Let’s review: how do vaccines work?

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On the face of it, suspicion of vaccines is incomprehensible. Vaccination has been one of the biggest lifesavers of the past 200 years. It is the cornerstone of public health, directly responsible for the dramatic drop in infant and child mortality and the dramatic extension of lifespan we have enjoyed over the last century. Despite countless conspiracy theories advanced by vaccine rejectionists in the past 200 years, not a single one has turned out to be true.

True, there are side effects, some serious. However, serious vaccine side effects like brain damage or death are so rare as to be measured per 100,000 people or per 1,000,000 people. There has been no effort to hide these serious side effects. Indeed parents are required to sign consent forms acknowledging the risk of serious side effects, including brain damage and death, before their children can be vaccinated.

So why are people suspicious of vaccines? There are many reasons including the American love for conspiracy theories, the public campaigns led by prominent celebrities, and the desire to assign causes to diseases like autism where the cause remains unknown. The most important cause of the suspicions, though, is one that is very easy to address. Most people don’t know how vaccines work.

To understand how vaccines work, you need to understand how the body defends itself from bacteria and viruses. Just like the body has a dedicated system to digest food (the gastrointestinal tract) or to remove waste products (the kidneys and urinary tract), the body also has a dedicated system to fend off bacteria and viruses; it’s called the immune system.

The body actually has three layers of defense against bacteria and viruses. The first is the physical barrier presented by the skin or the lining (mucous membranes) of interior passages like the mouth and nose. Although we are surrounded at all times by bacteria and viruses, most of them never make it beyond the skin. Of course the integrity of the skin and mucous membranes can be disrupted by a cut or puncture, allowing bacteria or viruses to be introduced directly into the body.

The second line of defense is a non-specific immune response. If bacteria colonize a cut on your hand, your body reacts in a predictable way. There will be swelling, redness, and pain, a response that does not depend on the identity of the threat. Special immune cells will race to the site and engulf the offending bacteria. When they die in the attempt, they accumulate as pus.

Even primitive animals have non-specific immune responses, but higher animals and human beings have an additional, more powerful response. We can produce antibodies. Antibodies are proteins that recognize specific bacteria or viruses and bind to them, thereby signaling to other immune cells that they are targets for swift neutralization. Each antibody binds to a specific site on a specific bacteria or virus.

We’re not born with those antibodies, though. We make them in response to a threat. For example, we are not born with antibodies to the chickenpox (varicella) virus. When exposed to the varicella virus, though, we can learn to make antibodies to it. It takes time, but gradually we can produce enough antibodies to fend off the disease.

Unfortunately, we don’t always get the time we need. We can make antibodies to smallpox, for example, but many individuals are overwhelmed and killed by the virus long before they could make enough antibodies to fend it off. Those who do win the race and manage to produce enough antibodies to survive are now permanently protected. That’s because the immune system retains the ability to make the specific antibodies against the smallpox virus. Whereas it may take days to produce smallpox antibody when first exposed, a second exposure will be met with rapid and massive production of antibody, generally preventing the individual from getting sick at all.

So in order to be protected from the disease, you had to get the disease, and you might die before you were able to make enough antibody to protect yourself. Imagine, though, if you could learn to make the protective antibodies without actually getting sick. That’s the theory behind vaccines.

In order to make antibodies to a virus (or bacterium) the body needs to “see” the virus. In other words, it needs to have direct exposure to the virus, but that virus doesn’t have to be functional, and it doesn’t even have to be whole. A virus can be inactivated (live attenuated) or killed and still produce an immune response. It can also be broken down into its constituent parts and the parts can produce an immune response. Any future exposure to the live virus (though contact with others who have the disease) will be met with rapid and massive production of antibody, preventing the individual from getting sick at all. A vaccine is merely an inactivated or dead form of the virus, letting you learn to make antibody without getting sick in the process.

Vaccines do not produce perfect immunity. The dangerous part of the virus might be the part that evokes the most powerful immune response. Rendering the virus harmless by inactivating it, killing it or breaking it up, may remove that part and the immune response to the less dangerous parts might be weaker. So actually getting the disease may produce a better immune response than the vaccine … but only if you survive the disease.

Successfully fighting off a disease depends on being able to produce enough antibody before the disease kills you. Until vaccines, the only way you could learn to produce antibody was to actually get the disease. Now, instead, you can learn to make antibody by being exposed to a harmless form of the virus or bacterium.

This piece first appeared in October 2009.

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  • Nurse Ashley
    • Sullivan ThePoop

      What is wrong with these people? Measles is too contagious for only 80% to cause herd immunity. Measles is so contagious that it can break through immunity (naturally acquired or vaccine acquired) if enough challenge is presented (you come into contact with enough people with measles). 80% of people vaccinated is good for polio herd immunity you need 95% for measles.

      • Young CC Prof

        See, we understand that.

        If you read outbreak studies carefully, most of the time, the only twice-vaccinated people who get sick tend to be the really heavily exposed, someone who was nursing a victim, in the hospital or at home, or the person who sat beside a victim on a 10-hour flight the day before the rash appeared.

        We also understand that measles is outrageously easy to spread, far more so than most colds. It and influenza are the only viruses that have really mastered the art of spreading by air. (Many others can do it sometimes, but really prefer spreading by touch, as they aren’t particularly good at it.)

    • Tim

      OOOOOOH – if you read to near the bottom of it, there’s a bit conflating autism with being undiagnosed PANDAS (go ahead, google it. it’s the latest rage amongst the chronic lyme/vaccines cause autism/ medical conspiracy theory crowd) – I was waiting for that to happen ever since I first learned about it last year courtesy of some protesters standing across the street from Boston Children’s.
      (They were upset about a family that apparently had DSS called on them – they brought their child to BCH with supposed PANDAS, and they began treatment like they would for any other emotional/mental issue that was as severe as this patient apparently presented – cognitive therapy and SSRI’s. The parents apparently got upset that they were not willing to keep giving their child who had no acute infection intravenous abx, and tried to kidnap from the hospital. You can guess where the story ends. This is obviously not 100% of the story, and it just what could be put together from the hospital and DSS’s statements, and the protestors story and trying to figure out what the logical chain of events was)
      Anyway, I remember these folks harrassing me on my way to visit my kid very well. They didn’t seem to understand why I was unwilling to pull my child out of the hospitals care just on their say so.

      • Dr Kitty

        http://www.nimh.nih.gov/health/publications/pandas/index.shtml

        This explains why antibiotics aren’t helpful for PANDAS. The bacteria aren’t the problem, the antibodies are the problem, and the antibodies hang around a lot longer than the bacteria.

        • Tim

          Yep – I read the stuff I could find after being accosted, and saw that the recommended treatment post acute-infection was , just as childrens was doing, CBT and psychiatric meds. Of course, much like the chronic lyme people, the PANDAS “advocacy” (i have a real hard timing accepting these people as legitimate advocates) are convinced that the only way to get better is constant IVIG and IV abx pretty much forever. I immediately drew the parallel in my mind between them and the chronic lyme people – I was waiting for them to become aligned with the autism folks as well, and it looks like it’s happening.
          The way I see it, you have 2 choices when you are confused and your child is critically ill – either you can put your faith in what trained professionals are telling you, or you can listen to internet “advocates” who espouse wild over the top treatments with no rational basis behind them.
          I picked #1, and from where I’m standing, its very very difficult to me to understand why some parents choose #2. It just makes no sense to me, as much as I try to understand (because I feel like I’d have a better chance of reaching people if I could empathize with why they feel the way they do) , but I just can’t do it.

          • The Bofa on the Sofa

            I picked #1, and from where I’m standing, its very very difficult to me to understand why some parents choose #2.

            It’s an issue of, “Doctors don’t know everything, therefore their opinion isn’t any better than anyone else’s”

            Which is completely crazy of course, but there it is. It’s “just their opinion” and, as we know, all opinions are equal.

          • Dr Kitty

            Tim, if you look at the lunacy what you’ll see is hope and certainty.

            Doctors say things like “we’re not really sure why this happens” and “this treatment might help”, and, for confidentiality reasons, don’t tell you stories about previous similar cases, except in the most general terms.

            The lunatic fringe has hope and certainty :
            Read our testimonials!
            We know what caused this!
            We have the cure!
            Your child could be just like this one!

