DR. BOBS DAILY: WHEN WE STOP LISTENING TO EACH OTHER, WE LOSE OUR HUMANITY Why does the vaccine debate have to get so ugly? Why are some people on both sides of the issue so harsh to each other? Why cant we all just get along? If the Beatles were still around, Im sure theyd write a song. I dont know if theyd call it We All Live in Two Separate Submarines or Lucy in the Sky With Red Spots All Over. Whatever it would be, the chorus would include Everybody Calm the #$*@%!& Down. If both sides could calm down and start listening to each other, everybody would be able to get along. Now, I figure that 95% of the population probably doesnt care. No, thats not right. They care, but they are happy to leave well enough alone. Most will vaccinate, some wont, and everybody simply chooses to love and respect each other. But such people are not vocal. They are the silent majority. Its the vocal minority that stirs it up. Am I one of those? Ya, I guess. So, Im writing to myself as well as to everyone else. But Ive never called anyone names, except for stupid. Im talking to all the pro-vaxers who get ugly and hateful in their comments, and the anti-vaxers who get hateful and ugly in their comments. If you all dont start respecting each other, were not going to get anywhere. Let me lay out a few talking points: Those who are pro vaccine simply want one thing. Or rather, they dont want one thing. Diseases. They dont want measles (a disease that is virtually preventable with the MMR vaccine). They dont want whooping cough (a disease that is mostly preventable with the DTaP vaccine). They dont want chicken pox (a disease that is . . . OMG, do I really have to keep saying it . . . preventable with the Varicella vaccine). They dont want the flu (not going to say it). They dont want any of these diseases that are still around. And, even more importantly to them, they dont want their babies who are too young to be vaccinated to get these diseases. AND, because vaccines arent 100% effective, they dont want their vaccinated children to catch them either. Add to that the immunocompromised; nobody wants them to catch what would be a far more serious disease. Then, they dont want diseases that have been eliminated, like polio and diphtheria, to return. Its that simple. So, when the anti-vaccination crowd doesnt respect such ideas, its no wonder the pro-vaxers get pissed. Now, Im pretty sure that the anti-vaxers dont actually want pro-vaxers to get sick. They probably dont want anyone to get seriously sick. They accept that there is a disease risk for their own children, but they cant possibly wish it on anybody else. How do anti-vaxers attack these goals? By claiming that vaccines dont work. If vaccines dont work, then all the pro-vaxer attempts at disease prevention are fruitless, and the anti-vaxers dont pose any risk because the vaccines they didnt get wouldnt have helped anyway. This makes pro-vaxers understandably angry. This is one of the most provocative areas of debate, but its one that I believe is improperly understood by one side. I firmly believe that vaccines do work. They do provide immunity. I do believe that vaccination is immunization. I dont believe its perfect immunity, and neither does anybody else on the pro-vax side. Some vaccines provide a very high level of immunity, like 99%. Some really suck, like this years flu shot. DTaP vaccine is somewhere in between - maybe 85 to 90%, but it wanes quickly. To say that vaccines dont work at all is incorrect, in my opinion. Whats the number one argument that anti-vaxers put forth to demonstrate that vaccines dont work? Its the finding that in some outbreaks, more vaccinated people catch a disease than unvaccinated people. Conclusion? Vaccines dont work. I look at it differently. If a vaccine is 80% effective, and 100 people are exposed to a very contagious disease, and 95% of the people are vaccinated, then whats going to happen? 3 or 4 out of the 5 unvaxed will catch it. Maybe even just 1 or 2. And about 19 of the vaccinated people will catch it. This happens all the time. Does it mean the vaccine doesnt work? No. It means the vaccine isnt perfect, but it still prevented about 80 people from catching it, then spreading it around to hundreds of others. And if its a vaccine that 99% effective, thats even better. But whats tough is that some vaccines wear off quickly, within just a few years, as is the case with the whooping cough portion of the DTaP. Many 4 to 5 year olds are susceptible before they get the booster, and many 8 to 11 year olds even more so. That doesnt mean the vaccine doesnt work well for a couple to three years after the initial series and each booster. To say that vaccines dont work doesnt accomplish anything useful, in my opinion. Ive studied so much data that show vaccines work, and I am convinced. Thats why I offer them in my office. If I didnt think they worked, I wouldnt bother. I know that some anti-vaxers will still hold to the belief that vaccines dont work, but I think such non-believers are the minority. Im not saying you are bad people in any way. Im not saying there is anything wrong with you as people to believe that. Im simply saying that I dont agree with you. Now, on another note, I think that most anti-vaxers do believe vaccines work. They arent willing to risk the side effects, but they do acknowledge that they at least work. These believers would point out to all vaxers that Hey, your kids are safe, or at least as safe as the vaccines effectiveness is. If MY kid catches a disease that your child is vaccinated against, your child is probably going to be fine. This assurance isnt perfect, but its the best we have. I know that this doesnt protect those too young to be vaccinated, and that these little ones can catch the disease from a sick unvaxed person (as well as a sick vaxed person in whom the vax didnt work). Thats scary, and its especially tragic when it results in a fatality or permanent disability. What makes the vaxers angry is when the non-vaxers say Hey, you have nothing to worry about because our kids cant make your kids sick. They can, in one of the above scenarios. Non-vaxers shouldnt claim otherwise. By at least acknowledging this, you might make the vaxers less angry at you. AND, other than the infants and the immunocompromised, almost all vaxers can rely on their immunity. You are all pretty well protected. Not perfectly, but well enough that you should be able to live life without fear. Now for the other side, because there are always two sides. How do the non-vaxers feel? I think that their number one issue is this: They want a choice. They dont want to be forced into a medical treatment they are not comfortable