Imagine we were confronted with an epidemic that would kill 20% of all those who weren't vaccinated against it. Suppose that the vaccine would blind 0.1% of those who received it, and that blindness would invariably set in within 24 hours of the vaccine. In a population of 10 million people, the choice would be between 2 million dead or 10,000 blind people.
The choice seems pretty obvious. The society confronted with this choice would sacrifice the eyesight of 10,000 of its citizens to save the lives of 2 million..
This is a simple model and a straightforward case of bioethics. But let's complicate things:
Suppose that the mortality rate was much lower - let's say 1%. Assume that adverse side effects are much more uncertain and long-term in nature, but some estimates are that 40% of those vaccinated will have their life expectancies reduced by 10 years. Let's further assume that expensive screening would allow health officials to eliminate from vaccination half of those who would lose life expectancy. This society would have more options to consider: can 40% of the population be expected to cut short their lives to save 1%? Should screening be offered to cut that in half, or should the money be spent to research ways to mitigate the effects of the vaccine?
Complicate it even more by saying that 80% of the 1% who die are over 70; or perhaps that a huge proportion of the 40% in danger of having shorter lives are from lower socio-economic backgrounds. Imagine further that the illness is an epidemic that returns from time to time, but usually in a mutated form, creating the need for booster shots to maintain immunity.
These are only some of the variables to consider when creating a vaccine policy. In real life, there are many more, and they are usually much more ambiguous. The US and other governments have instituted more or less mandatory vaccination policies for all its children against a wide range of illnesses. Some of these are serious but not easily contracted (Hepatitis, Diphteria); others are not serious for children but might be for others who are infected by the children (Mumps, Measles, Rubella), and some are a nuisance (Varicella) but not usually dangerous.
It has been generally assumed that vaccines work through a simple mechanism - when confronted with an immunogen that is attenuated, dead, or otherwise different from the virulent strain, the body's immune system fights it off and retains a "memory" of the mechanism to do so, thereby creating immunity.
This assumption is held so strongly that the medical community has been unafraid to extend the whole vaccine thing in several ways: adding more diseases to vaccinate against; doubling and tripling up on the immunogens to put into one shot; and vaccinating earlier and more often. Whereas kids used to get vaccines against polio and smallpox when they were toddlers and allowed to contract measles, mumps, varicella, and possibly rubella as they grew up (and with hope before it was too late), children today get vaccinated for the first time when they are babies, and have lots of follow-up shots and boosters.
This practice is safe, the doctors say, because adverse side effects are rare. But it is entirely in their discretion to determine whether a cold, fever, crankiness, or more serious conditions is at all related to the vaccine. After all, children get sick, and it would be unreasonable to attribute common and even uncommon ailments to the vaccines. Clearly, a rash on the injection site has to be related to the vaccine, but beyond that it's hard to figure it out.
If kids are getting sick more often than they used to, public health officials should be anxious to find out why. The most obvious place to start is to ask: what changed? Vaccine policy is one such thing; epidurals may be another; and there are probably more to choose from. It doesn't seem unreasonable to see whether the illnesses affect systems that are related to vaccines, e.g., the immune system and possibly the nervous system.
What is disturbing and frankly suspicious, is that the very idea that vaccines might cause problems is rejected out of hand. We don't hear "seems unlikely, but that's a possibility we have to study very carefully before we can discount it." We hear "not proven, now shut up."
What if it turned out that vaccines were the culprit for autism, asthma, ADHD, allergies, and other conditions that seem to be more prevalent? Could the government and medical community defend themselves by saying they had no idea? Could the objections of a small minority of people be taken as warnings that should have been heeded?
But perhaps more importantly in such a scenario than the "I told you so's" is what remedy would be offered to the victims, to those society sacrificed to avoid the hassle of measles, mumps, rubella, and chicken pox. Are we willing to bear the cost of supporting hundreds of thousands, if not millions of people who will grow up at a deep disadvantage because we weren't more cautious? Are we willing to accept the moral responsibility by seeking the truth, or is it easier to chalk it all up to bad luck, and leave these people to their fates?
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