The Minority Rules the Herd
Dec 03, 2010

By Christine Vara
“What?” you say.  “Minority rules?” 
“How can that be?”
Living in the suburbs of DC I’m constantly reminded about the power of the majority.  In these post-election days, references to the majority and the minority are intended to declare political influence within our government.  People accept that the majority rules because we live in a democracy and that is how it was intended.     
However, this may be why many vaccine advocates grow frustrated with the anti-vaccination sentiment.  People who favor vaccinations are clearly the majority in regards to numbers.  More people vaccinate than don’t – plain and simple.  History shows that immunizations have been effective at significantly reducing the prevalence of vaccine preventable diseases.  Yet, what concerns many vaccine advocates is that the actions of a small percentage of people – a definite minority percentage of the population – can adversely threaten public health.    
Take for instance the concept of herd immunity.  It is based on a delicate balance of numbers.  If the number of people immune to a disease (by means of vaccination or other natural immunity) can be sustained at a high enough percentage of the population, than it severely incapacitates that disease and the ability for it to flourish and spread throughout a community.  Interestingly enough, this “magic” number can differ according to the contagious nature of the various diseases.  Typically, for most diseases, it falls somewhere in the neighborhood of an 80-90% vaccination rate in order to provide protection to the “herd”.  
Fortunately, in most areas of this country, public health efforts have been able to maintain vaccination rates that fall within these percentages.  However, this is not the case in every area and for every disease.  (Take for instance reports of low vaccination rates in areas of CA.) 
In a recent comment thread here on Shot of Prevention, one person who was arguing against vaccines, pointing to the high percentage of people who are vaccinated, saying,

“I find it hard to understand the need for “vaccine advocates”. The CDC reports vaccine uptake rates are at an all time high. Hardly seems like the kind of cause someone would decide to devote their life to. I can think of a lot of things more dire than this.”

While the CDC data may report high rates of vaccination, there is also a host of growing concerns.  First, there is the increasing number of unvaccinated children that are being identified in the more affluent population.  In the past, vaccination barriers were often attributed to financial and medical access, but that is not the case in these more affluent areas and there is concern that this trend may continue. 
Another consideration is that there are often concentrated areas of unvaccinated children within a specific school or community, which then provides a safe-haven for diseases to thrive.  Even if vaccinated, a child can still be exposed to considerable risk of contracting a disease if a large enough percentage of students are not immunized.    (And by large percentage, we could be looking at only 10-15% un-immunized.)
This is when I think about comments I have often heard from parents who do not vaccinate their children. 

“If vaccination is as effective as you suggest,” they comment, “why are you worried about MY un-vaccinated child.  Your child should be protected.” 

Again, this type of comment fails to acknowledge the concept of herd immunity and the unfortunate, but realistic fact that immunizations are not 100% effective, 100% of the time.    Which is exactly why public health advocates must remain vigilant.  They understand that those who fore-go vaccination – even though they are a minority – still have the potential to push us past a tipping point.  
What is disconcerting about this is that our country expects that “majority rules”.  Yet, I wonder how many vaccinated people realize that the minority of unvaccinated people can have a direct effect on their majority decision? 
Everyone is entitled to their beliefs and to vaccine exemptions by the very nature of this great democracy we live in.  But am I too idealist in my vision of Americans as a people who care for their fellow man? Parents who choose not to vaccinate may be just as concerned about their children’s welfare as parents who do vaccinate.  However, their choice to not vaccinate impacts the health of those who do.  Somehow that doesn’t seem fair.  Yet this is the dichotomy that exists when we analyze opinions regarding vaccination.    
Even though the majority of people will vaccinate in a greater effort to protect themselves and others from illness and death…their actions can be “over-ruled” by the minority.  Meanwhile, those people who refuse vaccinations accept the risk that they may contract a potentially deadly disease – or even worse – spread it.  But do they realize that they are mostly protected from the herd immunity that their actions now threaten? 
I think of Shannon Peterson, who was advised not to vaccinate her children, only to lose her daughter Abigale to a vaccine preventable form of pneumonia.  Then I think of young Christina Adame, who just this week, at the age of 23, died of bacterial meningitis, despite being vaccinated.   With vaccination, there are certainly no guarantees.  But I can’t help but wonder, what can be done to prevent further loses like these? 
Do you think that people who choose not to vaccinate will have a change of heart once they are no longer protected by herd immunity?  Hopefully it doesn’t come to that.  But I do wonder, how much longer we all can rely on the protection of the pack?

