Vaccinating Kids in Missouri

The item in the paper this morning caught my eye: "Missouri's low vaccination rate leaves children vulnerable, experts say." According to the article, only 56.2 % of children 19-35 months old have their full set of vaccinations. This compares rather badly with the national average of 70.5%. Missouri's particularly poor performance may have something to do with the amount of money the state makes available for vaccinations, and the amount of people Missouri has to check records of schools and daycares to insure that kids are getting vaccinated as the law mandates. According to the article's quote from a group called Trust for America's Health, only Nevada budgeted less per state resident for public health. Missouri is 43rd in per capita public health funding from the CDC. So we are getting what we pay for. At the same time as this reduction in funding, the number of vaccinations has been increasing. I just took a look at the chart for kids 0-6 and there are eight more conditions being vaccinated for now, then back in the early 1960s when I was 0-6.

There is another factor and that is increasing "vaccination reluctance" on the part of parents to have kids vaccinated. Despite NO scientific support, the idea that vaccines cause autism has strongly taken hold in the popular thought stream. Really, to expand the idea more, the concept that vaccines cause neurological problems has taken hold extremely out of proportion to the actual occurrences. You see this latter when you start talking about flu shots for adults. Everyone remembers the "Swine Flu" fiasco of the late 1970s, and the cases of Guillian-Barre Syndrome that occurred. They were rare, but the reports of progressive paralysis and long recovery time were scary to everyone. Ever since then, vaccines have been under increasing scrutiny by everyone.

The problem with vaccine choice is that an individual's choice influences the whole so profoundly. If everyone decided that they would not vaccinate any one any more, you would see gradual increases in the communicable diseases until they were endemic--and possibly beyond the mere state of being present in the population to an epidemic proportion--beyond the expected amount so that much of the population is infected. If we just have a few people with no immunity, the disease will be confined in how many people it can infect and affect, as most will be immune. Thus a very low rate of disease. There's a tipping point somewhere, that if enough do not get vaccinated, an infectious disease can get a foothold and become endemic.

My main trouble with those who are anti-vaccine is two fold. One is that the whole enterprise takes on the look of conspiracy kookiness, with bogeymen around every corner--the doctor's in the pocket of Big Pharma, the government is hiding data, the government is in cahoots with Big Pharma (most of the conspiracy theories surround the drug companies). The second is the elitist "know better" attitude that anti-vaccine people often radiate. They sometimes act as if they are too clean and too knowledgeable to be felled by a communicable disease.

Vaccination is a risk/benefit decision at bottom. Any time we put something in the body, we run the risk of something bad happening. That risk varies, and we try to keep track of bad reactions and problems so we can stop doing things that seem too risky when compared to other things or doing nothing. It's a personal decision for each family and person to evaluate the use of vaccines for them and their family. However, it's a personal decision that can have profound effect on the entire community. If too many people decide not to vaccinate, there will be an effect on the community. People trying to decide on vaccines should talk to folks old enough to remember the times before vaccines were routinely available, or people with recall of the polio epidemic of the early 1950s.

In the meantime, Missouri should be spending just a little more money on public health. Cutting back here is penny wise and pound foolish. Prevention is always cheaper than sick care.

I blogged on the Flu/H1N1 vaccines last year--that post has some more information about how vaccines work and balancing the risk/benefit ratio for flu shots. Your link: http://southkansascityobserver.blogspot.com/2009/10/flu-ish-foolishness.html