To The Health of Us All: A Public Case for the General Use of Vaccines (Full)
This paper was originally written as the first project for math class at The School of Ethics and Global Leadership.
I hate needles. I admit it. I hate needles. I used to throw temper tantrums so that I wouldn’t get one, and to this day, I will wince at the thought of a second needle. But there is a reason the doctor prolongs what must be a torturous process for both her and me. Turns out that second needle contains vaccines for dangerous diseases. The American public isn’t familiar with the diseases they protect against, like diphtheria, or mumps, or whooping cough, because vaccines for the past century have done their job. But since these diseases have been vaccinated against, Americans don’t see that side of the vaccine, and instead see the needle. There have been a litany of arguments not to take a vaccine, including religious and medical exemptions which existed before and while smallpox made its rounds. However, many non-medical excuses have also developed against the use of vaccines, which not only are patently untrue, but are actually harmful to society, which is why it is ethical to mandate the use of vaccines with medical and religious exemptions.
That’s a bold statement. Isn’t there some fancy document that would cry foul to this in the most powerful country in the world? Yes, that document is the Constitution, and many would argue that the First Amendment in the Bill of Rights protects anyone’s right to just say no to vaccines. And normally, I would agree— if it weren’t for drunk driving. Now Americans, as much as they hate rubbing alcohol, love to drink. Do we have a right to drink? Yes, thanks to the 21st Amendment. Do we have a right to drink too much? Yes, thanks to the Ninth Amendment. And when we are done with our drinks some drive their automobile home. And there’s the problem. Remember, drunk driving is illegal. Anyone could argue, especially if they’re fighting fines and penalties, that the First and 21st Amendment protects their right to drive while drunk. After all, both are legal when not done in concurrence. However, Congress realized that drunk driving, when you tally the medical bill, the funeral bill, and the insurance bill along with the lost labor and taxes that comes with death, costs America 51 billion dollars. Presumably around the same time, Congress also realized that the Commerce clause gave it the power to collect taxes with any means constitutional, and that includes preventing 51 billion dollars from being run over by buzzed hooligans. In short, if you are by your actions hurting the nation’s tax income, the government is sending in The Man.
Now, you must be wondering, “What in the world does that have to do with vaccines?” Actually, that precedence has everything to do with vaccines. Now, don’t get me wrong, vaccines are great, but one vaccine isn’t that effective. If you’re the only one with a vaccine, you are still going to get sick, though if that happens, the sickness will be less harsh than if you were unvaccinated. If your friends get vaccines too, that still doesn’t help. Not even grabbing everyone in a community center and forcing them to get a vaccine will save you from an unpleasant experience in quarantine. Everyone has to get vaccinated, and when I say everyone, I mean ¾ of the population at the least, and often times up to 90%. This is the idea of community immunity, or herd immunity, displayed in Figure 1.
Figure 1: An infographic explaining community or herd immunity. While nobody, or close to nobody, is vaccinated, disease has a Medieval Age field day. Everybody gets sick, including people who may have the vaccine, though they don’t suffer as much. When a few people get vaccinated, almost nothing changes. But when almost everybody is vaccinated, the diseases suddenly have a problem. Not only is it harder to infect people, even when it does happen, the disease is much weaker than if it were to come off a defenseless person, reducing the reproduction number of the disease. Even those who aren’t in the 75% are protected, because since the diseases don’t have a playfield of bodies to roll in, they have to take meager steps to make it to an unvaccinated person without being beaten up by a much more prepared immune system of another host. In other words, everyone lives. For skeptics, I introduce Exhibit A, smallpox. Smallpox was a deadly disease that often left your body in an unspeakable rash. 30% of people smallpox infected died. And just a note, the bloody horror spread through social contact. If there was anyone you didn’t want to touch with your bare hands, it would probably be someone with smallpox. However, luckily for humanity, we banded together and found a vaccine, and together we didn’t reject the vaccine as voodoo magic, but as a cure. Today, smallpox is one of two diseases eradicated from the earth. However, there are still vaccine-preventable diseases that plague our land, and keep our workers from work, paying ridiculous hospital fees and occasionally signing their own will. All of that is bad for the national economy, including death, which is bad for taxes. Thus, I argue, it should be imperative that the government enforce vaccine use as a matter of law.
