Dr. Kirk Milhoan, newly named chair of the CDC’s vaccine advisory panel, recently questioned broad vaccine recommendations for polio and other childhood diseases in a recent appearance on the podcast “Why Should I Trust You?”. He also stated that promoting individual choice, not public health, was the key aim of the panel.
“Our sanitation is different, our risk of disease is different. And so all those play into the evaluation of whether this is worthwhile, of taking a risk for the vaccine or not,” he said.
The CDC vaccine advisory panel, known as the Advisory Committee on Immunization Practices, shapes national vaccine guidelines and influences insurance coverage for those vaccines as well as state laws. Here are why the comments from Dr. Milhoan could set a dangerous precedent for public health in America.
Getting Vaccinated Is A Unique Medical Choice
Deciding to get a vaccine for an infectious disease is fundamentally different than other medical choices, such as choosing which medicine to take for a disease like diabetes for example. The consequences of deciding between two different diabetes drugs like Metformin or Rybelsus will only affect the individual taking the drug. The individual will need to deal with whatever side effects ensues from the drug.
The decision to vaccinate extends beyond the individual. High vaccination rates create herd immunity, or the protection conferred upon an entire community if a certain percentage of the community gets vaccinated. In other words, by getting vaccinated, one is contributing to the overall health of the entire community by mitigating the spread of diseases that could be deadly.
The idea of herd immunity is not theoretical. Consider measles, for example, where 416 positive cases have already occurred in the United States this year, according to the CDC. The vast majority of cases have occurred in unvaccinated individuals, and in communities where vaccination rates were less than 95%, which is the percentage required to reach herd immunity whereby the disease would not spread.
Vaccination Protects The Vulnerable
Dr. Milhoan cited the importance of personal freedoms and individual choice in deciding what to put into our bodies as it relates to vaccines. Although deciding what we put into our bodies is of utmost importance, choosing to vaccinate protects not only the individual, but those who cannot protect themselves. Infants and those who cannot safely receive vaccines such as immunocompromised patients are at risk of acquiring deadly infectious diseases such as measles and polio when herd immunity is not reached in a population. When herd immunity is reached, our most vulnerable population is much less likely to get infected or suffer the consequences of infectious diseases. This would include those with cancer, patients on steroids, and transplant recipients.
Balancing Personal Liberties With Collective Responsibility
Advocates of personal choice like Dr. Milhoan often frame vaccination as a purely individual matter. Infectious diseases, though, do not respect personal boundaries, as a single unvaccinated individual who acquires a disease can ignite an outbreak that endangers an entire community.
This is precisely why public health requires balancing personal choices with communal responsibility in making decisions. Consider smoking, which is sometimes banned in certain public spaces. The rationale for this is because not only can smoking harm an individual and cause lung cancer, but the secondhand smoke can also harm those around the smoker. Secondhand smoke is a known risk factor for lung cancer. Smoking restrictions are widely accepted in American culture because they save lives. Vaccines, similarly save lives, and the World Health Organization asserted that global immunization efforts have saved at least 154 million lives.
Possible Emergence And Rise Of Deadly Diseases
Removing vaccine recommendations from the childhood vaccine schedule will invariably lead to less children getting vaccinated, with the return of vaccine-preventable diseases when immunization rates fall. Before widespread vaccination for polio in the United States, the virus paralyzed 15,000 children annually, according to the National Medical Association.
There is no cure for polio and the best prevention against polio is through vaccination. If the recommendation to vaccinate against polio is dropped by the CDC, then the risk for the disease returning to America could become a reality. Polio is a deadly disease, with up to 10% of those with paralysis dying from the infection, according to the CDC.
America’s vaccine recommendations have traditionally been built on science and evidence. The decision to drop these recommendations could put lives at risk.