Respect the Momma Bear

The NY Times has brought up vaccines again in this article, discussing a measles outbreak that involved nine unvaccinated kids and some others that were vaccinated. The Times is spot-on in its critique of the decision, discussing both sides and rightly pointing out the public health risk.

However, the angle that is always missing is still missing: the angle of benefit for the individual vaccinated. Rarely do people frame it that way, and when they do, they are often successful, in my experience. This is good for YOUR kid. Not the other ones. Not the public. Not the schools, or the government. YOU and YOUR kid. Why? Because, even if you buy the risk of autism (which I personally don't) the chances of having some bacteria or virus eat holes in your kid's brain large enough to park a Tonka truck in are greater than harm from the vaccines.

Vaccines do harm kids; according to VAERS data, the self-reported network, they do cause fevers and irritability, and can also lead to allergic reactions. But these reactions are much less common and much less devastating than the consequences of the admittedly rare sequelae of our major immunizable diseases. When I was on the pediatric wards, one of four kids I took care of was a CP patient that had an MRI that made me cringe, and the damage was from infection.

The whole problem is that we haven't respected the mother instinct. I'm a guy so I'm a bit bigger and probably physically stronger than my wife, but if there were someone or something threatening our kids, she would be the one to rip its trachea out and stomp on it. This instinct is so strong that it defies the laws of Newtonian and quantum physics. Even when I did a google search on 'momma bear' to get a picture for this post, I happened on a good blog where a mom avowed that she would 'rip the heart out' of anyone who attempted to accost her child. We joke about this in our society, but its very real. Just try it sometime. I dare you. Go up to a mom feeding her baby with mashed up bananas and take the food away. See what happens.

So what? So, doctors like to tell people what to do. It's our job; we go to school for a long time so we can do it. Guess what? Moms don't care. They go through labor to get their kid and who the hell are we to tell them what to do? I think they win, even though school is long. As a medical community, we will never be able to change a mom's mind by telling her what to do, and that is evolutionarily appropriate. Thank God for moms. Even though I'm done with mom doing her mom stuff now, I'm sure it saved my life a couple times when I was seven and stupid.

What Momma bears can teach us is that if we are to change the mind of a parent we will not do it by saying, 'you must succumb to our order to stick your kid in the leg with a needle that may or may not have mercury in it'. Instead we might try, 'I understand you are worried. In my opinion, the risk of getting this vaccine is much lower than the risk of getting a terrible disease if you don't get the vaccine. Both risks are small, but the risk of disease is much bigger than the risk of a serious reaction to the vaccine'.

Mommas don't care about other kids when it comes down to danger to their own cubs. They just don't. So we may plan as a profession with public health in mind, but that is no argument to a momma bear.

Why are vaccines so vital? Chicken pox isn't that bad, right? Well, it's not the normal outbreak that the vaccine is aiming to prevent. It's the rare outbreak that eats the child's brain, the rare measles infection that makes them dance like Satan's marionette, the rare meningitis case that kills them before they have a chance to wake up, or the rare HPV infection that progresses to fungating cancer eating into the wall of their vagina. Once you've seen those cases, vaccines aren't so scary. We just have to respect the interests of patients and their parents and let them know the real consequences they face; and, like it or not, I still believe we have to let them make their own choice.