My last newsletter shared my most recent Cancer Nursing Today column on nurses being ambassadors for science when discussing the cost benefit analyses that apply to all treatment decisions, whether vaccines, chemotherapy, or a common over-the-counter medication such as Tylenol.
I was horrified to read the story of the Inca children who were ritually sacrificed; your analogy to the fate of unvaccinated children provided a modern day equivalent to that earlier barbaric procedure, in my opinion. Theresa, I have tried to be non- judgmental in my approach to skeptical individuals who deny science, as my experience and the medical literature both confirm how ineffective such an approach is. However, knowing that vaccines protect people from diseases for which, in most instances, we have no treatment, I am filled with despair at the thought of losing a patient to a preventable illness. I need to figure out a way to communicate better the facts in such conversations, then (and this is the hard part) accept that I can’t control the final decision. I was never very good at letting autonomy trump beneficence, to be honest.
I appreciate your honesty, Lou! When children are involved, or any vulnerable group, it is hard to let autonomy trump beneficence. You ask a really good question, too. In my experience with end of life discussions, patients make the most merciful choice for their loved ones once they are given true information about their family member's situation and understand how honestly hopeless it is. I like to think that parents would always do the same, but obviously they don't. I wonder, though, if it would be possible to ask in an empathic way if they are vaccinated and if they can see any harm that came to them as a result of being vaccinated. Did any harm, and that has to mean real harm, come to anyone they actually know after that person was vaccinated? So many people are vaccinated against childhood diseases--our entire generation, right?--and we just don't see lingering harms. What I'm saying is, I wonder if you ask them what is real and true to them from their own experience with vaccines, what would they say. And then listen--if you can find the time. You could also maybe point out, if the parents are vaccinated, that they are putting their child at risk in a way they are not risking themselves and ask them how they feel about that. I wonder if empathy and a focus on their reality and their experience would be more effective than straight information, though the information about vaccines is great, and persuasive to the vast majority of people. Good luck.
Thanks, Harold! I have been reading about places running out of MMR vaccines because a lot of people believe in vaccines and do not want to get the measles and are getting vaccinated or re-vaccinated. It's sad, but maybe kids getting sick (and dying, alas) will show parents who eschew vaccines the importance of vaccinating their kids. That's a hard lesson, though.
Thank you for writing this powerful piece, Theresa. You make the excellent point that parents who refuse vaccines for their kids are exposing them to a risk they never had to face themselves.
When I talk with people about the measles vaccine, I always mention my mom, who was born before the measles vaccine was invented, and whose eyesight was severely and permanently damaged by measles. Imagine never being able to drive at night, or enjoy a beautiful view. That is what measles did to my mom.
Anti-vax parents might look at statistics about deaths from measles (I think the death rate from measles is 1 in 1200) and think that that is a risk they’re willing to take (or rather, as you note, to impose on their children). But in fact these diseases don’t have to kill a person to ruin, or greatly limit, their lives. What will these parents say to their children, should they become blind because of an avoidable disease?
This is a really illustrative comment, Mari. I had no idea your mom's vision was so bad, and that her vision suffered from having the measles. I remember when the HPV vaccine came out and was presented as a way to prevent cervical cancer. And yet some parents didn't want their kids to have it because it would make the kids promiscuous. There are a lot of glitches in that reasoning, but again, isn't having a promiscuous kid better than having a kid who grows up and dies of cervical cancer instead? One must also ask, would the parents have been as concerned about the vaccine if the promiscuity of male children were at issue and the survival of male children? I hate to ask that, but it must be asked.
Thank you for sharing this story. Every bit of truth helps spread the word about vaccines actually being good for kids.
When Matt heard those objections to the HPV vaccine, he said those parents’ slogan should be “Better dead than bed.” A friend of our sister-in-law died of cervical cancer when she was in her mid-twenties. She died just a year before the vaccine came out, and her parents have been very public in their anger at parents who are refusing a vaccine that could have prevented their daughter from catching and dying of that horrible disease.
As you say, it’s like child sacrifice. I’m sure the ancient sacrificial cult you learned about believed that they were sacrificing children for a higher ideal too. Doesn’t mean they are right.
I was a member of a fundamentalist Christian church for 15 years. We did not believe in vaccination. Called it "monkey pus." I became a mother while in that church, and my (now ex-) husband and I had to face that issue. Follow the church's teaching and a lot of alternative medicine rhetoric, or vaccinate? My father said the thing that tipped our decision and led us to vaccinate our infant son.
In a voice cracking with emotion, he said, "Well, if you decide not to vaccinate him, that's your choice. But you've got 20 years, and you'd better be thinking."
"Be thinking of what?" I asked.
