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A Physician’s Plea to Those Who Don’t Vaccinate

What value do vaccines have in your life?

Throughout July and August, Shot of Prevention is encouraging people to address this question.  Today’s guest post, by clinical cardiologist Dharmaraj Karthikesan, provides a personal perspective from someone who is genuinely concerned about the health and well-being of people who choose not to vaccinate themselves or their children.  

Photo Of RajHere’s what Dr. Karthikesan has to say:

I’ve heard people say that deaths from preventable diseases are the will of God.  Indeed all men must die, but not all have to die stupid.  I believe ignorance is deadly.  Sadly, it can also be contagious.

My issue resides with people who are opposed to vaccination and recently this issue became very personal. 

See, I have a new nephew in the family.  He lives in another country and so I only get to see him on Skype.  However, his parents were considering a visit and I was really looking forward to seeing him.   But due to the outbreak of diphtheria in Malaysia, where I live, I advised his parents to postpone their visit.  See my nephew hasn’t completed his vaccination schedule and I feared for his health.

My fears are not unfounded. This is the reality we are living in; where our lives are dictated by the decision of others. And every decision not to vaccinate affects the health of others in our community and in our world.

As a doctor, I try to appeal to people’s sense and reason when they tell me that they have decided against vaccinating.  Sometimes that communication fails and so I’ve decided to try to employ one other method.

Instinct.

I ask,

Do you instinctively feel that your child is safe without vaccination? 

Do you instinctively feel secure knowing that your child will recover regardless of the infectious disease that they may contract?

Do you instinctively feel impervious to all manner of infectious disease, even those which are airborne, just because you eat a certain diet or take certain homeopathic remedies?  

If it is difficult to honestly answer these questions affirmatively, then I beg you to consider what I have to say. 

Vaccines are safe.

I state the obvious first. I understand and empathize with those who feel that vaccines are dangerous and those who believe vaccines can be harmful or detrimental to health. Let’s assume that this is true. For a moment, let’s assume they are worse than death, or worse than the defects and disabilities they cause.

Let’s start with polio, which can cause disability and even suffocation if it involves the breathing muscles. Assuming your child recovers from polio, he may never run or play like a normal child. Are you prepared to accept that?

How about diphtheria, which affects your child’s breathing. In severe forms, it can affect the heart and nerves leading to death. Are you willing to take that chance? 

Now how about pertussis, which is known to cause violent, uncontrollable coughing making it extremely difficult for a child to get air into their lungs.  About half of babies who get pertussis need care in the hospital, and 1 out of 100 babies will die.  Is this the kind of suffering you want for your child?

There are serious dangers with all vaccine preventable diseases.  However, vaccines work to prevent infection by developing an immunity that imitates the infection.  This imitation spares one from suffering with severe illness.   Instead, vaccination allows the immune system to develop an arsenal of weapons in the form of’ ‘antibodies’. If your child should ever be exposed to these infections in the future, these antibodies will prevent the infection from spreading to your child by eliminating the threat early and preventing your child from getting sick. It’s quite simple actually.  Once the body knows the ‘enemy’, it is better able to defeat it.

So the question that begs for an answer is this;

Do you want your child to be facing these diseases alone, or do you want a strong arsenal of vaccines helping to form a protective shield?

The choice is yours.  But that’s the problem actually.  Vaccines are a choice and people’s choices are sometimes influenced by inaccurate information.

Doctors don’t make money from selling vaccines.

I’ve heard people justify their refusal of vaccines by saying that doctors only recommend vaccines because they make money from them.  What they don’t realize is this. The very people who convince them to despise doctors and modern medicine are actually doing so in order to make money from their fear and ignorance.

Let’s assume doctors are indeed making money from vaccines (which in most countries are given for free under their national health programme) .  Isn’t it then fair to ask if the alternative medicine practitioners are offering their services for free?

I challenge you to do this; if someone comes to you and says that vaccines are a propaganda of certain individuals (such as doctors, pharmaceutical companies or even governments), ask them if the alternative they are proposing is free. Are the essential oils, herbs and other health offerings offered out of the goodwill of these practitioners without expecting any monetary payment in return? I suspect that will be the last you hear of their goodwill and sage advice.

