BY RICK VOAKES, MD
Vaccines, Modern Miracle
The number of cases of actual measles has tripled in the USA since 2018. This is of great concern with newer research showing that measles is more dangerous than we thought. Besides the danger of brain and lung damage, the measles virus also damages the immune system for many years after recovering from the initial infection.
We often take for granted the protection that vaccines give from many horriblediseases like polio, meningitis, and diphtheria! If you saw any movies about deadly viruses that can wipe out huge populations, that could be happening now if it were not for the miracle of the vaccines that are available to us today.
© RICK VOAKES 2021
We are sorry to have to poke babies and make them cry, but the pain is just a few minutes, and can protect them from deadly diseases. As technology advances, we are able to make vaccines against more and more illnesses. This means more shots and more expense. But it also means a better life in the future for our children.
How Vaccines Work
Vaccines work by stimulating your own immune system to produce antibodies against dangerous viruses or bacteria. When your immune cells are exposed to foreign material, they start to produce antibodies to attack it. A vaccine would expose your immune cells to pieces of these dangerous germs, or milder forms of the germs which are harmless. This way, you don't have to go through the actual serious illness to become immune to it. Your immune system is doing this all the time, every day, to various mild viruses like colds, so it is no problem for your body to add a few more from your vaccines.
Several new vaccines are now available. One exciting new vaccine protects children and adults from many strains of human papilloma virus (HPV) which causes cervical cancer in women, and causes genital warts in both men and women. It is recommended for all girls and boys at the 6th grade checkup. It is now covered on the state vaccine program for all girls and boys over age 9.
There is also a new and improved version of the rotavirus vaccine (diarrhea virus) which so far has a very good safety record. It is an oral vaccine and is given at the 2, 4 and 6 month checkups.
Most children have already been vaccinated for Hepatitis B, but a different hepatitis virus (Hepatitis A) is much more contagious and can be transmitted by food. Hepatitis A virus is fairly common in Mexico, and we are importing more and more food from Mexico these days. There have been reports of Hepatitis A outbreaks due to food contamination in many states all over the USA. States which border Mexico (Texas, New Mexico, Arizona and California) have used the Hepatitis A vaccine for several years, and have virtually eliminated this disease in those states. The American Academy of Pediatrics now recommends that all children in the USA be vaccinated for Hepatitis A.
The most contagious form of meningitis is caused by bacteria called meningococcus. It can be prevented with a new vaccine which is given at the 6th grade checkup (age 11). It also needs a booster dose at age 16.
[NOTE: for info on covid vaccines, see the Health-byte on Covid.]
Links to Info about Vaccines
Safety of Vaccines
As parents and physicians our first concern is for the safety of our children. Could vaccines cause damage or endanger our children? As with any other treatment or medication, there could be rare side effects that are not expected. For vaccines, these are called "adverse events", and are reported to the CDC (Centers for Disease Control) by every doctor who recognizes one. Fortunately, these are on the order of one-in-a-million. (MUCH less common than most medications. More children die from Tylenol side effects than from vaccines.) When adverse events exceed the one-in-a-million level, the CDC and FDA react quickly to investigate and discontinue the vaccine if a connection is established, such as the first rotavirus vaccine in the 1990's (which was linked to 17 cases of intestinal blockage called "intussusception"---out of millions of doses given).
There are a several groups of people who post anti-vaccine messages on web pages andFacebook trying to convince parents not to use vaccines. These messages are inaccurate and based on emotional responses and not on the facts. For example, some people believe that MMR vaccines cause autism. This has been proven false by every scientific study done, on millions of babies. Others believe that the rare side effects of MMR vaccine are worse than the chance of dying from measles. When you look at the actual facts, the chance of dying from MMR vaccine is less than one in a million, while the chances of dying from measles if an unimmunized child were exposed, is one in 500. That is, an unimmunized child exposed to measles is 2,000 times more likely to die than a vaccinated child. I would hate to have those odds against my own child!
There have also been several "false alarms", where there seemed to be a connection between vaccines and something else. An example is the apparent increase in autism in the last ten to fifteen years. Could this be due to something in vaccines? The CDC has looked very hard at this question, and there have been literally hundreds of studies to see if this is the case. So far, there is absolutely no evidence to support such a connection. Here are the major points of interest:
(1) The "increase" in autism is actually due to an increase in diagnosing autism. In the past there were the same number of children with autism, but they were called by different names. New methods of categorizing the disease have caused the apparent increase in the statistics.
