The cases of measles in Minnesota have grown to 32, and as someone who has a hereditary rubella vaccine allergy, I’m worried. The measles and mumps vaccines are no longer available separately, which means that I have only had one dose of the MMR vaccine—the dose that almost killed me as a baby. Basically, I am probably not immune. So if you like having geeky science and technology articles from this nice person, please get vaccinated, as I could totally die.
I think about vaccines a lot because I am one of those theoretical people scientists talk about who cannot get vaccinated. The scientific community talks a lot about people who are against vaccines for religious or other reasons. But I don’t think we talk enough about the other people who don’t get vaccines: the people who aren’t anti-vaxxers, but can’t or don’t vaccinate for other reasons. Here are some of them.
1. People without Primary Care Physicians
In this country, it is unfortunate, but having a primary care physician is a luxury. It’s hard to get vaccinated without someone to tell you which ones to get and when, and if you don’t have health insurance, have high deductibles, or don’t have the time to meet with a primary care physician, you will likely not get the information you need to get vaccinated unless you are an uber nerd. With the population of people that are getting the measles right now being Somali, a lot of people are very quick with their Islamophobia to assume that these people are religious zealots. But when I think about people fleeing their war-torn home country, I imagine these people are getting established in America. And when you are establishing yourself in America, you likely don’t have health insurance yet. Also, the physicians here are probably ill-equipped to ask if they were vaccinated; doctors would need to be trained in cultural competency to remember to ask a teenager or an adult if they have all of their childhood vaccines. I haven’t had a primary care physician for a while, and it’s been interesting getting vaccines through the grocery store pharmacy counter when you think you probably need one.
2. People without Money
Luckily, vaccines are generally covered under insurance. But for people who pay out of pocket, have fun with that. The HPV vaccine costs $390 to $500. Vaccinations have the same price problems that the rest of our healthcare system does—that they are too high for an uninsured person to afford.
3. People without Time
Doctor’s offices are generally open during banking hours, so if you are a student or if you work during banking hours, good luck getting vaccinated. If you’re a bus commuter, a small trip to the doctor could take hours. If you work in retail, it is unlikely that your employer will give you time off to get vaccinated.
4. People without Spoons
People often talk about people not getting vaccinated to “prevent autism.” (Vaccines don’t cause autism, but even if they did, the implication that death by polio is better than living with autism is ableist.) However, they seldom talk about people with autism or mental illness trying to get vaccinated. The process of getting vaccinated is invasive and much more challenging for people with mental illness. The spoon theory is a metaphor explaining that some people only have the energy for a certain amount of activities on any given day—and some people might not have enough spoons left after their daily activities for getting to the doctor.
5. People with Allergies
Why aren’t the measles and mumps vaccines offered separately? And while we’re at it, why don’t they make special vaccines for the many people with egg allergies? My rubella vaccine allergy is hereditary; why isn’t there more research on it? And why isn’t there a special process for getting people like us vaccinated? I would imagine if one mixed some epinephrine with the MMR vaccine I could take it in a hospital setting, but nobody has researched such a concept.
Vaccinations are a public good, so I would like to see them funded by the public and administered in places that are convenient to the public, like schools, work, or at the DMV while people are waiting in line. I would also like to see people able to leave their place of work to get vaccinated. More care should be taken so that doctors ask adults if they are vaccinated and are sensitive to the needs of people with mental illness. People who don’t have doctors should not be without vaccines. Finally, vaccines should be developed for people with vaccine allergies.