Saturday, November 20, 2021

Let's Talk About Vaccines

     If you were born in the United States after 1955, you grew up in a country where polio was no longer a looming terror, where smallpox was gone and other preventable diseases were on the wane.  You grew up in a country that was rapidly achieving herd immunity against a wide range of dangerous diseases.  I suffered through mumps and chickenpox; my nieces and nephews did not.  Measles and chickenpox were rare when I was a child and have become even more so.

     We live in a part of the world remarkably free of the endemic diseases that once stalked it.  And vaccines have played an enormous part in that (measles, for instance) -- so large, and so widely touted to schoolchildren in simplified form that we think of them as almost magical shield against illness.

     But that's not how vaccines work.  The miracle is that these diseases are no longer circulating, or are barely circulating.  That's why nobody you know has had smallpox; that's why in all my life, I have only met one person who'd had polio.  Vaccines are a huge part of how we reached this point -- but they are not a perfect shield.  Effective vaccines greatly reduce the number of exposed people who actually get a disease, and the severity of the disease in vaccinated people who nevertheless catch it.   This then allows the traditional measures of quarantine and containment to work really well; ideally, it results in eradication of the disease.

     Commentators and reporters all across the political spectrum -- conservative, liberal, or trying hard to be neutral -- also grew up in the same lovely, mostly disease-free world, hearing the same stories as children about how vaccines ended most of the terrible diseases humanity once had to endure.  Except for HIV/AIDS, which primarily affected groups that have only the same overlap with journalism and political punditry as they do with the general population, the people we read and listen to have no more experience with pandemics and early-stage vaccination programs than the rest of us.  So we end up with talking heads online and over the air who tell us how the coronavirus vaccines will save everyone (if they're in favor of them) or (if they're opposed to them) that the vaccines must not be all that great since they do not, in fact, entirely eliminate the disease.  It's largely a matter of signalling political affiliation, not science.

     Well-intentioned people like a commenter to one of my recent posts then write, "I am deliberately calling this an injection and not a vaccination. Vaccinations prevent you from catching a disease and spreading it. At best this injection offers a very limit immunity from catching or spreading COVID-19, at best it make the course of the illness less severe. When you have to redefine a word to find your results you are lying."

     Nobody redefined anything.  No one is lying.  The things you learned in grade school Health were greatly simplified, stories for children.  Vaccines greatly reduce the likelihood of infection, which in turn reduces the spread of disease.  They have always worked this way.  They are not a total barrier to infection and transmission.  Some work better than others.  The graphs for measles before and after vaccines (linked above) show a dramatic decline.  On the other hand, the influenza vaccine has to be reformulated every year, based on a best-guess estimate of the strains that will predominate, and the effectiveness of flu shots varies from as low as 10% to as high as 60%; maybe it's not that great, but it's still less risk of catching the flu than you'd otherwise have.*  The coronavirus vaccines are all more effective than the best flu shot; the mRNA vaccines available in the U.S. are as effective as the measles vaccine and the Johnson & Johnson inactivated-virus vaccine is nearly as good.

     Vaccines work in the same way and just as well as they always have.  We have had it soft.  We grew up in a world that had the sharper corners rounded off.  Looks like they might be growing back.  Maybe it's time to grow a tougher skin in response.

     Diseases do not have politics.  Vaccines do not have politics.†  Anyone playing politics with the pandemic does not have your best interests at heart; they've just found a really good string to pull on, and they'll yank you around as much as you will let them get away with.
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* What, the flu is "no big deal?"  Maybe for you; it tends to knock me flat, and once you reach 65 years of age, the risk of a negative outcome goes way up.  Even a ten percent reduction is helpful if you're in a high-risk group, considering that one's life is at risk.
 
† I haven't talked about government mandates; the courts are fighting that one out.  As a general rule, in the United States the public health agencies closest to you -- city, county and state -- have the most power over you.  So there may be Federal overreach in the OSHA-path vaccine mandate.  It's irrelevant to me -- I took action on the basis of my personal health, not what the Great White Father in D. C. wanted me to do. 

4 comments:

  1. I have trouble understanding the vaccine controversy now.

    In my day (before yours) we had to have our "shots" before school started. The better off kids showed a doctor's certificate; the others got their shots from the school hired doctor. Later, in the Navy, shots were ubiquitous. You got them when told to. No discussion of rights.

    Some shots worked well, some not so much, but that's life.

    Today, it's become a matter of principle. Too bad. Maybe the gov't made a mistake in being mandatory and raising hackles. Maybe it would have been better if they just suggested, but who knows?

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  2. Interestingly, Bob, the Feds started out suggesting -- and giving the shots away for free. At this point, the Federal vaccine mandate is not in force; it's being litigated, and will almost certainly end up getting decided by the U. S. Supreme Court.

    Meanwhile, Uncle Sam is still suggesting. Some employers have mandated vaccination, which (absent a contract, and in some cases even then) they can generally do, the same way they can require employees to wash their hands and refrain from smoking.

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  3. Thankfully, as you pointed out, RX, life was considerably different for your generation when compared to earlier generations. In my own family, AFAIK, no one actually caught polio (although, a friend died of it) or smallpox or diphtheria (although I knew people who did catch either of them); but, I had an uncle who was severely affected by Grandmother's having had measles while pregnant with him. My sister died in infancy from a combination of diseases and could probably have been saved, having lived through the measles and scarlet fever parts, had penicillin been available to cure her pneumonia. We all went through measles, mumps, scarlet fever, whooping cough, chickenpox, and influenza, guaranteeing my lifetime affinity for any avoidance or curative agent available for whatever disease.

    I do recall that some shots were available at school; but, my mother did not trust the school system and denied them permission to give me any sort of shot. It was at about 15 years too early for polio shots and I have no idea what they were for. We received our shots from doctors.

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  4. IIt was a dramatic change . I'm 69 and I know 3 people that had polio .It just stopped happening . The other one is TB . There used to be entire hospitals devoted to the care of TB patients .

    Glenn

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