You're not just a freeloader if you don't vaccinate your kids

I just found out from listening to the Skeptic's Guide to the Universe that Time magazine graciously printed a very good article about the crank-based questions about vaccinations. There are many things to love about this article, but what I think gave me a moment of dark humor was this part:

Some parents have taken to cherry-picking vaccines, leaving out only the shots they believe their children don't need—such as those for chicken pox and hepatitis B—and keeping up with what they see as the life-or-death ones. But that can be a high-stakes game, as Kelly Lacek, a Pennsylvania mother of three, learned. She stopped vaccinating her 2-month-old son Matthew when her chiropractor raised questions about mercury in the shots. Three years later, she came home to find the little boy feverish and gasping for breath. Emergency-room doctors couldn't find the cause—until one experienced physician finally asked the right question. "He took one look at Matthew and asked me if he was fully vaccinated," says Lacek. "I said no." It turned out Matthew had been infected with Hib, bacteria that causes meningitis, swelling of the airway and, in severe cases, swelling of the brain tissue. After relying on a breathing tube for several days, Matthew recovered without any neurological effects, and a grateful Lacek immediately got him and his siblings up to date on their immunizations. "I am angry that people are promoting not getting vaccinated and messing with people's lives like that," she now says.

Emphasis mine. We can all have a dark laugh at the fact that chiropractors are part of the problem---why wouldn't one form of crankery promote another?---only because the little boy had no lasting damage. But what if he had? How many other small children are being put at risk because parents erroneously believe that vaccinations are bad because some guy in a white coat pretending to be a doctor said so? Or because they read that vaccinations cause autism on the internets? After all, the cranks yell louder than the people talking sense, which makes them more believable sometimes. (Believe me, I know---both anti-choicers spreading misinformation about abortion and creationists spreading lies about evolutionary theory are very adept at dominating search engine results and seeming like they know what they're talking about when they don't.)

Information that isn't surprising: Paranoia about vaccinations causing autism is groundless.

In 2001, however, a U.S. Food and Drug Administration study revealed that a 6-month-old receiving the recommended complement of childhood vaccinations was exposed to total levels of vaccine-based mercury twice as high as the amount the epa considers safe in a diet that includes fish. By the end of that year, thimerosal-free formulations of the five inoculations that included it—hepatitis B, diphtheria, tetanus and pertussis and some versions of Haemophilus influenzae type b (Hib)—had replaced the older versions. The result was a drop in mercury exposure in fully immunized 6-month-old babies from 187.5 micrograms to just trace amounts still found in some flu vaccines. Yet there's been no effect on autism rates. In the seven years since the cleaned-up vaccines were introduced, new cases of autism continue to climb, reaching a rate of 1 in every 150 8-year-olds today. That trend suggests that other factors, including heightened awareness of the condition and possible genetic anomalies or environmental exposures, are behind the climbing rates. What's more, in the decade since Wakefield's watershed paper, 10 of its 13 authors have retracted their hypothesis, admitting that the study did not produce solid enough evidence to support a connection between the measles virus in the MMR vaccine and autism......

In 2003, a 15-person committee impaneled by the CDC and the National Institutes of Health analyzed the available studies on thimerosal and its possible connections to autism and concluded that there was no scientific evidence to support the link. In a further show of confidence, the committee noted that it did "not consider a significant investment in studies of the theoretical vaccine-autism connection to be useful." Instead, the panel recommended that studies focus on less explored genetic or biological explanations for the disease.

Of course, one sign of crankery is moving goalposts. Since childhood vaccinations don't cause autism, then they must do something else really bad, right? Something to justify not going back and putting your child (and yourself) through one series after another of shots that cause crying and crankiness? One more assault on all those attempts to be organic, hormone-free, and all-natural? Maybe vaccinations are just bad for your immune system in a bit of "oh the irony!" cosmic karma?

Nope.

There is also little evidence to support the claim made by antivaccine activists that the battery of shots kids receive can damage the immune system rather than strengthen it. Experts stress that it's not the number of inoculations that matters but the number of immune-stimulating antigens—or proteins—in them. Thanks to a better understanding of which viral or bacterial proteins are best at activating the immune system, that number has plummeted. The original smallpox injection alone packed 200 different immune-alerting antigens in a single shot. Today there are only 150 antigens in all 15 or so shots babies get before they are 6 months old. "The notion that too many vaccines can overwhelm the immune system is just not based on good science," says Dr. Paul Offit, chief of infectious diseases at Children's Hospital in Philadelphia.

Obviously, asking questions and pushing for more, better science is good. It led to improvements in the current round of vaccinations, and could lead to improvements in the future. What's not cool is shirking your responsibility to vaccinate your children. As many people note, vaccinations work in part because they increase herd immunity, so getting vaccinations for yourself and your children is part of being a good citizen. But maybe you don't care about being a good citizen that much. Maybe you think there's a struggle between doing what's good for your child and what's good for the community. Maybe you've heard about free loading---the ability of unvaccinated to escape disease because all those sheeple out there have done their duty and gotten their kids vaccinated, creating herd immunity---and you think, "I get the best of both worlds. No shots for my kids and no need to worry about exposure."

Well, think again. A combination no doubt of lack of health insurance and the shirking of vaccination duties because of fears of autism has meant that we have a gap in the vaccination schedule---in a country with high mobility, and lots of immigration and international travel. Herd immunity is far from bulletproof in these circumstances. Not vaccinating your child isn't about just avoiding free loading; it's about avoiding real disease that have understood and preventable causes.

As immunization rates drop, that protection grows thinner. That's what happened in the current measles outbreaks in the western U.S., and that's what happened in Nigeria in 2001, when religious and political leaders convinced parents that polio vaccines were dangerous and their kids should not receive them. Over the next six years, not only did Nigerian infection rates increase 30-fold, but the disease also broke free and ranged out to 10 other countries, many of which had previously been polio-free.

Vaccination crankery is far from a harmless pleasure cruise, or a security blanket for parents seeking answers for why their kids have autism. It injures and it kills. And I think that it harms the parents of autistic kids by causing them to chase unicorns. One such victim is interviewed:

"There is no doubt in my mind that my child's first cause of autism is the mercury in vaccines," says Ginny DeLeo, a New York science teacher whose son Evan, born in 1993, was developing normally until he was a year old. The day the boy received his fourth dose of Hib vaccine, DeLeo had to rush him to the hospital with tremors and a 104 deg F (40 deg C) fever, which later led to seizures. Evan recovered, and several months later he received the first of two MMR shots. Within months, he stopped talking, and autism was diagnosed.

It's hard to predict what the fallout will be for this woman who believes something that's not true because it gives her some immediate relief for her pain. Maybe nothing will happen. But maybe she'll be consumed with bitterness, or distracted from what she needs to do, which is move on and start coping with her problems. Already she's showing those signs of hardening in an irrational belief, expressing an unwillingness to entertain doubt up front. There is the path that leads to problems.