"Be thinking of what you're going to tell him when he's lying in an iron lung, at the prime of his young manhood, unable to move or even breathe for himself.... If he gets polio, that could be the result. You've got from now until then to come up with an excuse for why you could have prevented it with just a simple vaccination, but didn't. You'd better make it a good one."
Forward, now, to about 6 years later. I got in touch with an old friend from the church. She and her husband lived in Michigan and were very outdoors-y types. Did a lot of outdoor sports and when they had children, took the kids with them even from the time when they were very small babies. They decided to vaccinate their babies, just as my ex- and I had done. The husband had never been vaccinated when he was little. That was a deliberate choice of his parents. So they decided to vaccinate their own kids.
They were going on a long, 4- or 5-day backwoods canoe trip with some friends and their own two small children---one an infant. Shortly before the trip, they took the baby in for his shots and, apparently, some kind of oral vaccine as well. About half-way through the canoe trip, the husband began to get sick. They had no communications equipment that would get a signal from where they were, and it would have taken as long to turn around as it would take to plow on through to the end, so that's what they did. Plow on. By the time they reached their destination, the husband was unable to sleep because of the pain he was in, and he could barely walk from the water's edge to a nearby road. He was screaming because he hurt so bad.
Through a very lucky coincidence, they were able to get him to a hospital where he was stabilized and then moved to a larger hospital in Duluth. He was hospitalized for months and became paralyzed. Had to have breathing assistance, the whole works.... It took doctors a while to figure out what was wrong. They finally nailed it: he had polio. And it looked like he'd gotten it from one of the vaccines his baby was given right before the canoe trip. He'd been playing with the baby after the pediatrician appointment and had kissed him gently on the lips. That's the only way they could account for how he had picked up polio.
It's not that the vaccine was so strong. The baby was fine. But the husband had never been vaccinated, and apparently as an adult he didn't have the necessary immune defenses to fight it. He eventually came home. Lived out his life as a quadraplegic. Eventually died, but way before he should have.
If a person has qualms about vaccines, there are ways to manage those issues. First, make sure your baby has a solid nutritional base so that he/she has a strong immune system. Breastfeeding is one way to get the mother's immune system to help protect the baby. Second, especially if the baby does have the benefit of breastfeeding, wait a little bit longer to give the vaccines. A month or two or three! Not years! Third, before going in for vaccinations, give the baby a few extra vitamins that might help his/her immune system be especially strong. Do your homework on this. Don't get crazy. Just think about it as a leg-up, not a trampoline jump. Fourth, spread out the vaccines. Instead of giving a bunch of them at the same time, spread out the bunch into different trips to the doctor. That way, instead of expecting the baby's immune system to mount a response to several vaccines all at the same time, you expect it to mount a response to only a couple each time.
I know these suggestions are not FDA and AMA approved, but if they make the difference between not vaccinating or vaccinating, they are certainly worth considering.
And BTW, yes. I have two grown sons who are pretty health men.
Wow, Brenda--thank you for sharing these two remarkable stories. Your father was brave and compassionate to put your child's well being at the center of the vaccine discussion and I'm glad you were able to hear what he said. I'm sure you, and he, are much more glad than I am. Kudos to you for being brave on behalf of your son. Your second story is really a knock-out punch. How tragic that the father was doing the right thing for his kids and yet no one realized he was putting himself in danger. I found an interesting piece on NPR that talks about how live polio vaccines can actually release polio into communities. In the U.S. we don't use live polio vaccines, but they are cheaper and more abundant so that's what gets given to children in less wealthy countries. Talk about adverse events. Yikes! Scary and avoidable. Thank you so much for writing and sharing these important stories. The NPR article, if of interest: https://www.npr.org/2019/11/16/780068006/how-the-oral-polio-vaccine-can-cause-polio
Thank you, Mimi for distilling the problem down to the basics: What the heck is happening in this country? It's a great question. It is hard when so many Americans are embracing values that others of us consider UnAmerican, like ignoring the separation of powers and the idea of equal justice for all, but my hope is that reason and common sense will eventually prevail. Thanks for your good wishes for my trip to Spain! And hugs.
I like what you said here “. Americans are embracing values that others of us view as un American”!!!! Hit the nail on the head . We see it so clearly! It’s common sense , second nature but yet so many other Americans are acting as though their behavior is ok - when it’s not !!!
lol could go on and on
You said it way more succinctly and elegantly!!!
Bracing myself to attend my husbands niece’s wedding at a Trump golf club in NY… against my wishes .
Oh no—a Trump golf club. Maybe try to see yourself as an anthropologist trying to understand a bizarre foreign culture. Or just make sure the bar is well-stocked. Or both. Stay safe and sane yourself!
Beautifully written
Thank you so much, David! I wanted to strike the right combination of empathy, thoughtfulness and advocacy, so your words mean a lot to me. Hugs!
