Thank you. This gets treated as a "Public Health trumps all" issue when it's really a "risk mitigation" issue. We could spend $X trillion dollars and wipe out all communicable disease, but at the expense of everything else that happens in our society. We have to balance costs, risks, and health outcomes all the time. End the hyperbole, start doing evidence based medicine, and quit the overreaction.

Your kids are in school, well past the time frame (0-9 months of age) when pertussis is considered significantly life-threatening. Yes, it's an inconvenience and an illness, and everything else that is negative about getting sick, but they were unlikely to be really, long-term injured from getting pertussis (unless they are otherwise part of an at-risk group that I don't know of). I'm sorry that kids got whooping cough. But since you don't mention any deaths/hospitalizations, what's the difference between this and, say, influenza or food poisoning?

Like I said, I'm going to reevaluate at various points in the future. Most likely the one that may change the equation is going into school. PreK age here is 3years old, so we very well may start vaccinating around age 3. The cost/benefit & risk profile changes quite a bit at that point, so it's worth reconsidering.

Thanks for lending your voice & support.

http://www.whale.to/a/image/gr2.html

I don't have a healthy fear of pertussis because the general improvement in hygiene and medical care in the early half of the 20th century--even prior to the widespread use of the pertussis vaccine--dropped the mortality rate and rate of significant adverse effect of the disease significantly. The vaccine helps keep the infection rate down, which is good, but not nearly as heroically life-saving as many care to think. (For pertussis. Other diseases vary.)

As for the notion of wiping out the human-communicable pertussis strains, I have been corrected. I relied too much on someone else's post in here that turned out to be incorrect. Sorry. That remains a valuable goal, and one that is making me re-evaluate the cost-benefit that I have spoken of elsewhere on this thread.

Ah, see, I leaned too much on a different poster's information. I learn something new. Perhaps we can eradicate pertussis, in which case I may need to reconsider.

The figures are off the top of my head. I made them up today, because I didn't want to be bothered to do the research all over again. But the relevant information on risks of vaccination can be found in the VAERS database, and the risks of infection from the various diseases (and the expected outcomes) can be found on various immunology websites, like CDCP. Those sites are for the US and federally administered, so if you're looking for data for other countries, YMMV.

I'm quite familiar with the concept. So long as the vaccination rate remains above X%, the chain of infection remains (likely to be) disrupted. If the vaccination rate drops below X%, the susceptible (ie unvaccinted) population can become infected.

As far as I'm aware, the vaccination rates in the US are well above X% for most, if not all, diseases that are significantly harmful (I exclude chicken pox, HPV, and a handful of others that have extremely low rates of significantly adverse outcomes per population infected). So no, I don't feel particularly bad about my child being outside the vaccinated herd.

Oh, you weren't worried about the X% of vaccinated people getting infected, were you? Because they're like, vaccinated, right? So they don't have anything (or very little) to worry about.

Nope. 95% or so of the other kids that come into contact with mine are vaccinated, and thus have nothing (or very little) to be concerned about. The vaccinated masses don't have a darn thing to worry about. Right?

Herd immunity is only relevant to susceptible populations. If 90% of the population is vaccinated, then the remaining 10% of susceptible individuals have a benefit from those who have been vaccinated.

So if I contribute to dropping that 90% vaccination rate to 85%, then I have hurt the 15% of people who are unvaccinated by increasing their risk of exposure to the disease. However, if I assume that those 15% of people (or their parents/guardians) have also made an educated risk assessment and have decided that the risk is acceptable, then why am I to blame?

An argument could be made that some % of the population is unable to be vaccinated for some reason or other, and that by diminishing the herd immunity, I am contributing to the possible infection of the few people who fall into that category. But I'm not sure where our vaccination rate stands for Pertussis...if the rate is above the 90-92% required for herd immunity, then there's no problem and I have no guilt.

I'm not "predicating" my cost-benefit on anything. I'm looking at the reality of the current situation. If vaccine rates drop significantly and diseases become more prevalent and more harmful such that the risk of my child having an extremely negative outcome go up significantly, then yeah, I'll probably vaccinate for some diseases.

