A Pox on All Our Houses

Vaccination talk has been the latest flashpoint on the all the social media sites we pretend we don’t check four times a day. The facts surrounding vaccinations haven’t changed, so I do not really know why it is the current topic du jour. It just must be something in the air. (Get it? Discussing infectious diseases? Something in the air? GET IT? Don’t worry. I will be here all week.) I have friends firmly rooted on both sides of the equation. Get them in a room talking about needles and the rotavirus and they will only agree on one thing – it is an important issue. And they are right, it is. Perhaps if I were wise I would stay out the discussion. But in all the reporting on reports, blogging about the feelings and posting about the posts, I haven’t heard a voice that represents my perspective. And so today, (on a day that I hope we can all remember we LOVE each other and it is alright to disagree) I am going to explain why I vaccinate my children and why I hope, pray, and plead that my community (and yours) chooses to do the same. PS. Not the shortest or happiest thing I have ever written. I promise to talk about something frothy and light tomorrow.

Viewed from a late night and a laptop, much of the worlds’ history looks like nothing so much as a quaint diorama with dark edges. A time when people were burned for witchcraft, the forests were full of fairies and there were monsters at the edge of a flat world. We think, with our packaged food and store bought air, that humanity has journeyed so far from the places it once was. It is easy to forget that each new age has been more enlightened than the one that came before it (except for you, Dark Ages), and that perhaps that doesn’t mean much at all. I am glad I was born in the 20th century, I much prefer a fast food nation to one in which an early freeze kills my crops and I starve to death. But I think in some ways the people that came before us knew things that we have forgotten. Their lives were short and they understood what it meant to be hungry for more of it. Yes, it was a time of fairy tales and things that go bump in the night. But it was also, like the age we live in, a time of real threats and real fears. The people that came before us knew there were wolves outside their door and they would have moved heaven and earth to keep the damn things out.

The first known case of smallpox was found in the Egyptian mummy of Ramses V, a pharaoh that died sometime in 1145 BCE, about three thousand years ago. He may have been royalty but the cause of his death was one of the great equalizers of mankind’s history. For the next three thousand years smallpox killed anywhere from 30% to 60% of the people it afflicted, although in children the death rate was closer to 80%. The wealthy died lying on silk sheets, the poor died in small, dark rooms, but they all died the same horrible way. Death from small pox is a painful, ugly, lonely thing.  And until after the 1970’s mothers all over the world knew its face.

The first sign is a fever often high enough to produce hallucinations, quickly met by days of throwing up and crippling back pain. At this point, smallpox’s characteristic pustules have not yet appeared and the mother sits by her child’s bedside and prays against the thing she already knows is happening. Maybe it is something else, perhaps an aggravated flu, the effects of a poorly prepared meal, one of the many painful quirks of childhood. Surely, my little girl cannot have the pox. Surely. By the third day, the fever abates and for a moment, the mother thinks, perhaps she will be alright. My goodness, all this worry over a stomach ache.  Yes, tomorrow she will be even better. The next day her daughter wakes up with the first pustules blooming across her forehead.

She is not alright.

At this point the little girl can infect people standing up to six feet away from her. The other members of the household are quarantined, but only the mother goes into her daughter’s dark room. In the next ten days, if her daughter lives through them, her little body will be overtaken by an aggressive rash full of those pustules, hard as marbles and embedded deep within her skin. They will attack her face, eyelids, mouth, arms, chest, leg, hands and feet. She will become unrecognizable. In some cases, the pustules are so numerous they fuse together to form a sheet. When this happens the skin begins to separate from the flesh underneath. If the girl is lucky the disease will not become malignant or hemorrhagic, as both manifestations of the disease are nearly always fatal. If she is lucky, she will not develop a secondary infection, pneumonia or go blind. If she is lucky she will live through the back breaking pain, the thousands of pustules will scab over and the scabs will fall off. They will leave behind deep pitted scars. If she is lucky, she will emerge disfigured but alive.

As a woman with children, I must step back and consider this mother and her child. If the mother has had the disease she is immune. If she has not and this is the more likely of the scenario, the odds of her catching it through the care of her child, is nearly one hundred percent. And yet she will sit by the girls’ bedside every day. She will brush the hair out of the little face she no longer recognizes and give her water when she is thirsty. And when it isn’t too painful for her baby, she will pick up that hot little body and tell her everything is going to be alright, because sometimes, the things we hope for are all we have as mothers. And then she will wait. Wait to see if the smallpox will take her little girl. Wait to see if her other children will become sick, too. Wait for the moment that she feels a little warm and my, hasn’t her back hurt all day?

And because disease is a greedy little bastard it will not keep her waiting for long.

In 1796, a man named Edward Jenner discovered that cowpox, a much less threatening form of disease, immunize against small pox. His grand invention, the smallpox vaccine, was the answer to thousands of years of prayers said by mothers kneeling by the bed of their sick. By the end of the 18th century smallpox was the cause of death of every tenth child born in Sweden and France, while in Russia the rate was closer to every seventh child. The smallpox vaccine, on the other hand, had a rate of .000198% chance of death, or one in a million. Over the next hundred or so years, it was used successfully, though at times sporadically, in developed countries. It was not used extensively worldwide. In fact, in the 20th century (you know, that one we left just twelve years ago) smallpox killed over 400 million people.

