Why High Vaccine Uptake is a Social Justice Issue

Breaking news from Minnesota

Situation Update (3/29/11) There have been 13 confirmed cases of measles reported in Minnesota. Cases have ranged in age from 4 months to 34 years old. Five of the cases were too young to receive vaccine, six were of age but were not vaccinated, and two have unknown vaccine status. There have been eight hospitalizations and no deaths.

I wrote this as a comment at Respectful Insolence, but I think it deserves a post of its own:

I've been thinking about Dr. Jay's various comments:
Dr. Jay at #67, 3/25 Friday afternoon

The hospitalization details are unavailable. I think that most of them are probably quite "soft" because most doctors are just confounded by this "new" disease

Jay's comment made me irate, but I wasn't sure why.

Later on in the discussion, Dr. Jay reveals that over the weekend, he has time to play two games of soccer, take his dog to the beach, and watch sports on TV.

I began to understand my ire.

In other words, Dr. Jay has leisure--he does not have to work another (or a third) job to make ends meet. He isn't caring for a second or a third or a fourth child, or older family members. He's not counting the money he has, and from that drawing up the weekly shopping list. He's not concerned with the worry of doing the week's laundry outside of the home (you know, are there enough coins for the washer and dryer, what will he do to keep the kids out of trouble while spending a couple of hours at the laundromat, making sure the family's laundry isn't just processed but not stolen)...

The freedom Dr. Jay has to spend his time over the weekend suggests his assumptions about what people do on a weekend. In other words, like many =>middle-class folk, Dr. Jay cannot imagine the reality--the daily tasks and worries that people with far fewer economic resources that he commands--must manage.

To get back to the subject of the hospitalized children:What we do know is that all of the hospitalized were children and we can infer that some were infants.

Another thing we can infer is that many of the 11 confirmed cases of measles in Hennepin county are Somali..

And what do we know about the socio-economic status of the Minnesota Somali? Here's Omar Hassan, owner of Robland Home Healthcare.

"The Somali community, we are new immigrants, most of them are low-income, their education is very poor,...

It's not that poor folk --even under-educated immigrants-- don't have the will or the desire or even the knowledge to care for their children ill with vaccine-preventable disease. It's that they do not have the resources, and their children may have better care in hospital.

And that is why high vaccine uptake is not just a public health issue, but a social justice issue.

Comments

[Melissa G]

Dr. Jay and the Sears clan have a lot in common. While first reading the Sears books, even as a True Believer at the time, the white moneyed privilege struck me. So many of their recommendations fail to take into account urban living conditions and poor economic circumstances. It really is as if most of the world is invisible to them.

[Todd W.]

Thanks, Liz, for shining a light on this all-too-often forgotten aspect of immunization. Even those of us fighting the good fight can forget about the social implications every now and then.

[Claire]

While I appreciate your conclusion, you are wrong about the reasons for the Somali community in Minneapolis area not vaccinating their children. Frankly, the community is terrified of autism and there is some anecdotal evidence that they have a higher incidence of it among the Somalis. There is a scientific study on same recently starting. In any event, the infamous Dr. Wakefield has gone up there a few times, once specifically to address the Somali community, at their request.

Can someone put that guy in jail already?