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Vac­ci­na­tion has been the biggest suc­cess sto­ry in mod­ern med­i­cine. Vac­ci­na­tion has been so suc­cess­ful that many peo­ple have nev­er ever heard of dis­eases like diph­the­ria and pertussis—diseases that were once major killers of chil­dren. As a result, many peo­ple doubt that vac­ci­na­tions are nec­es­sary. Yet vac­ci­na­tions work best if they are giv­en to prac­ti­cal­ly every­one.

If enough peo­ple are immu­nized against a dis­ease, that dis­ease can no longer cir­cu­late with­in the pop­u­la­tion. If we vac­ci­nate enough peo­ple against a dis­ease that hap­pens only in human beings, we can dri­ve that dis­ease into extinc­tion. Once a dis­ease is extinct, we no longer need to vac­ci­nate any­one against it. So the ulti­mate goal of near­ly all vac­ci­na­tion pro­grams should be to make the vac­cine itself unnec­es­sary.

As long as vac­ci­na­tion has been avail­able, there has been a vocal move­ment of peo­ple who are against vac­ci­na­tion. Most of these peo­ple have some self­ish motive for speak­ing out against vac­cines. Many of them are sell­ing some form of alter­na­tive med­i­cine. Some of them are faith heal­ers who want you to put mon­ey in their col­lec­tion plate. Oth­ers are sell­ing over­priced vit­a­mins and untest­ed herbal reme­dies over the Inter­net. Some anti­vac­ci­na­tion activists make their liv­ing by run­ning some sort of anti­vac­ci­na­tion advo­ca­cy orga­ni­za­tion. To get you to sup­port them finan­cial­ly, all of these peo­ple have to destroy your trust in your fam­i­ly doc­tor. Yet by doing so, they are under­min­ing pub­lic health.

Whom would you trust for advice about vaccinations, the professor or the movie star?
Whom should you trust for advice about vac­ci­na­tions, the pro­fes­sor or the movie star?

Whom should you trust when you have ques­tions about health care? If you were one of the cast­aways on Gilligan’s Island, whom would you have asked for med­ical advice: the Pro­fes­sor or the movie star? The cast­aways on Gilligan’s Island knew that they could trust the Pro­fes­sor. They knew that the Pro­fes­sor was bril­liant and well edu­cat­ed, and that he used his knowl­edge unselfish­ly to serve oth­ers. In con­trast, they would nev­er dream of ask­ing the movie star Gin­ger Grant for advice about sci­ence and health. They all loved Gin­ger, but they knew that she was poor­ly edu­cat­ed, that she loved atten­tion, and that she could be manip­u­la­tive.

Unfor­tu­nate­ly, many peo­ple would rather be seduced by a glam­orous movie star than edu­cat­ed by a pro­fes­sor. Thus, when they need advice about vac­ci­na­tions, they ignore pro­fes­sors. They assume that all pro­fes­sors are mere­ly the ser­vants of the greedy rich man. Instead, many peo­ple take med­ical advice from glam­orous celebri­ties and from peo­ple who sell over­priced vit­a­mins and untest­ed herbal reme­dies over the Inter­net. Unfor­tu­nate­ly, these celebri­ties and snake-oil mer­chants are scar­ing peo­ple away from vac­ci­na­tion. As a result, chil­dren and even some adults are suf­fer­ing and some­times even dying of pre­ventable dis­ease.

Many peo­ple want to turn to nat­ur­al or tra­di­tion­al ways to pro­mote health and pre­vent dis­ease. How­ev­er, vac­ci­na­tion is used to pro­tect us against the dis­eases that are a major threat to your child’s health, even if your child is well-fed. These dis­eases were seri­ous prob­lems back even when every­one breast­fed their babies and fed their fam­i­lies noth­ing but home­grown, home­made organ­ic food. So even if you are a “crunchy mama,” your chil­dren should still get all of the rec­om­mend­ed vac­ci­na­tions.

