Points for consistency? The case for public health in personal choice.

I check the ‘on this day’ app most days, for the chance some adorable memory will pop up.

Today Facebook reminded me of this day, two years ago, when four separate cases of the measles had been confirmed in Toronto. Do you remember that two years ago, when measles was all over the news? At this time I had two just-barely-one-year-olds and a four year old in kindergarten and dance. I had other friends with brand new little ones who weren’t old enough yet for their MMR vaccines. We knew there was a good chance that our kids were going to cross paths with someone who hadn’t had their own MMR shot, and while we’d done what we could, we all know that sometimes our bodies don’t develop immunity from a vaccination. Vaccines are pretty good, and a lot of them (like MMR) have a high level of efficacy.

15 months later, I found Jude dead in his crib. Four months after that the explanation came: influenza B. He’d been vaccinated, but had the terrible luck of being one of the small percentage of pediatric flu deaths who had received a flu shot.

Reading my two-year-old words today stopped me in my tracks. I typed those words knowing that I’m only able to do what’s within my own reach to protect my kids, and beyond that I need to hope and trust that others are doing what they can to limit their own risks and their own potential for spreading illness to those in their communities. I can do everything in my power to keep my kids safe, but I can’t do everything. I knew that then, and sadly became a living, breathing, just-barely-surviving example of the exact scenario I’d asked people to consider.

I remember early in my days as a mom, being in online communities where women with rapidly expanding abdomens would talk about everything from nursing to circumcision to vaccines. If you’ve ever been in these groups, you know how quickly these discussions can become heated, and how passionately people feel about their own views. But reading through and participating in these discussions, I couldn’t help but feel that I really couldn’t care less what everyone else was doing with their kids, provided they were keeping them safe – with one exception: vaccines and communicable diseases.

I care whether you vaccinate your kids. I care whether you send them to school sick. I care whether you show up to my house with a fever. I care because, while vaccination is a personal choice, it’s ultimately a decision that affects everyone you come in contact with. And that matters, because that means you’re not only making a choice for your own family, you’re also making a choice for everyone your family talks to, spends time with. You’re making a choice for a kindergarten class, your mom group, your workplace. The kid who goes to school with your kid who has a compromised immune system. The pregnant woman in the elevator. The elderly gentleman beside you on the subway. Your coworker’s husband who is fighting cancer. Your friend’s mom with a heart condition. Jude.

We made our choice, and we opted to do what we could to protect our own kids and everyone they come in contact with as much as possible. I don’t know how I could ever forgive myself if I could have done something to keep someone in my community safe… and didn’t. It always came back to that for me. We’re medically able to vaccinate. If we get sick we’d probably be fine. But what if we passed it on to someone who wouldn’t be fine.

I care whether you vaccinate. Whether you vaccinate or not, I care whether you choose to send you child to school knowing that they’ve been sick. I care if you go to work with a fever and pass it on to the person beside you. I care about how much you’re washing your hands.

I care because these personal choices may cost someone in your community their life. I’ve had this conversation so many times through the years, and I know how easy it is to blow off the flu, the chicken pox, the measles, as though they’re no big deal. And for most people that’s the case. They’ll get sick, maybe really sick, and they’ll get better.

Remember again how freaked out we all were with four confirmed measles cases?

What if we had ~3500 measles deaths every year in Canada, and ~36,000 measles deaths in the US? Not cases – deaths.

But we have that with the flu. Why aren’t we more careful? Why don’t we do everything in our ability to protect our own families and the people around us every day? Is it because we don’t understand exactly what the flu is? Is it because the flu shot isn’t 100% effective? I wish it were, but I’ll take 10%, 40%, 60% over the 0% I’d get without the shot.

On the day we launched this campaign, I immediately received an astounding mixed bag of responses. We knew that we were opening up a discussion that has become somewhat off-limits in recent years, and we’re supposed to tip-toe around vaccines. ‘It’s a hot-button issue.’ Public health, and our impact on it – not to be discussed! But personal choices about public health cost us Jude, and if we could prevent someone else from going through what we are, we were going to talk about it. Flu shots, staying home, washing hands, coughing in your sleeve, all of it. All the things you can do to protect yourself and those around you. I shared links on social media, watched as news outlets started to pick it up, and checked in on discussion wherever I thought discussion might be productive.

I shouldn’t have to light my kid on fire to keep others warm,” she said, to the mother of a recently cremated two-year-old. 

These past months have been an education – in public health, in health science, in government, in community, in empathy, in compassion.

This attitude. This, ‘my kid first and too bad for everyone else’. I get it. I love my kids more than I love anyone else’s. We all feel that way about our own children. But how far does this go? If you aren’t opting for vaccination, you’re relying on your community to protect your family. The more people around you who are vaccinated, the less likely your family is to be exposed.  What happens as more and more people choose not to vaccinate? What happens to your personal risk rates? You may not see those people’s health as your responsibility, but that means they don’t see your health as theirs. What happens to the risk rates of all the people around you, who aren’t receiving any protection from your personal choice?

I suppose there’s nothing left to say but,

“If you’ve chosen not to vaccinate your kids for whatever reason, please take extra precautions and please take extra care when exposing them to other children. We have chosen to vaccinate our kids (we love science!), but we also understand that no vaccine is 100% effective and the benefits come through herd immunity and we will take precautions with that in mind.

“If you’re on the fence about whether to vaccinate your kids, [insert vaccine-preventable illness] can kill them. That’s really all I have to say about it here.” – Jill, Feb. 2, 2015