harry wrote on 3/24/19 10:06 AM March 24, 2019> I have lived in
communities where polio was prevalent - and I have seen people from a
couple of generations crippled and maimed with the after effects of polio
(and not the unseen others who died for the lack of a vaccine). I know one
guy whose mother was unable to vaccinate him due to a death in the family
on the vaccination day at the primary health centre, and then forgot about
it. The guy fell sick in his 20s believing he had been vaccinated, and it
took very long for the doctors to diagnose polio, and eventually he did get
treated and recover, but has a terribly degenerative bone condition on his
spine because of the polio attack.
Weirdly, polio is a clean water disease. Before sanitation was
widespread, children contracted an almost-invariably mild case of polio
in early life, recovered, continued to come into contact with the polio
virus throughout their lives, and paralytic polio was unknown.
Enter sanitation, children don't encounter the polio virus until later,
and you have sad epidemics of paralytic polio.
OPV has largely wiped out polio in most
such places. Now the reason OPV failed in some cases (not mentioned in that
article) is for other reasons:
1) when you had communities of people mixing with and without vaccines - it
is possible under some circumstances for the disease to spread from a
recently vaccinated person (typically via stool or sneezing) to a
unvaccinated person; this has been known some time - and the US switched
back to IPVs because they have a large number of people who don't want any
vaccines who were at risk because of OPV ( I just hope those people dont
travel to india or any african countries ).
The OPV is a live, attenuated oral vaccine and unlikely to cause serious
illness in the vaccinated person. One of the touted benefits of the OPV
was that the presence of the live virus passively vaccinated family
members. OPV is a more effective and longer-lasting vaccine than IPV
(injected, killed virus), anyway, and the passive re-exposure
strengthened immune responses that might be waning. Unfortunately, the
OPV virus can become less attenuated as it reproduces, leading to
second-and-third-level contacts encountering a more virulent, wild-type
virus.
2) substandard vaccines, this is more common than you think - especially
when there is bulk ordering of millions of dosages of vaccines. those UP
vaccine deaths were most probably due to substandard vaccines.
Vaccine wear-off is a big issue as well. The immunity conferred by
vaccines declines over time. This varies by vaccine and individual, with
some vaccines wearing off in a few months while others might still be
going strong after 50 years. It seems generally foolish for us to assume
that vaccination against a disease in childhood will continue to protect
us in mid-life, *but most people do exactly that*.
I see anti-vax as really a first world problem for people who have the
means to procure aseptic food and environments, and treat themselves in
proper hospitals when there is the eventuality of disease.
It's a third world problem, too. In some places, vaccination programs
have been sloppy enough that they've transmitted other diseases along
with the vaccine. In others, vaccination programs have been infiltrated
by bad actors. The combination of these factors has led to serious
distrust of vaccine programs in some areas of Africa.
Polio is just
one of the many killers for the less fortunate communities i am talking
about (i saw a place where a rota virus killed every other child that was
born in the 6 month period that i was there, only because the vaccine was
not freely available at the primary health centre), and they are more than
happy to get the vaccine since it clearly improved survivability.
On the other hand, at some point the risk/benefit equation flips. When
my second child was up for the DT vaccination, our doctor remarked that
she was more likely to be bitten by a cobra (not endemic to the US) than
to contract diphtheria. Shortly thereafter, the vaccine schedule changed
to reflect the fact that diphtheria was no longer a threat to American
children.
Diphtheria is a terrible disease, and the vaccine is quite effective.
It's not risk-free though, and, as with the OPV, there's a point where a
given vaccine causes more harm than it prevents.
I do see parents in my son's first-world-like school who have not
vaccinated their kids with *anything* on the basis of some celebrity video
or misleading article talking about the disease in statistical terms.
Statistics can cut multiple ways, can't they?
If we kept everyone's vaccines current on every disease that vaccines
can prevent, it would be extraordinarily expensive and also likely cause
more harm than good. Some vaccines (I can attest to this for the rabies
vaccine) are just plain nasty, and only justified when there's a
possible exposure to a much worse disease.
First world children are, by and large, extraordinarily safe from deadly
diseases. Even if they contract diseases that we vaccinate against, they
have access to a higher level of medical care than any previous
generation. Communicable disease is less of a risk for them than the
family car, the neighborhood pool, or Mommy's handgun.
People get complacent when they have everything they need and they live
in a safe world.
I am extremely grateful for the push to develop an effective
tuberculosis vaccine. As antibiotics fail, TB threatens to become an
even bigger scourge than it is already.
--
Heather Madrone (heat...@madrone.com)
Blog: http://www.knitfitter.com/category/personal/
The Goddess moves mountains -- bring a shovel.
