anti-vaxxers aren’t just killing their own kids — they're putting others in danger, too
every year, children die because someone they never met chose not to get vaccinated
7 minute read
a vial of oral polio vaccine
ezra acayan/getty images
vancouver is currently trying to contain a measles outbreak that has racked up 13 confirmed cases thus far, and may have spread into alberta.
as with all the other measles outbreaks in the developed world of late, it has been driven exclusively by falling vaccination rates among the general populace.
below, a quick guide to why canada’s unvaccinated aren’t endangering just themselves.
unvaccinated people are definitely causing these outbreaks
a driver who decides to forego a seatbelt endangers themselves. a driver who decides to drive drunk endangers others. while the unvaccinated may often think they fit in the former category, they’re squarely in the latter. by refusing to immunize, an unvaccinated person turns themselves into a vessel for a preventable infectious disease.
western canada is currently in the grip of a measles outbreak imported to canada by international travellers. one of them was an unvaccinated 11-year-old boy who picked up the disease on a vacation to vietnam. had he been vaccinated against measles, he would almost certainly have returned without incident. but as it is, he became the carrier of what blossomed into a regional public health crisis.
the more unvaccinated people in a population, meanwhile, the easier it is for a disease to spread. if a measles-infected person steps onto a bus carrying eight unvaccinated passengers, those eight now become potential carriers themselves. this is why refusing vaccinations is different than other health decisions. a cancer patient who refuses to undergo chemotherapy doesn’t risk spreading their cancer to others. but an unvaccinated person stepping onto an airliner could be unwittingly passing a potentially fatal illness to someone they’ve never met.
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some people can’t be immunized
this is the most important point in all of this: there is a demographic of innocent people who, despite taking every precaution, can be sickened or killed if they happen to share a day care, public bus or hospital ward with an unvaccinated person. infants can’t be vaccinated for the first few months of life. vaccines also don’t work for people with compromised immune systems, be they chemotherapy patients or those with autoimmune diseases. the centres for disease control actually curates a lengthy list of those who cannot be vaccinated for medical reasons, and it includes pregnant women, people with tuberculosis, people with bleeding disorders and those with severe allergies.
in a society where more than 90 per cent of people are immunized, all these categories of people are protected because there aren’t enough carriers of the disease for it to gain a foothold, a phenomenon known as “herd immunity.” when vaccination rates drop, however, infants and the immunosuppressed suddenly find themselves surrounded by people who are potential carriers of preventable infectious diseases.
it’s no accident that some of the united states’ worst measles outbreaks in recent years have seized amish or orthodox jewish communities where vaccination rates were particularly low. as australia’s centre for human bioethics concluded in a recent paper, “opting out of vaccination can result in a significant risk of harm and death to others, especially infants and the immunosuppressed.”
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the unvaccinated are indeed killing innocent people who tried to protect themselves
europe currently holds the dubious distinction of being the world’s centre for vaccine skepticism. in a 2016 survey, up to 41 per cent of the population of france did not believe that vaccines are safe. as a direct result of this increasing abandonment of immunization, europe has recently been seized by outbreaks of preventable diseases. in just the first six months of 2018, 41,000 europeans came down with the measles, and 37 died. the disease was a bigger killer than terrorism for that year, and as always, deaths and severe complications were disproportionately suffered by infants and the immunocompromised.
one recent casualty was ioana czegledi, a nine-year-old romanian girl with a compromised immune system who caught measles during a routine visit to a pediatric hospital. “i only brought her into the hospital when it was absolutely necessary,” her mother told npr.
a particularly insidious belief among anti-vaxxers and the “vaccine-hesitant” is that diseases like measles aren’t that bad. this has even prompted the growth of “measles parties,” where parents willingly expose their unvaccinated children to the disease to “get it over with.” but measles isn’t the chicken pox: one in five cases require hospitalization and it kills roughly one in every 350 to 1,200 cases. in madagascar, a recent outbreak fuelled by low vaccination rates has killed 800.