However, I have been unfair to the other side of this debate by not telling their side of the story, even though it’s wrong and hurting our nation’s economy. Mercola.com is a popular website amongst anti-vaccine folks, and one of their stories actually proves my point. Dr. Mercola argued that 81 percent of 2010 California B. pertussis whooping cough cases in people under the age of 18 occurred in those who were fully up to date on the whooping cough vaccine. He then goes on to argue that the vaccine that covers whooping cough loses much of its effectiveness after just three years, has missed another strain of the same disease, and cause brain inflammation in small children. Note, vaccines do not actually cause brain inflammation. But Mercola does an interesting thing in his article. He points out that CDC data showed that 84 percent of children under the age of 3 had received at least four DTaP shots, DTaP being the vaccine in question, and he goes on to say, “yet, despite this high vaccination rate, whooping cough still keeps circulating among both the vaccinated and unvaccinated.” The herd immunity threshold that a community has to reach for whooping cough not to have a field day is actually 92-94 percent. The community, and I quote from Mercola himself, had an immunization rate of “84 percent.” It didn’t matter that 84% of children had the vaccine, but because the immunization rate was not at 92 or 94 percent, even children who did the right thing ended up with the worst cough in human history, and since vaccines are also medicine, the misapplication of the vaccine could allow the virus to evolve into that new strain Mercola said the vaccine missed, which means because of 8% of parents, our society might get a big surprise from Mother Nature. Once again, more proof that a few in society are affecting public health in a negative way.
But why do these chosen few decide to skip out on the vaccine if they don’t claim sickness or religion to be their motivation. The short answer is misinformation, but you may know it as autism. Autism is a real condition that affects many lives, but some people think vaccines can cause autism. No, vaccines do not cause autism, and there have been thousands of pages wasted proving that vaccines do not cause autism. The journal that released the original study that said otherwise retracted their own story as unscientific. And yet people like Jenny McCarthy (a celebrity spokesperson for this misinformation) and Joseph Mercola continue to tell whoever will listen, including scared expecting couples, that vaccines cause autism and brain inflammation when really they keep their child from choking from diphtheria. And at the center of it all, it’s really Big Pharma’s fault for making bad vaccines and government’s fault for not regulating them. Hey, here’s a thought, the bosses of ‘Big Pharma’ are going to use the product they’re selling. It’s one of those rare cases where the supposed snake oil person drinks his own snake oil and doesn’t die. They’re not going to make a bad vaccine, because they themselves don’t want to see themselves dead on the doctor’s table, and the same probably goes for their children. You are essentially accusing them of murder-suicide. Worst case scenario, they don’t take the drugs they make, but they know at some point they will take their own vaccine. I trust their life in their hands.
But I feel that I cannot prove my case to the government without math. Math helps make things seem real enough to take action on it. Take the average American city, with a population of 20,000. Now, let’s say there is an outbreak of whooping cough in the district, and the town needs to be vaccinated. Remember the point Mercola helped bring up: 92% of the population needs to get the vaccine or everyone suffers. The national immunodeficiency rate is .01592% so in the average town, there’s that much of a chance that one won’t be able to take the vaccine because of medical concerns. Say this is a new vaccine, and it contains porcine, and the religious community isn’t comfortable with that. 1.2% of Americans adhere to Jewish tradition, and .8% Islam, which are both major religions that forbid the consumption of pork. To apply this to our imaginary town, 2% of citizens won’t take the vaccine. All the rest of those 19600 citizens will take the vaccine. And that is still okay. 98% of people is above even the upper community immunity threshold of 94% for whooping cough. These means that even if the government were to pass legislation like I suggest that is wary of the Constitution, the law would still work, even for whooping cough with a threshold of 94%. But, as Mercola and the CDC pointed out, that number is much more likely to be 84% because some fear that it will cause autism or brain inflammation, both incorrect. Because they believe this misinformation, they decide to drop out of taking the vaccine. Because 14%, or 2800 people, decide to opt out, the community is no longer under community immunity, those 2800 people have robbed the entire community of their immunity to the whooping cough, including the 400 people who before were protected by the community’s overall immunity but now must suffer. If allowing a certain few to force everyone to get sick isn’t a gross violation of utilitarianism, I don’t know what is. This miserable calculation shows definably the effect of misinformation, and thus only solidifies my point that vaccines should be mandated, and it would be ethical to do so.
In conclusion, it is ethical and necessary for the government to mandate the use of vaccines with only religious and medical exceptions. Now, I do not enjoy my recommendation of this. I still hate needles, and in the moment, some distant disease can seem Greek to me. But that’s how you know vaccines are doing their job. If you’re being vaccinated against a disease that never occurred in your area in the past fifty years, chances are the doctor is sticking the last nail of that virus’ coffin into your skin. And while the experience for some will be no less unpleasant, I hope that I have proven that vaccines still serve a valuable purpose in our world, and that opting out is akin to running over your neighbor, or rather, your entire neighborhood.
Works Cited
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Immune Deficiency Foundation. (1995). PRIMARY IMMUNE DEFICIENCY DISEASES IN AMERICA. Retrieved from Primary Immune: http://primaryimmune.org/wp-content/uploads/2011/04/Primary-Immune-Deficiency-Diseases-in-America-The-First-National-Survey-of-Patients-and-Specialists-1995.pdf
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Mercola, J. (2012, April 17). Big Surprise – Whooping Cough Spreads Mainly through Vaccinated Populations. Retrieved from Mercola: http://articles.mercola.com/sites/articles/archive/2012/04/17/pertussis-vaccine-for-whooping-cough-effects.aspx
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