yet more on vaccinations

So I was reading my mother-in-law's new book The New Killer Diseases last night, which includes a section on vaccinations. The book maintains that MA law does not allow a waiver for vaccination of schoolchildren. Looking further, I found the relevant state law:

http://www.state.ma.us/dph/regs/reg105CMR220.htm

The portion regarding waivers is:

(C) The requirements in 105 CMR 220.500(A) and (B) shall not apply:
(1) upon presentation of written documentation that the student meets the standards for medical or religious exemption set forth in M.G.L. c. 76, � 15;
(2) upon presentation of appropriate documentation, including a copy of a school immunization record, indicating receipt of the required immunizations;
(3) in the case of measles, mumps, rubella and hepatitis B, upon presentation of laboratory evidence of immunity; or
(4) in the case of varicella, upon presentation of laboratory evidence of immunity or a statement signed by a physician that the student has a history of chickenpox disease.

The religious exemption applies only when there is not an epidemic of the relevant diseases...

And the MA Department of Public Health has a website which presents the public health benefits of vaccination:

http://www.state.ma.us/dph/cdc/epii/imm/vac_safety/infdes.htm

The table at the top of the page is very instructive. Here is another relevant section (important to me since my immune system is somewhat impaired):

"# Children who are unimmunized are not only at risk themselves, but pose a danger of transmission of disease to other children who cannot be immunized because they are too young or because they have medical conditions that weaken their immune systems to the point where they cannot be adequately protected by vaccines.
# Due to medical advances, the number of children and adults surviving treatment for leukemia, with organ and bone marrow transplants, and those with other conditions that weaken the immune system, is growing. In order to be protected, these most vulnerable individuals, must rely on the community to protect them from disease exposure by community-wide vaccination."

This sets it right out: people who don't immunize their kids are essentially saying that their individual child's health is more important than the overall health of the community.

Vaccinations again

so... thanks to a computer crash, I have had several hours to comtemplate the various responses to this whole topic, including especially hawkegirl's.

This all reminds me of a quote from Stalin: "A single death is a tragedy, a million deaths is a statistic." And I'd rather avoid the million deaths....

From different points of view, each of us is right. I approach the problem from a public health perspective, which isn't surprising given where I have spent the past 2 years. That is, what leads to the greatest good for the largest numbers of people? The data available to me show that vaccination *in general* (leaving specific diseases aside...) is a good thing by this standard.

hawkegirl OTOH is approaching things as a mother of individual children. If she vaccinated them, and one of them suffered debilitating complications, it would be terrible for her and her family. I don't deny that at all. I don't disagree with her decision, taken as the individual decision of an individual parent. If I had kids, I'd research vaccines carefully, and where I chose to vaccinate, insist on the least risky vaccine available.

However (and I am going out on a limb here), everything I know about epidemics suggests that parents who choose not to vaccinate, whether they acknowledge it or not, are relying on there being enough parents who "don't know any better" and vaccinate their children. This related back to herd immunity; as long as a certain percentage of the population is immune to a disease, outbreaks are likely to be very limited. In fact, they may be so limited that bad reactions to a vaccine are more common than the disease the vaccine is supposed to prevent. So in the immediate sense, the vaccine *is* more risky -- but as fewer kids get vaccinated, this won't remain the case.

What's happening right now with vaccines is that most drug companies don't manufacture them anymore. They are not profitable, especially when the cost of lawsuits is considered. Because of this, there are plans afoot in the CDC to make vaccine manufature a government function -- but this would likely eliminate research into making vaccines safer than they are now. Not a good thing IMHO.

(Another thing: WRT smallpox, we don't have to vaccinate against it any more *precisely because* it has been eliminated from the general population by widespread vaccination. [defense labs aside, but that is another wrinkle for another time...] The same thing is almost true of polio, and could be true of any other disease that is harbored only in humans...)

and one more link: MMR and autism not linked, finds giant study. From an epidemiological perspective, this research is as good as it gets...