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21 responses to “The Minority Rules the Herd”

  1. Michelle says:

    Getting a vaccine is a surgical procedure that does carry great risk. You can argue that the risk isn’t that great and no need for concern but if you’re a parent who’s child is vaccine damaged its hard to argue this. Its not appropriate to argue or say “Well, sorry to hear about your child who was harmed by a vaccine but we need to maintain herd immunity”, unless the herd were caring for the child.
    My child is MY child, not the states, not yours, not the guy across the street. It is my choice on how I will care for my child. This is America and we have a right. I don’t tell anyone which medical procedures they should or shouldn’t do, that isn’t my right. So, you care for your kid and I’ll care for mine. If you worry that your child will catch something from an un-vaccinated child then your children should be put in a bubble and never let out of the house. According to Paul Offit, children have constant attacks on their immune system. So people who vaccinate their children shouldn’t worry too much and have to think their child will be alright.
    You shouldn’t scare another parent(s) into doing something they don’t want to do because your scared about your child getting sick. It works both ways, and in both ways its wrong to force something on someone they don’t feel is right.

    • laura says:

      ” If you worry that your child will catch something from an un-vaccinated child then your children should be put in a bubble and never let out of the house.”
      Funny, because if you worry that your child will have vaccine damage then maybe you should put them in a bubble and never let them out of the house. The odds of true vaccine damage are so much lower than the risk of getting in a car and running errands, basic mathematics and logic (in addition to basic human kindness and altrusim) would dicate that YOU STAY HOME.
      Except, that would be a cruel and inhumane arguement to make. And only someone with no empathy for their fellow human would say something like that. So I wouldn’t argue that. But obviously you would.

  2. laura says:

    It frustrates me to no end that one of the most common line I hear from anti-vaxers is their claim that they have researched their decision more than we who vaccinate have (assuming that vaccination is the default and is only approached blindly). And YET they fail to understand the basic mechnisms of vaccines and immunity and the fact that their decision is not a personal one. It is not like they are choosing to pierce thier kids ears. This is something that has a direct impact on kids like my friend’s son who has primary immune disorder and his body won’t mount a substantial defense when presented with a vaccine. Or my other friend’s son who is undergoing treatment for Leukemia. Or my baby who will be born in Februrary and not fully vaccinated until 6-18months against various diseases (and even then not necessarily fully protected). Or people like Chrstina Adame that for no predictable reason will remain vulnerable. If they truly were as educated about the issue as they claim, they would stop asking these asinine questions about why we, or anyone, should care about their so-called personal decision.

  3. Michelle says:

    That’s just it. Just like the article above states. There are no guarantees. Especially with a vaccines, as you all know you could still get sick or die, like Christina Adame, even from something you’ve been vaccinated against.
    So, the best thing to do for those we love a and care for would be to educate each other on the importance of eating right, good sleep habit, vitamins and minerals (especially zinc, vit c, vit d3), good clean water, probiotics, breastfeeding, and hygiene because at the end of the day – vaccine or no vaccine – anyone at anytime could get sick.
    Instead of pushing something that has serious side effects, which can still leave a person vulnerable to illness, why aren’t we educating the public on how to take care of each other holistically??

    • laura says:

      Probably because most holistic/homeopathic treatments are about as effective as a placebo. If you are going to complain about guarantees, you are chasing after the wrong product. Vaccines aren’t magical. But at least they are effective.
      Guess what, I washed my hands, I ate fruits and veggies, I took vitamins and I breastfed and my daughter still got Pertussis. Those things help, sure. But it is ignorant to think that they are even remotely comparable to vaccines.

