Fear magnifies risk – nothing is truer when it comes to the debate surrounding vaccines. The fear of not having all the information to make the best decision for our child; the fear of being misled and pressured to protect the greater good at the possible expense of our own; the fear of lining pockets and supporting industry at a cost beyond monetary. These statements, just printed on paper, elicit emotion and make us feel vulnerable. There is so much information available at our fingertips, but very little of it has been verified and supported through actual study. Moreover, scientific research regarding vaccines is often dry and cumbersome to explore, whereas an editorial is by nature more interesting and thought-provoking. The moment emotion enters the debate is the moment that risk becomes distorted.

I still remember being on a general surgery rotation as a 3rd year medical student and hearing about a patient who had been given an inhaled sedative via intubation instead of oxygen and had coded on the table. To this day, I avoid surgery at all costs – not because the real risk of general anesthesia is significant, but because I am simply afraid. The data regarding anesthesia safety fails to fully convince me, as it is almost impossible to think rationally about something that elicits an internal fear response. However, it is hard to argue with simple math – so let’s examine just that:

“In infants younger than 1 year of age who get pertussis, about half are hospitalized. The younger the infant, the more likely treatment in the hospital will be needed. Of those infants who are hospitalized with pertussis:

  • 1 in 4 (23%) get pneumonia (lung infection)
  • 1 or 2 in 100 (1.6%) will have convulsions (violent, uncontrolled shaking)
  • Two thirds (67%) will have apnea (slowed or stopped breathing)
  • 1 in 300 (0.4%) will have encephalopathy (disease of the brain)
  • 1 or 2 in 100 (1.6%) will die”

http://www.cdc.gov/pertussis/about/complications.html

Among infants and children who receive the DtaP vaccine, the following reactions have occurred and may have been caused by the vaccine:

  • Seizure (jerking or staring) (0.007%)
  • Non-stop crying, for 3 hours or more (0.1%)
  • High fever, 105 degrees Fahrenheit or higher (0.006%)
  • Serious allergic reaction resulting in brain damage, coma or long-term seizures (less than 1 out of a million doses OR 0.0001%)

http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#dtap

If you look at the numbers, the risk of a serious adverse reaction to a vaccine is markedly less than the risk of a serious complication to the actual disease. The data are strikingly clear.
Herd immunity does protect the people among us that cannot be vaccinated because of weakened immune systems, secondary to cancer (and chemotherapeutic treatment), congenital immunodeficiency, and simply young (and old) age. But just because herd immunity protects our population on a large-scale, doesn’t mean the individual is thus compromised. As a pediatric intern, my colleagues and I were sick all the time. Still working, of course, but with illness. We were exposed to a diverse array of microbes daily, and our immune systems had to fight to keep us well. Sometimes, the system was overwhelmed and illness would result, but the antibody inventory grew with each exposure. The collective immunity that resulted helped all of us, we were less likely to get each other sick working in close quarters, and less likely to forfeit days off to cover for someone too sick to push through a shift. But, as an individual, we experienced benefit as well. I have more antibodies today to fight off infection – both through previous illness and maintaining strict vaccination updates. There is a real individual benefit there.

So, the issue of compensation. This is a tough one, but important to address. I have had patient parents convinced that because pharmaceutical companies seek profit, vaccines are inherently dangerous. The same parents often seek antibiotics when their kids are sick, but don’t classify this medication alongside vaccines. I really think it’s because when our kids our sick, we’ll do almost anything to get them better faster, but when they are well, we want to avoid anything that could make them feel off! The absolute truth is, just because some service or product carries a financial cost and someone profits through its use, the service or product doesn’t become inherently bad. It just doesn’t…. A + B does not equal C. There are so many additional elements to consider. Mentioned in a comment to a blog I previously wrote, was that the creator of the rotavirus vaccine had made ridiculous amounts of money by patenting his vaccine, and so as an individual, could no longer be considered credible. This concerned parent also commented that rotavirus doesn’t kill patients in developed countries, which is primarily true, but I will add this– before the vaccine, rotavirus used to infect and wreak havoc on our patients and their families. My own son had the illness, as he was born before the vaccine was available, and if I could take back the ER visit, blood draw and urine catheterization, the IV fluids and his protracted vomiting and diarrhea; I would. How is this less difficult to endure than the vaccine itself? I honestly don’t understand the logic. And even though you have to carefully examine safety data and confirm its origin and potential for bias, something can be both profitable and beneficial – the existence of one just does not exclude the other.

By the way, the risk of death from general anesthesia is about 1 per 1,000,000. It is, by comparison to most things, very safe. Certainly safer than half the things I did last week –