Tag: hiding in the herd

10 Myths About Chicken Pox and the Chicken Pox Vaccine

You remember chicken pox, don’t you?

Is this really a disease that we need to vaccinate our kids against?

Obviously, the folks who posted the following comments don’t seem to think so.

It is just as obvious that they are wrong though.

That she doesn't understand survivorship bias doesn't mean that you shouldn't vaccinate your kids.
That she doesn’t understand survivorship bias doesn’t mean that you shouldn’t vaccinate your kids.

No one ever says that chicken pox, measles, mumps, and rubella kills everyone that gets them.

Even in the pre-vaccine era, when measles would kill 500 people a year in the United States, there is a very good chance that you wouldn’t have known anyone that died of measles. Of course, that doesn’t mean that nobody died of measles or chicken pox or any other now vaccine-preventable disease.

You likely know someone that plays football, right? Maybe on a youth football team or in middle school or high school? Do you know anyone that plays on a team in the NFL? While millions of kids might play football, only a few thousand play in the NFL.

Benign diseases don't kill kids.
Benign diseases don’t kill kids.

Chicken pox was never a benign disease. It was considered a rite of passage because we all had to endure it, but it wasn’t something anyone looked forward to. You don’t die from a benign disease.

Trying to scare people into thinking that vaccines are poison... Anti-vaccine propaganda is all about fear.
Trying to scare people into thinking that vaccines are poison… Anti-vaccine propaganda is all about fear.

Part of that is actually true – “they keep you a customer for life” because you didn’t die from a vaccine-preventable disease!

The UK doesn't haven't routinely vaccinate against chicken pox, but they do have chicken pox deaths...
The UK doesn’t routinely vaccinate against chicken pox, but they do have chicken pox deaths and the same rise in shingles rates…

Many countries don’t have the chicken pox vaccine on their routine immunization schedule because they don’t think it is cost-effective and they were concerned about what controlling chicken pox could do to rates of shingles.

“About 3 in every 1000 pregnant women in the UK catch chickenpox. Between 1985 and 1998, nine pregnant women died in the UK from chickenpox complications. Their unborn babies are also at risk from a rare condition called foetal varicella syndrome (FVS). This can result in serious long-term damage to the baby or even death, particularly if the mother catches chickenpox in the first 20 weeks of pregnancy.”

Vaccine Knowledge Project on Chickenpox (Varicella)

These countries have the same rates of shingles as countries that do use the chicken pox vaccine, but still have high rates of chicken pox and complications of chicken pox!

The UK does not vaccinate for chicken pox, but young, otherwise healthy kids die with chicken pox in the UK.

Don't trust the CDC, but do trust anyone with a website or Facebook page that says what you want to believe.
Don’t trust the CDC, but do trust anyone with a website or Facebook page that says what you want to believe…

Most folks should understand that when anti-vaccine folks say “do your research,” they mean look at their websites and Facebook groups that regurgitate misinformation and anti-vaccine propaganda.

Natural immunity is not better than vaccine induced immunity when you consider the risks of a natural infection, which can include death.
Natural immunity is not better than vaccine induced immunity when you consider the risks of a natural infection, which can include death.

We don’t need disease.

There is no diet that will help you beat chicken pox.
There is no diet that will help you beat chicken pox.

While you will be at higher risk for complications from chicken pox and most other diseases if you have a compromised immune system or are malnourished, if you are otherwise healthy, there is nothing you can do to boost your immune system to try and beat chicken pox – besides getting vaccinated.

Homeopathic vaccines do nothing.
Homeopathic vaccines do nothing.

There is also no homeopathic remedy or homeopathic vaccine that can help you avoid chicken pox.

Adults don't need boosters to most vaccines, so actually are up-to-date and immune to most diseases.
Adults don’t need boosters to most vaccines, so actually are up-to-date and immune to most diseases.

The chicken pox vaccine provides long lasting protection. Ironically, anti-vaccine folks often misunderstand how herd immunity works, the one thing that can protect their unvaccinated kids as they try to hide in the herd

Chicken pox parties were never as common as folks think they were, but when done, it was out of necessity, as we didn't have a vaccine.
Chicken pox parties were never as common as folks think they were, but when done, it was out of necessity, as we didn’t have a vaccine.

Chicken pox parties kind of made sense in the pre-vaccine era. Since it was inevitable that your child would get chicken pox, you wanted them to get it at a young age, so they weren’t at increased risk for complications as an adult.

But intentionally exposing your child to a life-threatening infection when a safe and effective vaccine is available?

