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Monday, September 19, 2011

Kids: To vaccinate, or not to vaccinate?

David Brooks

If you’re a parent, you wouldn’t do anything to put your child at risk, would you? Of course not.

Except you do, all the time – as do I.

We all drive our kids around town, and we let them drive when they’re old enough, even though few things in the modern world kill and maim more people than car accidents. How can we be such awful parents?

Because modern society can’t exist, and we can’t exist in it, without automobiles. We all made the decision that the benefits of driving outweigh the risks by a long shot.

That thinking explains why my kids got vaccinated.

Vaccines are medicine injected directly into the body to create a system-wide response. They’re potent stuff. Most of the time, they’re wonderful, but sometimes, they don’t work and sometimes, they even cause harm. People have had strokes or fits, and have even died, because of reactions to vaccines.

Those problems have occurred in a incredibly tiny percentage of the hundreds of millions of vaccinations given over the past century – just as a tiny percentage of car trips result in injury – but why subject my kids to that risk at all?

Because the benefits of being vaccinated, for us and for all of society, outweigh the risks by a long shot.

When I was born, an average of 450 Americans died each year of measles. When my parents were born, several thousand a year died of whooping cough. When my grandparents were born, smallpox killed more people around the world than AIDS does today.

Now smallpox is eradicated and the other two reduced to minor issues, thanks largely to national vaccination programs.

Of course there are risks, there are trade-offs, there are costs. Even the mainstream medical community, understandably gung-ho about vaccinations, is concerned about limits.

The Centers for Disease Control, for example, held an unusual public hearing in Concord in June to gather input about whether meningococcal vaccines for infants and small children should be added to the list of recommended shots. Very few infants in the U.S. suffer from this type of meningitis each year, but it kills or maims many of those who are infected – how do we balance the risks and costs of the vaccine compared to the benefit?

It’s not easy, which is why the topic will be the subject of the next Science Cafe New Hampshire, held Wednesday in Concord. (See box for details)

The topic has become far more complicated because vaccinations are the target of some irrational fears.

The issue was kicked off by a fraudulent 1998 British study that used altered medical histories to claim a link between autism and common childhood vaccines for measles and mumps.

The study has been retracted – autism often becomes obvious after vaccines are given because both occur at around the same age, not because of causality – yet the damage continues, fueled by minor celebrities and pundits who find the “antivax” bandwagon a good way to extend their careers.

More significantly, questions about mandatory vaccinations have tapped into widespread distrust of government and authority, often interlaced with religious or political concerns.

This has led to more parents opting out of getting their kids vaccinated, which explains why the U.S. is seeing a slight but alarming return of diseases like whooping cough and measles – a shameful step backward for a great nation.

People who can’t be vaccinated depend on the protection of being surrounded by vaccinated people, which creates a sort of shield against them encountering disease that is known by the inelegant term “herd health.” One prominent critic of the anti-vaccine crowd in Australia is a couple whose daughter died of whooping cough because she was too young for vaccinations.

The opt-out crowd counts on herd health, too. Their stand offers little risk as long as enough other people are vaccinated. The success of the movement is causing this protection to fray, however, as the disease outbreaks demonstrate, to the detriment of us all, not to mention our health care expenses.

My kids are grown now, so I don’t control their vaccination schedule any more. But if and when grandkids come along, they’ll be getting all their shots on schedule, or my name isn’t granddad-to-be.

Granite Geek appears Mondays in the Telegraph, and online at David Brooks can be reached at 594-5831 or