To Vaccinate or Not to Vaccinate

4 June 2015

Last week, an e-mail popped into our in box calling for voters in California and Vermont to campaign against state laws that will limit the allowable

exemptions from mandatory vaccinations. Sent by an

organizations called Citizens for Health, the appeal cites

“bodily integrity and personal and domestic sovereignty”,

alluding to some vague potential loss of liberty and

founding constitutional principles.

Notably absent from this appeal is any mention of the responsibilities that necessarily accompany freedom. What Citizens for Health considers “the essence of American liberty” – the right to refuse an immunization – inherently includes the ability to pose risk to others. Refusing a vaccination places you at risk for contracting the particular disease. Once infected, you become a vector for transmission. You are now a danger to infants, transplant recipients, cancer patients, those living with HIV/AIDS, the elderly, and others with weakened or compromised immune systems. While you may have the right to place yourself at risk, that right does not extend to posing danger to others.

There is a powerful meme on Facebook that asks “Remember that time you got polio? Of course not, because your parents had you vaccinated.” There is no arguing with that sentiment. The statistics speak for themselves. The absence of smallpox in our world is a result of what Citizens for Health term “forced medical treatments.” Perhaps equally troubling is that this freedom from illness is enjoyed because herd immunity is gained via widespread immunization. Those demanding the right to refuse vaccination rely on others to provide this protection. There is something perversely shortsighted and selfish in this. Guaranteeing others the basic liberty we enjoy is an essential aspect of our freedom. Concentrated self-interest is not.

Monitoring Emerging Disease Threats

The global public health community is closely monitoring the progression of two new diseases, H7N9 Avian Influenza and Middle East Respiratory Symptom Coronavirus (or MERS-CoV). This process is illustrative of a core health challenge in an increasingly mobile world. The Black Death that decimated Europe between 1348 and 1350 traveled via wind-powered ship and human and animal overland movement. The 1918 influenza pandemic that killed perhaps 100 million moved via steamship and motorized transport. Today, an infected individual can be on the other side of the globe within a day.

The challenge, therefore, is to identify where and when these diseases appear. Exposures due to local conditions (such as close proximity to domestic poultry) indicate one prevention approach. Ready human-to-human transmission demands a more aggressive stance, such as the countermeasures mounted against SARS. This creates a delicate balancing act for public health officials. Conveying too much information that can be taken out of context can be viewed as hype or overreaction. For example, the term pandemic refers not to the severity of a disease, but to the extent of its spread. Conversely, withholding information runs the risk of needlessly exposing populations to the emerging disease.

On May 29, 2013, Secretary of Health and Human Services Kathleen Sebelius declared MERS-CoV outbreak a "significant potential for a public health emergency that has a significant potential to affect national security or the health and security of United States citizens living abroad." This authorizes certain activities to speed up identification and prevention of the disease’s spread. As health officials react to the changing situation, individual should remain vigilant. Be aware of where these diseases are present, especially if travelling internationally. If you have been in an affected region, be mindful of flu-like symptoms. Seek medical advice if you think you make have been exposed.

As always, maintaining a general level of health is a first step. Frequent hand washing, cough etiquette, current immunizations, and proper exercise, rest, and diet all contribute to the ability to stay healthy.

#mers #h7n9 #flu #birdflu #avianflu