Monday, March 18, 2013

For the herd's sake: Vaccinating Dear Boy

On Valentine's Day, Lovely Husband and I exchanged cards, murmured thanks for the other's love and commitment then went and allowed a stranger to stab holes in Dear Boy's arms. Nothing says I love you like a suite of immunisations. Of course, that's a throw-away line - but somewhere under the rhetoric, I think there's a kernel of truth: I love my son and want him to avoid preventable diseases; although I hate causing him a moment's pain, I'm willing to if it prevents weeks or months or a life of suffering.

Vaccination is apparently the third-rail of parenting discussions. It can be a sometimes awkward and sometimes downright nasty conversation killer. It can rub up against religious beliefs, parenting philosophies and approaches to life more generally. It can pit science against emotion: evidence against gut feelings. But it also brings up a lot of issues for me about the validity of numerous positions, about how we gain and evaluate knowledge and the difficulty of respecting other people's decisions when, to be frank, you're pretty sure they're just wrong (more on this below). But I figure it needs to be talked about. In Australia, at least, each set of parents has to make a deliberate decision about it: you either do it as prescribed; do it on a different schedule or you fill in all the paperwork for registering as a conscientious objector.

I am pro-vaccine for several reasons:

  1. I have faith in science (even though they get it wrong occasionally, they're usually capable of admitting that and fixing it, STAT). As a corollary of that, I believe vaccinations work. I know they're not 100% effective for all people, but they do for 90% plus. I know they can have a lot of side-effects, from the subtle to the serious, but I much prefer those odds than coping with the effects of the disease. The numbers are on my side (like my faith in science I have faith in statistics too). Science has effectively eradicated the worst of the preventable diseases where immunization rates are high. That's hundreds of thousands of lives saved in Australia alone and millions of cases prevented. (I think people who continue to preach about vaccinations causing autism are dangerous. They're among that breed of people who don't care about things like evidence, who listen to a charismatic preacher and take their word as gospel without bothering to check whether their ideas, their beliefs, their myths have any grounding in fact. The man who claimed he had proof lied. He made it up. It took a while but science got to the heart of it in the end.). As an academic I am torn between the positions of knowing how to research and accessing information in an objective sense and recognising that I am completely unqualified to make a truly informed decision about medical matters and need to rely on people who have trained extensively in these areas. In my area, which is the study of creativity, the same ideas apply. How do we really know something is creative? The answer is usually because the experts tell us it is. How many people truly understand that E=MC2? I don't and I'm a smart cookie. I read a book about it and everything. But I still don't really understand it, not in the way a physicist does. So I have to trust that when they say it's a fundamental principle, that it's right. I trust the 95% of medical professionals/organisations that say vaccinations work, vaccinations are good, vaccinations are necessary, even with the corollary problems and potential side-effects. I understand people will think that naive, but I believe it's naive to assume you can make a truly informed decision on this issue without any kind of medical training.
  2. My grandfather had polio and hasn't been able to use his right arm for most of his life. More than the physical impairment, there was also a social cost. Living at the time in rural Queensland, my grandfather was sent to a city hospital hours away to be quarantined in a disease ward with dozens of other children. He tells stories of rascally capers, but it was hardly ideal. He spent a long time away from his parents, from his family; he even picked up a smoking habit before he was ten; his schooling was interrupted. A friend we made recently at the library has watched the ongoing consequences of polio in her mum, in near constant pain now like so many polio sufferers with a post-polio syndrome.
  3. Vaccinations for kids are free in Australia. If they weren't, we'd pay.
  4. Vaccinating is the socially responsible thing to do. I pay taxes to help the government help those who can't help themselves and I follow the road rules so I don't injure myself and other people. I vaccinate because some people can't and need the services of the herd immunity. I think it's incredibly selfish to rely on others to take risks with their children's health and draw on all the benefits while at the same time putting the herd at greater risk. I don't understand why parents who are willing to protest against nuclear proliferation or gas-mining or whaling aren't also doing their part or putting their bodies on the line to protect their social/health environment. Not sure how conscientious the objectors are when non-vaccinated children and adults can create holes in the herd immunity and infect those who are either too young or too sick to have the required immunity to fight disease. 

So my dear, Dear Boy is fully immunised. We were a little late with the 12-month shots but only because the first clinic after the Christmas holidays was full by the time I booked in. We received a letter from Centrelink warning us about the withdrawal of benefits and potentially having to pay money back if we didn't keep up to date. Now, I am all for encouraging vaccination (which the government used to do financially with a vaccination bonus but this changed last year) as well as exclusion policies for non-vaccinated kids in childcare centres and schools when diseases are present, but having it tied to financial support is pretty rude. Punatively forcing parents to give back money already received is beyond the scope.

Here's how vaccinations have worked out for us:

Birth: Dear Boy was given Hep B (as well as the Vitamin K). I wasn't entirely sure the Hep B was necessary but Lovely Husband felt pretty strongly about it. Lovely Husband and I were both given Whooping Cough injections for free by a nurse who came around the wards, checking to see if anyone wanted them. My parents and brothers all paid to get them so they could visit. Our tiny newborn screwed up his face but that was about it. At that stage, it probably wasn't that much more of a shock to his system than lights, air, noise, etc.

Two Months - Dear Boy was given the Diptheria, Tetanus, Pertussis, Hep B, Poliomyelitis, HiB and Pneumococcal vaccines in two injections (one in each chunky thigh) and an oral Rotavirus dose. He squawked briefly then fell asleep for almost the whole day. I spent the day on the couch with him in my arms, freaking out (belief in science doesn't equate to being anxiety free, obviously).

Four Months - Same deal as the two-month ones: two needles and an oral dose. Dear Boy squawked loudly when he got the injections then squalled for about five minutes. No reactions, no temp.

Six months - Same again. Dear Boy let loose a howl of rage with the second needle but was distracted by toys. He was grisly most of the day, with a slight temp.* I had to do these ones on my own. Not fun.

Twelve months - Dear Boy didn't even make a noise for the first two needles (Measles, Mumps & Rubella and the HiB), in the arms for the first time because he'd started walking. He raged after the third, stingy Meningococcal C one but was fine after five minutes of cuddles and rough housing with Lovely Husband. I made sure Dear Boy couldn't see my face with these ones after reading about kids feeling more pain if they see their parent's anxiety. He had a mild fever that day, and then again about a week or so later, which is apparently quite common with the MMR.

So that's where we're up to so far. Next up is Chicken Pox at 18 months (unless he's already had it), then the pre-school boosters at 4 years old, and the high school boosters in Year 7 and 10. At the moment they're contemplating making it compulsory for boys to also have the Human Papilomavirus needle in Year 7 (currently only for girls). I am all for this for much the same reasons as above. Even though it won't prevent my own child from getting cervical cancer (because, well, der), it might save a girl/woman's life somewhere down the line.**

*Where he's had a fever, we'd given him doses of panadol. We never gave pain relief before the needles as some medical practitioners advise to do. Our healthcare nurse gave us a good argument for why it was essentially unnecessary for us, but may be necessary for other kids with complicated medical issues.
** The argument that girls shouldn't be given the HPV vaccine because it may encourage promiscuity is stupid. And factually incorrect. Sure, you may have religious grounds for not wanting to prevent (or even eradicate) the most common sexually transmitted disease, but cervical cancer kills approximately 5000 women each year in the US, some of whom are straight and married and Christian. It's men's promiscuity you need to do something about given they're more likely to be carriers and disseminate the disease.

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