Ask Amma

Why did I miss this basic fact about vaccination?

In Why on 16 January 2021 at 8:00 pm

Did it really take a pandemic to make me realize the most basic fact about vaccination?

Reader, it did.

Today I am more than a tad embarrassed to read what I so smugly wrote 10 years ago … a smugness I wore perhaps to cover my insecurity, my mistrust of Big Pharma, my discomfort with doctors. With valid reason … but the comfort offered in the form of “making my own” vaccine schedule was, alas, misguided. The schedule I ended up with was probably just fine, in fact I could have modified it even further with no harm done. However my reasons for doing so ignored one basic fact.

Ignoring this fact I dove deep into the literature and online fora populated by people who recommended any approach other than vaccination including nutrition, herbs, and living in the first world where the vaccine-preventable disease incidence was low. In India, I would hear from people (who mostly lived within India’s first world enclaves) that vaccines came from a different, less holistic approach to health. People would caution against specific risks they attributed to vaccines, the general risk that came from interfering with the immune system, the increase in the number of vaccines given at earlier ages, and the neglect of nutrition, sanitation, environmental health, biodiversity, and the bulldozing of traditional knowledge that respected communities and offered a truer path to health.

I became one of those people.

How did I follow this path?

It’s so obvious as to make me wince, but I must own up. What I ignored in pursuit of evaluating the risks and benefits of each and every vaccine for my child based on the lifestyle and health practices of our family was the simple fact that vaccination is a matter of public health. This means I take a vaccine to contribute to the layer of protection for the community as a whole. Like contributing a square to a quilt, which may protect you or may protect others.

If everyone contributes a square then everyone will be protected. What if some people can’t contribute a square? If the squares are designed well and stay intact, then if most people contribute, the quilt can still cover those unable to contribute. Once everyone is warm, new people might think, we don’t need a quilt anymore but they would be mistaken, for in fact the reason we are all warm is that we are all protected by this quilt made mostly by others.

I don’t know if anyone else has used the metaphor of a quilt to explain vaccination. I just thought of it in this instant and am sharing here because I am certain that if anyone had explained it to me this way I would have thought about the issue very differently. I can remember being in doctors’ offices explaining why I was selectively delaying certain vaccines. One doctor said, given your attention to healthy diet and lifestyle this may be okay for you but as a doctor I have to go with the standard schedule. Other doctors assured me of the long standing safety record of the childhood vaccines and warned me about the effects of the specific diseases. But I did not believe we were at risk. Or, as in the case of chicken pox, I accepted the risk. The doctors warned me that daycares and schools required these for admission – but this did not apply to us until many years later. Till then, we would protect our little one from the risks we associated with vaccines and from the non-holistic approach to health of which vaccines were a part.

What not even one doctor told me was: “the aim of vaccination is to protect the community, there are some people who for medical reasons cannot be vaccinated, so a very high percentage of the public must be vaccinated to maintain herd immunity and each person who gets vaccinated contributes to that.” Had even one doctor said, “this is not about protecting only you, this is about protecting the community,” I would have embraced that community spirit and with it, most of the childhood vaccines.

“Doctors might not realize that this line of reasoning would be more effective with patients,” my friend Laura said when I shared my revelation with her. She added that many doctors may themselves not studied public health in medical school.

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