The Wonderful World of Measles

I remember when the Rubella vaccine was invented. My elementary school must have thought it was the greatest thing, and they arranged a mass vaccination. It was with foreboding and dread that I carried home to my mother the permission form by which the puncturing of my precious flesh with subsequent pain would be enabled. I quivered and pled long and dearly with my mother to forgo the vaccination, but the next day saw me trudging back to school with signed permission in hand. 

Vaccines gave me a childhood blissfully free of worry over the common childhood diseases feared by every generation that had preceded me going back thousands of years. My adult life has been pretty much worry free as well. What happened then? Why did we just experience a mini-epidemic of measles, a disease preventable by vaccine since 1963?

Trust

Vaccination is an act of faith. Most of us lack the technical expertise and facilities do our own research and prove to ourselves that vaccines are effective and safe. We lack time to read the scientific literature bearing on the issue. Instead, we trust. We trust our doctors to be informed and tell us the right thing to do. We trust (do we?) scientists from government agencies such as the Centers for Disease Control and Prevention to keep up with the latest research and keep our doctors informed. We trust our elected officials to fund and properly staff these efforts. 

The world is imperfect and authority figures are not always worthy of trust. Events such as Love Canal, the Watergate Scandal, the Poisoning of Michigan and the ensuing PBB Crisis, the Financial Crisis of 2008, and many more events involving betrayal of public trust remind us that a healthy skepticism is valuable. 

Familiarity

It seems ironic that growing up in a world free of childhood disease has resulted in a generation of parents without the needed perspective to balance any lack of trust and cynicism toward medicine and government. My mother knew the loss of a sibling from childhood disease. I myself grew up across the street from a boy just enough older to have been born and struck by polio before any vaccine had been invented and made available. 

My mother knew exactly why I was to be vaccinated. Once glance out the window and across the street provided all the reinforcement necessary, as did surely her memories of a lost sibling. Mothers today lack that terrifying familiarity with the deadly and disfiguring diseases that vaccines are defending us against. Our very success has given us room in which to indulge our doubts. 

Compulsion and Worldview

Penalties from bad decisions can fall to the innocent, raising the question of compulsion. Infected infants too young to receive the measles vaccine have paid a price in suffering imposed by those who've indulged in forgoing their own vaccinations. Do we compel citizens to be vaccinated? Can we make room for exceptions? How much "room" is the right amount?

The scientific method can lead us to vaccines and quantify their risks and benefits and costs. We blend that data with values from our worldview to produce decisions. Do we suggest that infants be kept home for their first year until they can safely be vaccinated? Or do we as a society agree to be vaccinated so as to allow infants some safety in public? These questions are not answerable by the scientific method. Their answers derive from our worldview and the values it engenders. 

As for Me and My House...

Some decisions are so important they must be made correctly, as this father in New Zealand found the hard way. Joshua knew this when he challenged the people just before entering the promised land. Diseases like measles can rampage through a society, and good faith means nothing. We must be correct in our decisions to vaccinate or not. 

Decades of freedom from fear over once-common diseases like measles and polio seem to have given many in society the mental-latitude needed to rationalize an anti-vaccine stance. Some room can be made to accommodate strong beliefs, but not if those beliefs become widespread, not when they are wrong and widespread.

Balancing our modern cynicism should be a healthy fear of what communicable diseases such as measles can do and how fast they can spread and how many they can hurt. We've lost the fear. Our grandparents had it, and we are perhaps the worse off for having lost it. Those questioning vaccines against measles might do well to have a sit-down with their grandparents. 



Epilog: I hold fond memories of growing up in the City of Detroit across the street from the Berlinski family. Perry Berlinski suffered lifelong the effects from being stricken by Polio before any vaccine was available. His sister Pam with two of her friends taught me to ride bicycle without training wheels, an occasion that remains one of my most vivid childhood memories. Andy Berlinski was the younger brother, spending many lazy afternoons practicing his catching skills by bouncing a ball off the side of our brick house and catching it in his baseball mitt. Perry's impact lives on as I frequently cite him in helping my kids and their friends understand the life-giving benefits of vaccines and the dangerous game that it is to avoid them.