这两天，兽楼处的文章在朋友圈被刷屏了，因为里面讲了一个通过疫苗接种成为巨富的发家致富的故事，也讲了一个不计其数不合格的疫苗被植入儿童身体却惩罚轻微的故事。

    出离愤怒之外，这让我不禁想起我曾在2014年11月贴在我朋友圈的一个贴子，疫苗真的有必要打吗？

    14年10月《时代》周刊上曾刊登过该周刊的资深记者Jeffrey Kluger的一篇文章，《谁在害怕小小的疫苗？》。文章中，他发现那些不情愿给小孩接种疫苗的家庭，大都觉得自己比医生懂得更多。这样不合常理的行为却没有导致反接种的人群减少，为什么呢？

   通过其调查，他总结了一些原因：

1、  疫苗是安全的且对小孩的健康是关键的课正在被忽视；

2、  许多受过良好教育和家境富裕的人，相信自己能控制和降低不幸降临到自己家庭的随机性，更偏好选择不接种疫苗

3、  私立学校的接种率明显低于公立学校

4、  不愿接种的人担心疫苗可能带来的后遗症，如多动症、躁郁症、自闭症、过敏等

5、  阴谋论盛行，一些人认为疫苗是某些逐利的医生和医药公司的获利源泉，为了利益他们会隐瞒某些危险。

    同时，他也指出，如果一旦被告知不接种疫苗引发的并发症，如腮腺炎会导致耳聋，则接种率会上升。他的结论是，没有科学证据证明疫苗是危险的和会引起疾病的，也没有科学证明说，如果小孩没有接种，就会有更多的危险。

   可是他说的第五条似乎并非阴谋论，药品的竞争和因此带来的吃回扣现象似乎并非个例？那么，如果疫苗是有利可图的，如果进口和国产疫苗存在着巨大的价差，如何保证完全不懂的老百姓没打上不合格的疫苗呢？如何保障易感人群没有因为接种而引发更严重的生理或心理疾病呢？

   如果这些都没保障的情况下，能不能还老百姓选择打和不打的权利呢？能不能还儿童们一个纯洁的身体呢？

张军平

2018年7月22日

参考文献：

Jeffrey Kluger. Who's afraid of a little vaccine? Time. 2014 Oct 6;184(13):40-3.

附原文：

I’ve felt ridiculous plenty of times in my life, but rarely so much as the day I took my first daughter to the doctor to get her first round of vaccines. It was a routine visit during which her weight, length, alertness and other basic metrics would be checked. But at the end of the appointment would come the shots.

When that time arrived, I held my daughter in my lap, knowing two things she could not: that in a few seconds, she’d be howling in pain and outrage and that the needle that would be plunged into her wonderfully chubby thigh would introduce a stream of viral traces into her otherwise clean and pristine immune system. I was seized by a sudden fear that I was doing a very bad thing.

 That’s what the people behind the antivaccine movement would have me believe, but I knew better and for a long time, so did most American parents. In 1952 there were 57,879 cases of paralytic polio in the U.S. By 1961, just six years after the vaccine was introduced, the number was 1,312 -- a 98% reduction. Today the figure is zero. In the 1950s, before the introduction of the measles vaccine, 3 million to 4 million Americans contracted the disease each year and 48,000 were hospitalized. In 2012 there were just 55 cases.

But recent outbreaks of measles in New York City and Orange County, California; whooping cough throughout the entire state of California; and mumps in the communities around Ohio State University in Columbus suggest that the hard-learned lesson that vaccines are not only safe but also critical to the health and safety of all children is being unlearned.

For most diseases, vaccination rates must remain very high---up to 95% in some cases--to establish what’s known as herd immunity, the protection provided by an entire community to the handful of people who can’t be vaccinated because of a demonstrable medical condition. In the U.S. at large, the numbers are pretty good, with close to 95% of incoming kindergartners in compliance with vaccine guidelines, according to a 2012–13 survey from the U.S. Centers for Disease Control and Prevention (CDC).