As an adult cardiologist, I don’t administer vaccines.  However, science tells us that vaccination can help prevent stress on our hearts that can result from various infections such as influenza.  This is why I support vaccines. Because I know it can help save the lives of my patients who I care very deeply about.

 Your choice endangers others.

The most unacceptable outcome of not vaccinating is when an intentionally non-vaccinated person spreads an infection to others.

Vaccinated individuals help form a barrier around others who cannot tolerate vaccination due to defects in their immune system.  Also, young babies are especially vulnerable to these deadly infections while they are too young to complete their vaccination schedule.  By having a large percentage of the population vaccinated, we can help contain the spread of infection through ‘herd immunity’.

Unfortunately, one person’s decision to not vaccinate themselves or their children can result in the spread of infection to countless other innocent lives.

If you choose not to vaccinate, 

Have you ever taken the time to speak with someone who has been permanently disabled as a result of a vaccine preventable disease?  

Have you talked to a parent who has lost a child who was too young to be vaccinated?  

Have you ever spoken to a parent whose unvaccinated child has suffered from a vaccine preventable disease and asked them how it felt to watch their child suffer?  Or asked the child themselves how they liked suffering when their pain could have been avoided with a simple vaccine?

Have you forgotten that your parents likely vaccinated you when you were young and you are still alive today?  

Good intentions don’t always make for good decisions. 

I will not vilify those who refuse vaccines. I know that they believe they are making the right decision and that they believe vaccines are in some way harmful.  But I just want them to realize how dangerous the diseases are that we are trying to contain and even hopefully eradicate.

Ask yourself,

Does it scare you when your child develops a fever after vaccination? Understand that it happens because your child has a healthy immune system, which is now producing the aforementioned antibodies.

Does it frighten you to see the rise of autoimmune diseases, environmental allergies, life-threatening food allergies, ADHD, seizure disorders, asthma, and cancer? Have you considered that you, your parents and possibly even your grandparents have been vaccinated.  So why would vaccines suddenly result in the rise of these conditions now? Perhaps there are other explanations. 

Vaccine safety has been extensively studied, so why do you steadfastly hold on to the belief that vaccines are dangerous?  Do you really believe that there is a huge international conspiracy to hide the truth?  And do you have any credible studies to back your claims?

Have you considered that there may be other causes to the ailments and “injuries” that you claim are a result of vaccination?  

Ignorance and ego are twin beasts that devour us from within – they prevent us from gaining sense and perspective. So I beg of you; read and reflect on what I have written here. I am not the enemy. And you are not mine. I just honestly want what’s best for you and your children, and I want your decisions to stop threatening the welfare of those I love and care about.  And that includes you and your children.

I want to live in a world that is safe from preventable diseases – a world that is not shackled by fear and stricken with disease.  I want to be able to have my nephew visit me in Malaysia without concern that it may cost him his life.

As Thomas Sowell once said,

“It takes considerable knowledge just to realize the extent of your own ignorance.”

So I am pleading to those who currently refuse vaccines.  Seek knowledge beyond where you are currently seeking it.  Act with compassion knowing that your decisions may actually be dangerous to those you love the most.  Be courageous enough to consider that you may have misjudged vaccines.  And if nothing else, be compassionate!

A note about the author: Dharmaraj Karthikesan is a clinical cardiologist who has also worked as a physician in the infectious disease unit of Hospital Sultanah Bahiyah, Alor Setar and as the head of internal medicine department in a district hospital in Lahad Datu, Malaysia. He is passionate about immunizations and often writes about his perspectives in articles published in local newspapers, Asian Scientist Magazine, the American College of Cardiology and on his personal blog “My life as a doctor and the way I see it…”   

Please consider sharing your own story about the value of vaccines by contacting us at shotofprevention@gmail.com.

 

  1. July 14, 2016 at 5:32 pm

    Well said!

    Like

  2. Bryce Spooner
    July 15, 2016 at 11:37 am

    “And every decision not to vaccinate affects the health of others in our community and in our world.”
    So all of the millions of adults walking around that are not up on their vaccinations are affecting your health?

    “Vaccines are safe.”
    So are you willing to sign for and take responsibility and pay me millions if my child is injured?

    “Let’s start with polio”
    Polio is 95% asymptomatic. 4% with minor illness and less than 1% have any series health issues.