Do your research. Get vaccinated and protected.

More on Chicken Pox Myths

Vaccine Analogies and Metaphors

Analogies and metaphors are a good way to explain things, including that vaccines are safe and necessary.

We are sunk if we stop vaccinating.
As the CDC explains, we are sunk if we stop vaccinating.

Here are some of my favorite vaccine analogies and metaphors.

Getting vaccinated is like:

  • applying sunscreen before going to the beach
  • applying insect repellent before going camping in the woods
  • making sure that your kids are wearing a seat belt or sitting in an age-appropriate car seat or booster seat when you get in the car
  • installing anti-virus software on your new computer

When do you put on your seat belt? When you get in the car, before you get in an accident. Just like a vaccine. You get it before you get sick. Yes, some vaccines do work after you have been exposed to an illness, but they don’t work after you are already sick.

There is a problem with these metaphors though; they don’t include the risks to other people.

These do:

  • taking driver’s ed and getting your license before driving
  • taking swimming lessons before going in the water without a life jacket
  • putting your gun in a locked safe
  • putting a fence around your backyard so that no one in your neighborhood can drown in your pool
  • making sure folks don’t text and drive

That’s right.

Vaccination equals protection.

And not just protection for the person getting vaccinated. Being unvaccinated puts others at risk too, as you might start an outbreak.

Getting your kids vaccinated is like taking them to swimming lessons instead of just throwing them in the lake. Either way they can learn to swim and have protection/immunity from drowning. But one method (throwing them in the lake) is much more dangerous than the other.

Analogies can also help explain how vaccines work.

“Vaccines are a like a wanted poster, they just show your body what the bad guys look like, so when faced with them for real you are ready, prepared, and able to stop them before they cause harm.”

Can vaccines overwhelm the immune system?

Are there analogies that explain the idea of free-riders – folks who intentionally don’t vaccinate their kids and attempt to hide in the herd?

“If all my child’s friends are vaccinated, won’t he be protected by herd immunity? Why should I put my child at risk for vaccine reactions if all the other children around him are already immune?

This is like riding in a carpool where everyone contributes each month to pay for gas, repairs and parking. One morning, a new neighbor shows up and says, “I think I’ll ride along with you. But I’m not going to pay, since you’re going downtown anyway and you have an empty seat.” If enough people choose to take a free ride on other children’s immunity, herd immunity will soon disappear.”

Why is herd immunity so important?

And to explain the idea of what some folks consider vaccine injuries.

“I have found that it sometimes helps to give parents an analogy. I ask them the following: If they were to put gas in their car and then later got a flat tire, would that mean putting gas in the car had caused the flat tire? No. The two events were just a coincidence.”

Karen Lewis on What Vaccine Safety Means

What are some good analogies to describe how some anti-vax folks think?

Since that bridge isn’t 100% safe (I Googled that some bridges have collapsed), I’m going to let my kids swim across this river with fast moving water.

Have you heard the bridge analogy?

There are also versions with crocodiles in the water…

In case it’s not clear, in this analogy, walking across the bridge is like getting vaccinated. Swimming across the river is like intentionally not vaccinating your kids.

There are plenty of other good analogies that help to explain the importance of vaccines.

“Clusters of unvaccinated people are like patches of dry grass that, with a single match, can start a wildfire that will burn not only dry material, but sometimes wet as well. The match could be a student who returns from a trip abroad with measles or a train commuter with whooping cough.”

Saad Omer

It’s also important to remember that anyone, even those who are well prepared, can get burned in a wildfire. That’s why the analogy works so well.

“Vaccinating one’s children is like paying taxes. We all have a moral and a legal duty to pay taxes because we have a moral and a legal duty to contribute to the upkeep of our society and to its public goods (e.g., a good public health system, national defence, etc.).”

Vaccine Refusal Is Like Tax Evasion

Why are we concerned about those who are unvaccinated if our own children are fully vaccinated?

“Think of camping as an analogy. If everyone at a campground properly stores their food, bears won’t be enticed to come around. If even one person leaves their food unprotected, it invites bears in to investigate all the campsites for opportunities to eat.”

How does choosing not to immunize affect the community?

These analogies help explain how unvaccinated folks put others at risk.

“Being intentionally unvaccinated against highly contagious diseases is, to carry Holmes’ analogy a bit further, like walking down a street randomly swinging your fists without warning. You may not hit an innocent bystander, but you’ve substantially increased the chances that you will.

