Thursday, April 21, 2016

Diving In, Part Two (Or, Why the Vaccine Debate Isn't Cut and Dried)



In case you missed, it, Part 1 of my writing on vaccines in the US can be found here.


I suppose that, like most other very controversial subjects, it shouldn't surprise me that the vaccine debate tends to get framed as an all or nothing, black and white, choosing sides issue. Whenever we are driven by fear, human beings tend to lose the ability to think rationally and begin to believe that there is a Right and a Wrong answer, and the question of whether or not to vaccinate can certainly be a fearful one.
I do continue to be mystified, however, by people who should know better - public health officials and medical practitioners, for starters - that position vaccines as an all-or-nothing proposition, and here is why:
Vaccines are not all created equal. Accusing me of being "anti-vaccine" because I am concerned about the safety and/or efficacy of some vaccines or the current US vaccination schedule is akin to saying I am "anti-car" because I wouldn't consider driving a Volkswagen but I might choose a Toyota.
  • There are a vast array of vaccines available, some of which were created decades ago and some that are fairly recent. 
  • Some vaccines on the market are multivalent (that is, they are designed to inoculate against more than one disease-causing organism) and others are monovalent (for one organism only).
  • Some vaccines were created to work against bacterial disease and others were designed for viruses.
  • Some vaccines contain adjuvants (chemicals that are supposed to increase the body's immune response to create stronger immunity) such as aluminum and others do not.
  • Some vaccines are designed to be injected once in a person's lifetime and others require multiple boosters in order to maintain a high level of immunity.
  • Some vaccines contain inert ingredients derived from animal parts, others from human fetal tissue, and things like MSG (monosodium glutamate).
  • Some vaccines have been tested many times over a long period of years on individuals of all ages, genders and races, and others have been "fast-tracked" which means that there was a determination that there was some public health risk that necessitated them getting to market faster, so there hasn't been the same rigorous level of testing. 
I could go on, but hopefully it is imminently clear that the vaccines Americans are encouraged to give their children (and have themselves) are very different from one another. Much like buying a car, it is important to do research on each individual vaccine in order to determine a risk/benefit ratio and decide what is comfortable for you. For example, when my daughters' doctor recommended the chickenpox vaccine for them, I researched it as thoroughly as I could and ultimately chose not to have them get those shots because I felt as though the risks outweighed the benefits. Similarly, they have not had the HPV vaccine and I don't foresee either of them getting it anytime soon. (If you're curious about why, you can read this post particular to the Gardasil vaccine. Since I wrote it, there has been a great deal more information published by other people who are critical of both Gardasil and Cervarix that shouldn't be difficult to locate online.)

Please don't think that I am under the impression that doing research on the safety  and efficacy of individual vaccines is a simple endeavor. I am fully aware that it is not, and I know how lucky I am to have both the time and the educational background to locate, digest, and mostly understand the data. Many, many people are unable to do what I have done, and the system is unfortunately not set up to support any kind of patient education regarding vaccines or any other pharmaceutical, for that matter. Many vaccines are available through drugstores and grocery stores in America, which makes it a challenge to have an in-depth conversation with the provider regarding risks and possible complications. Even if you go to a physician for vaccines, many of them aren't as well-informed about the individual attributes of each vaccine as they could be, and a great deal of them are unwilling to have a candid conversation about the ingredients of individual vaccines. In a perfect world, the person who is recommending that you inject your child with something would have looked at the studies done on that drug to determine whether or not it is a good idea, but the amount of information is incredibly huge. The doctors I've met are content relying on the word of the CDC that vaccines are safe, but because these drugs are created and sold by massive corporations who may or may not be interested in the greater good of public health, but who are nevertheless incentivized to create a product that they can bring to market quickly that will produce enormous profits for their shareholders. In turn, these corporations use that money to lobby lawmakers who wield a great deal of power over government agencies responsible for determining whether these vaccines are safe and effective and when they get to go to market, as well as recommending where in the vaccine schedule they ought to be placed. There is a very clear conflict of interest for many physicians and scientists working on vaccines who are being paid by large pharmaceutical companies to create new vaccines. And, in many states, regular family physicians are paid by the state to give patients vaccines, so the more children they inoculate, the more they are rewarded. 

Ultimately, this issue is much more nuanced than many of us would like to believe, and because it is so complicated, we often fail to have productive conversations about it. In my heart of hearts, I believe that we are all striving for a country with healthy children, but if we are going to get there, it will, at some point, mean that we sit down together without fear or anger or labels and get everything out on the table with that singular goal in mind. 









 

1 comment:

Carrie Link said...

Thank you.

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