Of Vaccines and Men: Sympathy for the Anti-Vaxxer
“But I did really want to know. I mean, it’s interesting, don’t you think, to know all about people? What they feel and think, I mean, not just who they are and what they do.”
― Agatha Christie, Three Blind Mice and Other Stories-
So you’re an anti-vaxxer. You’re convinced of your convictions, and want nothing more than for the majority opinion to consider the possible (and likely) harm that vaccines may pose to human health. You’re repulsed by the banner of levity others have imposed on you and wonder if vaccine proponents have considered the multitude of hours of research you’ve put in to exhaustively understand the workings and drawbacks of vaccines. It’s okay, I get it. As with all technical and scientific things, the preparation of vaccines isn’t clearly enumerated to the public. You’re expected to accept an injection of pathogens and/or their toxins, yet your doctor isn’t enumerating the contents that will be coursing through your veins and capillaries? The companies producing the viruses probably have the clandestine processes protected from public knowledge as intellectual property. So you took initiative, went online to see what the content of the vaccines were, and how they’re said to function. I can certainly understand your horror and skepticism. Never mind that vaccines have been working for more than a century. I can certainly empathize.
So, who is an Anti-Vaxxer?
‘Anti-vaxxer’ is a term conferred upon a person who displays vaccine hesitancy, a reluctance or refusal to accept vaccination either for self or for one’s children. Anti-vaxxers include those who have an outright refusal of vaccines, delay of vaccination, accepting vaccines with qualms regarding them and selective acceptance of vaccines, while refusing others.
Vaccine hesitancy is nothing new, but has gained traction in recent years. For instance, there has been an unfounded belief that vaccines are linked to, or may cause Autism, though this view has been debunked by multiple studies.
Vaccination
Vaccination—the provision of a vaccine to a person—involves introducing an immunogen into their body. Immunogens are disease-causing pathogens that have been killed or weakened in a way that will decrease the chance of causing actual disease. The body, on encountering the immunogen, reacts to it by preparing defenses against it, either through its immune cells that kill it or by antibodies, protein structures that bind the immunogen leading to their demise. At this point, the body is said to have acquired immunity against the pathogen, and has systems in place to recall the pathogen structure. If in the future the body should be confronted by the actual pathogen, its immune system will unleash protective mechanisms that will quell the pathogenic attack, preventing actual disease.
According to the WHO, more than 20 life-threatening diseases can be prevented by vaccination, or immunization as it is alternatively named. According to the CDC, routine vaccination begins in the first year of life. From birth to 15 months, vaccines against Measles, Mumps, Rubella, Varicella, Hepatitis A, Tetanus, Diphtheria, Pertussis, Human Papillomavirus and Meningococcal may be administered.
There sometimes are side effects experienced, varying with the vaccine. These include mild side effects such as: a sore arm or limb (at which the vaccine was administered), redness, fatigue, poor appetite or a low-grade fever. These usually disappear after a few days. Severe side effects like serious allergic reaction may occur, but affect a low percentage of the vaccinated population.
How vaccines are prepared
Vaccines, as noted above, are composed of immunogens whose element is dead or weakened pathogens. There are three ways a vaccine may be generated:
· Changing the pathogen’s (bacteria or virus) genetic blueprint to effect poor replication. Organisms use their genetic makeup to reproduce, so to speak. In this instance, this process will be impaired, leading to vastly decreased capacity to infect healthy cells. In this instance, the pathogen is referred to as being attenuated.
· Destroying the pathogen’s genetic makeup, rendering it incapable of replicating. This is routinely done by treating live pathogens with formaldehyde which kills them. Subsequent purification steps remove toxic formaldehyde, making the purified vaccine safe for human administration.
· Extracting the toxin from the pathogen (mostly bacteria), purifying it and denaturing/inactivating it, eliminating its infectious capability. The process is performed with formaldehyde, and subsequent purification to make it safe for administration.
Vaccine preparation is performed in sterile, controlled conditions which greatly decrease any chances of infection. Institutions preparing vaccines have to adhere to, among others, the FDA’s guidelines and standards.
So, do vaccines actually work? Are they worth the trouble?
With the advent of vaccination came the eradication of Smallpox in 1979. Smallpox, which killed 300 million people in the 20th century alone has not been detected in 40 years.
Polio, a once prevalent, debilitating and incurable disease has seen its cases decrease by 99% since 1988.
