Should I Vaccinate My Child For Travel?

The single most surprising question I get asked by readers of this blog is this: “should I vaccinate my child for travel?” I say “surprising” because, to be honest, the...

The single most surprising question I get asked by readers of this blog is this: “should I vaccinate my child for travel?”

I say “surprising” because, to be honest, the travel jab question was a no-brainer for me.

As, I think, it is for most child-free adults contemplating travel to the developing world.

Y’know. You’re going somewhere where there are tropical diseases, dangerous diseases, ones that are almost eradicated in the developed world, but kill millions elsewhere in the world.

So you see a specialist doctor, get your recommended shots, and vastly reduce your chances of contracting said diseases.

End of story…

One would think this approach would be the norm for people travelling with their kids.

You don’t want to put your child through a month-long course of agonizing injections if he or she gets bitten by an animal that might be rabid.

You don’t want your child paralysed by polio. You don’t want your kid getting measles complications in a third world hospital.

Ergo, one would think, you’d vaccinate.

But this doesn’t seem to be the norm.

Especially not online, where scaremongerers shout loudest of all and the voodoo voices dominate dialogue.

***

Online, I’ve seen advice from homeopaths seriously recommended as an alternative to doctors, citronella presented as a better insect repellent than DEET, not to mention a bunch of utter (and dangerous) garbage about “natural immunity” or (worse) “inherited natural immunity”.

Let’s start with rabies. This is 100% fatal when contracted. NO ONE has EVER had any natural immunity to rabies. You get it, you die.

Around 55,000 people died of it last year – it kills tens of people a year in well-touristed Bali.

You can acquire immunity via surviving an infection (“natural immunity”) or being vaccinated.

I can honestly not see why anyone would risk their child’s life by giving them whooping cough (pertussis), which kills 300,000 people every year, worldwide, rather than give them the jab.

As to “inherited natural immunity”. Mothers do hand on antibodies to their newborns, resulting in increased immunity for a short period.

But, as should be obvious from the numbers of families where, for example, grandmother, mother and grandchild have all had chickenpox, or, more simply, the fact that a myriad forms of flu and common cold still exist, it’s not an effective protectant.

Edward Jenner developed vaccinations precisely because so few people have natural immunity to serious diseases. His invention has saved an incalculable number of lives over the last couple of centuries – hundreds of millions, if not billions — and vastly increased the quality of life for everyone.

***

Sadly, it’s precisely because childhood vaccination programmes work –- polio cases in the UK have dropped from 4000 a year when vaccination was introduced to a handful of cases, almost all among adults to old to have been vaccinated –- that some parents are now opting out.

There is a tiny risk of polio in the UK and the US. Why?

Not because unvaccinated children have “natural immunity”. Not because polio’s not an infectious disease. But because everybody else vaccinates their kids, so the disease is (currently) not out there.

This enables parents to focus not on the diseases, which can and do return (measles is soaring in the UK), but on perceived and largely anecdotal risks of vaccination.

In countries where polio-crippled adults beg on street corners, you won’t see many people opting out of the polio jab from a concern for “side-effects” –- because they’ve seen what the disease can and does do.

Worldwide, over a million under-5s die every year from diseases that could have been prevented by vaccination (more than one-third of them from measles).

That’s a lot of grieving parents. Very, very many more, I would venture to suggest, than those who even claim – let alone can demonstrate – any damage to their children from vaccination.

***

Online forums, however, are full of people who have traveled with their kids without vaccinating them proselytizing others to do the same.

One assiduous online self-promoter, whose blog and social media feeds cover her own and her family’s various health complaints in quite mesmerizing detail, posts all over the internet as an advocate of homeopathy and travel without vaccinations – presenting her own avowedly excellent health as an example.

Now.

Of course you can travel non-vaccinated and not get sick. You can drink drive and not have an accident. You can smoke crack and not become addicted. You can smoke cigarettes and not get lung cancer.

But your risk of health problems is higher when you do not vaccinate. End of story.

