By Dr. Jonathan Wood
April 21-28 = National Infant Immunization Week
Childhood immunization is in the news. Childhood immunization is always in the news.
Why? Because it is exceedingly important, likely the single most successful preventative health measure in the history of modern medicine. But also, it is newsworthy because we are still failing to achieve the kind of immunization coverage that an advanced industrialized nation ought to achieve.
And why are we failing?
• Sometimes there is a shortage, but that is an infrequent and minor impediment.
• Sometimes cost enters into it, but that has all but been erased in Maine due to the fact that all childhood immunizations now are paid for by the state.
• Sometimes physicians don’t take advantage of immunizing children who need to “catch up” due to misunderstandings about when vaccines can or cannot be given, but that accounts for only a minimal number of the missing vaccines.
So why? Myths! There have been genuine concerns about vaccine safety in the past and that has been discussed and re-discussed, researched and re-researched, settled and re-settled. The organizations who look after vaccine safety have been extremely diligent worldwide in evaluating these concerns. Conclusions: our vaccines are exceedingly safe and offer little or no risk, especially when compared with the advantage of preventing the horrible, even deadly diseases which the vaccines are directed towards.
Beyond the vaccine safety concern, which I will not address in detail here because it has been done before, what are some concerns that people put forth?
1. The vaccines aren’t as effective as everyone says they are?
Wrong! These vaccines are amazing and we all need to recognize the profound effect they have had on our society. Examples:
• In 1964-1965, before rubella immunization in the U.S., an epidemic of rubella that resulted in an estimated 20,000 infants born with this disease. The result? 2,100 neonatal deaths. Of those that survived, 11,600 were deaf, 3,580 were blind, and 1,800 were mentally retarded. Due to the widespread use of rubella vaccine, only six cases were provisionally reported in the U.S. in 2000.
• The number of hospitalizations and deaths due to chickenpox (yes, chickenpox!) has dropped more than 90% since its introduction in 1995.
• In the 1980’s, the bacteria HIB caused over 20,000 cases of severe disease each year. It was the leading cause of pneumonia, meningitis, and epiglottitis, Most of these children were hospitalized and many died or experienced severe lifelong disability. Since the introduction of the HIB vaccine in the early 1990’s, the incidence of invasive HIB disease has decreased by greater than 99%. For those of us who experienced this horrible germ, this is astounding and a godsend!
• The year before the measles vaccine was licensed, there were over 450,000 cases in the US. The death rate is anywhere from 3/1000 to 10/1000, with complication and hospitalization rates much higher. Within 4 years, the incidence was less than 10,000 cases/year. Currently,
• What would we prevent over time if we completed routine immunization of one year’s worth of children in the US? Over 20 million cases of disease and 42,000 deaths would be prevented! And the money saved…? Over 13 billion dollars in direct health care costs!
2. These diseases don’t exist.
Wrong! These diseases most certainly do exist, not only in underdeveloped countries but right here in the USA. And with international travel what it is today, even the less common diseases are increasingly likely to find their way into the US, where our under-immunized children will be at tremendous risk. Just a few examples:
• Pertussis (whooping cough) outbreaks are increasingly more prevalent, including several each year in Maine. Over 21,000 cases of pertussis are diagnoses yearly in the US. A 2010 outbreak in California resulted in the deaths of 10 children.
• Two internationally imported US outbreaks of mumps in 2006 and 2009/2010 resulted in more than 6500 and 3500 cases respectively. Although this is a large number of cases, it pales compared with the over 300,000 cases reported each year prior to immunization.
• Worldwide every year, tetanus kills 300,000 newborns and 30,000 birth mothers who were not properly vaccinated. Thankfully, the number of reported US cases remains low due to immunization. That said, an increased number of tetanus cases in younger persons has recently been reported, a potentially dangerous trend.
• There are an estimated 45 million cases of measles each year worldwide resulting in more than 800,000 deaths! An exceedingly infectious germ, this disease is easily transported and transmitted via air travel. The recent MMR vaccine “scare” which caused decreasing immunization rates has resulted in increased outbreaks throughout the industrialized world.
3. The number of vaccines is ridiculous, so many more than we had when we were kids.
The number of vaccines has increased, but the purity of these vaccines is so improved and the manufacturing techniques are so advanced, that the actual number of antigens in 2012 is less than the number of antigens than in the 1990’s even though the number of diseases prevented has increased. Hard to imagine, but absolutely true!
4. Vaccines will traumatize my infant and cause long-term psychological trauma.
Children’s long term memory has not developed by the time the majority of routine immunization has been completed. Parents may be traumatized, but children are not. There is no evidence to support this worry and it defies common sense. Do kids cry with their shots? Yes. Do toddlers cry when they fall down? Yes. Does either of these things scar them for life? Or even for the day? No! Pick them up, comfort them, and they will bounce back to baseline before you know it.
If we were worried about infant psyche from traumatic experiences, we should be worried about their routinely crying when they are hungry or have a diaper rash. Or perhaps even when they pass through the birth canal, perhaps the most traumatic event any of us has ever experienced. All of these are unavoidable and none result in psychological damage. Your kid is very resilient!
5. My child’s immune system will be overwhelmed.
NO! Wrong! Our immune system is challenged daily by a multitude of antigens. Our diet alone exposes children to many more antigens than immunization will ever do. In fact, it has been repeatedly shown that the introduction of multiple antigens (combined vaccines or multiple shots in one visit) actually increases the responsiveness of the immune system. Our immune system actually does better with multiple doses, not worse!
• These diseases are really bad.
• These diseases are still out there… big time!
• You do not want your kid to have any of these diseases, so don’t pick and choose.
• Immunize your kids.
• Immunize them as infants and young children - -
o they will protected earlier, they won’t remember, and their immune system will like it
• Don’t be swept up by myths that defy logic and countless years of data
TV5 Forecast Center
Debunking Immunization Myths
By Dr. Jonathan Wood
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