Wednesday, June 15, 2011

Risk/Benefit Analysis- Vacation Vaccination

How many times have you heard a person complain- I don't care about such and such- I just wish I had a choice?  The fact of the matter is that you always have a choice- but you perform a Risk/ Benefit analysis of your options before you make that choice. Telling ourselves that we don't have a choice is one of the ways we make ourselves feel better about having to make the tough decisions.   What we choose to perceive plays important roles in our choices. Our faith, belief system, politics, history, genetics, customs, comfort levels- all have a role. When we let these factors play into our choice- it sometimes feels like the choice itself has been eliminated for us. Sometimes by putting events into God's/fate's/the majority's hands- we step back and it is easier to accept control is not ours- or relinquish control a little more easily because someone else is making the decisions.  Sometimes we know from past experiences, or others' past experiences what the result will most likely be and we attempt to save ourselves headaches or time by taking the path of least resistance. There are times that we want to be the person who makes that decision and there are times we just wish someone would go on already and make it.  The disconnect happens when we make the decision and get resistance or provide resistance when the decision has been made for us.

In my day to day activities- I make about 85 choices/decisions an hour. What to eat, what to feed the kids, how much to feed the kids, what to wear, how to get the kids to get dressed, no don't wear that, wear something appropriate- why isn't this appropriate- I don't know it just isn't. Why? Because of what people think? Yes. Why does that matter? Ultimately it doesn't, but it does and you will learn that people treat you different based on what they think of you and I have enough battles to fight- that is not one I choose to fight.  But some people might like it. Yep. So can I wear it? Do you want to fight that battle? Yes, so can I wear it? No. But I want to. I know- but I said no. Then why did you ask me if I wanted to fight that battle? I was curious. That's not right. Neither is that outfit- go change.

So I load the kids into the van and venture off to the new clinic 12 minutes from our house. Yep- 12 minutes. I can't park in that amount of time at Tripler. How's the care you ask? Who cares? 12 minutes. In 24 minutes- I can ask for a referral if I need it. If not I wander the 12 feet over to the pharmacy there and get what I need or 12 feet the other direction and get immunizations or blood drawn. 12 minutes. This week we ventured to Tripler 3 times. Had I been able to make these specialty appointments closer to home- I would have saved myself an hour and a half, 2 gallons of gas and a headache- times 3. If I charge what I'm worth per hour- let's face it- I wouldn't be debating this because world class physicians would be knocking on my door- but let's say 10 bucks an hour, $3.75 a gallon- I would have saved $67.50 this week. We won't even get into sweat/stress equity. Yet in the civilian counterpart world- I would be paying that in co pays alone-at least- so beggars can't be choosers- or can they? Everyone has a choice. It's whether or not you believe you do.

SO A quick physical and TB test for Miss Bella Boo turns in to a vaccination marathon. Apparently over the past few years- I have let her currency on the rare disease immunization front slide a bit. I distinctly remember her getting a whole series of shots not so long ago- so I was a bit put off that she was due for not 1 or 2, not 3 or 4 nor 5- but 6 yes folks 6 shots. It also does not help that I spent the better part of the past couple of weeks reading a fascinating book about Vaccine A- the history and suspicions surrounding the Anthrax vaccine. That book led me to read up on the history of vaccination.  I had a choice. There is nothing that says she has to get the vaccines. If I choose not to, then she can't go to school. If I choose to get them- we face any numbers of complications- but hopefully none. I used to believe vaccination was the lesser of two evils. It is a convenience for both the immunee and the medical staff. The whole point of vaccination is to give your body a chance to build immunity under a controlled situation. Whatever the side effects of the vaccination- they will clearly be less than the full blown disease counterpart. The CDC no longer routinely touts vaccinations as "safe" - they say that they are less risky than contracting the disease. Wow- there's some crazy feel better mumbo jumbo for you. I firmly believe they are correct. I do believe that all vaccines are less risky than their full blown disease.  But no 2 bodies are the same and something as less risky as peanuts to one body could result in death for another. Vaccines are no different. Yet the numbers show that the adverse effects are rare enough to make it worth it. The question you have to ask yourself is worth it for who? 

I do believe vaccination is valuable and has deterred innumerable mass outbreaks of disease. But the quest to find the quicker, better, faster, cheaper vaccine has not been without casualties. Many have heard of controversy surrounding thimerosol in vaccines. Thimerosol keeps staph bacteria from growing in vaccines- it was added in the 1920's after 12(of 22) children who received the diptheria vaccination died due to the staph contaminant. The problem is Thimerosol contains mercury- and mercury can be bad when ingested, inhaled, or otherwise internalized. In the 20's they did not know the risks from this compound and had they- when confronted with thousands of deaths from diptheria- it might have had more benefits than risks to continue using it until an alternative could be found. Yet according to the CDC - there have been few reported cases of diptheria in the past 2 decades. So the risk is starting to outweigh the benefit. If you have a very small chance of contracting a disease naturally and there is an associated risk with the vaccination- what is the best choice? That's a tougher decision. Diptheria itself is not a death sentence. It has been shown that caught early- antibiotics effectively treat it. It is still highly contagious thought- so that is a definite consideration. Yet is it the fault of the vaccine-or does the problem lie with the additive to the vaccine or the potential for spoilage. By 1999 they removed thimerosol from most vaccines, yet some still contain fun ingredients like formaldehyde, aluminum phosphates, phenols, or glutaraldehydes.

There is also the association of vaccinations with Autism or other autoimmune disorders. The problems here are many fold. You will rarely find the scientific community lining up to declare causality. Like the medical community- more things are found through exclusion than inclusion. They will point out that there is a correlation, but that correlations in no way imply causality. It reminds me of a study we discussed in college. It was an during infant development study- the correlation between healthy babies and bottled water was made. Study after study was performed- yet causality could not be determined. It eventually was revealed that the socioeconomic fators of the babies were being overlooked. Babies who were given bottled water were from upper class families who had more access to healthcare, better nutrition and higher education. The babies who received tap water were usually from middle to lower class families who did not have the means to buy fancy water or seek routine healthcare. A randomized double blind test(repeated many times over the past few decades and endorsed by municipal water companies!) showed there was actually very little difference between the health benefits of tap vs. bottled water. Bottled water companies will tell you it's better for you- but there is no real evidence of that. If this line of though fascinates you- I highly reccommend the documentary Tapped- it was definitely an eye opener for me- a former water snob.

So here's the thing- the side effects from vaccines are rare. Rare means less than 1 in hundreds who get it. The diseases they buid immunity against are uncomfortable and potentially life threatening. Yet the rare side effects only are rare if they don't affect YOU. Once they affect you- they are anything but rare. Yet the government and varying control agencies have to act like the parent in the situation. There may be a chance someone might have a reaction- yet if that keeps the other kids at the school free from disease- that is worth the risk.  They will be sorry if you have a reaction and they will gently point out in 12 different spots in the literature that there is the potential for reaction, fever, pain, neuroses and brain damage(some view autism as this anecdotally) but the benefit outweighed that possibility.  My advice is this- if you are concerned- do your research. The incidence of reaction is small- but that doesn't mean there isn't a causality either. You can opt out- but if you do- you have to be prepared to fight that battle. That battle might be not getting into school or it might be a rare disease-but the choice is yours.

1 comment:

Amy said...

Stinkin' choices..