Like it? Share it!

Sign up for news and updates!






Enter word seen below
Visually impaired? Click here to have an audio challenge played.  You will then need to enter the code that is spelled out.
Change image

CAPTCHA image
Please leave this field empty

Login Form



Every Outbreak has a Silver Lining PDF Print E-mail
Swift
Written by Joe Albietz   

Every time we have an outbreak of a vaccine-preventable illness, medical journals, the skeptical blogosphere, and even one oddball astronomy site seize the opportunity to re-iterate two related points: 1) Vaccines are safe, and they are unrelated to autism. 2) When rates of vaccinations drop, diseases return.  These incidents are exceedingly salient to the current public debate surrounding vaccination and more than worthy of the attention they receive.

And yet, in spite of the evidence, in spite of our vigilance, people still fear vaccines and outbreaks continue.  Faced with a frustrating and seemingly perpetual battle, it is easy for skeptics to become jaded and cynical, feeling as though we are either preaching to a silent choir or an unfortunately vocal brick wall.  That’s why I think it is worth taking another look at the most recent measles outbreak to have gained skeptical attention because the situation may not be as bleak as it sometimes appears.1

In January of ’08, an unvaccinated 7-year-old boy on vacation with his family in Switzerland contracted measles.  On return to his home in San Diego he managed to infect 11 other children before the outbreak was contained.

All of the children infected with measles were unvaccinated, 9 of them intentionally so.  Three infants were under a year of age and thus too young to have been vaccinated.  This is an entirely typical pattern of infection for a vaccine-preventable outbreak, and while it is extremely important to point out the fact that vaccines do work, that’s not necessarily the most important point for skeptics to hear.

You see, the school the index case attended had 376 children.  36 of them had a Personal Belief Exemption (PBE) on file, meaning their families had opted out of vaccination.  7 of these 36 kids contracted measles.  This is in sharp contrast to the other 340 vaccinated children in the school, none of whom became infected; like I said, vaccines work.

But here’s the silver lining: of the 29 unvaccinated, uninfected children,11 were vaccinated by their parents during the outbreak. These parents were not the unreachable, hopeless vaccine denialists.  They were not members of the choir, nor the wall.  They were parents who made a decision they felt to be in the best interest of their child.  Once it became clear their decision to not vaccinate was a mistake, they changed their minds. True, in this case an undeniable, immediate threat to their child’s health and life was the motivator, but it is reasonable to hope they might find a more subtle, less lethal argument equally persuasive.

A majority of these families appear to have been staunch anti-vaccinationists whose fear of vaccines was unlikely to ever be overcome, but not all of them.  Families who fail to vaccinate are a far more heterogeneous group than we as skeptics often credit them for.  Different families will be persuaded by different arguments, and scientific, rational, personal, anecdotal, even emotional arguments all have value.  This outbreak, and others as well, show me that there is still hope.

That’s why I’m preaching to the choir now and hoping it does not fall silent.  Keep blogging, podcasting, and writing about vaccination.  Loudly and publicly confront the campaigns of misinformation spread by anti-vaccinationist groups.  Most importantly, continue to talk to the people around you, your family, friends, and co-workers.  Individual skeptics can have a real impact, one measured in children’s suffering prevented and lives saved.

  1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm

Trackback(0)
Comments (27)Add Comment
...
written by Cuddy Joe, January 20, 2009
Good advice, thank you.

Aside: I'd like to request that Swift "introduce" new writers, at least give a brief bio on who we're reading when they first appear. I agree totally with what Joe Albeitz has posted, but, um, who is Joe Albeitz?
report abuse
vote down
vote up
Votes: +6
...
written by Jalbietz, January 20, 2009
I'm glad you enjoyed the article. It has been a while since my last Swift post; you can find my bio under the Swift contributors link.
report abuse
vote down
vote up
Votes: +0
...
written by LovleAnjel, January 20, 2009
That is some of the best news I've heard on the vaccine front in a long time. I have a feeling a lot of parents don't vaccinate their children because they do a cost-benefit analysis, and think that the probability of an outbreak happening is so low as to be negligible. Once one happens, they re-assess the cost-benefit ratio and decide to vaccinate.
report abuse
vote down
vote up
Votes: +3
Choir Response
written by Jim Shaver, January 20, 2009
That’s why I’m preaching to the choir now and hoping it does not fall silent.