    “Now how about pertussis”
    Recent study’s by the CDC prove that the recently vaccinated spread the disease.

    “Let’s assume doctors are indeed making money from vaccines”
    Doctors are paid for giving vaccines. Recent documentation from Merck proves it.

    “Your choice endangers others.”
    Herd immunity does not exist. Millions and millions of adults are walking around who are not caught up and are essentially not vaccinated. Also, how does a non vaccinated person spread a disease they don’t have? It is the recently vaccinated that can spread disease unknowingly.

    Like

  3. Joel A. Harrison, PhD, MPH
    July 16, 2016 at 10:47 am

    @ Bryce Spooner

    Yep, only 1% who were infected with polio developed paralysis, not just “any series [serious ] health issues.” That 1% totaled an average of 15,000 per year. Some did regain some mobility, others remained paraplegics or, worse, confined to an iron lung. When the oral polio vaccine was in use, it actually caused around six cases a year. So 15,000 vs 6. The inactivated vaccine has NOT been found to cause any cases. So, if you think up to 15,000 paralyzed children isn’t something to be upset about, not much anyone can say. And polio is just as infectious today as it was 60 years ago.

    As for “herd immunity does not exit.” You really DON’T KNOW WHAT YOU ARE TALKING ABOUT. I suggest you go to your local university library and get the following article:

    Paul E. M. Fine (1993). Herd Immunity: History, Theory, Practice. Epidemiological Reviews; 15(2): 265 – 302.

    I guess you don’t understand the basic principles of immunity, that is, why once we get a specific disease, we don’t get it a second time, that is, our immune system recognizes it and repels it before it can take hold.

    You ask “how does a non vaccinated person spread a disease they don’t have?” Simple, as you said yourself in the case of polio, “Polio is 95% asymptomatic. 4% with minor illness and less than 1% have any series health issues.” So, people can be asymptomatic or just have minor illness, yet spread the disease. Don’t you even understand what you, yourself, have written?

    As for compensation, we have the Vaccine Court which actually do give out compensations in the millions to deal with lifetime disabilities that may have been caused by a vaccine. I say may because the Court errs on the side of the families when in doubt. However, this doesn’t mean the Court bends so far as to award families for problems that science has shown NOT caused by vaccines. So, the Court awards a half dozen to dozen cases per year. If we didn’t have vaccines, who would help the 10s of thousands of families whose children got the diseases the old fashion way? This isn’t a perfect world; but the risks from the natural diseases was exponentially higher than from the vaccines. And the Court pays the lawyer fees even if one loses the case. If one went the usual lawsuit route, cases would drag on for many years and it would be a crap shoot whether one won or lost. The Court, as I wrote, errs in favor of the plaintiff and lawyers risk nothing by taking on a case because they get paid either way. Vaccine manufacturers make little profit on vaccines, yes they do make a profit, that is what they are in business for. Vaccines are very difficult to manufacture and the standards are much higher than any other product, including other pharmaceuticals. Remember when we had a flu vaccine shortage because they found a bacteria contaminated some lots of one manufacturer? They lost all the funds used to manufacture the vaccine that year. And the majority of childhood vaccines are purchased by governments and large non-profits who negotiate reasonable prices. One lawsuit, whether justified or not, if the jury rules in favor of the plaintiff, could cost the entire profits of several years. So, vaccine manufacturers were refusing to continue manufacturing them. For those of us who understand the ramifications, the risk of 10s of thousands of injured and dead children, this would have been a catastrophe. Which is why the Vaccine Court was set up. However, if one can prove negligence on the part of the manufacturers, they can still be sued.

    As for: ““Now how about pertussis”
    Recent study’s by the CDC prove that the recently vaccinated spread the disease.

    Almost 100% of children prior to the vaccine got pertussis with up to 50,000 hospitalized and between 40 – 50 deaths per year. In addition, a few also lost their vision or suffered brain damage. Those vaccinated do shed virus, though lower than if they had the active disease and for a shorter time, and if those around them are vaccinated, they either don’t get the disease at all or, often a milder case. This is NOT a perfect world; but a rational choice is to prevent the full-blown disease in almost all children and risk a few cases.