One might usefully analogize the risk of disease to a crapshoot. A person’s chance of being infected is, as Dr. Singer acknowledges, a matter of luck. But is it really OK for the unvaccinated to load the dice to increase the odds against other people? If so, by how much?”

Ronald Bailey on Vaccines and the Responsibility To Not Put Others at Risk

Of course, there are plenty of bad vaccine analogies and metaphors that anti-vaccine folks push:

  • getting vaccinated is like rape
  • getting vaccinated is like the Holocaust
  • “genes load the gun but the vaccines pull the trigger”
  • vaccine manufacturers are like tobacco manufacturers
  • I won’t set my child on fire to keep yours warm (this doesn’t work as a vaccine analogy, mostly because there is no benefit to setting your child on fire. Would an anti-vaxxer let their child start a campfire to keep their friends from dying in the cold?)
  • getting a vaccine is like eating a handful of M&Ms out of a big bowl when you know that a few have been poisoned
  • getting a child  vaccinated is like giving 1,000 kids 1,000 cupcakes, telling them to pick one and eat it, knowing that one of the cupcakes is poisoned (it’s maybe like letting a child with a severe peanut allergy choose a cupcake, knowing that there is a one in a million chance that the cupcake he chooses has been made with peanuts…)
  • I want safer cars, but that doesn’t make me anti-car

You understand why the anti-car one is a bad analogy, right? Folks who want safer cars generally still drive and ride in cars!

Have you heard any good or bad analogies or mataphors about vaccines?

More on Vaccine Analogies and Metaphors

Is the La Leche League Anti-Vaccine?

Why would anyone think that the La Leche League, an organization who’s mission is to support breastfeeding, might be against vaccines?

“Many parents have questions about the compatibility of vaccines and breastfeeding. Your healthcare provider can address any questions that come up for you.”

la leche league international on Vaccines

They certainly don’t make any strong statements supporting vaccines…

“The LLLI Health Advisory Council suggests families discuss the pros and cons of influenza vaccines with their health care practitioners.”

la leche league international on Influenza

The cons of influenza vaccines?

What are those exactly? That the protection babies get from their mother’s pregnancy flu shot doesn’t last until they go to college?

What’s the greatest evidence that they might not support vaccines? I mean, besides anti-vaccine La Leache League leaders who actively say that they are against vaccines?

Bob Sears is giving two lectures  on vaccines at an upcoming La Leche League breastfeeding conference.
What exactly will Bob Sears be talking about during his two lectures on vaccines at this upcoming La Leche League breastfeeding conference?

Bob Sears is giving two lectures on vaccines at an upcoming La Leche League breastfeeding conference.

Will he really discuss the benefits of vaccines for pregnant and post-partum mothers and their families?

“Dr. Bob Sears, a renowned Dana Point pediatrician who has been sought out by parents who wish to opt out of the state’s mandatory vaccine requirements, has been placed on probation for 35 months by the Medical Board of California.”

Dr. Bob Sears, renowned vaccine skeptic, placed on probation for exempting child from all vaccinations

And considering that he nearly lost his medical license over giving an improper vaccine exemption, what can we really expect from his talk on California’s vaccine law?

“Remember that La Leche League is exclusively focused on breastfeeding support and has no stance on vaccinations.”

La Leche League USA

No stance on vaccinations?

Actually, with bringing Dr. Bob to their conference, it seems like they made a very clear stance…

“Nursing also allows your baby to give germs to you so that your immune system can respond and can synthesize antibodies! This means that if your baby has come in contact with something which you have not, (s)he will pass these germs to you at the next nursing; during that feeding, your body will start to manufacture antibodies for that particular germ. By the time the next feeding arrives, your entire immune system will be working to provide immunities for you and your baby. If you are exposed to any bacteria or viruses, your body will be making antibodies against them and these will be in your milk.”

Can Breastfeeding Prevent Illnesses?

And they have also done a good job of making it sound like breastfeeding infants don’t need vaccines.

They do!

While breastfeeding is great, it is not a substitute for getting vaccinated. In fact, antibodies in breast milk will not protect a baby against most vaccine-preventable diseases.

If the La Leche League truly wants to support what’s best for kids, they should move away from pushing non-evidence based therapies, especially craniosacral therapy and referrals to chiropractors for breastfeeding problems, and they should take a stand supporting vaccines.

The La Leche League is on this list of other organizations that speak out against vaccines.
The La Leche League is on this list of other organizations that speak out against vaccines.

Then maybe they wouldn’t appear on any lists from the NVIC.

