Wednesday, February 19, 2014

I Want the World To Know

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

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

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

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

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

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

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

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

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

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

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

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