Can I ask a potentially dumb and (depending on things) poltiically charged question? Did you vaccinate Kid A? Feel free to keep this private if you want, I'm asking for my own curiosity as I am delving into things.
I feel very strongly about vaccination. I don’t trust doctors for shit, but I do trust actual research evidence, and the research very clearly shows that vaccination carries tiny risks compared to non-vaccination in cases without a clear medical reason not to vaccinate.
Wisconsin is a state that makes it very easy for parents to enroll unvaccinated kids in public schools basically by signing a sheet of paper saying they don’t want to. Not coincidentally, we’re also a state with consistently high rates of pertussis, frequently reaching outbreak status. Diseases like pertussis, where the actual vaccine’s efficacy is relatively low (~80% for pertussis) depend even more on herd immunity than other vaccines, though of course herd immunity is still crucial for the protection of people too young to be (completely) vaccinated, people who cannot be vaccinated, and people who are immunosuppressed. The DTaP vaccine, which children receive to protect against diphtheria, tetanus, and pertussis, is a 5-shot series beginning at 2 months; most pertussis deaths are infants younger than that exposed to unvaccinated or incompletely vaccinated people, but complete protection isn’t provided until the last shot around age 4 (and even then, some people are less protected than others). Research published last year in Pediatrics shows a clear connection between clusters of “personal conviction” vaccination waivers and pertussis outbreaks in the state of California, where a number of infants have died from pertussis in the past several years.
For another example, MMR is a very effective vaccine, with 99% efficacy after the required two doses—but the second dose isn’t administered until around age 4, and the first is given around 12-15 months. Measles, which has been making a publicized comeback in the US (probably also somewhat due to the fact that many adults who received MMR in childhood only got one dose, as the two dose schedule wasn’t standard until the mid-90s), is so incredibly virulent that just being in the same place as an infected person over the next 24 hours carries a high risk of infection. Aside from turning all public spaces into potential infection vectors, this has chilling implications for doctor’s offices, where infants under 12 months tend to spend more time for routine visits.
Flu shots are all dead vaccines, which means you cannot get the flu from them, but because people often don’t have a clear picture of how vaccines work, they’re often blamed for illness that manifests before they would have had a chance to take effect anyway. And of course, they are always based on guesswork—what strains will predominate this year?—so they are sometimes pretty effective and other times not very effective at all. But they are also another case where, due to comparatively low efficacy, herd immunity is really important. And people often don’t think of the flu as that dangerous, but again, that depends on which population we’re talking about. I had H1N1 in 2009 and had cardiac damage that persisted for several years; a friend’s husband actually had to be placed in an induced coma due to H1N1 complications. H1N1 also has a higher-than-usual rate of complications for pregnant people; at least one pregnant person in Madison has died from it this flu season.
I can understand why people would distrust doctors and even public health campaigns, but there’s no evidence that any of these vaccines are harmful, and good evidence that they reduce risk. Where they provide unequal benefit, it is generally the result of biased research—Gardasil, for instance, protects against the four strains of HPV most commonly associated with cervical cancer in White people, while failing to protect against most of the HPV strains that are typically linked to cervical cancer in Black people. The vaccine isn’t harmful, but it’s true that the benefits for Black people are much smaller than for White people.
I think my doctor was actually making noises at me that I should turn down the at-birth hepatitis vaccine for Baby B (a major reason I have no interest in keeping her around after the birth). She said something ridic like “Well, do you think the baby will be using IV drugs or having unprotected sex?” Like, lady, if every parent waited to vaccinate for hepatitis until they felt this was a likely prospect, the coverage rate for this vaccine would be about 2%. There’s no reason NOT to get it, so it’s not a good idea to delay protection. (As a counter-example, antibiotic eye ointment typically applied to newborns is generally not indicated and contributes to antibiotic resistance–that’s a standard intervention with good reason to forego.)
The entire purpose of vaccines is to prevent diseases before they happen. I really do think that the biggest reason there is controversy around them is that we are comfortably removed from a world in which kids routinely catch measles, pertussis, polio, etc. People do sometimes have unpleasant reactions to them, and VERY rarely, health/life-threatening ones. But if you compare that to the risks of the diseases they prevent, it’s no contest.