            That can look better to people who have had little hope and nothing certain for a very long time.
            I don’t blame the ones who grasp at straws, I blame the ones who hold the straws out and persuade them to ignore

          • Dr Kitty

            Sorry, Disqus ate the end of the post.

            “who hold the straws out and persuade them to ignore the lifebelts being thrown by conventional medicine. Wakefield, Mercola, Sears, Dorey, I’m looking at you.”

          • Tim

            I see that, that they are offering miracles – I just don’t understand believing in miracles. If something worked, it would become mainstream – unless you believe that all pediatricians just like watching kids suffer, which is sortof a silly thing to believe.

  • Gretta

    I kinda get a charge out of vaccines. For instance, I just got a flu shot. Now I know the vaccine isnt perfect, but I feel like I just got suited up for battle !! BRING IT ON, INFLUENZA. BRING. IT. ON.

  • Gene

    My daughter just had her 4 year check up. In the US, we usually give four shots around this time (MMR, Varicella, Polio, and DTaP – plus Flu). My Ped normally splits up the shots (two at 4 years, two at 5 years). I asked him if we could give all of them (no reason not to). His response: “I see no problem with that. You’re on the front line and your kids are at higher risk” Yep, my kiddo got all four shots today (plus FluMist). Good news is that she doesn’t need any more (excepting annual flu) until she’s 10. My son gets his flu vaccine in two weeks. And I’m awaiting my flu shot (given at work).

    Seriously, when you see the damage vaccine preventable illnesses can cause, you become RABIDLY pro vaccine. In order to protect my family, I will happily turn my children into pincushions.

    • Bombshellrisa

      My husband’s aunt had polio before the vaccine was available. She has post polio syndrome. She told us she was so happy that the vaccine was available to her children, she made them get every shot available. When anti vax people start talking around her, this sweet, disabled lady turns into someone else entirely. Dr Amy’s direct delivery and speech has nothing on this nice lady with a cane. She tells them “better a little pain with a shot than volunteering them to a potential lifetime of misery”, among other things.

    • rh1985

      My aunt (mother’s younger sister) had pertussis as a baby. She survived but was in the hospital and very sick. My mother was so mad when she saw a news report today about pertussis vaccination rates dropping.

  • hightops

    Nice discussion. If I was still teaching, I would ask to borrow it.

  • Sullivan ThePoop

    Great! This is what we get when people go around saying things that make it seem like autistic children are not real people, that they have been stolen, and are missing. http://www.mlive.com/news/kalamazoo/index.ssf/2013/09/teen_with_autism_and_her_mothe.html#incart_river_default

    • Lizzie Dee

      Did you look at the mother’s blog? Whatever happened here, I don’t think it was caused by daft theories about the causes of autism. A nightmare story.

      • Dr Kitty

        I think so much energy was spent on Issy that no one actually looked at her mother as someone who was quietly losing all perspective.

        The last few entries on the blog, the weird response to being told, politely, that the Recipient’s Rights Office doesn’t work harder just because you get all your friends to send letters (even decorated with stars and flags), the poor woman was clearly falling apart. It isn’t an excuse for what she did, but that blog doesn’t appear to be written by someone calm, rational and thinking clearly.

        • Lizzie Dee

          With a reality so relentlessly awful, not all that surprising. This poor woman is hardly in the same category as those who think missing a bath is a major trauma. A terrible situation made worse.

          As you probably know, Dr. Kitty, there is a bit of a debate going on here about the suicide rate amongst those left terrified by lack of support.

        • Lizzie Dee

          With a reality so relentlessly awful, not all that surprising. This poor woman is hardly in the same category as those who think missing a bath is a major trauma. A terrible situation made worse.

          As you probably know, Dr. Kitty, there is a bit of a debate going on here about the suicide rate amongst those left terrified by lack of support.

  • Sue

    Anyone notice how many chiropractors seem to be anti-vax?

    I don’t mean those chiros who limit themselves to helping with your back or neck muscle spasm. I mean the worrying number who think that manipulating the spine ”strengthens the immune system” (cos, you know, nerves connect to all the organs), and that vaccines and all pharmaceuticals are POISON.

    I find it hard to understand how a profession that allegedly trains in the mainstream clinical sciences can come up with such wacko views.

    • The Bofa on the Sofa

      But…but…but…not all chiropractors are whackos!

      (as I always say, the surefire sign your profession has a problem is when you have to defend it by saying that not ALL of them are bad)

      • moto_librarian

        It’s the same problem that midwifery has. I believe that CNMs are a great option for many women, but CPMs, DEMs, and some CNMs are promoting practices that are harmful for women and their babies. Until the ACNM takes a stand against this, the entire profession will remain suspect.

  • Jocelyn

    Great post. 🙂 Just saw this, thought it was relevant: http://themetapicture.com/to-vaccinate-or-not-to-vaccinate-that-is-the-question/

  • BeatlesFan

    My daughter had her 6-month shots this afternoon; while at the doc’s office, I made an appointment for my son to get his 4-year shots next week. When my son was first born, I bought into the anti-vax hype, and delayed some while flat out refusing others. I am so, so relieved I saw the error of my ways, and that my son didn’t have to suffer for my ignorance.

    This is a wonderful, helpful post, and it makes me feel even better about my babies being protected.

  • GiddyUpGo123

    Does anyone know if the efficacy of the pertussis vaccine has diminished at all over the years, maybe because the virus is mutating? Just very curious about this: my neighbors (a family of four) came down with pertussis last winter. Only the older daughter was spared; the rest of them had the full-on vomit-when-you-cough version of the virus. But, they’d all been vaccinated within the past two years, so I found it odd that three of the four of them got sick.

    We drove their son to school once a week so were exposed to it, but none of us got it. I’d just received my booster about two months earlier, and my kids are all fully vaccinated.

    The CDC rep who called my neighbor told her that sometimes there are bunk vaccines and she and her family may have gotten a bad batch that didn’t give them a whole lot of immunity. But I’m hugely bothered by all the anti-vaxers I know who are jumping up and down going “Seeeeeee?????? Vaccines don’t woooooorrrrkkk!!!” Anyone have any guesses?

    • Young CC Prof

      The efficacy of the pertussis vaccine has gone down for two reasons.

      1) For safety, the old whole-cell vaccine was replaced with an acellular version. Fewer side effects, but the immunity doesn’t seem to last as long, maybe five years tops.

      2) More unvaccinated schoolkids = more epidemics = more exposures = more chances for vaccine failure. In other words, loss of herd immunity.

    • kellymbray

      Also Pertussis is a bacteria not a virus FYI

    • Sullivan ThePoop

      It’s not that pertussis mutated, it is that we changed vaccines to one that was safer with less efficacy. Although, if everyone was vaccinated like they should be then we probably would have never known.

  • Amy M

    And I just read about the mumps outbreak in NJ right where I grew up. I don’t think anyone I know is involved…everyone with it was at the same bar, and at least one had contact with a toddler. I’d put money on that toddler not being vaccinated…though I suppose he may have had the first round but not the booster. Sigh..most of the people with suspected mumps were in their 30s, which means THEY should have been vaccinated…how long does the MMR immunity last?

    • Young CC Prof

      The first dose (12 months) often fades by adulthood. In 1990, we figured this out the hard way (remember the college measles epidemics, with WAY too many adult cases?) So in like 91 or 92, they started requiring a second dose for adolescents. This seems to work permanently in 95% of people.

      • Certified Hamster Midwife

        In my school district it was required as part of the physical going into sophomore year of high school, I think.

      • Sullivan ThePoop

        Only for measles and rubella though. They found, at least in England, that after 16 the mumps component drops to 83% effectiveness, but doesn’t seem to wane anymore after that. It is doubtful that this is a change. It has most likely always been this way and we never would have noticed if there were not so many unvaccinated children to start an epidemic.

        • Young CC Prof

          Interesting! 83% effective would be good enough if everyone got it. Couple that with a low coverage rate and large pockets of unvaccinated people, and 83% is a pretty thin blanket.

    • Dr Kitty

      In the UK pregnant women are tested for rubella immunity and offered postnatal MMR if non-immune, so adult herd immunity to mumps is increased that way.
      Is it the same in the US?

