Wednesday, February 19, 2014

I Want the World To Know

I really, really don't want to be the Person Who Keeps Talking About Vaccinations, if for no other reason that I have sat next to these people, on both sides of the coin, at dinner parties and I'd sooner eat an oyster than be that person and oysters make me vomit.

And yet a couple of items slipped under the door today and I felt as if I should give them attention, which is another way of saying I'm currently avoiding writing something and aggravating people is possibly the second-best way of procrastinating and I've already cleaned the copper-bottomed pots. 

First, a Berkeley student with measles rode BART over three days, potentially exposing tens of thousand of people to measles. Unfortunately, San Francisco has a lower-than-average rate of vaccination, which means that people who might normally be protected, aren't. Also, there were people on those trains who were under the age of six months, or going through chemotherapy, or living in some immune-compromised way or another and they are now at risk. People like my daughter's friend who, because of poultry allergies, cannot have the usual course of vaccinations and must rely on herd immunity to remain healthy. Enough of the population gets sick and she's at risk, and since she has underlying respiratory conditions, this is a higher risk than her family would ever have taken.

When families choose not to vaccinate, they are making that decision for other families as well. "So?" people might ask, "It's just measles. People get measles all the time; it's not a big deal." In fact, I got a totally respectful comment to the last blog I wrote about this: I think that vaccinations have gone too far. When I was a kid i had chicken pox and therefore got the lifelong immunity. Also German Measles. Never got anything else, like mumps, but got vaccinated for those. I don't think every little childhood disease needs a shot, but having said that you must consider the overall health of the child, family history, etc. Love the blog. Thanks for your kind words about the blog and thanks for not escalating this.

I've already lost people in my life over my belief and had people unfriend and unfollow me over this; polite disagreement is a glorious thing. Now, let's consider what you said: You had chicken pox and are now immune. Good! But thanks to Livestrong.com and the CDC, here are some potential side effects of having chicken pox:
  •  pneumonia 
  •  bleeding problems 
  •  infection or inflammation of the brain (encephalitis, cerebellar ataxia) 
  •  bacterial infections of the skin and soft tissues in children including Group A streptococcal infections 
  •  blood stream infections (sepsis) 
  •  toxic shock syndrome • bone infections 
  •  joint infections 
 [On an anecdotal level, my mother was permanently deaf in one ear because the fever from a "Harmless childhood illness" was so high it cooked the nerve to the ear.]

And from WebMD:
  • Pregnant women who have chickenpox during the first half of pregnancy may go into labor early (premature labor) or have a miscarriage. 
  • Pregnant women who have chickenpox in the last part of pregnancy are more likely to develop varicella pneumonia. Even a healthy pregnant woman is at risk of dying if she develops varicella pneumonia. 
  • Up to 2 out of 100 fetuses whose mothers have chickenpox during the first 20 weeks of pregnancy will also get chickenpox. This is called congenital varicella and can cause birth defects that can include one limb (usually a leg) smaller than the other, scars on the limbs or eye problems such as cloudy lenses. Low birth weight (weigh less than expected at birth).
  • Seizures. The baby can have seizures after birth.
  • Intellectual disability.
  • Shingles. Fetuses who have chickenpox will not have chickenpox again. But they can still have shingles, even as babies or young children. 
  • Death. Up to 7 out of 100 of the fetuses who get congenital varicella die. 
So, those can happen, but let's assume most of these complications don't happen that often. Luckily, there isn't any complication with a high rate of probability, right? Except, there is. Once you have had chicken pox, you carry the virus for the rest of your life in your nerve cells. As you grow older, or have secondary health issues taxing your immune system, or are just under the stress that being alive can offer, the virus can flare up and cause shingles. If you've never experienced shingles, count yourself lucky; I've been told the pain is terrible.

The CDC says that 1 in 250 people will be diagnosed with shingles annually, but when you consider that shingles is not usually a disease of young adulthood, the odds of getting shingles get higher as you get older. My mother-in-law developed shingles and then developed a secondary nerve condition where she was in agonizing pain nearly all her waking hours. For years, every day she'd have to decide whether to stay alert and in agony or take her pain pills and feel better but be completely zonked out. My mother-in-law was a wonderful person. I loved her and I smile when I think of who she was, but part of me wishes she had died the day before all of this started, because I don't think she had a good day for the last five years of her life. People suffer terribly from shingles, and anyone who doesn't vaccinate their child now is as much as saying that they are prepared to let that happen. Chickenpox isn't nothing.