    I really get tired of the mantra that doctors get paid for vaccinating. First, many kids in US get vaccinated at public health clinics where the staff is on salary. Second, so what? Doctors get paid to treat children with antibiotics. Do you think they should work for free? The amount they make for vaccinating kids is only a minuscule part of their practice. They have to purchase the vaccines, store them (refrigerate them), they have expiry dates, and have to be tossed, purchase the syringes, and they or their nurse give the shots. Do you work for free?

    I repeat the most important part. Who paid, who helped the parents of the 10s of thousands of children who got the diseases naturally prior to the vaccines and were injured or, worse, died?

    Like

  4. Gray Falcon
    July 18, 2016 at 8:31 am

    I suspect a hundred polio shots cost far less then treating one person paralyzed by polio.

    Like

  5. Bryce Spooner
    July 18, 2016 at 12:07 pm

    Dr. Harrison,

    There hasn’t been a wild case of Polio in the US for the last 2 decades, but there have been cases caused by the vaccine itself. The Polio vaccine actually causes Polio. Bill Gates sent the oral version of the vaccine to India in 2012 which ended up paralyzing 47,500 kids and adults. They call it non-polio acute flaccid paralysis (NPAFP) which is even worse than regular Polio. http://www.ncbi.nlm.nih.gov/pubmed/22591873

    Why don’t you explain how heard immunity works when there are millions of adults walking around without ever getting the disease or getting their booster shots?

    The recently vaccinated are much more likely to spread disease then the non-vaccinated. A non-vaccinated person will have symptoms if they get whooping cough, a recently vaccinated person may not have any symptoms and be a carrier.

    I never said there was anything wrong with a Doctor making money on vaccines. The author of this article stated that Doctor’s don’t make any money selling vaccines, and I merely corrected that statement.

    Like

  6. Chris
    July 18, 2016 at 12:57 pm

    “There hasn’t been a wild case of Polio in the US for the last 2 decades, but there have been cases caused by the vaccine itself.”

    Which vaccine? OPV or IPV? Be specific which one, and then tell us what John Saloamone had to do with it.

    “The recently vaccinated are much more likely to spread disease then the non-vaccinated.”

    Really, with the vaccine presently used in the USA? You’ll need to come up with some solid evidence by that.

    Now let’s look at a more likely way to get polio in the USA. Look up at the sky, do you see these strange craft flying overhead? Those are called “airplanes.” The bigger ones with lots of windows are full of people, some of them coming from all corners of our planet. Sometimes someone is on one and does not know that they are infectious, gets off and spreads a disease.

    So until a disease is eradicated from the entire planet, there is still a way to come to your community. If it can elsewhere it can happen in your country. A quote from that link: “At end-2013, 60% of polio cases were the result of international spread of wild poliovirus, and there was increasing evidence that adult travellers contributed to this spread.”

    By the way, Mr. Spooner, did you read the above article? Malaysia is not an American state, and what the CDC writes does not necessarily apply there or anywhere outside the USA unless they specifically make that clear. And I am sure your “recent CDC study” was not done outside of the USA.

    Like

  7. Chris
    July 18, 2016 at 1:44 pm

    Sorry typo: John Salamone had to do with it.

    Like

  8. Lawrence
    July 18, 2016 at 3:33 pm

    And AFP isn’t Polio – because we can tell the difference, genetically.

    Like

  9. Joel A. Harrison, PhD, MPH
    July 18, 2016 at 9:58 pm

    @Bruce Spooner

    The article you refer to claiming 47,500 cases of acute flaccid paralysis was published in the Indian Journal of Medical Ethics, not an infectious disease nor an epidemiology journal. However, the entire article is based on several false premises. The WHO began surveillance in areas at the same time they introduced their vaccine program. These were often rural areas where no public health surveillance had ever occurred before. They found a number of case of acute flaccid paralysis. These cases were investigated, including serology tests to look for the cause. The cause in most cases was an enterovirus; but not polio. Ignoring this, the article you refer to took the number of case found by the population of the area and estimated how many cases would be found in all of India. The problem was several fold:

    This assumes that no surveillance had been carried out in other areas of India. Totally false. The number of cases of acute flaccid paralysis were know in many areas of India. And the number went down after a period of time following introduction of the vaccine. They also assumed the cases found in the one rural area were polio, which most weren’t.
    The WHO is aware of the small but real risk of the oral attenuated vaccine causing a few cases of polio. On average around 6 per million. However, compared to many thousands without the vaccine, despite the tragedy of those getting it from the vaccine, the number saved is exponentially greater.
    The WHO program tries to conduct serological tests on every case of acute flaccid paralysis discovered. The results is that India was not too long ago declared polio free. And prior to this, the WHO had statistics on the number of cases of acute flaccid paralysis in India, including serology.

