GELFAND ON DEATH FROM BAD JUDGEMENT- When young children are dying by the dozen from a largely preventable illness, you just want to start screaming. It's even a vaccine preventable illness, at least for the most part. We trivialize it by calling it the flu, but a true influenza attack is not that modest bug that is going around town right now. The real H1N1 flu is a lot worse, has already killed more than two dozen children around the country this year, and has killed somewhere around 150 Californians this flu season, many of them young adults. It's a real tragedy, and there is plenty of blame to go around.
It's actually the lesser problem that some Americans are actively against vaccination. What seems to be the more serious problem is that a majority of Americans are just too busy to bother getting the shot, thereby failing to protect themselves and their neighbors. Maybe there's a little needle phobia too, but at least in my case. the shot didn't really hurt that much. Maybe I'm just getting a little insensitive in my dotage, but when the nice pharmacist at Vons gave it to me, I really didn't feel much at all. Then my arm got a little achy, which I take to mean that the vaccine was doing what it was supposed to do. Then the ache went away.
I should probably admit that I got the shot not out of a sense of duty, but good old fashioned fear. I don't like being sick to my stomach or too weak to walk to the refrigerator. "The jab," as the British call it, was hardly anything at all, and a week of high fever and all that other stuff is the possible alternative.
The disease can be really bad. So bad that even CBS News, about which I have been fairly critical in the past, has made the influenza a major story. The old joke is that if somebody were to nail a hundred dollar bill to the door of your bedroom and you can walk over to take it, then you don't have the real influenza. The other joke is that when you have a mild flu or a bad cold, you may fear that you are going to die, but when you have the influenza, you are afraid that you won't die. (Thanks to the commenters at the Science Based Medicine blogs for supplying these lines.)
I actually don't think these lines are very funny, but are meant to remind us in some way of what it is like to really suffer, and why we would like to avoid it the next time.
For some reason, we have a fairly low percentage of people in this country who routinely get the flu shot, year after year. I suspect that one reason is that the country as a whole doesn't do much to emphasize the fact that you need to get your shot right now, and here is where you can go to get it.
It's the failure to make the vaccination available in an inexpensive and predictable way and in the same places, year after year.
It would be easy to pick a fight in this column with the anti-vaccine movement. That makes for lots of angry comments and an interesting kind of readership, but I think that by and large, the anti-vaccine movement is dwindling. The mass media, with a few dramatic exceptions, are starting to understand the point that there is no "balanced" story to be made. Vaccines are one of the greatest medical improvements of the past 100 years (and if you count the original vaccinations against smallpox, its more like 200 years). I will simply offer a couple of historical anecdotes.
People of my age remember that there was always somebody who walked with leg braces and crutches. There was a guy who sold newspapers in front of the cafeteria near where I lived who had the braces, and I have a couple of friends about my age who still suffer from disability and post-polio syndrome. One of them limps along because the damaged leg is 3 inches shorter than the normal one. In the 1950s, right before the introduction of the Salk Vaccine, there were cyclic epidemics that sickened tens of thousands, paralyzed some, and killed a few. One relative of mine spent 3 weeks in Country General in an iron lung. The mass immunization of the American people, children in particular, with the Salk Vaccine and later the oral vaccine effectively obliterated polio from the United States. There are a few people who are so opposed to vaccines that they will try to convince you that the Salk Vaccine wasn't what eradicated polio. They try to explain that polio was on its way out, and the vaccine had no effect.
I don't usually like the expression "use your common sense" when it comes to scientific questions, but in this case, use your common sense. In the first part of the 1950s, there were thousands of children, and some adults, who became paralyzed in one form or another. In the first part of the 1960s, after mass immunizations, the numbers approached zero. That drop was not due to changes in sanitation, or the presence of nuclear testing, or the invention of the Bikini bathing suit. It was due to the vaccine.
Or here's another anecdote. In the 1800s and early part of the 1900s, a large percentage of children did not live to see adulthood. One common cause of childhood death was something called diptheria. People who talk about the history of America and the introduction of vaccines point out that when you visit an old graveyard from that era, you can find sections with small gravestones, sometimes listing several children from the same family and the same year. This was diptheria. If you look into the form of the actual disease, you will find out that it was (notice that past tense of the verb) an illness that involved a sore throat with an exudate that gradually choked the life out of you.
Diptheria is gone in this country. If you look in the World Health Organization statistics for diptheria, it is hard to find it in the western hemisphere. In the United States, we have gone 15 years with at most 2 cases per year of diptheria, and most of those years the number was zero.
Still, there are a couple of anomalies which we can credit to the anti-vaccine fear. For some reason, those superior sounding bastions of culture and learning on the continent -- France, Germany, and Britain -- have been endemic for measles for more than a decade in the case of Germany, and more than 2 decades in the case of Britain and France. This is the same continent that brought us the bacterial explanation for common diseases, the Mona Lisa, and the introduction of aseptic surgery. Yet it seems to be among the worst in terms of harboring the superstitious fear of vaccines. Measles came roaring back as a major epidemic in Britain recently, bad enough to mobilize the public health officials to providing a concerted immunization campaign.
By the way, in an unvaccinated population, practically everyone gets measles, and there are serious complications which can include death in about one out of every thousand patients. That's why we had so many children die of measles in this country before the vaccine came along. The Europeans are starting to see increased numbers of children dying from a delayed kind of measles encephalitis, and are starting to sound the call on childhood vaccination.
One last anecdote that I feel is worth telling. I heard it at a dinner party a couple of months ago, and it was told by a doctor who had served several decades ago in the Peace Corps as a Public Health Service doctor. Since he only had about 50 Peace Corps volunteers to take care of, he spent some of his time volunteering at local hospitals. At that time, the U.S. was already largely rid of polio, but in Guyana, where he was practicing, there were still cycles of the disease. That's the way the illness works in an unvaccinated population. It waxes and wanes, just like it did in the US in the pre-Salk days. So this doctor came up with an idea and shopped it around among some of the charitable organizations. The first two or three he visited were sympathetic to the idea of mass vaccination, but lacked the money to sponsor the program. Eventually he found his way to the Lions Club. As he started making his pitch, the leader said, "We'll take care of it." Our doctor friend tried to explain that they were taking on a large and expensive task, but they repeated, "We'll take care of it."
So the doc got on the phone and called the Canadian company that was making the vaccine, and they shipped what he needed without even asking for payment up front.
With a little help, 78,000 children were inoculated in a 3 week period. That sounds like a lot of shots, so I asked whether they were using the oral or injectable vaccine. It was the oral vaccine, which allowed such strong penetration into the unvaccinated population.
However perfect or imperfect the memories were after all these years, the World Health Organization statistics on polio show that Guyana has not reported even one case of polio in the past 20 years.
In a previous article I wrote for CityWatch, one commenter supplied a link that claims that vaccines don't work. I think you have to work very hard to try to make that case, and when evaluated, it doesn't hold water. You don't need to argue a lot of complicated statistics. You just have to think back to the years of diptheria, polio, and smallpox. By the way, there is a dust up going on right now regarding the way the new Gardasil vaccine is being reported in the mass media. It is mostly a culture war story, as explained by the most credible internet urban myth site snopes.com, [http://www.snopes.com/medical/drugs/gardasil.asp] but that is a story for another time.
(Bob Gelfand writes on culture and politics for CityWatch. He can be reached at [email protected])
-cw
CityWatch
Vol 12 Issue 9
Pub: Jan 31, 2014