Yes, most people get through German Measles without incident, but there is a percentage of the population for whom it can be catastrophic. If a pregnant woman gets German Measles, she can miscarry or have a stillbirth. If the developing fetus makes it to term, there is up to a 50% likelihood of  Congenital Rubella Syndrome, which is devastating.

Imagine that Berkeley student on the BART was infected with German Measles. How many pregnant women, how many fetuses, could he have risked? This used to happen all the time, and then we decided as a society that vaccinations were for the common good and pregnant women, and mothers of infants, and people like the family of my daughter's friend could go out and not worry about dying of certain diseases. That luxury is being taken away from us as a culture, and a small percentage of our population is doing it.

[Assuming I just lost another chunk of people who read me. Sorry.]

If you have less than two minutes to spare, I think Penn and Teller did a lovely if profane job of summing up the cost/benefit analysis of vaccinations.

That's it. I'm done. I promise I'll try to go back to being the other person you don't want next to you at a dinner party, the one who fishes out her phone while hooting "Wait! Let me show you my cats!"

21 Comments:

Anonymous Marianne said...

I'm sure I was just one of many that Tweeted you a link to the measles story. I'm so glad you responded so elequently. Much better job than I could ever do. Also? I like to have you to point to and say, "No, It's not just me and my conservative Republican Southern self...See?? Here's an environmentally-friendly, vegetarian, home-schooling hippie-ish chick and SHE feels the same way." (Those were total compliments, meant with love)
Like you've said before, it's not politics...it's science.

1:04 PM  
Blogger Amy Wirth said...

Thank you. I am in the same boat of losing friends and trying to keep my mouth shut when I just can't. My mother was a NICU/PICU nurse for many years and had twins as patients whose parents chose not to vaccinate. At four, the twins contracted measles. One was fine, the other became mentally retarded. Both my grandfather and my father in law had German measles before the vaccines were available and had lifelong debilitating heart problems as a result. A few years ago, the last time I didn't bother getting everyone flu shots, my kids got the flu and my body's immunological response was to kickstart the latent chicken pox virus into high gear and before I realized I had shingles, my partner - who grew up elsewhere and had never been exposed to chicken pox - contracted chicken pox at 48. She was almost hospitalized but came out of it. We were told not to worry about the six-month old who hadn't had the varicella vaccine yet, since I was breast feeding, but he got it too. Fortunately, they both came out of it okay, but I hate that they will now be exposed to all the side complications. And even though I had a mild case of shingles, it's definitely the gift that keeps on giving. Okay, end rant. Thank you for fighting the good fight. You were my favorite child actress when I was a kid (shameless fan girl whatever) and I loved your homeschooling book, as I really related when I was still homeschooling.

1:18 PM  
Anonymous Robin Raven said...

Even if I totally disagreed with something you posted, I wouldn't stop reading your lovely blog, and I have a feeling your other readers feel the same way. :)

Having said that, I totally and completely agree with you. This was wonderfully said. Have you ever heard of the website, What's The Harm? It's fascinating (and a bit depressing) because it exposes the damage done by the anti-vaccination movement as well as other forms of pseudoscience.

2:18 PM  
Anonymous Christine said...

While no one likes to be "that person" it's important that we speak out in support of vaccines. Much like getting vaccinated, speaking out about them is part of our collective responsibility. Especially since many people are misinformed. Additionally, when we share science based info about vaccines it helps people realize that even though they may been fortunate enough to survive without permanent health issues from measles, chickenpox or any other preventable disease, not everyone comes through these diseases unscathed. Some have permanent health issues. Some die. As someone who blogs exclusively about immunizations, there are many days when I would like to write about something else...like interesting dinner party conversation tips or my love for oysters. But then, I honestly don't find either of those as important as potentially saving lives. Thanks for speaking out!

8:50 AM  
Blogger Queendivakat said...

Excellent and so eloquent. I made sure to vaccinate my son and refused to allow children over or allow him to go to other homes where children were not vaccinated. Why? Because, I've never had chicken pox and I am one of those that cannot get this vaccination. I've always been careful to avoid contamination, but in cases like you described, it's impossible. So thank you for standing up for all of us.

BTW . . . we spoke briefly at Vroman's at Jen Lancaster's book signing and I was so impressed by how humble you really are.

8:06 PM  
Anonymous KMB said...

I agree with everything you say and am proud of you for having the guts to say it, and say it so well. Plus, I would love to sit next to you at a dinner party and look at photos of your cats. Bring on the animal stories! Love them and loved all of your books. Keep up the good work.

1:51 PM  
Blogger Julie said...

