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Decarboxylation: What It Is, & Why You Should Decarb Your Weed

Decarboxylation: What It Is, & Why You Should Decarb Your Weed


Have you ever wondered why you need to heat cannabis to feel the psychoactive effects? In order to get high from cannabis, you need to decarboxylate it first. But, what is decarboxylation and why should you decarb your weed? We’ll walk you through everything you need to know about getting the most out of your herb. 

What is decarboxylation?


Did you know that raw cannabis is non-psychoactive? The herb only becomes psychoactive when two things happen. First, when the bud dries and ages. Second, when the cannabis is heated. More psychoactive compounds are created by heating the plant than via ageing. In order to release the full potential of marijuana’s psychoactive effects, you must first go through a process called decarboxylation.


“Decarboxylation” is a long word for a simple process. To decarboxylate your herb, you just need to heat it. Applying a little heat to dried bud inspires some fascinating chemical reactions in the plant. Namely, you transform compounds called cannabinoid acids into a form that is readily usable by the body.

Cannabinoids are chemicals found in the cannabis plant that bind to cells in the body to produce effects. Sometimes decarboxylation is called “activating” or “decarbing”.

You probably have already heard that the primary psychoactive compound in cannabis is delta9-tetrahydrocannabinol (THC). THC is what gets you high when you smoke a little flower or eat an edible. But, you won’t find much THC on a live, growing marijuana plant, if any at all. What you find instead is another compound called THCA, which is short for tetrahydrocannabinolic acid.

THCA is not psychoactive. That’s right, this acid compound won’t get you high. In order to feel the mind-altering effects of cannabis, you need to transform THCA into psychoactive THC. So, you apply a little heat.

Each time you take a lighter to a joint or place your cannabis in the oven, you are acting the part of an amateur chemist. You are converting one compound into another. You’re turning an otherwise non-psychoactive plant into a psychoactive one. To get specific, you are removing a “carboxyl group” from the acid form of THC. Hence the term “De-carboxylation“. Without that carboxyl group, THC is able to freely bind to cell receptors in your brain and body.

Are there benefits to raw cannabis?


If you want a high, you need to decarb first. However, there are some benefits to leaving your cannabis raw. Keep in mind that “raw” does not mean dried and cured. When you dry and cure your cannabis, a little decarboxylation happens as the herb ages.

Raw, uncured cannabis has a variety of health benefits. Cannabinoid acids are potent anti-inflammatories. The herb is also packed full of vitamins and nutrients found in other healthy greens.

To use the herb raw, you’ll need to use freshly picked buds or fan leaves. You can also store raw cannabis in the refrigerator for a day or two like you would any other leafy green herb. Though, be mindful of mould and wilting. Densely packed cannabis flowers can become mouldy quite quickly when they’re exposed to moisture. You really want to use them as quickly as possible. They also begin to lose potency and denature the longer they sit.

Many medical cannabis patients have success by simply drinking raw cannabis juices or smoothies. You can find more information on raw, dietary cannabis here.

If you’re hoping for some psychoactive edibles, however, it’s best to decarboxylate your cannabis before you begin the cooking process.

Why do I decarb before cooking?


If you’re cooking with cannabis, it is highly recommended you decarboxylate before you begin making your edible. If you ingest cannabis and want the full psychoactive effect, you need to first decarboxylate before cooking with the herb. Activating your cannabis prior to cooking ensures that THC’s psychoactive potential is not wasted.

If you don’t decarb before cooking, you risk losing potency and are not making the most out of your cannabis.

Do I need to decarb CBD strains?


The short answer? Yes. CBD is short for cannabidiol, another common cannabinoid found in the cannabis plant. Unlike THC, CBD is non-psychoactive. Just like THC, CBD is found in its acid form in raw cannabis. This raw form (CBDA) has health-promoting properties on its own. But, activating CBD makes it more readily available for the body to use.

To use the proper term, activated CBD is more bioavailable. This means that the compound can be put to use by your body right away. When left in its raw form, your body has to do some extra work to break down the molecule and it may use the acid form in a slightly different way.

The same goes for other cannabinoids as well. Their raw form is the acid from. To make them more bioavailable, you need to decarboxylate. Bioavailability is why you need to decarb your weed.

Temperature and terpenes


When it comes to decarboxylating, the lower the temperature you use, the longer the decarboxylation process is it’s going to take. However, this is not a bad thing! When using a lower temperature, you to lose fewer terpenes throughout the decarboxylation process.

Have you ever wondered why buds of even the same strain can have different tastes and smells? The answer is hidden in terpenes. Simply put, terpenes are the oils that give cannabis plants and flowers their unique smell such as berry, mint, citrus, and pine. There are many medicinal benefits to terpenes; some will successfully relieve your stress while others will promote focus and awareness.

Terpenes also work in tandem with THC and other cannabinoids to amplify the medical benefits of certain strains. For example, one common terpene is linalool. Linalool is the compound that gives lavender its unique scent. Strains like L.A. Confidential and Lavender tend to have high levels of linalool. Research suggests that this may amplify the sedative effects of THC.

The max temperature for terpene expression is 310 to 400°F (154 – 204.4°C). Anything above that will burn off the terpenes, altering flavor and lessening medical effects.

How to decarb before cooking


Decarboxylation is a super simple process. Before you throw some cannabis into your pasta sauce or some “herbal seasoning” to your next pizza, make sure you follow these easy steps:

  1. Preheat the oven to 240° F. / 115° C.
  2. Break up cannabis flowers and buds into smaller pieces with your hands. We use one ounce, but you can elect to do more or less.
  3. Put the pieces in one layer on a rimmed baking sheet. Make sure the pan is the correct size so there is not empty space on the pan.
  4. Bake the cannabis for 30 to 40 minutes, stirring every 10 minutes so that it toasts evenly.
  5. When the cannabis is darker in color, a light to medium brown, and has dried out, remove the baking sheet and allow the cannabis to cool. It should be quite crumbly when handled.
  6. In a food processor, pulse the cannabis until it is coarsely ground (you don’t want a superfine powder). Store it in an airtight container and use as needed to make extractions

Watch the video

Fortunately, we’ve created this easy step-by-step video to walk you through the decarboxylation process. It really is not complicated, and taking a little time to properly activate your herb will produce amazing results. Watch the video below to see how it’s done:



Medicare Prescriptions Drop After Medical Marijuana Legalized

Big Pharma’s nightmare has come true as Americans are depending less on the pharmaceutical industry and more on medical marijuana as an alternative to prescription medication.

Marijuana is a natural plant that can’t be patented, unlike chemical-made synthetic tablets. Marijuana can be used to treat chronic pain, depression and anxiety. This may be why more are choosing to toke and smoke the herb and less are choosing to swallow pills.

