To Vaccinate or Not To Vaccinate

Being a nurse, I occasionally get the person who wants my opinion on whether or not to vaccinate.  Because I was recently approached to offer my opinion, I have a few thoughts I’d like to share on the subject here.

The non-vaccination movement is largely based on the work of a man named Andrew Wakefield.  His worked “appeared” to link the MMR (measles mumps rubella) vaccine to causing autism.  Many well-meaning parents who feared that their children would develop autism choose to not have their children innoculated with this vaccine, or in many cases, with ANY vaccines.  It has recently come to light that Mr. Wakefield’s very limited study was in fact, fraudulent.  You can read that story HERE.  There are others who simply think that vaccines are “toxins” to which they don’t wish to expose their children.  And there are those who believe that there’s a government conspiracy in there somewhere.

Children are routinely vaccinated for a number of diseases.  Some of the vaccines they receive are measles, mumps, rubella, tetanus, diptheria, pertussis (whooping cough), rotavirus, hepatitis B, polio, haemophilus influenzae type b, varicella (chicken pox), and meningitis. 

Because most parents DO vaccinate, the children who live amongst them who are unvaccinated generally enjoy an environment free from many previously common communicable diseases.  This is called “herd immunity“.  The more people who have immunity equals a lesser chance for those who DON’T have immunity to be exposed.  When the numbers of the herd who are immune drops, the potential for the non-immune to contract and spread these diseases to other non-immune individuals (and vaccinated individuals who have less immunity) rises.  The magic number for herd immunity is about 90%.  When the percentage of immune individuals drops below that 90% number, the chance for diseases to spread in a community begins to increase.  So what happens when a community “bucks the herd”?  Well, we can look to Boulder, Colorado, for the answer to that question.  Boulder holds the dubious distinction of being one of the least vaccinated communities in the United States.  And it has a high rate of whooping cough as a result.  Whooping cough (pertussis) is endemic in that community.  A community where, to be a bit cheeky, parents are more concerned about fumes from paint and carpet than they are about potentially deadly communicable diseases.

Because of aggressive vaccination programs, smallpox (which swept through the indiginous populations of the Americas and killed millions) is unknown to us today.  Polio, which struck terror into the US population in the 20th century, has been all but eradicated from the western hemisphere.  How often do you hear of someone having diptheria?  How about tetanus (lockjaw)?  In most developed countries, these diseases have become almost entirely a thing of the past.

So, what are some of the little thought of effects of non-vaccination?  Healthcare costs are something that we are all congnizant of these days.  Let’s say your child comes down with a fever and appears to have a viral illness of some sort.  The vaccinated child is seen by a practitioner who is able to “rule out” many possibilities for the cause of the symptoms.  The non-vaccinated child is seen by the same practitioner who now must test for many other potential illnesses.  These can be costly tests.  And the child will more than likely be requiring isolation until a source is determined.

Many of these diseases can be worse to get as an adult.  What about these young girls who grow up and want to have children.  To be exposed to some diseases while you are pregnant can be fatal to the unborn child, or leave the child with horrible disabilities.  Every pregnant woman who has never had chicken pox, was vaccinated before the varicella vaccine became available, or who has no immunity from previous exposure, knows to stay the heck away from any kid who does!  Early in a pregnancy, chicken pox can cause all manner of problems.  The pregnant mother is also at risk for chicken pox pneumonia, which can be deadly!

Other demographics who are at increased risk for disease and death because of the non-vaccinated individual are the young who have not completed their vaccinations, the elderly, and the immunocompromised.  That means that any one who has a disease which affects their immune system (like HIV/AIDS), or has to permanently take medications which suppresses their immune system (like a transplant patient, or a rheumatoid arthritis patient), or those who temporarily take medications which suppress their immune system (like someone who is undergoing chemotherapy for cancer) are ALL at increased risk from the non-vaccinated person.

Now let’s say an unvaccinated child has grown up and is considering what to do as a career?  Do you think a hospital will allow an unvaccinated person work there?  Nope.  How about if this person wants to join the military?  Teach school?  There are many professions which would now be closed to this person, or if they choose to follow these paths, they will now have to get many series of vaccines…they would have to “catch up”.

What if this child decides he wants to travel internationally?  He or she may want to reconsider any travel to a non-western country.  Or they could get all “caught up” on their missed vaccines as well as receive more vaccines depending on what they might be at risk for due to their itinerary.  Or they could roll the dice and travel unvaccinated and chance 1) getting sick, and 2) bringing disease back to their own country where they could potentially expose more people to disease.

Diseases like Hepatitis B and polio are gifts that keep on giving.  Should you contract and survive polio, you are still at risk for post-polio syndrome.  Those of us who weren’t alive during the polio epidemics simply cannot appreciate the horror.  Twenty-five percent of those who contract Hepatitis B go on to develop liver cancer.  These are not benign diseases we are talking about here.

I think that not vaccinating children is an irresponsible, short-sighted, selfish, and potentially devastating choice.

