(S)Icky Urban Moms

Peter Burkholder — Mon, 24 Sep 2007 19:44:00 -0700

In the last few days I’ve been perusing the DC Urban Moms site trying to track down a childcare situation for my younger son that isn’t as depressing as his current one. Although I try to stay focused on the task at hand, I have a hard time not getting distracted by the gorge-inducing discussions on hiring admission consultants for preschool at Sidwell Friends or today’s doozy on avoiding vaccinations. I couldn’t hold my tounge and had to respond to this:

I know that there is not currently clear scientific support for the autism theory or any other negative effects from the recommended vaccine schedule. But it just seems like a lot to me and with all the anecdotal evidence … I’d rather be safe than sorry, particularly since it doesn’t hurt anything to delay them.

with this:

Doesn’t hurt anything to delay them….unless your child dies.
There are several things that trouble me about this thread. One issue is the weighing of anecdotal vs. statistical evidence (and evaluation of risk), the second issue is ethical.

With regards to evidence and risk, the hesitation seems to be based on unsubstantiated ties to autism, or substantiated but rare adverse reactions. With respect to MMR, note that as recently as the 1989-1991, 123 children died from measles (“http://www.metrokc.gov/health/immunization/compare.htm”). In 1994, and outbreak leading to 294 cases started among skiers at Breckenridge, so it ‘snot just the hoi polloi who are susceptible (http://www.cdc.gov/mmwr/preview/mmwrhtml/00032422.htm). More outbreaks are listed at http://www.cdc.gov/nip/diseases/measles/history.htm#global

In contrast to the real chances of catching the disease, especially in DC with the large population of people travelling worldwide, the adverse reactions are in the 1 in 1,000,000 range (ibid, metrokc.gov). Frankly, if kids of DCUM aren’t getting vaccinated, then you should list that in your playgroup info so you stay away from each other. The risks from measles alone are real and the evidence is hard to deny.
The ethical issue regards herd immunity. If immunity rates are over 94% (http://en.wikipedia.org/wiki/Herd_immunity) then measles won’t be able to spread through a population. In the case where a vaccination poses a remote risk of side effects, it’s tempting to forgo the vaccination and rely on immunity of the herd to protect you. However, if the immunity level falls below a certain threshold (somewhere between 83% and 94%) then all the unimmunized are at risk. By choosing to delay or avoid a vaccine, you risk pushing the immunization rate below that threshold, and you are putting at risk just not your own child, but all those who could not get vaccinated or for whom the vaccine did not provide immunity. And that just seems wrong.

Ellipsis: (S)Icky Urban Moms

(S)Icky Urban Moms