Marijuana is not only a natural, safer alternative, but the prices for pharmaceutical drugs have sky rocketed. Now people are seeking an alternative to “modern medicine” in the form of cannabis.

Research shows states that legalized medical marijuana has caused a sharp decline in the purchasing of prescription meds. Using data on all prescriptions filed by Medicare D enrollees from 2010 to 2013, it was found that the use of prescription drugs was replaced with marijuana for health problems that marijuana could substitute for. For health problems where marijuana could not substitute, like blood-thinners, prescriptions didn’t drop.

“National overall reductions in Medicare program and enrollee spending which covers the cost of prescription medication.

When states implemented medical marijuana laws estimated to be $165.2 million per year in 2013.” – Researchers Ashley C. Bradford and W. David Bradford

The study’s finding’s add more arguments to the debate about whether to legalize marijuana or not for medical purposes. Already 25 states and the nation’s capital have legalized marijuana for medical purposes. That list includes Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and Washington, D.C.

Other States have legalized medical marijuana for limited use including – Alabama, Florida, Georgia, Iowa, Idaho, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia, Wisconsin, Wyoming.

Two states –  Florida and Missouri – are expected to vote for medical marijuana legalization in November.

On one hand legalization would save an estimated $470 million in Medicare part D spending if widely available. On the other hand, Big Pharma would lose customers, and as said by George Carlin, they want customers — not cures.

Various drugs have adverse side effects, and some even include suicidal thoughts and death. Not one known death can be attributed to marijuana, and opioid dependency is being decreased by Marijuana.

But could there be benefits to using marijuana? It’s already been revealed that the age old myth that marijuana kills brain cells is indeed false.

The myth was due to experiments where scientist took chimpanzees, strapped them with a gas mask and pumped them full of smoke. The study forgot to take into account that they didn’t allow the chimpanzees to breathe. Which holding your breathe for too long can kill brain cells on it’s own, by not breathing and taking in no oxygen and just smoke this would definitely kill brain cells — but marijuana isn’t to blame.

In fact, according to researchers Marijuana might do the opposite and grow brain cells. Marijuana compounds may also protect the brain from developing the Alzheimer’s disease according to researchers at the Salk Institute in San Diego. THC and other chemical compounds found in Marijuana remove amyloid beta proteins from the brain — which are toxins found in Alzheimer’s patients. The THC compounds also reduced cellular inflammation. What other health benefits lie ahead for cannabis users? Only time and more medical research will tell. But to reap its benefits we need to legalize marijuana as it’s still considered a schedule 1 drug by the federal government.

Spain Has First Case Of Diphtheria In 28 Years Thanks To Anti-Vaxxers

391 Spain Has First Case Of Diphtheria In 28 Years Thanks To Anti-Vaxxers

A six-year-old boy who had not been vaccinated is Spain’s first case of diphtheria in 28 years. The young boy, from the Catalan city of Olot, is reportedly very ill and is being treated with antitoxin. The parents, who had chosen not to vaccinate their child, are “devastated” and have now had their younger daughter immunized as a result.

Diphtheria is a bacterial infection that spreads through coughing or sneezing, according to the World Health Organization. Once infected, sufferers can experience a sore throat, fever and swollen glands in the neck. Diphtheria can lead to serious complications even with treatment, with 10% of cases resulting in death. Spain’s Health Ministry had to scramble to find the drug to treat the child as there had not been a case of diphtheria in Spain for almost 28 years due to the country’s high vaccination coverage (over 95%). The antitoxin was eventually delivered from Moscow to Barcelona by the Russian ambassador.

“The family is devastated and admit that they feel tricked, because they were not properly informed,” Catalan public health chief Antoni Mateu told El País. “They have a deep sense of guilt, which we are trying to rid them of.”

The child remains in critical condition in Vall d’Hebron hospital’s intensive care unit, but is responding to treatment. Health officials have launched an investigation to find the original carrier, which they admit could be difficult if the carrier isn’t showing any symptoms. All those in contact with the child are under surveillance, and his classmates have been checked to see if they’ve been vaccinated. As a cautionary procedure, they have also given the children preventive medicine.

“Vaccination is the best way to prevent diphtheria,” the WHO said in their report. They warn of the risks of parents hesitating or refusing to vaccinate their child, as gaps in coverage can accumulate and result in an outbreak. The WHO is working closely with the Spanish Ministry of Health and calls for increased vigilance to improve monitoring systems, raise awareness of the importance of vaccination and strengthen immunization programs.

Psychedelic Honey Exists, But Only This Bee Produces It


Psychedelic Honey Exists, But Only This Bee Produces It…

Deep in the caves of the Himalaya Mountains, a special species of bee exists which produces hallucinogenic honey.

When people seek solitude, simplicity and ‘enlightenment’ they often venture to a cave – metaphorically or literally – to shun the influence of the world and go within.

The mountains in Nepal are a popular destination to those who desire to glean wisdom from humble silence. In the same area, however, there is another teacher who, locals say, can be quite powerful…

Credit: traveladdicts.com

Deep in the caves of the Himalaya Mountains, a bee that produces what locals call “mad honey” exists, reports Curious Meerkat. Mad, or red honey, is produced by Apis dorsata laboriosa, or the Himalayan Cliff Bee. The bee is the largest in the world and makes an incredibly unusual honey which is said to have hallucinogenic effects.

Because the Apis dorsata make honey out of Rhododendron flowers, a beautiful – but toxic – flowerwhich which is poisonous to humans and contains grayanotoxins, the honey made from the nectar isquite a trip.

Credit: Raphael Treza

In small quantities, it relaxing and is purported to have numerous health benefits. It is described as rather pleasant, if not intoxicating. In larger doses, true mad honey, Rhododendron poisoning (or honey intoxication) can take place. This causes vomiting, muscle weakness and heart irregularities.

Though it is harmful in high doses, locals will go to remarkable lengths to get their hands on the rare honey. The brief documentary above goes into more depth to describe the honey and the intriguing reasons it is sought after.

14 Years After Decriminalizing All Drugs, Here’s What Portugal Looks Like

In 2001, the Portuguese government did something that the United States would find entirely alien. After many years of waging a fierce war on drugs, it decided to flip its strategy entirely: It decriminalized them all.

If someone is found in the possession of less than a 10-day supply of anything from marijuana to heroin, he or she is sent to a three-person Commission for the Dissuasion of Drug Addiction, typically made up of a lawyer, a doctor and a social worker. The commission recommends treatment or a minor fine; otherwise, the person is sent off without any penalty. A vast majority of the time, there is no penalty.

Fourteen years after decriminalization, Portugal has not been run into the ground by a nation of drug addicts. In fact, by many measures, it’s doing far better than it was before.