    So, if one were to go to any remote area of the world, one would likely find various disease states. Doesn’t mean one caused them, except of course with extremely isolated populations like Indians in the Amazon. I just love it when someone finds one article and, especially with no training in epidemiology and no in depth knowlege of the specific subject matter, makes the typical ignorant mistake of assuming the one article is correct.

    And BIll Gates didn’t send the oral polio vaccine to India, he helped fund the WHO’s program along with others, including this nation.

    How does immunity work “when there are millions of adults walking around without ever getting the disease of getting their booster shots?” Simple, as more and more kids were vaccinated, and humans are the only reservoir for polio, eventually no wild virus was detected in our waters and elsewhere in this nation. So, without the disease present, then being vaccinated or not doesn’t matter. However, as with measles, another virus with only humans as its reservoir, if such a microbe were to be introduced into an area with low rates of vaccination, all hell could break lose. If antivaccinationists were distributed randomly in the population, then the risk of a major outbreak would be minuscule; but antivaccinationist tend to live in specific areas where sometimes more than 40% of kids go unvaccinated. If someone brought measles or polio into these communities, it would not be pretty. Years ago some groups of Amish did not vaccinate (it is a misconception that all Amish avoid vaccinations. They are not a monolithic group; but composed of many different groups with overlapping belief systems; but not all the same). Someone from a similar sect in the Netherlands visited kindred in Canada who visited Amish in the US with the result of several paralyzed children.

    As for the polio vaccine, in the US we use the inactivated vaccine, the killed vaccine, so there has NEVER been a case caused by this. Prior to the introduction of the killed vaccine only, there were a few cases, around six per year, caused by the oral vaccine; but given that polio was much more prevalent in the world at the time and the risk, as with the Amish, still existed, it was 6 verse many more. We have been using the killed vaccine for around 15 years. Prior to that, a combination of the killed and oral were used for several years. One more thing, the oral attenuated vaccine confers more immunity, e.g. gut immunity, than the killed. In areas where polio is still in the water, etc. the risk is higher, so they continue with the oral.

    As for “The recently vaccinated are much more likely to spread disease then the non-vaccinated. A non-vaccinated person will have symptoms if they get whooping cough, a recently vaccinated person may not have any symptoms and be a carrier.” First, cases of whopping cough begin as mild colds, so not likely people will notice.

    Before the availability of pertussis vaccine in the 1940s, more than 200,000 cases of pertussis were reported annually. Since widespread use of the vaccine began, incidence has decreased more than 80% compared with the prevaccine era. This includes significant decreases in hospitalizations. Also, older kids and young adults can have very mild or even subclinical disease and still pass it on. It depends what you mean by a “carrier.” Those vaccinated may shed virus; but much fewer than someone with the natural disease. No matter how you look at it, the stats make it clear that the number of cases of pertussis has declined exponentially.

    Get your facts straight!

    Like

  10. Amanda
    July 19, 2016 at 12:45 pm

    So, I was reading the stories from the “victims of vaccine preventable diseases, and a few of the stories were about infants less then two months of age dying from Pertussis. BUT, the vaccination for Pertussis is given at their two month appointment, so this vaccine couldn’t of saved them, they weren’t even old enough to receive it. Also there isn’t any statements about if these “victims” have been previously vaccinated or not, and a “statement from a mother” I read didn’t even say if her son was vaccinated, and it for sure didn’t say she regretted not vaccinating, none of it does. Literally this entire website is utter ridiculousness, anymore who has done minimal research would notice. ALSO, how does an unvaccinated child who has never been exposed to a disease, put your vaccinated child at risk? PS.Doctors do make money off how many of their “Customers” are vaccinated. I give this website a negative 5000.

    Like

  11. Chris
    July 19, 2016 at 2:09 pm

    Amanda, that is the point. The way to protect vulnerable populations is to make sure enough people are vaccinated to provide adequate community immunity:
    http://www.historyofvaccines.org/content/herd-immunity-0

    If a you have a better way to protect newborns or others who are vulnerable to vaccine preventable diseases (including ones who do not respond to the vaccine), please share. Just make sure you provide verifiable documentation to support your answer.

