Vaccines and relative risks

Holy crap.

I suspected that my two posts about Dawn Winkler, the antivaccination activist running for Governor of Colorado on the Libertarian ticket, might generate some comments and attract some of Dawn’s fellow antivaxers to the comments. Little did I suspect just how many, or how hysterical they would become. Because yesterday was a travel day for me, I didn’t see many of them until just now, and, even having had a fair amount of experience with the irrationality of many antivaxers, even I was a bit taken aback.

I suppose I shouldn’t have been.

One statement, I think, embodies the main problem with reasoning in hard core antivaxers, so much so that it immunizes them from any rational explanations or data:

HELLO, WAKE UP SLEEPY HEADS, THESE VACCINES ARE NOT 100% FOOLPROOF AND NOBODY REALLY KNOWS FOR SURE (I DON’T CARE WHAT RESEARCH HAS BEEN DONE) WHAT REACTION THEY WILL GET FROM ANYTHING. EVERY SINGLE PERSONS IMMUNE SYSTEM IS DIFFERNT SO IF IT HAPPENS TO BE YOUR CHILDS SYSTEM THAT DOESN’T TAKE WELL TO THE VACCINES, WILL YOU STILL BE SITTING UP HERE PREACHING ABOUT ALL THE BENIFETS AND HOW THERE ARE SUCH A MINIMAL AMOUNT OF PEOPLE HURT BY THEM? I’M SORRY, BUT WHEN IT COMES TO HUMAN LIVES, THERE IS NO MINIMAL ALLOWANCE OF DEATHS AS FAR AS I’M CONCERNED. IF THEY ARE NOT TOTALLY, 100% RISK FREE, THAN I AM NOT TAKING THAT CHANCE WITH MY CHILD’S LIFE.

(Capitalization left exactly as it appeared in the original comment. Antivaxers, in my experience, have a tendency to type in all caps.)

In any case, I would like to thank the inappropriately named “MyKidsWillBeSafe” for helping me to illustrate this point (I say “inappropriately named” because her kids are not be safe and because, not only are they not be safe, but they may well endanger other kids because they are unvaccinated). The problem is an utter lack of understanding that (1) nothing in this world, especially not a medical intervention) is “100% safe”; and (2) compared to many other things to which we subject children for much less benefit than vaccines, vaccines are orders of magnitude less likely to cause injury or death. It’s all a matter of weighing potential risks versus benefits, and for the childhood vaccines presently in use in the U.S. there is no question that the benefits far outweigh the risks.

One example was perfect: “So can we also assume that you never allow your child to ride in a motor vehicle? That is certainly far from 100% risk free.” Indeed, the risk of a child dying in an automobile accident is many orders of magnitude greater than the risk of being injured by vaccination. And, of course, the parent who is driving is completely responsible for subjecting the child to the risk of serious injury and death. I would point out another example, which produces a smaller risk than cars but larger than vaccines: Sports. Consider, about four children per year in the U.S. die as a result of an injury from playing baseball or softball, an average that, as of the mid-1990’s, had not changed appreciably since the 1970’s. That’s right, around 4-5 children a year in the U.S. die of injuries suffered playing baseball or softball. But deaths are only the worst injuries. Among children ages 5-14, around well over 100,000 children per year are taken to the emergency room for injuries suffered playing baseball. These include sprains, contusions, fractures, dental injuries, head injuries and concussions, and internal injuries. In fact, baseball has the highest child fatality rate of any sport. And those are just the injuries severe enough to cause the coach and parents to take the child to the emergency room. In fact, if you look at all sports injuries in children, there are approximately three million sports injuries per year!

I have to wonder if “MyKidsWillBeSafe” will allow her children to play sports, run, or ride a bicycle. Surely she drives them around in her car. If so, why on earth does she do this? Why on earth is she subjecting her children to such horrendous risk??? Does she plan on letting her children swim? Does she know how many children drown each and every year? I’ll tell her: “An estimated 5,000 children ages 14 and under are hospitalized due to unintentional drowning-related incidents each year; 15 percent die in the hospital and as many as 20 percent suffer severe, permanent neurological disability.”

MKWBS demands 100% safety of vaccines. Why doesn’t she demand 100% safety of these activities, which are far more dangerous than any vaccine (particularly being driven around in a car)? And, although they have some benefits, I would argue that vaccination has benefits that are at least as compelling as the exercise and teamwork children derive from sports. Heck, I’ll personalize it for her, even though I prefer data whenever possible. During my residency, I took care of so many children injured in car crashes that I truly do not remember how many I dealt with. One episode that will haunt me for the rest of my life occurred when I had to watch a five year old child who had suffered brain death due to traumatic brain injury suffered in a car crash be unplugged from the ventilator while his parents held him.

I never saw a single death from vaccines. That doesn’t mean that they don’t occasionally happen. However, they are far more rare than deaths from the activities listed above.