(2) A preservative containing trace amounts of mercury (thimerosal) was used in many vaccines to prevent bacterial growth. There has been concern that the mercury could have caused autism or other adverse effects. However, there has never been shown to be an increase autism or any other behavior problems among children who got thimerosal vs those who didn't. Furthermore, when thimerosal was removed from almost all vaccines in the last 5 years, there was no change in the incidence of autism or other behavior problems. Additionally, there have never been any reports of mercury toxicity in any children receiving thimerosal.
There are many misconceptions that both doctors and parents have about when and when not to give vaccines. If you are allergic to actual components of the vaccine or have had a serious reaction, such as anaphylaxis (shock, wheezing, passing out), then you should not get the vaccine.
Otherwise, you should NOT delay getting vaccine for these "lame" reasons, which are NOT associated with any adverse effects:
(1) having a minor illness or fever under 102.
(2) getting over an illness.
(3) taking antibiotics.
(4) fever from a previous DPT shot, if fever was less than 105.
(5) mother or other family member is pregnant.
(6) child was premature.
(7) recent exposure to a disease.
(8) having allergies in general.
(9) allergies to duck meat or feathers, or to chicken eggs.
(10) family member had a vaccine reaction.
Another misconception is that vaccines are safer or work better if given separately. Giving many vaccines at once is not only much more humane (why force a child to endure the pain over and over again?) but each vaccine in a combination works just as effectively.
Unfortunately, there is a growing movement of parents who are“vaccine hesitant” or anti-vaccines. It started over 20 years ago, with the hoax about measlesvaccine causing autism. This was instigated by a single researcher in England who faked his results to gainnotoriety. He is now in jail, but the damage he caused continues through falsely eroding the public’s trust in vaccines. There was a big surge in the anti-vaxxer movement with increased use of social media. This started to die down when the public became more aware of the actual facts about vaccines, but recently a new surge has been shown to be due to unethical people who make upanti-vax stories and post them for profit (through ads) on social media such as Facebook and Twitter. These were recently banned from Twitter. Also, when Instagram disallowed these posts from gettingadvertising sponsorship, the posts suddenly disappeared (guess why!). So be aware that the vast majority ofanti-vax posts are instigated by criminals trying to make a profit from attracting curiosity on social media.
New Book About Vaccine Safety
Review by Paul A. Offit, MD
Division of Infectious Diseases, Vaccine Education Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, University ofPennsylvania School of Medicine, Philadelphia, Pennsylvania
Today, more than ever before, parents are concerned about the safety of vaccines. Fear of vaccines has been fueled by information provided on television programs, in newspaper and magazine articles, and on the Internet. Much of this information is based on opinions that are unsupported by scientific evidence. As a result, some parents are choosing to withhold, separate, or space out vaccines. The consequences of delaying vaccines have been predictable; recent outbreaks of diseases such as pertussis and measles have centered on communities where parents have chosen not to vaccinate their children. Doctors, scientists, and public health officials, alarmed by the trend, have tried to counter the flood of misinformation, but their voices have often been drowned out by the journalistic drumbeat of balance, representing both sides of a controversy even when only one side is supported by scientific evidence. With the bookDo Vaccines Cause That?! A Guide for Evaluating Vaccine Safety Concerns, Martin Myers and Diego Pineda step into the fray. Myers is the director of public health policy and education at the Sealy Center for Vaccine Development at the University of Texas Medical Branch and the executive director of the National Network for Immunization Information (NNii). Pineda is a science writer and associate editor at the NNii. Together, they have written the single best standalone resource for parents who are concerned about the safety of vaccines and for health care professionals who are looking for a way to answer parents’ questions. The book’s chapters progress logically. First, the authors make a case for the necessity of vaccines, recognizing that most vaccine-preventable diseases are rarely seen and, therefore, are no longer compelling. Second, the authors describe the psychology of decisions made under uncertainty and compare the risks from vaccines with other risks, such as driving to the pediatrician’s office. Third, in a chapter titled “Missing Information and Technical