As any parent can tell you, fear is simply part of the job. Beginning even before one's child is born, fear is a constant companion, an ambient ocean that swells and subsides at every stage of the child's life. Even otherwise joyful or thrilling moments are sometimes laced with fear, such as when one's son or daughter stands for the first time, steps onto a school bus, rides a bike, gets a driver's license, or even graduates from school. Indeed, the altruistic concerns of parents are so extensive and diverse that quantifying them is effectively impossible. Some of them are, of course, justified. Some of them, well, not so much.
One of the many perceived fears that at first glance appear to be justified is fear of doctors, or of medicine in general. Medical professionals poke, prod, and otherwise involve themselves deeply in the physical health of our children throughout their lives. It is a profoundly intimate involvement that sometimes seems to strain the limits of acceptable familiarity, or more importantly, safety. Many parents are largely ignorant of the science behind a medical professional's ministrations and prescriptions, and have become increasingly cynical over the proliferation of pharmaceuticals. Moreover, parents prefer to remain the overseers of their child's well-being. Fueled by tragic anecdotes from patients and families whose loved ones have suffered permanent injury or death under a physician's care, along with the desire to remain in charge of their child's physical health, some parents are understandably resistant to certain recommended treatments. This particularly applies to treatments that are designed to be preventive rather than remedial.
In this context, it is perhaps comprehensible that a small, but growing number of parents are requesting that their children be exempted from immunization.
As with any medical procedure, there are risks involved with vaccinations. Adverse side-effects occur at varying rates and range from the very mild to severe. Mild side-effects include such things as local skin irritations, bumps, upper respiratory tract infections, fevers, chills, soreness, aching muscles or joints, nausea, and fatigue. These constitute the vast majority of adverse events. More seriously, anaphylactic shock or other severe allergic reactions have been shown to occur. In addition, some vaccines have been alleged to be connected to autism, inflammatory bowel disease, encephalitis, meningitis, and other debilitating illnesses, up to and including infection with the disease the vaccine is supposed to prevent, or even death. A brief search of the Internet shows that a significant number of people, including some politicians and many who work in some kind of health care profession, believe that vaccines are unnecessary or even harmful. Yet a majority of physicians, nurses, health care organizations (such as the Center for Disease Control, the National Institutes of Health, and the World Health Organization), and governments agree that vaccinations have statistically reduced instances of infectious diseases or eliminated them entirely from a population. In fact, most objections to vaccines seem to come from practitioners of alternative medicine, or from anguished parents who have lost children or whose children have developed debilitating conditions, apparently as a result of having been vaccinated.
Of course, it can be hard to parse the details, but the weight of the currently available science on the topic of vaccine safety and adverse effects seems heavily in favor of immunization. The following excerpt from the CDC article, Some Common Misconceptions, summarizes the issue of side-effects:
Vaccines are actually very safe, despite implications to the contrary in many anti-vaccine publications (which sometimes contain the number of reports received by VAERS, and allow the reader to infer that all of them represent genuine vaccine side-effects). Most vaccine adverse events are minor and temporary, such as a sore arm or mild fever. These can often be controlled by taking acetaminophen before or after vaccination. More serious adverse events occur rarely (on the order of one per thousands to one per millions of doses), and some are so rare that risk cannot be accurately assessed. As for vaccines causing death, again so few deaths can plausibly be attributed to vaccines that it is hard to assess the risk statistically. Of all deaths reported to VAERS between 1990 and 1992, only one is believed to be even possibly associated with a vaccine. Each death reported to VAERS is thoroughly examined to ensure that it is not related to a new vaccine-related problem, but little or no evidence suggests that vaccines have contributed to any of the reported deaths. The Institute of Medicine in its 1994 report states that the risk of death from vaccines is "extraordinarily low."
That science supports the continued use of vaccines is no doubt cold comfort to bereaved parents, whose stories would be compelling even in the absence of controversy. Yet just as compelling are the stories of those parents who have lost children to disease due to a lack of immunization, or are now caring for infected children. Their anguish is no less poignant and should not be overlooked. Combined with the knowledge that outbreaks still occur, and that before the advent of vaccines, millions were lost or permanently scarred by disease on an almost yearly basis, this provides a strong argument in favor of immunization. Even many of the most fervent advocates against vaccinations are usually willing to acknowledge the overall societal benefits of immunization, which include the virtual elimination of smallpox and polio and the sharp reduction in outbreaks of other diseases in industrialized countries.