In 1959, the World Health Organization decided to change that and set about destroying the disease one vaccine at a time. Vaccination clinics were set up in bustling metropolises and places without roads.  And mothers –oh the mothers!- who had watched sisters, brothers, husbands and babies succumb to the disease drove, walked, biked, begged their way to the clinics. And then they waited in lines that stretched into the night, for the opportunity to vaccinate those they loved against something they hated. By 1976, the disease had been completely eradicated from the planet. I think about those mamas offering their children up to a needle dipped in pox so that those babies could live in a better world. And my goodness, it worked. Those mothers, with their faith, understanding and determination, killed smallpox. The beast that had maimed and broken and devoured for thousands of years was vanquished by the same hands that cooked dinners and wiped tears off of soft cheeks. They slammed the door shut on that dark room and made sure no mother would have to enter it again. Ever. What a powerful, moving monument. I can hardly catch my breath thinking of it.

We are so far removed from the things that came before us, we do not realize how delicate our current situation is. I mean, this is after all the western world. Won’t we always be disease free? Because we eat organically and well, know better? I mean, that isn’t how it works? The names of the things that vaccinations protect my children from are foreign to me -Pertussis, Measles, Polio, Pneumococcal- to name a few. But just a generation ago these were words used at the dinner table, they represented real things that maimed and killed. My dad had friends that had polio, my mom had a complicated bout of mumps and pertussis is now making a new resurgence, taking away our beautiful babies as it passes us by.

How are we letting this happen? Why aren’t we in lines stretched into the night, offering our children something that will help give them a better world?

And here I think is the true problem, the stumbling block. I think that we believe, or would like to believe, that we have conquered the primal world. That we have moved past the point of our history where there are monsters at the edge of the map. And my, wouldn’t that be nice? But we have not. We will not. We cannot. Life is not without hard decisions. Life is not without risk. And I will sit here and freely admit that vaccines are accompanied by risk. Our current vaccinations are not burdened by the statistics that weighed down the smallpox vaccine. There is no one in a million death rate. In fact, there simply is no official or (agreed upon) unofficial death rate. (Of course, there are anecdotes and conjecture but perhaps those are our modern day version of haunted forests and evil spirits.) For most vaccines the possible complications include fever, irritability, and soreness. One in a million people that receive the vaccine may have a serious allergic reaction. The CDC reports that in the weeks following a vaccine a few cases of seizure and brain damage have been reported but that “these [instances] are so rare it is hard to tell if they are caused by the vaccine.” With the absence of a proven connection, this is the equivalent of me stating that a few weeks after I ate garlic bread my heart stopped and so garlic bread caused the cardiac arrest. Not likely.

As a mother, I understand thinking that one in a million or “so rare it is hard to tell” are chances I would rather not take with my children.  And this is precisely what many mothers do choose. But the choice we are making is not between complete health and one in a million. The choice we are making is between a world in which polio lives an ocean away and a world in which it lives down the street. For years, families have been able to choose to not vaccinate their children because enough of the community was vaccinated to keep disease at bay. This concept is called Herd Immunity. Theoretically, as long as 85% of the population remains vaccinated then vaccine preventable diseases will not run rampant. But the numbers required for Herd Immunity to work are not comforting. Only 15% percent of the population can forgo vaccines for us to remain safe. In some communities across the country the percentage of people opting out of vaccinations for philosophical reasons has reached 13% - 19%. When adjusted to include those that cannot have vaccines because of health concerns the number crosses over 20%. The dam has been breached.

I have heard the stories of the mothers that did not vaccinate because they had a feeling they shouldn’t and then later in life they discovered their child had an autoimmune disease that could have been potentially complicated by the vaccinations. I believe in motherly intuition. For them, not vaccinating was the right decision. I have friends with children that cannot be vaccinated because of health issues, for them not vaccinating was the right decision. But they are the exception, not the rule. My children and I (and probably yours and you, too) are the rule. It is time to accept that we live in a real place with real threats. As mothers we will never be able to eradicate disease, sorrow, danger from our children’s lives. I know that. But there are some dark rooms we never have to walk into again and it is our duty to make sure it stays that way. It is time to protect our children the best way we can. The wolves are at our door and for the first time in history we have the power get some of them the hell out of our sight.

So let’s do this thing.

Curious about what your babies are being protected against with all those needle pokes? Check out this fact sheet by the CDC. 

Just a few highlights (or lowlights)…

Before vaccines in the United States:

Pneumococcal killed over 6,000 people each year

Measles killed an average of 450 people each year

Complications of mumps include deafness at a rate of 1 in 20,000 that contract the virus and it was the leading cause of viral encephalitis.

Paralytic Polio afflicted 13,000 – 20,000 people each year. Many of them children

One million people die each year of liver cancer caused by Hep B they contracted as children. Currently, 2 billion people worldwide have been infected with the virus.

Worried about complications from vaccinations? Read this article.