More on Vaccines and the La Leche League

How Can I Get Vaccinated If My Parents Are Anti-Vaccine?

What do kids do when their parents are anti-vaccine?

    Most teens do know what's in a vaccine and they want to get vaccinated and protected.
Most teens do know what’s in a vaccine and they want to get vaccinated and protected.

Whether or not they know it, they hide in the herd, at least until they understand what’s going on.

And then they often make a choice to either continue with their parents beliefs and remain unprotected or they get caught up.

Can Minors Consent to Getting Vaccinated?

Since getting vaccinated is a medical procedure, in most cases, you are still going to need the consent of a parent, guardian, or other adult family member if you are still a minor, which leaves out simply going out and getting caught up.

“State law is generally the controlling authority for whether parental consent is required or minors may consent for their own health care, including vaccination.”

Abigail English, JD on  the Legal Basis of Consent for Health Care and Vaccination for Adolescents

Are you still a minor?

“In most states, age 18 is the age of majority and thus, before treating a patient under the age of 18, consent must be obtained from the patient’s parent or legal guardian.”

Ann McNary, JD on Consent to Treatment of Minors

When it comes to immunizations and health care, in addition to what state you live in, that likely depends on whether or not you are an emancipated minor (court order), married minor, pregnant minor, or minor parent (situational emancipation). It also can depend on the type of health care you are seeking, like if a minor is seeking birth control or treatment for an STD.

“States Parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child.”

Convention on the Rights of the Child

Are you a mature minor? In some states, you can also give consent for medical procedures, including getting vaccinated, if you are a mature minor – someone who is old enough to understand and appreciate the consequences of a medical procedure.

In Washington, for example, minors may get immunizations without their parents consent after their health care provider evaluates the minor’s “age, intelligence, maturity, training, experience, economic independence or lack thereof, general conduct as an adult and freedom from the control of parents.”

Fourteen other states, including Alabama, Alaska, Arkansas, Delaware, Idaho, Illinois, Kansas, Louisiana, Maine, Massachusetts, Montana, Nevada, Oregon, Pennsylvania, South Carolina, Tennessee, and West Virginia have laws that allow mature minors to consent to general medical treatment either in all or a range of restricted circumstances.

How Can I Get Vaccinated If My Parents Are Anti-Vaccine?

Believe it or not, this question comes up a lot more than you can ever imagine.

If you are old enough to consent to getting vaccinated on your own, then you are all set and can start to get caught up on your immunizations.

If not, then your options are more limited, but might include:

  • talking to your parents about your concerns
  • asking someone, like your pediatrician, to be an advocate and talk to your parents with you
  • petitioning the court for emancipation ( you may get a whole lot more than the ability to get consent to get vaccinated though…)
  • waiting until you are old enough to consent to get vaccinated without your parent’s permission

While waiting is likely the easiest option, since that leaves you at risk for getting a vaccine-preventable disease, you should probably think about talking to your parents.

Why don’t they want you to get vaccinated? Do they have specific concerns about side effects? Do they have a religious objection?

Vaccines are safe and necessary. Hopefully you can help your parents understand that and they will allow you to get caught up on all of your vaccines.

More on Getting Vaccinated If Your Parents Are Anti-Vaccine

Which Vaccines Don’t Prevent the Spread of a Disease?

As most folks know, Dr. Bob Sears has been put on probation by the California Medical Board.

Most vaccines don't prevent the spread of diseases?
Most vaccines don’t prevent the spread of disease???

Surprisingly, that hasn’t kept him from posting dangerous misinformation about vaccines, including his latest idea that “most vaccines don’t prevent the spread of a disease.”

Which Vaccines Don’t Prevent the Spread of a Disease?

If vaccines don’t prevent the spread of disease, then how did we eradicate, eliminate, and control so many diseases?

Dr. Bob Sears actually reassured parents that measles wasn't deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe - another well-nourished population with lower vaccination rates than the U.S.
At least seven people have died in Italy with measles over the last few years. That’s not so good for Italy.

When was the last time you saw someone with small pox, rubella, diphtheria, or polio, for example?

It is true that vaccines don’t prevent the spread of some infections though.

There is tetanus, for example, but guess what?

Tetanus isn’t contagious.

Any others?

Well, unlike most other vaccines, the meningococcal B vaccines are not thought to decrease nasal carriage of the meningococcal B bacteria. So if you are vaccinated and an asymptomatic carrier of the bacteria, you could theoretically spread it to someone else, as could someone who is unvaccinated.

