Bill & Melinda Gates Foundation

Vaccinating Children is a Social Responsibility

January 05, 2012

This post originally appeared on RH Reality Check and is reposted here with permission.

So, I am that mom on the playground, the one who—while happy to play with my kids— craves adult interaction and looks for opportunities to strike up conversations with other parents.  It’s actually pretty easy (presumably because other mothers find pushing a toddler on a swing as mind-numbingly dull as I often do). I comment on similarities between our kids, something mine is doing, or something hers just said and nine times out of ten we are deep in discussion about our lives and experiences with motherhood within five minutes.  We trade stories and advice about sleep training, breast feeding, potty training, discipline techniques, daycare, and pediatricians.

Of course, I always try to be careful not to be too opinionated during these conversations.  In my liberal New Jersey town, I can be almost certain that the random playground mom agrees with my politics but parenting issues are so much trickier.  I never know who is going to agree with my stance on sleep training (just turn the monitor off, the kid will stop crying eventually) and who will think I’m barbaric; who will agree with me that jarred food is really just as good as pureeing it yourself and who will think I’m lazy; or who will view the sleep fairy (the one who gave my daughter a present every morning that she slept in her own bed the year she was three) as a cute invention by a desperate mother and who will think I was just too wimpy to get bedtime right.

And, yes, before you say anything, the reason I fear the judgment of other parents is clearly because behind the smiling and nodding I’m judging them as well.   

Still, in nearly all of these conversations—even if our parenting styles are radically different—we can find a common ground on which to bond and commiserate. There is one topic, however, that I just try to avoid—vaccines. A friend once described it as the third rail of parenthood.  Just don’t touch it.  

 
As parents when we make the decision whether or not to vaccinate our children we have to think not only of them but of their friends and classmates.

While vaccines were once widely regarded as the medical miracles they are, today there is a large contingent of parents who distrust them and choose not to get their children vaccinated at all or pick and choose which vaccines they’re going to get and when.  Opposition to vaccinations began when British researcher Andrew Wakefield published a study in the Lancet suggesting a link between vaccines and autism. Over the next decade or so, study after study failed to replicate this link but distrust of vaccines grew anyway and celebrities like Jenny McCarthy publicly blamed vaccines for their children’s autism.  Unfortunately, this trend does not seem to have stopped even after information was released last year which showed that Wakefield fabricated his data.  

It’s hard to predict where a parent is going to stand on this issue.  Smart people with whom I tend to agree on most issues of politics and parenting completely disregard the science, express a generalized distrust for medicine, and refuse to vaccinate their children.  I know that a large and growing proportion of parents in my progressive community are using the school system’s broad “religious exemption” to send their unvaccinated children to school.

If this subject were to come up as we watched our children come headfirst down a slide, I might just smile, nod, and walk away but it would be painful. Because what I really want to say is “wow, that’s not just stupid, it’s selfish.” 

There, I said it. Choosing not to vaccinate your child is selfish and the only reason you can afford to do it without the likelihood that your child will get a life-threatening illness is because I vaccinated my child. 

An op-ed in the New York Times last week said this in a slightly nicer way. The article was written by Steven L. Weinreb, a physician certified in oncology and hematology who is himself suffering from a form of leukemia. Weinreb recently underwent a stem-cell transplant and explains that until his new cells mature he has the immunity of a newborn and is very prone to diseases such as chicken pox, measles, and the flu.  These illnesses, which are usually not life threatening can be very dangerous to newborns and people with compromised immunity system and yet those are the people who cannot get vaccinated as the vaccines can be dangerous to them as well. Not to worry, he says: “My newborn buddies and I do have some protection, however: the rest of you.” 

