Vaccinations

Sanofi announces positive CHMP opinion for dengue vaccine

Cabriolet. “Sanofi announces positive CHMP opinion for dengue vaccine.”  22 Oct 2018. Online image. Flickr. 22 Aug 2019.

One interesting and currently relevant medical issue that is being, or has recently been reported in the popular media is the decision to vaccinate or not vaccinate our children.  The importance of this issue is because vaccines are supposed to protect the public against many infectious and potentially lethal diseases.  Aren’t they?

The following are media reports that discuss the topic at hand.  Some of the information provided is factual and some are myths, but they help us to recognize false information in order to consider additional research.

Vaccinations: It’s Not YOUR Choice

Vaccinations: It’s Not YOUR Choice

Solomon, A. (2019, August 22). Vaccinations: It’s Not YOUR Choice [Blog post]. Retrieved from //fivethirtyeight.blogs.nytimes.com/2013/07/15/senate-control-in-2014-increasingly-looks-like-a-tossup/

This article is written by a concerned mom who supports vaccinations.  She recognizes that diseases that were wiped out will come back if we don’t.  She explains that to vaccinate or not to vaccinate is NOT a personal choice.  She states that, “A personal choice does not affect hundreds, thousands of people, entire communities.” She gives examples of things that are a choice such as breast feeding, homeschooling and God.  Those are individual decisions that we can make for each unique family dynamic. Vaccinations are NOT a personal choice, and should never be, ever.  She addresses the autism myth and says that shell take her chances, at least her child would be alive.  By choosing not to vaccinate you are exposing children, parents, grandparents and are potentially taking them away from their families. She paints the picture of a frail five-week-old infant with pertussis in the ICU with tubes and machines, fighting for their life over a disease that has a cure.  Finally she asks us to spend the rest of our time and energy finding the solution to disease like cancer, and HIV that we haven’t figured out yet.

I’m A Mom And A Vaccine Researcher. Here’s Why You Should Vaccinate Your Children.

https://www.huffpost.com/entry/child-vaccinations-risk_n_5cb75091e4b08233dbddae6d

Nixon, K. (2019, August 22).  I’m A Mom And A Vaccine Researcher. Here’s Why You Should Vaccinate Your Children. Retrieved fromhttps://www.huffpost.com/entry/child-vaccinations-risk_n_5cb75091e4b08233dbddae6d

This article is written by a mom who is also a vaccine researcher.  She explains that as a vaccine researcher she has spend nearly a decade learning about the tragic stories of loss that ultimately led people to make vaccines.  She states that, “these stories are real for me, as real as they’d be if I witnessed any living person today hold their baby and watch it die. I have a phrase I use in vaccine arguments: “Until you’ve had to read as many accounts of women holding their babies while they died as I have had to do, you don’t get to say vaccines are the dangerous thing here.”  She goes back in history to the Victorians and their maternal agony over child loss due to these diseases and just how fully infective these diseases were to society.  In culture now, we rarely witnesses tetanus and polio so it is easy not to fear it.  Because of this we live in a world that is privileged and believe that our risk does not exist or if it does, it can be extinguished.  What has been lost from our memory is that there are huge risks to not vaccinating.  She explains that this effects the global community, the very old, the very young and the ill.  These individuals rely on herd immunity for protection.  She states that we have lost any connection to the idea of a grater good, for people outside of our own families.  She asks us to trust doctors and researchers like her.  She asks us to trust moms like her, who understand that you love your baby.

A Message for the Anti-Vaccine Movement

https://www.youtube.com/watch?v=QgpfNScEd3M

Kimmel, J.  (2019, August 22). A Message for the Anti-Vaccine Movement. Retrieved from https://www.youtube.com/watch?v=QgpfNScEd3M

