By Jane Katz-Field, MD
MEASLES?? In Vermont? Didn’t they wipe that out? Actually, because of effective vaccination programs starting in the 1960s, measles was basically eliminated in this country by the late 1990s. Today we are seeing some of these vaccine-preventable diseases again because of people’s choices not to vaccinate their children. What are parents asking?
- “Are vaccines safe?”
No vaccine is 100% safe. Vaccines can cause redness or tenderness at the injection site and, in very rare cases, more severe reactions. But few things are harmless. Two hundred people each year are killed when food lodges in their windpipe. Yet most of us choose to eat solid food. We figure the benefits outweigh the risks. Similarly, the current vaccines that we recommend are safe in that the benefits of protecting against the diseases dramatically outweigh the risks.
Fourteen studies on three different continents have not shown any connection between autism and vaccines. But doubt has been planted in people’s minds and has led many to refuse vaccines. One father admitted to me that, although he knew the claim linking vaccines with autism was fraudulent, doubt remained and, to his own surprise, he was fearful of vaccines.
Vaccines are studied in tens of thousands of children before they are released and are monitored after licensure. No other medical product goes through such a rigorous safety process.
- “Why do we need vaccines when these diseases are no longer a threat?”
The reason we don’t see most vaccine-preventable diseases is because immunizations have been a success. I still remember most of these diseases. A classmate of mine in the 1950s had a limp from polio. Many infants I cared for in the 1980s had meningitis caused by a bacteria for which we now have a vaccine. For me, whether to immunize my four sons was not a difficult decision. But when the diseases are no longer visible, the decision gets harder.
- “How can a baby’s immune system handle so many vaccines?”
A newborn’s immune system is powerful enough to successfully respond to the thousands of germs the baby is exposed to right after birth. And today’s vaccines expose children to far fewer parts (proteins and sugars) of the bacteria or virus in the vaccine than in the past.
- “What else is in the vaccine?”
An adjuvant is a component that boosts the immune response to the vaccine so that less of the vaccine is needed. The most common adjuvant used, in a little over half of the vaccines for the past 70 years, is aluminum salt. Aluminum is also found in breast milk, formula and certain foods. There is no evidence suggesting any long term negative effects from aluminum.
- “Why can’t vaccines be a personal choice?”
People who choose not to vaccinate are not living in a bubble. The disease a child might contract threatens everyone else. Vaccines are not 100% effective, so even if you are vaccinated, there’s a tiny chance you could contract the disease. Also, many children on chemotherapy for cancer, or on immunosuppressive medicines for transplants or some other disease, cannot be vaccinated. Babies less than one year old are too young to be immunized against measles and those less than 6 months old are too young for the influenza vaccine and are not yet fully protected against whooping cough. These vulnerable children depend on those around them to get vaccinated.
The risks were illustrated a few years ago when an unimmunized boy contracted measles in Switzerland. His symptoms appeared only after arriving back home in San Diego. By the time he was diagnosed he had exposed over 900 people, three of whom were infants exposed in their pediatrician’s waiting room. All three got very sick. Megan Campbell, the mother of a hospitalized infant, spoke publicly about how angry she was that the mother who chose not to vaccinate had made a decision for Megan’s child that had almost killed him.
“Herd immunity” refers to stopping the transmission of a virus or bacteria by having a critical number of the population immunized. Measles, which once killed 500 people each year, is one of the most contagious diseases we know. Currently the U.S. is about 90% immunized but, in some communities, the rate is down to 75%, which is why we’re seeing measles outbreaks. Two months ago a non-immunized child here in Windham County came down with measles—Vermont’s first case in 10 years. Last year, whooping cough killed 10 babies in California. So there are severe consequences in the community when parents choose not to immunize their children. It is not just a personal decision, just as drunk driving is not just a personal decision.
- “How do I know what information to believe?”
I encourage my patients to be skeptical, to ask questions and to try to find answers. Much of the current anti-vaccine movement bases its arguments not on real statistics but on anecdotes, which are powerful, emotional and personal. These are the kind of stories we hear from some TV celebrities. Anecdotes are good for raising questions, but we need to look to scientific studies to answer our concerns.
There are serious risks of not vaccinating for the entire society and children are so much safer when they are vaccinated. Let’s talk about our fears and try to get answers to questions. But let’s not allow our fears to make the world more dangerous for all of our children.
Dr. Jane Katz-Field is a pediatrician on the Brattleboro Memorial Hospital medical staff who practices in the Just So Pediatrics group.