Monday, July 21, 2008

Bad Actor, Smart Parent

Via Salon.com's "Broadsheet" blog: Amanda Peet isn't as annoying as I thought. I may have to start categorizing her as "smart person, bad actor".

The issue? She smacked down Jenny McCarthy (okay, perhaps an instance of using an elephant gun on a mosquito) over the issue of childhood immunizations (McCarthy blames them for her son's autism). Peet apparently said that people who don't immunize their children are "parasites" because they're taking advantage of the fact that nearly everyone else has immunized their children. She has since apologized for the use of the "parasites" word, but hasn't backed off her basic point.

I believe that people who do not immunize their children are freeloaders (my choice of word is a little less nasty than "parasite" but perhaps meaner in terms of judging intentions) — they can only get away with this because the nasty diseases are kept at bay by everyone else being immunized. Yes, there are risks associated with immunizations (autism, though, has been shown again and again to not be one of them); but those risks are very small in absolute terms, and they're even smaller when compared to the alternative: if enough people don't vaccinate their kids (and "enough" may be as small a number as 15%), then we could easily see epidemics of diseases that we thought were conquered in the US during the 1950s.

I predict that within the next ten years, some hyper-crunchy (Waldorf or similar) no-one-here-is-immunized school will be laid low (or worse, wiped out) in a viral outbreak that would have been prevented by simple immunization. I just hope that that event will end this anti-immunization fad once and for all.

4 comments:

Raven said...

I won't speak for other people, but as new parents, it's not a question of immunize or not, but rather immunize safely.

We're not anti-immunization parents, but we are staggering our daughter's shots, and this is because after researching the topic, we don't feel public health officials have proven that it's safe to inject babies with the CDC's prescribed number of vaccines in the suggested timeframe. If you know of any long-term studies completed by the CDC that assess the long-term effects of its immunization schedule, I'd like to see them.

As it is, we've found scant hard data explaining the recent explosion of neurologic and immune system disorders in children. And I don't know that it has been shown "again and again" that vaccines are not a causal or contributing factor in Autism. I know there was a New England Journal of Medicine study from 2002 that posited that the MMR shot did not cause Autism, but there was also some concern about some of the author's ties to a vaccine manufacturer and statistical adjusting. As I understand it, the latest autism research is trending toward multiple causes, including pollution and viruses (vaccine and non-vaccine).

Ultimately, we want to immunize our child safely and aim to do whatever we can to do so. To that end, we're absolutely believe in immunizing as advised for Pertussis, Diphtheria, Tetanus, and Polio. For the other vaccines, we will stagger and request modifications, specifically no vaccines that contain thimerosal and no live virus vaccines.

Cecily said...

As a well-intentioned, somewhat educated parent it stings to see such harsh terms as parasite and freeloader used to describe and judge parents who opt out of immunizations. Although I'm not a complete freeloader, I am walking a fine line between that and what I assume would be labeled as a responsible parent because while I've chosen to have my child immunized for some diseases, I am opting to not have her immunized for others and/or to not follow the rigid CDC immunization schedule for the remaining vaccines.

In my opinion, this is not a black-and-white issue (regardless of what Amanda Peet says), and I'm always sad to see people's harsh judgements focused on parents who are simply trying to protect their children. It's not my intent to minimize the concerns of those without children because I realize we all share a concern about public heatlh issues. However, my belief is only a parent knows the frustration of searching for a doctor who will give them a straight answer that can be backed up by actual data. Only a parent knows the dissatisfaction of hearing over and over again the regurgitated CDC/AAP schpiel. Only a parent knows the fear of being armed with little more than inconclusive, often conflicting, data against these inflexible doctors who sometimes refuse you as a patient (actually they refuse your child as a patient) if they sense any possibility you may question their opinions. And only a parent knows the piercing pain of watching your 2 month old being injected with 7 vaccines in one visit - vaccines which contain aluminum, mercury, human fetal lung cells, cow heart-muscle extract, monkey kidney cells, and on and on and on. Freeloader or parasite, I'm the only advocate my child has and while many parents fold under the peer pressure, there are more and more of us who are simply unwilling to be bullied and silenced by the medical community. This is my job as a parent and as a responsible citizen.

I can appreciate the concern those of us on the other side of this issue may cause you but I also understand why some parents opt out all together. There is very little conclusive data about vaccines and there probably never will be because that would require parents to offer up their children as test cases.

Where our focus should be is on the inflexible, defensive medical community who often backs parents into corners, humiliates them, and uses scare tactics to force us to buy into their one-size-fits all set of vaccines and their dangerous immunization schedule. It's only been very recently that we've gotten confirmation from some within the medical community that they also do not follow the prescribed schedule and have concerns with the side effects of and ingredients in today's vaccines.

Please understand it's not my intent to provoke an argument, but this is a complex issue and I don't think it benefits any of us to look at it as an either/or issue. I'm sure some will attack my point of view and that's okay, I'm used to being dismissed or ridiculed on this topic. My only hope in writing this is to show you and others a different perspective on this emotional issue. I hope you take my comments in the spirit that they are intended.

rantingnerd said...

