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Should Vaccinations Be a Civic Duty?

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This post was originally featured on The Soapbox on October 10, 2012.

Ever since Dr. Andrew Wakefield’s 1998 study allegedly linking vaccines to autism, parents have wondered whether getting their child vaccinated is worth the risk.  Celebrities such as Jenny McCarthy have taken up the cause, urging parents to consider the potential ill effects of what were once considered routine shots.

The problem here? It was never true.

But don’t take my word for it—the British medical journal, BMJ pointed out in 2011 that the original Wakefield paper was in fact “fraudulent.” The article further goes on to state that “Wakefield altered numerous facts” and “sought to exploit the ensuing MMR scare for financial gain.” These claims and the evidence BMJ was able to present later led to Wakefield being struck from the medical register by the British General Medical Council.

This may all seem like medical trivia, but the consequences are very real. In the figure below (credit: BBC), we see that measles cases were relatively rare before Wakefield’s paper was released.  Since then, however, measles incidence has increased dramatically.

Measles has become more common since Wakefield's 1998 paper was released.

Measles has become more common since Wakefield’s 1998 paper was released.

Fortunately, as Nature reports, several U.S. states have either passed or are considering laws to require parents to demonstrate that they have “received factual information about the risks and benefits of vaccination from a health-care practitioner or the state’s health department” before they would be qualified for an exemption.

This is a start, but the problem is that vaccination rates may be falling enough to actually cause public health problems. When everyone is immunized against measles, it no longer has any available hosts, and cannot survive in that population.  Over generations, this makes the likelihood of even being exposed to measles vanishingly small.  This is why unvaccinated children don’t all come down with measles.  But as the number of unvaccinated children increases, so too does the chance of an exposure leading to full-fledged measles.  In turn, these isolated cases can lead to further infections, starting an outbreak.  Treating these children costs time and resources that might have otherwise been spent elsewhere. It’s said an ounce of prevention is worth a pound of cure, and here the cure is potentially being taken from patients with unpreventable illnesses.

Additionally, as a virus replicates in its host, it is prone to developing mutations.  Not only could these mutations increase resistance to treatment, there could also arise mutations that circumvent the immunity that vaccinated patients have, suddenly leaving the population vulnerable to disease.

The whole situation is akin to a patient not finishing his/her cycle of antibiotics because he/she feels better after three days. Parents see healthy examples of unvaccinated children and think there is no need to vaccinate their own. As more and more parents start to think like this, however, the potential for real harm greatly increases.

This is why I believe that it is time for us to consider vaccinations as more than a personal choice and rather a civic duty. Certain things are done by society to keep everyone safe, but they only work when everyone buys in. Take traffic lights for example. Everyone goes when the lights are green and stops when they’re red. By and large, this keeps everyone safe. When some knucklehead decides he/she is above these rules and decides to run a red light, well that’s when accidents happen.

In order to preserve the health of children both present and future, it is imperative that everyone is vaccinated. Only then can we sure that our children are safe from many very preventable diseases.

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