    • Chris says:

      There are no guarantees.

      With pertussis rates going up, your children (and yourself) have a greater risk of actually getting that particular bacterial infection. Please tell us what the risks are from the DTaP vaccine compared to getting pertussis. Show us the research the vaccines leave a person more vulnerable to illness.
      And what is this “holistically” thing you write about? Wouldn’t that include preventing diseases by educating the immune system through vaccines?

  4. concerned parent says:

    Okay vaccination is and should remain a personal decision. Like Michelle pointed out it isn’t for me to decide what is best for your child. I have both vaxed and unvaxed children. I will say this my vaccinated child is much more ill and has more frequent problems w/allergies than my nonvaxed children. While you give the disclaimer in your article that vaccines aren’t 100 percent effective…that is not how it is presented to the parents in the pediatric office.

    • Snoozie says:

      No, vaccination should not remain a personal decision. It affects public health. You would not say, “Taking a crowded airplane flight when infected with tuberculosis is a personal decision.” When our personal decisions affect the health and well-being of those around us, they are no longer private, personal matters.

  5. Tiffany says:

    “My child is MY child, not the states, not yours, not the guy across the street. It is my choice on how I will care for my child. This is America and we have a right”
    The article clearly isn’t arguing one’s right to make a decision regarding her child’s health. Obviously there IS that right… But the old adage comes to mind “My rights end where another man’s nose begins.” I have a right to do whatever I want…until it affects another person. Unfortunately this is not the case for vaccination. Even though it absolutely DOES affect everyone else, individuals can still decide to risk someone else’s kid’s health in addition to their own child’s health.
    To answer the last question, no, I don’t think people who choose not to vaccinate will change their minds. Mostly because I don’t think their decision is based on fact, science, and logic. I think it’s based on fear and a basic distrust of government and medicine. So when kids start dying of completely preventable diseases (or I should continue to say more kids, since some kids have already passed away), NO, I still don’t think they’ll change their minds.

  6. Michelle says:

    “Probably because most holistic/homeopathic treatments are about as effective as a placebo.”
    Actually, there are quite a lot of studies that show the opposite. In fact, these studies employed double blind studies, accepted by scientists. But, of course I suppose it is possible we don’t know what was in those placebo’s, if we were using pharmaceutical studies as an example. For instance, in a new analysis, researchers looked at 176 studies published in four major medical journals between January 2008 and December 2009 to see what placebos were used. They didn’t get very far with their analysis, only 8.2 percent of all pill studies and 26.7 percent of all injection studies disclosed the contents of the placebo, according to the study in the Annals of Internal Medicine.

  7. Michelle says:

    “And what is this “holistically” thing you write about? Wouldn’t that include preventing diseases by educating the immune system through vaccines?”
    No. The ingredients used in vaccines go against everything that is holistic.

    • Chris says:

      Please provide the journal, title, date and authors of something that actually defines “holistic” and is effective at preventing at least one disease (like pertussis). Thank you.

    • Chris says:

      I am sorry I am having trouble with the term “holistic.” Possibly because this one article describes with the following paragraph:

      “Holistic” also begs a question, albeit one that may escape the comprehension of the naive: homeopathy can’t be holistic, because it eschews pathophysiology in favor of “symptoms,” and for many other reasons; Traditional Chinese Medicine can’t be holistic because it knows nothing of the nervous system, the endocrine system, cells, anything at the molecular level, and more; chiropractic can’t be holistic because it clings to its “subluxation” theory and its theory of “nerve compression” leading to all manner of systemic “dis-ease,” against all evidence; naturopathy can’t be holistic because it readily accepts all three of the aforementioned claims, along with almost any other implausible claim that comes along, and ignores overwhelming evidence to the contrary. And so forth, for every “CAM” claim there is. “Holistic,” like many other terms and phrases common to “CAM” promotions, is an advertising slogan.

