The Realities of Not Vaccinating

In our individualist culture, it's tempting to think that the vaccination is an individual choice. But diseases like measles remind us that no person (or family) is an island, and vaccinations are an essential responsibility towards our community as well as ourselves.

Just as I was leaving London for South Africa, I got updates for all my vaccinations. Typhoid, hepatitis, diphtheria, polio, tetanus. I didn't think twice about it.

I got teary enough watching Benedict Cumberbatch's moving portrayal of Alan Turing: his work saved an estimated 15 million people who would have otherwise perished in conflict and look how we ended up treating him.

No doubt there will never be an epic movie about vaccination, a singularly powerful story about one of our greatest human achievements which saves 2 to 3 million lives every year. Yet, just like Turing, rather than revering vaccination as the hero of the war on disease, increasingly we are rejecting it.

A measles outbreak in a developed country like the US is one thing, but imagine what could happen if there was a serious measles outbreak here in South Africa? The government struggles to ensure that each child has enough food, toilet facilities in their school, or basic healthcare. An outbreak here could be devastating.

Having said that 16 countries in Africa, including Tanzania, Morocco, Libya, Mauritius, Eritrea, Gambia and Egypt have almost 100% vaccination rates, and five others - Zimbabwe, Algeria, Kenya, Botswana and Lesotho, have higher rates than the US.

And it is little wonder that Africans are happy to take up the offer of vaccines: measles are a very real thing. In 2000, the World Health Organization reported that 60% of the 777,000 measles deaths worldwide occurred in sub-Saharan Africa. By 2007 concerted efforts meant measles deaths had reduced by 91%. Despite ongoing issues with poor health systems, vaccination has been a major public health success in Africa.

"It is a strange first-world irony that wealthier, better-educated parents are the ones reducing infant vaccination rates," Matt Zahn, medical director of Epidemiology and Assessment for the Orange County Health Care Agency, told the Guardian. "Many people in this country have never seen a case of measles," he said. "We're a victim of our own success."

"The virus's relatively low prevalence in the US has emboldened parents to eliminate or delay children's vaccinations," he said, "because they assume the risk of infection is negligible thanks to widespread vaccinations. You're riding on the immunisation rates in your community."

So called 'herd immunity' is particularly necessary for people who can't be vaccinated - small babies and immunocompromised people, like those on chemotherapy or transplant recipients. They need everyone else to be vaccinated.

In our individualist culture, it's tempting to think that the vaccination is an individual choice. But diseases like measles remind us that no person (or family) is an island, and vaccinations are an essential responsibility towards our community as well as ourselves.

If the statistics on vaccine efficacy and safety aren't convincing enough, then what is?

To bring the reality of not vaccinating a child home, The Vaccine Knowledge Project has produced several short films about the impact of infectious diseases. In tragic hindsight, Jo Walton, whose daughter has serious complications from measles, says that now she knows the devastation it can cause, she knows she would choose vaccination.

Another film meets Sarah, who has been left irreversibly brain damaged, deaf and partially blind by measles:

It's a heart breaking story, but made all the more disturbing that despite everything we now have to protect against this happening, this is the choice that large numbers of western parents are making for their children.

This article was originally published on the author's blog, The Mehta Analysis.

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