I have influenza A this week. Sitting in my bed fighting a headache and nausea has given me plenty of time to wonder if getting a flu shot would have prevented this illness. But I’ve always been a little leery of flu shots. I know that flu shots are not 100% effective – the vaccine is made to combat a certain strain of the virus, and sometimes the predictions about which flu strain will be most prevalent are wrong and the flu shot is not very effective. I’ve wondered if getting a flu shot gives one overconfidence – a feeling of immunity liable to make one less careful with hygiene. Perhaps, though, my hesitation to get a flu shot is just ignorance. Perhaps the benefits, not just to me, but to society as a whole, far out weight the burdens. I honestly can’t say, because I’m ignorant of any data about flu shots.
Though there have been major influenza outbreaks in the past, the illness somehow doesn’t seem to induce the fear and terror that diseases like measles or smallpox do. So while refusing a flu shot might not be a huge deal, these other diseases poses a much greater threat.
In the past few years, a variety of factors, including scientific and religious ones, have led to a movement away from all vaccinations. A couple of the more prominent factors have to do with the MMR vaccine and Autism.
The only vaccine for MMR (measles, mumps, rubella) was derived from an aborted fetus. Because of this, certain religious groups found it morally objectionable to use the vaccination. Correspondingly, vaccination rates dropped. Later, MMR suffered another blow after a poorly conducted “study” about vaccines and autism was published in “The Lancet” – one of the world’s premier medical journals. The study claimed that vaccinations could cause autism, but a closer look at the data debunks this. The study had a ridiculously small sample size which was not chosen at random. In the years following the paper’s publishing, a number of researchers took a careful look at the paper and thoroughly discredited it, finding that the author had conflicts of interest, had broken ethical codes, and had manipulated evidence. The author was tried, found guilty of serious professional misconduct, and had his license to practice medicine taken away. Although The Lancet published a retraction, it did little to reverse the damage done by the original paper.
Because of falling vaccination rates, we have begun to see small outbreaks of diseases formerly thought to be eradicated. The effects of the phony study hit the UK and Ireland first, where a drop in vaccination rates led to disease outbreaks and deaths. Though the study was retracted 10 years ago, the effects can still be seen. In the past few years a variety of disease outbreaks have taken place across the United States, including a couple minor outbreaks here in northwest Montana.
I once heard someone say that vaccination was like a stone wall where each vaccinated person was a stone and each unvaccinated person was a hole. If everyone were vaccinated, the wall would be strong. But even a small number of holes would seriously weaken the entire wall. This brings up the question, “can we let freedom(to decide for ourselves about vaccines) jeopardize our safety?” Or more specifically, “can we let individual freedoms jeopardize group safety?”
This has been a rather long introduction, but bear with me. All that’s left now is to answer the above question by discussing ethics and my opinion (for whatever it’s worth!)
We’ll start with ethics. There are two classes of behavior or action: self-regarding (things which ONLY affect you, and others-regarding (things which affect other people). Ethics is only concerned with the second class of actions: things which impact others. Let us now consider vaccinations: do they affect self, others, or both? If one is completely physically isolated, self. But that applies to so few people that it hardly deserves consideration. There are very few proper hermits in this world. This means that for the vast majority of people, vaccination is an others-regarding action. It is the choice between being a stone or a hole in the wall.
In short, my opinion is that the social contract demands vaccination of diseases likely to cause outbreaks and death. Those who do not wish to be vaccinated should not be forced to, but by refusing vaccination also relinquish their right to be part of society – the community inside the wall. Perhaps this is an oversimplification, but at first glance, it seems like a good solution: no one is forcing you to be vaccinated, but at the same time, you are not permitted to let the consequences (illness) of your action (vaccine refusal) fall on others.
So what about the flu shot… is it a breach of ethics for me to refuse that vaccination?