I am a nurse with a focus in public health. Thank you. I also live in a "Berkeley-esque" college town with a high concentration of unvaccinated families. I have seen babies die of pertussis (whooping cough) because families didn't get a booster.

I chose to stagger and delay vaccines until my little one was 3 months old because she was born with a neurological anomaly. Part of that choice meant that my kid didn't go out in public for those 3 months. At all. Neither did I. I live in the country and my pediatrician made visits at home. Not vaccinating means that people should quarantine for EVERY illness throughout life. If an unvaccinated adult or older child has a "cold" and goes out in the world, s/he is potentially exposing not-yet vaccinated or under- vaccinated infants to lethal-to-them viruses. Perceived benefits never outweigh actual costs.

4:19 AM  
Anonymous Anonymous said...

Thank you for speaking out on such an important issue, and for being a voice of sanity to help counter misinformation and ignorance surrounding vaccination.

5:02 AM  
Blogger Eris said...

Smart and well written. Thank you.

5:05 PM  
Anonymous Susan R said...

Well said! I can't stress my belief in the importance of vaccinations enough. My husband has a compromised immune system and we have to pay very close attention to his exposure. I grew up before the chicken pox vaccine and can tell you first hand about the side effects. I got chicken pox at age 16 and I also got varicella pneumonia and varicella hepatitis. I spent 10 days in the hospital and missed a month of school. My sister was 13, caught the pox from me and ended up with encephalitis. Thankfully, we were both fine but we were otherwise healthy children. I imagine that the results could be very dire in children who weren't otherwise healthy.

8:45 PM  
Blogger Arlington, VA said...

I agree with much of what was said. I believe that vaccinations have made massive improvements in health in the last few decades. However, I have to admit that I worry over some of the side effects. Before I get put through the thrasher, let me assure you that my two children are both fully vaccinated. However, I worried enough that I would have preferred to go to the extra time and expense to have them receive staggered vaccinations. By receiving a different one each month, I felt that their immune system wouldn't be "overwhelmed" in any one month. I understand that pediatricians don't think that is necessary, but it seems like a reasonable precaution for those of us who are concerned. The kids would still receive vaccinations within the same time frame. In the end, I didn't end up staggering them because some of the vaccines were not available separately, and it also seemed somewhat cruel to make my children go through several different vaccinations rather than getting it over with all at once. I did delay one vaccination that was due when my daughter was ill. Again, the pediatrician said that the illness shouldn't be an issue, but I didn't think that we needed to test her already compromised immune system. Overall, I think that there are ways to move forward that are reasonable, and don't have to be "all or nothing" approach. My daughter still received that vaccination within the proper time window, and I felt better having her receive it when she was healthy. I don't like it when either side -- pro-vaccination or anti-vaccination -- makes it a black-and-white issue, and doesn't recognize that there are some valid concerns with each approach. As you discussed, it's a hot issue and people have polarized in either direction, so it's become one of those topics that you don't want to discuss at dinner parties for fear of offending someone.

Despite my worries, I am pro-vaccination, and received the DTAP booster a few years ago myself. (Although I shock everyone by avoiding the flu vaccine each year. In the past ten years, I've gotten the flu vaccine twice. Both of those years, I later got the flu (not as a result of the vaccine). The other eight years, I've stayed healthy. So, at a minimum, I don't feel "compelled" to get the vaccine.)

I've also had close calls that made me happy to have immunity (albeit natural immunity, rather than from a vaccination). For example, when I was 6 months pregnant, a woman with the chicken pox entered my OB/GYN's office (for her annual appointment), and asked if the doctor could also check her for chickenpox, because she believed she had it. She very clearly had chickenpox, and was sitting in the middle of a waiting room filled with pregnant women. The front desk didn't do anything, and had her sit in the waiting room with us for over 20 minutes. When the doctors finally got word of it, they rushed out and pulled her into a room. Then they again let her exit through the waiting room. Apparently, she forgot something, and she returned to wait in the line at the front desk for another 10 minutes. It was absolutely ridiculous. The office decided to test every pregnant woman that had been in the waiting room for varicella immunity to see if we had to be concerned about our fetuses. Thank goodness, I'd had the chickenpox as a child, and was found to be immune. (Note: I didn't appreciate the $150 bill that I received for that test.) But, as you mentioned, there are clearly people in this world who are absolutely clueless and will happily infect everyone around them.

6:28 PM  
Blogger Shinny said...

