It remains with me after all these years: the barking, barking, the continuous barking in a Queens apartment that sounded like a strangled seal. I don’t know how Ivan didn’t break his ribs or rip his insides apart. It must have been near the end of his illness. My parents wouldn’t have allowed me near him if they thought he was still contagious.
By this time, whooping cough, a once prevalent and deadly disease, was rapidly disappearing. Today it is virtually unknown in the US, but the situation is different worldwide. Today nearly 50 million people still suffer from pertussis and nearly a third of a million die from it annually.
Chances are you won’t know the terror the sound brings. Unless you live in Smithtown, about twenty miles from my home, that is. On the first day of summer, thirteen students were reported to have contracted the disease. This followed an alert issued in October in the same area when a nurse in a maternity ward was diagnosed with whooping cough. Fortunately, no infants contracted the illness, and for teenagers whooping cough is seldom fatal.
The thing about pertussis is that it is the only vaccine-preventable disease in which there is an increasing number of deaths in the U.S. The reason, it seems, is that some parents are opting out of having their infants immunized.
Reasons for non-compliance with immunization are several, including religious objection to certain medical procedures to an ideological opposition to government mandates. But the biggest reason is the fear that inoculations are related to the increased rate of autism. Figures for autism have risen dramatically since the 1960s.
No one cause has been found to be the culprit but many point to a host of environmental factors. Vaccination mandates for infants is counted as one possible cause. The concern is that infants’ immunize systems are too weak to handle the barrage of shots (the CDC recommends 69 doses of 16 vaccines; typically children receive 28 shots for 15 illnesses by the age of 2) to which children are subjected. How these vaccines interact with one another hasn’t been determined.
According to the Long Island Press, only the shot for measles, mumps and rubella (MMR) has been studied for its association with autism (none was found). http://www.longislandpress.com/2011/06/23/a-look-inside-the-immunization-dilemma/ Most vaccines and their ingredients and their interactions with one another haven’t been tested for their association with autism.
The concern for the dramatic increase in autism is understandable. It is a frightening prospect for a parent to have an autistic child. The cause(s) of the rising numbers will be difficult to uncover, just as they have been in the fight against breast cancer.
Years ago women on Long Island were similarly concerned about the apparent high rate of breast cancer here. Certain that environmental causes were at play, their organized to bring the matter to the attention of the public and successfully petitioned to devote money to research. Strides have been made in the field of breast cancer since the founding the New York State-wide Breast Cancer Hotline and Support Program at Adelphi University) thirty one years ago. http://www.adelphi.edu/nysbreastcancer/ What still hasn’t been determined is which, if any, environmental factors play a role in breast cancer. What had seemed fairly clear at the beginning—contaminated water, overhead electric lines, etc.—turned out not to be primary factors.
The causes of breast cancer are multiple and complex, as I suspect will be the causes of autism. Meanwhile, what is a new parent to do? The pull to refuse inoculations is strong. Why put your child at risk at all, a reasonable parent can well ask. All good parents want to protect their children from harm. Only bad or negligent parents would do otherwise. Since the science is hard to sort out and the pictures of autism are heartbreaking, the reasonable course appears to be to err on the side of caution.
But erring on which side? The problem is that we know what autism is like but few know what the diseases that are prevented by the vaccine regimen are like. If parents lived through a smallpox epidemic or a polio outbreak or heard whooping cough like I did, then their emotional responses to possible outcomes would be balanced. Right now they are not and therefore they are inclined to see autism as the greater threat.
There is another factor at work in choosing not to inoculate a child. As long as everyone else’s child is vaccinated, any given child is safe even without an inoculation. This is known as community or herd immunity — the higher the percentage of individuals who are immunized, the smaller the number of susceptible individuals will come into contact with an infectious individual. Herd immunity has been compromised by increasing numbers of parents who refuse to inoculate their children out of concern for their safety.
Opting out, however, puts other children at risk for the very illnesses for which immunization was put in place. This is true for whooping cough; measles and mumps also seem to be making a comeback.
Society can tolerate small numbers of conscientious objectors to public health measures. But there is also good reason to compel people to take risks that serve the greater good. The ethical problem is that what one parent deems to be in the best interest of his or her child may endanger the welfare of someone else’s child.
Many serious and fatal childhood diseases have been eliminated in my lifetime due to immunization and the program needs to continue. At the same time, sustained and objective research has to go forward to looking at the full spectrum of risks that childhood vaccinations may entail and finding safe methods of protecting all children.