I see myself as a protector of women and children, a gatekeeper of sorts. For this reason, I bristle at the tactics of coercion used to move women out of their space of intuitive agency, and into a place of fear. There is no tactic as powerful as altruistic guilt, as insinuating that a woman is dangerous, reckless, and selfish if she chooses not to vaccinate herself or her child. The most prevalent and most unsubstantiated meme is that of “herd immunity” or the notion that high vaccination compliance protects a community from an outbreak.
A brilliant commentary by Cornell, Harvard, and Stanford vetted immunologist, is a must read on the subject, for anyone intending to wield the “greater good” rhetoric, or who has been subject to the scorn of those who do. Here is an overview of the matter according to Dr. Obukhanych.
She begins by defining the term, and orienting us to the fact that “herd immunity” is not a scientifically validated concept, let alone one that applies definitively, predictably, or preventatively to vaccinated communities:
Herd immunity is not an immunologic idea, but rather an epidemiologic construct, which theoretically predicts successful disease control when a certain pre-calculated percentage of people in the population are immune from disease.
The humble origins of this powerful meme may surprise you. In fact, it has no basis in vaccine-induced antibody production and heralds from an observation by A.W. Hedrich, in 1933, that measles outbreaks in Boston between 1900 and 1930 were suppressed when 68% of the children contracted the virus. Mass vaccination in 1967 did not stop the measles epidemics, and still has not, today.
Dr. Obukhanych sites the example of rubella vaccination in children, who do not personally benefit, but who suffer risks of this intervention for the theoretical protective benefit of pregnant women in the population. Mass vaccination in 1970 in Casper, Wyoming resulted in failure of heard immunity principles, and in a rubella outbreak affecting over one thousand individuals including pregnant women.
If the concept of herd immunity is the bedrock of government mandates to increase vaccination compliance, where is the evidence that this is a reasonable, realistic, or safe goal to strive for?
Undermining the concept of herd immunity
Outbreaks in highly, if not completely vaccinated populations have been documented for decades. This article states:
Although the evidence for vaccination-based herd immunity is yet to materialize, there is plenty of evidence to the contrary. Just a single publication by Poland & Jacobson (1994) reports on 18 different measles outbreaks throughout North America, occurring in school populations with very-high vaccination coverage for measles (71% to 99.8%). In these outbreaks, vaccinated children constituted 30% to 100% of measles cases.
She highlights three challenges inherent in the proposed effects of a live attenuated vaccine such as MMR that are largely applicable to ALL vaccines:
1. The antibody production resultant from a live attenuated virus is of lesser capacity and for lesser duration. She states: “The herd-immunity concept is based on a faulty assumption that vaccination elicits in an individual a state equivalent to bona fide immunity (life-long resistance to viral infection).”
2. Secondary to individual biochemistry and genomics, a significant percentage of those vaccinated will not mount an anticipated antibody response. Repeatedly revaccinating these non-responders does not improve the efficacy of the vaccine intervention – second, third, and fourth boosters will not bring these individuals into the herd.
3. Those who have been vaccinated can manifest “modified” versions of the infective illness, but remain undiagnosed because of their vaccinated status, may transmit to contacts. This has also been demonstrated, notably, in the case of pertussis, discussed here.
4. As those who are naturally infected and sustainably protected begin to die off, and the vast majority of our communities undergo immunologic manipulation by the vaccine schedule, we are priming a population for large epidemics of likely more treatment resistant strains – “it is not vaccine-exempt children who endanger us all, it is the effects of prolonged mass-vaccination campaigns that have done so.”
To prevent an outbreak, 70-95% of the population, according to very-broad theoretical estimates, has to be truly immune – that is, resistant to viral infection, not just protected from developing the full range of symptoms that conform to the accepted clinical definition of the disease. However, even 100% vaccination compliance can at best make only a quarter of the population become resistant to infection for more than ten years. This makes it apparent that stable herd immunity cannot be achieved via childhood vaccination in the long term regardless of the degree of vaccination compliance.
Finally, she asks the question at the forefront of my mind:
Why, for the sake of an unattainable idea, would pediatricians and public-health officials pester those families who choose to shield their children from potential vaccine injuries or to ensure their children’s health via natural vaccine-independent strategies?
May patient autonomy trump all medical interventions, now, and forever.