I was horrified to read the story of the Inca children who were ritually sacrificed; your analogy to the fate of unvaccinated children provided a modern day equivalent to that earlier barbaric procedure, in my opinion. Theresa, I have tried to be non- judgmental in my approach to skeptical individuals who deny science, as my experience and the medical literature both confirm how ineffective such an approach is. However, knowing that vaccines protect people from diseases for which, in most instances, we have no treatment, I am filled with despair at the thought of losing a patient to a preventable illness. I need to figure out a way to communicate better the facts in such conversations, then (and this is the hard part) accept that I can’t control the final decision. I was never very good at letting autonomy trump beneficence, to be honest.
I appreciate your honesty, Lou! When children are involved, or any vulnerable group, it is hard to let autonomy trump beneficence. You ask a really good question, too. In my experience with end of life discussions, patients make the most merciful choice for their loved ones once they are given true information about their family member's situation and understand how honestly hopeless it is. I like to think that parents would always do the same, but obviously they don't. I wonder, though, if it would be possible to ask in an empathic way if they are vaccinated and if they can see any harm that came to them as a result of being vaccinated. Did any harm, and that has to mean real harm, come to anyone they actually know after that person was vaccinated? So many people are vaccinated against childhood diseases--our entire generation, right?--and we just don't see lingering harms. What I'm saying is, I wonder if you ask them what is real and true to them from their own experience with vaccines, what would they say. And then listen--if you can find the time. You could also maybe point out, if the parents are vaccinated, that they are putting their child at risk in a way they are not risking themselves and ask them how they feel about that. I wonder if empathy and a focus on their reality and their experience would be more effective than straight information, though the information about vaccines is great, and persuasive to the vast majority of people. Good luck.
Theresa, You are so right on about vaccinations. Keep up the good writing. Harold
Thanks, Harold! I have been reading about places running out of MMR vaccines because a lot of people believe in vaccines and do not want to get the measles and are getting vaccinated or re-vaccinated. It's sad, but maybe kids getting sick (and dying, alas) will show parents who eschew vaccines the importance of vaccinating their kids. That's a hard lesson, though.
Thank you for writing this powerful piece, Theresa. You make the excellent point that parents who refuse vaccines for their kids are exposing them to a risk they never had to face themselves.
When I talk with people about the measles vaccine, I always mention my mom, who was born before the measles vaccine was invented, and whose eyesight was severely and permanently damaged by measles. Imagine never being able to drive at night, or enjoy a beautiful view. That is what measles did to my mom.
Anti-vax parents might look at statistics about deaths from measles (I think the death rate from measles is 1 in 1200) and think that that is a risk they’re willing to take (or rather, as you note, to impose on their children). But in fact these diseases don’t have to kill a person to ruin, or greatly limit, their lives. What will these parents say to their children, should they become blind because of an avoidable disease?
This is a really illustrative comment, Mari. I had no idea your mom's vision was so bad, and that her vision suffered from having the measles. I remember when the HPV vaccine came out and was presented as a way to prevent cervical cancer. And yet some parents didn't want their kids to have it because it would make the kids promiscuous. There are a lot of glitches in that reasoning, but again, isn't having a promiscuous kid better than having a kid who grows up and dies of cervical cancer instead? One must also ask, would the parents have been as concerned about the vaccine if the promiscuity of male children were at issue and the survival of male children? I hate to ask that, but it must be asked.
Thank you for sharing this story. Every bit of truth helps spread the word about vaccines actually being good for kids.
When Matt heard those objections to the HPV vaccine, he said those parents’ slogan should be “Better dead than bed.” A friend of our sister-in-law died of cervical cancer when she was in her mid-twenties. She died just a year before the vaccine came out, and her parents have been very public in their anger at parents who are refusing a vaccine that could have prevented their daughter from catching and dying of that horrible disease.
As you say, it’s like child sacrifice. I’m sure the ancient sacrificial cult you learned about believed that they were sacrificing children for a higher ideal too. Doesn’t mean they are right.
Gotta comment. Two stories:
I was a member of a fundamentalist Christian church for 15 years. We did not believe in vaccination. Called it "monkey pus." I became a mother while in that church, and my (now ex-) husband and I had to face that issue. Follow the church's teaching and a lot of alternative medicine rhetoric, or vaccinate? My father said the thing that tipped our decision and led us to vaccinate our infant son.
In a voice cracking with emotion, he said, "Well, if you decide not to vaccinate him, that's your choice. But you've got 20 years, and you'd better be thinking."
"Be thinking of what?" I asked.
"Be thinking of what you're going to tell him when he's lying in an iron lung, at the prime of his young manhood, unable to move or even breathe for himself.... If he gets polio, that could be the result. You've got from now until then to come up with an excuse for why you could have prevented it with just a simple vaccination, but didn't. You'd better make it a good one."
