The issue: Vaccination is better than cure
Text: Micha Jacobs; Photography: Levien Willemse
Of course no one wants to have a blocked nose, sore throat, coughing fits and days spent in bed feeling feverish. However, not every body is as resistant to the pathogenic effect of autumn and winter weather. So: Put on a coat, wrap on a scarf and head to your GP for a flu vaccination! No, says the Jehovah’s Witness. Yes of course, says virologist Ab Osterhaus. "The objections to vaccination are based on fallacies." |
Vaccination is better than cure
Is it true that you recently had a flu vaccination? "Yes, I’ve been getting them for years."
Why? "I think that it is sensible to have yourself vaccinated against influenza, especially if you belong to a high-risk group, as I now do. I do not want to have the flu. I have not had the flu once since I started having the vaccinations."
Do you understand that there are people who have a fundamental/moral objection to vaccinations? "In the Netherlands, there is no formal obligation to have yourself vaccinated against childhood diseases. This has to do with the integrity of your body: everyone should have the right to self-determination. I think that this is a good thing. In America, for example, you cannot enrol your children in school if they have not been vaccinated against measles. This results in an indirect obligation. In the Netherlands, everyone is offered the State Vaccination Programme for children and you may chose to withdraw from this programme for whatever reason. That is a constitutional right, which I think is a good thing. Fortunately, almost all parents do allow their children to be vaccinated."
So we have a right to self-determination, something that a child does not have. A parent does. What are the moral objections when it comes to vaccinating a child? "I think that parents who do not have their children vaccinated place a very heavy burden on themselves. These parents are fraught with worry when their child becomes seriously ill and requires hospitalisation. Suddenly we need to pull out all the stops to save this child. This can lead to tragic cases, even resulting in death."
In which groups of society does this occur? Amongst members of the reformed churches, or amongst immigrants? "No, not amongst members of the reformed churches, or amongst immigrants. In the Netherlands we have a so-called bible belt. This area is home to a certain category of people who think that they should object to vaccination based on certain biblical references. This is only a small percentage of our population. Fortunately, the rejection of vaccination for religious reasons is becoming less common in this group. Apparently there are several ways of interpreting the Bible. If a person continues to object to vaccination for religious reasons, there is not much more that can be done."
But religious reasons are not the only reasons why people are hesitant. "No. There are people who become convinced, by information on various websites, that it is so healthy for a child to contract a childhood disease. Nonsense! One of the theories used to support this is the so-called hygiene theory. That is: our children are developing asthma and eczema more frequently, because we allow them to be vaccinated. If this were true – and I don’t think that it is – I would prefer to have a treatable condition such as eczema or asthma than a childhood disease that can be fatal. Opinions may differ on this matter. It is also worth noting that children are "bombarded" with viruses during their first year of life, resulting in plenty of intensive stimulation of the entire immune system. I am not at all convinced that vaccinations play a role in this matter."
Is vaccination, or not, a matter of life or death? "It can absolutely be, but the public does not read the advice by the Health Council. These are the people who gather the information from all studies, evaluate critically whether a vaccine should be added or not and who include the level of acceptance as a social factor in that decision. That is actually remarkable: you offer society an important health measure and you receive resistance to it. For example, if there is an outbreak of meningitis (as was the case in Noord-Brabant several years ago) and there is no vaccine available at that moment, then every mother suddenly wants to have her child vaccinated. In other words: if there is a sense of urgency, if children are really dying, then everyone wants to have their child vaccinated."
Even the opponents that we mentioned previously? "You cannot be categorical. Those people in the bible belt are not included. And the anthroposophists? If they are very stubborn, they will not participate either. These people often come from critical environments – think of Bilthoven or the Ring of Canals in Amsterdam, although here also they are fortunately only an exception. We once saw an outbreak of measles at an anthroposophical school. Local general practitioners did not recognise it at first, because there had not been a case of measles for years and many of them had not seen it before. My generation experienced the horrors of diseases such as polio, today’s parents have not. They have never seen a child crippled by polio, never mind a death as a result of a childhood disease. And then there are all sorts of claims, for example that a child can become autistic as a result of vaccination. There is not a shred of evidence to prove this. In fact: there is evidence that this is not the case. These stories continue doing the rounds and that is frustrating."
Are there health risks associated with vaccination? "No. The side effects are extremely limited and usually non-existent. The pain of the injection may sometimes last for a day. There are many stories about vaccination. You hear a story about someone who went for his or her first flu vaccine and suddenly became ill. That would not be as a result of the injection. This person probably already had the flu before receiving the injection, or it developed within one week after the vaccination. This is due to the fact that the flu vaccine only starts working after one week. And vaccination occurs at the start of the flu season."
This could provide ammunition for opponents. "But it is based on fallacies. The main reasons for people not having the vaccination are fear of injections, indifference and ignorance."
Perhaps compulsory vaccination is a necessity, rather than a choice? "From a virological perspective I think that everyone should have their children vaccinated against childhood disease, but it is a drastic measure to make something compulsory. More than ninety percent of children in the Netherlands are vaccinated. You need a certain buffer to exclude a virus. Even if you do not vaccinate the remaining five percent, the virus does not stand a chance as a result of group immunity, unless there are clusters of unvaccinated individuals. Look at the bible belt. If a virus enters a primary school there, it is an entirely different story. We have seen that in the past with outbreaks of polio and measles. Enormous problems."
Do you think that more people will die in future who do not vaccinate? "No, I think that the acceptance of vaccines will only increase."
How will you target the group that will not have themselves vaccinated if a pandemic looms? "That is not important for a pandemic, which will undoubtedly happen. When you see many sick people around you and you even witness your neighbour dying from a viral infection, you know that it will be your turn soon – then you will come for the vaccine yourself."
Monday, 10 November 2008 (week 46).
Every week in 'the issue' an academic from Erasmus University Rotterdam responds to a current topic in the media. 'The issue' is brought to you in cooperation with Erasmus Magazine, the opinion and information magazine of Erasmus University Rotterdam.
