So we may or may not have a guy with a worm in his brain running CDC or HHS. Time will tell. But it is clear that, for the moment, we have a guy with a famous last name who appears to be a vaccine skeptic, and who has the ear of the President-elect.
What’s up with that? Vaccines prevent childhood diseases. Shouldn’t they be as American as apple pie?
Yes. And no. Yes, because vaccines prevent childhood diseases and save many lives. No, because a segment of the population is convinced that vaccines cause illness and deaths on their own, and are widely recommended, not because of their ability to protect the public health, but because they make profit for some. Those some include the vaccine manufacturers and the medical- industrial complex of researchers and academics who move in and out of government, and are used by the manufacturers to make sure that their products are sold – to everyone. To some, getting all our kids immunized is the way we keep childhood diseases at bay. To others, getting all our kids immunized is the way the vaccine manufacturers make big bucks. Which they do, sometimes. If you can make a vaccine and sell it for $200 and every kid in the US has to have that vaccine in order to go to school, you stand to make $200 times 73 million kids, or $14.6 billion, which is more than chump change.
So what’s the skinny? Do vaccines work? Do they have big risks? Is some shadowy cabal trying to trick the American public into getting vaccines, just to make the big bucks?
Vaccines work. I know and have carefully studied the process by which vaccines are approved, which is a good but not a perfect process. I’ve looked at the evidence: I remain completely unconvinced that vaccines cause autism. Vaccines don’t cause autism. Or SIDS. Or developmental delays. The flu vaccine doesn’t cause the flu. The Covid-19 vaccine doesn’t cause sterility or contain microchips that allow you to be controlled by the Martians. And so forth.
On the other hand, every vaccine works by stimulating the immune system, and when you stimulate the immune system, sometimes it gets overstimulated and has unintended consequences, from allergic reactions to an inflammation of the heart and sudden cardiac death, to Guillain-Barre Syndrome, a very scary but usually temporary paralysis.
The truth is that vaccines work, are generally safe, but the social value of a particular vaccine depends on the risk of serious injury or death from the disease the vaccine prevents. Then there’s a second truth. It is also true that every vaccine ever invented will likely cause harm to a few people, from allergic reactions to paralysis or even death, and we are unlikely to predict who will be harmed, although most people, and society itself, benefits.
And all vaccines involve a difficult ethical tradeoff: vaccines work best to save lives when everyone is immunized, but when everyone is immunized some people who might have never been harmed by the disease will be harmed by the vaccine itself. But it is not clear to most of us how the decision to vaccinate everyone is made. What is clear is that few of us are involved in that decision making process.
When we choose to vaccinate everyone, we are choosing to protect the community at the expense of some individuals, regardless how safe and effective a particular vaccine has been shown to be. This tradeoff becomes more complicated when you consider profit and the decision-making process: how do we balance the notion that someone will be hurt from every single vaccine with the notion that someone else is profiting from the vaccine process. And how do we accept decisions to vaccinate everyone, when it is not clear who makes this decision at the end of the day. And what’s worse, we must acknowledge that almost all our decision processes may be significantly, and some would say unfairly, influenced by those who will profit from the decision to vaccinate everyone.
Underlying all the hype from both sides is a serious controversy: what’s more important, protecting the community or protecting individuals? Our culture struggles to answer this question and shifts in its understanding of what matters more over time. I suspect that the current controversy around vaccines is one part fear of a science that is rarely explained to normal people, one part fear of complications that result from all vaccines, one part distrust of government and whomever it is who makes these decisions, and one part a very healthy skepticism about the role of profit in driving all these decisions.
No person is an island. It would be a mistake to encourage the fears without emphasizing the benefits, which are real. And a mistake not to change some of our other processes, which frighten too many people unnecessarily.
