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The Heroes among Us

January 20th, 2015 Leave a comment Go to comments

Henry David Abraham MD

Any baseball fan knows that at Fenway Park there is a brief ceremony at every game recognizing the Heroes among Us- veterans, firefighters, police workers, and community activists who stand and take a well-earned bow. Added to that list I’d like to see vaccination workers, especially those who put their lives on the line around the world to prevent polio, diphtheria, whooping cough, tetanus, measles, and smallpox. Vaccine workers have been abused by Afghan tribes. They’ve been killed by the Taliban. And yet they persist in trying to reduce illness, suffering, and death afflicting millions.

It’s hard for people to be afraid of things they haven’t experienced. Polio is a case in point. As a kid growing up in Philadelphia I had a wonderful community resource in the summer – the public swimming pool. But in the sumer of 1954 polio was loose in American cities. The city fathers shut down the pools, and the police looked the other way as folks turned on the fire hydrants to cool us down in the city heat. I escaped polio in 1954. My friend John was less lucky. Polio paralyzed his face and throat. The following year the March of Times, founded by FDR, our famously paralyzed President, funded one of the largest field trials of vaccination in history. The results were staggering. In 1953 35,000 people had polio. By 1961 there were only 161 cases recorded in the United States. Ask someone today born after 1960 what polio is. Thanks to the vaccine, the answers you get are likely to be spotty. Gone are the images of wards filled with children in iron lungs and leg braces. The last case of polio in all of the Americas was in 1991.

The last known case of polio in the Americas. Luis Fermin Tenorio, 1991.

Like any drug, a vaccine is not perfectly safe or 100% effective. But the numbers speak for themselves. A complication from vaccination occurs once in 2.5 million doses. But becoming paralyzed from a natural infection by the virus occurs in one in 100 cases. The polio vaccines are not perfect, but they reduce the chance of getting sick by 80%.

So why has the epidemic disappeared? One answer is “herd immunity.” If only one or two kids in a classroom get sick, the chance of an epidemic spreading to the other kids is much less the more the rest of the class is immunized. This source of protection begins to fall apart the greater the number of kids who are not immunized. Hence, the alphabet soup of DPT and MMR shots our kids get poked with before they even show up in school.

There have always been folks who are suspicious or downright antagonistic toward vaccination. The great caricaturist, James Gillray, attacked the vaccine against smallpox made from cows by drawing miniature cows growing out of the bodies of the haplessly vaccinated. Today’s anti-vaxers don’t draw like Gillray, but they exercise their First Amendment rights. They also represent a lamentable assault on the common good.

Who are the anti-vaxers? Some are Libertarians who believe that government should not mess with their children. Some are celebrities with an ill child looking for a simple answer to a complex problem. Some are members of a religious sect. Others are health nuts nursing personal theories of sickness and health. And some are salesmen of products to health nuts, talking down vaccination while talking up coconut oil. And God bless the Internet- the flames of all of these ideas are fanned on the Web. A common theme is that the rights of the individual are more important than the safety of the group, and that government and corporations can’t be trusted. Sadly, not all anti-vaxers can be, either.

One of the more notorious cases of anti-vaxing came to light after a paper was published in 1998 in the scientific journal Lancet, claiming that autism was associated with the MMR vaccine. But the “data” in the paper were falsified, and the lead author had been paid to testify by a litigant in an anti-vaccine law suit. It took over a decade for this misdeed to be corrected. In the meanwhile, thousands of children were needlessly left unprotected from ancient scourges of childhood, and honest autism researchers were thrown off the scent for autism’s actual causes and treatments.

An equally dangerous activity comes from feckless legislators who permit parents to take “philosophical exemptions” to their state’s vaccination requirements. When we’re talking philosophical in statehouses, we’re not talking Edmund Burke here, but the Gospel according to Granola. On Vashon Island, Washington, for example, across the Puget Sound from Seattle, 18% of the kids were not immunized against polio, measles, mumps, rubella, diphtheria, whooping cough, tetanus, hepatitis B and chicken pox at one point. You can wipe that smile off your face, East Coasters. 11 states reported increases in such exemptions in 1999, including Massachusetts, despite a measles outbreak in California a decade before that sickened 43,000 unimmunized children and killed 101. And in 2012 seven percent of Massachusetts kindergartners were not immunized against polio (compared to ½ % of those in Nebraska).

Clusters of unvaccinated children are not only in danger themselves. They but are also a threat to the ‘herd immunity’ that walls out viruses, since a weakened “herd” reduces protection for the unborn fetus, the infant too young to be immunized, and the older person with a weakened immune system. And since no vaccine is perfect, even vaccinated kids are at increased risk. And a virus can travel from one side of the world to the other in a day. The worldwide rise of whooping cough in the last decade makes the point. Vaccination protects your children, and the rest of us.

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