    Liked by 1 person

  12. Joel A. Harrison, PhD, MPH
    July 19, 2016 at 5:07 pm

    @Amanda

    In 2010, 10 infants died from pertussis in California. They were either too young to be vaccinated or had only had the first shot. So, how did they get infected? By people around them who were NOT vaccinated or had not either been fully vaccinated or didn’t get a booster shot. It’s called cocooning, that is, keeping a barrier between unvaccinated and partially vaccinated infants and those who pose a risk of infecting the infant. And there are no absolutes in this world except for death and, possibly taxes. Prior to introduction of the pertussis vaccine, literally all infants got it, with an average of 50,000 hospitalized and 30 – 50 deaths. Yes, not that many deaths; but a horrible experience for young parents to watch their newborn hooked up with tubes coming in and out and turning blue from coughing. And some also ended up blind or with brain damage as the cough was so intense that it caused retinal damage or brain damage. No, no vaccine can guarantee that every single child is protected; but the statistics are clear that the vaccine reduced the number exponentially.

    “How does an unvaccinated child who has never been exposed to a disease put your vaccinated child at risk?” Simple. How do you know the unvaccinated has never been exposed? Older kids and young adults often get subclinical cases or very mild symptoms. Your question shows you lack any understanding of how microbes work and how our immune systems respond. And I repeat, there are NO absolutes. Vaccination has reduced the number of cases by a tremendous amount. Maybe, someday we will have a vaccine that protects even better; but, in the meantime, the one we have is far better than just taking a chance on exposure to the natural disease.

    As for doctors make money on vaccines. Yes, they do. Not much; but a little. They have to purchase the vaccines, often refrigerate them, too those that have expired, purchase the syringes, etc. And if they really wanted to make money, sick kids pay much better than a quick shot. As I wrote in a previous comment, do you think doctors should work for free?

    Feel free to give whatever point system you wish to give. My rating of you would take a minus with too many digits after it to fit in this comment. You obviously have already closed your mind.

    Like

  13. Joel A. Harrison, PhD, MPH
    July 19, 2016 at 10:26 pm

    A little history and background on pertussis:

    “Before vaccines were available, reported pertussis occurred with an average rate of 157 cases per 100,000 population, high death rates, and peaks of illness every two to five years. One peculiarity of the clinical history of pertussis is that cases were more common among girls than boys, unlike many other infectious diseases that tend to predominate in boys.
    The toll of pertussis before vaccines was staggering. For example, from 1926 to 1930, there were 36,013 pertussis-related deaths in the United States. The average death rates from 1940 to 1948 per 100,000 population per year were 64 in children less than 1 year old, 6.4 in those 1–4 years of age, and 0.2 in those 5–14 years of age. More than 90% of the reported pertussis cases occurred in children less than 10 years of age, with about 10% of those in children less than 1 year of age.

    By 1974, extensive use of vaccines decreased the average annual incidence of reported pertussis to less than 1 per 100,000 population.”

    From Cherry HD (2007). Historical Perspective on Pertussis and Use of Vaccines To Prevent It: 100 Years of pertussis (the cough of 100 days). Microbe; 2(3); 139-144. Available at:

    http://www.antimicrobe.org/h04c.files/history/Pertussis%20and%20Vaccines-Microbes.pdf

    “In babies younger than 1 year old who get pertussis, about half need care in the hospital. The younger the baby, the more likely treatment in the hospital will be needed. Of those babies who are treated in the hospital with pertussis about:

    Mom holding crying baby
    1 out of 4 (23%) get pneumonia (lung infection)
    1 out of 100 (1.1%) will have convulsions (violent, uncontrolled shaking)
    3 out of 5 (61%) will have apnea (slowed or stopped breathing)
    1 out of 300 (0.3%) will have encephalopathy (disease of the brain)
    1 out of 100 (1%) will die”

    From CDC Pertussis (Whooping Cough). Available at: http://www.cdc.gov/pertussis/about/complications.html

    Like

  14. Varun
    August 2, 2016 at 5:53 am

    Great article and very well said!!!

    Like

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