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Vaccination Strategies

A news story which ran recently here in New Zealand reported on reactions to a school which refused to allow unimmunised children to attend during an outbreak of measles. A lot of discussion was shown but at no time were the parents asked why they didn’t have the free and well publicised immunisations done, although one mother said she made a “well informed” decision not to do it.

I suspect it wasn’t well informed of course, because anyone who is well informed will have the treatment done. Being extensively informed is not the same as being well informed. A person who can quote a few facts about immunisation, such as it offers good but not total protection, that side effects are real but rare, and that an immunisation rate of about 90 to 95% gives benefit to those who cannot be immunised is better informed than someone who can quote 100 incorrect, outdated, or misleading bits of propaganda, such as immunisation causes autism!

The health professionals said they didn’t want to make immunisation compulsory because people had the right to refuse it, but I think there is a case to say that they don’t actually have that right. If a parent refuses medical treatment for their child which could save the child’s life the state can step in and override the parent’s wishes. Since measles can lead to serious consequences and occasionally death is there not a case to say that the freedom to refuse treatment could be overridden here too?

In some ways the case should be stronger in fact because unless the magic 90% or more of the population are immunised herd immunity won’t occur and there will be no protection for those who can’t be immunised for genuine reasons or for the small number where immunisation fails.

On the other hand I listened to a podcast today where an historian talked about the history of the understanding and treatment of infectious diseases, especially cholera. He mentioned cases going back over 100 years and as recently as during the Haiti disasters. In that case genuine attempts to help were rejected by many people because they suspected conspiracies to cause harm by the authorities who wanted to treat them with modern medical techniques.

So it seems that forcing treatment on people will often be counter-productive even though the increasing silliness of the vaccine denial crowd is endangering everyone. Maybe a better approach would be to have an expert available to show people the real facts so that they are genuinely better informed. A GP could normally do this but they are often too busy so it might be worthwhile to hire a new type of health professional with this specific task. Sure it would cost money but think what it might save in the long run through reduced healthcare costs.

I think a lot of people would respond to this if the real statistics, the evidence of lies and ignorance from the anti-vaccination groups, and the possible negative effects of failure to vaccinate were pointed out. There would be some so tied up with the imagined conspiracy that they would never believe the truth no matter how it was presented but they would be in the minority. It should at least be enough to allow the herd immunity effect to work again.

But I don’t think that sort of initiative would ever happen because political and business activities are almost always short term. Maybe a propaganda (oops, I mean information) campaign on TV would be more appropriate. One emphasising the social consequences of not immunising would be best: consequences like having your child kept out of school and possibly endangering other people.

That would work for some of the deniers but not the die-hard conspiracy theory believers. They are beyond all hope.

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