ELIZABETH WASIK: The wrong diagnosis

I am a family nurse practitioner. For a long time now I have observed that the public is no longer afraid of vaccine-preventable illnesses. I am not alone in this observation. Many clinicians and researchers are wrestling to find solutions to this problem.

Our waning fear of communicable diseases is dangerous. In 1900, 894 U.S. citizens died of smallpox. In 1920, 7,575 people died of measles and 13,170 died of diphtheria. In 1922, 5,099 people died of pertussis, otherwise known as whooping cough.

Smallpox was eradicated in 1980. In the 1940s and 50s, polio affected more than 35,000 persons each year; it has since virtually been eradicated from the planet by way of global efforts to immunize. Yet to this day, polio remains endemic in three countries _ Pakistan, Afghanistan, Nigeria _ and we continue to vaccinate because of the very real threat of resurgence.

With a healthy dose of fear of death or disability, our grandparents took our parents, and our parents took us, to the doctor's office to be vaccinated. It is our good fortune to have inherited a world relatively safe from communicable diseases. This is a gift from our elders and a result of scientific advances and persistent public health efforts to vaccinate. This is a privilege we should guard and protect.

But our collective memory is fading and this is increasing our individual and associated communitywide vulnerability to communicable diseases.

In 2017, 118 U.S. citizens contracted measles. This year, 137 cases of measles had been confirmed as of September, according to the Centers for Disease Control.

According to the CDC, influenza (flu) caused a record-breaking 181 pediatric deaths during the 2017-2018 flu season. Historically, 80-85 percent of flu-related deaths have been among pediatric patients ages six months and younger. Unfortunately, this population is not old enough to receive the flu vaccine. Infants and children are quite literally shielded through the phenomenon known as herd immunity. Herd immunity protection grows stronger the more people get vaccinated.

This may be why some vaccine skeptics are mistakenly encouraged to believe their child is not at risk when they choose not to vaccinate. In actuality, they are tearing a tiny hole in an invisible fabric shrouding us all in safety.

You have every right to be skeptical. I wish all of my patients were concerned about what they were putting into their bodies. If only I could convince as many people to stop drinking soda and eating fast food. The aforementioned are very serious public health threats.

It's when fear overrides reason that clinicians become concerned.

The truth is, every legitimate shred of scientific evidence points toward the safety and efficacy of vaccines.

And now, let me be clear, vaccines do not cause autism. Andrew Wakefield's 1998 article in the BMJ Lancet was retracted for being deceptive, scientifically unsound and irresponsible. Seventeen credible studies have since been published, all failed to link vaccines to autism and yet the myth persists.

Perhaps part of the problem stems from the fact that science hasn't yet provided a complete enough explanation for what does cause autism. Meanwhile, the public has traded its fear of communicable diseases for a fear of autism, the former forgotten and the later devastatingly tangible. The debacle of some unscientific claims that vaccines cause autism offers individuals the false hope that by refusing vaccination they can choose for their child a life without autism. This decision subverts reason, and instead many are choosing to be ruled by a fictitious fear.

By making the decision not to vaccinate we are harming our children, our neighbors' children the elderly and the frail. By choosing not to vaccinate we are turning our backs on science and reason. Perhaps most astonishingly we are refusing to believe that anything else could be the cause of autism. If we believe vaccines cause autism, then we aren't looking for the root causes of autism. We are only hurting ourselves and each other in the process. It's as though we are ready to hang an innocent man for crimes he did not commit while the real perpetrator runs free.

I offer parents and concerned citizens a source for their anger and fear, though I doubt that it will offer them any consolation. Every year more and more tons of toxic chemicals are released into our environment. I doubt if there is a place on Earth left untouched.

Mounting evidence suggests that even low-level exposure to toxic chemicals leads to premature births, behavioral and neurocognitive problems and intellectual deficits. Groups like the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have released policy statements and are calling for timely action to identify and reduce human exposure to toxic substances. The University of California, San Francisco has an entire program on reproductive health and the environment with scientific research articles documenting the harms associated with various chemicals we encounter daily. Meanwhile, every week another environmental protection, synonymous with human protection, is erased from our public policy.

Acknowledge your fears and resist acting rashly. It is imperative that we keep it together, and instead of turning our backs on science, embrace it, not without question but logically. In my opinion, and in the opinion of many more like-minded experts in their fields, science is a powerful tool for goodness.

And lastly, I implore you, as the new flu season approaches, talk to your health care provider about vaccination. Vaccination is the single best way to prevent the spread of communicable diseases.

May you and your loved ones be healthy as the seasons change.