The background: In 1974, the dictatorship that had isolated Portugal from the rest of the world for nearly half a century came to an end. The Carnation Revolution was a bloodless military-led coup that sparked a tumultuous transition from authoritarianism to democracy and a society-wide struggle to define a new Portuguese nation.

The newfound freedom led to a raucous attitude of experimentalism toward politics and economy and, as it turned out, hard drugs.

FILE – In this April 25 1974 file picture, people cheer soldiers in a tank driving through downtown Lisbon during a military coup.
Source: Associated Press

Portugal’s dictatorship had insulated it from the drug culture that had swept much of the Western world earlier in the 20th century, but the coup changed everything. After the revolution, Portugal gave up its colonies, and colonists and soldiers returned to the country with a variety of drugs. Borders opened up and travel and exchange were made far easier. Located on the westernmost tip of the continent, the country was a natural gateway for trafficking across the continent. Drug use became part of the culture of liberation, and the use of hard narcotics became popular. Eventually, it got out of hand, and drug use became a crisis.

At first, the government responded to it as the United States is all too familiar with: a conservative cultural backlash that vilified drug use and a harsh, punitive set of policies led by the criminal justice system. Throughout the 1980s, Portugal tried this approach, but to no avail: By 1999, nearly 1% of the population was addicted to heroin, and drug-related AIDS deaths in the country were the highest in the European Union, according to the New Yorker.

But by 2001, the country decided to decriminalize possession and use of drugs, and the results have been remarkable.

What’s gotten better? In terms of usage rate and health, the data show that Portugal has by no means plunged into a drug crisis.

As this chart from Transform Drug Policy Foundation shows, the proportion of the population that reports having used drugs at some point saw an initial increase after decriminalization, but then a decline:

Source: Transform Drug Policy Foundation

(Lifetime prevalence means the percentage of people who report having used a drug at some point in their life, past-year prevalence indicates having used within the last year, and past-month prevalence means those who’ve used within the last month. Generally speaking, the shorter the time frame, the more reliable the measure.)

Drug use has declined overall among the 15- to 24-year-old population, those most at risk of initiating drug use, according to Transform.

There has also been a decline in the percentage of the population who have ever used a drug and then continue to do so:

Source: Transform

Drug-induced deaths have decreased steeply, as this Transform chart shows:

Source: Transform

HIV infection rates among injecting drug users have been reduced at a steady pace, and has become a more manageable problem in the context of other countries with high rates, as can be seen in this chart from a 2014report by the European Monitoring Center for Drugs and Drug Addiction Policy:

Source: European Drug Report 2014: Trends and developments/EMCDDA

And a widely cited study published in 2010 in the British Journal of Criminology found that after decriminalization, Portugal saw a decrease in imprisonment on drug-related charges alongside a surge in visits to health clinics that deal with addiction and disease.

Not a cure but certainly not a disaster: Many advocates for decriminalizing or legalizing illicit drugs around the world have gloried in Portugal’s success. They point to its effectiveness as an unambiguous sign that decriminalization works.

But some social scientists have cautioned against attributing all the numbers to decriminalization itself, as there are other factors at play in the national decrease in overdoses, disease and usage.

At the turn of the millennium, Portugal shifted drug control from the Justice Department to the Ministry of Health and instituted a robust public health model for treating hard drug addiction. It also expanded the welfare system in the form of a guaranteed minimum income. Changes in the material and health resources for at-risk populations for the past decade are a major factor in evaluating the evolution of Portugal’s drug situation.

Alex Stevens, a professor of criminal justice at the University of Kent and co-author of the aforementioned criminology article, thinks the global community should be measured in its takeaways from Portugal.

“The main lesson to learn decriminalizing drugs doesn’t necessarily lead to disaster, and it does free up resources for more effective responses to drug-related problems,”  Stevens told Mic.

The road ahead: As Portugal faces a precarious financial situation, there are risks that the country could divest from its health services that are so vital in keeping the addicted community as healthy as possible and more likely to re-enter sobriety.

That would be a shame for a country that has illustrated so effectively that treating drug addiction as a moral problem — rather than a health problem — is a dead end.

In a 2011 New Yorker article discussing how Portugal has fared since decriminalizing, the author spoke with a doctor who discussed the vans that patrol cities with chemical alternatives to the hard drugs that addicts are trying to wean themselves off of. The doctor reflected on the spectacle of people lining up at the van, still slaves of addiction, but defended the act: “Perhaps it is a national failing, but I prefer moderate hope and some likelihood of success to the dream of perfection and the promise of failure.”

The Doublethink of Anti-Vaxxers, Explained in One Revealing Tweet

The Doublethink of Anti-Vaxxers, Explained in One Revealing Tweet

Over at the New York Times, Andrew Revkin writes about this tweet from pediatrician Dave Stukus, summing up an actual conversation between a patient and one of his colleagues.

Hopefully, one day people will realize that getting vaccinated for the flu is just as important as getting vaccinated for any other dangerous disease (indeed, the flu has killed far more people than Ebola).

Actual discussion: Parent “I want vaccine for my child” Doc “There isn’t one, but we have ” Parent “We don’t believe in that”

Unfortunatly : Much worse to come, on Ebola.

The Ebola epidemic in west Africa poses a catastrophic threat to the region, and could yet spread further!

ON MARCH 25th the World Health Organisation (WHO) reported a rash of cases of Ebola in Guinea, the first such ever seen in west Africa. As of then there had been 86 suspected cases, and there were reports of suspected cases in the neighbouring countries of Sierra Leone and Liberia as well. The death toll was 60.

On October 15th the WHO released its latest update. The outbreak has now seen 8,997 confirmed, probable and suspected cases of Ebola. All but 24 of those have been in Guinea (16% of the total), Sierra Leone (36%) and Liberia (47%). The current death toll is 4,493. These numbers are underestimates; many cases, in some places probably most, go unreported.

This all pales, though, compared with what is to come. The WHO fears it could see between 5,000 and 10,000 new cases reported a week by the beginning of December; that is, as many cases each week as have been seen in the entire outbreak up to this point. This is the terrifying thing about exponential growth as applied to disease: what is happening now, and what happens next, is always as bad as the sum of everything that has happened to date.

Exponential growth cannot continue indefinitely; there are always barriers. In the previous 20 major outbreaks of the disease since its discovery in 1976, all of which took place in and around the Democratic Republic of the Congo, the initial rapid spread quickly subsided. In the current outbreak, though, the limits have been pushed much further back; it has already claimed more victims than all the previous outbreaks put together.

Grim reckoning

There are two reasons for this. Those earlier outbreaks were often in isolated places where there are few opportunities for transmission far afield—the transfer of the virus between a wild animal and a human that sets off all such outbreaks is more likely off the beaten track. And they were mostly recognised quickly, with cases isolated and contacts traced from very early on; one was stopped this way in Congo in the past few months. The west African outbreak has broken through the barriers of isolation and into the general population, both in the countryside and the cities, and it was up and running before public-health personnel cottoned on. There is no reason to expect it to subside of its own accord, nor to expect it to come under control in the absence of a far larger effort to stop it.

