Our horror of vaccinations doesn't make sense

Apparently, we're once again tackling the subject of smallpox vaccinations:

Stanford is one of four university medical centers around the country testing [a new] vaccine, which has been used for decades in Japan, but needs approval from the Food and Drug Administration to be brought to the United States. If the clinical trials and more widespread ones in the future work out, VaxGen of Brisbane plans to market the vaccine worldwide. A global vaccination program in the 1970s wiped out smallpox as a natural disease but didn't erase its threat as a biological weapon. The trials will show whether this vaccine might have fewer side effects than Dryvax, the only vaccine licensed in this country.

That's all well and good, but if we're still worried about vaccinations, we have a perfectly good one available. Keep in mind that, according to the same article, the risk of an adverse reaction from the current vaccination is infinitesimally small:

According to the federal Centers for Disease Control and Prevention, 14 to 52 out of every 1 million people who have received smallpox vaccinations in the past have experienced potentially life-threatening reactions, with 1 or 2 fatalities for every 1 million vaccinations.

Compare this risk to the fact that smallpox, if it actually hit our shores, would carry with it a 30% mortality risk -- which is just a wee bit higher than 1 to 2 fatalities for every 1 million vaccinations. The success of vaccinations has proven to be their own undoing. When my parents were growing up, vaccinations were a marvelous, low-risk alternative to the horrific scourge of diseases, and scourges they were. In a few minutes, I was able to dig up some statistics for just a few of the contagious diseases against which our children can routinely be vaccinated: polio (25%-75% mortality rate), diphtheria (9%-20% mortality rate), smallpox (30% mortality rate), whooping cough (a 1% mortality rate, which sounds low until you learn that, for a child, a single exposure to the disease guarantees infection; 360,000 children still die worldwide from this one), measles (a half million children died of measles in 2000 alone), etc. The problem is that now, thanks to aggressive vaccination, we don't see these diseases anymore. No born-and-raised American has ever seen a child choke to death from diphtheria, seen a child's lung's stop functioning because of polio, or seen a child's heart muscle destroyed by measles. To us, they're all hypothetical diseases. And in the face of a hypothetical disease, the risk of a vaccination suddenly swells out of all proportion. For example, as I noted above, diphtheria has a 9%-20% risk of mortality. The risks associated with the vaccination are:

RISKS DTaP may cause mild side effects (slight fever, mild crankiness, tenderness of the injection site for a few days). DTaP may rarely cause the following more serious complications: * fever, high (more than 105 degrees F) in 1 out of 16,000 children * non-stop crying for 3 hours or more in 1 out of 1,000 children * seizure in 1 out of 14,000 children More severe problems occur extremely rarely. These include: * serious allergic reaction (less than 1 in 1,000,000 children) * long-term seizures/brain damage (so rare that the association with the vaccine is questionable)

Diptheria is not a hypothetical disease. It is endemic in the Third World, and is reemerging in the First World:

Diphtheria has re-emerged in the newly independent states of the former Soviet Union and in some other parts of the world at near-epidemic levels. The increases have generally been the result of failed public health and immunization programs in areas weakened by economic and social turmoil. In the United States, the diphtheria threat is shifting from children to adults and adolescents. Cases are occurring in persons who have not been immunized or in vaccinated persons who did not receive periodic booster doses to maintain their immunity. Routine vaccination of both children and adults is essential to prevent the re-emergence of diphtheria in the United States.

And the diseases are indeed out there waiting. Some of you may recall that, in the early 1990s, there was a measles outbreak in the Pacific Northwest, because parents were refusing to vaccinate their kids. The risk they took with their kids' lives proved to be significant:

The biggest cause of the 1989-1991 measles epidemic in the U.S. was failure to vaccinate preschool children on time. This measles epidemic was responsible for 55,000 cases and more than 120 deaths. Nearly half of those deaths were in children under age five, most of whom had not been immunized.

It's true that parents right now are saying, "Well, I don't vaccinate my kids, and they're not sick" -- and they're right. The non-vaccinators' kids are not sick because people like me take the risk and vaccinate their own children. If a sufficient number of people within a group are immune to a disease, the disease cannot get a foothold (there aren't enough vectors), and even those who are not immune are protected. (It's called herd immunity.) The problem is that, if the numbers shift -- more non-immune than immune -- that herd immunity vanishes, and you've got an epidemic. So, if you're on the fence about vaccinations, check out the numbers. I bet that, when you realize that all these horrific diseases are still out there wandering the globe, that their mortality rate is scarily high, and that the vaccination mortality rate is correspondingly low, you'll be lining up for those shots. UPDATE: Coincidentally, after writing the above post, I came across this in the NY Times:

Polio apparently reached Mecca, Islam's holy city, just before last month's annual pilgrimage by two million Muslims, and World Health Organization officials now fear that it could be spreading around the world, carried by returning pilgrims. In crowded nations with spotty vaccination coverage, like Bangladesh and Indonesia, "there could be substantial consequences," Dr. Bruce Aylward, coordinator of the W.H.O.'s Global Polio Eradication Initiative in Geneva, said in an interview. "This is a crucial point," he added. "We're staring at the whites of the eyes of this thing." A Saudi government spokesman said his country had feared the arrival of polio this year because it was known to be spreading across Africa. The Saudis started a sweeping polio inoculation campaign in September, hoping to head off the threat before the height of the hajj, or pilgrimage, in late January.