How big is your village?

I am about to do something I swore I would never do.

I am going to write about vaccines.

Girlplayingdoctor

 

Before I do though, I have a few disclaimers.

Disclaimer #1: My children are both fully immunized and both had a reaction to their first immunizations. Nothing that I would classify as a major reaction, just a change in behaviour, fevers, and a few restless nights. As a result of this, I decided to put our kids on a modified immunization schedule and only get one (max 2) immunizations at one time, especially the combo ones. Needless to say, it took a lot longer than the prescribed pediatric immunization schedule, but neither of them have had any kind of reaction after that first time (when they both got 4 shots at once), and they are now fully immunized.  

Disclaimer #2: I am a former pharmaceutical sales rep. Yes, it's true, I worked for the BIG BAD PHARMA Wolf. Only, it was the best job I ever had, the one job where I felt that what I was doing was actually helping people and damn it, I was really good at that job!

Disclaimer #3: During my career as a pharmaceutical rep, at one point, it was my job to sell vaccines.

Disclaimer #4: I have a chronic disease (Rheumatoid Arthritis) and have been on many different medications for it since 1991. I have been in clinical trials for new drugs and I have injected various medicines into my body weekly for the past 15 years. Without these medicines, made by, studied, and marketed by pharmaceutical companies, I would most likely not be alive today. And also because of these medications, I am now considered an immunocompromised person.

Ok, I think that's about it for the disclaimers. Now, back to this whole vaccination "debate".

Conversations about vaccines. HA! My friend Heather posted a comment on Facebook the other day about vaccines and it has since garnered 782 comments. SEVEN HUNDRED AND EIGHTY TWO COMMENTS! That is a lot of feels people. Shit, if that post was one of those "comment on this post and a kid in Africa gets a vaccine so he/she doesn't get polio!!", that post alone could have saved 782 kids from a disease that is LITERALLY non-existent on our country. (Canada was deemed a polio-free country in 1994 - thanks to, you guessed it, a vaccine!)

Look, just so we are clear, I am not here to condemn or condone anyone's choices in this matter. I am going to make an assumption (and hope I am not making an ASS out of U or ME) that both those who vaccinate and those who don't, do so with all of the information that they need to make an informed and educated decision. What I am going to do, is ask for a bit of consistency in these decisions and maybe some deeper critical thinking about what these "choices" mean, not just for you, your child and your family, but for everyone around you.

I know for a fact, that all of us are all doing the best we can to keep our children safe. Safe from disease, safe from harmful chemicals, and safe from, well... any and all the bad things that are out there in the world that could harm them in any way. 

So here is the hard truth for everyone. Sometimes that's going to work and sometimes it just doesn't. 

Sometimes you can do all the right things according to your set of values and choices; vaccinate, don't vaccinate, eat organic, eat McDonald's, breastfeed, formula-feed, and on and on and on and on... and still, things can happen that you have no control over. 

Example:

My kid had a lung infection this past summer from a bacteria called Streptococcus Pyogenes. Most of you know it more commonly as Strep Throat. You or your child have most likely had it at some point in your life. Your throat hurts, A LOT, you go to the doctor, you get a prescription for some penicillin (a medicine made by a pharmaceutical company) and bam, you are back to work/school in a couple of days. Easy peasy right? 

Not always. In RARE cases, Group A Strep infections turn SUPER NASTY!

That lung infection in my child turned out to be a very bad pneumonia and he quickly went into severe septic shock and had a cardiac arrest in the pediatric ICU. He was put on a heart-lung bypass machine for 6 days because his own heart and lungs couldn't handle the work of fighting the infection and keeping him alive at the same time. My son survived this infection and the measures that had to be taken to save him, thanks to many factors, not the least of which was the medicines that he was given (again from those darn pharma companies), the blood products that he needed, the incredible team of doctors, nurses and respiratory techs that looked after him and all the love that we could muster around him.