Trying to be precise about how bad things could get, absent that effort, is not possible. This is not just because the actual number of cases is not well known. The rate at which cases give rise to subsequent cases, which epidemiologists call Rο, is the key variable. For easily transmitted diseases Rο can be high; for measles it is 18. For a disease like Ebola, much harder to catch, it is lower: estimates of Rο in different parts of the outbreak range from 1.5 to 2.2. Any Rο above 1 is bad news, though, and seemingly small differences in Rο can matter a lot. An Rο of 2.2 may sound not much bigger than an Rο of 1.5, but it means numbers will double twice as fast.

And Rο is not a constant. It depends both on the biology of the virus, the setting of its spread (city or country, slum or suburb) and the behaviour of the people among whom it is spreading. Over the course of the crisis the second two factors are bound to change as the virus moves to different places and as people start to adapt. Given high rates of mutation, which bring with them the possibility of evolutionary change, it is possible that the first could change, too. Peter Piot, one of the researchers who first identified the Ebola virus in 1976, stresses that the course of an outbreak does not always follow smooth curves; it can stutter and flare up. None of this complexity, though, offers much reassurance. While doubtless imperfect, plausible model-based extrapolations such as a recent one from America’s Centres for Disease Control and Prevention (CDC) suggest, in the absence of intervention, that there could be 1.4m cases in west Africa in the next three months.

Not that Ebola will necessarily be contained in west Africa. Despite it having infected health-care workers in America and Spain, and worries that one of those Americans could have passed it further, public-health experts are largely confident that outbreaks can be contained in countries with robust medical systems and the ability to trace contacts. But transfer to other places with poor health systems might allow the virus to take hold in new cities. Especially if it makes inroads into Nigeria, where one set of cases has been successfully controlled, the virus could travel on to India, rich in slums with poor health care, or China, where infection control in hospitals can be worryingly lax.

The steps to avert such a cataclysm are reasonably clear: cases must be identified quickly, patients isolated and their contacts traced; changes in behaviour which reduce transmission rates must be encouraged through education campaigns and community action. The difficulty is doing all these things quickly and on a large scale. Modelling suggests that getting 70% of the sick into settings that reduce transmission of the virus—clinics, treatment centres or safe settings for treatment in the community—would bring things under control. That is a tall order.

The three countries currently afflicted are all exceedingly poor and plagued by various levels of instability and dysfunction. Guinea, the only one to have avoided civil war following independence, has been plagued by military coups and civil strife. In Sierra Leone many public institutions had only just started to be rebuilt after the civil war that finished over a decade ago. The wounds of Liberia’s civil war are fresher and deeper. Foreign peacekeepers maintain public security; many institutions barely exist. At the start of the crisis the countries had only a few hundred doctors between them. Many of those doctors, including Sheik Umar Khan, who led Sierra Leone’s response, have since died of the disease. In an echo of the way that, inside the body, it targets the immune system first, in the community Ebola hits health-care workers hardest.

Providing the infrastructure for a better response is thus a matter for outsiders. Some help has come from governments, some from non-governmental organisations such as Médecins Sans Frontières (MSF), an NGO which has provided about two-thirds of the isolation beds used to treat Ebola patients so far. Expansion moves apace. Beneath the looming Peninsula Mountains to the south of Sierra Leone’s capital, Freetown, the sleepy village of Kerry Town is the scene of frantic activity, as more than 200 construction workers sweat through the night to complete the first of six Ebola clinics to be set up in the country by the British army (some snatch a nap on the table in the morgue). Solar panels are being installed, a borehole drilled for water, a concrete access road laid to link up with the coastal highway. The centre will hold 90 beds, with an additional 12 set aside in a ward for the health workers. A military spokesman says the site should be completed by the end of the month.

For a few billion more

The 70-bed Ebola treatment unit in Bong County, Liberia, was built by Save the Children, an NGO; it took about four weeks to build. Chris Skopec of International Medical Corps, the NGO that runs it, describes it as “something in between a tent and a concrete structure”. But it has all the necessary features: quarantine rooms, decontamination areas and large toilet spaces (patients suffering from vomiting and diarrhoea may pass out). It is close enough to villages for people to reach, not so close for them to protest at its presence.

These efforts are impressive. Liberia’s capacity to treat Ebola victims has nearly doubled in the past two weeks, and America has promised to build 17 100-bed units in the coming months. However, thanks again to the power of exponential growth, if the number of beds can be doubled only at more or less the same rate that the virus doubles the number of cases, the disease’s head start will grow ever more overwhelming. For the caseloads predicted for late November and December, the 70% treatment level seen as needed to bring things under control corresponds to tens of thousands of beds.

For a sense of the resources required to raise the tempo, consider that the 70-bed facility in Bong cost $170,000 to build. It needs a staff of 165 to treat patients and handle tasks like waste management and body disposal. It is likely to go through nearly 100 sets of overalls, gowns, sheets and hoods per day. The monthly cost of running the unit comes out at around $1m, which is about $15,000 a bed. The WHO puts the costs of a 50-bed facility at about $900,000 a month. These figures suggest that a 100,000-bed operation would cost in the region of $1 billion-$2 billion a month.

Various countries have promised substantial aid, but not yet on that scale. America has pledged $350m and set aside another $1 billion to fund the activities of its soldiers in the area. Britain has committed $200m. The World Bank has set up a $400m financing scheme; the first $105m reached the governments of the affected countries in just nine days. The UN, of which the WHO is part, has taken in about a third of the $1 billion it says it needs to fund its own efforts in the region; all told, though, Ban Ki-Moon, the UN secretary-general, sees a need for much more than that—“a 20-fold surge” in assistance.

Money is of little use without staff. China has sent some 170 medical workers to the affected countries. Cuba, long focused on medical work overseas, has sent a similar number, and has plans for 300 more. Others have been less forthcoming. The facilities America’s soldiers are building will require a staff in the thousands; despite being trained for biological and chemical warfare American troops will not be among them. Last month MSF rejected a pledge of $2.5m from the Australian government, demanding Australian doctors instead. Australia demurred.

While there are medical volunteers from overseas, Ebola is a harder sell than other crises. David Wightwick of Save the Children says that in the aftermath of Typhoon Haiyan hitting the Philippines there weren’t enough seats on the planes for all of the international volunteers—but when he asked 28 logisticians to travel to the affected countries, 21 said no. Nevertheless, Bruce Aylward, who is overseeing the WHO’s response in west Africa, says an increasing number of NGOs and foreign governments are now looking to deploy staff to the region.

