I do not like being told what to do.
A paramedic prepares a diphtheria vaccine to be given to students at a primary school on the first day of a campaign in Tangerang, Indonesia, on Dec. 11, 2017. Indonesia began the campaign to immunize 8 million children and teenagers against diphtheria. Tatan Syuflana/Associated Press
I was a difficult child. I know I am not easy for my wife or my employer.
In the 1980s, I disagreed with the United States’ military policy. I was arrested for peacefully blocking a bus taking visitors to the celebration of a nuclear-armed submarine.
In the 1990s, I was part of Doctors Without Borders teams in Bosnia and Bangladesh. My experience in Bosnia convinced me that there are times that military force can help prevent evil. I then volunteered to serve in our military, and in 2003 I was a medical officer on active duty in the U.S. Army.
My experience in Bangladesh was working as a doctor in a dirt-floor field hospital in a refugee camp. The children in the camp had not received regular vaccinations. One day two boys were admitted with what we thought was severe strep throat. They were responding to treatment for the first week but both suddenly died. Shortly thereafter, another child came in with a similar presentation, and I was really worried. We did not have any laboratory testing in the refugee camp, but we were able to get a laboratory technician to come from the capital city and obtain a throat swab. A week later, we received the result: The child had diphtheria.
I am not an infectious-disease expert. Quite honestly, at the time I was not even sure that diphtheria still existed. What I did know was that two boys had just died of an infectious disease, that I was the most experienced medical person in a refugee camp with over 40,000 people, and that I had better learn a lot quickly. I learned that diphtheria can release a toxin leading to rapid death even when the patient appears to be responding to treatment. This perfectly explained the sudden death the week before in the boys who had seemed to be getting better.
We moved quickly. We got more throat swabs and the results confirmed additional cases of diphtheria in family members of all three boys. We treated all the family members with prophylactic antibiotics. We accelerated vaccination plans for the camp. This outbreak was contained, but I had a glimpse of the world before vaccines. It was not a pretty sight.
Diphtheria is the “D” in the routine childhood vaccine DTaP. To most of us in America today, diphtheria is as remote as smallpox. The difference is that worldwide mass vaccination programs led to the eradication of smallpox, while diphtheria is still present in many parts of the world. Diphtheria was once known as “the Plague among children.” In 1921 there were over 200,000 cases of diphtheria in this country and over 15,000 died from it. We are lucky that because of widespread use of vaccines, Diphtheria is currently extraordinarily rare in this country. If we stopped using vaccines, it would return. The death rate from diphtheria still ranges from 5 percent to 20 percent even with treatment.
No one among us likes to be told that we are required to receive the pain of a shot and the day or two of feeling poorly that often accompanies any vaccination. We do not like to consider the possibility of a serious reaction to a vaccine because, if it happens to us, or our children, we do not care about data that prove serious vaccine reactions to be an extraordinarily rare event. In Bangladesh, I saw a glimpse of the world before there was widespread use of vaccines, and it honestly was a scary place.
If you are hesitating about accepting a vaccine that a government is telling you that you must get, I really do understand your questioning of this “authority.” So here is an idea: Try to imagine yourself responsible for the health of 40,000 unvaccinated people in a refugee camp with diphtheria smoldering. For a person like me who hates being told what to do, the Bangladesh refugee camp helped me accept vaccine recommendations.
Please get vaccinated against COVID. We all understand the idea of “taking one for the team.” This is one of those times.
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