There is a buzz in the medical world regarding an article recently out of New Zealand written by the parents of a child who ended up in the intensive care unit with a severe infection, making them have to confront and rethink their decision not to vaccinate (original article: http://www.abc.net.au/local/stories/2013/06/06/3776327.htm). While stories such as this one are not always front-page news, sickness and death related to otherwise preventable diseases occur much more often than many people think. Whether the culprit is Tetanus, as in the New Zealand case, chickenpox in a current San Diego outbreak or the Measles epidemic in largely unvaccinated communities in Brooklyn, many families are having to deal with the very real consequences of their decision to withhold some or all childhood immunizations. Too often, parents make this decision based on little factual data and as a result, deadly vaccine-preventable diseases are on the rise!
How many children are unvaccinated?
While actual numbers vary by region, about 1 in 5 children are underimmunized (having received some vaccines) or fully unimmunized (having received no vaccines at all). Studies in some urban populations demonstrate that up to 40% of children have not received some or all immunizations recommended for their age.
The Catch-22:
Through strict adherence to a standardized immunization schedule, we have rid society of some of the worst illnesses including Polio and Smallpox! Immunizations have been so successful in eradicating these deadly diseases that few parents have any firsthand knowledge of someone who’s contracted one. As such, it is hard to convince them of the need to vaccinate their child when the perceived likelihood of getting the disease seems so small, which is not the reality.
“Well if everyone around my child is immunized, then my child is safe…”
According to recent studies, many parents who decide not to vaccinate their children acknowledged that their decision could put other children in the community at risk but they believed their own child would remain healthy. This belief is derived from a misunderstanding of the concept of “herd immunity”; vaccinating a large proportion of a population provides protection for unimmunized individuals. Most diseases spread from person to person and in this theory, the likelihood of an unimmunized person coming into contact with a contagious person is minimized. This is especially important for those too young to be vaccinated or those with immune problems. However, the fault in this logic is it does not apply to all diseases, i.e. tetanus, where the vaccine protects only those who have received the shot should they come in contact with the bacteria. Thus, such diseases may still exist in a community and individual unimmunized children are still at risk for any and all of these infections.
“Can’t I pick and choose which vaccines my child receives?”
As many as one in ten parents opt for “alternative vaccine schedules”, which involves refusing certain vaccines, delaying until the child is older or spreading out immunizations over a much longer time period than is recommended by public health organizations. While these children may possess some degree of immunity from the vaccines that they do receive, they are still largely at risk. First of all, for most immunizations, often three to four doses are needed to fully protect the child. Furthermore, according to a recent study, children whose parents opted out of 1 or more recommended vaccines were 22 times more likely than fully vaccinated children to contract measles and nearly 6 times more likely to contract Pertussis. Remember, there i. s no advantage to skipping or delaying vaccines, but there is a significant disadvantage: the length of time in which children have inadequate level of protection is increased.
“But what about Mercury in vaccines? Does it lead to Autism?”
Claims have been made over the years regarding the safety of some routine childhood vaccines suggesting they can cause diseases such as autism spectrum disorders or other developmental delays. The original study that alleged an association between the preservative Thimerosal, a mercury derivative, in MMR (measles-mumps-rubella) vaccines and autism has since been revoked (as has its publisher’s medical license!). From this scare, in 2001 the CDC reduced or removed mercury-derivatives in all routinely recommended vaccines for children. However, the damage was done; measles cases tripled between 2001-2010 largely due to children not receiving the immunization. Top researchers have investigated many claims (including the MMR-autism link, the use of preservatives in vaccines and countless general studies about vaccine safety), concluding that vaccines are safe and do not cause autism nor any other chronic disorders.
In conclusion,
Immunizations are a very important, occasionally controversial, topic in the minds of some parents. Successful vaccination programs have helped reduce or in some cases fully eliminate the threat of some of the most dangerous childhood diseases but many vaccine-preventable diseases still exist with devastating consequences. In terms of risk versus benefit, vaccinations are a must! Often with a little more discussion with your pediatrician, the importance of childhood vaccines can become apparent and clear. As always, maintaining an open dialogue with your pediatrician is fundamental, such that any and all questions or concerns are addressed.