The more people who don’t vaccinate, the closer all communities come to dropping below that 90% which will put more and more people at risk.  Communities like Boulder are doing no one any favors.  I, for one, would never send my child to public school in a city like Boulder, or Ashland, Oregon (the city with the highest rate of non-vaccinated children in the United States).

The potential risks of vaccinations is far outweighed by the potential risk of non-vaccination.

Personally, I am hoping that the small pox vaccine once again becomes available.  I’ll get it as soon as it does.   Because of communities like Boulder, it is now recommended that adults get a booster vaccine for pertussis.  It is available with the tetanus/diptheria booster, and the next time my Td comes due, you can bet I’ll be vaccinating for pertussis as well.  Not because I’m concerned with contracting pertussis as it is one disease that is less serious in adults than it is in children, but because I don’t want to be the one who passes pertussis to a child.  Pertussis is a very serious infection in young children.  (Those who staff NICUs – Neonatal Intensive Care Units – are often required to be up to date on their pertussis vaccination).

It isn’t that long ago that the anthrax scare swept across America.  I was concerned about that potential biological weapon threat, but we have a growing number of potential petri dishes of biological agents being introduced into the general population each year.

I believe it is time for the non-vaccinating public to rethink their decision…especially in the new light that the “science” upon which many have based their decision has been largely disproved and the “scientist” discredited.  And because, for the good of their communities, vaccinating is the right thing to do.

That being said, there is one vaccine that I do not believe should be on the routine vaccination schedule.  As I have written before, the Gardasil vaccine which protects against HPV (human papilloma virus) should only be given to those who have chosen against abstinence, are sexually active, and especially if they are not monogamous, as HPV can ONLY be transmitted sexually.  Some would also put Hepatitis B into this category, but since Hep B is not only sexually transmitted but can be transmitted with the transference of infected blood as well as body fluids, one can be at risk in other ways as well, like through a tainted blood transfusion. 

Not quite done yet, I have one more thought to offer.  Were, say, an immunocompromised student attending a public school to suffer harm because of exposure to a disease brought to the school by a non-vaccinated child OR were an elderly nursing home patient to suffer harm by a disease brought to the home by a non-vaccinated child, I would not be against charges being brought against the parent of the child who spread the disease.  I think parents should be held accountable for their risky decision to not vaccinate.

And that is one blogger’s opinion.

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About Lou (Linda)

Just a girl from Colorado trying to live life to God's glory with a certain amount of gusto! View all posts by Lou (Linda)

13 responses to “To Vaccinate or Not To Vaccinate

  • Whitney

    I just have one question. Which papers Opinion section are you sending this to to be published in? AWESOME!!

  • Playground Confidential » Why Some Parents Choose To Not Vaccinate

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  • Caleb

    I found this blog to be interesting. Aside from nursing school, how long have you been studying vaccinations? I think the idea of reccomending a parent be charged for not getting their child imunized is insane. In my experience, the parents who choose to not immunize their children are not making that decision based on impulse. My wife and I have done extensive research on both sides. If anything, it is easier to just follow the masses and immunize. However, to assume the infected always starts with an individual who has not had immunizations is wrong. If that were the case, the only ones getting any of these “preventable” diseases would be those who have not had immunizations and the “responsible” ones would not be at risk. Everybody clings to statistics that show the decline of these diseases since the inception of immunizations. However, even the CDC will admit these were already steadily declining. Also, some of these immunizations only cover a small portion, for example, 4 of 104 strains. I don’t think there is any bad intentions coming from the pediatricians, they are simply doing what they have been told to do. I do think the negative effects of immunizations are under studdied. The CDC is responsible for marketing to the public and researching the negative effects. Not even one tenth of the funds spent on marketing goes into researching the negative long term effects. While I respect your opinion, I question your research. If you are interested in viewing information from practicing medical doctor who has devoted thousands of hours in studying immunizations, go to drtenpenny.com.

  • Lou (Linda)

    Hey Caleb, thanks for visiting my blog. I’ve been a nurse for 20 years. Vaccinations are something that you deal with throughout a nursing career, not just in nursing school. For one of my jobs I am a travel vaccination specialist. Yes, it would be insane to charge every parent who did not immunize their child. That’s not what I said, however. What I said was where I think it would be fair to charge them is if their unvaccinated child went on to make someone else sick. I do not assume that all disease is spread by unvaccinated individuals. However I think it is important to take into account that an unvaccinated person is more likely to contract and transmit diseases (which have vaccines available for them) than the unvaccinated person. Diseases do have natural ebbs and flows. But vaccinations are largely responsible for the control of many diseases that used to be routine killers. Countries with less aggressive vaccination programs have more of these preventable diseases. Yellow fever is a disease which is mosquito borne and very infectious. Many countries will not even let a person who has not been vaccinated for the disease into their country. Some countries won’t let a person who has visited a country with Yellow Fever in if they have recently traveled to a country within the endemic zone. This is being done in order to keep the disease at bay.