Still, the MenB vaccines can protect you from getting actual meningococcal B disease, and if you don’t have meningococcemia or meningococcal meningitis, you won’t expose and spread it to someone else. That’s why the MenB vaccines are especially useful in outbreak situations.

Any others? After all, Dr. Bob did say that “most vaccines don’t prevent the spread of a disease.”

Vaccines That Don’t Prevent the Spread of a Disease

There are a few other examples of vaccines that don’t prevent the spread of a disease.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

Of course, any vaccine that is delayed or skipped won’t work to prevent the spread of a disease.

Just like they are seeing measles outbreaks and deaths now, because of low vaccination rates, in Ukraine there were 17,387 cases of diphtheria and 646 deaths from 1992 to 1997. Also high, were cases of measles (over 23,000 cases in 1993) and pertussis (almost 7,000 cases in 1993).

And because of waning immunity, vaccines don’t do as good a job of preventing the spread of pertussis and mumps as we would like. Still, that’s only when the vaccines don’t work, and even then, as Dr. Bob says, they do work to reduce the severity of symptoms.  During recent mumps outbreaks, the rates of complications are far below historical levels. The same is true for pertussis.

Have you ever seen or heard an unvaccinated child with pertussis? It is truly heartbreaking, especially when you realize how easily it could be prevented.

We typically see the same thing with flu. Even when the flu vaccine isn’t a good match or isn’t as effective as we would like, it still has a lot of benefits, including reducing your risk of dying.

“IPV induces very low levels of immunity in the intestine. As a result, when a person immunized with IPV is infected with wild poliovirus, the virus can still multiply inside the intestines and be shed in the faeces, risking continued circulation.”

Inactivated poliovirus vaccine

Does the fact that IPV, the inactivated polio vaccine, can sometimes lead to infections and shedding mean that it doesn’t prevent infections?

Of course not!

“IPV triggers an excellent protective immune response in most people.”

Inactivated poliovirus vaccine

Most people vaccinated with IPV will be immune, won’t get wild polio, and so won’t be able to get anyone else sick.

Vaccines reduce disease by direct protection of vaccinees and by indirect protection of nonimmune persons. Indirect protection depends on a reduction in infection transmission, and hence on protection (immunity) against infection, not just against disease. If a vaccine were to protect only against disease, and not at all against infection, then it would have no influence on infection transmission in the community and there would be no indirect protection (vaccination of one person would have no influence on any others in the community). It would be possible to reduce disease with such a vaccine but not to eradicate the infection.

Plotkin’s Vaccines

But because IPV doesn’t provide indirect protection, we still use OPV in parts of the world where polio is more of a problem.

Vaccines work. Even the few that don’t prevent the spread of infections, still help to reduce disease.

What’s the Difference Between Infections and Disease?

Wait, is there a difference between infection and disease?

Yes there is, something that Dr. Bob, who actually wrote a book about vaccines, seems to have overlooked.

An infection is simply the presence of a virus, bacteria, or other organism in your body.

A disease, on the other hand, is a virus or bacteria in your body causing signs and symptoms.

All vaccines work to prevent disease, or at least they do when you actually get vaccinated.

A very few don’t prevent infections and the spread of infections, but that is not a good reason to skip or delay your child’s vaccines. In fact, it is one of the reasons why it is important to have high vaccination rates! Even natural infections don’t always keep you from becoming asymptomatic carriers that can infected others. Many people who have natural typhoid (remember Typhoid Mary?) and hepatitis B infections go on to become chronic carriers without any symptoms, but still able to infect others.

If you understand that a few vaccines don’t prevent the spread of infections, then you should understand that you can’t hide in the herd and expect to be protected, even though most folks around you are vaccinated.

What to Know About Vaccines and the Spread of Disease

Despite what Dr. Bob says, almost all vaccines work to prevent the spread of disease and infections, at least they do when you get your kids vaccinated.

More on Vaccines and the Spread of Disease

How Anti-Vaccine Are You? Take Our Quiz.

It’s easy to be anti-vaccine when you are hiding in the herd. You don’t get vaccinated and you don’t vaccinate your kids, and instead, you simply rely on the fact that everyone else around you is vaccinated to protect you from vaccine-preventable diseases.

Would you vaccinate your high-risk child?
Would you vaccinate your high-risk child? Photo by Janko Ferlic.

Of course, this is a terrible strategy, as we are seeing with the increase in cases of measles and pertussis, etc. It is much better to learn about the importance and safety of vaccines, get fully vaccinated, and stop these outbreaks.