But that figure conceals a lot of holes. Louisiana has an impressive 96.6% rate for the measles, mumps and rubella (MMR) vaccine and a 98.3% rate for diphtheria, tetanus and pertussis. Mississippi leads the nation with a near perfect 99.9% for both. California, meanwhile, clocks in at just 92.7% and 92.5%, and Colorado rolls in last at a woeful 85.7% and 82.9%.

In New York City, vaccination rates in public schools top 98%. But a recent survey of 245 of the city’s private schools revealed that half of them are below 90%, and 37 of them are below 70%. Nine schools fall in a range from 41% down to 18.4%.

In Ohio, it’s not all of Columbus that’s turned against vaccines; it’s mostly places like the Clintonville community, an upscale neighborhood where the antivax movement has gained traction. “There are a lot of university employees living there,” says Misti Crane, a reporter for the Columbus Dispatch who, along with co-investigator Jennifer Smith Richards, analyzed statewide vaccination rates and led the charge in establishing the high-income, low-vax link. “They are dual-income and college educated. It’s a community of ‘Hey, I know better.’”

But what these folks think they know just ain’t so. And not only are their own children being put in danger, but so, potentially, are everyone else’s.

 Julie Snoeberger doesn’t care what you want to call her -- and there are few names you could come up with that she hasn’t heard before. “I’ve been called a crackpot and a baby killer,” she says.

Snoeberger began steeling herself against this kind of criticism more than 15 years ago, when her baby son began getting his first rounds of vaccines. After his 12-month shots, he developed chronic ear infections. At 18 months, she says, the MMR vaccine transformed him within 48 hours from a happy, verbal child to one who was violent, antisocial and had “lost all his words.”

The medical community has heard stories like this before and patiently refutes them: if her son developed signs of autism, they were linked not to the vaccine but to the simple fact that the disorder often begins to present itself at the same age at which kids start getting vaccinated. And as for ear infections, well, they are practically ubiquitous among babies.

The arguments that have been central to the antivaccine movement for decades are familiar: The shots are overused and teeming with toxins. They cause autism, bipolar disorder, ADHD, allergies and more. They are profit centers for greedy doctors and Big Pharma, and everybody’s keeping the dangers quiet. “The conspiracy theories come up a lot,” says Joan Bowe, director of personal health for the Delaware County General Health District in Ohio, which was hit by the mumps epidemic earlier this year. “They usually involve the government wanting the vaccines out there.”

None of that is true.

“As I perceive it, vaccines should be an elective procedure,” says Dr. Janet Levatin, who practices near Cleveland, citing measles as one argument in favor of that belief.

 Other doctors–those who support vaccines–have a number of ways to deal with patients who believe the shots are dangerous. Some simply refuse to treat the family.

 Why So Blue?

 There are a lot of theories about why vaccine denialism is such a problem in left-leaning communities, and one of the most persuasive is the master-of-the-universe phenomenon. The wealthier you are and the higher your education level, the more you lose sight of the randomness of misfortune and come to believe you can control variables and eliminate risk.

 “When people achieve a certain status, they think they’re invincible,” says Roberts. “They think it will never happen to them, and if it does, they’ll have the resources to deal with it.”

 Persuading the Avoiders

One way epidemiologists and psychologists have found to open people’s eyes to the dangers of vaccine avoidance is to frame the risks not in general terms–the numerical odds of contracting a disease–but rather the specific consequences. Mumps can cause deafness, for example, and, says Roberts, “once we see those complications, vaccine rates go way up.”

 The vaccine opponents are not going away anytime soon, though encouragingly, some are going dark. Playboy model and talk-show host Jenny McCarthy, who more than anyone else lit the antivax fires, speaks little of the matter anymore. Parents who don’t vaccinate increasingly complain that they are becoming pariahs in their communities, resented by parents who seek to protect their own children and see the antivax parents as undermining their efforts. Some doctors view this kind of impromptu, parent-on-parent persuasion as the best way to bring vaccine opponents around.