      • rh1985

        I was tested for rubella immunity, I think varicella maybe, and a couple of other things, but it was something the IVF doctor did, not my OB. Since the OB got all my records, I have no idea if they would have otherwise tested for immunities.

        • Amy M

          I was also tested for rubella and varicella immunity, both of which I have, due to MMR vax, and having chicken pox when I was 7. They thought I had no chicken pox titer, but turned out the lab messed up, and after re-test, it was what it was supposed to be. I’m pretty sure my OB did both tests, though I saw an RE, so maybe he did, not sure.

      • heather

        I was born in 72. Got mumps as a toddler even though I had already been vaccinated. Probably gave it to my infant brother – he is deaf in one ear. Had the booster at age 21. In my 30s with my 2nd or 3rd pregnancy it was discovered that I was not immune to rubella, so they gave me the shot the day I had her.
        So yes, they do test here.

      • Young CC Prof

        My early-pregnancy bloodwork included rubella and chickenpox titer. (Both came back nice and strong, one from the booster I had 20 years ago, the other from the disease 24 years ago. I tend to get fevers from vaccines, but then I sero-convert like crazy, which is good.)

        I’m not sure if those pregnancy boosters are large enough in number to increase herd immunity much. Still, even a few strongly immune people in the right places can break a transmission chain.

    • Sullivan ThePoop

      This is another case of where we discovered that the mumps component of MMR has waning immunity after 16 because of people who are not immunized.

      • Amy M

        Aha, that explains it. Should I ask for a booster? My children are probably due for theirs next doctor visit, if they didn’t have it last one (can’t remember). And we all need flu shots soon anyway.

        • Sullivan ThePoop

          It depends where you live. The US doesn’t have any single mumps boosters and usually won’t give you another MMR unless you really need it.

          • SkepticalGuest

            I disagree. I got TWO MMR shots as an adult. One was required for college–a booster because of the known waning immunity. That was in 1992. I got another in 2009 when I was going back to college for a second Master’s Degree. Again, it was required for me to enroll.

            I hardly think most doctors would hesitate to give an adult a booster shot of MMR.

          • Sullivan ThePoop

            They will give you one if you need it after checking your titers or if you never had it before, but most people will not test low even for mumps.

  • Bombshellrisa

    OT: http://vbacworkshops.com/workshop-schedule/workshop-for-doulas-madison-october-19-2013/
    Taught by a public health scholar. And only $99 dollars!!!

    • Certified Hamster Midwife

      It’s interesting to me that she isn’t just a birth junkie/homebirth supporter, but decided to become a doula. And not just any doula. Now that she hasn’t been a doula all that long, in the grand scheme of things, she has to be a doula *leader* and teach continuing education workshops. Good hustle, good way to translate blog fame into a business, but interesting to me that she always has to be a leader at whatever she’s doing.

    • Sullivan ThePoop

      Who would pay her to teach anything?

      • Bombshellrisa

        Other “birth workers”. I know I have better uses for $99. I wonder if anything she is presenting is data, or if its all from her personal experience being so belligerent to the hospital staff trying to attend her and “educated” about VBACs that she feels qualified to teach about “the feelings of VBAC and HBAC women”.

  • anonymous

    Great article. Type alert: First sentence, “the vaccine” or “vaccines” (but not “the vaccines”). 🙂

    • anonymous

      Haha! I mean typo alert. I, too, am a victim of this problem. 🙂

    • Amy Tuteur, MD

      Thanks!

  • Carol

    Thanks, Dr. Amy, for posting this! I have no medical training and only knew the very basics of how immunizations work — the basics learned at the doctor’s office having each of my children immunized. 🙂 This fleshes out my knowledge quite a bit.
    I remember years ago reading a quote from an elderly doctor who began his career before many immunizations were available. He said something like, “No one in their right mind would be against immunizations if they had ever stood in a hospital ward full of children with whooping cough.”

  • Tim

    Said it a million times, will say it again. We allow ‘religious’ exemptions – fine. charge people who cause anothers death via not vaccinating with manslaughter. see how quick those people stop this crap then

    • LibrarianSarah

      Or file a wrongful death suit and hit them in the wallet. People will stop this crap when there are immediate consequences to THEM and THEIR STUFF. It’s too bad that at the moment it’s mostly other people face the consequences of their actions.

    • I worked soemwhere that required a signed letter from your religious leader in order to get out of vaccines. That was pretty awesome, because 99% of ‘religious’ exemptions have nothing to do with faith

      • The Bofa on the Sofa

        And the majority of religions have absolutely no problem with vaccination.

        I always thought that the bureaucratic way to do that would be that the churches themselves would be the ones who would apply for the exemption, and verify that, yes, their religion opposes vaccination. Then members of the church need to show that they are, indeed, members-in-good-standing, to get the exemption.

        Basically, if you want to claim a religious exemption, you better show us that your religion is opposed.

        We have religious freedom in the US, but there is a limit. You can’t just make up your own religion with your own rules and expect the government to let you alone. Rastafarians aren’t exempt from marijuana laws just because they claim that smoking weed is part of their religion.

        • Zornorph

          You oppress me, mon.

          • Dr Kitty

            http://www.theguardian.com/commentisfree/2012/aug/07/snoop-dogg-rastafari

            Nice article from Benjamin Zephaniah about Rastafarianism.
            “People don’t know if we should be thought of as a religion, a political movement, a cult, or black hippies. Christians and Muslims call themselves broad churches, but we have a church so broad no one knows where it starts or where it ends.”

        • The Bofa on the Sofa

          In contrast, the Native American Church (“Peyote Religion”) has been around for centuries (at least, peyote as part of a religious ceremony), and therefore, their claim that peyote is part of the religion is justified. Thus, when it came into question whether it was legal, congress made it legal for them to use it.

          • LibrarianSarah

            Native American religions are a unique case and often get more leeway than other religions due to both Americas history of cultural imperialism and the status of Native Americans as both citizens of the US and members of their own sovereign tribes. Native American law is complicated and often confusing because of these factors.

          • The Computer Ate My Nym

            Nonsequitor alert, but the concept of a “Native American Church” never made much sense to me. There are (or at least were) a lot of different NA cultures and religions and collapsing them into one makes little sense. Is there a European Church? Peyote is certainly a part of some NA religions, but not all. (Wanders off grumbling in a vaguely discontented way.)

          • auntbea

            The religion that uses peyote decided to call itself the “Native American Church.” That’s their formal title, not a category name.

          • rh1985

            the closest thing to a “European” church was probably the Catholic Church before the reformation.

            I’m such a history nerd…..

        • PJ

          Rastafarianism is a real religion, not just something made up to smoke pot. Maybe there are people who appropriate it as an excuse to legitimise pot taking, but to suggest it is somehow less legitimate than the Native American Church is a little insulting and shows a misunderstanding of how and why it originated.

          • Zornorph

            I live in the tropics, which makes it very hard to take seriously. Certainly Haile Selassie didn’t quite know what to make of it. Must be weird to have a sect spring up randomly declaring your divinity when you did nothing to suggest or encourage it.

          • PJ

            What does living in the tropics have to do with anything, unless by living in the tropics you mean, say, “I am a black Jamaican man who grew up in the extreme poverty of the Jamaican slums during the struggle for independence”?

          • Zornorph

            To see Rastas up close limits one’s ability to take them seriously. What’s really fun is to make snarky comments about Bob Marley. It’s like drawing a picture of Mohammed – they freak right out.

          • PJ

            I’ve seen plenty of Rastas up close. Most of them were living in excruciating poverty in countries that are still profoundly stamped by a legacy of colonialism and racial oppression. Not really something I found particularly funny, but it takes all kinds, I guess.

        • Bombshellrisa

          I thought that for some, it’s not the vaccination so much as what the vaccine is derived from-if there are fractions of blood cells, those who do not accept blood or blood products may not accept those.

          • The Bofa on the Sofa

            I thought that for some, it’s not the vaccination so much as what the vaccine is derived from-if there are fractions of blood cells, those who do not accept blood or blood products may not accept those.

            Right. That covers the Jehovah’s Witnesses. Are all the anti-vaxxer religious exemption people JWs? Not in the least.

            (interesting, even the Catholic Church advocates vaccination despite the use of aborted fetal cells in the development of vaccines)

          • Bombshellrisa

            I would agree, that is only a small portion and even then, not all JWs are opposed to blood fractions.