with. Thats probably the number one freedom that they want preserved. IF vaccines were 100% harmless to every single person that got them, I think that we could insist on vaccination. BUT because they are not, because occasional severe and even fatal vaccine reactions do happen, it is unethical to force them on anyone. Yes, I know they are safe for MOST people, but not for all. And this is an issue that creates so much discord. Back in the 70s and 80s, when severe (but rare) vaccine reactions began to be reported, victims were crying out for help and no one was listening. The medical community was in complete denial that severe vaccine reactions were even possible. These victims were ignored. A generation of doctors were trained that severe vaccine reactions cant happen. So, its taken many many years, but now almost everyone in the medical community agrees that they CAN happen. They arent common, but they can happen. They are still some naysayers, however, who use pseudoscience to demonstrate that those who have severe vaccine reactions have genetic problems which would have eventually caused the same problems anyway, given time. The vaccine just happened to trigger the problem sooner, or triggered it coincidentally. Yet the vaccine isnt the cause. So, these naysayers continue to make victims and their families angry and up in arms. Those doctors are the minority, but they are a vocal minority, and families are worried that more and more doctors will once again believe that severe vaccine reactions cant happen. And, will that lead to forced universal vaccination? Such parents are worried it will. So, families who feel their children are victims of a vaccine reaction will continue to be very vocal, as they should be. As long as the right to choose is threatened, which it currently is in the back rooms of the legislatures in most states, vocal anti-vax parents will continue to fight back. How can pro-vaxers respond? Acknowledge that bad vaccine reactions can happen, thats how. Stop trying to tell these parents and their children they are wrong. Have a little empathy. It didnt happen to your child, but it did happen to someones. Have a heart. I know that the pro-vax vocal minority wont, but all the rest of the quiet, majority vaxers certainly can. And you can get louder about it. Anti-vaxers can reciprocate by acknowledging that the diseases can kill and maim as well. It, too, is uncommon. Yet it happens. What else do non-vaxers want? They dont want to be discriminated against. They want to be able to attend school if they want (if not sick, of course). They want their children to be able to play with the vaxers children. They dont want it to even be an issue that affects social and family life. And non-vaxers dont want their pro-vaxer relatives to give them such a hard time. And the vaxers want the non-vaxers to stay home if exposed to a contagious disease, as we are seeing happen with measles (a disease which is preventable with the MMR vaccine). And they should. I think it IS a non-vaxers responsibility to accept a quarantine if exposed to a disease that other people dont want to catch. It sucks to have to miss school and work, but I kind of think that non-vaxers sign up for that when they make that choice. This would help reduce the spread of the very diseases that the vaxers are trying to prevent, and theyd thank you for it. I think that non-vaxers also want health care. They want to be able to go to the doctor without being read the riot act every time. Read them the riot act once, then move on. They dont want to have to call 10 different pediatricians just to find one who isnt prejudiced against their kind. This trend is actually going in the wrong direction; instead of become more understanding, more pediatricians in my area are discriminating against these people compared to a few years ago. A final bit of food for thought. Lets talk about rights. Which right is more important, the right to not get sick with a disease or the right to make health care decisions for yourself and your child? The way I see it, the diseases were here first. They are ubiquitous to our world. Whether created by God or by evolution, they are here. They are the status quo. Because we have invented a medical treatment to try to change the status quo, yet that treatment can cause harm to a very small percentage of people, it is my belief that we shouldnt force anyone into accepting this treatment. Life happens, death happens. Its terribly tragic when death happens before its time. Nobody wants anyone to die. And no one wants their child to suffer a severe vaccine reaction. So, it is my opinion that ethically speaking, we must give precedence to what the status quo was or is, that diseases exist and cause some casualties, and those who decide they want to take part in the disease prevention can enter into vaccinations by their own free choice. I know, I know, pro-vaxers will say that anyone who doesnt vaccinate is benefiting from all those who do, and I agree. They will go on to say that its not fair that most people accept the risk of vaccines in order to be protected from the diseases, for the good of society. To that, I will answer, Wait, you are saying that most people will accept the WHAT of WHAT? The risk of vaccines? But wait, there is no risk, right? Thats what youve been preaching. So, if theres no risk to vaccines, then theres no problem if you get them for your child and another family doesnt. Your child is protected. Either theres NO risk to vaccinating, so you cant bring up such a point, OR, there IS risk to vaccinating and thats the very thing that anti-vaxers are trying to get across in the first place. Pro-vaxers cant make both points. Bottom Line: Because there will always be those who dont vaccinate, wed better figure out a way to get along and love each other, because theres only one planet (for now). Mars colony is a long time away. I love to write things that are funny, fun, controversial, fun, stupid, pointless, fun, and funny. I hate it when I have to get serious. I want to get back to writing stupid stories about funny people in my office. But this is a serious issue, one that isnt going away, and one in which nobody seems to be making any progress toward reaching an understanding. The answer wont be to make everyone vaccinate, neither should the answer be to allow diseases to run rampant and kill people left and right. The answer needs to be somewhere in the middle, and it needs to include love, understanding, and calm-headed people who will actually stop and listen to each other. Taking tomorrow off. Dr. Bob
Posted on: Thu, 22 Jan 2015 21:40:10 +0000
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