The rubella vaccine

Today I want to write about something that has bothered me for a while, but which has intensified since I became pregnant. And I know that I run the risk of jumping into a rat’s nest of controversy, as there are many people who passionately believe in one side or another of this controversy. But hey, science is sometimes controversial, so I’ll just take a deep breath and plunge right in.

I want to talk about childhood vaccinations.

You might have heard a lot of stories on the news or in the papers in the last few years about the controversy over vaccinations. Do kids really need them, should they get them, or (and this is really the favorite topic in the media) is the increase in the rate of vaccinations connected with the increased rate of autism in today’s children?

I consider myself very well educated on these topics, and let me just put my position out there. I do not believe there to be any credible scientific backing behind the purported link between vaccinations and autism. I think any “scientific” evidence supporting it is spurious at best. I understand that autism is on the rise among today’s children, my heart breaks for those families with autistic children, and I easily understand how they might want an answer for what has caused the condition. But the science just does not support their claim that it is due to vaccinations.

That’s all I want to say about the recent controversy over vaccines. The main focus of what I want to say about the decision of whether to have your children vaccinated or not is not simply, as I have heard it said, a personal decision. Yes,, it is personal. But it is also a social decision as well. Here’s what I mean.

Rubella, or German measles, is not a very common disease these days (at least in the US). That’s because vaccinations against rubella have been going on for years – it’s a part of the MMR vaccine, and it’s very effective. Some may argue that it’s silly to vaccinate against rubella. Actually, compared to regular measles, rubella is usually pretty mild. You might have a rash, low grade fever, swollen glands, headaches and body aches. Or you might not ever really notice that you have it at all. But here’s the sticky thing. While rubella might not be all that dangerous for children or adults, it is devastating to pregnant women and their unborn children. A pregnant woman who contracts rubella within the first 20 weeks of her pregnancy has a significantly increased risk of spontaneous miscarriage. And even if disease doesn’t kill her child, it is at high risk for congenital rubella syndrome. This syndrome includes a host of birth defects, including heart malformations, deafness, mental retardation, eye defects, low birth weight, or problems with the spleen, liver or bone marrow. These problem can plague a child for the rest of his life.

The easiest way for mothers to protect their unborn children against congenital rubella syndrome is to be vaccinated themselves. That way, even if they encounter someone with rubella, they and their baby will be protected. But here’s what I worry about: I’m sure there are plenty of women who don’t know of the dangers that rubella poses. And so their vaccinations are not up-to-date. What if they come into contact with someone else carrying rubella because they believe that “whether or not I get vaccinated is strictly a personal decision that doesn’t affect anyone else”? I hope that you clearly see that suddenly this is not simply a personal decision. The unvaccinated individual has significantly increased the risk of someone else being born with a serious birth defect – or perhaps even caused the baby to not be born at all. That’s not personal. That’s social.

I realize that I’m not going to sway anyone’s opinion on whether or not they or their children should be vaccinated. (Especially if their belief is based on religious reasons.) However, I just want to make people aware. This really is not just a personal question, and it makes my blood boil, both as a scientist and an expectant mother, when people suggest that it is.

Incidentally, for everyone who’s reading this – have you been vaccinated against MMR?