Thank you for tackling a touchy subject. Haven't lost me yet as a reader even though you barely post anymore. ;) My mother-in-law has German Measles when she was pregnant with my husband and of course in the 70's no doctor would say for sure that was the cause but my husband was born blind in one eye and his legs were deformed. Thankfully Shriner's Hospital was there to save him from being crippled and he can walk now but still has troubles with his ankles and feet. She did not get vaccinated as a child because she was the last of 10 kids and they lived on a farm, so couldn't afford to worry about such trivial things as vaccinating the kids. Stay strong and keep up the fight. I also have an uncle who survived polio, again farmers and I suppose he was lucky to have even been born at the hospital back in the 40's.

5:43 AM  
Blogger Write is Never Wrong said...

Thank you. SO well said. I had to add that my children had chicken pox before the vaccination was even available (they are 22, 20 and 18 now) but when my daughter were 10 and 8, they had shingles. And it was horrible. Their doctor had never heard of a child with shingles and here he had two on his hands. Both of my girls have physical scars that are painful to the touch now because of shingles.

Had the vaccination been available earlier, or had they been born a bit later, it would have been on my list of must haves. Because they suffered so badly and still may in the future if they get a flare up.

I'm not completely sold on the HPV vaccine yet. I've let that up to my kids now that they are adults. But everything else was a high priority. Every.Single.Shot.

Thanks for having the guts to stand up against an increasing popular belief that has the potential to wreak such needless havoc on our community.

1:28 PM  
Anonymous Jen on the Edge said...

My 80-something grandmother grew up in an era without most of the vaccinations we have now. She told me once that anyone who had lived during that time would totally be pro-vac because they would have seen firsthand the horrors of smallpox, measles, and more.

I had chicken pox when I was in high school and it was horrible. I was happy that a vaccine had been invented by the time my daughters came along.

6:18 PM  
Blogger Cool 70s Mom said...

The "we don't vaccinate" mentality has gained a disturbing momentum and I totally don't get it.

11:39 AM  
Anonymous Paula said...

Sorry I'm late to the party. I wish there had been a rotovirus vaccine when my kids were little. And I wish people whose kids are sick would let other people know that. My SIL didn't tell me one of her kids had rotovirus and brought her over (she would not stay home from work when her kids were sick). This poor kid had diarrhea like I had never experienced. My kids got very sick, and my husband got even sicker. I learned during that time that, worldwide, rotovirus kills more children than any other illness.

Everyone should remember to get their kids the bacterial meningitis booster before high school too. And keep in mind, the chicken pox vaccine is still currently a wait and see vaccine because we don't know how long it conveys immunity. It may require boosters throughout life, and an elderly person with illnesses may not be able to have the booster and be vulnerable.

My son got measles and chicken pox from his vaccine, so has lifelong immunity to those diseases.

11:44 PM  
Blogger NCS said...

I completely agree with you Cool 70's Mom.

9:04 AM  
Anonymous Anonymous said...

Loved this post. It's so difficult to explain why one is pro-vac!

7:31 AM  
Anonymous Marie said...

I have just discovered your blog, and though I am not a mother, I have the same concerns as you in the two posts I've read so far (I do have plenty of nieces, nephews, and great-nieces and -nephews). I had chickenpox as a child (age 3 or 4), and when I was in my middle 50s, I got shingles. I was lucky: it came, and it went about 37 days later and left no lasting pain. I lost a lot of sleep during that time, and shingles is now the yardstick by which I measure other ailments. When I started school in 1955, I got all the required vaccinations, and I am very glad of it. Keep irritating people, Quinn. It's a public service and a good thing. (BTW, I loved you in The Goodbye Girl.)

11:08 AM  
Anonymous Anonymous said...

I just read your blog at times, but find you to be generally amusing and smart. On your vaccination topic I agree with you whole heartedly. I am old enough to remember Iron Lungs and the thousands of children in this country that were going to spend their lives in that monstrosity. Get the shots. Get the shots!

2:05 PM  
Blogger Marcy Marks said...

For another example of the devastating effects of those "ordinary childhood diseases" that far too many anti-vax parents want to ignore, actress Gene Tierney was exposed to German measles when she was pregnant with her first child in the 1940s and her daughter was born blind and severely retarded. I seriously don't understand why anybody would choose to risk exposure to childhood diseases like mumps, measles and chicken pox when safe, inexpensive and available vaccinations are available and recommended. I had all three of these diseases as a child because the vaccines hadn't been discovered yet (yes, I'm old) but got in on the ground floor of Jonas Salk's polio vaccine in the mid-1950s. People who lived through that era could NEVER be anti-vax! (I am a huge fan of yours, Quinn.)

7:48 AM  

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