Ok, this is a tough one, and controversial too. Full disclosure: I’m unashamedly pro-vax. I became a covid vaccinator for (which I had to study the immune system and vaccines in general) because I was jumping for joy when we got those pandemic-defeating vaccines. I’m stating this up front because, while I know I’m going to do my utmost to set out both sides of the argument in a reasonable, balanced, non-judgemental manner, it shouldn’t be too much of a spoiler alert to reveal that I’m going to come down in favour. I’d like to begin by saying that I genuinely understand why some people fundamentally disagree with me on this. I’d like to make it very clear that I respect people’s freedom and ability to choose what works for them. I have a very good friend who is antivax, and we’ve had long and respectful conversations about this. We’ve agreed to disagree. But: I totally understand why she came to her antivax conclusion, and I know that if I had walked a mile in her shoes, there’s a good chance I’d have come to the same conclusion. I’ve read the antivax literature, and here’s the thing: it strikes me that (shock horror) there may well be small risks to being vaccinated. My antivax friend, who turned out to be way ahead of her time when it came to gut health, postulates that some kids might have currently undiagnosable genetic/epigenetic conditions that will predispose them to serious adverse reactions to vaccines. If you think about it, that makes sense. If she’s right, there’s every chance that someday we’ll be able to figure out who these kids are and exclude them from vaccination programmes, hoping against hope that herd immunity will protect these children from the diseases they cannot be vaccinated against. Currently, as an example of progress made in screening babies for very rare but previously life-threatening conditions, babies are all tested for rare diseases which render them intolerant of specific proteins which would otherwise accumulate in their brain causing brain damage. Proteins that the rest of us take for granted. My point is that what works for the vast majority of people doesn’t work for absolutely everyone, and while one day we might well be able to figure out what works for every single individual, we cannot ban something that is beneficial to the vast majority just because it may cause complications in a few. We don’t ban antibiotics even though many people are allergic to one or several. We don’t ban sugar just because some people are diabetic (although…); we don’t ban gluten just because some people are Coeliac, we don’t ban salt because it contributes to high blood pressure, we don’t even ban smoking or alcohol (although…) The issue here, though, is that it could be considered crazy to vaccinate if you know that there are possible side effects that can be avoided by refusing the vaccine. This seems like a pretty logical conclusion when you are not sick and you have zero reason to believe you will be sick even without the vaccine. I’ve read the ‘Why Vaccines are Dangerous’ book by Vance Ferrell which is full of the most distressing case studies on babies that have died within hours of certain vaccinations. My heart goes out to all those families that have lost a baby following routine vaccinations. I for one have little doubt that if my babies had died within 24 hours of an immunisation, I’d be antivax today. For sure. Reading these harrowing accounts, I have little doubt that vaccines were the cause of death in some of these cases. I think it’s important to acknowledge this, because while the risk is exceedingly small, it’s there and if we pretend it isn’t, we risk losing people’s trust, and it is impossible to recover it. Ok, so I understand why you might not want to risk your perfectly healthy baby’s life no matter how small the risk. But, and this is the humongous but: that risk assessment only works if everyone else gets their baby vaccinated. That gives us herd immunity, which can eventually eradicate a disease. If everyone figures the vaccine risks are too high and uptake decreases accordingly, your baby is now at massively increased risk of infection. You might argue this doesn’t matter because these infections aren’t even that bad, but that’s where things get interesting. Because none of us remember pre-vaccine good old bad old days, we have collectively forgotten how nasty these bugs are. Even something as supposedly mild as measles can kill and maim children in numbers that the vaccines simply cannot compete with, even allowing for some risks of complications. Even more compellingly, some people rely on others taking up the vaccines because they cannot be vaccinated, for example because they are too young (babies before 8 weeks old) or because they have a battered immune system which won’t react to a vaccine, or in cases of live vaccines, because they are pregnant. Pregnant women cannot have the rubella vaccination, but rubella is super noxious to unborn babies. Pregnant women rely on either having been vaccinated or herd immunity. I cannot overly exaggerate the fear a pregnant woman experiences when she realises she has been in contact with rubella until she can be reassured she had antibodies present prior to the infection (we keep a sample of her booking bloods which we can refer back to if needed) due to having been vaccinated by her forward thinking parents. But a pregnant woman is also at risk because her immune system takes a battering in order for her to stay pregnant. Her normal immune system would destroy the intruder that is the baby. But the consequence of muting the immune system is that now even mild-ish (when you’re not pregnant) infections (like ‘flu, or even Covid) are much more dangerous. So us midwives do recommend that pregnant women get those vaccines. That seems pretty sensible to me. Vaccines work by cleverly convincing your immune system to make antibodies against a virus or bacteria. Antibiotics work a little bit like very unspecific antibodies (but only against bacteria, we have very little to combat viruses, apart from vaccines) but when you get a vaccine, you develop the capacity to make exactly the right antibodies. You no longer need those antibiotics. Much as your immune system is grateful for the invaluable help afforded to it by wonderful antibiotics, the assistance does have its drawbacks. It wipes out all the bacteria, both good and bad. And not needing them reduces the risks of antibiotic resistance. How amazing is that? I won’t go into the details, but l do recommend the YouTuber Philipp Dettmer for a nice clear explanation. Bottom line, vaccines encourage your immune cells to protect you even more than they normally would. It gives them a mega head start in a bug vs human confrontation. And a pregnant woman can pass on the resulting immunity to her baby. This gives the baby, who is born with zero immunity, a mega advantage until it too can get vaccinated. And of course, anything that reduces the odds of a pregnant woman being admitted to ITU on a ventilator is a no brainer! Because as always, what is good for mum is good for baby. Babies fare very badly if mum is fighting for her life because now, to save her life that baby needs to be evicted, ready or not… Bottom line, it’s all about how one perceives risk though. I cycle a lot, and many reasonable people would argue that the risks I’m taking are crazy. I think those people aren’t entirely wrong. But then again, cycling protects my heart and lungs (personal win) and it helps reduce emissions (societal win). I think vaccines are vastly less risky than cycling (please watch out for us crazies when you’re driving, we thank you!), but the personal and societal advantages gained by vaccines are immeasurable.