Funerals and friends

With the number of sick outstripping the capacity of the treatment centres, more care is being moved into the community—which requires a reliance on local people with rudimentary training that Dr Aylward says would have been considered heretical in earlier Ebola outbreaks. The isolation is needed because it is when people are at their sickest that they are at their most contagious. The virus is transmitted by direct contact with body fluids and excreta: the most infectious are blood, faeces and vomit, which are most likely to be contacted when the sickness is at its height.

The minimum basis for community care is to have two structures, which might be tents or shacks, set aside for suspected and confirmed cases. The carers would not be health workers, but trained community members with proper protective gear. People who have already survived the disease appear to have subsequent immunity and could be well employed in such settings; the dependability and duration of their immunity is not fully clear, and they would still need to follow safety procedures, but they would run less risk. The sick would be given only rudimentary care, not least because communities often lack reliable electricity or water supplies.

Most will go into such facilities with a fever brought on by something more common but less lethal than Ebola, like malaria; there are not yet tests for Ebola in the field that would keep such cases out. Some will die who otherwise would not; the hope is, though, that 70% will come out alive. If only people with Ebola went in, that figure would be more like 30%.

Such care units are being piloted in Sierra Leone and Liberia, and in many cases there may seem little if any alternative. Still, Christopher Stokes of MSF urges caution. If the locals are not properly trained, he warns, “you can amplify the epidemic, because they will feel confident in being around patients and they will catch it themselves and infect others.” The fact that the virus succumbs very readily to disinfectants such as bleach is welcome, but it will not help unless the disinfectants are used thoroughly and consistently.

Mr Stokes prefers decentralisation, “where you go closer to the community with smaller units [of about 30 beds], but with properly trained staff, which MSF has done in Guinea.” The approach worked well; at one point the outbreak in Guinea seemed almost to have been stopped. But economies of scale suggest that most new treatment centres will be a lot bigger, with some offering 100 beds or more.

Isolation reduces transmission. So can behaviour change, on which governments, lacking the wherewithal for much else, have concentrated their response, and which experts like Dr Piot see as the heart of the problem. Much of the focus to date has been on the burial of the dead. Those who have died remain, for a while, very infectious, and funerals can bring people from some distance. Six months into the epidemic a WHO study concluded that 60% of all cases in Guinea were linked to traditional burial practices that involve touching, washing or kissing the body. All the earliest cases of the disease in Sierra Leone appear to have been contracted at a single large funeral in Guinea, one which was also crucial in reigniting the epidemic in that country.

Now the traditions and beliefs that place such reverence on the treatment of the dead are being regretfully put aside by many; funerals that were once vibrant social events are in some places becoming practical exercises in the burial of body bags. “My aunt was taken away like a broken fridge and there was no other way,” says Charles Washington, a hotel worker in Liberia. But there are still traditional, dangerous funerals going on. There is more to be done through community engagement to reduce dangerous practices and to make rituals safer. Involving churches, traditional healers and the region’s secret societies more would bolster this and other interventions, such as those which help people to understand how the disease is transmitted.

Leaflets, placards and public-service announcements tell citizens in all three countries how to protect themselves through hand-washing and minimising contact with the ill. Sierra Leone went as far as locking down the country for three days during which officials and volunteers went house-to-house to educate people as well as search for hidden outbreaks. In Liberia and Sierra Leone, Ebola is a popular topic on the radio, which is how most people get their information. The broadcast advice is sensible and sometimes musical: “Ebola is Real” by F.A., Soul Fresh and DenG is proving popular in Liberia. Public buildings have temperature checks at the entrance; many also have chlorine baths for hands and shoes. People are aware of the danger surrounding them; many speak of little else.


Mobile phones also spread useful information—and may provide vital data to health workers. The CDC is tracking the location of people who call helplines in order to see where the disease is spreading. A Swedish NGO called Flowminder has captured people’s movements in the region using mobile-phone records.

Change in behaviour is real, but by most accounts it is patchy. Some people continue to believe that Ebola can be fought with animist remedies or witchcraft. Much to the frustration of a beleaguered cemetery keeper, people still wander through his graveyard in Freetown on their way to work, oblivious to the risks. Taxi drivers may disinfect their vehicles more, but in Liberia they chafe against new rules limiting passenger numbers. When livelihoods are at stake, onerous rules will be broken.

And crafting clear messages is hard. Dr Piot points to juxtaposed posters saying first that there is no cure and second that the infected should get to treatment centres. Despite such mixed messages, early fears that treatment centres would be shunned as death traps have not, in the main, come true; many centres are full. But this leads to another problem. Is it sensible to encourage sick people to take long journeys with no bed at its end? Progress depends not just on more beds, but on more local information on where to find them, and what to do if they are not available. Communities and the people from whom they seek advice need to be informed enough for such responses. They need to be involved in ways that help them decide how to reorganise their lives. Add that to the list of things easier said than done.

Veni, vidi, vaccini

Changing behaviour could slow the spread of the virus; a vaccine could potentially stop it. In large part because of worries that Ebola might be used as a biological weapon, vaccines that protect lab animals against the virus were already on the shelf when the outbreak began. Two are now being tested for safety in humans, and one of them could, if it is safe, be tested for efficacy quite soon, most likely in health-care workers in west Africa. Its maker, GlaxoSmithKline, could have 10,000 doses ready in a few months. Meanwhile thought is going into how to scale up production of any vaccine that proves successful. The ideal would be to come up with some mixture of direct payment to companies and guaranteed purchases that would mean copious stocks were available the moment the good news came through.

The other vaccine in trials might possibly, on the basis of animal tests, have the added benefit of helping those infected fight the virus as well as keeping the uninfected safe. At the moment there is a striking lack of such therapies: ZMapp, a cocktail of antibodies that has worked in animals, is of unproven efficacy and exhausted supply. A lower-tech alternative is to use blood serum from recovered patients, which contains the antibodies that helped them fight the virus. Such blood would have to be screened for other pathogens and matched to the recipients’ blood type, but WHO experts have been guardedly optimistic about the idea.

Even if treatment centres are hugely expanded, people’s behaviour changes radically and a vaccine proves effective, the damage already done to the region is huge. The patterns of work and food supply are already disrupted. Some farmers have abandoned their fields because they wrongly fear being infected by water in irrigation channels; some in cities are panic-buying. Salaries to public employees are not secure. The World Bank warns that Liberia’s rubber production, a big export earner, could fall drastically.

For now mounting deaths, understandable confusion and increasing economic dislocation have not caused widespread civil unrest. But many fault their governments for not protecting or preparing them better for the epidemic, and the grudges that animated past civil wars and coups sleep lightly. Few diplomats see a return to the bad old politics as out of the question; Filipino UN peacekeepers in Liberia have been withdrawn by their government. If civil order breaks down, the epidemic will get still worse.