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worldwide, measles claims roughly 100,000 mostly children people per year, a death toll that is nevertheless down dramatically from the 2.6 million it used to claim in the pre-vaccination era.
without immunization, preventable diseases could absolutely surge back to 1930s levels
alberta is famously the world’s largest rat-free jurisdiction, and it got that way through hard work: rats routinely try to enter the province via the saskatchewan border or by hitchhiking aboard trucks. however, any time a rat is spotted in alberta, it prompts a military-grade response to kill it and any other rats in the surrounding area. it may seem overzealous, but if alberta’s rat patrollers slacked for only a few months, the rodents would be free to gain the foothold they enjoy in every other corner of the settled world.
infectious, vaccine-preventable diseases are similar: without public vigilance towards immunization, there’s no reason they can’t return with just as much deadliness as in the pre-vaccination age. it was not too long ago that a vaccine-preventable disease, diphtheria, was canada’s leading cause of childhood death. any canadian over 90 is the survivor of an age in which they could reasonably expect classmates to disappear because a sudden diphtheria infection had choked them to death. before the measles vaccine, the united states used to see it kill 500 people per year and hospitalize 48,000 others. even polio, which currently exists only in small corners of africa and central asia, could conceivably explode once again into canadian schools and hospital wards if it was allowed to sweep freely through countries filled with the unvaccinated.
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the damage from a single unvaccinated child can be overwhelming
in 2015, a single, measles-infected person spent the day at disneyland. nobody knows who they are, where they got the measles or even if they knew they were carrying the disease when they decided to visit the happiest place on earth. that single measles carrier ended up causing an outbreak that sickened 147 people in cases ranging from canada to mexico to seven u.s. states.
in canada, calls are rising for mandatory vaccination of children, with 70 per cent saying it should be a requirement to enter the public school system. legal professionals in both canad and the united statesare weighing the legality of suing the unvaccinated for damages. if these actions all seem a bit heavy-handed, it’s because of the immense damage that unvaccinated people can do to civil society. even if nobody is permanently injured or killed by the current outbreak, it has spawned a minor crisis as public health officials scramble to arrest the spread of the disease before it gets out of control. measles is one of the world’s most infectious diseases, and any public place visited by a measles carrier is suspect.
after an employee at a richmond toys “r” us became a confirmed measles case, vancouver coastal health had to quickly warn customers and employees of the toy store that they or their children could be next. earlier this year, b.c. children’s hospital had to put out a public alert warning parents that their already-sick children may have been exposed to measles because they shared a waiting room with a known measles patient. all of this could ultimately have been sparked by fewer than four unvaccinated people who picked up measles in south asia. and this kind of response isn’t cheap: a smaller outbreak in arizona ultimately cost us$800,000 before it was stopped.
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vaccine-injured children aren’t a myth, but the risk is overwhelmingly outweighed by the benefits
every year, seatbelts are estimated to save 15,000 lives in the united state alone. in rare circumstances, a seatbelt can also kill you. since 1990, an average of 1.5 u.s. children per year are killed by seatbelt entanglement.
naturally, 1.5 is a much smaller number than 15,000, so public health professionals continue to widely recommend universal seat belt use. similarly, although immunization has singularly sent whole global plagues into retreat, sometimes a shot goes wrong. this is almost exclusively in the form of rashes, fever or allergic reaction, although in rare (roughly one in a million) cases a vaccine can spark a lifelong disability. canadian public health professionals keep close tabs on every incident of vaccine injury, and in the united states there is even a no-fault compensation program for those injured by vaccines (no such national program exists in canada, although there have been calls to implement one).
the measles vaccine is also particularly safe. of 102 million doses of mmr (measles, mumps, rubella) vaccine administered to americans between 2006 and 2017, only 120 resulted in payouts from the national vaccine injury compensation program. according to one estimate, it is approximately 6,000 times more dangerous to get measles than to receive the measles vaccine. this is roughly the difference in risk between going for a jog or driving in a grand prix race.
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despite this, the prospect of vaccine injury often emboldens anti-vaccination communities, sometimes with catastrophic results. the philippines was recently subject to revelations that a newly introduced dengue fever immunization might make the disease worse if patients hadn’t previously contracted the illness. the scandal caused vaccine trust to plummet across the country, directly spawning an ongoing measles outbreak that has already killed 130 people and may possibly be at the root of other outbreaks along the north american west coast.
• twitter: tristinhopper | email: thopper@nationalpost.com
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