Vaccines and health care, in general

I recently ventured back to Vox Popoli's blog, where an article/rant on the Evils of vaccines, which I knew would garner much fan-fare from his all-too-eager-to-please-the-master-Vox crowd, caught my attention.

Spoiled trust fund baby, Vox Popoli, rants a predictable conservative, religious diatribe on the evils of vaccinations.

In his typically hateful anti-female rhetoric, Popoli writes a response to Megan McArdle's article "More parents forgoing vaccinations." In her article, McArdle discusses the public health dangers that ride along with parents' refusals to vaccinate their children (which was based on a New York Times article about the same topic.

Popoli states at one point, in typical misinformed, unresearched fashion (in regards to McArdle):

"But your health isn't at risk if you've been vaccinated, right? What a loathsomely liberal fascist little cow! I truly don't know understand why Instapundit likes McArdle so much, she never writes anything even remotely intelligent and regularly coughs up hairballs of asininity like this. If the vaccine industry wasn't hiding so much information about the children being harmed by vaccines, if Congress wasn't indemnifying both the industry and the medical personnel who inject vaccines into non-consenting children, if millions of dollars weren't being paid out by VAERS, if there weren't very good medical reasons to avoid going along with the insane U.S. vaccination schedule, she still wouldn't have a point."

Note to Self #1: Self, if your "argument" isn't strong enough or backed up by any scientific sources, it is acceptable to call your opponent a "liberal fascist little cow" to try to prove your point.

Observe Popoli again doing this in Example #2:

"And there is no more evidence that vaccines are safe than there is that they cause autism, since the vaccine industry has resolutely resisted proper double-blind scientific studies into the safety of its products in favor of population surveys and metastudies of those surveys.

Don't get me wrong, vaccines aren't inherently bad. A limited and voluntary schedule of individual doses at a somewhat older age, spread out over time, is a perfectly reasonable program... in fact, that's how most adults over thirty today were vaccinated. But pumping infants full of toxins that have never been tested in combination with each other, 19 shots in the first six months, isn't just asking for trouble, it's demanding it."

I guess, once again, we should just take this Mensa member's word for it, regardless of the fact that he has no public health, medical, or scientific training or education. Or perhaps the fact that he is a man, and believes himself to be all-knowing, we should just take his word for it.

Bringing us to Note to Self #2: if your argument still isn't strong enough, it's acceptable to fall back on the trusty ole' "she's a woman, I'm a man, hear me roar" argument.

Anyway, the point of my article is not to debate the merits of vaccination programs. But, for the record, I think the benefits of requiring vaccinations for most vaccine-preventable diseases are in the best interests of public health. For libertarian-minded folks (as some of those who frequent Popoli's blog) this breaches their interest for society free from government control. A couple of them had decent points, for example a commenter named Bethyada:

"Beelzebub, I am very pro vaccination (though the US schedule sounds a little excessive). Yes the benefits for many (not necessarily all) vaccines are a group benefit. So what? You can't force law abiding citizens to place into their persons something just because you see the benefit.

Don't you see how draconian your position is? I would rather live with much more risk and less security and have my freedom. How much is life worth living as a slave to the well intentioned?

bethyada, do this because it is in your best interest even though you don't agree with me and it is best for the society.

You don't care for me other than how my cog best fits into your machine."

(I agree to disagree based on my own knowledge of public health and vaccines, but I can see his/her point from a libertarian ideology)

I will not, however, engage in the debate with obsessed uber-parents who are extremely misinformed on the topic and convinced that their primary care providers and their vaccines caused the slightest imperfection to their precious, previously perfect little Lambs of God. And luckily, in my job (public health for adults), I never have to.

Observe many of the comments over at Popoli's blog:

"For the children who are affected negatively by vaccines, it is definitely not in their best interest to have been vaccinated.

Obviously, the State is willing to take the risk of sacrificing some individuals. As usual, the risk for the individual is catastophic, while the risk to the State is negligible."

.
zeno | 03.25.08 - 7:40 am | #

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kids need to eat more dirt!
Rory | 03.25.08 - 7:22 am | #

I ate dirt when I was a toddler. I got sick every April and September.

...But it turns out that those months were the blooming seasons for the hedge in our backyard, to which I'm allergic. If my mom had paid a little more attention, I would have been VERY healthy.

Instead, my parents assumed that I was a "sickly child," and I got every shot known to man--which also made me sickly.
Mrs. Pilgrim | Homepage | 03.25.08 - 7:40 am | #

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STDs are a real current public health crisis. Perhaps chastity belts for the unlicensed?

