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tdap
Um. I should post something! I feel like I have a bunch of things that are almost ready to post and no energy to get any of them the rest of the way.
OK here, have a contribution to the vaccination discourse:
If you would like someone to use as an example of someone who might not be here if other people didn't vaccinate their kids, here I am. I didn't get the full childhood pertussis/whooping cough vaccination course as a child.
Not because of ethical or religious or financial reasons - my parents were going to get their kids all the vaccines they needed, for sure!
And not because I have some kind of "immune condition" that always gets mentioned in pro-herd-immunity posts, which always calls to mind the kids in childrens' hospital commercials or people with visible disabilities.*
Nope, I just got the first dose of the combined DTP vaccine as a toddler, and then slept for two days straight, which understandably worried my parents and my doctor.
That's not, afaict, a listed side effect of the current TDaP vaccine, and I don't think it was ever a common one for DTP either, and it was never connected with any larger diagnosis for me than 'this one had a weird and scary side effect'. But they decided among themselves that it was probably not a good idea to continue with the pertussis vaccine in particular, which was known to have slightly more risk of side effects. After all, the risk to me in skipping it was fairly small - bad reactions were still super rare, so everybody else around me would be vaccinated, so the chances I would contact anyone who was contagious were low.
Because of that, because this was the 80s and whooping cough was a disease you only heard about in old novels, it was no big deal. And nobody would ever think to point to me and say "there's an example of someone who depends on herd immunity because of medical reasons"; a note in my childhood vaccination record is the only effect it ever had on my life. And I didn't even know I was one vaccine short until I was an adult and anti-vaxxers started showing up in the news and my mother mentioned it in passing.
But if we hadn't had herd immunity, if pertussis was contagious in the community, it would have been a very different risk calculation when I was a toddler. And I might not be here now.
*not that there's any reason not to protect those people too! but the way it's worded always feels like it's designed to be othering, to let people say 'well, I don't know anyone that sick, so it's fine'. I know DW doesn't need the reminder, because you probably do know anyone that sick. Or you are someone that sick. But there are lots of other reasons people can't get vaccines, too, and you probably know people who aren't fully vaccinated for medical reasons like mine, that they might not even know about - and a good thing about herd immunity is that they don't have to be drastic reasons, they can just be 'better safe than sorry' reasons, like my weird two-day nap. And abusing that 'better safe than sorry' makes everybody way less safe, you can't predict who.
OK here, have a contribution to the vaccination discourse:
If you would like someone to use as an example of someone who might not be here if other people didn't vaccinate their kids, here I am. I didn't get the full childhood pertussis/whooping cough vaccination course as a child.
Not because of ethical or religious or financial reasons - my parents were going to get their kids all the vaccines they needed, for sure!
And not because I have some kind of "immune condition" that always gets mentioned in pro-herd-immunity posts, which always calls to mind the kids in childrens' hospital commercials or people with visible disabilities.*
Nope, I just got the first dose of the combined DTP vaccine as a toddler, and then slept for two days straight, which understandably worried my parents and my doctor.
That's not, afaict, a listed side effect of the current TDaP vaccine, and I don't think it was ever a common one for DTP either, and it was never connected with any larger diagnosis for me than 'this one had a weird and scary side effect'. But they decided among themselves that it was probably not a good idea to continue with the pertussis vaccine in particular, which was known to have slightly more risk of side effects. After all, the risk to me in skipping it was fairly small - bad reactions were still super rare, so everybody else around me would be vaccinated, so the chances I would contact anyone who was contagious were low.
Because of that, because this was the 80s and whooping cough was a disease you only heard about in old novels, it was no big deal. And nobody would ever think to point to me and say "there's an example of someone who depends on herd immunity because of medical reasons"; a note in my childhood vaccination record is the only effect it ever had on my life. And I didn't even know I was one vaccine short until I was an adult and anti-vaxxers started showing up in the news and my mother mentioned it in passing.
But if we hadn't had herd immunity, if pertussis was contagious in the community, it would have been a very different risk calculation when I was a toddler. And I might not be here now.
*not that there's any reason not to protect those people too! but the way it's worded always feels like it's designed to be othering, to let people say 'well, I don't know anyone that sick, so it's fine'. I know DW doesn't need the reminder, because you probably do know anyone that sick. Or you are someone that sick. But there are lots of other reasons people can't get vaccines, too, and you probably know people who aren't fully vaccinated for medical reasons like mine, that they might not even know about - and a good thing about herd immunity is that they don't have to be drastic reasons, they can just be 'better safe than sorry' reasons, like my weird two-day nap. And abusing that 'better safe than sorry' makes everybody way less safe, you can't predict who.
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My brother wasn't able to get a flu vaccine for many years because of a severe egg allergy, given that most flu vaccines are egg-incubated. It's not exactly what people think of when they're considering people who can't be vaccinated for whatever reason (though I suppose it is an "immune condition") but it did mean that he didn't get a flu shot until well into his late teens or so, when his allergy had faded.