This video shows the night talk show host Jimmy Kimmel, discussing vaccine controversies.  He jokes that parents are more scared of gluten than they are smallpox.  He understands that you might not take your advice about vaccinations from a talk show host like him, but you might take it from almost every doctor in the world.  These doctors he states, have learned how to “magically” prevent deadly diseases.  He makes a good point about “those little shots” of Botox to make lips plump, contain botulism, a toxin that causes paralysis and respiratory failure.  On a serious note he explains that not getting vaccinations effects everyone.  Unvaccinated kids put all kids at risk.  He says that if you think you know more than a doctor knows, then you shouldn’t be able to go to the doctor anymore.  So, if you fall and cut your head open, you will not be admitted to the emergency room.  After all, they can’t possibly know what they are doing.  He invites real doctors to hear them out.  These doctors state that the downside to vaccinations are practically nonexistent and that there is no reason not to vaccinate your children.  The doctor’s joke and ask if anyone has polio?  No, one doctor says, because there are vaccinations for that. One doctor mentions that they went to school for 8 years, and their pretty sure they know what their talking about.  Each physician then complains that this whole thing is stupid and that they had to come in on their day off just to explain this to us.  In the end, they all beg of us to vaccinate.

So – Are vaccines safe?  Why is everyone so afraid?  Is there, or isn’t there, a correlation between immunizations and autism?  Where did this myth come from and why do we question this when we vaccinate our children?  What is the truth about immunizations?

Vaccines protect the public against many infectious and potentially lethal diseases.  Tetanus causes lock jaw (Crisp, Jackie, et al., 2017).  Pertussis is a highly contagious respiratory tract infection that sounds like a high-pitched bark as the patient coughs and struggles to breathe (Crisp, Jackie, et al., 2017).  Most of us are familiar with the flu that causes vomiting, diarrhea and high fevers (Crisp, Jackie, et al., 2017).  Complications with any of these diseases can potentially lead to death.  I can remember getting the chicken pox as a little girl.  I have two brothers who had it at the same time.  The three of us had red spots covering our bodies and fevers of 104 degrees.  Such high fevers can potentially cause seizures.  My mother took care of us for days, around the clock, with cold compresses, Tylenol and oatmeal baths.  Now there is a vaccine for this illness.  I have two children, 5 and 14 who fortunately will never know what it’s like to have the chicken pox because they were vaccinated.

My father is in a wheelchair because he had polio as a child.  My grandmother has told me stories about when he first became sick.  My father was dying and there was no ambulance who would take him to the hospital because they had a feeling, he had polio and they did not want to touch him in fear of “catching” it.  My grandfather had to carry him miles to the nearest hospital.  Most people at that time died of polio, or ended up paralyzed, in an iron lung.  My father, too, was paralyzed from the neck down. However, after a period of time, he regained most of his mobility aside from his left leg, which lays limp by his side.  This has negatively affected his quality of life but, he is lucky to be alive and able to have a family.  Polio has since been eradicated from the United States because of the polio vaccine.  Because of this, thankfully my children will never know the horror of what it is like to have this disease.

Why are we so scared of the Measles, Mumps, and Rubella (MMR) vaccination in particular?  “Measles causes fever, rash, cough, runny nose, and red, watery eyes. Complications can include ear infection, diarrhea, pneumonia, brain damage, and death.  Mumps causes fever, headache, muscle aches, tiredness, loss of appetite, and swollen salivary glands. Complications can include swelling of the testicles or ovaries, deafness, inflammation of the brain and/or tissue covering the brain and spinal cord (encephalitis/meningitis) and, rarely, death Rubella, causes fever, sore throat, rash, headache, and red, itchy eyes. If a woman gets rubella while she is pregnant, she could have a miscarriage, or her baby could be born with serious birth defects (CDC, 2018).”

Serious side effects are rare. Anaphylaxis can be a concern – hives, rash, swelling in the mouth or throat, tightness of the chest, anxiety, nausea and vomiting.  This would be a true adverse reaction and a major side effect.  However, this does not happen often, and one must recognize that a person could become anaphylactic to anything in the environment such as peanut butter or bee’s etc., not just vaccinations.  Most side effects are mild and include soreness, redness or swelling at the injection site, fever, rash and achiness.  Most are local reactions and clearly outweigh the seriousness of getting the actual diseases.  In none of the vaccination information sheet does it say that a complication or side effect of this is autism.  So, where did autism come into the equation?

