Replies

I was talking about keeping focuses about the here and near future. Yeah, measles killed so many millions of people centuries ago. But at the same time, I don’t give a $&@; about the media fearmomgering on disease. Should I worry about the fact that I came two days away from giving measles from a failed vaccine to me to my seven year old cancerous sister, or just move on, because she died anyways. That’s exactly what I did, I moved forward from that, and my mother even more. I also weigh out risks, and frankly, with 95 percent of the population vaccinated, and a fraction of 1 percent not getting vaccinated for reasons other than health. Like I said, I weigh the risks, and measles now is less dangerous than antibiotic-resistant bugs or cancer. That’s here, that’s now. And I don’t like the fearmomgering antivaccine people who blow the negatives out of proportion anymore than the fearmomgering nuts who tell me everyone will die of measles.

Here and the near future can benefit from learning and remembering lessons from the past. Some old diseases can come back and for some vaccination remains our only defense. If there were only 1% not vaccinating for reasons other than health there wouldn't be a problem. We pro vaccine folks have had start speechifying because the anti-vaccine forces have actively pushed the overall vaccination rates too low. And they're fairly organized about it. And alas my back yard is reputed to be one of their strongholds. Chiropractic was invented here 120 years ago, their most prestigious temple to it is here and they are legion in numbers and political power here. I'm told by colleagues in vaccine providing specialties that many chiropractors encourage their customers not to get vaccinated. As a Dermatologist I don't dispense vaccines nor hear excuses against receiving them, so my testimony on that can only be hearsay. But we've certainly had many Pertussis outbreaks in schools around here.

My grandfather had polio 50 years before the vaccine and survived to become a physician with a paralyzed leg. And I heard tales from my father's medical school days of the polio wards of the 50s. So I grew up well aware of the consequences of then mostly preventable disease. Vaccines are statistical concepts, they don't claim to work for every individual. You didn't get measles because 'your' vaccine failed. You also got it because someone else exposed you to it who either also had vaccine failure or hadn't been vaccinated, and the same for whomever exposed him and so on ad nauseum back beyond the introduction of the vaccine. You got measles in spite of your vaccination. Prior to your vaccination you would have almost certainly have gotten measles, the only question would be when? You might have been over it well before your poor sister got cancer. Another bad thing you certainly had no control over. Bad things happen to good people. Why being a popular topic for philosophers and theologians forever. I don't claim to understand that, but hopefully your poor sister does, now.

You remind me of something that occurred in med school. I was on the Pediatric ward dealing mostly with cancer patients. I loved that rotation because I seemed to be a good luck charm; all my patients were tolerating treatment well and getting better. Memorable sweet, but tough kids. One day a teenage girl confessed to having had a rash for a couple days. She'd been too modest to let it be known she had it before. It look like chickenpox. She'd been playing with all the other cancer kids. It was the first time I'd ever seen my superiors panic. Fortunately it turned out she had herpes simplex, chickenpox's cousin, more widely spread than normal because of her own immunosuppression, but only spreadable through direct contact not through coughing. The location she'd been too modest to show, she hadn't been contacting the other kids so they were ok. And the first antiviral against that had just come out so she did fine as well.

She taught me the importance of keeping situationally dangerous infections away from vulnerable patients and that such wasn't a battle the doctors could fight alone. She should have reported her rash earlier. People who are sick should avoid exposure of not just immunosuppressed patients, but their immediate families. And where practical measures to reduce the rate of diseases in the general community may help prevent such diseases from reaching those most vulnerable. There are a lot more vulnerable folks now than in the past. That's a credit to medical improvements. People with diseases suppressing their immune systems are being kept alive much longer. And many autoimmune diseases are being greatly improved by medical immunosuppression. Also people are living longer and seeing age reduce their immune systems. We want to keep them all around as long and as well as we can. Simple public health measures, like vaccination, like an immigration system that excludes contagious people, are some of the ways we accomplish that. And when we so such not working properly we gripe and try to fix things. Yet try to be proportionate and not produce the "little boy cried wolf" syndrome. There are costs there too. Fearmongering of vaccine side effects, real or imagined, and resulting litigation have certainly increased the costs and thus reduced the cost-benefit ratio of vaccination. Political responses (including by HRC as first lady) have reduced the number of vaccine suppliers and further increased vaccine costs. Years of such nonsense have us vaccine defenders on edge.