The Commentaries
Some commentators have said that the US have gotten
too used to medical success and forgotten what measles really is. Many of the
modern day parents were vaccinated against the disease as infants and have
never seen a case of measles or experienced its severe complications. Even the
prominent advocates of freedom of choice in America were vaccinated for measles
as kids. Since they don’t know what the disease is, they can afford to prevent
their kids from getting their shots. After all, a man cannot run when he
neither feels nor thinks something is chasing him. I do agree with the notion
that Americans are getting complacent with basic public health issues like
vaccination.
In Africa, we can barely afford such complacency. The horrors of
poorly treated and untreated measles are evident among us. We still see deaths
from measles. Vaccination rates in Nigeria for instance are between 50-79%,
80-89% for Ghana and less than 50% for South Sudan. So we cannot be accused of
complacency. Our problem may well be illiteracy and ignorance among parents who
refuse vaccination for their children. I long for the day when Africa can
afford to sit back and see measles conquered and driven out of the continent
like the former colonial masters were.
Another reason for American parents refusing
vaccination may be their lack of trust for medical science in general and the big
pharmaceutical companies in particular. Some Americans now feel that medical
science cannot be trusted; that doctors always hide information from their
patients; that medicine causes more harm than good; that the measles vaccine
causes more deaths than measles itself. Informed commentators like Dawn Babcock
Pabble have pointed out that the disease caused only 450 deaths per year in the
USA before the introduction of the vaccine. Such people may be missing the
point by looking at the death statistics alone. It goes beyond death. Anti-vaccination
campaigners seem to forget about the cases of deafness, blindness and mental
retardation caused by measles. They also seem to forget the amount of money
used to treat measles patients, the uncertainties and emotional trauma their
parents experience and the inevitable fear of death hanging over these
children. In addition, they forget the people who are already immuno-compromised or who have
leukemia. Such patients cannot take any vaccine and depend on the immunity of others to
survive. They are therefore at risk of dying if others do not get vaccinated.
The
anti-vaccination guys also point out that these vaccines are manufactured by
large pharmaceutical giants who rake in huge profits annually. Could this be
the reason why they continually push more vaccines to the public so that their
owners can get wealthier? Some may posit that probably, there are no inherent
benefits in these vaccines. Though such suspicions are understandable, it
amounts to paranoia when there are no hard facts to support them. While it may be
true that the vaccine makers make more money than they should, should we stop using their products that have been scientifically proven
to save lives? The Americans and indeed the whole world may be suffering from
“informational gluttony” or information overload.
This leads to the issue of unhindered public access
to junk science as well as access to compromised studies like the Wakefield
study. In the past, medical science was limited to doctors and people in the
medical community. Now, anyone can simply go to the internet and “whip” up 20
causes of anemia in less than a minute. While this trend may be considered
beneficial to all concerned, caution must be applied. The internet has not only
made correct information accessible but has also put a lot of incorrect facts
out there. People will generally believe what they choose to believe and when a
lie is repeatedly told, it begins to sound like the truth. This may be a major
reason why American parents are beginning to believe that vaccines are
dangerous and should be avoided. They are ignorant of the scientific fact that
the incidence of measles in America is still relatively low because of the herd
immunity they currently enjoy. This herd immunity is derived from the large number
of people that are already immunized. However, when more and more kids refuse
immunization, this herd immunity will be gradually eroded. Then the Americans
may find themselves back in the pre-1963 era. That is the danger that they are
subjecting themselves and the rest of the world to.
(If this were
an African country, the major news stations in the West will be shouting
themselves hoarse about how primitive Africans are by now. I still remember how
Nigeria kept on appearing on the map of “Ebola countries” in one international news
station even after the country had been declared Ebola free by the World Health
Organization (WHO). I hope no one will accuse me of reverse discrimination. I simply
cannot afford the cost of litigation.)
Talking about cost, the ballooning cost of
healthcare in the USA has also not helped the pro-vaccination cause. With
healthcare getting more expensive, and health insurance companies struggling to
stay afloat, it will not come as a surprise that Americans are thinking of cutting
down their medical bills. A major contributor to this health costs may be the
several tests conducted and treatments given to patients that are simply not
needed. More access to medical knowledge has made doctors prescribe more and
more drugs to avoid future litigations. This has pushed the health cost higher
and higher. Though vaccination is covered by standard health insurance, many
Americans feel that the current immunization schedule is not set up in an
optimal cost effective way. One American parent complained of his child getting 23 vaccination shots in just one year compared to the 8 shots he had in
the 80s when growing up! Are ALL
of these vaccines necessary or are Americans just simply been extravagant
because they have “excess” medical knowledge? It is unlikely that an African
parent will subject his/her child to such torture in the name of preventing
diseases. So, if a parent disagrees with this schedule, he/she may be excused.