          • The Bofa on the Sofa

            Yep, so now back to my bureaucratic suggestion: you claim a “religious objection” you need to show that your religion actually teaches that you can’t have vaccines. Otherwise, you are just making it up.

        • auntbea

          They are in Guam!

        • R T

          It’s not religious freedom if you start forcing people to define what their beliefs are. Religion is a very personal thing. The first amendment prohibits states from discriminating between people based on their religious beliefs.

          • The Bofa on the Sofa

            So then why are people who refuse to get shots for “religious reasons” exempted from the standards that others are held to?

            They are the ones who are asking for special treatment for their “religion.”

            If you want to stop discriminating, then you end all special treatment of religion, which includes things like, letting them run around unvaccinated.

            As I said, there are absolutely limits to “freedom of religion.” You can’t go out and sacrifice a virgin, and claim that your religion requires it, and that makes it ok. So that ends the idea that the state has to accommodate every individual belief that is asserted to be religious.

          • R T

            Arguing over the validity of religious exemptions is pointless when half of the states have philosophical exemptions. The bottom line is our government doesn’t think unvaccinated people are a big enough threat to public health to start going to great lengths in forcing compulsory immunizations. This may change someday, I doubt it, but it might.

          • Box of Salt

            “half of the states have philosophical exemptions” Not quite half.
            Here’s a link to the CDC page summarizing which states allow what kinds of exemptions:
            http://www2a.cdc.gov/nip/schoolsurv/schImmRqmtReport.asp
            Two states allow only medical exemptions: WV and MS.

            “This may change someday, I doubt it, but it might”

            It’s already changing. While philosophical exemptions aren’t going away, several states are passing laws adding requirements for obtaining them beyond just asking, such as consultation with a health care provider. This includes WA, CA, and VT. An effort to weaken requirements failed in MA last year.

            We live in a democracy. If you think the government should care more about your point of view, let your representatives know about it, and don’t vote for the folks who oppose it.

          • R T

            The funny thing about the new California law is the governer signed it with the caveat a religious exemption would now be allowed in CA. He said he was directing the health department to implement the religious exemption at the same time. If you claim a religious exemption you would be excused from the mandatory consultation with a healthcare professional.

          • Box of Salt

            Yes, Gov Brown is messing with it, but it’s still a step up from “turn the school vaccination form over and sign the statement on the back” policy that it’s replacing. It’s not clear that Gov Brown has the authority to write new law, and CA does not currently have any religious exemptions (check my previous link)

            Here’s a l ink to the Sacramento Bee article about his signing: http://blogs.sacbee.com/capitolalertlatest/2012/09/jerry-brown-signs-bill-requiring-signatures-for-those-opting-out-of-vaccinations.html

            I haven’t heard much about it since last fall when he signed it, but I will continue to keep my eyes and ears open since we are approaching the date (Jan 2014) is coming up fast.

            Part of my point is that the tide is turning away from the anti-vaccine point of view, and these legislative changes show that.

          • auntbea

            We already deal with this, in the case of conscientious objectors. You do indeed need to state what your beliefs are, why they mean you can’t fight, and how your life up to that point has demonstrated your commitment to the religious or moral beliefs you espouse.

      • R T

        Well, that’s completely illegal and lawsuit worthy for sure…if you’re in the States anyway: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof;…” It very rare to lose a case involving a religious exemption because religion isn’t just belonging to a church or claiming a particular recognized religion. The first amendment prohibits states from discriminating between people based on their religious beliefs.

        • are you a lawyer, or are you just making things up? the place I am referencing is a *huge* employer, I’m pretty sure their counsel knows better than you do. Maybe they had to do some math about if the lawsuits from that would outweigh lawsuits from patient deaths due to unvaccinated workers?

          • An Actual Attorney

            The First Amendment doesn’t apply to corporations. They (despite what it may seem) aren’t the government. The government, however, is prohibited by the First Amendment from ruling on the propriety or orthodoxy of your religious beliefs.

          • The Bofa on the Sofa

            The First Amendment doesn’t apply to corporations

            Wasn’t there a famous case recently where the SC ruled otherwise? If nothing else, that corporations have a right to free speech…

          • An Actual Attorney

            They are “people” and have the right to speech free from gov’t oppression. But they aren’t prohibited from constraining others’ speech.

          • Squillo

            Would the First Amendment have much to do with the case RT & Shameon are discussing, anyway? Aside from the fact that, as you point out, the Establishment Clause (and everything else) only applies to the government, I would think an objection might be raised based on federal or state anti-discrimination laws. Of course, the outcome would depend on a judge’s interpretation of “undue hardship,” I guess.

          • An Actual Attorney

            The answer to that is rather complicated, and probably belongs on another blog.

          • R T

            Right, if it went to court they would lose. It has happened over and over again and the results are always the same.

          • R T

            Nope I’m not making it up. They may not have been challenged on it yet, but if they were they would lose. I don’t have to be a lawyer to know what the legalities of this situation are. What state is this located in and I’ll find you more information? I’m assuming a state with out a philosophical exemption?

  • Amy M

    I think there were two reported cases of measles in MA this week, at least that is what I heard on the radio news this morning. One was an adult who came back from a trip abroad and the other was a toddler too young to have received the MMR. One was in the Boston area, the other was in Central Mass…will go looking for more info, that’s all I heard…

    • Amy M
    • Amy M

      Ok, so it looks like those two were the only reported cases so far, and they are warning everyone who may have been around those patients (in the hospitals they were treated in) to be alert for symptoms. Hopefully no one else gets sick. The traveling guy I understand, but I wonder where the kid picked it up from? I mean, I understand HOW he got it, as he was not vaccinated yet, but from what source, if there are no other reported cases and it was not connected to the traveling adult? Can an immunized person transmit measles to a susceptible person?

      • Kerlyssa

        If they themselves have measles, yes, they can. Like condoms and bridge supports, vaccines have a failure rate. Have sex/a bridge/enough vaccinated people who have been exposed to measles long enough, and you will get a failure.

        • Amy M

          But that person would have to be sick? Or could they be carrying a low level of virus (or be making low levels of antibodies I guess would be a better way to put it), and maybe not have symptoms, but be able to fully infect a non-vaxed person?

          • Box of Salt

            If you are not immune (whether due to vaccine failure or failure to vaccinate), you will spread the * before * you have symptoms. And with measles the rash is not the first symptom to appear, which may leave a lag between infecting others and diagnosing the index patient.

          • Box of Salt

            ^ spread the disease before.

            Apparently the hot weather where I am is impairing my ability to type. And proofread.

          • Amy M

            So would we expect to see someone else with measles that the toddler had contact with, then? Either in MA, or if the kid was somewhere else, or in contact with someone who was somewhere else?

          • Amy M

            What I am trying to understand is: How can there be only one isolated case of measles? Where did it come from? When measles outbreaks would occur/do occur where vaccines are not available, how does it start…is there always a patient zero? Does it lie dormant in humans somehow? It isn’t like flu with an animal vector, is it?

          • Box of Salt

            epidemiologists

            a chance to figure it out.

          • Box of Salt

            Disqus butchered my comment so I’ll try again:

            Someone obviously infected the toddler. However, it may not have been a direct contact since the measles virus lives in the air for a few hours infecting the susceptible. Unless there are other cases identified, it may be difficult to trace the virus donor.

            To my knowledge, measles immunity either works or it doesn’t – I haven’t heard of milder cases occurring due to partial protection as we see with pertussis and chicken pox. Those better informed than I please correct me if I’m wrong.

          • Amy M

            Got it. So someone infected, but perhaps not symptomatic yet, could have sneezed on the kid, on her way to Europe, and is now long gone. She is now in Europe, with measles, but since she has no memory of sneezing on a kid on a public street near a playground in Metro West Mass on the way to the airport shuttle, no one will ever make the connection.

          • Dr Kitty

            Pretty much. Measles is about as infectious as it gets.
            All the hand sanitiser in the world won’t help, and if you’re exposed and non-immune, you’ll get it. Coughing, sneezing, touching surfaces etc- the kid could have got it from a hand rail on a bus.

