The belief that public health measures are not intended for people like us is widely held by many people like me. Public health, we assume, is for people with less - less education, less-healthy habits, less access to quality health care, less time and money.
Nigeria and Pakistan are two countries that have had a lot of trouble with polio. And part of the reason is that there's a lot of political unrest, and people really distrust what the government is doing. That has an effect on people's health, and it has an effect on the health of children.
Imagine the action of a vaccine not just in terms of how it affects a single body, but also in terms of how it affects the collective body of a community.
Some of the most interesting research that I did was about risk assessment and how ordinary citizens like me handle risk assessment and how irregular our risk assessments are.
The risk of getting Hep B from a blood transfusion is a tiny number, but it's a bigger number than the risk of side effects from the vaccine.
Most of us believe that dirt is good for our kids, but some of us are wary of the grass in the parks, which may or may not have been treated with toxic chemicals.
As for mercury, a child will almost certainly get more mercury exposure from her immediate environment than from vaccination. This is true, too, of the aluminum that is often used as an adjuvant in vaccines to intensify the immune response.
In the story of Thetis and Achilles, it's clear this isn't really a safe environment. She's gone down to the River Styx - the dead are being ferried across in the background. There's something in this mythology that says that if you want invulnerability, if you want immortality, you pay a price.
One of the mysteries of hep B immunization is that vaccinating only 'high risk' groups, which was the original public health strategy, did not bring down rates of infection.
On the pro-vaccine side - and not everyone does this, but I saw it enough for it to make me really uncomfortable - is a tendency to accuse people who are wary of vaccination of being stupid and not understanding science.
Fears that formaldehyde from vaccines may cause cancer are similar to fears of mercury and aluminum, in that they coalesce around miniscule amounts of the substance in question, amounts considerably smaller than amounts from other common sources of exposure to the same substance.
If your child's going to ride in a car or go swimming or play soccer, all of those things involve risk. And if your child doesn't do any of those things, then they're probably sitting too much, and that involves risk, too.
A vaccine introduces a small amount or a tempered version of the virus into the body - just enough to that the body is able to recognize it and deal with it when it encounters it again in the future.
We've been using vaccination in some form for hundreds of years now. We have almost nothing in our modern medicine that we've been using that long, and it's been consistently productive even though, you know, the older vaccines were much more dangerous than vaccines we're using now.
Herd immunity is, it turns out, not incredibly easy to understand. It took me quite a bit of reading before I fully grasped it. But understanding herd immunity is essential to understanding why we vaccinate the way we do.
Yes, there's a higher rate of people living below the poverty line who aren't vaccinated. But it's much rarer for that to be a product of choice than a product of circumstance.
I think there's a temptation to try to think of people who don't vaccinate as a homogenous community, but I'm not convinced that's true. I'm not even sure that the word 'community' is totally accurate there, you know.
I think that protecting children at the age where they're most vulnerable against diseases that are highly contagious is prudent.
There's a cultural expectation that everyone will be immunized, in part to protect the entire population. When people refuse that expectation, they're indulging in a certain kind of political or social immunity.
I think that people's resistance to vaccination isn't going to disappear until we address some of the nonmedical reasons for that resistance and people's discomfort and distrust of the government. That's bigger than what most medical professionals can handle.