This hasn’t seemed to have deterred most anti-vaccine “experts” yet, as they continue to spout their anti-vaccine myths and misinformation and push their anti-vaccine talking points.

But as they continue to tell you that vaccines don’t work, how about asking what they would do in these ten high-risk situations?

Amazingly, some folks continue to try and justify skipping vaccines and accept the risk of disease, even when that risk is much higher than usual and they could be putting their child’s life in immediate danger!

How will you do with our quiz?

Would you choose to vaccinate in these situations?

1. Baby born to mother with hepatitis B.

You are pregnant and have chronic hepatitis B (positive for both HBsAg and HBeAg). Should your newborn baby get a hepatitis B shot and HBIG?

Background information:
Many anti-vaccine experts tell parents to skip their baby’s hepatitis B shot, saying it is dangerous, not necessary, or doesn’t work (typical anti-vax myths and misinformation).

However, it is well known that:

  • from 10 (HBeAg negative) to 90% (HBeAg positive) of infants who are born to a mother with chronic hepatitis B will become infected
  • 90% of infants who get hepatitis B from their mother at birth develop chronic infections
  • 25% of people with chronic hepatitis B infections die from liver failure and liver cancer
  • use of hepatitis B immune globulin (HBIG) and hepatitis B vaccine series greatly decreases a newborn’s risk of developing a hepatitis B infection (perinatal transmission of hepatitis B), especially if HBIG and the first hepatitis B shot is given within 12 hours of the baby being born

Would your newborn baby get a hepatitis B shot and HBIG?

2. Your child is bitten by a rabid dog.

Your toddler is bitten by a dog that is almost certainly rabid. Several wild animals in the area have been found to be rabid recently and the usual playful and well-mannered dog was acting strangely and died a few hours later. The dog was not vaccinated against rabies and unfortunately, the owners, fearing they would get in trouble, disappeared with the dead dog, so it can’t be quarantined. Should your child get a rabies shot?

Background information:
Although now uncommon in dogs, rabies still occurs in wild animals, including raccoons, skunks, bats, and foxes. These animals can then expose and infect unvaccinated dogs, cats, and ferrets, etc.

To help prevent rabies, which is not usually treatable, in addition to immediately cleaning the wound, people should get human rabies immune globulin (RIG) and rabies vaccine.

The rabies vaccine is given as a series of four doses on the day of exposure to the animal with suspected rabies and then again on days 3, 7, and 14.

Although rare in the United States, at least 1 to 3 people do still die of rabies each year. The rabies vaccine series and rabies immune globulin are preventative, however, without them, rabies is almost always fatal once you develop symptoms. A few people have survived with a new treatment, the Milwaukee protocol, without getting rabies shots, but many more have failed the treatment and have died.

Would your child get a rabies shot? What if he had picked up a rabid bat?

3. Traveling to Romania.

You are traveling to the Romania to see family with your 9-month-old baby. Neither of you have had the measles vaccine. Should you both get vaccinated before making the trip?

Background information:

Over the past few years, over 100 people have died in measles outbreaks across Europe, with many in Romania.

Although the first MMR vaccine is routinely given when children are 12 months old, it is now recommended that infants get vaccinated as early as age six months if they will be traveling out of the country.

Since the endemic spread of measles was stopped in 2000, almost all cases are now linked to unvaccinated travelers, some of whom start very large outbreaks that are hard to contain.

Would you both get vaccinated before making the trip?

4. Tetanus shot.

Your unvaccinated teen gets a very deep puncture wound while doing yard work. A few hours later, your neighbor comes by to give you an update on his wife who has been in the hospital all week. She has been diagnosed with tetanus. She had gotten sick after going yard work in the same area and has been moved to the ICU. Do you get him a tetanus shot?

Background information:
Most children get vaccinated against tetanus when they receive the 4 dose primary DTaP series, the DTaP booster at age 4-6 years, and the Tdap booster at age 11-12 years.

Unlike most other vaccine-preventable diseases, tetanus is not contagious. The spores of tetanus bacteria (Clostridium tetani) are instead found in the soil and in the intestines and feces of many animals, including dogs, cats, and horses, etc.

Although the tetanus spores are common in soil, they need low oxygen conditions to germinate. That’s why you aren’t at risk for tetanus every time your hands get dirty. A puncture wound creates the perfect conditions for tetanus though, especially a deep wound, as it will be hard to clean out the tiny tetanus spores, and there won’t be much oxygen at the inner parts of the wound.