The key component of the controversy seems to revolve around contamination and/or infection from vaccine preservatives or similar causes related to quality of either the caregiver or the product. Re-use of needles is not uncommon in some parts of the world, and mercury-based ingredients are often cited as a cause of debilitating conditions. But these are problems that can be solved through adequate education concerning sanitation, and improvements in the development of vaccines. It is very conceivable that continued innovations and education concerning vaccines will eventually lead to the eradication of more diseases, and that serious side-effects may become so rare as to be negligible.
Nevertheless, perhaps rigorous research into any connection between immunizations and autoimmune reactions is still called for. No parent should ever be asked to preside at the funeral of their child, least of all when death may have been the result of doing what they thought was the right thing. With respect to this issue, there is no substitute for good science.
It is within this much larger context that religion makes its appearance in a rather powerful and disturbing way. Mentioned above was the fact that a growing number of parents are requesting exemptions from vaccination. According to an article by the Associated Press, these parents are objecting on religious grounds.
Every state requires children to be immunized against a variety of diseases before being allowed to attend school. But most also allow parents to opt out of immunizing their children on one or more grounds, including medical, religious, or personal/philosophical reasons. Of the roughly 28 states that allow only medical or religious exemptions, the AP found that 20 showed a two or three-fold increase in claims for a religious exemption. Perhaps not surprisingly, many of these claims are not genuine, but are still granted. Parental fear of the dangers perceived to be associated with immunization has resulted in some taking advantage of the religious exemption designed for those with genuine religious sensitivities.
It may be argued that these parents are simply doing what is necessary to protect their children, at least in their eyes. To be sure, that some are taking advantage of a religious exemption is no indication that religion itself is at fault. Yet the primary point isn't just that some appear to putting themselves, their children, and their surrounding communities at risk at all, dishonestly or not. Rather, the point is that religion is an absolutely terrible excuse for an exemption in the first place.
Some religious groups are well-known for their adherence to faith over medicine. Christian Scientists are but one such group. In the name of God, these groups potentially expose themselves and their communities to deadly ailments, and themselves or their loved ones to injuries that only medical science can truly address, merely because an ancient book tells them to. This means that, to them, no matter how effective or safe a treatment might be, it's still not acceptable.
To put it another way, vaccines could be demonstrated as 100% safe and effective and some would still be permitted to object on the basis of their beliefs about God. Religious freedom, it seems, trumps both societal health and parental accountability.
Does this make sense to you? Is it reasonable to allow one segment of the population to expose themselves and everyone else to the potential for contagion on these grounds?
Although the debate between science and religion has raged for centuries, it has been largely a philosophical conflict waged in books, articles, public and private debates, and today on the Internet. To the best of my knowledge, no one has ever contracted or spread a disease because they believe in a 6,000-year-old Earth, or that snakes, bushes, and donkeys are capable of human speech, or that one day a divine savior will return. In the case of vaccinations (and perhaps other preventive forms of medicine), however, it seems that governments are willing to permit religious beliefs about medicine to take precedence over the well-being of all constituents.
The exalted place religion audaciously claims in society surely must be counter-balanced against the risks it poses to that society. Just as those who smoke are prevented from lighting up in certain surroundings due to the risks it poses to bystanders, so too should the religious be prevented from exposing the rest of society to infection simply because they believe in a supposedly sublime truth. In a society that values pluralism and individual freedom, it makes absolutely no sense to privilege one group with the means to avoid a moral obligation to everyone else. A group that claims moral superiority yet gives no thought to the harm its beliefs may indirectly cause to those around them. This is, in a word, bullshit.
There may be good reasons to be concerned about vaccines, and good arguments might be made on medical, scientific, political, or financial grounds against mandatory mass vaccinations. Maybe the same arguments could even apply to other forms of health care rejected by religious believers. However, arguments that appeal to religion are, quite frankly, bankrupt, and turn religious faith into a bona fide threat to public health. Let's stop pretending otherwise. We owe our children nothing less.
Have a good weekend and stay tuned.