I think back to those days before he got sick and I remember the talk on the school playground at drop off and pick up times. "There's something going around", "So and so has been sick too", "Everyone's been fighting a bit of a cough lately". It's not like it was much different than any other time, because really, there is always "something" going around at school. Germs and viruses just LOVE schools and all the nooks and crannies and multiple tiny bodies cramped into not very big spaces. The only difference this time was that someone's kid got a sore throat and a bit of a cough, and my child almost died, and NO ONE could have foreseen either of those events. And there was no medication that either of them could have taken to prevent either the sore throat or the sepsis. Sometimes, it's all comes down to just dumb luck. 

Vaccines and the diseases that they prevent are a bit different though. There is at least some measure of control that we have with these diseases. One that is readily available and rather effective. Have you ever seen anyone with the measles or the mumps or diptheria? I know I haven't. And to be honest, up until a few minutes ago when I Googled it, I wasn't exactly sure what Rubella was, and why it needed to be eradicated, but 30,000 infant deaths and 20,000 infants born disabled during the last U.S. outbreak in 1962-65, is PLENTY good enough reason for me!

Yes, I know that vaccines have side effects. ALL medicines have side effects. Many of the products that we consider "natural" medicines have side effects too. As a former pharmaceutical rep, I am actually quite well versed in medication side effects, the measures taken to study, document and report these side effects and the analysis that both health care professionals and individuals have to make to assess the risk/benefit of taking, versus not taking a medication for any given condition or situation. And as a chronic disease sufferer and life-long medication user, I also know quite intimately how the side effects of medications can affect ones life significantly. No medication is completely benign and no one is saying that vaccines are either.

Let's have a look at something. Below is the list of side effects listed in the product monograph of a common medication. I warn you, its a long list. 

More common side effects:

Abdominal pain
acid or sour stomach
belching
bloating
cloudy urine
decrease in amount of urine
decrease in urine output or decrease in urine-concentrating ability
diarrhea
difficulty having a bowel movement (stool)
excess air or gas in stomach or intestines
full feeling
heartburn
indigestion
itching skin
pain or discomfort in chest, upper stomach, or throat
pale skin
passing gas
nausea
noisy, rattling breathing
rash with flat lesions or small raised lesions on the skin
shortness of breath
swelling of face, fingers, hands, feet, lower legs, or ankles
troubled breathing at rest
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
vomiting
weight gain

Less common side effects:

Abdominal cramps
stomach soreness or discomfort

Rare side effects:

Agitation
back, leg, or stomach pains
bleeding gums
blistering, peeling, loosening of skin
blood in urine or stools
bloody, black, or tarry stools
blurred vision
burning feeling in chest or stomach
change in vision
chest pain
chills
clay-colored stools
coma
confusion
constipation
cough or hoarseness
dark urine
decreased urine output
depression
difficulty breathing
difficulty swallowing
dilated neck veins
dizziness
dry mouth
extreme fatigue
fast, irregular, pounding, or racing heartbeat or pulse
fever with or without chills
frequent urination
general body swelling
general feeling of tiredness or weakness
hair loss, thinning of hair
headache
hives or welts
hostility
impaired vision
increased blood pressure
increased volume of pale, dilute urine
irregular breathing
irritability
itching
joint or muscle pain
lab results that show problems with liver
lethargy
light-colored stools
loss of appetite
lower back or side pain
muscle twitching
nosebleeds
painful or difficult urination
pains in stomach, side, or abdomen, possibly radiating to the back
pinpoint red spots on skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rash
red skin lesions, often with a purple center
red, irritated eyes
redness of skin
seizures
severe abdominal pain, cramping, burning
severe and continuing nausea
sore throat
sores, ulcers, or white spots in mouth or on lips
stiff neck or back
stomach upset
stupor
swollen or painful glands
tenderness in stomach area
thirst
tightness in chest
unpleasant breath odor
upper right abdominal pain
vomiting of blood
vomiting of material that looks like coffee grounds
wheezing
yellow eyes and skin

In case you haven't guessed, this is the list of the common, less common, and rare side effects listed for Children's Advil. If we used the same criteria that some use for not giving vaccines (based on the risk of less common or rare side effects) on our use of Children's Advil, would we ever use it? Why is one medication deemed less harmful than another? Are they not both made by large pharmaceutical companies just out to make the big bucks? How is the science behind one medicine not given the same credence as another? I seriously want everyone to think about these questions and at least answer them for themselves. 