Amen, brother! smilies/smiley.gif
report abuse
vote down
vote up
Votes: +1
...
written by JeffWagg, January 20, 2009
Swift Bios: http://www.randi.org/site/inde...phies.html
report abuse
vote down
vote up
Votes: +0
...
written by Rogue Medic, January 20, 2009
I have been writing about this a bunch. My blog is about EMS (Emergency Medical Services), but I can do more to save lives and to prevent illness by persuading people to vaccinate their children.

I try to educate a bit about science and this topic is an excellent example of people completely misunderstanding science.

Jenny McCarthy will probably kill far more people than all of the serial killers in American history, combined.
report abuse
vote down
vote up
Votes: +5
the tally so far
written by MadScientist, January 20, 2009
36 originally unvaccinated
7 contracted measles (and are now unlikely to ever get it again)
11 since vaccinated

That leaves 18 still highly susceptible to measles.

That's about 1/3 of the susceptible population in that school now very likely to be resistant due to vaccination, 1/6 who are very likely to have a developed immunity, and still 1/2 who'd better have a good god and hope their prayers work the next time measles roams around their neighborhood.

I'm a bit surprised that the kid would have had an opportunity to catch the virus in Switzerland though; what's the story there? Do they also have rabid anti-vaccine people or did they just run into another group of disease-bearing foreigners?
report abuse
vote down
vote up
Votes: +1
...
written by Cuddy Joe, January 20, 2009
Thanks for the bio sources!
report abuse
vote down
vote up
Votes: +1
...
written by Rogue Medic, January 20, 2009
For the bio sources, if you go to the top of the page, move the cursor over the Swift Blog tab, you will see Swift Blog Biographies as a choice.
report abuse
vote down
vote up
Votes: +0
...
written by BillyJoe, January 20, 2009
Jenny McCarthy will probably kill far more people than all of the serial killers in American history, combined.
Replace "Jenny McCarthy" with "Vaccinators" and you will have what Jenny McCarthy believes with all her heart and mind (yeah!)to be true. The facts are on your side, but try to tell Jenny McCarthy that. Like George Bush, in her...um...mind she will always be right
report abuse
vote down
vote up
Votes: -1
...
written by BillyJoe, January 20, 2009
I have a feeling a lot of parents don't vaccinate their children because they do a cost-benefit analysis

Cost-benefit ratio?
Are vaccines not free in America?

BJ
report abuse
vote down
vote up
Votes: -4
...
written by Cuddy Joe, January 21, 2009
I think LovleAnjel might have meant risk/benefit ratio.
report abuse
vote down
vote up
Votes: +2
...
written by Rogue Medic, January 21, 2009
BillyJoe,

I agree that she may think this way, but she is not somebody with an opinion anyone except her immediate family should pay any attention to. Her scare stories do make sense to the misinformed. There will always be plenty of people who just do not understand or trust science.

One of the criticisms of the companies that make vaccines is that they are profiteering. Vaccines are not free in the US, unless you are on Medicare/Medicaid. Even then Medicare may have a small copayment requirement.

Nothing wrong with calling it a cost/benefit ratio, side effects are costs.

