By Jane M. Orient, M.D.
According to the Oath of Hippocrates, physicians have the duty to advise their patients according to the best of their ability and judgment. In In most cases, most physicians recommend vaccination, believing that for a particular patient, the benefit exceeds the risk. Patients or their parents, however, have the right to decline to follow their doctor’s advice.
But with vaccination, government restricts this right. Every time there is a measles outbreak somewhere there is an outcry to restrict vaccine exemptions, to protect the public—and, just coincidentally, vaccine manufacturers.
Measles is extremely contagious, and with today’s air travel, a patient incubating measles but not yet sick can arrive any time and cough virus particles all over Disneyland. Most patients recover fully, with robust lifelong immunity. But some get serious complications or die. Measles is two to four times worse than in pre-vaccination days because it affects more adults and infants. Mothers with only waning vaccine-induced immunity cannot give their babies the antibodies that once protected infants of naturally immunized mothers during their most vulnerable period.
The public health or guilt-trip rationale is this: “My baby is immunosuppressed and can’t get vaccinated. So, you must vaccinate your baby because if there’s an outbreak, your unvaccinated baby might catch measles and give it to my baby, who might die.” Of course, parents fear for their children, although the last measles death in the U.S. occurred in 2015.
This argument assumes that the risk of vaccine to healthy children doesn’t exist—or doesn’t matter. Worries are attributed to “antivax quacks,” and the omniscient Mark Zuckerberg of Facebook is reportedly going to protect the public by suppressing information he judges to be “not credible.” Public health people prevented the screening of the 2016 movie Vaxxed: from Coverup to Catastrophe in Phoenix. The film shows children with devastating neurologic damage, and parents telling how their once normal child changed dramatically just after getting a vaccine. But these are mere anecdotes; there is “overwhelming evidence” of safety, the experts assure us.
Most children tolerate their vaccines well, but package inserts list an intimidating number of rare but serious events—that might or might not have been caused by the vaccine. Moreover, according to the Cochrane Collaboration, “The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate.”
Safety studies are always limited. Terrible but rare complications might not show up in the limited number of study subjects, or might be delayed until after the study concludes. Chloramphenicol was a widely used antibiotic, until one in 50,000 patients got lethal aplastic anemia. And let us not forget thalidomide and the babies without limbs. One incentive to be cautious and avoid attempts to cover up adverse effects is the prospect of being sued. But vaccine manufacturers are immune from product liability. The only recourse for vaccine-injured patients is Vaccine Court, which has paid out $4 billion in damages. Two out of three claims are denied.
But aren’t the risks worth it? What if large numbers of parents start to refuse vaccination? Maybe there would be a huge outbreak, spreading like wildfire, causing thousands or millions of deaths? Shall we not pit the worst imaginable hypothetical scenario against an unknown number of vaccine adverse reactions? Is it not worth it to eradicate the scourge of measles?
The fact is that measles probably can’t be eradicated, not with an imperfect vaccine. In Saudi Arabia, where vaccination rates were between 95 percent and 98 percent, there were 4,648 cases of measles in 2007 compared with 373 in 2005. The best we can do is probably to aim for disease control. A freedom-based approach—for example, seeking better vaccines, excellent diagnostic and contact-tracing tools, and open communication—is more likely to lead to an optimal result than forcing the currently available vaccine on unwilling recipients.
Deciding what is best for individual patients is difficult, fraught with danger and full of uncertainties. Doctors may advise, or patients may choose a course that is harmful. But if governmental authorities, imbued with a sense of infallibility, impose their will on everyone, the consequences of a bad choice affect millions.
Trading freedom—and free speech—for supposed security ultimately leads to a loss of both. And if government can dictate what you must inject into your own children, what limits can be placed on its power?
Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989. She is currently president of Doctors for Disaster Preparedness. Since 1988, she has been chairman of the Public Health Committee of the Pima County (Arizona) Medical Society. She is the author of YOUR Doctor Is Not In: Healthy Skepticism about National Healthcare, and the second through fourth editions of Sapira’s Art and Science of Bedside Diagnosis published by Lippincott, Williams & Wilkins. She authored books for schoolchildren, Professor Klugimkopf’s Old-Fashioned English Grammar and Professor Klugimkopf’s Spelling Method, published by Robinson Books, and coauthored two novels published as Kindle books, Neomorts and Moonshine.More than 100 of her papers have been published in the scientific and popular literature on a variety of subjects including risk assessment, natural and technological hazards and nonhazards, and medical economics and ethics. She is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives, and is the managing editor of the Journal of American Physicians and Surgeons.