      • Michelle says:

        Well, not sure why we are focusing on this term. I’m pretty sure you understood where I was going.
        So, I guess then when I discuss the words holistic and homeopathic I’m talking about how we can take care of our bodies, without or limiting the use of vaccines, to help benefit our immune system (clean water, vitamins/minerals, sleep, exercise, nutritious foods, breastfeeding, etc). I’m talking about using a holistic approach to health.
        “Holistic Health is actually an approach to life. Rather than focusing on illness or specific parts of the body, this ancient approach to health considers the whole person and how he or she interacts with his or her environment. It emphasizes the connection of mind, body, and spirit. The goal is to achieve maximum well-being, where everything is functioning the very best that is possible. With Holistic Health people accept responsibility for their own level of well-being, and everyday choices are used to take charge of one’s own health.”
        This isn’t regarding holistic or homeopathic but I’m curious, is it fair to assume that your argument is: if pharmaceutical vaccines were never developed the human race would have become extinct?

      • Chris says:

        I am sorry, but I don’t see how that website shows its methods are effective in preventing pertussis. It actually looks like a sales pitch, lots of claims but no evidence to back it up.
        Perhaps you could just answer the question on how a child actually getting pertussis, a very real possibility, is better than getting the DTaP vaccine. Please provide some references. Thank you.
        Also, if breastfeeding is protective: then why do babies who are solely breastfed get pertussis? Why did my six month old daughter get chicken pox when she was only getting breast milk and cereal mixed with breast milk? (oh, a side note: at the college library this afternoon I read this article, it has some interesting stuff on babies and bacteria).
        Also, I am not saying that without vaccines the human race would go extinct. Due to variations in human immunity, enough will survive. Though according to the book Plagues and Peoples by William McNeill diseases like smallpox and measles wiped out about 90% of the native population of the American continents. That still left 10%.
        Of course even in the 20th century in there are times when families had children die due to illness. I knew my maternal grandmother had two sisters, but it was only when I saw the family Bible that I learned she also had two brothers. One died when he was six years old, and the other when he was a little less than a year old.
        What evidence do you have that without vaccines losing children to diseases will not again become the norm? You can start by showing actual evidence that the DTaP vaccine has higher risk than pertussis. Also, the evidence needs to be something I can find in my local medical school library. No websites like the “holistic” one, no news reports, and no studies by lawyer paid researchers like the Geiers. The evidence should be similar to the following list (many more at ):
        Impact of specific medical interventions on reducing the prevalence of mental retardation.
        Brosco JP, Mattingly M, Sanders LM.
        Arch Pediatr Adolesc Med. 2006 Mar;160(3):302-9. Review.
        Encephalopathy after whole-cell pertussis or measles vaccination: lack of evidence for a causal association in a retrospective case-control study.
        Ray P, Hayward J, Michelson D, Lewis E, Schwalbe J, Black S, Shinefield H, Marcy M, Huff K, Ward J, Mullooly J, Chen R, Davis R; Vaccine Safety Datalink Group.
        Pediatr Infect Dis J. 2006 Sep;25(9):768-73.
        Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus.
        DeStefano F, Mullooly JP, Okoro CA, Chen RT, Marcy SM, Ward JI, Vadheim CM, Black SB, Shinefield HR, Davis RL, Bohlke K; Vaccine Safety Datalink Team.
        Pediatrics. 2001 Dec;108(6):E112.
        Pediatrics. 2010 Jun;125(6):1134-41. Epub 2010 May 24.
        On-time vaccine receipt in the first year does not adversely affect neuropsychological outcomes.
        Smith MJ, Woods CR.

      • Chris says:

