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Vaccines are like…onions?

By Stephanie Wasserman

This week is National Infant Immunization Week, and it is also the week the Colorado Children’s Immunization Coalition (CCIC) celebrates its members, supporters, partners and friends at our annual SOUP! (Shots Offer Unrivaled Protection) event. All of this excitement around immunization advocacy led me to reflect on my experience thus far as executive director of the Colorado Children’s Immunization Coalition. What I have learned in the past six months is that immunizations are a lot like onions. Let me explain.

The movie Shrek, which is about a misunderstood ogre, was such an integral part of my children’s regular TV viewing that despite the many years since their childhood (my children are now 22 and 17), I have much of the dialogue from this movie still memorized.  There is a scene between Shrek the ogre and his sidekick donkey that goes something like this:

Shrek: For your information, there’s a lot more to ogres than people think.
Donkey: Give an example?Shrek and Donkey
Shrek: Example… uh… ogres are like onions!
[holds up an onion, which Donkey sniffs]
Donkey: They stink?
Shrek: Yes… No!
Donkey: Oh, they make you cry?
Shrek: No!
Donkey: Oh, you leave ’em out in the sun, they get all brown, start sproutin’ little white hairs…
Shrek: [peels an onion] NO! Layers. Onions have layers. Ogres have layers. Onions have layers. You get it? We both have layers.
[walks off]
Donkey: Oh, you both have LAYERS. Oh. You know, not everybody like onions. What about cake? Cake has layers.  Everybody loves cake!

Now substitute the word “immunizations” or  “vaccines” for “onions” and you see where I’m going with this. There’s a lot more to immunizations than people think. Vaccines are like onions. They don’t stink like onions, but they can make you cry, including my 22-year-old daughter who still cries every time she gets immunized.  But, like onions, vaccines should not be left in the sun.  But most importantly, layers.  Onions have layers.  Vaccines have layers.

Now at the core of this “onion” is this elegant and logical center.  You have a problem—that is a vaccine-preventable disease; next you have a safe, efficient and reliable intervention that comes in a tiny, relatively easy to use package—that is the vaccine; and finally you have the outcome—a healthy child.  What else in life is so clean and logical? And yet there are so many layers that sit on top of this elegant and logical center.  The layers include research, manufacturing, access, financing, storage, demand, delivery, hesitancy, disparities, innovation, regulation, law, belief systems, attitudes, myths, costs and cost effectiveness, social networks and irrefutable scientific evidence.  I see immunization coalitions and organizations, like CCIC, playing a critical role in peeling away those layers to get to that crystal clear core at the center. And that core is:  Vaccines are safe and save lives.

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