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Though, interesting point - and not one that I think is necessarily relevant to your case, I legit think this is just interesting - sometimes when weird reactions happen after vaccines, they're coincidental, we just don't know it. As in an article I read a year or two back, a personal story from a doctor whose young patient, with no personal or family history of seizures, had a seizure in his office. They'd been finishing up the appointment, about to give the kid his routine vaccines - and if he'd chanced to have that seizure just five minutes later, everybody would've blamed the shot. If he'd then gone on to have a seizure disorder rather than one freak incident, everybody, including the doctor, would've blamed the shot. A lot of these really rare reactions are so rare that we actually don't know if they happened because of the vaccine or if they're just coincidentally timed.
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(This is the first time I've 'met' someone else with an egg issue. Normally I just get blank stares.)
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I'm an old and was in grade school in the 1950s and remember when the entire country went to stand in line to get fed the oral polio live vaccine on sugar cubes. Some of the parents of polio victims are still alive and I'd love to see the tinhatters try to tell them kids are better off not getting vaccinated.
My dad is a Really Old who was six in the early 1930s when his mother was diagnosed with TB. There actually was a TB vaccine by then but no one was vaccinating poor immigrant families. For two years every Sunday his dad took the kids to the hospital to stand on the lawn outside the hospital and wave at their mother through the windows. After that they went every Sunday to visit her at the cemetery.
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But because really good herd immunity exists for things like mumps and pertussis, and because the vaccines are known to be so safe and unremarkable, if a kid has a weird but not life-threatening one-time reaction afterward you can just say, 'Well, that's weird, maybe we shouldn't give 'em this one just in case' and not worry too much about whether the reaction really was linked to the vaccine.
Whereas in a post-anti-vax world, you have to think a lot harder about whether continuing with the series is necessary even if they do have bad reactions. And as a doctor you have to think a lot harder about whether saying "just in case" will encourage the parent to stop all vaccinations "just in case", so maybe instead you should minimize it and keep going. Everything antivax is terrible!
(And of course, historically, there have been some cases where the vaccine's side-effects really are bad enough that nobody should have gotten it: iirc there was one early flu (I think?) vaccine that they really pushed everybody to get, but it turned out that the infection/mortality rate for that particular flu strain was low enough that you had a higher chance of having a bad reaction to the vaccine than you would have of getting a bad case of the flu, and it set back popular acceptance of flu vaccines by years.)
If 20% of the population are going to get sick, and 5% of those are going to get dangerously sick, but your vaccine has a 2% chance of getting someone dangerously sick, you are actually better off vaccinating nobody than you are everybody. But of course it's really hard to know the stats that accurately beforehand. And anti-vaxxers make it hard to talk about that kind of risk, too.
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The problem with that approach is that a baby too young to be vaccinated can pick it up at the grocery store or a bank, from someone who isn't actually feeling particularly terrible, just a cold, and die of it.
I just had my 10 year TDaP yesterday while I was at my doctor's for something else.
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(My parents were softcore Christian Scientists but my mom grew up in a big city during the polio epidemics and there were people who died of lockjaw in my dad's rural hometown, you bet they got their only child vaccinated.)
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I think I read a book about that, or a similar vaccine setback where the doc just made a terrible mistake, but damned if I can find the title now with all the anti-vax bullshit out there (thanks Google).
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OUCH. That sounds like somthing out of Eugene O'Neill, Jesus.
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It was probably the 1976 Swine Flu, which wikipedia says was discussed in one of the books I read - there were about 500 cases of GBS related to the vaccination effort, along with other bad reactions, but the flu they were vaccinating against basically fizzled, so the vaccine caused more severe illnesses than the flu. Although there's now some debate as to how many of those reactions were really causally linked (and, of course, it's hard to look up or talk about because of anti-vaxxers.)
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Good for your parents! Some things are just important.
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I actually do tend to lean far toward the skeptical in terms of medical interventions in general, because a lot of the science really isn't that good - see discussion of the '76 flu vaccine above - but most of these vaccines have science that is the best science we have for anything, in terms of risk vs. known benefit, and the anti-autism aspect of anti-vax (along with the attitude of wanting complete control over your child that often comes with it - some of the stuff I've read about anti-vax correlating with other abuse -) is just so horrible.
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And HEY, we just had a measles outbreak in our state! Overlapping into the next one!
https://www.usatoday.com/story/news/health/2019/02/11/measles-spread-anti-vaccination-communities-new-york-clar-county-washington/2812667002/
And then people protested against a bill that would end an opt-out exemption, because Andrew Wakefield should burn in hell, if there is one.
https://www.usatoday.com/story/news/nation/2019/02/11/washington-vaccine-bill-protest-amid-measles-outbreak/2835502002/
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My dad's childhood in a nutshell! He always thrashed everyone in Four Yorkshireman type "who had the worst childhood" contests.
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Now, naturally, my county has a hecking pertussus 'outbreak' of ~10 cases. :/
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And yes, the herd immunity at the time let the doctors make those risk assessments. I'm sure there are plenty of similar stories quietly out there.
I'm fully vaccinated now. I insisted during my adult tetanus vaccinations that I get full DTap or Tdap given I have crappy lungs to start with, let's go with the possible fever over actual whooping cough risk. Also, damn Wakefield, turning it back into an actual risk of a disease that I could contract.