From www.onelook.com, a handy dictionary site - definition 2:
▸ noun: value measured by what must be given or done or undergone to obtain something ("The cost in human life was enormous")
report abuse
vote down
vote up
Votes: +0
...
written by Cuddy Joe, January 21, 2009
As LovleAnjel used the term, she was referring to parents who compare the risk of supposed side effects (like autism) of vaccination versus the benefits of having been vaccinated. In medicine, the risk/benefit ratio addresses the side effects or other risks vs benefits, regardless of costs. A cost/benefit ratio is more of a business term.
report abuse
vote down
vote up
Votes: -1
Not Necessarily
written by Scotty B, January 21, 2009
Let's not forget that not all anti-vaxxers are entirely opposed to vaccine use. There are those that follow the "too many, too soon" gambit. If that is the case, these parents may figure, "Hey, our kids are old/developed enough, one vaccine won't hurt them."

Wouldn't be surprised if it turned out to be 30% of the anti-vaxxers feel this way. smilies/wink.gif
report abuse
vote down
vote up
Votes: +0
...
written by Rogue Medic, January 21, 2009
Cuddy Joe,

Only LovleAnjel knows what she meant when she used the term. Cost is an acceptable synonym for risks that are not financial. Frequently it cost/benefit used as you describe, but it is not inappropriate to use it otherwise. We should be as skeptical of reading too much into the wording of someone else, as we are of reading too much into any other information.
report abuse
vote down
vote up
Votes: +1
...
written by Rogue Medic, January 21, 2009
Scotty B,

Where do you get the 30% figure?

While that percent would not surprise me, I would only be making a wild guess at any particular percent.
report abuse
vote down
vote up
Votes: +0
...
written by Rogue Medic, January 21, 2009
Sorry, that should read:

Frequently cost/benefit is used as you describe,
report abuse
vote down
vote up
Votes: +0
...
written by Cuddy Joe, January 21, 2009
Rogue: "Only LovleAnjel knows what she meant when she used the term."

Which is why I said it 'might' be what she meant. Given the context in which she used it, it should have been risk as opposed to cost to differentiate risk of unintended negative side effects from cost in dollar terms. I've worked in a clinical field as a licensed clinician for over 30 years and have never heard the clinical aspect referred to as 'cost'/benefit ratio.

As for your directives as to what others ought to be skeptical about, take your own medicine and get back to us.

report abuse
vote down
vote up
Votes: -2
...
written by BillyJoe, January 21, 2009
I agree that she may think this way, but she is not somebody with an opinion anyone except her immediate family should pay any attention to.

I agree,but I was just pointing out that anti-vaccers are as convinced about their point of view as you are, and will be about as difficult to convince otherwise.

Vaccines are not free in the US

That's your first problem then.

Nothing wrong with calling it a cost/benefit ratio, side effects are costs.

Okay, in cost you are including risk. I would call that risk/benefit ratio, however, but nevermind
report abuse
vote down
vote up
Votes: -4
...
written by Rogue Medic, January 21, 2009
Cuddy Joe,

I've worked in a clinical field as a licensed clinician for over 30 years and have never heard the clinical aspect referred to as 'cost'/benefit ratio.


Perhaps you should not lead such a sheltered life. smilies/smiley.gif Cost, as I have shown with the definition, is not only a financial term.

As for your directives as to what others ought to be skeptical about, take your own medicine and get back to us.


Ouch! smilies/shocked.gif


Rogue: "Only LovleAnjel knows what she meant when she used the term."

Which is why I said it 'might' be what she meant.



In that case, maybe we should be skeptical and just look at what you wrote.

As LovleAnjel used the term, she was referring to parents who compare the risk of supposed side effects (like autism) of vaccination versus the benefits of having been vaccinated. In medicine, the risk/benefit ratio addresses the side effects or other risks vs benefits, regardless of costs. A cost/benefit ratio is more of a business term.


While earlier you did write that was what LovleAnjel might have meant, when you responded to me, you were much more definite in LovleAnjel's meaning. I guess you two communicated in the mean time. After all, I wouldn't want to apply skepticism toward anything that you would write. I should have scrolled up and read what you wrote earlier, but I did not. Mea culpa.