Forward, now, to about 6 years later. I got in touch with an old friend from the church. She and her husband lived in Michigan and were very outdoors-y types. Did a lot of outdoor sports and when they had children, took the kids with them even from the time when they were very small babies. They decided to vaccinate their babies, just as my ex- and I had done. The husband had never been vaccinated when he was little. That was a deliberate choice of his parents. So they decided to vaccinate their own kids.
They were going on a long, 4- or 5-day backwoods canoe trip with some friends and their own two small children---one an infant. Shortly before the trip, they took the baby in for his shots and, apparently, some kind of oral vaccine as well. About half-way through the canoe trip, the husband began to get sick. They had no communications equipment that would get a signal from where they were, and it would have taken as long to turn around as it would take to plow on through to the end, so that's what they did. Plow on. By the time they reached their destination, the husband was unable to sleep because of the pain he was in, and he could barely walk from the water's edge to a nearby road. He was screaming because he hurt so bad.
Through a very lucky coincidence, they were able to get him to a hospital where he was stabilized and then moved to a larger hospital in Duluth. He was hospitalized for months and became paralyzed. Had to have breathing assistance, the whole works.... It took doctors a while to figure out what was wrong. They finally nailed it: he had polio. And it looked like he'd gotten it from one of the vaccines his baby was given right before the canoe trip. He'd been playing with the baby after the pediatrician appointment and had kissed him gently on the lips. That's the only way they could account for how he had picked up polio.
It's not that the vaccine was so strong. The baby was fine. But the husband had never been vaccinated, and apparently as an adult he didn't have the necessary immune defenses to fight it. He eventually came home. Lived out his life as a quadraplegic. Eventually died, but way before he should have.
If a person has qualms about vaccines, there are ways to manage those issues. First, make sure your baby has a solid nutritional base so that he/she has a strong immune system. Breastfeeding is one way to get the mother's immune system to help protect the baby. Second, especially if the baby does have the benefit of breastfeeding, wait a little bit longer to give the vaccines. A month or two or three! Not years! Third, before going in for vaccinations, give the baby a few extra vitamins that might help his/her immune system be especially strong. Do your homework on this. Don't get crazy. Just think about it as a leg-up, not a trampoline jump. Fourth, spread out the vaccines. Instead of giving a bunch of them at the same time, spread out the bunch into different trips to the doctor. That way, instead of expecting the baby's immune system to mount a response to several vaccines all at the same time, you expect it to mount a response to only a couple each time.
I know these suggestions are not FDA and AMA approved, but if they make the difference between not vaccinating or vaccinating, they are certainly worth considering.
And BTW, yes. I have two grown sons who are pretty health men.
Wow, Brenda--thank you for sharing these two remarkable stories. Your father was brave and compassionate to put your child's well being at the center of the vaccine discussion and I'm glad you were able to hear what he said. I'm sure you, and he, are much more glad than I am. Kudos to you for being brave on behalf of your son. Your second story is really a knock-out punch. How tragic that the father was doing the right thing for his kids and yet no one realized he was putting himself in danger. I found an interesting piece on NPR that talks about how live polio vaccines can actually release polio into communities. In the U.S. we don't use live polio vaccines, but they are cheaper and more abundant so that's what gets given to children in less wealthy countries. Talk about adverse events. Yikes! Scary and avoidable. Thank you so much for writing and sharing these important stories. The NPR article, if of interest: https://www.npr.org/2019/11/16/780068006/how-the-oral-polio-vaccine-can-cause-polio
What the heck is happening in this country??? Have fun in Spain ! But I’m glad you are coming back to help us stay sane !!❤️
Thank you as always for bringing attention to an important matter ! Stay well !! Xoxo Mimi
Thank you, Mimi for distilling the problem down to the basics: What the heck is happening in this country? It's a great question. It is hard when so many Americans are embracing values that others of us consider UnAmerican, like ignoring the separation of powers and the idea of equal justice for all, but my hope is that reason and common sense will eventually prevail. Thanks for your good wishes for my trip to Spain! And hugs.
I like what you said here “. Americans are embracing values that others of us view as un American”!!!! Hit the nail on the head . We see it so clearly! It’s common sense , second nature but yet so many other Americans are acting as though their behavior is ok - when it’s not !!!
lol could go on and on
You said it way more succinctly and elegantly!!!
Bracing myself to attend my husbands niece’s wedding at a Trump golf club in NY… against my wishes .
Wish me luck !!!
Take care !! Be well , stay safe and sane !!
Mimi
Oh no—a Trump golf club. Maybe try to see yourself as an anthropologist trying to understand a bizarre foreign culture. Or just make sure the bar is well-stocked. Or both. Stay safe and sane yourself!