In 1998 the autism related controversy started when some concern arose about the safety of the vaccine (Khan Academy 2013).  In Britain a form of the MMR Vaccine produced three cases of associated febrile convulsions (Khan Academy 2013).  Apprehension regarding the vaccine surfaced.  A new strain was introduced in 1988 – the Jeryl Lynn strain (Khan Academy 2013).  Cases of aseptic meningitis were diagnosed with other strains of the vaccine while the Jeryl Lynn vaccine did not (Khan Academy 2013).  The National Health Service withdrew two of the three available MMR vaccines in favor of the Jeryl Lynn’s strain (Khan Academy 2013).  MMR vaccination rates continued to fall despite removal because of the concern of adverse reactions (Khan Academy 2013).  In 1994, Richard Barr pursued a class action suit against manufacturers of MMR vaccine indicating that MMR was a defective product and should not have been used (Khan Academy 2013).  He sought the help of Jeremy Wakefield a gastroenterologist and medical researcher who agreed to participate in this study covertly for his own financial gain (Khan Academy 2013).  The money that Barr paid Wakefield to carry out the study was given directly to Wakefield and was not used for the study itself (Khan Academy 2013).  The Wakefield study falsely concluded that autism was directly caused by the MMR vaccine (Khan Academy 2013).  In 1997, Wakefield created a patent for a new MMR vaccine; one that would have competed with the existing MMR vaccines and did not cause autism (Khan Academy 2013).

Since that time numerous studies have disproven Wakefield’s reports.  “The paper, which suggested a link between the measles-mumps-rubella (MMR) vaccine and autism, was eventually retracted in 2010 (Heft, 2014).”  Even before the complete retraction, in 2004, ten of the paper’s 13 authors cosigned a partial retraction of its main interpretation (Heft, 2014).” “What the public didn’t know in 1998 was that the now-retracted study, which involved just 12 children, would turn out to have some serious flaws—and even to contain apparently falsified data. The 12 years between its publication and its retraction, left a lot of time for the unfounded and never-confirmed vaccine-autism link to take hold in the minds of worried parents (Heft, 2014).”

Some people still have concerns despite numerous studies that have shown there is no link between receiving vaccines and developing autism.  In 2011, an Institute of Medicine (IOM) reported on eight vaccines given to children and adults which concluded that with rare exceptions, these vaccines are very safe (CDC, 2018).  The CDC has released extensive evidence indicating that there is no link between vaccines and autism however, the stigma remains, and parents are nonetheless hesitant to vaccinate their children.

The Regional Office for Europe of the World Health Organization (WHO) did a series of workshops in 2017 (WHO, 2017). The organization discussed the public’s response to false information about vaccines, including media and court cases related to alleged adverse reactions of vaccines (WHO, 2017).  Italy has had outbreaks of vaccine preventable diseases in recent years (WHO, 2017).  “Since July 2016, there have been 35 measles deaths in the region: 31 in Romania, two in Italy (along with 4044 measles cases), one death in Germany and one in Portugal (WHO, 2017)”.  Some parents are frightened to vaccinate their children as a result of misleading media reports, court cases of alleged adverse reactions and repetitive, deliberate exaggerations by anti-vaccination campaigners (WHO, 2017).  Polio, tetanus, diphtheria, hepatitis B, pertussis, Haemophilus influenza type B, measles, mumps, rubella and varicella are now a school-entry requirement across Italy (WHO, 2017).  One of the largest challenges for public health officials has been how to respond to the abundance of misleading information (WHO, 2017). “Studies show that simply correcting myths about vaccines may not be effective and can even backfire (WHO, 2017)”.  The US CDC delivered information of evidence refuting these claims which reduced these misperceptions (WHO, 2017).  “Most hesitant parents do not oppose the scientific evidence, but the appeals and messages of vaccine deniers make them feel afraid and uncertain (WHO, 2017)”.  The public has impractical expectations.  They want 100% certainty that vaccines are safe and effective but of course with any vaccination there are always possible side effects and adverse outcomes (WHO, 2017).   The public has false logic including the belief that all-natural things are good and all unnatural things are bad (WHO, 2017).  A public information campaign aimed to identify false information found that a major source of confusion was the multitude of contradictory media reports (WHO, 2017).  There was also apprehension over babies being too young to tolerate a triple vaccine, “the team devised messages explaining that the MMR vaccine helps to build a baby’s immune system rather than attacking it (WHO, 2017)”.  “Religious beliefs, lack of trust in health authorities and providers, safety concerns and a lack of perceived benefit of vaccines were among the reasons for vaccine hesitancy around the world (WHO, 2017)”.

