February 8, 2015
Following a recent outbreak of measles in Southern California (ground zero of which appears to have been Disneyland, of all places), there’s been a lot of talk about what should be done about parents who chose not to immunize their kids. The vast majority of what I’ve read on the topic has come down hard on the “anti-vaxxers,” and there is a lot of outrage over what many consider an egregiously selfish, uninformed, and reckless point of view that elevates the individual choice of a relatively small (and in most cases, highly privileged) group over the well-being of society in general, including its weakest members. Some pediatricians are refusing to treat children whose parents won’t allow them to be vaccinated, and some schools are insisting that non-immunized kids stay home until the worst of the epidemic is over. A handful of lawmakers are suggesting that inoculations should be mandatory, while parents of kids who can’t be vaccinated (because of autoimmune diseases or other medical conditions) are furious that their children are at risk of contracting a serious illness because of anti-vaxxer parents whose justification for not immunizing their kids (i.e., herd immunity) is premised largely upon the outrageous hubris that presumes the rest of us will.
I’m not going to rehash the compelling (and indisputable) arguments in favor of routine childhood vaccinations, arguments that have been made far more cogently and articulately by those with rigorous expertise in the areas of pediatrics, epidemiology, and community health, mostly because there is no reasonable, intelligent, responsible rebuttal. The overwhelming scientific evidence demonstrates conclusively, emphatically—with about as much certainty as one could hope for—that routine vaccination works. It prevents children from contracting diseases that can become very serious indeed and, over time, has virtually eradicated illnesses that used to be considered deadly. There is no legitimate contrary viewpoint, and every “rationale” for not vaccinating has been roundly, thoroughly debunked though, as Amy Tuteur, M.D. pointed out in her excellent piece, “What everyone gets wrong about anti-vaccine parents,” the decision not to immunize has almost nothing to do with hard science and almost everything to do with a staggering level of self-absorption and arrogance.
And so, because far smarter people than me—you know, real scientists, whose opinions are backed up by facts, statistics, and studies published in peer-reviewed journals—have already so exhaustively demonstrated the correctness of their position, I’m not going to waste anyone’s time making the case for immunizing your children. Like brushing your teeth and changing your underwear, you just should, period, and entertaining an anti-vaxxer for even thirty seconds is thirty seconds I could be spending eating a Girl Scout cookie and looking at pictures of koala bears.
Part of the problem is that, precisely because of routine childhood vaccination, we in America have forgotten that not so long ago, it was not uncommon for children to die from diseases like polio or whooping cough. Most of us in America (and in other industrialized countries) cannot even begin to comprehend losing a child to an entirely preventable illness – it’s simply unthinkable. We’ve come to take our robust good health for granted, so much so that anti-vaxxers ignore the fact that not vaccinating presents a significant health risk to their offspring. They pooh-pooh the notion that their kids might get sick, and, in any event, generally have access to the kind of high-quality, affordable health care they assume will guarantee a complete recovery if their kids do get ill. Because that’s what we expect in the United States of America in 2015 – that our children will be 100% normal, healthy, and perfect. Anything less is unacceptable.
And now I’m about to get shrill.
Because whatever anti-vaxxers might say in defense of their position (vaccines are loaded with toxic chemicals, you can’t trust Big Pharma, there’s no evidence that routine vaccination actually prevents illness), the real reason most parents choose not to vaccinate (though few may admit it) is that they’re afraid of the A-word. You know, autism. Which, in the United States of America in 2015, is apparently the single greatest tragedy a parent can endure. Thus, there are some parents who are so afraid, so out of their minds petrified that their child might develop autism (despite an incidence rate of less than 1%), they are willing to ignore mountains of scientific research disproving any link between vaccination and autism and to expose their children (and others) to illnesses that are entirely preventable but in some instances can be deadly.
Never mind that this autism terror is based upon a single “research study” conducted twenty years ago that time and further inquiry have established was utterly and thoroughly devoid of any merit. Never mind that since the Lancet article was published, nothing, and no one, has been able to establish (by means of the scientific method or otherwise) any correlation between vaccination and autism whatsoever. Never mind that the ancillary theories about preservatives in vaccines causing autism have been proven baseless. Never mind that most of the people spouting anti-vaccination rhetoric have about as much pretension to scientific credibility as I do to playing running back for the Broncos.