***

Why are people so scared of vaccinations? And why does this fear only kick in when they’re parents?

Firstly, there’s the bewildering belief that what is sold as “natural” is somehow safer and more effective.

Now, I’m not anti-natural: I’d rather get my vitamins from fresh fruit and vegetables than from supplements (“natural” or otherwise), and would rather ride out a bug than mess with antibiotics.

In the case of serious illness or accident, however, I’m rushing straight to a hospital with evidence-based medicine, into the warm and statistically proven embrace of Big Pharma.

Homeopathy is not ineffective. It works as well as a placebo, because people believe in it. (For a fascinating article on the placebo effect and homeopathy, click here.)

Mind you, if anyone would take a dangerously ill child to a homeopath or alternative therapist over a Western hospital – let’s say they’re comatose, fitting or running a fever of 104+ — I’d be really interested to hear from you.

If you wouldn’t leave a dangerously sick child in the hands of a homeopath, don’t base your vaccination decisions on their advice.

While I’m on this soapbox, it’s worth knowing that many medicines marketed as “natural” contain chemical ingredients (including antibiotics), while others can be toxic (the preeminent “natural” anti-malarial is banned in India). (See this pathologist’s report for more on this. )

The “natural” healthcare industry, often presented as a series of backyard mom and pop organisations, is often at least as greedy as and always infinitely less regulated than Big Pharma.

***

Then there’s the vaccination scare thing.

Bizarrely, these vary from country to country. In the UK, our big one was about the MMR injection, a combination jab against measles, mumps and rubella.

(Why vaccinate against these often trivial illnesses? Rubella can cause birth defects and miscarriage; measles can kill and cause brain damage; mumps can cause sterility in men.)

The MMR scare in the UK was started by a now-discredited doctor who claimed, on the basis of a sample size of 12, that the MMR jab could cause autism. (For a chilling analysis of the scare and the role of media in it, check this piece by Ben Goldacre.)

It was a psychologically compelling idea. The jab is administered around the time when autism spectrum conditions tend to present in children.

Many parents, whose children presented with autism around the time of the MMR jab, still hold that it was the jab that caused their children’s illness.

Of course they do! It’s only natural, when a heartbreaking condition strikes, to look everywhere for an answer, a reason why…

Christ! It struck a chord with me. My brother lives with Aspergers syndrome, an autism spectrum condition that makes many aspects of life very challenging for him.

Taking my child to the doctors for his jab with screaming bold-face headlines in the newsagents about how it would give him autism was…

Well, difficult, honestly…

Even though he’d had the full programme of jabs, beginning at a few weeks old (as in most of the developed world, our government gives them out free), I was afraid my son would present with my brother’s condition. And then I’d forever be blaming myself, and the immunisation, for his condition.

He had it. He was fine.

The only noticeable side effect he’s had from any of his myriad injections is a sore arm (this is, along with mild fever, among the side effects you’ll find listed in painstaking detail in the literature).

***

So… Should you vaccinate your child for travel?

If you’re anti-vaccination, or, as happens in well under 0.001% of cases, your child has had a reaction to vaccines severe enough for doctors to recommend that they are not vaccinated further, and you’re starting in the developed world, you’re going to run about the same risk wherever you go.

Y’know. Madrid, London, Tokyo, New York, Melbourne, Auckland – your child can get sick there, and infect other children there (babies too young to be vaccinated routinely die in the West via infections contracted from unvaccinated children). But their chances of contracting, say, polio or typhoid are minimal.

If you’re headed to Rwanda, East Indonesia, Mongolia, Suriname, rural Brazil, Mali, India, Pakistan or Nigeria, for example -– your risks are very, very different.

And I think the question you should ask, when planning to travel with an unvaccinated child to regions where dangerous diseases are prevalent is: “Could I live with myself if my child died of these diseases or was permanently damaged by them?”

For most of us, the answer will be no. And most of us, therefore, will want to change either our travel plans or our approach to vaccinations…

I’m interested to hear where you stand on this — what jabs did you have? Where did you go? Whose advice did you take?