            We had a small measles outbreak here recently- shows how good our herd immunity was, because almost all the cases were in the Roma community (who have low vaccination rates) and one case was in an adult over 50 (who required hospitalisation).

          • Young CC Prof

            No. No animal vectors like flu, no dormancy like chickenpox. (That means it’s potentially eradicable, if the human race ever got our act together. It’s next on the to-do list after polio.)

            You need either “in person” transmission, or you have to touch the same object no more than a few hours apart.

          • Sullivan ThePoop

            there is some dormancy with measles in certain people but I don’t believe it is contagious when it reinfects like shingles, still it could be eradicated.

          • Sullivan ThePoop

            I am not sure about measles, but I know that people who get pertussis who even have one shot in the series are not contagious.

          • fiftyfifty1

            No, if they get pertussis and they are coughing, they are contagious. A vaccine-breakthough case of pertussis may be LESS contagious than an unvaccinated one (because there may be less coughing/a lower bacterial load/shorter course) but it is still contagious.

          • fiftyfifty1

            Yes, it can work that way. The severity of any illness can vary, even in an unvaccinated population. Some people with the illness will be very sick. Others may just feel a little under the weather but still potentially be contagious.

        • Certified Hamster Midwife

          If you have sex with a bunch of people who have measles on a bridge, then you’re in trouble.

          • prolifefeminist

            bwahahaha! thanks for making me snarf my coffee!

      • Young CC Prof

        Proof by example: In third grade, my class was hit by chicken pox. Half were immune, the other half caught it. The class included twin brothers who were already immune, but they had a non-immune younger sibling. Younger sibling was infected at around the same time. He wasn’t in school, no other known exposures. The most logical explanation is that the twins carried the virus to him, possibly just on their skin or clothing, possibly inside their bodies before their antibodies wiped it out.

        Measles is actually more contagious than chickenpox.

        • Amy M

          Thank you! This is what I was getting at. So perhaps this is how this kid got measles then?

          • Young CC Prof

            That’s what I’m thinking.

    • LibrarianSarah

      The non-Boston one was in Framingham. That’s not really Central Mass but I’m way out west so it could all be a matter of perspective.

      • FormerPhysicist

        I’d call that a suburb of Boston, or still Boston area. Pike to Framingham is included in the Boston area hourly traffic reports. 😉

        • LibrarianSarah

          That’s what I was thinking myself but I didn’t want a whole bunch of Bostonians to reply “Are you crazy! Framingham is like half-way to Worcester!” and then get in a Massachusetts area fight.

          Hey it made perfect sense in my head.

          • Tim

            I’m from framingham and i’m insulted. It’s on like donkey kong.

          • prolifefeminist

            Ahhh…you are all making me homesick. I’m from the Cape, but moved out of New England ten years ago. It’s still “home” to me though.

      • Amy M

        I live in Shrewsbury, MA, which is Central MA and work in Fram, so I still consider it Central, but I guess it’s really metro-west. whatever. 🙂

    • BeatlesFan

      I’ll be keeping an eye on Mass I guess… I’m in NH, so measles in MA is a little too close or comfort to me. At least tourist season is over! Until the leaves change, anyway.

  • ngozi

    I have said it before, many of the people who are against vaccines do not know what it is like to live in a time without them. I live around people all day long that had the whole round of childhood diseases. Some of the people I know had to help keep their siblings alive, tending to them all night during whatever illness. Also, we live in a time of all the social welfare to help pay for these vaccines. That was not always so.

    • The Bofa on the Sofa

      That’s not the only problem, though. It’s also that they dismiss the cost of disease. See, for example, the opposition to the chicken pox vaccine, on the grounds of “we all had it, and we came out of it ok.” Now, aside from the fact that 1/20 000 die from the chicken pox, it’s the casual dismissal of the suffering caused by the chicken pox that bothers me. Yeah, I had it, and I survived. You know what else? It sucked. I was friggin miserable. I also had to stay home for two weeks. Yeah, it was ok because my dad worked right across the street, and could check on me, but you know what? It’s not that easy for everyone. I don’t care that most people don’t die from the chicken pox, it is a friggin awful disease.

      A good example of this type of dismissal is when Dr Jay Gordon, a pediatrician, said he wasn’t concerned about the mumps, for the same reason (everyone had it, and they pretty much came out fine). And to show how benign it was, he said, look, even all the kids on the Brady Bunch had it, and it was no big deal. True, the Brady Bunch did an episode where they all got the mumps, but that someone who should know better would actually use this to show how benign the mumps are is about as looney as you can get.

      BTW, I’m not making that up. Jay Gordon used The Brady Bunch to argue that the mumps were not dangerous. The guy is a serious joke,

      • Amy M

        Mumps are also worse for adults–males who get mumps post-puberty can become sterile. That’s pretty serious.

        • The Bofa on the Sofa

          So you don’t to vaccinate babies! See?

      • Zornorph

        The mumps caused all the Brady males to have awful perms.

      • AmyP

        I had chicken pox as a teenager. Yes, it was terrible.

        I had whooping cough somehow, too, despite being properly vaccinated. Lucky me.

      • Karen in SC

        A friend of mine and her husband had to use up all of their vacation time when child #1, then child #2 came down with chicken pox (before the vax).

        The Brady Bunch had Alice to help LOL.

      • MaineJen

        I had chicken pox at age 10, before the vaccine was widely available. To this day I have scars on my scalp (under my hair) and abdomen: raised, sometimes painful bumps. From scratching too hard, I guess? I would spare my children that, at the very least…not to mention the more serious complications.

        • prolifefeminist

          I had it at age 12 (also before the vaccine was widely available) and it was absolutely HORRIBLE. I remember counting 96 spots just on my face. Miserable, miserable time. So glad my kids won’t have to go through that.

        • me

          I had it at age 10 (before vax was available) and for me, it was the greatest illness ever 😉 I didn’t feel particularly sick, just a little itchy. I didn’t get any pock marks or anything, just got to stay home from school and watch tv and sleep on the couch for two weeks.

          That being said, one of my cousins got it as an infant and damn near died. My husband also had a particularly bad case. Point is, you never know. Maybe my kids would have had an easy go of it, as I did, then again maybe not. Fortunately we don’t have to find out. They are fully vaccinated. Why would I want to deal with chickenpox X3 anyway? All that calamine lotion and oatmeal baths? No thanks. Give ’em the shot. It’s over in two seconds (or two hours, in the case of my drama queen oldest who swears she will never walk again after each and every shot, lol).

          • The Bofa on the Sofa

            Yeah, it’s possible to have a mild case of the chicken pox, but still, you had to be home for 2 weeks, and that comes at a cost (to your parents, if they are working, for example, and to your schooling).

            It’s also possible to have a mild reaction to the vaccine. Like my kids had. They were back to normal before they left the exam room, even. No itching, redness, or swelling. So even in the world of “mild reactions,” I’d take the vaccination over a mild case of the pox.

          • Sullivan ThePoop

            Have you had your titers checked? I had a cousin who only got 3 pox during her chicken pox infection and then she got it again as an adult.

      • Wren

        I feel so guilty for not getting my kids the chicken pox vax, even though it isn’t on the routine schedule here. My daughter had a typical case, in which she was extra grumpy for a day or two then itchy but fine. My son though, he had an ear infection, a high fever for days and days and his back was so covered in pox you couldn’t see where one ended and the next began. He was not just itchy. He was in pain. Over a year later he still has scars all over his back and a few other places.

      • KarenJJ

        It’s even the two/three weeks off work to care for housebound kids. I’d be able to do it, but it would be hard. Others in less secure employment would find it very difficult.

      • Sue

        That argument about ”childhood illnesses were no big deal” belonged to a time when you couldn’t do anything about them anyway, medicine was less sophisticated in general and, many mothers STAYED AT HOME.

        Thank goodness we’ve moved on…

        (Disclaimer – no offense intended to SAH parents – just making the point that not every family has automatic care at home for a series of sick kids)

        • Box of Salt

          Plus the people who did die from those diseases aren’t around to point that out.

          (It drives me nuts when they say “but I survived it….)

        • FormerPhysicist

          I’m a SAHM and I don’t want a succession of kids home for two weeks with chicken pox. I’m pretty sure I’d consider it a big deal. And I shudder at the thought of quarantine.