        I am a history buff. I like reading biographies and the history of places. I also belong to a local history museum. It is interesting to see how diseases have influenced history. The book I mentioned earlier, Plagues and Peoples is all about that, which is why it was prominent in a chapter of Jared Diamond’s Guns, Germs and Steel. Here are a couple of examples of disease influencing history:
        Evidence of Smallpox Epidemic Found by First Europeans to Northwest (it made it across the continent!)
        Measles and the Whitman Massacre
        I just read a book by history professor, Leslie Reagan, titled Dangerous Pregnancies. It is about the 1960s rubella epidemic and its impact on society. She argues that it influenced abortion laws (it was actually legal to get an abortion if the child was known to be disabled, which was pretty much certain the mother had rubella early in pregnancy — there were wrongful birth lawsuits when women were denied abortions and had very severely disabled children), and the passing of laws providing education to disabled children (many of the parent advocates had children disabled from Congenital Rubella Syndrome).
        Other books include Panama Fever (controlling yellow fever made construction of the canal possible), The Ghost Map (about cholera), The Great Influenza (about the 1918 flu epidemic, which actually had an impact on WWI), Polio, an American Story (the race for prevention, birth of the March of Dimes), The Cutter Incident (the reason there is so much regulation), Inside the Outbreaks (about a department of the CDC), Henry David Thoreau (his biography, he was quite devastated when his brother died from tetanus) and on and on.
        I mention this because it is true that if you forget history, you are doomed to repeat it. So please tell us how we can skip repeating history if we discontinue vaccines.

  8. Margaret says:

    I love everything you’re saying Chris! smarty pants. Anyways, I’m a much simpler thinker, not dumb, just simple. I think all this holistic hogwash should be thrown out the window when, to date, I believe there are 10 babies under 3 months DEAD from pertussis just this year in California (a state where many choose not to vaccinate). How can anyone dispute those numbers and still say vaccines are bad? The more people who are not vaccinated, the more who will die, it’s common sense no?…starting with the poor, innocent babies who have no vaccine coverage yet. I’m sorry but isn’t death WAY worse than any silly side effect the minority has their panties in a twist about? Call me crazy (I’m sure some will find a way, funny enough). But really anyone who disagrees with me on that is the crazy one. Death is the bottom line here, and it’s happening. I find it shocking that many are choosing to risk death for their children rather than a possible side effect…or for the fact that they’d be foregoing their “homeopathic” rainbows and butterflies approach to health and well being. If that stuff actually worked, there’d be no reason for science and medicine as it is practiced today. So if homeopathy doesn’t focus on an illness at hand because it’s too busy considering the whole self and it’s interaction with the environment (what?!)…then what does is do for a child that needs a cardiac repair because of a congenital defect, or one needing a cardiac transplant due to cardiomyopathy, or one with cystic fibrosis needing a lung transplant…all which would result in death? Homeopathy is just a feel good approach to wellness, and it’s a bunch of crap for those who actually need a real medicinal or surgical solution. That’s why science has evolved and we do things the way we do, because it’s been tested through time and it works. That’s why homeopathic, holistic approaches are ancient…it’s been tried and it doesn’t work. Before vaccinations were discovered, half of the children in families were wiped out by diseases. That doesn’t happen anymore because we discovered vaccines. People need to stop being so fearful and emotional over vaccinations, pulling every last insignificant “fact” from every unsubstantial source, and look at history…look at where we are now…and understand that we’ve discovered something very right about vaccinating. PERIOD.

  9. Heidi says:

    Throughout human history there have been “population bottlenecks” where large portions of the population were wiped out by starvation and/or disease. I wonder if we are not facing another bottleneck, where many in our population will die due to a weakened “herd immunity.” The arguments against vaccinations hold up an extremely small percentage of the population with adverse reactions to vaccinations as a reason why no one should be vaccinated, but it seems to me that a much larger portion of the population will ultimately die due to non-vaccination than will be saved. Remove all the emotion over the subject and you will see that the most logical course of action remains to vaccinate all children.

  10. […] immunizations not only benefit the children directly, but that they also contribute to overall herd immunity, thereby working to protect even those who remain unvaccinated.  Some of these parents feel that […]

  11. Babs says:

    In the past, vaccination barriers were often attributed to financial and medical access, but that is not the case in these more affluent areas and there is concern that this trend may continue. – – – so it’s not as much a concern when you can’t get vaccinated because you’re poor, but if you choose not to vaccinate, action must be taken

  12. […] combination of all these factors can adversely impact the number of people immunized and the herd immunity that Benjamin relies on.  It is suggested that a vaccinated person who contracts a disease will […]

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