One day in Egypt, Lydian and I went out to find bottled water in Nazlet al Samaam. After we got a big box of bottles, we walked back to the opaque metal gate of our apartment complex, but the gate was locked. We walked around to a different gate and yelled over the stone wall to see if someone could hear us. Suddenly, the big metal gate opened up. Whew! What a relief! A girl living inside our apartment complex had heard us yelling and came and opened the gate for us. What luck! As the big metal door swung open, I got my first good look at the girl’s face and I could see very clearly that she was covered head to toe with chicken pox.
I smiled at her and tried to act un-phased by the blisters on her skin. I thanked her graciously as we stepped past her, though inwardly I wanted to run away and immediately, instinctively, I pulled hand sanitizer out of my pocket to douse Lydian and I though neither of us had touched her (we had touched the gate while leaving the complex on our way out, though). My mind reeled as we walked up the steps with the big box of bottles. I huffed and puffed from the combination of exertion and anxiety as I tried to remember whether chicken pox was one of the vaccinations Lydian had been given.
Yes, she’s had the chicken pox vaccine. I told myself. Varicella…yes, that’s right. I breathed a small sigh of relief as we reached the top of the stairs.
“What was wrong with her?” Lydian asked. “Was that chicken pox?” She’d never seen anyone with the disease.
“Yep.” I said as we neared the front door of our apartment still panting. I pulled out my keys. “You’ve been vaccinated.”
“Good.” Lydian smiled.
I didn’t tell Lydian that most vaccines aren’t 100% effective because I’m a big believer in the placebo effect and I didn’t want to make her worry. I prayed that the varicella vaccine, given to Lydian several years ago would still be doing its job. Online I found that two doses of the vaccine are 98% effective and let me tell you, that was a relief to see.
As a kid, after contracting chicken pox, I developed problems with my heart. My heart would stop for 5 to 10 seconds, I’d black out and then it would race at 200+ beats per minute. My parents were beside themselves. There was nothing they could do for me and they thought I was gonna die. Doctors didn’t know what to do. I wore heart monitors on and off for a year and didn’t get to go outside to recess or participate in P.E. When I was a kid, chicken pox took my family on a wild ride that lasted longer than a year. In high school, I had arrhythmias that only cleared up when I started jogging. Still to this day, I have to take care of my heart. If I don’t get enough exercise to keep it strong, it gets weak really fast. It’s hard to really quanitify the full effect that my illness had on my life. And there’s no way to predict who will end up with extra health problems as a result of something like chicken pox.
My daughter didn’t catch chicken pox while we were in Egypt, thank god, because she’d been vaccinated. As a traveler, I think about vaccines differently perhaps than people who never go abroad. Getting sick with the measles while en route to South Africa is very real to me and an illness like this could be a major, life-threatening issue in Africa. You can’t get on a plane with a communicable disease like that. Medical evacuation to a country with adequate healthcare costs upwards of $100,000. If someone catches you trying to board a regular plane with a fever, it’s likely you’ll be quarantined, especially in Africa which means that you’re stuck there and you may very well die there.
Indeed, we thought very carefully about passage through Ethiopia because it’s a major hub to Western Africa where the Ebola virus is raging right now. If I lived in a place like West Africa where Ebola was endemic and I had the opportunity to vaccinate myself and my family against the disease, I would absolutely do it. No question. I think most people who’ve seen the ravages of the disease would. I guarantee that there will be few to no anti-vaxxers in Liberia and Guinea when the Ebola vaccine becomes widely available. And in time, I think that many of the anti-vaxxers in the U.S. will see the virtues of vaccinating against measles, mumps, rubella, whooping cough, and polio again too, but perhaps not until the disease actually knocks at their door.
I don’t believe that something as passive as a blog post like this has the power to persuade, but it doesn’t have to. There are plenty of people who agree with what I’m saying and I know that when the measles comes to our town, we’ll all still be able to go out for coffee and talk about it. Not so with the anti-vaxxers. When the measles makes it to western Nebraska, it will be a time of great woe and a gnashing of teeth, as they say for those who have not vaccinated their kids. It will be a time for serious soul-searching. The kind that people do bedside at a hospital late at night, praying for God to please, please just let their kid live.
Major diseases that warrant the development of a vaccine are costly in a number of different ways to those who become sick and to their loved ones. There are medical bills, time spent off work and away from school. There are emotional costs. The worry. The guilt. Families with little babies may righteously feel angry with folks down the street who choose not to get vaccines that could protect their young ones from diseases that are fatal to infants. So there are social costs for anti-vaxxers (good luck making peace with the couple who loses their baby because you didn’t vaccinate your teen against measles). I imagine it won’t be long before anti-vaxxers are sued for the deaths of those who couldn’t get vaccinated. Children and adults who become ill may not just get sick with the disease, but go on to have other complications, or they may die. Personally, my stress-o-meter would be off the charts if my daughter fell ill with the measles, chicken pox, or any disease that could be prevented with a vaccine if I’d knowingly left her vulnerable to it when I could have protected her. But I believe that diseases can devastate families and whole communities. I’ve seen it happen and I can imagine it.
I don’t travel into areas of the world with major disease threats without the medical back-up to treat those diseases for our family. If there’s no back-up and the risk is high, we don’t go. We skipped a trip to the interior of China because of the risk of Japanese Encephalitis (we hadn’t gotten the vaccine yet), and we avoided Saudi Arabia because of the risk of meningitis. Calculating the risk of contracting a particular disease in a particular place depends first and foremost on the ability to believe that I, or a person in my family could get sick even if the odds of getting sick are low. If the risk of contracting Japanese Encephalitis in Guilin, China during the summer months is 1% that may seem “low”. But if someone in my family is among one of those unlucky 1%, there’s a 33% chance that they’ll die from the disease. And if they don’t die, there’s a 30-50% chance that they’ll be seriously crippled by the disease. If you don’t feel equipped to calculate those odds on your own, ask your doctor for advice.
I take anti-malarials with us into malaria zones, and we get vaccines to protect us from everything we can including meningitis, hemorrhagic fevers, and pneumococcal disease while we’re abroad. To go without this sort of armor would be ignorant and dangerous.
A major illness while traveling can put our lives on the downward spiral in short order. Good doctors, hospitals equipped with the latest technologies, and untainted medications aren’t as easy to come by throughout the world as they are in the U.S. Each person who gets vaccinated against a major disease in any country is not just protecting themselves, but also poorer people throughout the world, the people who lack access to quality healthcare and vulnerable people (like babies and the elderly, for example). In the United States, we think in terms of ourselves; we’re individualists and we believe with all our hearts that this is the right way to be. But actually, there are many right ways to be and there is indeed a line in the sand between individualism and pure selfishness. That line and one’s love for other people in general should be considered carefully by anti-vaxxers. To not vaccinate your body or your child’s body against a disease seems personal, very personal, but in fact, it affects everyone.
It’s hard for me to understand how anyone living in the United States could opt out of vaccines while there are so many people in other, poorer, less educated parts of the world that are desperate for them. But again, for the folks who have actually lost loved ones to devastating diseases like the measles, there is no question: get the vaccine. Vaccinate your loved ones. Do it because you love them and you want them to live a long life and be healthy. But for people who have been lucky enough to grow up without the worry of measles or mumps, for people who have never seen what the disease can do to the body, how painful the symptoms and side effects can be and what’s really at stake, the decision is blurry. Although it frustrates me to know that there are people out there saying “no thank you” to health, on behalf of their children no less, I also know that it’s only a matter of time, before these ugly diseases will knock at the anti-vaxxers door. And when that happens, vaccines won’t look so scary anymore.