          • Antigonos CNM

            Been there, done that. All three of mine had chicken pox [sequentially, not together] and the mumps. I wish I could upload the picture of my son at age 2, who literally blew up over two hours, his face and neck simply disappearing under the swollen glands [he didn’t feel particularly sick, though; chicken pox made him more miserable.] No vaccines for either disease when my kids were small.

      • ngozi

        Chicken pox is especially miserable the older you are. I got it when I was in the second grade. My sister was 14 when she got it and had it BAD. It is my humble observation that chicken pox is worse the older you are.

        • Young CC Prof

          Yup, back in our day, some parents used to deliberately expose their kids to chicken pox in order to prevent more serious adult cases. A generation before that, little girls were deliberately exposed to rubella.

          At the time, it made sense. With no vaccine, if you’re probably going to catch a disease sooner or later, do it at the least dangerous time.

        • fiftyfifty1

          Good research backs up your observations. Chicken pox is more severe and more dangerous the older you get and it is especially dangerous in pregnant women.

    • Young CC Prof

      Absolutely. My grandmother nursed two children through a normal, uncomplicated case of measles. She got down and prayed for gratitude when the vaccine came out, that finally children could be spared that.

    • Mishimoo

      100% agree.
      We took our youngest for his 2 month check-up and vaccinations yesterday. Sure, he’s a little miserable today but it’s worth it. I used to have gastro ALL the time as a kid and now there’s a vaccine for rotavirus. I am so grateful for that, let alone all of the rest!

  • Mel

    Why are vaccines important?

    My Grandma T almost died from the Great Flu epidemic of 1918. Her mom and grandma held her upright for 6 days straight so she could breathe enough to survive.

    My Grandpa E almost died from whooping cough at 18 months old. He lost over 15 pounds from the vomiting that came with horrific coughing fits. He struggled with breathing problems for the rest of his life.

    My Nanna got polio when she was three. She spent a year in an iron lung. She was never able to walk on her feet; the muscles were so weak that they pronated and she walked on her ankles all her life.

    My brother David died from septic shock. He was born without a spleen which compromised his immune system. We had no way of knowing about his lack of spleen (it was the early eighties before sonograms). He was just fine for a year, caught an ear infection from a pneumococcal bacteria and was dead within 24 hours. The pneumoccocal vaccine came out a few years later.

    We tell these stories to everyone we meet. These people suffered real pain due to illnesses that can be avoided.

    • Karen in SC

      Haven’t these mothers read Little Women?

      • Amy M

        Of course not, they don’t sell that at the crunchy store. They should though…those Little Women were pretty crunchy. No electricity, no vaccines, homebirths, probably canned their own produce, made their own clothing. I bet they would have worn their babies if they’d had any and of course cloth-diapered since disposable wasn’t available at the corner store, but no babies in that book. Poor Beth…I guess she just wasn’t meant to live. Did they homeschool? I don’t think so, wasn’t Jo a teacher eventually?

        • The Computer Ate My Nym

          They did homeschool. Beth was homeschooled all along because she was too shy for regular school (probably a bit of social phobia that no one thought her important enough to try to treat) while Amy was homeschooled after the (?private) school she was going to beat her for misbehavior. And they all got lectures periodically on how bad their behavior was and how far they were from being the perfect “little women.” (Though I’ve seen some criticism that suggests that Alcott may have been snarking in those passages.)

          OTOH, they didn’t do their own cooking or cleaning. They had a maid. This always confused me as a child since they make a big song and dance about how poor they are, but they have a maid. Huh?

          • Sullivan ThePoop

            Everyone did in those days.

          • Kerlyssa

            Everyone? Except the vast, starving underclasses said maids were drawn from.

          • Sullivan ThePoop

            true

          • The Computer Ate My Nym

            Well, Jo was working as a companion and Meg as a governess, both personal service industry jobs, so I suppose it kind of was…The only one who didn’t do any work at all seems to have been the father. This was, apparently, very consistent with MLA’s actual life experience. Her mother was one of the US’s first social workers, she and her sister’s worked, her father sat around and philosophized when he wasn’t spending his wife’s money.

          • Sullivan ThePoop

            Her father was a mess!

          • The Computer Ate My Nym

            Well, presumably not the maids.

          • Sullivan ThePoop

            No, they usually lived with the family they worked for.

          • Kerlyssa

            Oh, you can’t fool me. It’s maids all the way down!

          • Amy M

            Yeah, it’s been a while since I read it. 🙂 Were they always poor, or only since Dad went off to war? If the latter, maybe they didn’t have the heart to turn the maid out, since the men in her family undoubtedly were on the front lines as well.

            Did you ever read March? I forget who wrote it, but it was supposed to be from the father’s point of view, off in the Civil War. It was pretty good.

          • The Computer Ate My Nym

            I haven’t read it, but will add it to my phone now. It sounds intriguing, though I never liked the father in LW. He never seemed to me to be of any actual use except for making the women in the family feel guilty about…everything.

          • Mel

            They had lost some money helping one of Dad’s friends.

          • The Computer Ate My Nym

            Which was probably a polite way of saying, “Fell for one of dad’s friends’ schemes…” At least, it was what tended to happen to the real life Alcott.

          • AmyP

            Just as a poor person in the US today might have a vacuum cleaner, fridge, freezer, car, washing machine, dryer, microwave, electric oven, central heating, AC, etc. They would have given a pinkie and their maid, too (maybe even both pinkies) for that stuff.

          • LibrarianSarah

            Reading Alcott’s books get a whole lot more interesting after you learn that she loved alcohol, opium, and money a hell of a lot more than she loved faith, family, and old-fashioned morals. She actually would have rather written more seedy stuff but “little women” paid the big bucks so “little women” it was. Booze and opium aren’t cheap.

        • Bombshellrisa

          I thought Meg had twins. She also tried to make elderberry jelly (remember? Now it would be called a “Pinterest fail”). Pretty sure they gardened too.
          Totally right-their mom stayed at home and homeschooled them. They sewed too.

          • Amy M

            Ok, so they DID homeschool, but other schools were available, I guess for the wealthy.

          • Bombshellrisa

            And maybe because the two older girls had to work, so the schooling was at home to permit them to do that.

        • BeatlesFan

          Actually, Meg had boy/girl twins, Jo had two boys, and Amy and Laurie had a girl, named for Beth.

      • Young CC Prof

        How about Little House on the Prairie? You can find out all about the long-term effects of scarlet fever (blindness) or diphtheria (muscle fiber damage and disability). Or you can get vivid descriptions of an entire town being taken down by malaria, and about how the doctor actually saved freaking everyone with quinine.

        • Antigonos CNM

          But you see, THAT DOESN’T HAPPEN ANY MORE. So goes what passes for logic, you don’t need to be vaccinated against these diseases! They’re extinct!

        • Amy M

          Or Helen Keller…wasn’t she blind and deaf from scarlet fever? I actually had scarlet fever once, but I also had antibiotics, so I am not blind and/or deaf.

          • Young CC Prof

            I’m not sure what disease Helen Keller had, but it’s quite clear she wasn’t born that way, and lost her senses due to a severe fever as a toddler.

        • Bombshellrisa

          I was thinking if that this morning-Laura Ingalls Wilder’s books and even Lucy Maud Montgomery’s books (Anne of Avonlea) dealt with realities of home birth and childhood diseases that we simply don’t see routinely anymore.

        • The Bofa on the Sofa

          Mary didn’t go blind from scarlet fever, that is likely Laura simplifying it for the kids books. More likely meningoencephalitis (I probably butchered that spelling). I was reading about it yesterday.

    • The Computer Ate My Nym

      My grandmother and all but one of her sisters got the flu in 1918, along with their parents. That one child, age 7 or so, took care of them through the flu. She got it afterwards and is reported to have said, “now I’m going to lay down and YOU can take care of ME for once”. She died a few days ago at age nearly 100. I miss her.

      My other grandmother got polio as a child. She survived but had facial palsy for the rest of her life. It didn’t ruin her life, but it definitely changed it. If she hadn’t had it, she might have married someone else and I might never have been born. I wonder if that means that I should declare vaccines evil?

    • KarenJJ

      My Mum’s great uncle survived 4 years of World War 1, only to catch the flu and die while waiting for a boat home to Australia.

