Vaccines are perhaps the most important — and effective — public-health intervention ever conceived. Myriad data show that vaccines like the measles, mumps and rubella vaccine, or MMR, are 90-99% effective and save millions of lives each year. Some, like the polio vaccine, have even managed to eliminate the disease they target.
But despite their utility, they are not without controversy. Anti-vaxxing, the movement against vaccination (mostly targeted at childhood vaccines), has gone from a fringe belief to a topic discussed in the highest realms of government.
And even if you got your shots, you aren't immune — anti-vaxxing is taking a toll on your health, regardless of what you believe.
A person's immune system starts developing in the womb, where antibodies are passed on from the mother through the placenta (this is called passive immunity). But this immunity starts to decrease soon after birth — that is when vaccinations step in.
A typical vaccine schedule for a child under the age of 7 living in the United States goes like this:
- On a baby's very first day in the hospital, infants typically receive a hepatitis B vaccination.
- At age two months, they receive vaccinations for rotavirus, pneumococcal, polio, diphtheria, tetanus, whooping cough, and haemophilus influenzae type b.
- Between the ages of one and two years, infants receive more shots for chickenpox, measles, mumps, rubella, and hepatitis A.
- By the age of six, children have received booster shots for some of the diseases listed above, and should have started to receive an annual flu vaccine, too.
In America, more than 90 percent of children get all of the above mentioned vaccines, according to the US Centers for Disease Control and Prevention.
That is no mean feat. The measles vaccines alone has helped prevent millions of deaths over the years, the CDC reports. Prior to the vaccine, almost everyone caught the disease at some point in their lives. As a result of the vaccine, many doctors practicing today have never treated a case of it.
“You never send out a police force without training. What a vaccine does is provide training.”
But more and more people are opting not to vaccinate their children — and the consequences may be dire. Eighteen US states allow for religious or philosophical exemptions from vaccination. And according to surveys of pediatricians in America, there's been a rise in parents deciding to opt-out from vaccinations for their children.
To understand just how anti-vaxxing impacts us, Inverse spoke to two vaccine specialists — Walter Orenstein, professor at Emory University, and Mark Doherty, a researcher at pharmaceutical company GlaxoSmithKline, which produces and sells many common vaccines.
They identified three key ways anti-vaxxing takes a toll on your health.
1. Less immunity for you
“Our immune systems function as an army or a police force, they detect the pathogen and then destroy it before it can cause a disease,” Orenstein tells Inverse. “You never send out a police force without training. What a vaccine does is provide training.”
When a person comes in contact with a disease for the first time via molecules called antigens, they can contract the illness. A vaccine essentially gives you a small-enough dose of specific antigens to train your body's immune system, but the dose is not strong enough to make you ill.
“Getting an infection leaves damage in your body for the rest of your life."
In the case of babies, this is particularly important. Many infants are too weak to fight off some diseases. That is also why most of the important vaccines, like the MMR, should be provided before the age of six.
After receiving the vaccine, the antibodies your body creates to fight off the antigens live on in your immune system's memory back. Armed with this artificially acquired immunity, the chances of later contracting diseases from those specific antigens plummets.
Anti-vaxxing, on the other hand, leaves your body vulnerable to diseases it hasn't encountered before — which, if you are a baby, is likely most of them. And if you do contract one of the diseases, the long-term affects could be as devastating as the short-term symptoms.
“These diseases are not benign,” Orenstein tells Inverse.
Measles is a case in point. A 2019 study suggests that measles could lower immunity to other diseases — including the ones you previously had immunity to. Vaccination, by contrast, likely strengthens your immune system across the board, Orenstein says.
The long-term affects of not getting vaccines only become obvious years down the line, Doherty says. But they are becoming increasingly noticeable as our healthcare systems get better at tracking these connections over time, he says.
"When people will die, they will start to notice."
“Getting an infection leaves damage in your body for the rest of your life,” Doherty tells Inverse. "Infections are not trivial. A third of all cancers, a third of all strokes… are down to infectious diseases.”
This is the case even for common diseases like the flu, he says.
2. Less immunity for everybody else
Anti-vaxxing doesn’t just affect you. It ripples around you and into your community more than you might think. The resurgence of the anti-vaccination movement is directly to blame for outbreaks of diseases like measles and whooping cough, according to researchers at the University of Michigan.
And experts warn that measles outbreaks will continue to rise if we keep on this path.
“When you have high immunity levels the likelihood of a transmitting case is markedly reduced,” Orenstein says. “You break the chains of transmission.”
When about 93 percent of a community has been immunized, it conveys herd immunity. Herd immunity is when so many people are vaccinated within a given group that diseases can’t travel easily between them, so a single case is highly unlikely to turn into an outbreak. Over time, the disease eventually becomes rare, because it has nobody left to infect — we know that this is true, because it is precisely what happened with small pox.
Herd immunity also raises protection for people who cannot undergo vaccinations, including those with specific immune illnesses or allergies.
What herd immunity does not do, however, is vanquish the need for people to get vaccinated for those same rare diseases. That is because the disease pathogens can reappear, for example by traveling in to a community from abroad. That is why it is necessary to keep giving new babies shots and feeding the positive cycle.
3. It affects your quality of life
Vaccinations don't just benefit your health and the health of your community — they also benefit your wealth and quality of life, too.
As a whole, vaccines have a net economic benefit to society of approximately $69 billion in the United States alone, Orenstein says.
“There’s a substantial public health benefit, on average 10 dollars for every dollar invested,” Orenstein says. A study published in 2014 analyzed the savings made due to mass vaccination in the US during one year, 2009, is demonstrative of his point.
In that study, researchers concluded:
Analyses showed that routine childhood immunization among members of the 2009 US birth cohort will prevent ∼42,000 early deaths and 20 million cases of disease, with net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs, respectively. The direct and societal benefit-cost ratios for routine childhood vaccination with these 9 vaccines were 3.0 and 10.1.
Vaccination also prevents medical bills and other costs that can come from visiting a doctor when an illness strikes, and decreases the chances of having to pay for long-term ongoing medical bills resulting from unexpected side effects and long-term problems — like the paralysis that can result from polio. If the average vaccine schedule costs $1,200 to complete, then that seems like a bargain compared to the hundreds of thousands of dollars that treating and living with the diseases they prevent can incur, experts at the Harvard Medical School say.
The science of vaccines
What many people who are vaccine-skeptic or anti-vaccination do not understand is the amount of science and research that goes into creating a vaccine, and testing it, Orenstein says.
“It’s not like you take it out of the test tube today and inject it tomorrow. There are systems in place," he says.
Ultimately, both experts — and the scientific community at large — agree that the pros of being vaccinated outweigh the cons of not being vaccinated. Any adverse events resulting from vaccines are incredibly rare, and often coincidental.
“Benefits vastly outweigh the risks,” Orenstein says.
But vaccines' amazing abilities also result in a "prevention paradox," Orenstein says. When most people are vaccinated, nobody experiences the repercussions of not being vaccinated. As a result, they may never be exposed to all the diseases vaccines are designed to prevent — and that means they might not realize how serious they can be.
“There are diseases the population has never seen or never heard of because of the effectiveness of vaccinations,” Oresenstein says. So people are not worried about them.
“If anything, vaccines are victims of their own success.”
But there may be hope yet. Doherty believes that eventually the anti-vaccination movement will peter out or return to the fringe — the evidence that they work and are worth it is just too great to ignore.
“Vaccine skepticism is a philosophy that can never really thrive, because when people will die, they will start to notice,” he says.