The real solution though may be to reduce the
current vaccination regimen to acceptable levels. Isn’t it possible to remove
some of the inoculations? The notion that one size fits all may actually be a
dangerous one and may be the cause of the adverse reactions that is often
talked about. The future of safer measles vaccination may lie in the ability of
medical science to make vaccinations individualized through the use of genetics
and molecular biology.
The Politicians
Funny as it may sound, some opposition
politicians have latched onto the vaccination saga to score cheap political
points. It is shocking that even first world politicians will stoop so low as
to use just about anything to discredit the Obama administration. While I
cannot give judgment on his health policies, I erroneously thought that only
African politicians play such mischievous “politricks”. New Jersey Governor
Chris Christie and Kentucky Senator Rand Paul both stand out in this hall of
shame. Governor Chris Christie initially stated publicly that parents should
have "some measure of choice" in vaccinating their children and
Senator Rand Paul called the decision not to vaccinate "an issue of
freedom.
" Freedom!!!??? When a person’s freedom endangers the life of
other people’s children it ceases to be freedom. It becomes an assault! If
people have the freedom not to vaccinate their children, then drunk drivers
should be allowed on the roads and smokers allowed to smoke on commercial
flights. The remarks of these two gentlemen have stoked the controversy further
and given impetus to the anti-vaccination movement.
Here in Africa, it has also
been reported that highly influential figures deny their children vaccination
as well. This accounts for the presence of polio in Nigeria till date. Americans
should be wary of such politicians as Christie and Rand who seem to want to
take them back to the dark ages by their statements. They should probably watch
out for them in 2016 when they launch their respective presidential campaigns.
Risks, Benefits and the Middle Ground
It must be realized at this point that
there are risks as well as benefits to the measles vaccination. A proper
risk-benefit analysis should be conducted to determine the full extent of this.
In highlighting the risks of
vaccination, it is important to recall that the association between measles
vaccine and autism has been scientifically disproved several times. That leaves
the incidence of adverse reactions like febrile convulsions and
thrombocytopenia purpura. Since these are relatively rare, isn’t it wiser to
still give the vaccine and prevent blindness, deafness, mental retardation and
death?
The anti-vaccination camp will wisely
remind us all that the “rare” cases of febrile seizures and thrombocytopenia
purpura are not just cases. Rather, they are children born to loving parents,
with siblings and other caring relatives. Should they become sacrificial lambs
for the good of society? In the same vein, the pro-vaccination camp will
probably retort “is it better to endanger the entire population and spend
millions of dollars to treat and rehabilitate measles patients because an
infinitesimal few will get thrombocytopenia purpura?”
The middle ground here will be to ask “how
committed is the medical community to making vaccines safer for the populace?”
If vaccines are made safer, then there will be less adverse effects or no
adverse effects. Then the anti-vaccination guys will probably be convinced to
allow their children get vaccinated. Then this whole debate will end and
Americans will begin to behave like the responsible people they are known to
be. Then I can stop writing this article and go to sleep.
If wishes were horses, beggars they say
will ride. The debate will probably go on forever because vaccines may never be
100% safe. No drug can ever be 100% free of side effects. (Though, I still
recall one of my lecturers in medical school saying “never use the word ‘never’
in medicine”). But as Africans, we must draw some lessons from the measles
debacle in America.
Firstly, we should strive to eradicate
measles by encouraging vaccination. Maybe then, we can begin to consider opting
out of vaccination. Next, politics should never be allowed to come between
proven medical science and the lives of our citizens. We should also educate
our populace by regularly giving out correct and factual health information. Next,
we should remember that good Patient care does not necessarily mean doing more
tests and prescribing more medication but rather optimizing available resources
to achieve good health. Finally, we should never take success for granted and
become complacent like the Americans seem to be doing.
I rest my case.
Thanks for reading this rather long post. See you again......
I will like to highlight the recent 7.8 magnitude earthquake in Nepal. I am quite sure you are aware of the details. I will not focus on the fact that presently over 3700 people are dead,7000 injured and millions of dollars worth of infrastructure destroyed. The death toll is rising by the minute.