Never mind.
Because even if there was a connection (and there’s not, Jenny McCarthy, so maybe confine your contributions to the world to showing off your spectacular breasts), it says a lot about a person they are willing to (1) expose their child to unnecessary illness; (2) place those who can’t be vaccinated at risk for contracting a disease that, for them, could be deadly; and (3) unravel the incredible success of routine vaccination that, if practiced rigorously, would guarantee the eventual extinction of these diseases—all because they think it will further protect their child against the already unlikely possibility that they will develop autism.
Lest you think I’m suggesting that we should all hope that our child will be born with or develop a disability – I’m not. To say that it’s hard to parent a child with autism is so ridiculously inadequate as to be laughable – and I know from whence I speak, because I’ve been doing it for almost 21 years. I’m not going to even attempt to describe our family’s journey (and it isn’t over), or the toll it has taken on all of us, or the heart-breaking struggles my daughter encounters on pretty much a daily basis. I won’t even say that being Allison’s mother has been one of the greatest joys of my life, although it has been, or that I love her exactly the way she is (I do).
What I will say is that anti-vaxxers seem to believe that having a kid like my daughter is so thoroughly intolerable that they are will do anything—anything—to prevent the extremely remote chance that their child will develop autism, even if it involves the far more likely scenario that their unvaccinated kid will needlessly contract a disease that could have serious repercussions for them and for others. The most extreme potential consequences of the anti-vaxxer philosophy seems to suggest a kind of, “soft eugenics,” I’ll call it – the idea that it would be better for your child to die than to be disabled (and I acknowledge that I’m verging on the hysterical with that statement). It’s worth noting, moreover, that if all of us got on the anti-vaxxer boat, we’d be knee-deep in polio and mumps and diphtheria in no time, and as we buried our children, or slid them into iron lungs, everyone would be asking themselves how we ever allowed ourselves to be so willfully ignorant.
I’m aware that I am particularly sensitive on this subject because, as the parent of a child with autism, I have spent a good amount of time wondering what caused my daughter to be different. Was it something I did while I was pregnant with her? Was it the fact that she may have suffered from undiagnosed IUGR and was (marginally) premature and low birth weight? Was it a matter of simple genetics? I’d like an answer to this question, and even though it won’t change the diagnosis or make her life any easier, still, I’d like an answer. It would be so nice to have an explanation, to have a tangible, concrete cause – like, say, a vaccine – because it would give me someone to blame (besides myself, that is). See, when your child is anything less than 100% normal and healthy and perfect, you want some answers. So, I’d love it if we could prove that there was a link between vaccinations and autism, because guess what? Then we could stop children from having autism.
Except that there is no link. And you can decide not to vaccinate your kid, and damn the consequences (to your kid, and to everyone else), and maybe your child won’t be autistic. Or maybe he will. Or maybe she’ll get cancer, or maybe he’ll be dyslexic. Or maybe—probably—she’ll be just fine. But here’s the thing: We don’t get to choose what our children are going to be like. We don’t get to decide if they’re going to be good at sports or musically gifted or pretty or funny or smart. We can strive for an optimally healthy pregnancy and the best pediatric care available, but sometimes—and I know this shocks our can-do, no-problem-too-big American attitude—sometimes, kids aren’t normal, healthy and perfect, whether you vaccinate them or not. I would love to have had a say in whether or not my daughter was going to be autistic, but I didn’t get one, and if I had one thing to say to the anti-vaxxers (aside from, you’re wrong), it would be, if you can’t tolerate a child who is less than 100% normal, healthy, and perfect, you probably shouldn’t have one.
Do I wish that my daughter was free of the challenges that her autism imposes, that she had the same opportunities as her sisters? Of course. Would I wish the difficulties she faces upon anyone? Never. But any parent who willingly adheres to an absurdly indefensible proposition (and all that goes with it) in the desperate hope that he can protect his child from autism communicates with absolute clarity precisely how much he values any life that is less than 100% normal, healthy and perfect. And that’s a real tragedy.