Pity the small boy. When I was a lad, there were no vaccinations against measles, mumps and chicken pox, so when someone local had a dose of a disease I was marched round to be infected. I realise now that measles exposed me to around a 1 in 500 chance of death (see later), but there wasn’t much choice back then, and no doubt it was character forming.
Nowadays, of course, we have vaccines to do the job of small children. But as successful as campaigns have been in saving countless lives, some have aroused strong emotions, as a result of ticking several fear-factors. First, we inject healthy people, usually vulnerable children, and it’s imposed, either through pressure or by legal compulsion. If your child is to attend a kindergarten in, for example, Florida, they must have been vaccinated against the following: DTaP – diphtheria, tetanus, pertussis (whooping cough); Hepatitis B; MMR – measles, mumps, rubella (German measles); polio and varicella (chicken pox). Added to this is the fact that there can be side-effects. And finally, multinational corporations make a heap of money out of this mass medicalisation.
All of which is true. Little wonder, then, that claims that vaccination may cause adverse outcomes such as autism find a ready audience.
Health check
But we can work out roughly the risks without immunisation by tracking the course of a disease like measles over the decades. In England and Wales in 1940, just over a decade before I was born, there were 409,000 measles cases, of which 857 died – a ‘case fatality rate’ of 0.2%, which is also that quoted by the Centers for Disease Control and Prevention (CDC) in the US. In other words, the 1 in 500 chance of death I mentioned earlier. Vaccination started in the 1960s, and by 1990 the number of cases had dropped to 13,300 with one fatality. Since 1992, there have been no childhood deaths from measles in the UK, only as adult consequences from early infections.
So it seems rather a good thing to be vaccinated and, rather like stopping smoking, it is also good for the people around you. This is because of herd immunity, which means that sufficient people are immune so that an infection does not turn into an epidemic. The current English vaccination rates for measles (as of 2009) are 88%, up from 80% in 2003 – but still not back to the 92% level in 1995, let alone the 95% recommended by the World Health Organization (WHO). In 2010, US vaccination coverage for children between 19 and 35 months of age was below 90% in eleven states.
Measles is the first M in the MMR vaccination, and coverage went down after the highly publicised claim in 1998 that MMR was associated with autism. This has now been discredited, although it continues to have strong supporters in the US – just try searching on “vaccine autism”. And its impact continues to be felt far and wide. After an outbreak of measles in Liverpool in February 2012, the UK’s Health Protection Agency revealed that 7,000 children under five years of age had not received their full measles vaccine.
Risk assessment
The real problem is that with any mass intervention there will always be bad occurrences that happen around the time of the jab – essentially coincidences. For example, in September 2009 a headline in the UK newspaper Daily Mail declared that “Schoolgirl 14 dies after cervical cancer jab”, quoting the head teacher as saying, “During the session an unfortunate incident occurred and one of the girls suffered a rare, but extreme reaction to the vaccine.” Three days later reports revealed that the girl had cancer and the death was coincidental: however this was not headline news, and this tragic event is used repeatedly on websites as proof of the dangers of the HPV vaccine.