Lighten up, Francis. Maybe I should use more emoticons, smilies/cry.gif but I am just pointing out that there are many words that have multiple meanings. When it comes to risk management, cost/benefit is one term that is used as a synonym for risk/benefit. smilies/smiley.gif
report abuse
vote down
vote up
Votes: +0
...
written by Scotty B, January 21, 2009
written by Rogue Medic, January 21, 2009
Scotty B,

Where do you get the 30% figure?


Mostly I just made it up. I took the 11 kids that got vaccinated divided by the 36 kids with the Personal Belief Exemption. What I was saying was that I wouldn't be surprised if the percentage of anti-vaxxers who believed in the "too many too soon" mantra matched the percentage of those with the PBE who were later vaccinated. Tongue-in-cheek like.
report abuse
vote down
vote up
Votes: +0
...
written by Rogue Medic, January 21, 2009
Scotty B,

Thank you. I was just wondering if somebody had conducted a survey, or some other method of polling anti-vax people, on this.
report abuse
vote down
vote up
Votes: +0
Health Departments
written by LindaRosaRN, January 24, 2009
Health department personnel lagged for years in acknowledging that people weren't immunizing out of fear. For the longest time, they operated on the assumption that people weren't immunizing because of the cost, even in affluent areas. Any idea what sort of outreach such departments are doing now about this problem?
report abuse
vote down
vote up
Votes: +0
...
written by BillyJoe, January 24, 2009
That's cute..."for the longest time"...except for Dorothy from the Wizard of Oz, I don't think I've ever heard that expression used. smilies/smiley.gif

Also it took me the longest time to work out what you were saying because I took the unintended meaning of your ambiguous first sentence.

BJ

report abuse
vote down
vote up
Votes: -3
...
written by LovleAnjel, January 27, 2009
Aaaa! Much consternation-- I work in animal behavior and we use 'cost/benefit' in terms of fitness (ex: being eaten by a predator is a cost of foraging in the open) so that's where my thoughts were being constructed from. I guess I should be more careful about jargon (and drink more caffeine before I post).

But you all figured out what I meant despite wording. If parents think diseases have been completely wiped out, they may think the risk of any side effects (not just autism, depending on the shot there are several unpleasant things that have a slight chance of happening) is too much and not vaccinate. Once they see kids getting sick, they realize it's now worth the risk.
report abuse
vote down
vote up
Votes: +0
...
written by Trish, January 29, 2009
I think a lot of people who don't vaccinate have misconceptions about how powerful the human body is in fighting disease, partly because of the very success of vaccinations in not only reducing the number of infections, but also in creating "herd immunity" whereby the chain of infection is hard to keep going because of the high percentage of vaccinated persons. Also, the high numbers of deaths from these diseases are no longer part of living memory - at least in the U.S.

Ironically, the flip side is that an awful lot of Americans believe in mild vitamin deficiencies - like, "I'm tired, I should take vitamins." Again, because vitamin deficiency diseases are no longer part of living memory in our culture, people don't realize that vitamin deficiencies make people really, deathly sick, not mildly "rundown" [as vitamin sellers would have us believe] Someone with scurvy, pellagra or rickets might not know that the basis was a deficiency in diet, but they surely felt really, really sick, and if the situation wasn't corrected, they died. Vitamin sellers don't help when they make claims that x number of people don't get the RDA of vitamin whatever, neglecting to mention that RDAs are intentionally set very high, that vitamins are very redundant in modern food supplies [orange juice is everywhere] and that ODing on fat soluble vitamins is dangerous, too.

Vaccines & vitamins are two examples of why even everyday people need the input of science to make good decisions, while personal observations don't produce enough info to make wise choices.
report abuse
vote down
vote up
Votes: +1

Write comment
This content has been locked. You can no longer post any comment.
You must be logged in to post a comment. Please register if you do not have an account yet.

busy