He goes on to explain that the purpose of vaccines is to protect “the herd.”  Weinreb states that “if 75 percent to 95 percent of the population around us is vaccinated for a particular disease, the rest are protected through what is called herd immunity.” Unfortunately, the new distrust of vaccines mean that the vaccine rates in the herd are dropping and the results are just what public health professionals feared. Weinrab points to measles as a good example of this dangerous trend.  Before the vaccine was introduced in 1963, 400 to 500 people in the United States died from the disease each year.  By vaccinating the majority of the population, cases of the disease have dwindled.  For each year between 2001 and 2008, the median number of cases (not deaths) in the United States was 56. In the first six months of 2011 alone, however, there were more than 150 reported cases—the most since 1996. And, the vast majority of those who were sickened had not been vaccinated or had uncertain vaccination histories.  

As parents when we make the decision whether or not to vaccinate our children we have to think not only of them but of their friends and classmates.  Weinreb says this: “We assist the infirm, pay our taxes and donate to charity, and getting vaccinated — for the flu, for adult whooping cough, for pneumonia—is just another important societal responsibility.” I couldn’t agree more.

I would, however, add the HPV vaccine to that list and suggest that part of our social responsibility is to vaccinate our children—both boys and girls—against this sexually transmitted infection that can lead to cervical cancer (which kills approximately 5,000 women a year in this country). While it may not be your child you save, widespread vaccination is the only way we can wipe out this very common disease.  

I realize that the HPV vaccine differs from the others in at least one key way; my child will not get HPV by sitting next to your child in class or riding the school bus with him.  HPV is a sexually-transmitted virus and as such individuals have to play a more active role in its transmission.  And, here is where a different kind of opposition arises.  The opposition to this vaccine is not rooted in the now debunked research connecting vaccines to autism (though it has undoubtedly benefited from a generalized mistrust of vaccinations). This opposition, which comes largely from the same far right voices that oppose sex education, condom availability, access to birth control, and abortion, suggests that since HPV can be prevented through behavior (don’t have sex),  vaccinating against it is unnecessary.  Moreover, they argue that vaccinating young women against HPV (like giving them a condom or letting them get emergency contraception without a prescription) will make them promiscuous.  Like so many arguments this one boils down to the patronizing desire to control women’s sexual behavior and the irrational idea that if you take away the consequences of sex girls will turn into sluts. 

Good news, it doesn’t happen.  A new study from the Centers for Disease Control and Prevention found that having received the HPV vaccine did not affect whether young women engaged in sexual activity. Researchers used data from the National Survey of Family Growth (NSFG) to look at the behavior of young women ages 15 to 24:

“A main goal of this NSFG analysis was to explore any association between sexual behaviors and receipt of HPV vaccine. Results do not indicate a difference in sexual experience by HPV vaccine status.” 

Specifically, young women who are vaccinated against HPV are no more likely to be sexually active or to have more partners than unvaccinated girls. The lead researcher on the study explained:

“This survey represents a snapshot in time, and we cannot rule out the possibility that the HPV vaccine leads to sexual risk taking.  But this should help calm concerns of parents and (health care) providers to some degree.”

In fact, there is more good news from the study as the research also found that young women who were vaccinated were more likely to use condoms than their unvaccinated peers.  “Sexually active young women who had received the vaccine were more likely to report always using a condom in the past 4 weeks than sexually active young women who had not received the vaccine.”  The researchers say that it’s possible that those young women who received the vaccine are more likely to be concerned about STIs and safer sex in the first place or that receiving the vaccine and perhaps the education that goes with it can lead to safer sex.  Either way they conclude that “data do not suggest that receipt of HPV vaccine causes dis-inhibition or perceived lessened risk and thus more sexually risky behavior.”

So we can scratch the fear that vaccines cause autism off the list (despite what Michele Bachmann said a few months ago), and we can scratch the fear that the HPV vaccine causes promiscuity off the list as well. 

Now we’re back to the facts: HPV is the most common STI, it can lead to cancer, and we now have a vaccine to prevent it. We have a vaccine that prevents cancer. And so I say, as parents, and as members of the herd, it is part of our societal responsibility to get our children vaccinated against HPV.

 
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