And about Big Pharma. The thing you may not know about these companies is, that while they may not be perfect, and I completely agree that they do need to be held to a higher standard, they are also full of good, hard-working people who care about making people's lives better and healthier and they care about making a good living while doing that. Trust me, the two concepts are not mutually exclusive. 

Let's try this another way. How many times have we heard "it takes a village" in regards to raising children?  And while we may be able to control our mini-villages when our children are young and primarily stick within our circles of friends and family who follow a certain way of doing things, we can't control the bigger villages that our kids are inevitably going to venture out into. At what point do we consider and teach our own children that there are others in these bigger villages that we all need to take care of as well? If we look at immunization programs as less of a "choice" to make for our families alone and more of an approach to population protection for our youngest and, immunologically-speaking, weaker members of society, present company included, then are we not responsible as members of our larger villages to provide that protection to them? 

I can't help but feel that in all of the discussion (and I do use that term lightly) about pro-vaxxing vs. anti-vaxxing that is going on these days, that there is a sense of some #firstworldproblems, Capital P, Privilege accompanying it. We take for granted that many of the diseases that we vaccinate against don't exist in North America anymore. It is as if we've been lulled into a state of complacency. We don't see babies dying from rubella or measles anymore. We don't see the devastating effects that polio can have on a child's body. We think that a case of whooping cough is no biggie, because we easily have access to medicines that can treat it (even though in 2012, there were 20 pertussis-related deaths in the US, the most since 1955, and most of these in infants under 3 months of age.)  

In many developing countries, this is not the case. Mothers and fathers will literally walk miles with their children to get them vaccinated. These parents know death, they see children dying of diseases that are treatable and preventable in other parts of the world and they don't have access to the hospitals and medicines that we all take for granted. I can't help but wonder how they would feel about these 'debates' about vaccinations that we keep having from behind our laptops and iPhones, sipping our lattes and watching our kids climb all over those germ-infested slides and tunnels at the local play place, while they watch their children suffer and die. 

There are many choices that we make as parents and many of them are true choices that affect only us and our kids and our immediate families. There are other decisions that we have to make that take us out of our little bubble worlds and that need to be made with our larger 'villages' in mind. I know that no one makes these vaccine decisions with the intention of hurting or harming another child or human being, but the reality is that this can and does happen. There could be a child fighting cancer in your son's class who is immunocompromised. Your daughter's best friend may have a new baby sister who is too young to be immunized. And an unvaccinated child carrying a communicable virus, that could seriously harm them, is a risk that these vulnerable villagers shouldn't have to take. And you just don't know for sure about any of these things, until way after the fact.

Just like you don't know if your child will be the one in a million who will have a major reaction and long term side-effect from a vaccine (or any medication). 

Just like you don't know if your kid is going to go into septic shock and almost die from a common bacteria that causes sore throats.

Just like you don't know if or when you or your child will need some of those medicines made by pharmaceutical companies to stay alive or even to just keep a fever down. 

My point is that there are no guarantees in this life. But there are risks that we can mitigate, not just for ourselves and our children, but for the villages we claim to be a part of and all the vulnerable people within it. And THAT is what vaccines do. For almost everyone. 

My hope is that we can all start looking at these risks and the decisions that we make about them from a broader, more population protection perspective and will a lot less complacency than what we are currently doing. 

N~