These types of deep wounds that are associated with tetanus infections might including stepping on a nail, getting poked by a splinter or thorn, and animal bites, etc. Keep in mind that some of these things, like a cat bite, might put you at risk because you simply had dirt/tetanus spores on your skin, which get pushed deep into the wound when the cat bites you.

Symptoms of tetanus typically develop after about 8 days and might include classic lockjaw, neck stiffness, trouble swallowing, muscle spasms, and difficulty breathing. Even with treatment, tetanus is fatal in about 11% of people and recovery takes months.

Would you get your teen a tetanus shot?

5. Cocooning to protect baby from pertussis.

Both of your unvaccinated teens go to school with a personal belief vaccine exemption. You are due in a few months and are a little concerned about the new baby because there have been outbreaks of pertussis in the community, especially at their highschool. Should everyone in the family get a Tdap shot?

Background information:
Pertussis, or whooping cough, classically causes a cough that can last for weeks to months.

While often mild in teens and adults, pertussis can be life-threatening in newborns and infants. In fact, it is young children who often develop the classic high-pitched whooping sound as they try to breath after a long coughing fit.

In a recent outbreak of pertussis in California, 10 infants died. Almost all were less than 2 months old.

Since infants aren’t protected until they get at least three doses of a pertussis vaccine, usually at age 6 months, experts recommend a cocooning strategy to protect newborns and young infants from pertussis. With cocooning, all children, teens, and adults who will be around the baby are vaccinated against pertussis (and other vaccine-preventable diseases), so that they can’t catch pertussis and bring it home.

There is even evidence that a pregnancy dose of Tdap can help protect infants even more than waiting until after the baby is born to get a Tdap shot.

Would everyone in your family get a Tdap shot?

6. Nephew is getting chemotherapy.

Your nephew was just diagnosed with leukemia and is going to start chemotherapy. Your kids have never been vaccinated against chicken pox and haven’t had the disease either. Your brother asks that you get them vaccinated, since they are around their cousin very often and he doesn’t want to put him at risk.

Do you get your kids vaccinated with the chicken pox vaccine?

Background information:
Kids with cancer who are getting chemotherapy become very vulnerable to most vaccine-preventable diseases, whether it is measles, flu, or chicken pox.

According to the Immune Deficiency Foundation, “We want to create a ‘protective cocoon’ of immunized persons surrounding patients with primary immunodeficiency diseases so that they have less chance of being exposed to a potentially serious infection like influenza.”

Would your get your kids vaccinated with the chicken pox vaccine?

7. Outbreak of meningococcemia at your kid’s college.

Your child has just gone off to college. There is an outbreak of meningococcemia in her dorm (8 cases already). It is the strain that is included in the Menactra and Menveo vaccines, although she has not been vaccinated. Do you encourage her to get vaccinated?

Background information:
Neisseria meningitidis is a bacteria that can cause bacterial meningitis and sepsis (meningococcemia).

Depending on the type, it can occur either in teens and young adults (serogroups B, C, and Y) or infants (serogroup B).

Although not nearly as common as some other vaccine-preventable diseases, like measles or pertussis, it is one of the more deadly. Meningococcemia is fatal in up to 40% of cases and up to 20% of children and teens who survive a meningococcal infection might have hearing loss, loss of one or more limbs, or neurologic damage.

Meningococcal vaccines are available (Menactra and Menveo) and routinely given to older children and teens to help prevent meningococcal infections (serogroups A, C, Y and W-135). Other vaccines, Bexasero and Trumenba, protect against serogroup B and are recommended for high risk kids and anyone else who wants to decrease their risk of getting Men B disease.

Would you encourage her to get vaccinated against meningococcemia?

8. Cochlear implants.

Your preschooler has just received cochlear implants. Should he get the Prevnar and Pneumovax vaccines?

Background information:
Cochlear implants can put your child at increased risk for bacterial meningitis caused by the Streptococcus pneumoniae bacteria (pneumococcus).

Would he get vaccinated with Prevnar and Pneumovax, as he is no at high risk for pneumococcal disease?

9. Splenectomy

Your child is going to have his spleen removed to prevent complications of hereditary spherocytosis. Should he get the meningococcal and pneumococcal vaccines first?

Background information:
Without a spleen, kids are at risk for many bacterial infections, including severe infections caused by Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis bacteria.

In addition to their routine vaccines, kids with asplenia might need Menveo or Menactra, Bexsero or Trumenba (Men B), and Pneumovax 23.

Would your child get these vaccines that are recommended for kids with asplenia?

10. Ebola

Ebola is returning, but this time an experimental vaccine is available.

