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This transcript has been modified for clarity.
Hi. I am Art Caplan. I am at the Division of Medical Ethics of the NYU School of Medicine. We have talked about it in the past, but the measles epidemic in the United States continues. Many states report cases.
There are a very large number of cases in New York, both in New York and in Rockland County. The Orthodox Jewish community is a particular subgroup affected by the measles epidemic. Diseases have spread rapidly in this community, due to large families with many children.
People got sick from travelers who were not vaccinated and who had measles but did not know that they had it. I am told that there is at least one flight attendant who was on a flight to Israel and who fell into a coma with encephalitis due to measles. I know that a number of children are in intensive care units because of measles. This is not a banal disease.
Measles did not exist in the United States. The CDC announced its eradication more than 12 years ago. yet we are still struggling with it. This is mainly due to fears and concerns expressed by people opposed to vaccination.
What should you be prepared to say if you are discussing vaccines with someone? How are the concerns about immunization today different from what they were 10-30 years ago?
The objections of the anti-vaccinators have evolved. Previously, the main concerns of the anti – vaccinators were related to safety, especially the link with autism and mistrust towards the pharmaceutical industry, namely that the pharmaceutical industry was making pressure on vaccines to earn a lot of money. These are the old objections. They have probably fueled some of the resurgence of things like measles and mumps, without being vaccinated against the flu, as we see it today.
Some new arguments have been added. A new argument is that natural is good. We are beginning to see this – not in communities with little education or understanding of vaccines, but in the rich and educated communities of the upper class.
Think of it as people who pay special attention to Gwyneth Paltrow and try to use foods, supplements and other natural substances to treat or prevent disease. It is also these people who believe that nature is good and that nothing will happen if we are not designed to adapt to it, if we accept it and live with it. It is a very dangerous attitude, but it is an attitude that you must look for and see if it exists.
There are people who say that it is better to develop measles naturally than to get vaccinated. This is clearly wrong. Given the number of people hospitalized, the risk of brain damage and the risk of death – in some parts of the world, tens of thousands of people are dying of measles – there is no point in developing a case natural measles.
It is true that many people with measles do not experience any other side effects than certain inconveniences, itching, fever and rashes. But overall, the idea that nature is always good and that measles would not exist if we were not ready to deal with it is simply wrong. In fact, that explains why we have drugs.
Medicine is there to help and help when nature hurts us. Sometimes nature is here to kill us. People and patients need to understand that nature or what is natural is not always the best of things. You must be ready to respond to this particular concern.
The other argument that is new is "I have the right to do what I want to do". We are currently seeing a lot of individualism in our society, with people saying, "You can not get me vaccinated" or "I'm not going to do it because I want to do what there is to better for me and my children. "
I think it is unfortunate because we are not getting to the point that many people can not vaccinate – newborns, immunocompromised people, older people whose immune systems are not healthy. weakens – and we must protect them. It's not fair to say, "I do not care about my neighbor." It should be emphasized that the purpose of vaccination is not simply: "Well, do you want to protect yourself or not?" it's doing something in the community.
In the same vein, when children are involved and need their vaccines, the state has the right to say, "You must do it or you will be fined." This is the basis of what we do with car seats and bike helmets.
We sometimes say that parents' choices about their children are not absolutely untouchable. The government can intervene and protect the children. Children have the right to health and vaccination is one of them. This argument that "it's up to the parents and that's the end of the story" needs to be addressed. Not with regard to children's health, nor with regard to the health of the community.
I think we have been able to overcome the security problems. Study after study demystified the idea that autism is linked to vaccination. Big Pharma 's complaints have also been dismissed because Pharma is making a lot more money by treating illnesses than by preventing illnesses.
The alternative medicine movement is also making a fortune. I think there is almost a profit ratio between natural food vendors and natural solutions to problems such as measles, compared to what the vaccine industry gets from the sale of vaccines.
It is these new arguments that, in my opinion, now explain the recurrence of measles – concerns about vaccines and vaccine objections. We need to take seriously the idea that some people think that what is natural is normal and that we have nothing to do with it, or the idea that "I have rights and no one can trample on them. – they are immutable, untouchable and nobody can challenge them. "
Both points are wrong. When talking to patients or community members, you should be ready to report it.
I am Art Caplan. I am at the Division of Medical Ethics at NYU. Thank you for watching.
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