Jargon: Why Can’t Medical Researchers Talk Normally?!,” they describe differences between what scientists mean when they use certain words or phrases and how parents perceive their meaning. (An extensive glossary of scientific terms is also included as an appendix.) Fourth, in one of several chapters that make this book unique, the authors provide a method by which parents can evaluate scientific information and separate causal from coincidental associations. Fifth, in a manner similar to Robert Park’sVoodoo Science: The Road From Foolishness to Fraud, the authors provide several tips on how to recognize junk science and those who represent it. Again uniquely, in a section titled “Argument Against the Person (the ‘Ad Hominem’ Fallacy),” the authors confront the weapon of conflict of interest, often used to denigrate those who stand up for good science. Sixth, the authors direct parents to resources that are most likely to provide accurate, up-to-date information and offer tips on how to separate resources that are science based from those that are pseudoscience based. These first 6 chapters are unflinching. Myers and Pineda trust their readers by describing in vivid detail serious adverse events that, although rare, were clearly caused by vaccines, such as vaccine-associated paralysis caused by Sabin’s live, attenuated polio vaccine; pneumonia exacerbated by an experimental respiratory syncytial virus vaccine; intussusception caused by a rotavirus vaccine available in the late 1990s; and paralysis and death caused by an inactivated polio vaccine made in the mid-1950s, one of the worst biological disasters in our country’s history. Similarly, the authors bravely name names when discussing the politicians (Dan Burton), activists (Robert F. Kennedy, Jr), journalists (David Kirby, Edward Hooper, and Dan Olmstead), and doctors (Andrew Wakefield and Mark Geier) who have misrepresented vaccine science to the public. In the second half of the book, the authors examine vaccine safety issues individually, addressing concerns that vaccines might cause asthma, autism, diabetes, Guillain-Barre´ syndrome, multiple sclerosis, inflammatory bowel disease, arthritis, Gulf War illnesses, macrophagic myofascitis, encephalopathy, encephalitis, sudden infant death syndrome, cancer, AIDS, birth defects, and mad cow disease. The chapter on asthma is typical of the authors’ clear, critical, and compelling thinking. Section subheadings include: “What is Asthma?”; “What Causes Asthma?”; “Missing Information and the Asthma Epidemic” (which describes possible contributions from obesity, tobacco smoke exposure, and the hygiene hypothesis); “Asthma and Vaccines” (which summarizes the epidemiologic evidence); and “The Bottom Line” (which proffers a conclusion). InDo Vaccines Cause That?!, the authors have followed ancient teachings. Somewhere between the 4th and 6th centuryBC, Lao Tzu, the founder of Taoism, wrote, “Give a man a fish; feed him for a day. Teach a man to fish; feed him for a lifetime.” By providing parents with information that they need to make decisions today, as well as educating them on how to analyze and interpret misinformation in the future, Myers and Pineda have provided a timeless resource. Every pediatrician who sees parents who are concerned about vaccines and every parent who seeks accurate information about vaccine safety should read this book.
Some groups have formed to try to oppose the use of vaccines. These are generally poorly informed people who have a very high paranoia level with regard to the US government and tend to extend that paranoia to the CDC. In a recent column by Marilyn vos Savant, she explains why some people cannot be convinced to give their children vaccines:
"Some people think that if other children are vaccinated, an unvaccinated child doesn't put them at risk. Isn't the risk only to the unvaccinated child? The answer is "no."
Many people cannot be vaccinated, such as those who are allergic to the vaccine and those who have immune systems weakened from other diseases. Also, some people do not develop immunity even after being vaccinated, and many children are too young to be vaccinated. An unvaccinated child who becomes ill puts all of these people at risk too.
Yet it is important to understand that the parents who decline to vaccinate their children will not be swayed by these arguments. Why? Because they fear that the vaccination itself may cause terrible harm. This is surely mistaken, but they believe it, and that's the crux of the matter. Given the choice of risking great damage to their children versus putting others at risk of these diseases, they naturally choose the latter. This means the only way to reach these parents is through education. Appealing to altruism is not going to work."
Values Are Important
Dr Holly Witteman recently wrote a short paper in Pediatrics, which makes a lot of sense to me, and reflects the way I address vaccine refusal in my practice. Here is the whole article: