Monday, December 07, 2009

To vaccinate, or not to vaccinate

Paola was wondering why we decided to vaccinate le Petit against the H1N1 virus. The truth is, we hesitated a long time before making up our minds. If a vaccine exists for something, I'm likely to want to be the first in line for it, and doubly so if it's for le Petit health (even if the line is, ahem, five hours long). My husband, on the other hand, is somewhat vaccine-skeptical. Not that he's opposed to the normal series of vaccines against childhood illnesses, and he certainly doesn't believe any of the bizarre urban legend/conspiracy theories floating around linking, for example, the MMR vaccine to autism. But I had to work hard to convince him to vaccine le Petit for hepatitis B -- an optional vaccination in France, generally proposed for older infants -- and he does rather anxiously check for potential side effects in the days following any shots. So when I started lobbying for the H1N1 shot it was an uphill battle, and I, too, was skeptical at first.

Although I haven't seen the latest numbers, I would guess that in France at least half of the population has no intention of getting the H1N1 flu shot. My husband isn't planning to. I, however, will as soon as I can. We both agreed to vaccinate le Petit, and here's what decided us, in no particular order:

  • I take public transportation every day during rush hour, when "standing room only" on the RER A means "breathing room barely." I figure that if there's a flu virus out there it probably has my name on it, and I don't want to give it to le Petit or the ten-month-old baby that shares our nanny and plays at our house every day.

  • Dr. Sears had a post on their site which I interpreted as pro-vaccine. I'm far from an unconditional Dr. Sears fan, but I know that they tend to be vaccine-conservative, so I figured that if they were more or less in favor of the H1N1 flu vaccine, it probably was for a good reason.

  • Our much-trusted pediatrician recommended it. He also assured me that kids under 10 would be vaccinated with the non-adjuvant form, which I've heard is better tested in young children.

  • Although I don't have complete confidence in either the government or the pharmaceutical companies, I trust both of them far more than I trust a virus.
Finally, having spent one scary evening in the emergency room when le Petit suffered from an unexplained high fever, I can all too easily imagine finding myself in the same position again. Add breathing difficulties, an unknown pandemic, and I shudder at the regrets I might have. So, I decided the risk I wanted to take was to trust that the vaccine was safe and effective, and that le Petit wouldn't have any problematic side effects (he hasn't).

I understand and repect parents who choose not to vaccinate for H1N1, of course.

I think it is interesting, however, to see how people evaluate risk: poorly, generally. We are terrified of flying, but think nothing of getting behind the wheel of a car. We worry about chemical contaminants and genetically-modified foods, but without any real idea of the data that might support our anxiety. Cloud wrote about this quite eloquently. I'm no better than anyone else -- I'm a computer geek, not a scientist -- but for once, I did at least read the official information provided by the ministry of health. The infamous Guillan Barre Syndrome, the only dangerous flu vaccine side effect I've heard about so far, was mentioned, and the chances of contracting it were estimated at one in one million. I told my husband he'd do better to worry that le Petit and I would cross the street safely on our way to the vaccination center. That didn't stop him from nervously calling and texting us all afternoon.

Le Petit was just fine. I based this assessment on the soundest measure of his health that I know: he refused typically, stubbornly and categorically to nap. Take that, swine flu!


Cloud said...

Thanks for the nice words and the link!

Petunia had been home for less than a week when our day care got their first case of H1N1- in Pumpkin's room. Luckily, that case didn't infect anyone else (the parents pulled her out very quickly, and it was right before a weekend), but I freaked out. I was in luck- our county had just gotten its first shipment of vaccine, and hadn't publicized it much yet. So Pumpkin got vaccinated the next day.

Here in the US, half of the people seem to be freaking out because they can't get the vaccine and the other half are freaking out because they think the vaccine is some sort of government conspiracy to... well, I don't know what they think the government is trying to do.

I figured that since they were using the same methods that they used to make the seasonal vaccine, and I get that for myself and my family every year, I had no reason not to get the H1N1 vaccine. I thought the risks of the vaccine were very low, and it appears that the data from its actual use are supporting that.

You're right- people are in general very bad at analyzing risks. I am, too, at least at a first response, "gut instinct" level. So I make an effort to step back from whatever is freaking me out and think it through carefully.

Inki said...

I am completely with you. We see the same thing here in Norway that Cloud is mentioning from the US - a lot of people standing in line to get the vaccine (even some claiming to be in high-risk groups to get it before they were supposed to), and some very vocal people being doomsayers and predicting all kinds of bad side effects of the vaccine, even though we have had a disproportionately high number die from H1N1 compared to our population.

We got ourselves and our two-year-old vaccinated when they released the shots for our demographic (after they had offered it to the high-risk groups), and we had no side effects.

We were also offered to have our 2-month old vaccinated as part of a study to see how babies that young deal with the vaccine, and although it sounds scary to have the word "research study" in the same sentence as your tiny baby, we figured the potential side effects of the vaccine were lower than the potential side effects of her getting H1N1, and we enrolled her in the study. She has had no side effects from the first shot, and if she will be monitored closely (with 5 blood tests spread out over the next 11 months) so if anything happens, we know we have the best help available. And she's helping humanity expand its knowledge about babies and H1N1 vaccines :-)

paola said...

I've pretty much decided I won't have my kids vaccinated. Firstly they are not in any of the 'at risk' groups. Secondly, from what I have heard from friends whose kids have contracted the H1N1 virus, the reactions have been relatively strong, but not excessively so, so highish fever for a couple of days, then aches and pains which have subsided with paracetomol and bed rest.

In fact, even my ped seems to think there is no need to vaccinate ( they are not vaccinated for seasonl flu either)

My only concern would be if a mutation to a more agressive form of flu takes place. So far this has been sporadic here in Europe (the first case i Europe was actually in April BTW) We have only had one case in Italy. I think though if the situation changes, I will be one of the first in line to vaccinate the kids.

As for myself, well my age group seems to be immune ( there was a similar flu epidemic in the late 70's so most people in their late 30's and above are probably immune). In fact there are no recommendations for over 27's to be vaccinated. I have been (and am regularly) vaccinated for the seasonal flu as with a kindergarten aged child who brings home anything and everything I generally catch everything that my son brings home with him.

Parisienne Mais Presque said...

Thanks all for sharing! What I find interesting is that this is one of those things where rational decision making can take you either way, I think. Especially since the doctors aren't even all in agreement.

Apparently now the big rush is over, at least in our town, and anyone can go now and get vaccinated in around five minutes. Makes me shrug. I'll be going for myself next week...