Even if things do not fall apart, there is the most uphill of struggles ahead. Dr Piot cautions that an Ebola outbreak is an all-or-nothing affair; it is only over when the last patient is either dead or fully recovered. When it has struck on this scale, the challenges that remain after that will still be huge; whole public-health infrastructures will need rebuilding. But first there is a mountain to climb.

Why Patriarchal Men Are Utterly Petrified of Birth Control

Conservatives are fighting a rear-guard action against one of the most revolutionary changes in human history.

When people look back on the 20th century from the vantage point of 500 years on, they will remember the 1900s for three big things.

One was the integrated circuit, and (more importantly) the Internet and the information revolution that it made possible. When our descendants look back, they’re likely to see this as an all-levels, all-sectors disruption on the scale of the printing press — but even more all-encompassing. (Google “the Singularity” for scenarios on just how dramatic this might be.)

The second was the moon landing, a first-time-ever milestone in human history that our galaxy-trotting grandkids five centuries on may well view about the same way we see Magellan’s first daring circumnavigation of the globe.

But the third one is the silent one, the one that I’ve never seen come up on anybody’s list of Innovations That Changed The World, but matters perhaps more deeply than any of the more obvious things that usually come to mind. And that’s the mass availability of nearly 100% effective contraception. Far from being a mere 500-year event, we may have to go back to the invention of the wheel or the discovery of fire to find something that’s so completely disruptive to the way humans have lived for the entire duration of our remembered history.

Until the condom, the diaphragm, the Pill, the IUD, and all the subsequent variants of hormonal fertility control came along, anatomy really was destiny — and all of the world’s societies were organized around that central fact. Women were born to bear children; they had no other life options. With a few rebellious or well-born exceptions (and a few outlier cultures that somehow found their way to a more equal footing), the vast majority of women who’ve ever lived on this planet were tied to home, dependent on men, and subject to all kinds of religious and cultural restrictions designed to guarantee that they bore the right kids to the right man at the right time — even if that meant effectively jailing them at home.

Our biology reduced us to a kind of chattel, subject to strictures that owed more to property law than the more rights-based laws that applied to men. Becoming literate or mastering a trade or participating in public life wasn’t unheard-of; but unlike the men, the world’s women have always had to fit those extras in around their primary duty to their children and husband — and have usually paid a very stiff price if it was thought that those duties were being neglected.

Men, in return, thrived. The ego candy they feasted on by virtue of automatically outranking half the world’s population was only the start of it. They got full economic and social control over our bodies, our labor, our affections, and our futures. They got to make the rules, name the gods we would worship, and dictate the terms we would live under. In most cultures, they had the right to sex on demand within the marriage, and also to break their marriage vows with impunity — a luxury that would get women banished or killed. As long as pregnancy remained the defining fact of our lives, they got to run the whole show. The world was their party, and they had a fabulous time.

Thousands of generations of men and women have lived under some variant of this order — some variations more benevolent, some more brutal, but all similar enough in form and intention — in all times and places, going back to where our memory of time ends. Look at it this way, and you get a striking perspective on just how world-changing it was when, within the span of just a few short decades in the middle of the 20th century, all of that suddenly ended. For the first time in human history, new technologies made fertility a conscious choice for an ever-growing number of the planet’s females. And that, in turn, changed everything else.

With that one essential choice came the possibility, for the first time, to make a vast range of other choices for ourselves that were simply never within reach before. We could choose to delay childbearing and limit the number of children we raise; and that, in turn, freed up time and energy to explore the world beyond the home. We could refuse to marry or have babies at all, and pursue our other passions instead. Contraception was the single necessary key that opened the door to the whole new universe of activities that had always been zealously monopolized by the men — education, the trades, the arts, government, travel, spiritual and cultural leadership, and even (eventually) war making.

That one fact, that one technological shift, is now rocking the foundations of every culture on the planet — and will keep rocking it for a very long time to come. It is, over time, bringing a louder and prouder female voice into the running of the world’s affairs at every level, creating new conversations and new priorities in areas where the men long ago thought things were settled and understood. It’s bending our understanding of what sex is about, and when and with whom we can have it — a wrinkle that created new frontiers for gay folk as well. It may well prove to the be the one breakthrough most responsible for the survival of the human race, and the future viability of the planet.

But perhaps most critically for us right now: mass-produced, affordable, reliable contraception has shredded the ages-old social contracts between men and women, and is forcing us all (willing or not) into wholesale re-negotiations on a raft of new ones.

And, frankly, while some men have embraced this new order— perhaps seeing in it the potential to open up some interesting new choices for them, too — a global majority is increasingly confused, enraged, and terrified by it. They never wanted to be at this table in the first place, and they’re furious to even find themselves being forced to have this conversation at all.

It was never meant to happen. It never should have happened. And they’re doing their damndest to put a stop to it all, right now, and make it go away.

It’s this rage that’s driving Catholic bishops into a frenzied donnybrook fight against contraception — despite the very real possibility that this fight could, in the end, damage their church even more fatally than the molestation scandal did.  As the keepers of a 2000-year-old enterprise — one of the oldest continuously-operating organizations on the planet, in fact — they take the very long view. And they understand, better than most of us, just how unprecedented this development is in the grand sweep of history, and the serious threat it poses to everything their church has stood for going back to antiquity. (Including, very much, the more recent doctrine of papal infallability.)

That same frantic panic over the loss of the ancient bargain also lies at the core of the worldwide rash of fundamentalist religions. Modern industrial economies have undermined the authority of men both in the public sphere and in the private realms; and since they’re limited in how far they can challenge it in the external world, they’ve turned women’s bodies into the symbolic battlefield on which their anxieties over this play out. Drill down to the very deepest center of any of these movements, and you’ll find men who are experiencing this change as a kind of personal annihilation, a loss of masculine identity so deep that they are literally interpreting it as the end of the world. (The first rule of understanding apocalyptic movements is this: If someone tells you the world is ending, believe them. Because for them, it probably is.)

They are, above everything else, desperate to get their women back under firm control. And in their minds, things will not be right again until they’re assured that the girls are locked up even more tightly, so they will never, ever get away like that again.

If you’re a woman of childbearing age in the US, you’ve had access to effective contraception your entire fertile life; and odds are good that your mother and grandmother did, too. If you’re a heterosexual man of almost any age, odds are good that you also enjoy a lifetime of opportunities for sexual openness and variety that your grandfathers probably couldn’t have imagined — also thanks entirely to good contraception. From our individual personal perspectives, it feels like we’ve had this right, and this technology, forever. We take it so completely for granted that we simply cannot imagine that it could ever go away. It leads to a sweet complacency: birth control is something that’s always been there for us, and we’re rather stunned that anybody could possibly find it controversial enough to pick a fight over.

