Thursday, October 23, 2008

Vaccinations

OK, before I start to rant and rave, you might want to just take a quick glance at this article:

This is a topic that was tiring before it even got to this point.  In 1998, Andrew Wakefield (A gastroenterologist, a bowel doctor) and his colleagues looked at 12 children who had bowel disease and developmental disorders, who had all recently had a vaccination of some sort.  All of these children had been referred to him as patients.  They were not blindly chosen for the purposes of a research study.  These patients had been selected (on some level) for care, specifically for their bowel problems.

For some reason, the daft Dr. Wakefield decided that he saw a trend, and published a "study" (this is in quotes because this is a study only in the most limited sense.  An article would be a better term).  The fact that this "study" made it into Lancet (a peer reviewed, and somewhat prestigious medical journal) only makes this story all the more tragic.

The media picked up the story, and before long an international scare burned across the globe.  Parents were petrified of giving their child something that could cause brain damage.  Media generated statistics (read: lies, half-truths, and misintepretations) were thrown into the mix.  Before long, people acted with what was felt to be justified outrage.  In their minds, the medical community was posioning their children.

By 2006, the majority of the authors of the "Wakefield Study" had issued statements of retraction, condemning the study.  The limitations of the study far outweighed any relevance to the practice of medicine, or the safeguarding of children.

The year is 2008, and we see children dying of a preventable disease.  Diseases which have been mostly conquered for decades.  Why?  Because parents remember the media feeding frenzy of 1998, and not th quiet retractions that have happened since then.  No real press has been given to the clarification that, in FACT, there is no proven link between vaccinations and autism spectrum disorders.

Correlation does not equal causation.  If you give a child a vaccine, and months later the child develops mental disorders (or any disorder) that does not mean that the vaccine is the culprit.  Think about it.  In the intervening months the child: ate, fell down (at least I did as a child), learned a new skill, breathed, had a band-aid applied (again, at least I did as a child), played in the dirt, etc.  Any one of these things could be just as guilty (or contributory) as the vaccine.  Or it may have no role at all in the child's developing condition.

Now, another chain of events.  Your child gets Measles (or mumps, or rubella), and now has a chance of dying, suffering from neural damage, or losing their sight.  The child also has a chance of spreading these diseases to others.  Pregnant women may spontaneously abort their unborn child due to rubella infections.  We know for a fact that this happens (if you want to discuss Disease Theory, I'll give it a short try, but this is pretty well established).

Please vaccinate your children.

But now that I've said that, we have to respect a parent's right to bring up their child.  There may be reasons to not vaccinate their children (though none of the above appear to be valid to me).  Strict religious reasons may prevent a parent from vaccinating their children (Not what I believe in, but a patient's beliefs should be recognized and respected.  It is one of those big reasons that life is so sacred).

I don't believe that the government should mandate immunizations in any but the direst circumstances (smallpox containment is an example).  Parents should be able to opt out of immunizations.  However, I believe that the default position should be one of immunization.  Require some level of energy expenditure to prevent the immunization, even if it is simply requiring a simple signature on a simple form.  This way, apathy will still result in protection of the child from potentially fatal illnesses, and help reinforce herd immunity.

Education should also be taking place.  Every flyer discussing immunization should list some of the relevant facts regarding the immunization/autism controversy.  Point out the level of discredit that Wakefield has suffered.  Point out the incidence of diseases of concern (not just MMR, but Autism as well).

The vehemence surrounding this is astonishing at times.  I know parents want the best for their children, and I know that I will never be able to assess "Best" for every parent in every situation.  However, the logic behind some of these decisions, and the numbers that are making these decisions is just baffling.

Stay safe, folks, and take care of each other.

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