    Perhaps the negative effects of vaccinations are understudied. I would say this is because, while there might be some longer term negative effects, the benefit of vaccinations clearly far outweigh the risks of getting vaccines. Thanks for the link to drtenpenny. I will check that out.

  • Carrie Swartz

    I agree with most of your post wholeheartedly. The exception is the part about HPV vaccination. The studies on the efficacy of Gardasil (the only currently commercially available HPV vaccine) show that it is more effective when given to young people before they become sexually active. I agree that it would not be necessary if a couple had been abstinent until they began a sexual relationship and then were monogamous with each other, but, let’s face it, that’s a rare case. Even one previous sexual partner can put you or your partner at risk for abnormal pap smears, genital warts, or even cervical cancer if you were exposed to HPV. But, then, let’s again consider the couple that waits until marriage to begin a sexual relationship and let’s assume that they remain monogamous during their marriage. But, then, the husband tragically dies in an accident or illness and the wife remarries. If that young woman had never been vaccinated for HPV when she was young, she would be at risk in her new marriage for HPV diseases. Life is unpredictable. Far too many young women and mothers and daughters have been afflicted and died from cervical cancer. The HPV vaccine is a huge step in reducing the incidence of cervical cancer among our young women. HPV is far more common than most of the other diseases we vaccinate for…doesn’t it make sense to protect yourself and your daughters?

  • Lou (Linda)

    Hi Dr. Swartz. Thanks for adding to the discussion here. While I know that we are learning more and more all the time about HPV, it is my understanding that once the body deals with an HPV infection it eradicates the virus and while you may test positive for antibodies that does not mean you are contagious, rather, you are immune to whatever strain it was that you had. The widow in your scenario would more than likely be safe from transmission from a new partner after a given period of time. I don’t advocate that no one gets Gardisil, but that in appropriate cases, it might not be an appropriate vaccine. I don’t think we should vaccinate every single girl at this point. I would imagine that given time and further testing that Gardisil will also become available to men and older women, even those who are sexually active already. Because of the newness of this vaccine and a host of other co-issues, I’m just not ready to say that Gardisil is the right choice for every girl and young woman yet. Ten years down the road when the vaccine has been around for awhile and is shown to be a good vaccine in the longer run, then I would probably adjust my stance on it. But for those for whom the vaccine is clearly a good choice now when evaluating risks and benefits, I say get it!

  • Kay

    The MMR vaccine contains formaldehyde and live virus that is injected directly into the blood and will travel to all major organs and “live” there and replicate forever. It just makes sense that problems will arise as sequelae to these deposits, which would not happen if one contracted the disease and had to be filtered through the liver and lymphatic system. I wanted to be a nurse but now I am thinking twice if I have to get this vaccination. The ELISA test has a 15% margin of error compared to PRN or PRMN (protein reactive microneutralization) but the PRN and PRMN are not available to the public yet!! Only at Mayo Clinic for trials. So since I did not “pass” the measles ELISA, they want me to get all three in the MMR. I don’t think the risk of cancer from formadehyde is worth it.

  • Lou (Linda)

    Just an FYI for you…the MMR vaccine is not injected directly into the blood stream. It is injected subcutaneously (into the fat under the skin) and is absorbed slowly through the lymphatic system. As a nurse you’d be exposed to lots of things worse than a trace of formadehyde. I’ve been directly exposed to TB, meningococcal meningitis, MRSA, hepatitis A/B/C/etc, and probably quite a few other things to which I was blissfully unaware. I’ve been assaulted in any number of ways including being hit, bitten, and spit upon. Nursing ain’t for the faint hearted. Good luck in whatever your career choice ends up to be!

  • Kelly McCartin

    I Just stumbled upon this blog and I was very encouraged reading it. I completely agree with you and love the way you wrote out your opinion. I am currently in nursing school and have to deal with people talking about this subject more than I would like to hear. To me it just seems foolish as to why a parent would not want to vaccinate their children to protect them. But then again, that’s the generation that we live in and it’s sad to say this, but I believe it is going to bite them in the butt. If you would have had this discussion with someone 50 years ago, everyone would have thought you were crazy not to vaccinate your kids. Maybe they had a better view of what life and everyday sickness and death was all about. All this to say, I will be sharing this with my class and to anyone I come in contact with questioning whether or not to have their kids vaccinated. Thank you!

  • Lou (Linda)

    You’re welcome! Once something like polio hits here in the states again, the pendulum will swing the other direction. Sadly, as you say, people will need to be bit in the butt for that to happen…

  • Jemima

    If vaccines WORKED, then this author wouldn’t care if others are vaccinated.

    You sound like a drug dealer telling potential customers how ‘cool’ they will be if they just start doing drugs.

  • Lou (Linda)

    Uhhhh, yeah….they DO work, but thanks for your input.

  • A Recent Comment « Blah Blah Blog

    […] today a person left a comment on my post called “To Vaccinate or Not To Vaccinate“.  This was the comment: “If vaccines WORKED, then this author wouldn’t care if […]

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