Should people who engage in medically risky behavior be in the public venues?

If Abagail Adams saw today in 1776, she wouldn't write about the lack of women's representation as a glaring omission, but as the blessing of God's providence.

Men too can be stupid, but most don't insist on parading it in public.
tz | 03.25.08 - 8:12 am | #

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So what's the big deal with a few hundred or a few thousand kids being born autistic in a country of 300 million?
Eddie

So what's the big deal about a few thousand people getting (fill in disease here) from not getting vaccinated?

So what's the big deal about a few thousand people (out of a country of 300 million) getting killed from being in Iraq?

Something about having to break a few eggs.....

And the "big deal" is that the incidence rate of autism has risen exponentially over the past 10-15 years, indicating a direct cause-effect relationship.
Inquiring Minds | 03.25.08 - 9:23 am | #

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Well more droolie kids give them liberal douches more opportunity to show just how compassionate they is by having the police state stick a gun in my face and ask for some more "contributions" for "public health issues".
Michael Maier | 03.25.08 - 9:42 am | #

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...At the "two week check-up" (check-up for whom, exactly?) that same doctor informed us that she had a batch of "shots" ready for our two-week-old child and intended to administer a battery of vaccinations. I politely refused. She politely refused to accept my refusal.

I got less polite. And so did she.

I said, "You told us that you would support our decisions on these matters. That's why we chose you as our pediatrician!"

To which she replied, "It is your choice. But I never said I would support your decision. If you refuse these mandatory vaccinations, I can no longer be your pediatrician."

I calmly said, "Please hand me my child." When the child was in my arms, I said, "You can no longer be our pediatrician. It has nothing to do with mandatory anything. It's because you're a liar and a shill."...
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*end of comments*

It is sometimes frustrating to talk to people when it comes to their own health, and it is usually futile when it comes to talking to them about their children's health. The best we can do, as medical providers, is to give them current guidelines and practice current standards of care, and be up-to-date on the current research in our fields. But usually, people will follow where their prejudices lead. The mistrust and misunderstanding of the health care system and providers is so great in this country that it makes it difficult to establish a rapport between patients and providers.

I'm going to take a leap here and say that most health-care providers have a genuine interest in helping people be healthier and remain illness-free, or at least enhance quality of lives for their patients. Yet, those in private practices rely on money from insurance companies to turn a profit in their businesses, all while paying malpractice insurance with annual premiums that are sometimes in the six-figure range. In such a litigous society (especially one that makes it so easy to sue doctors and nurses for malpractice), they are bound by fears of losing their licenses, incomes, and means of support for themselves and their families.

Most medical practitioners maintain their practices under the current standards of care for their profession. If those standards (the CDC is the gold standard for immunizations, for example) are not met, then a patient may have a legal case against the provider for not following the currently accepted standard of care. The CDC's immunization schedule is the one that Vox Popoli and other, more adamant vaccine denialists disagree with. For medical providers this is often a no-win situation. Patients like the commenters on Popoli's blog are probably the same ones who would bitch and moan if there were a new epidemic of polio or measles and their children weren't vaccinated for them. They would probably then sue the medical providers for NOT mandating the vaccines.

I think further education is necessary. There are many, many misconceptions on the dangers of vaccines. (the autism/vaccine "link," expect an article on that topic later)

Doctors and nurse practitioners, while often accused of "playing God" in a negative way, are at the same time held up to those God-like expectations by their patients when they are sick. It is a double-standard that we have to accept. Patients expect their medical providers to know immediately what is wrong with them with often vague symptoms and tens of thousands of illnesses to choose from. If we get it wrong, they threaten a lawsuit, and at the very least, they leave the practice as patients.

From my perspective, the one thing I would ask from my patients, is to expect your medical provider to stay up-to-date on the latest professionally-accepted research and standards of care, and to remember that healthcare is a cooperative process. We will usually give you as many options as possible under the current standards of care. Most of us are no more trying to "play God," than we are genuinely concerned for your health, AND trying to avoid any potential lawsuits from an over-litigous society. Don't start your visit with your health-care provider on the defensive before you give them a fair chance. Don't go into the visit with a chip on your shoulder, because you will already alienate yourself from your provider, who would probably like to work WITH you to a better health outcome. While many aspects of health-care in the U.S. suck, don't take it out on your doctors and nurses. We are usually here to help.