But if we’re wise, we’ll keep our eyes on the long game, because you can bet that those angry men are, too. The hard fact is this: We’re only 50 years into a revolution that may ultimately take two or three centuries to completely work its way through the world’s many cultures and religions. (To put this in perspective: it was 300 years from Gutenberg’s printing press to the scientific and intellectual re-alignments of the Enlightenment, and to the French and American revolutions that that liberating technology ultimately made possible. These things can take a loooong time to work all the way out.) Our grandchildren and great-grandchildren will, in all likelihood, still be working out the details of these new gender agreements a century from now; and it may be a century after that before their grandkids can truly start taking any of this for granted.

That sounds daunting, though I don’t mean it to be. What I do want is for those of us, male and female, whose lives have been transformed for the better in this new post-Pill order to think in longer terms. Male privilege has been with us for — how long? Ten thousand years? A hundred thousand? Contraception, in the mere blink of an eye in historical terms, toppled the core rationale that justified that entire system. And now, every aspect of human society is frantically racing to catch up with that stunning fact. Everything will have to change in response to this — families, business, religion, politics, economics…everything.

We’re in this catch-up process for the long haul. In the meantime, we shouldn’t be surprised to be confronted by large groups of well-organized men (and their female flunkies, who are legion) marshaling their vast resources to get every last one of Pandora’s frolicking contraception-fueled demons back into the box.  And we need to accept and prepare for the likelihood that much of the history of this century, when it’s finally written, will be the story of our children’s ongoing struggles against the organized powers that intend to seize back the means of our liberation, and turn back the clock to the way things used to be.

The fight for contraception is not only not over — it hasn’t even really started yet.

Endangering the Herd

The case for suing parents who don’t vaccinate their kids—or criminally charging them.

Families from across the U.S. living with autism take part in a rally calling to eliminate toxins from children's vaccines in Washington June 4, 2008.

What if a mother decided not to vaccinate her daughter for measles, based on rumors that the vaccine causes autism, and her daughter gets the disease at the age of 4 and passes it to a 1-year-old, who is too young for the vaccine, at her day care center. And what if that baby dies?

That’s the sad scenario, more or less, of a Season 10 episode of Law & Order: Special Victims Unit. And it’s the hypothetical case study in a provocative paper in the Journal of Law, Medicine and Ethics that explores whether there’s a case for holding people legally accountable for the damage they cause by not vaccinating their children. “One can make a legitimate, state-sanctioned choice not to vaccinate,” the bioethicist Arthur L. Caplan and his co-authors write, “but that does not protect the person making that choice against the consequences of that choice for others.” Since epidemiologists today can reliably determine the source of a viral infection, the authors argue, a parent who decides not to vaccinate his kid and thus endangers another child is clearly at fault and could be charged with criminally negligent homicide or sued for damages.

As you’d expect, the growing anti-vaccination movement responded in fury. After Caplan wrote a related post for the Harvard Law Blog, angry comments poured in. “This article is industry propaganda at its worst,” one commenter declared. Another wrote: “Caplan would have familiar company in fascist Germany.” The blog eventually shut down the comments for violations of the site’s policies against “abusive and defamatory language” and the sharing of personal information.

Here’s why the anti-vaxxers are wrong and Caplan and his co-authors are right to raise the idea of suing or criminally charging them: Parents who choose not to vaccinate their kids for reasons of personal belief pose a serious danger to the public.

Measles vaccines are about 95 percent effective when given to children. That leaves a 5 percent chance that kids who are vaccinated will contract measles. This means that no matter what, the disease still poses a public health risk, but we rely on others to get vaccinated to hugely reduce the likelihood of outbreaks. That’s the process known as herd immunity.

Unvaccinated children threaten the herd. Take the San Diego measles outbreak of 2008. After unknowingly contracting the disease on a trip to Switzerland, an unvaccinated 7-year-old boy infected 11 other unvaccinated kids, according to the Centers for Disease Control and Prevention. The majority of the cases occurred in kids whose parents had requested personal belief exemptions (or PBEs) through the state of California, one of 17 states to allow them. But three of the infected were either too young or medically unable to be vaccinated. And overall, 48 children too young to be vaccinated were quarantined, at an average cost to the family of $775 per child. The CDC noted that all 11 cases were “linked epidemiologically” to the 7-year-old boy and that the outbreak response cost the public sector $10,376 per case.

Today, several states blame a rise in preventable diseases on the declining child vaccination rates. In Michigan, less than 72 percent of children have received their state-mandated measles, mumps, and rubella (MMR) vaccines. In New York, as Caplan noted in his blog post, pockets of Brooklyn’s Hasidic Jewish community are experiencing a mini measles epidemic. Thirty cases have been confirmed so far. According to Dr. Yu Shia Lin of Maimonides Medical Center, some members of the community avoid the measles vaccine because they think it causes autism. The most visible proponent of this idea, former Playboy Playmate Jenny McCarthy, will receive a giant new platform for her viewpoints when she joins the daytime gossipfest The View on Sept. 9.

The belief that the MMR vaccine causes autism goes back to a 1998 study published in the Lancet by a British gastroenterologist named Andrew Wakefield. In 2010, after years of criticism, the journal finally retracted Wakefield’s study, announcing that it was “utterly clear, without any ambiguity at all, that the statements in the paper were utterly false.” Britain’s General Medical Council later revoked Wakefield’s medical license, noting that he’d failed to disclose his role as a paid consultant to lawyers representing parents who thought vaccines had harmed their kids. The CDC makes clear there is no connection between vaccines and autism.

Yet this dangerous idea persists. Often, it persists among people who are simply doing what they think is best for their kids. Which is why it’s necessary to take extra measures to ensure nonvaccinators understand the risk they pose to other people’s children.

Dorit Rubinstein Reiss, a professor of law at UC Hastings College of the Law and author of the blog Before Vaccines, argues in support of Caplan and his co-authors that if you fail to take reasonable precautions to prevent your child from transmitting a deadly virus to another child, you should bear the cost of that risk. If the government doesn’t impose liability, it is giving anti-vaxxer parents a free pass for posing a danger.

There should be exceptions, of course. A child may be too young to receive a vaccine or may be undergoing a medical treatment like chemotherapy that prevents vaccines from working. A vaccine shortage or lack of access to a medical facility would legally excuse a parent for not vaccinating.

There are legal obstacles to penalizing parents who don’t vaccinate their kids. Courts are generally less likely to impose liability on someone who fails to act than they are on someone who acts recklessly. Also, proving cause and effect will sometimes be difficult. Then again, to win damages, a plaintiff would only have to prove that it’s “more likely than not” that a nonvaccinated child infected another person.