In gen­er­al, the vac­cine-pre­ventable dis­eases are caused by germs that can spread eas­i­ly from per­son to per­son (or that can be car­ried by mos­qui­toes) and that eas­i­ly sneak past the body’s innate immune sys­tem. The innate immune sys­tem is a prim­i­tive, gen­er­al-pur­pose sys­tem that attacks any­thing that looks for­eign to the body. Vac­ci­na­tion alerts the oth­er part of your immune sys­tem: the part that learns to rec­og­nize spe­cif­ic germs and mount a spe­cif­ic defense against them. Vac­cines give you the gift of time. They allow your body to rec­og­nize and destroy a dan­ger­ous germ right away, rather than let­ting the germ run ram­pant through your body for sev­er­al weeks. As a result, you become immune to a dis­ease with­out hav­ing to have the dis­ease first.

The anti­vac­ci­na­tion move­ment is a symp­tom of a larg­er prob­lem: the fail­ure of many of our social insti­tu­tions and the result­ing break­down of trust in those insti­tu­tions. Many peo­ple feel that health pol­i­cy is being dri­ven by the prof­it motive of the health­care indus­try. As a result, they sus­pect that vac­ci­na­tion is just a rack­et. At best, they imag­ine that vac­ci­na­tions are being sold to the pub­lic sim­ply to make mon­ey. At worst, they imag­ine that the vac­cines are serv­ing some sort of weird agen­da out of a sci­ence fic­tion movie.

In No More Measles!, I explain the basic facts about infec­tious dis­eases and vac­ci­na­tions. I explain how vac­cine pol­i­cy in the Unit­ed States is made. The Food and Drug Admin­is­tra­tion decides which vac­cines should be avail­able. The Cen­ters for Dis­ease Con­trol and Prevention’s Advi­so­ry Com­mit­tee on Immu­niza­tion Prac­tices decides which vac­cines should be rec­om­mend­ed. (Both of these insti­tu­tions take con­cerns about vac­cine safe­ty seri­ous­ly. Vac­cines have been refor­mu­lat­ed or tak­en off the mar­ket because of con­cerns over the­o­ret­i­cal risks or very rare side effects.) Both the FDA and the CDC are ulti­mate­ly con­trolled by Con­gress, which gives them their fund­ing and pass­es laws that spell out what they must do. How­ev­er, the U.S. fed­er­al gov­ern­ment does not reg­u­late doc­tors or med­ical prac­tice. Instead, the state gov­ern­ments then decide who should be allowed to give vac­ci­na­tions and who must receive them. For exam­ple, the state gov­ern­ment may require chil­dren to get all of the rec­om­mend­ed vac­cines before the child enters pub­lic school.

fdr-children-warm-springs
In 1921, Franklin Delano Roo­sevelt was par­a­lyzed by an ill­ness that was thought to be polio (but may have been Guil­lain-Bar­ré syn­drome). In 1927, he estab­lished a hos­pi­tal in Warm Springs, Geor­gia, to care for par­a­lyzed chil­dren. In 1938, while he was Pres­i­dent of the Unit­ed States, he launched a nation­wide cam­paign that sup­port­ed the devel­op­ment of the vac­cine that is wip­ing out polio.

Back in the 1930s, the Amer­i­can peo­ple became unit­ed in the strug­gle against polio. Dur­ing the Great Depres­sion, ordi­nary peo­ple sent their dimes march­ing to Wash­ing­ton, DC to sup­port the Nation­al Foun­da­tion for Infan­tile Paral­y­sis, which then became known as the March of Dimes. After the polio vac­cines stopped the spread of polio in the Unit­ed States, the March of Dimes turned its atten­tion to pre­vent­ing birth defects.

Unfor­tu­nate­ly, we have lost that sense of shared mis­sion. To me, it is most dis­turb­ing that peo­ple on the polit­i­cal left are becom­ing increas­ing­ly hos­tile to vac­ci­na­tion. The peo­ple on the left are sup­posed to pro­vide the polit­i­cal sup­port for pub­lic health. If the peo­ple on the left do not stand up for chil­dren and the poor, who will?

As in the 1930s, ordi­nary peo­ple need to get involved in the strug­gle to erad­i­cate infec­tious dis­eases. Small­pox is gone. Polio is almost gone. Measles and rubel­la are next in line for erad­i­ca­tion. Once these dis­eases have been wiped off the face of the earth, we can safe­ly stop vac­ci­nat­ing chil­dren against them. But it would be mad­ness to stop vac­ci­nat­ing before then.