Williams: Don’t let affiliations thwart lifesaving medical decisions

About the writer: Bruce Williams is a McMinnville medical practitioner of long standing. He is a fellow of the American College of Physicians and former member of the National Health Service Corps.

A practicing physician’s response to the county commissioners’ request for information about vaccines:

Thank you for the opportunity to speak of the impact of vaccinations. As a frame of reference, I was born in 1955 and have experienced directly or indirectly many of the illnesses now prevented with vaccines, both personally and as a practicing physician.

Most poignantly, I attended grade school in the 1960s with two classmates affected by congenital rubella syndrome. They suffered from vision loss and severe hearing impairment.

Prior to the rubella vaccine becoming available in 1969, some 60,000 children in America were born every year with congenital rubella syndrome. Now it is a few hundred a year.

Many patients over the years have come my way with limb weakness from polio. A significant percentage have suffered post-polio syndrome, a progression of their weakness in late life after earlier damage from the virus.

It is worth noting that Jonas Salk, developer of the first polio vaccine in the 1950s, chose not to patent his work, leading to almost worldwide eradication of the disease over subsequent generations. He was also a strong advocate for mandatory vaccination programs.

Sadly, polio is still present in the US, with a case of paralytic polio occurring in an unvaccinated man in 2022 in New York state. The case prompted the study of lake water in the state, and dozens of samples proved positive for the virus.

Measles (usually in an atypical form) and whooping cough (Pertussis) are always around, and I have seen both illnesses.

A new outbreak of traditional hard red measles is currently active in Florida at a school where more than a hundred children have never had a vaccine. More cases than the 6 reported so far are anticipated.

Severe complications include blindness and, for about one out of every thousand children infected in a modern Western country, death. The death rate in other parts of the world can be much higher.

Side effects I have seen to vaccine inoculation include malaise, low-grade fever, musculoskeletal aches and pains, and local swelling. I’ve had one patient in my career with swelling of her entire arm after a pneumonia vaccine, which resolved over a few weeks.

Patients have reported to me reactions such as Guillain-Barré, but I have never seen such a thing myself. Severe reactions are, fortunately, very rare.

The development of vaccines for severe communicable illness is one of the most amazing aspects of modern life. It began with Edward Jenner using cowpox to protect against smallpox 250 years ago.

The recent use of HPV vaccines to prevent cervical and head and neck cancers illustrates the broad potential for vaccines in the future.

Obviously, the benefits of a vaccine or a vaccine program must outweigh the risks. This calculation is the everyday work of public health professionals, who base their decisions on carefully derived data.

Making policy decisions based on religious conviction or wistful thinking is not appropriate. The decisions can get more complex when vaccine programs are made mandatory for the good of an entire society, but the benefits are clear when one takes into account past experience and realizes that the diseases we are speaking of have not disappeared, but are simply lying dormant, waiting for the opportunity to maim and kill again.

As for COVID 19, the situation that has evolved in the United States with regard to the virus and various vaccines for it is remarkable.

When this protean virus came on the scene four years ago, it initially caused respiratory illness ranging from the sniffles to fatal pneumonia. Over time, it became clear the virus is capable of much more.

A number of my patients died in the early years of lung complications, including a 36-year-old father after three months in intensive care at the Oregon Health Sciences University Hospital. Last year, a 48-year-old male patient came in with multiple pulmonary emboli due to COVID.

Two years ago, a 60-year-old woman I see suffered dozens of strokes and remains aphasic. I have had patients with COVID suffer renal failure, diabetes, heart attacks, and lingering “long COVID.”

The virus makes brain disease such as Parkinsonism and Alzheimer’s worse, with brain infection occurring commonly. Loss of smell is a sign the virus has invaded the brain.

The vaccines — developed in record time, based on 20 years of research — are remarkably helpful.

However, in this country, their use has not kept up with that of the rest of the world, and the consequences are well-documented. The average life span has declined in the U.S., as a million Americans have died needlessly.

Vaccine hesitancy is present in my everyday practice.

From my perspective, the sad part is that it’s not based on a rational analysis of the risks and benefits, rather upon group identification. Patients decide whether or not to get a COVID vaccine based on a Facebook group or church they visit, and the risk of losing acceptance in that group or church, rather than a clear appreciation of the benefits and rare difficulties associated with vaccines.

Sadly, vaccine partisanship has cost us many, many lives. COVID will likely be with us for many generations, and the vaccine is very powerful in preventing serious disease.

People should keep up with their shots, especially if they are past 50. That way, we can maintain a reasonably open society and continue to socialize reasonably freely.

People with symptoms should wear a mask for a week, for the good of their friends and family.