Parents who don’t vaccinate their kids may have the most heartfelt reason in the world: fear for their own children’s safety. But the basis for that fear is simply unfounded, and their decisions are putting other kids directly at risk. The bottom line is that the government’s interest in protecting children from getting the measles should trump parents’ interest in making medical decisions for their kids. The creators of Law & Order: Special Victims Unit seem to agree. The name of the episode in which a little girl dies as a result of a mother’s refusal to immunize her son? “Selfish.”

Jed Lipinski is a freelancer journalist in New York. Follow him on Twitter.

Growing Up Unvaccinated

Baby getting a vaccination

I am the ’70s child of a health nut. I wasn’t vaccinated. I was brought up on an incredibly healthy diet: no sugar till I was 1, breastfed for over a year, organic homegrown vegetables, raw milk, no MSG, no additives, no aspartame. My mother used homeopathy, aromatherapy, osteopathy; we took daily supplements of vitamin C, echinacea, cod liver oil.

I had an outdoor lifestyle; I grew up next to a farm in England’s Lake District, walked everywhere, did sports and danced twice a week, drank plenty of water. I wasn’t even allowed pop; even my fresh juice was watered down to protect my teeth, and I would’ve killed for white, shop-bought bread in my lunchbox once in a while and biscuits instead of fruit, like all the other kids.

We ate (organic local) meat maybe once or twice a week, and my mother and father cooked everything from scratch—I have yet to taste a Findus crispy pancake, and oven chips (“fries,” to Americans) were reserved for those nights when Mum and Dad had friends over and we got a “treat.”

As healthy as my lifestyle seemed, I contracted measles, mumps, rubella, a type of viral meningitis, scarlatina, whooping cough, yearly tonsillitis, and chickenpox. In my 20s I got precancerous HPV and spent six months of my life wondering how I was going to tell my two children under the age of 7 that Mummy might have cancer before it was safely removed.

So the anti-vaccine advocates’ fears of having the “natural immunity sterilized out of us” just doesn’t cut it for me. How could I, with my idyllic childhood and my amazing health food, get so freaking ill all the time?

My mother would have put most of my current “crunchy” friends to shame. She didn’t drink, she didn’t smoke, she didn’t do drugs, and we certainly weren’t allowed to watch whatever we wanted on telly or wear plastic shoes or any of that stuff. She livedalternative health. And you know what? I’m glad she gave us such a great diet. I’m glad that she cared about us in that way.

But it just didn’t stop me getting childhood illnesses.

My two vaccinated children, on the other hand, have rarely been ill, have had antibiotics maybe twice in their lives, if that. Not like their mum. I got many illnesses requiring treatment with antibiotics. I developed penicillin-resistant quinsy at age 21—you know, that old-fashioned disease that supposedly killed Queen Elizabeth I and that was almost wiped out through use of antibiotics.*

My kids have had no childhood illnesses other than chickenpox, which they both contracted while still breastfeeding. They, too, grew up on a healthy diet, homegrown organics, etc. I was not quite as strict as my mother, but they are both healthier than I have ever been.

I find myself wondering about the claim that complications from childhood illnesses are extremely rare but that “vaccine injuries” are rampant. If this is the case, I struggle to understand why I know far more people who have experienced complications from preventable childhood illnesses than I have ever met with complications from vaccines. I have friends who became deaf from measles. I have a partially sighted friend who contracted rubella in the womb. My ex got pneumonia from chickenpox. A friend’s brother died from meningitis.

Anecdotal evidence is nothing to base decisions on. But when facts and evidence-based science aren’t good enough to sway someone’s opinion about vaccinations, then this is where I come from. After all, anecdotes are the anti-vaccine supporters’ way: “This is my personal experience.” Well, my personal experience prompts me to vaccinate my children and myself. I got the flu vaccine recently, and I got the whooping cough booster to protect my son in the womb. My natural immunity—from having whooping cough at age 5—would not have protected him once he was born.

I understand, to a point, where the anti-vaccine parents are coming from. Back in the ’90s, when I was a concerned, 19-year-old mother, frightened by the world I was bringing my child into, I was studying homeopathy, herbalism, and aromatherapy; I believed in angels, witchcraft, clairvoyants, crop circles, aliens at Nazca, giant ginger mariners spreading their knowledge to the Aztecs, the Incas, and the Egyptians, and that I was somehow personally blessed by the Holy Spirit with healing abilities. I was having my aura read at a hefty price and filtering the fluoride out of my water. I was choosing to have past life regressions instead of taking antidepressants. I was taking my daily advice from tarot cards. I grew all my own veg and made my own herbal remedies.

I was so freaking crunchy that I literally crumbled. It was only when I took control of those paranoid thoughts and fears about the world around me and became an objective critical thinker that I got well. It was when I stopped taking sugar pills for everything and started seeing medical professionals that I began to thrive physically and mentally.

If you think your child’s immune system is strong enough to fight off vaccine-preventable diseases, then it’s strong enough to fight off the tiny amounts of dead or weakened pathogens present in any of the vaccines.

But not everyone around you is that strong, not everyone has a choice, not everyone can fight those illnesses, and not everyone can be vaccinated. If you have a healthy child, then your healthy child can cope with vaccines and can care about those unhealthy children who can’t.

I would ask the anti-vaxxers to treat their children with compassion and a sense of responsibility for those around them. I would ask them not to teach their children to be self-serving and scared of the world in which they live and the people around them. (And teach them to love people with autism spectrum disorder or any other disability supposedly associated with vaccines—not to label them as damaged.)

Most importantly, I want the anti-vaxxers to see that knowingly exposing your child to illness is cruel. Even without complications, these diseases aren’t exactly pleasant. I don’t know about you, but I don’t enjoy watching children suffer even with a cold or a hurt knee. If you’ve never had these illnesses, you don’t know how awful they are. I do. Pain, discomfort, the inability to breathe or to eat or to swallow, fever and nightmares, itching all over your body so much that you can’t stand lying on bedsheets, losing so much weight you can’t walk properly, diarrhea that leaves you lying prostrate on the bathroom floor, the unpaid time off work for parents, the quarantine, missing school, missing parties, the worry, the sleepless nights, the sweat, the tears, the blood, the midnight visits to the emergency room, the time sitting in a doctor’s waiting room on your own because no one will sit near you because they’re rightfully scared of those spots all over your face.

Those of you who have avoided childhood illnesses without vaccines are lucky. You couldn’t do it without us pro-vaxxers. Once the vaccination rates begin dropping, the drop in herd immunity will leave your children unprotected. The more people you convert to your anti-vax stance, the quicker that luck will run out.

This piece originally appeared on Voices for Vaccines.

Also in Slate:

*Update, Jan. 6, 2013: This post has been updated to clarify that the quinsy the author contracted, not the author herself, was resistant to penicillin.

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