  • thankfulmom

    What is the current vaccination rate here in America? Someone posted on facebook that it is down to 50%. I didn’t want to waste time arguing, but I am curious.

    • Box of Salt

      Nonsense. California’s uptake rates are easily available from the state website: http://www.cdph.ca.gov/programs/immunize/Pages/ImmunizationLevels.aspx

      If you click on any of the summary reports, you’ll see overall rates are all over 90%, although some private schools are lower. Keep in mind that California has had one of the most easily obtained personal exemptions in the country (a law was passed this year changing that).

      The problem comes in when there pockets in certain areas where a lot of children are exempted and unvaccinated, because that is how outbreaks start. The Excel spread sheets break the data down by school, and you can dig into them and find out where the danger areas are (i.e., Marin county).

      Some diseases (such as measles) need a fairly high immunized percentage for herd immunity to prevent outbreaks, and those numbers down in the 80s% range for certain areas and schools don’t have it.

    • Sullivan ThePoop

      There are some areas where the vaccination rate is below 50% and unfortunately the unvaccinated seem group together providing the perfect vector for infectious diseases to cause an epidemic.

  • mollyb

    Vaccines are victims of their own success. They have worked so well that we literally cannot comprehend a world where a woman could expect to lose at least one child to routine childhood illnesses. And because we no longer live in that world, some imagine it no longer exists.

    • Sue

      Agreed, mollyb – spectrum bias, much like in childbirth.

      We don’t see mothers and babies dying much any more, so we question the very things that stop that happening. Same for vax.

      It would be nice if we didn’t have to go back to the poor outcomes in order the learn the same lessons over again.

  • Zornorph

    Why vaccinate when you can protect your baby with mama’s milk?

    • Amy Tuteur, MD

      I know that you are joking, but many anti-vax people are not, so it’s worthwhile considering what breastmilk can and cannot do. Breastmilk can provide some passive immunity to some infectious diseases. Passive immunity isn’t “real” immunity. It’s the mother’s antibodies fighting the infectious agent. The baby doesn’t make antibodies because it hasn’t been infected before.

      Passive immunity can also be provided by injection of antibodies from someone who has been infected in the past. So, for example, if you are an adult who has never had chickenpox and get exposed, you can receive VZig, varicella immunoglobin and that can prevent varicella or, more typically, lead to a milder case.

      Of course mothers can only provide passive immunity to their babies if they themselves are immune. Many of the women boasting about passing antibodies to their babies appear to be utterly clueless about where those antibodies came from; the mother’s antibodies came from VACCINATION. Ironic, isn’t it?

      • Amy M

        Thank you. I think this is one of the most widely misunderstood things about immunity/breastfeeding. Unfortunately, a lot of the ones who misunderstand it don’t want to hear the truth either.

        • The Bofa on the Sofa

          I think it is very generous of you to call it “misunderstood.” This attitude does not have any relationship to “understanding”, it is about magic. The belief that breast milk is a magical elixir and can do everything. You don’t need to understand magic, you just assert it.

          • Amy M

            I meant that the concept of passive immunity is misunderstood–they think it lasts longer than it does, and protects more than it does.

          • The Bofa on the Sofa

            That’s because it’s magic. There are no limits to magic.

          • Zornorph

            Clearly, it was thanks to Lilly Potter’s breast milk that Harry survived the attack by Voldemort.

          • Karen in SC

            Zorn, are you trying for a Pablo Midwife certification? Good one!

          • Amy M

            late to the party but: too bad she didn’t think to milkshare…all those muggles wouldn’t have died in the final standoff. badump-bump!

        • rh1985

          I see this ignorance on my “due date club” and it infuriates me on behalf of those poor babies. 🙁

      • Guestll

        One of the most irritating things about the whole crunchy “but I breastfeed, ergo, immunity!” anti-vax arguments is the inherent classism. IME, it’s generally accompanied by “and my kids don’t do daycare.” Note to lurkers using this (scientifically flawed) argument — your relative privilege can’t compensate for your ignorance.

    • rh1985

      While I know you are joking, there is a mother on my due date club who is planning to refuse both a pertussis booster for herself AND is also against vaccinating infants for it, because she will be breastfeeding. AND she is pregnant with twins who are more likely to be premature and so more likely to get VERY sick from a virus. I honestly feel angry on behalf of those poor babies.

      • Zornorph

        I swear, there’s like a religion forming around breastfeeding. I mean, I worship breasts, but I’m a guy and it’s for a different reason. But for some of these women, breastfeeding seems to be their version of communion. Take this breast, eat, drink; do this in remembrance of me.

        • rh1985

          It’s kind of sad that someone could be so pro-breastfeeding yet not even get how breastfeeding passes down immunities. The mother HAS to have the immunity first it doesn’t come out of nowhere!

      • Amy M

        Yes, my (slightly) premature twins were born in January in New England (aka RSV season). We were told not to go out in public places much if we could help it, until they were a little older. Of course, I had to go back to work when they were 12wk old, but they did go to a small family daycare rather than a large center. And we’ve always had them vaccinated on schedule because we’re not idiots. Anyway, they did eventually get RSV, but not until they were a year old, and were, luckily, strong enough to handle it wo/hospitalization. No pertussis because we were all vaxxed and there were no outbreaks around here that I know of. We are all asthmatics in this house..we do not f**k around with upper respiratory viruses. Preemies are high risk for asthma, breastfed or not, hopefully her twins will be born at term or very close to.

      • Young CC Prof

        Yes, because breasts can create antibodies out of nothing to diseases Mom has never had.

        (PSA: Other pregnant ladies, especially ones expecting winter babies, get your 26-week pertussis booster. It’s like prenatal vaccination against one of the few baby killers that’s still common!)

        • rh1985

          I am definitely getting one ESPECIALLY since I am due in February. Especially since this is a winter due date board it boggles the mind…

          • Young CC Prof

            I’m so lucky, my due date board (January, over on The Bump) is like 95% sane pro-vaxxers. We’ve had vaccine threads, most people are somewhere between lukewarm vaccinators and rabid pro-vaccine, like me. We had a “birthing plan” thread, almost everyone said, “I plan a healthy baby, there are other things I want, but they are negotiable.”

            Very sane and science based group overall. Some are crunchy, but they’re reality-based crunchies, who are generally great people. If they weren’t I probably wouldn’t have the energy to deal with them.

          • rh1985

            I am sure most are sane, but the insane ones stick out to me the most. This one in particular. The other being a different twin mother in complete denial about the possibility of a c-section.

      • Sue

        If this woman is not getting herself vaccinated, whose antibodies does she hope to pass on?

  • T.

    Sometimes I think that people that can do this:

    http://www.dailytelegraph.com.au/news/opinion/grieving-parents-speak-out-against-anti-vaccination-extremists/story-fni0cwl5-1226650422913

    Have no soul at all. Not even the deaths of children can make them change their mind. It was not the fact they weren’t vaccinated that killed those kids! It was not!
    Remind me too much of the “Babies die in hospitals too” bingo.

    • Anj Fabian

      If it makes you feel any better, Meryl Dorey was looking for handouts because she lost a court case.

      http://www.news.com.au/national-news/avn-campaigner-ordered-to-pay-11000-in-costs/story-fncynjr2-1226704620071

      • Sue

        Yep – she called for a frivolous AVO and was defeated, and ordered to pay costs. Of course, all the acolytes paid up and she raised more than enough money.

        Meanwhile her followers are waaaaaaaing because both major political parties want to stop ”conscientious objectors” being able to access immunisation incentives, which they say will penalise the poor. Can’t have it both way, folks. Save your money.

    • Sullivan ThePoop

      That was disgusting. What is wrong with those people?

    • LibrarianSarah

      It almost makes me wish there were a hell so I could hit Meryl Dorey right in the face when I see her there.

    • rh1985

      That makes me so angry. That poor sweet baby and her poor family. It makes me want to keep this baby in a bubble once she’s born.

      • Amy M

        Oh do you know its a girl?!

        • rh1985

          early guess was a girl. too early to be 100% but I keep subconsciously referring to the baby as her/she. I should know for sure on the 16th.