I am in the US and I do have health insurance, and the cost of vaccines for my child are non-zero ($10/shot, if I read my Benefits Summary correctly, though it might be $10 per vaccine course [a series of 3 shots for a specific disease would be $10]). And I would also be required to make additional pediatrician well-visits, which likewise carry an additional cost--2-week, 1 month, 3 month, 6 month, 9 month, 12 month visits are what I have now. With vaccines, a 2 month visit would be required, a 4 month visit would be required, and the 9 month visit would be changed to an 8 month and 10 month visit, totaling 3 extra visits. With a 45 minute drive to the pediatrician's office each way, it's also a time issue.

So while the cost & time might not seem significant to you, it *is* significant to our family.

Eradicating infectious diseases?
You cannot eradicate Pertussis. It's a bacteria that exists and thrives independently of a human (or any other) host.

So unvaccinated kids infect your vaccinated kids with diseases that they are supposed to be vaccinated?

Yes. Exactly. Some kids can't be vaccinated because of allergies or age. And unvaccinated kids are the cause of some of those kids dying.

What you're actually saying is that unvaccinated kids infect other unvaccinated kids. What the GP said was that your vaccinated kids have nothing to worry about. Right?

Those that have to take the risk of exposure to the disease because of allergies or other factors are an entirely different matter.

As noted elsewhere, bacterial diseases like Pertussis are NOT going to be eradicated, ever. They don't require a human host, so there will always be a risk of infection. So, taking the "disease eradication" out of the argument, why do you insist that everybody get vaccinated?

If you and your child are vaccinated, what is the risk to you if they come into contact with the disease? You've already given your kid immunity (or something like 95-99% immunity), right? So if my kid happens to carry the disease, you shouldn't have to worry about it.

So why do you care?

I don't vaccinate my kid. Not because I'm afraid of autism (as noted before, the autism link is flat out not there). But because the risks on either side are so minimal that I don't see the point.

The odds of my kid being exposed to, say, pertussis are about 10%. The odds of her contracting the disease (ie the bacteria taking hold and causing symptoms) is about 0.5%. The odds of her having a serious case of the disease (involving hospitalization) is about 0.01%. The odds of her having any sort of permanent disability/harm are about 0.005%. And the odds of death are about 0.0001%.

In contrast, the odds of having a mild reaction (mild fever, cold/flu symptoms, localized swelling) to a pertussis vaccine are about 1%. The odds of having a major reaction (lengthy illness, actually getting pertussis, etc) are about .01%. The odds of having a major allergic reaction to the vaccine are about .008%. The odds of having brain swelling, fever that causes brain damage, or other severe outcomes is about 0.005%. And the odds of death are about 0.00005%. And even with the vaccine, the odds of her still contracting the disease are about 2%--with all the odds of the above multiplied by a factor of .02.

In short, the risk involved in either course of action is ridiculously small--similar odds with winning the Lotto. BUT getting the vaccine costs me money, time (a trip to the doctor), possible fear of the doctor (something I don't want her to be afraid of) and discomfort/pain to my child.

I've weighed the risks. I've done a cost/benefit analysis for both courses of action. And I (and my wife) choose not to vaccinate. And yes, we have done similar comparisons for each and every vaccine that is offered, from the Diptheria, Pertussis, Tetanus (DTaP) vaccine to the HPV vaccine to the Chicken Pox/Varicella vaccine. And none of them make a definitive case that vaccination is orders-of-magnitude better than non-vaccination.

I have not ruled out the possibility that I will reevaluate that cost/benefit and risk analysis at some later stage in her life (say, when she goes to pre-school) and come to a different conclusion.


So again, I ask, what in all these odds and risks and everything, makes me evil for not vaccinating my child?

Switzerland:
-Human Rights
-Politics
-Mandatory Gun Ownership/Military service
-Universal Health Care, and good results to show for it
-A diversified and regional Education system, with decent, but not stellar, results.

The only real challenge is that it's kind of hard to become a citizen. Good luck!