Background information:
There were nearly 30,000 cases and just over 11,000 deaths during the 2014-16 Ebola outbreak in West Africa.

You are in an area that is seeing an increasing number of Ebola cases and there is still no treatment for this deadly disease. An experimental vaccine is being offered.

Do you get the vaccine?

How Anti-Vaccine Are You?

It’s easy to be anti-vaccine when you are hiding in the herd – seemingly protected by all of the vaccinated people around you.

Would you still delay or skip a vaccine in a high-risk situation?

More on The Anti-Vaccine Quiz

Comparing Lightning Strikes to Measles Deaths

Have you ever heard that your child has more of a chance of getting hit by lightning than getting measles?

Since getting struck by lightning is rare, folks like to use it in comparisons to other things that they also think are low risk when trying to make a point.

There are problems with this type of argument though.

Understanding Risk Perception

In an age when many folks are overly anxious about things, it is important to understand the difference between real and perceived risks. Unfortunately, our biases often lead us to worry about the wrong things, sometimes with tragic consequences.

“No intervention is absolutely risk free. Even the journey to a physician’s office with the intention to receive a vaccination carries the risk of getting injured in an accident. With regards to risks of vaccination per se, one has to distinguish between real and perceived or alleged risks.”

Heininger on A risk–benefit analysis of vaccination

Vaccines have risks, but they are small risks, as we know that vaccines are safe and necessary and the decision to skip or delay your child’s vaccines carries with it a much greater risk.

Comparing Lightning Strikes to Vaccine Preventable Diseases

How common or rare do you think it is to get hit by lightning?

  • odds of being hit by lightning – 1 in 1,171,000 (each year)
  • odds of ever being hit by lightning – 1 in 14,600 (lifetime risk)
  • on average, 26 people die after being struck by lightning each year (since 2007), which is down from a recent historical average of 45 deaths per year (30 year average) and way down from when we used to see 400 lightning strike deaths each year before 1950
  • on average, 252 people are injured after being struck by lightning each year
Actually, just since 2000, at least 5 people have died of measles in Canada.
Actually, just since 2000, at least 6 people have died of measles in Canada.

Although 26 people dying after lightning strikes sounds like way too many to me, especially since one recent death was a 7-year-old boy in Tennessee playing under a tree, with 1 in 1,171,000 odds of getting hit, it sounds like we are pretty safe.

But is it fair to use those odds to justify your decision to keep your kids unvaccinated?

Of course not!

Why is our risk of getting struck by lightning so low?

What happens when we hear thunder or see lightning?

When Thunder Roars, Go Indoors!

What happens when a thunder storm approaches and you are at your kids soccer or baseball game?

“Postpone or suspend activity if a thunderstorm appears imminent before or during an activity or contest (irrespective of whether lightning is seen or thunder heard) until the hazard has passed. Signs of imminent thunderstorm activity are darkening clouds, high winds, and thunder or lightning activity.”

UIL on Lightning Safety

Many ball fields now have lightning detectors to alert officials of nearby storms. And just about everyone has access to weather apps on a smart phone that can alert them to an approaching thunder storm or nearby lightning strikes.

The point is that most of us understand that lightning is dangerous, so we go far out of our away to avoid getting hit. The risk of getting hit by lightning isn’t 1 in 1,171,000 with folks running around outside waving golf clubs in the air during thunder storms or sitting on their roofs under an umbrella watching the storm.

The risk of getting hit by lightning is 1 in 1,171,000 because most of us go inside once we know lightning is nearby.

“Based on the media reports of the fatal incidents, many victims were either headed to safety at the time of the fatal strike or were just steps away from safety. Continued efforts are needed to convince people to get inside a safe place before the lightning threat becomes significant. For many activities, situational awareness and proper planning are essential to safety.”

A Detailed Analysis of Lightning Deaths in the United States from 2006 through 2017

And the same is true with measles and other vaccine-preventable diseases. They aren’t as common as they once were because most of us are vaccinated and protected.

If you skip or delay your child’s vaccines, you will increase the risk that they will get one of these vaccine-preventable diseases. And you will increase the risk that they will get someone else sick.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

And if enough people don’t get vaccinated, herd immunity fails, and we will see a return of pre-vaccine era levels of disease.

What to Know About Vaccines and Risk Perception

Folks often misuse lightning strikes when they think about risks, not understanding that the risk of getting hit by lightning is low because we take a lot of precautions to avoid getting hit by lightning.

More on Vaccines and Risk Perception