  • Meerkat

    Wow, great timing! I am taking my 1 year old for his check up and vaccinations today. I am a regular reader of this blog and other science blogs, and am totally for vaccines, but I will admit it… I am a little nervous of a reaction to the vaccines. The irrational part of my mind keeps replaying the interview with Teple Grandin that I read some time ago, that more research needs to be done on kids who regressed into autism after vaccinations…so the rational part of my mind is forcing me to stop looking at the Internet and knit while my son is sleeping…

    • ccccat

      Meerkat, that research has been done to death. The only reason people think kids regress after having vaccines is that a) Andrew Wakefield faked his data on the subject, and b) kids get vaccines at the same age that the developmental delays associated with autism become apparent. That doesn’t mean the child didn’t already have signs of autism though. Several studies now have looked at home videos of babies and highly trained people can successfully pick out the kids who eventually were diagnosed with autism from those who were not. Early diagnosis is still tricky but clinicians are getting better and better at it.

      • Amy M

        There is new research all the time, into finding markers that can be tested via blood test or other screening in infancy…I believe science will eventually be able to figure that out.

      • Meerkat

        Thank you! I agree. That’s why I like this community so much. If I ever have an irrational anxiety flare up I can always get a reality check here.

    • The Bofa on the Sofa

      that more research needs to be done on kids who regressed into autism after vaccinations

      Keep in mind that kids do not regress into autism after “vaccinations.” The only association between any vaccine and autism that has even been suggested is with MMR, and as Box of Salt notes, that is due to the fact that autism typically starts becoming apparent about the same time as the MMR shot.

      No other vaccine even has this type of apparent association with autism. No one ever says, “They got their DTAP and BAM!, autism.” Nor Hib nor Prevnar or anything else.

      I have mentioned this before – the temporal association between MMR and the presentation of autism made the link worth examining. It has been, and has been found to not be present. That’s good. However, that is the end of the vaccine/autism connection, despite what the anti-vaxxers tell you. There is no basis for implicating any other vaccine. The link to MMR was not based on the fact that it was a vaccine, but because of the apparent association. Since no other vaccine has that type of association, it is illogical to say, “Well, if it’s not MMR, maybe it’s another vaccine?”

      • Dr Kitty

        Since moving the MMR shot back from 18-24 months and then 15-18 months and now to 12-13 months, that coincidental temporal association is much less easy to make.

    • The Computer Ate My Nym

      Much as I respect Grandin’s work with animals, she’s not a doctor and has no special insight into the risks or non-risks of vaccines. Children get a lot of vaccines at ages 1.5-2. That’s also about the time when the symptoms of autism start becoming noticable. There has been a lot of research into vaccines and autism and it’s all been negative except the bits that Wakefield made up.

      Also, contrary to what you may have heard from Jenny McCarthy, autism is not always a fate worse than death. The vast majority of the people whose diagnoses are driving the “autism epidemic” are “high functioning” people with probable Asperger’s syndrome. The non-verbal autistics are rare (though more overtly frequent now that they are no longer being labelled “mentally retarded”.)

      In short, relax. I can’t tell you your son won’t be autistic, but I can tell you for sure that you didn’t cause him to have autism by vaccinating him.

      • Meerkat

        Yup, that’s pretty much what I found out from credible sources as well. Fear is irrational, and I am so annoyed with myself for even reading the stuff that made me worry… Oh well, the baby didn’t like the ouchies but seems fine otherwise.

  • NonAP

    To much science not enough antidote for AP types to understand. Just wait until there is a serious death-causing measles outbreak or maybe polio and then they will get it. Too young to understand the real danger of these disease along with all of the internet and social media disinformation. Talk about, publish, post but they will never be convinced until people around them are dying around them. Sorry cold truth.

  • fiftyfifty1

    ” Indeed parents are required to sign consent forms acknowledging the risk of serious side effects, including brain damage and death, before their children can be vaccinated.”

    They are not required to do this where I work.

    • Kerlyssa

      You don’t need to ahve them sign a consent form for medical treatment of their child?

      • fiftyfifty1

        Verbal consent is sufficient.

        • Kerlyssa

          Interesting. What state/country/province/etc is this, if you don’t mind me asking?

    • Rabbit

      We have never been asked to sign a vaccine specific consent either. The general consent we signed when our kids started seeing the doctor doesn’t cover the risks of any specific treatment or preventative measure. The pediatrician gives us the vaccine information sheet, asks if we have any questions, and then my kids get their vaccines. I know about the risks because I actually read the pieces of paper I get, but I doubt everyone does. We’ve moved a fair bit since my first was born, and have been with 4 different pediatrician practices, from the clinic at Children’s Hospital in Boston, to a small 1 doc practice in deep east Texas. Same procedure at all of them. The only variation was with our first pediatrician in Austin, who would give us the info sheets one appointment early, so we could read them before the appointment where the vaccine was due.

      • Sullivan ThePoop

        Weird, I always had to sign a sheet and initial another for every vaccination.

    • Guestll

      I’m in Ontario, I’ve never been offered nor signed a consent form pre-vax.

  • Kerlyssa

    Small quibble. As I read it, it appears to imply that diseases always leave permanent immunity, while vaccines only sometimes do. Both vaccine and disease initiated immunity can wane over time. A lot of anti vaxxers believe that they are getting lifelong immunity by getting a disease, when in fact it may be equal immunity, or 8 years vs 6… and prone to the same difficulties with mistaken records/immunoweirdness that can lead to unexpected lapses in immunity in specific individuals.

    • LynnetteHafkenIBCLC

      I hate it when I come down with immunoweirdness. 😉

      • Kerlyssa

        Oh, like I’m going to type out a couple example syndrome names. Those suckers are like a paragraph each! 😉

        • Guest

          In our house we call it “wonky immune system.” So glad to know the pros are with us on that. “Immunoweirdness” will definitely be my stand by term from now on.

          • KarenJJ

            Immunoweirdness is a great one!

    • Durango

      I believe that even “natural” chicken pox immunity is no longer for life, as I seem to recall hearing/reading that constant re-exposure to the virus is required to keep up immunity. Since the virus has been so dramatically reduced, you don’t get re-exposed. But I freely admit I have no idea if this is true. I personally am in favor of dramatically reducing death/disability from chicken pox for the cost of booster shots. Can anyone confirm this?

      • PollyPocket

        I’m no infectious disease specialist, but my understanding of chicken pox is that the virus remains dormant after the first outbreak (like cold sores) and can recur at any time as singles.

        • Amy M

          It seems to recur more often in older people/people who are more likely to be slightly immunocompromised, though it is true anyone who had chicken pox is at risk.

      • Kerlyssa

        Per the CDC-

        “In otherwise healthy persons, clinical illness after reexposure is rare; such illness is more likely to occur among immunocompromised persons. However, as with other viral diseases, reexposure to wild-type varicella often leads to reinfection that boosts antibody titers without causing clinical illness or detectable viremia. VZV remains dormant in sensory-nerve ganglia and may be reactivated at a later time causing herpes zoster (i.e., shingles) — a painful vesicular rash usually appearing in a dermatomal distribution of one or two sensory-nerve roots.”

        In other words, Yes. We’re no more sure of lifelong(and lives are getting longer!) immunity for disease based immunity in a non endemic population than we are for vaccine based. Part of the problem with looking at endemic disease immunity is that the literature is based off a population where infection and reinfection/exposure was universal. It’s not a straight comparison.

      • Sullivan ThePoop

        Chicken pox immunity is usually for life for most people. The re exposure is required to keep the dormant virus that is left behind after an infection in check so that it does not cause a shingles infection.

        • Klain

          My mother had chicken pox quite badly as a child. Years later my brother contracted chicken pox (we noticed the spots while at the Emergency waiting for his broken arm to get x-rayed). I didn’t get it, which my mother attributed to her passing on some antibodies. She however got a mild case.
          Fast forward to a ski trip as a young adult and I get chicken pox from someone else on the trip! Luckily it was extremely mild.

          • Sullivan ThePoop

            The antibodies that are passed on during pregnancy only last 6 months to a year.

    • Sullivan ThePoop

      It is true that natural immunity does not always last forever and usually a vaccine has a similar length of immunity as a natural infection. What makes natural infections lead to strong immunity is that you are exposed to every single antigen associated with the pathogen.

    • Young CC Prof

      Pertussis, neither the disease nor the vaccine provide permanent immunity. The disease it’s an average of 10 years, vaccine average of 5.