By STEVEN L. WEINREB
West Hartford, Conn.
I HAVE chronic lymphocytic leukemia. Three months ago, I underwent an allogeneic stem-cell transplant, in which my wise, 52-year-old white blood cells were replaced by bewildered, low-functioning cells from an anonymous European donor. For the next seven months or so, until those cells mature, I have a newborn’s immunity; I am prey to illnesses like chickenpox, the measles and the flu.
These diseases are rarely fatal, unless you’re a newborn or someone with a suppressed immune system like me. My newborn buddies and I do have some protection, however: the rest of you.
Young babies, the immuno-compromised and people who get chemotherapy are not able to process most vaccinations. Live vaccines in particular, like those for measles and chickenpox, can make us sick. But if 75 percent to 95 percent of the population around us is vaccinated for a particular disease, the rest are protected through what is called herd immunity. In other words, your measles vaccine protects me against the measles.
It’s the reasoning of Clarence, the angel from “It’s a Wonderful Life”: If you are vaccinated, you won’t pass a disease on to someone else, who won’t pass it on to six more people, and on and on. To quote Clarence, “Strange, isn’t it? Each man’s life touches so many other lives.”
Unfortunately, vaccination rates for many diseases in Europe and in areas of the United States are falling. This is partly due to Andrew Wakefield, a British doctor who published a paper, now discredited, in 1998 in The Lancet tying childhood vaccines to autism. Celebrities like Jim Carrey have also taken a strong antivaccine view. As a result of these unwarranted fears, childhood diseases are returning. The rate of whooping cough cases has spiked over the past 20 years. In 1990, the incidence was 2 per 100,000 people; in 2000 it was 3; by last year, it had risen to nearly 10.
Measles cases are also increasing. For each year between 2001 and 2008, the median number of cases in the United States was 56. In the first six months of this year alone, there were more than 150 reported cases — the most since 1996. A vast majority of those who were sickened had not been vaccinated or had uncertain vaccination histories. Before the vaccine was introduced in 1963, 400 to 500 Americans died of measles every year.
During last year’s flu season there were 55,403 reported cases of influenza A and B; 116 children died of the disease. And now flu season is back.
The truth is, we should not get vaccinated for ourselves alone; we should do it for one another. Having cancer has taught me the value of living in a community. We assist the infirm, pay our taxes and donate to charity, and getting vaccinated — for the flu, for adult whooping cough, for pneumonia — is just another important societal responsibility. After all, we’re in the same herd.
Steven L. Weinreb, an internist who is certified in oncology and hematology, is on medical leave from his job at a private practice.