Between 2000-2018, there was a 73% drop in Measles deaths due to vaccination.
4. These are substantial numbers and significant victories in the fight against these illnesses. It is also cost-effective and convenient to undergo vaccinations, which typically require a single dose. Some may require three or more; yet others may require boosters after a certain number of years, Tetanus for instance. If you opt for treatment, you may require it after every infection episode. Also, a disease like polio would be irreversible, causing shrinking of limbs.
A case for the Anti-Vaxxer: Complaints, Concerns and Convictions
The number of Anti-Vaxxers has seen a rise over the past few years. There has been growing resistance to the prospect of vaccination, ever since the advent and expansion of information technology. With the internet being readily available, a lot of people are able to conduct research, for instance with medical diagnoses and prescriptions meted out. There is currently a wealth of scientific information and data for consumption of the average person who is motivated to wade neck deep in it. With resources such as WebMD and search engines like Google that deliver a multitude of libraries and information to the concerned citizen, nothing appears beyond reach. It certainly requires a deep comprehension of the scientific subject matter. Also, in a world where studies are constantly debunked or supported, with appended adjunct data expanding the scope of previous hypotheses and stands, it is not enough to read one, or even a couple of articles.
Some of the concerns, complaints and claims anti-vaxxers field are:
· Religious beliefs, with claims that chemicals derived from animals shouldn’t be used for human inoculation, as was the case with cowpox employed in vaccinating smallpox.
· The notion that enforcing vaccine administration violates civil liberties and the individual’s right to choose or accept what is administered to an as seen highly personal level.
· That vaccines may cause disease. For instance, some claim a correlation and possible causality between vaccination and the recent rise of the number of cases of Autism. Yet others view the mild side effects of vaccination as disease or substantial discomfort that shouldn’t be experienced, and wouldn’t be sans vaccination.
· Chemicals apparently contained in vaccines, particularly formaldehyde, are noxious if introduced to the human body. There are residual but negligible amounts of formaldehyde in some vaccines, but none have been shown to be toxic or worthy of a health alert.
· Some vaccines don’t appear to exhaustively serve their purpose, flu vaccines for instance.
· The bolstering of sanitary and sterile conditions has led to a decrease in the incidence of illnesses, not necessarily the vaccines against them.
The purported link between vaccination and Autism, a staple piece of apparent evidence used by anti-vaxxers to champion noncompliance, was given voice especially by actress Jenny McCarthy and her organization Generation Rescue. McCarthy’s son was diagnosed with Autism, which she later attributed to the MMR (Measles-Mumps-Rubella) vaccine. The hypothesis holds that the MMR vaccine damages the intestinal lining, allowing the entrance of encephalopathic proteins which affect the brain.
It is certainly logical to be wary of formaldehyde, which is the main ingredient for embalming fluid employed in the preservation of bodies postmortem. It may also be a lot to ask to take something with blind faith, not knowing enough of a vaccine’s mode of actions. It may be difficult for health personnel, particularly doctors, nurses and pharmacists who administer vaccines, to describe in lay terms the processes by which vaccines confer immunity. I’ve certainly never had this explained to me, though in fairness I never asked. In short, some of these concerns, though not supported by current evidence, are not entirely baseless.
Consequences of Vaccination Noncompliance
As noted previously, the advent of vaccines has led to numerous successes in the eradication and containment of disease à la Smallpox and Polio. However, in recent past, particularly with the rise of the vaccine hesitancy movement, there has been a resurgence of illnesses that were previously controlled. According to the WHO, Measles has seen a 30% increase in cases globally. Furthermore, in 2000 the CDC declared that Measles had been eliminated from the United States. However, in 2013 there were 159 cases of an outbreak reported, which the CDC attributed to clusters of people unvaccinated due to their philosophical or religious beliefs. By 2014 the number quadrupled to 644. Since then there have been sporadic outbreaks in different states, following the pattern of inflicting unvaccinated persons or children. This is a truly troubling notion, given that there was no disease incidence in the year 2000.
Children are at an especially higher risk, given that their environments are controlled only to a certain degree. They’re far more likely to engage in unrestricted and unrestrained group activities both at school and at home. They also seldom have the perception to discern their sickly fellow children, and rarely if ever have the foresight to enact a level of remove from someone affected. Diseases like the cold spread with incredible celerity. It stands to reason that children would fall prey to diseases like Measles in much the same way.