santopaul79. (2019, August 22). Stop the Anti-vaxers before it’s too late [Blog post]. Retrieved from https://www.flickr.com/photos/91040523@N05/16228652489/in/photolist-qY6sQn-r4tm4r-25hU8EB-BqXp1k-dXewbi-qJ55Zg-2dQpcnR-294TFoX-BtmBc4-S52fpH-2ft48b1-2dwbTJn-2biJoJx-2fEAFU8-SC7evY-YGPdMr-seDA1Z-2699jzN-22NEXVU-X7Ec8G-2doEJRN-253UbWC-o87nb5-Y9KYMR-ebE2Fm-22eC66E-23JoiNn-2djBjjw-Lor45B-QHMimF-2gpGBPE-2gdpepr-sTU2xw-rSU693-rEHEe3-qt77us

Some find concern with the use of thimerosal, a mercury-based preservative in many vaccines including the MMR vaccine.  Studies have shown that there is no link between the ingredient and autism.  “Since 2003, there have been nine CDC conducted and/or funded studies which have found no link between thimerosal-containing vaccines and ASD, as well as no link between the measles, mumps, and rubella (MMR) vaccine and autism in children (Vaccine Safety, 2015).”  As a matter of fact, in the year 2000 “thimerosal was removed or reduced to trace amounts in all childhood vaccines except for some flu vaccines (Vaccine Safety, 2015)”.  This was done as a national effort to minimize if not eliminate exposure to mercury before studies showed the preservative was not harmful.

Many myths have been disproven such as better hygiene and sanitation will make diseases disappear, making vaccines unnecessary (Questions and Answers on Immunizations, 2018).  In fact, the diseases we can vaccinate against will return if we stop vaccination programs (Questions and Answers on Immunizations, 2018).  While better hygiene and clean water do decrease the spread of disease, many infections can spread regardless of how clean we are (Questions and Answers on Immunizations, 2018).  Another myth is that vaccines may have damaging, long-term side-effects that can be fatal that are still unknown (Questions and Answers on Immunizations, 2018).  When the fact of the matter is, vaccines are very safe.  Most reactions are usually minor and temporary, such as a soreness or redness at the site of injection. Serious reactions are rare and are carefully monitored and investigated (Questions and Answers on Immunizations, 2018). An individual is more likely to be seriously injured or even die by a vaccine-preventable disease than by a vaccine (Questions and Answers on Immunizations, 2018).  Some believe that vaccine-preventable diseases are almost extinct, so there is no reason for vaccination.  Even though vaccine preventable diseases have become scarce in many countries, the infectious agents that cause them to continue to “circulate can cross geographical borders and infect anyone who is not protected (Questions and Answers on Immunizations, 2018)”.  Another misconception is that childhood illnesses are just part of life or that it is better to develop antibodies through disease than through vaccines (Questions and Answers on Immunizations, 2018).  Vaccine preventable diseases do not have to be part of growing up and they “interact with the immune system to produce an immune response similar to that produced by the natural infection, but they do not cause the disease or put the immunized person at risk of its potential complications (Questions and Answers on Immunizations, 2018)”.  Some believe that giving a child more than one vaccine at a time can increase the risk of overloading the child’s immune system (Questions and Answers on Immunizations, 2018).  However, “scientific evidence shows that giving several vaccines at the same time has no adverse effect on a child’s immune system (Questions and Answers on Immunizations, 2018)”.

