Millions of people watched a youtube video a few years ago of a former Washington Redskins Cheerleader and beautiful young woman who was walking like a chicken supposedly as a result of getting the flu vaccine a few weeks earlier. No one ever was able to prove that this isolated instance was indeed related to getting the vaccine, but undoubtedly this video influenced the perceptions of many who watched it.
Conversely there is no dispute from anyone that about 1/1000 children who get measles infection will suffer from a rare and devastating neurological disease called Subacute Sclerosing Pan Encephalitis. The virus will trigger an inflammatory response in the body of infected kids that will attack their brains and almost all of those who suffer this complication will experience severe permanent neurologic damage if not death. Were it not for measles vaccination, tens of thousands of children in the world in the last few decades would have suffered severe debilitating neurologic compromise.
Of course, we will never know who the names of the children whose brains were saved, but we can say for certainty that this is but one of the many known bizarre, debilitating and not all that rare complications from the many diseases we vaccinate against.
Even death is a not at all an uncommon complication from the germs that are commonly vaccinated against. Flu season is fast approaching and the Influenza virus will kill approximately 35,000 American this year of all age groups, just like it does every year .
I feel like there is so much misinformation and faulty logic out there about vaccines that I felt compelled to address it in this blog. Many have been influenced by counterculture horror stories of vaccines that are founded on flawed logic and fantasy. I politely offer the patients I see with this perspective the vaccine and give them my “strongest recommendation” to get it based on my analysis of the risks and benefits.
Yet still many say no in spite of my effort to convince them.
The reason I make this recommendation this is clear to me: I took an oath to do no harm and based on the best available scientific evidence, which I spent the better part of my life gaining the skills to assess, there is no disputing that Vaccines have saved millions upon millions of human lives.
Population Medicine is a tricky game. The goal is to identify problems and then implement population based changes that ultimately cause more good than harm. This is not always easy and the history of medicine has been littered with mistakes. But numbers don’t lie: Hundreds of Millions of people are alive today because of vaccines.
For someone to convince me as a physician to stop recommending vaccines they would have to prove, scientifically, that vaccines do sufficient harm to outweigh the benefit from the innumerable lives vaccination has saved. It can be easy to lose sight of the HUNDREDS OF MILLIONS of lives vaccines have saved when we hear isolated horror stories of the dangers.
The truth about vaccines is pretty straight forward: No physician, nurse or public health professional has ever suggested that vaccination of any kind does not have risks associated with it. In fact every person who gets a vaccine does so only after getting informed consent about the risks of vaccinations. There is no disputing that people have died from the consequences from vaccinations.
But the risks and toxicity of the germs they prevent is, simply put, much, much, much greater. Influenza, Mumps, Measles, Diptheria, Polio, Rubella and the other bugs we vaccinate against are nasty stuff. They cause problems beyond simply making people feel unwell for a few days. They attack the body and cause dangerous and bizarre syndromes (like SSPE) in some unfortunate individuals. They infect hearts, brains, nervous systems and kidneys which often causes serious consequences and death.
To illustrate the dangers of the germs we vaccinate against consider the following example. The most well known complication of flu vaccination is a syndrome called Guillane Barre Syndrome. GBS is a rare ascending paralysis that is triggered when something introduced to the body produces an “autoimmune” response to some of our nerve cells. It is usually short lived and self limited but can occasionally be serious and even more rarely fatal. It occurs in 1 in every several hundred thousand people who get flu vaccine.
I know this sounds scary but here is the catch: Flu vaccine is not the only thing that causes GBS. It turns out the actual flu virus that you may get from your neighbor, relative or somewhere in the community also can and will cause GBS. In fact studies show that people are far, far more likely to get GBS from actual flu infection than they are from flu vaccination and that people who get GBS from the actual flu virus as opposed to the vaccine typically have a much more serious and complicated course.
In fact many of the risks of vaccination are things that are caused in greater likelihood and severity by the actual germs we aim to vaccinate against. So if you are worried about getting GBS this winter, your best bet is to get the flu vaccine not take your chances with the highly virulent and much more immunogenic wild type flu strains circulating through our communities.
The moral of the vaccine story is that everything in life has risk associated with it. There is no such thing as a “risk free” path in any endeavor and certainly not when it comes to health and medicine. That a vaccine has risk to it should put in good company: most of the things we do in daily life carry a risk of harm. In fact most of the routine things we do in daily life carry a much greater risk of harm than flu vaccination with much less clear, tangible benefit. Have you taken notice of the tremendous risks associated with driving a motor vehicle lately?
The logical error most people make is not in their admittedly accurate identification of the risks associated with flu vaccination but in their failure to acknowledge the benefits of vaccination and their failure to accurately consider the risk of non-vaccination. This is a math problem and to come to the correct answer you have to accurately consider all the variables, not just the most visible ones.
That flu vaccine has risks or has definitely harmed people is not sufficient to disqualify it from being a good idea.
One of the funny and unfortunate truths of population medicine: we will never be able to place a definite name or face on the people who population based preventive interventions like vaccines save, but for the unfortunate few we harm there is always a name, a face a story and maybe even a youtube video.
While these stories resonate in our mind good medicine is like a good baseball manager who “plays the percentages” to maximize his team’s chance of a desirable outcome. It's strictly a numbers game. In this case the numbers do not lie: vaccines save way more lives than they take or harm.
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