causes of cervical cancer. Gardasil also protects against two types that cause genital warts and is approved for boys between nine and 26 as well. The vaccine works only if given before an infection, so doctors recommend it for kids well before they could become sexually active. Although most states don't require HPV vaccination, many are considering mandating it for preteen girls.
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