What is the cost of Jenny McCarthy appearing on Oprah to blame her son’s autism on vaccinations? Or notable pediatricians such as Dr. Jay Gordon and Dr. Bob Sears downplaying the risks of vaccine-preventable diseases? Unfortunately, when one family decides not to vaccinate, other families can pay the price–even those who’ve chosen to vaccinate their kids, explains author Seth Mnookin in The Panic Virus: A True Story of Medicine, Science, and Fear.
The notion that people should base medical decisions on what is “right for them” is particularly problematic in a public health context, where individual choices cannot be cordoned off from each other. Consider the case of Julieanna Metcalf, a fifteen-month-old fully vaccinated girl who was taken to the hospital on January 23, 2008, with what her mother thought was a particularly bad case of the flu. It was only after extensive tests that doctors discovered that Julieanna had a compromised immune system that rendered the vaccine for Hib ineffective. By the time she got out of the hospital almost a month later, Julieanna had suffered multiple seizures and had had a buildup of fluid in the brain so dangerous it required emergency surgery. She’d also lost all her motor skills—including the ability to swallow—and will require multiple immune globulin injections each week for the rest of her life.
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Even with her weakened immune system, Julieanna might not have caught Hib if everyone around her had had their shots, but the Minnesota community in which she lived was a place where the same ethos emanating from Gordon’s and Sears’s waiting rooms and Winfrey’s couch had taken hold. The outbreak that ensnared Julieanna also resulted in the hospitalization of four other children. One was a baby who was too young to have been vaccinated. The parents of the three others had all chosen not to vaccinate their children; one of those, a seven-month-old girl, died of the disease.
Those realities are obviously hard to square with Bob Sears’s downplaying of the dangers of vaccine-preventable diseases—but Sears didn’t need to look to Minnesota for proof that those diseases actually can be “that bad.” Ten days before Julieanna ended up in the hospital, a seven-year-old boy who was later revealed to be one of Sears’s patients returned from a family vacation in Switzerland with the measles. While the boy’s parents had made a choice not to vaccinate their child—as his mother explained in a Time magazine article, “We analyze the diseases and we analyze the risk of disease, and that’s how my husband and I make our decision about what vaccines to give our children”—many of the people who paid the price for that decision had less say in the matter.
Within days, the measles virus had spread to a swim school, a pediatrician’s office, a Whole Foods, a Trader Joe’s market, and a charter school; passengers on a plane headed to Honolulu were quarantined at a military base; and a ten-month-old child was hospitalized and required medical care for a full month. (According to Gordon, the hospitalization was an overly dramatic reaction: “My guess is that if this had happened in the 1960s, no one would have been hospitalized. They would have said, ‘Oh well, an . . . outbreak of measles.’ “) An additional forty-eight children who were too young to be vaccinated had to be quarantined in their homes, at an average cost of $775 per family. In total, the outbreak cost more than $10 million to contain.
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