December 16th, 2015
To Vaccinate Or Not
The other day I was riding my bike and thinking about how I am required to get a flu vaccine every year or wear a mask during the entire flu season, and this really irks me because I work really hard to be healthy and I don’t like being told I have to do something, but then it hit me. Not a car, fortunately, but the realization that I was thinking like the antivaxxers. Well, not exactly. The flu vaccine is different from the vaccines in the childhood vaccine series. They make a new one every year based on the strain(s) of flu they think will circulate in the U.S. and make us sick. Last year, the vaccine was only 19% effective. I risked side effects for 19%. However, other information from U.S. government health agencies website vaccines.gov put that in context: “Recent studies show vaccine can reduce the risk of flu illness by about 50–60% among the overall population during seasons when most circulating flu viruses are like the viruses the flu vaccine is designed to protect against.” as well as pointing out that: “Most childhood vaccines produce immunity about 90–-100% of the time.” But how can I expect parents to follow mandatory vaccine laws to protect their children and the people around their children if I am not willing to do the same?
In regard to mandatory vaccine laws, there is a new law in California, SB 277, which does not allow for religious or personal-belief exemptions. The law does however leave open the ability for a medical exemption. Previously, Mississippi and West Virginia were the only states to ban vaccination waivers based on religion. The law goes into effect for the fall 2016 school year and will be phased in over time. “Children who have a personal-belief exemption on file before Jan. 1, 2016 will have more time to comply with the law,” the LA Times reports. “Such children who are in nursery school or preschool must comply to enroll in kindergarten; those in elementary school must do so by 7th grade. Those already in junior high and high school will remain exempt.” Unvaccinated children would have to be home-schooled or do independent study.
When I first heard of this bill passing, I had mixed thoughts. There are people all across the country who are afraid of being overlegislated and subsequently losing the ability to have control over their lives and their families’ lives, and this is a prime example of that. Unfortunately, the law may not have its intended effect, as telling people what to do without choice often causes pushback in the opposite direction. We may actually see fewer people getting their kids vaccinated. With the new law, if people continue to choose not to get their kids vaccinated and the law is enforced, other infants, kids, pregnant moms, and health-compromised people might be safer at daycare and school — but not outside of daycare and school. Also, in a recent study in Pediatrics published March 3, 2014, researchers found that trying to change an antivaxxer’s opinion may actually make the problem worse.
I work as an FNP-C at a clinic for adolescents (ages 13–25) in California, and we get a significant number of patients who need vaccinations. The clinic where I work has a large population of recent immigrants with incomplete or missing records, and they need to continue their series or start it over in order to enroll in school. I was open to the research about vaccines possibly having negative effects such as autism, but the original research was falsified and subsequent research has not shown any correlation. Changes have been made to vaccines deemed less safe in the past. For instance, there was a question about risk versus benefit of the active/oral polio vaccine, as a very small group of kids being vaccinated were getting polio. There was enough evidence to compel people working in public health to assist in getting it changed to an inactive form, or IPV. What we have seen since the antivax information hit the media and people stopped vaccinating their children is a pertussis outbreak and a measles outbreak. A mom in Canada had all seven of her unvaccinated children come down with pertussis and now is questioning her choice not to vaccinate.A few months ago, there was an article in Scientific American about antivax parents refusing the vitamin K injection for their newborns, which can put them at risk for internal bleeding. These examples show how dangerous ignorance and distrust can be.
The bottom line is that if there are any risks of vaccination, they have been shown historically to be outweighed by the benefits, at least for the older vaccines.