> Raven said...
>
> I won't speak for other people, but as new parents, it's not a
> question of immunize or not, but rather immunize safely.
>
> We're not anti-immunization parents, but we are staggering our
> daughter's shots, and this is because after researching the topic, we
> don't feel public health officials have proven that it's safe to
> inject babies with the CDC's prescribed number of vaccines in the
> suggested timeframe. If you know of any long-term studies completed by
> the CDC that assess the long-term effects of its immunization
> schedule, I'd like to see them.

I don't know of any such studies; I'd be very interested in seeing
them, if they exist.

I think spacing out immunizations makes a lot of sense -- it certainly
can't hurt -- and would never argue otherwise.

I'm on record (I think somewhere in the Ranting Nerd archives) as
saying that the state of medical "science" is pretty dismal. I have
no idea why so many immunizations are put together. I keep thinking
that it's got to be profit somewhere -- but I'd think that vaccine
companies would rather have more shots and charge more. (Maybe it was
cost control from the governmental side?)

> As it is, we've found scant hard data explaining the recent
> explosion of neurologic and immune system disorders in children.

Heavy metal accumulation seems to be a possible culprit (which is why
the thimoseral claim was important to address). But no one knows.

> And
> I don't know that it has been shown "again and again" that vaccines
> are not a causal or contributing factor in Autism.

Thimoseral has been shown to be a null agent. Plenty of countries
(Japan, if I remember correctly, and many of the Scandinavian
countries) got rid of thimoseral preservatives many years ago (in the
late 1990s) and autism rates have not come down. Autism rates or
onset times are not appreciably different between places that have
different immunization schedules.

> I know there was
> a New England Journal of Medicine study from 2002 that posited that
> the MMR shot did not cause Autism, but there was also some concern
> about some of the author's ties to a vaccine manufacturer and
> statistical adjusting. As I understand it, the latest autism
> research is trending toward multiple causes, including pollution and
> viruses (vaccine and non-vaccine).

Plus heavy-metal accumulations, as I mentioned above.

> Ultimately, we want to immunize our child safely and aim to do
> whatever we can to do so. To that end, we're absolutely believe in
> immunizing as advised for Pertussis, Diphtheria, Tetanus, and Polio.
> For the other vaccines, we will stagger and request modifications,
> specifically no vaccines that contain thimerosal and no live virus
> vaccines.

That sounds eminently reasonable.

rantingnerd said...

Cecily --

It sounds like you have run into some rigid and
obnoxious doctors, and you have my deepest
sympathies on that score. Doctors should work
with their patients, not against them.

Providing more information should be a basic job
duty of a doctor (especially a pediatrician).
Spacing out vaccination shots seems eminently
reasonable, and doctors should be flexible on
that.

The medical community (or "complex" if you want to
be snarkier) is historically very resistant to
patient participation, and nearly as resistant to
new research that tells them that their practices
have to change. (This is slowly changing over the
past couple of decades, but there's a long long
way to go.)

Medicine in the US also has a very nasty past
(forced sterilization in the name of eugenics,
lobotomies performed by the truckload, and the
Tuskeegee Experiment are just the tip of that
particular iceberg). People have some really
good
reasons to distrust the medical community
and the US Government on these things.

The only way out of this twisty maze is good
scientific research, and more of it. I've run
into (and am related to, or am related-by-marriage
to) a number of people who don't understand what
"good science" means. And this has led them to
believe things which are unsupported by data, or
contradicted by data, or are simply demonstrably
false.

Scientists have a huge educational gap to
overcome. And research organizations have a
credibility problem given their obfuscatory ways.
That doesn't mean there isn't good data out there.
Which means that your doctors should know it and
be able to provide it!



At the risk of sounding like a heartless economist
for a moment, the cost-benefit tradeoff for any
individual family is clearly against
vaccination: the potential downside (under current
conditions in the US) of any one child not being
vaccinated is miniscule, while the benefit of not
vaccinating (in the form of avoiding clear and
present [if small] risks from vaccination) is
manifestly larger.

The problems with this formulation are twofold.

One problem is pragmatic -- if enough people don't
immunize, we'd have epidemics coming back. And
"enough" is much smaller than you might think --
possibly as small a fraction as 10% not immunized
might allow an epidemic to sweep through. And
anyone not immunized would then at higher risk.
So push this onto the "higher cost" part of the
ledger -- anyone not immunizing against a
particular pathogen is betting that enough other
people will, to keep everyone safe, so that
they can avoid the risks of immunization.

(My deep fear is that we could see epidemics of
diseases we haven't seen in the US for 50 years,
diseases which most doctors haven't been trained
to treat. My nephew contracted whooping cough
[pertussis] a few years ago [and gave it to his
77-year-old-grandmother, too] and it took quite a
while for the doctors to diagnose it, because none
of them had ever seen it!)

Another problem with the cost-benefit formulation
is a moral argument (hopefully shorn of the
hyperbolic and incendiary name-calling this time):
What do you owe your neighbors in terms of
preventing an epidemic?


My question for you is: if polio, diphtheria,
pertussis, and other diseases were rampant, would
you take the small risk of side effects (a much
smaller risk than contracting the disease itself)
in order to immunize your child?