I’ve always been fine with having my children vaccinated, but lately I’ve been looking at the internet, and…well, I’m just not sure. I just don’t know if it’s safe.
We’re not sure what you’ve been reading, but we can imagine. There have been vaccination nay-sayers for as long as there have been vaccinations. Which, by the way, has been longer than two hundred years. It started with the Englishman Edward Jenner and his discovery of using the cowpox virus to prevent smallpox. In the 18th century, this disease killed more than 400,000 Europeans yearly, and caused blindness, deafness, and disfigurement in hundreds of thousands more. It was highly lethal, killing more than 80% of the children who became infected. In spite of Jenner’s work and the promise of preventing this infection, he was persecuted by a fervent group of “vaccine hesitant” individuals. Thankfully, smallpox is gone, but not because we figured out how to kill the virus. Rather, we developed a vaccine that boxed it into a corner, and finally into a couple of test-tubes hidden away somewhere.
The effectiveness of the smallpox vaccine, as well as that of many others currently in use, has fostered a lot of the opposition to the idea of vaccination in general. Out of sight, out of mind. We no longer see the infections that routinely swept across this country, such as polio and measles. These are still serious problems in other areas of the world, but many of us have no experience with them. As an example, prior to an effective vaccine, measles killed 500 Americans each year, and was the reason for 48,000 hospitalizations and 1,000 cases of permanent brain damage annually. Even today, 146,000 people will die from measles this year worldwide. We’ve lost sight of how dangerous this virus is.
And speaking of measles, as we write this chapter, there continues to be an outbreak in the Pacific Northwest, centered in Washington State. To date, there are more than 50 documented cases of measles, most in unvaccinated individuals. This virus is highly contagious, and it’s thought that the transmission rate is near 100% when an unvaccinated person comes in contact with the virus. How does this kind of outbreak happen? Well, it seems that a lot of parents don’t think it’s important to have their children immunized, or maybe themselves. They’ve joined the same “vaccine hesitant” camp that Edward Jenner faced. When enough people join that camp, our “herd immunity” is no longer effective. Let’s consider what we mean by that.
Suppose we have 100 head of cattle (our “herd”). If enough of them are vaccinated or are immune to a specific infectious disease, let’s say…measles, the disease might affect one or two of the animals, but will not spread among those who are immune. The infected cows get over it (or die) and the measles fritters away. There’s a critical number of immune cows that will be needed to cause that frittering, and it seems to be in the neighborhood of 90%. Less than that, the herd is not immune and the infection will spread. In many parts of the country, vaccination rates exceed 97%, conferring significant herd immunity. In the area where we are seeing this outbreak, estimates of vaccination against the measles virus is less than 40%. A disaster waiting to happen, and it did.
What might be causing this parental vaccine hesitancy? We would say it’s the dissemination of bad and inaccurate information. In fact, if the internet could be vaccinated against bogus medical advice, we’d all be better off.
So what is the truth here? What is factual and what is not? We’re going to state categorically that childhood vaccinations are effective and life-saving. That’s been proven over and over again. And as we noted, it’s this very effectiveness that allows some of us to lose sight of the dangers of whooping cough, polio, diphtheria, pneumonia, meningitis, and other previously common infections. We’ll also state that these vaccines are very safe. There are some risks involved, and those need to be looked at. But what are they? Let’s start with what they’re not.
There is no evidence anywhere that links vaccinations—specifically the MMR—with autism. None. And there is no evidence that the mercury-containing preservative thimerosal is connected with autism either. The confusion arose—now debunked—that thimerosal acted in the same way that another more toxic form of mercury does. While thimerosal has been proven to be safe, for those parents still hesitant, some vaccines are available that are free of this preservative.
Contrary to what you might find on the internet, there is also no evidence that the MMR, diphtheria-tetanus, or pertussis vaccines are causally related to the onset of type 1 diabetes. Likewise, no evidence exists that links the flu vaccine to the development of Bell’s palsy.
A more recent parental concern relates to the safety of established immunization schedules. The thought is that too many vaccines are given over too short a period of time and that a child’s immune system would be overwhelmed. That concern has only grown with the needed addition of other effective vaccines, such as those for hepatitis, the rotavirus, meningitis, and HPV. Most of us view this as a huge victory for our public health. Yet there are those of us who would space these vaccinations over a longer period of time. The reality is that the current schedule is designed to protect children against diseases when they are the most susceptible. If this period of susceptibility is drawn out, we’ll see more infections. And as far as “overwhelming” our immune systems, there is no evidence to suggest that possibility. In fact, a group of researchers suggest that the newborn’s immune system could safely respond to up to 10,000 vaccines at a time. (We’d hate to be in that clinic!)
Those are not the risks of vaccinations. Now let’s consider what we know to be the actual dangers.
In the post on febrile seizures, we note an increased incidence of these after the MMR vaccine. This increased risk is very small, and as we also note, most experts would recommend giving the next dose of MMR in spite of a previous febrile seizure.
Serious allergic reactions (anaphylaxis) are possible with many of these vaccines, including tetanus, chicken pox, MMR, hepatitis B, and the flu vaccine. The risk is small, only 0.65 cases per 1 million doses. There are many components of a vaccine that can be the culprit that causes an allergic reaction, including the antigen itself, preservatives, egg proteins, yeast, gelatin, and latex. It’s rare, but it can happen.
Local reactions commonly occur in up to 50% of those being vaccinated. They depend on the specific vaccine, and include localized redness, pain, swelling, and a mild fever. These usually go away on their own in a couple of days, without any treatment
There is weak evidence to suggest that the MMR vaccine can cause joint pain in women and children, but if it happens, it doesn’t last long and is gone.
For us, there are two key points with this issue:
- Vaccine-preventable diseases are dangerous, and they can kill.
- Vaccinations are safe and effective.
If you’re interested in more information, forget the internet, unless you’re searching for one of these sites:
- CDC.gov/vaccines – Search the site for vaccine information statements or a list of precautions for commonly used vaccines
- Every Child by Two – ecbt.org
- Immunization Action Coalition – immunize.org
- Vaccinate Your Baby – vaccinateyourbaby.com
- Voices for Vaccines – voicesforvaccines.org
- Children’s Hospital of Philadelphia Vaccine Education Center – http://vec.chop.edu/service/vaccine-education-center
- org – This is the American Academy of Pediatrics website
Jonathon Swift, the author of Gulliver’s Travels, didn’t know about the internet, but he understood human nature.
“Falsehood flies and the truth comes limping along after;
so that when men come to be undeceived it is too late:
the jest is over and the tale has had its effect.”
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