Vaccines

There's a lot of chatter, both in Canada and worldwide, about vaccinations. The spotlight is heavily on anti-vaccine proponents and parents, while those parties are pushing back against that criticism.

To top it all off, last week the Toronto Star ran what many in the scientific/medical community are describing as a tone-deaf scare piece lacking context or scientific merit. The Star's initial response ranged from nonsensical to arrogantly dismissive, but they have since printed a rebuttal piece put forth by medical experts and admitted fault in the presentation of the piece, while still defending the substance of it.

A few comments on the state of the discussion:

1) Vaccines - at least the recommended ones - work.

Full stop, vaccines work. Any piece on vaccinations that doesn't include something along these lines somewhere is simply wrong. MMR works. Gardasil works. The flu shot works. They all work to reduce the incidence of the diseases they're meant to vaccinate against.

2) Vaccines are safe, by any reasonable definition of that word.

Most reactions to vaccines are annoying but benign. No one likes redness, swelling, or tenderness around their injection site, which is the most common reaction to vaccines. A self-limiting fever or muscle pain can also occur with some vaccines. These aren't fun, but no one's in real danger from these reactions.

In some vaccines, there is a very small chance of an allergic reaction, of fainting, or having a seizure. These are serious concerns, but they are very rare and people are generally asked to stay in the clinic in case something like that does occur. These rare side-effects can be managed, which is why it's advised that people stay in whatever clinic gave them the vaccine for 15 minutes or so, just in case that happens. The chance of long-term disability or death from these events is highly unlikely if managed properly.

More serious events have been reported. However, their incidence rate is so low that it's uncertain that the vaccine played any role. More importantly, even if they did play a role, there's a greater likelihood of that person being struck by lightening than experiencing one of these debilitating side-effects.

I feel pretty safe walking around, even though I might be struck by lightening. Vaccines are safe.

3) Not all vaccines are equally effective.

While all the recommended vaccines work, not all of them work as well as we'd like them to. The MMR vaccine is very effective. Gardasil works well against a few select strains of HPV and those strains are certainly the ones we'd most like to protect against, but there are other strains of HPV that it doesn't protect against. The flu shot has variable effectiveness each year, though even in the worst years, does do a reasonable job of reducing the chances of catching the flu.

Despite the variable effectiveness, everyone should have all these vaccines. They all protect against diseases nobody wants and (see above), they're safe. Still, it's worth acknowledging that not all vaccines are created equal.

4) It's ok for parents to have concerns about vaccines.

Being a parent is scary. You want the best for your children and there's a lot of conflicting information out about virtually every subject. Vaccines are no exception. It's reasonable for parents to have concerns. These shouldn't be dismissed, and it shouldn't be denied that vaccines do carry a risk, albeit an incredibly small one. Parents listen to reason when they feel they're not under attack. The best advocates for vaccines take their time with resistant parents, explain their position without accusing the parents of doing something wrong, and are pleasant but persistent. They don't accept the parent's conclusion, but do accept the parent's motives - which, in the vast majority of cases, are to do what's best for their children.

The worst advocates for vaccines kick the kids of non-vaccinating parents out of their practice. They give up the only element of influence they have over non-vaccinating parents: a sympathetic ear from a medical expert interested in their children's well-being.

5) Authoritative sources - physicians, professors, the media - should be held to a higher standard.

The Toronto Star is getting piled onto because they're a visible, credible voice in this discussion and they got things wrong. Very wrong. Melody Torcolacci, a professor at Queen's, is under fire for promoting unsubstantiated views on vaccines in a university course. A cardiologist in the US is being harshly criticized for taking an anti-vaccination view.

I'm in full support of the unyielding criticism of these actors. These sources have a responsibility to tell the truth and should know better than to present falsehoods as fact. Some even stand to profit off these views, by spreading fear without justification. Concerned parents aren't the problem - the people making a living off disseminating fear and doubt without evidence are.