Pertussis, or Whooping Cough, has also seen a dramatic rise in cases, likely due to vaccine hesitancy.
Don’t hesitate, don’t refuse: A case for Compliance
I do not condemn the anti-vaxxer’s stance. Much like administering chemotherapy to a cancer patient, there are risks albeit limited and negligible to the use of vaccines. However, I disagree with their arguments and have a deep concern for the ramifications of their choices. Vaccines are an important tool in imparting immunity, tools whose efficacy has been shown multiply in numerous studies. A lot of hypotheses and views controverting this have been disproved: the MMR vaccine against Measles has not been shown to cause Autism, and the Flu vaccine has been shown to protect against the strains of Flu developed against. Though not as efficacious as other vaccines, the flu vaccine decreases the incidence of the illness between 40% and 60%. Of note, according to the WHO, vaccination prevents 2-3 million deaths a year; a further 1.5 million could estimably be avoided if global coverage of vaccines improved.
Also, a lot of caveats don’t appear to have been considered. For instance, Autism is a neuropsychiatric illness whose etiology and pathophysiology don’t appear to be linked to immunity or exacerbated by its debilitation. The chemicals used in vaccines, both the toxins inactivated or chemical components such as formaldehyde are used in appropriate or negligible amounts. Vaccines are also rigorously tested before the final product is achieved. These include testing in animal and human cells in vitro, or outside the body. There is also titration performed: using graded amounts of the vaccine to optimize the best amounts or concentration to adopt. Before human use, vaccines are tested in animals, from lower animals like rodents (mice and rats) to mammals (pigs and cows) and finally to non-human primates (monkeys). The vaccine is administered, and after immunity is perceived the animal is exposed to the disease. After that, rigorous assessment of immune cells and tissue is conducted to ensure that the vaccine works. After animal trials come human trials: in fact, of the five phases of clinical trials, Phase 1 tests the safety of the vaccine. Test subjects are evaluated for possible mortality as well as mild and adverse side effects. The FDA conducts rigorous oversight of the vaccine clinical trial. Only effective vaccines that have few and mild side effects are approved for use.
With all said, this presents itself as a classic optimization problem. Between accepting and shunning vaccination, which option has the highest reward and fewer risks? With the latter, your highest reward is the limited certainty of mild to moderate side effects by not receiving the vaccine. Your risk, the ultimate one, is contracting an illness that could have been prevented and suffering its symptoms, possible mortality or permanent life altering changes. By accepting the vaccine, depending on the type, you may get a transient side effect which clears in a couple of days. But the crucial reward bestowed is lifetime immunity to the disease in question. Some vaccines may require boosters every couple of years, but that is a rather small price to pay.
A Call to Action
Someone who lives on an undulating plain, who’s content with his or her acumen, will swear that the earth is flat. Only from positioning ourselves on the sun or at a point of observation without can we glean the truth. Admittedly, though vaccines do work with varying degrees of success, the populace needs to be educated about them in substantial detail. Contents of vaccines, modes of action and side effects need to be enumerated and explained to individuals and to parents. Unenlightened people sometimes have a curiosity that knowledgeable people may sometimes take for granted, and some questions may not have been thought of before, or may appear arbitrary and trivial yet important to the person receiving the vaccine or his/her caretaker.
To this end some resources do exist, including the WHO, the FDA and the CDC. The FDA has on its site a page detailingthe vaccine approval process. The CDC has a list of possible side effects for a host of vaccines; this will aid a person to know what to anticipate. The Salzburg Statement on Vaccination Acceptance, from the proceedings of the Salzburg Global Seminars at the WHO outlined different courses of action to be adopted by different groups, including policymakers, health professionals and parents. Finally, health professionals ought to be receptive to their patients’ concerns and queries on vaccines and their possible side effects. A little reassurance goes a long way, and is a small price to pay for compliance.
It would be a shame if vaccine hesitancy would lead to the resurgence of antiquated illnesses like Smallpox and Polio. The return of Measles in the United States proves that nothing can be negated. There are simply no substantiated instances of vaccines causing actual disease, and there has been and continues to be biotechnological advancement to ensure that this will not transpire. Have a little faith, get vaccinated, and vaccinate your children as recommended. It is imperative that you do so; yours or your child’s health depends on it.
https://medium.com/@urizeniczoa/of-vaccines-and-men-sympathy-for-the-anti-vaxxer-8240eee6af8c