As a result of all of the confusion, Measles, which had been practically non-existent in the United States just a century ago, has since reemerged.  According to the CDC, there have been 107 outbreaks of measles this year alone.  Schools require children to get routine vaccinations to attend.  This has helped control the spread of the disease through herd immunity.  The rationale behind herd immunity is that if enough people are vaccinated against a particular disease, viruses can’t spread from person to person as easily.  The entire community or “herd” is less likely to have an outbreak of the disease.  Through this process, it is possible that the disease can become eradicated all together.  In the past few years, we have been seeing a rise in children not being immunized as a result of “anti-vaxxers,” who choose not to vaccinate their children due to non-medical exemptions.

In combination with all the myths, children with autism and their younger siblings are less likely to be fully vaccinated.  A study showed that more than 3700 children with autism and almost 500,000 children without, “after receiving an autism diagnosis, rates of vaccination were significantly lower (82%) compared with children of the same age who did not have an autism diagnosis (94%) (Community Practitioner, 2018)”.  Siblings not being vaccinated contributes to the spread of the disease.

Due to the resurgence of measles, Autism Speaks, the nation’s largest group to advocate for autism, funded research to help distinguish if there is any link between vaccinations and autism (Bits and pieces, 2015).  The conclusion was that “the results of this research are clear: Vaccines do not cause autism (Bits and pieces, 2015).”  Autism Speaks urges all children to be vaccinated.

A bright-eyed little boy with red hair, blue eyes and freckles sits on the edge of a treatment table in a doctor’s office.  He licks a lollypop as the nurse places a ninja turtle band aid on his right upper arm.  He just received his MMR shot.  “You were very brave,” the mother says to him.  The child smiles.  This mother’s decision to vaccinate her child essentially saved his life from a very harmful disease.  The doctor explained to the mother prior to administration that vaccines are safe, effective, and they do not cause autism.  The doctor stated that they protect us from many deadly diseases and the benefits of being vaccinated far outweigh the risk of any negative side effects.

References:

Bits and Pieces. Autism Speaks Alters Position on Vaccines. (2015). Palaestra, 29(1), 55. Retrieved from http://library.neit.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103805316&site=ehost-live

Cabriolet. “Sanofi announces positive CHMP opinion for dengue vaccine.”  22 Oct 2018. Online image. Flickr. 22 Aug 2019.

Children with Autism at Increased Risk of Vaccine-Preventable Disease. (2018). Community Practitioner, 91(4), 12. Retrieved from http://library.neit.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130613578&site=ehost-live

Crisp, Jackie, et al. Potter & Perry’s Fundamentals of Nursing. Elsevier Australia (a Division of Reed International Books Australia Pty Ltd.), 2017.

Helft, Emily Willingham and Laura. “The Autism-Vaccine Myth.” PBS, Public Broadcasting Service, 5 Sept. 2014, www.pbs.org/wgbh/nova/body/autism-vaccine-myth.html.

Khan Academy.92013, January 27. Retrieved October 15, 2018 from http://www.youtube.com/atch?v=HGb91dbNdM

Kimmel, J.  (2019, August 22). A Message for the Anti-Vaccine Movement. Retrieved from https://www.youtube.com/watch?v=QgpfNScEd3M

Measles, Mumps, and Rubella (MMR) Vaccine Safety. (2019, August 21). Retrieved from https://www.cdc.gov/vaccinesafety/vaccines/mmr-vaccine.html

Nixon, K. (2019, August 22).  I’m A Mom And A Vaccine Researcher. Here’s Why You Should Vaccinate Your Children. Retrieved from https://www.huffpost.com/entry/child-vaccinations-risk_n_5cb75091e4b08233dbddae6d

santopaul79. (2019, August 22). Stop the Anti-vaxers before it’s too late [Blog post]. Retrieved from https://www.flickr.com/photos/91040523@N05/16228652489/in/photolist-qY6sQn-r4tm4r-25hU8EB-BqXp1k-dXewbi-qJ55Zg-2dQpcnR-294TFoX-BtmBc4-S52fpH-2ft48b1-2dwbTJn-2biJoJx-2fEAFU8-SC7evY-YGPdMr-seDA1Z-2699jzN-22NEXVU-X7Ec8G-2doEJRN-253UbWC-o87nb5-Y9KYMR-ebE2Fm-22eC66E-23JoiNn-2djBjjw-Lor45B-QHMimF-2gpGBPE-2gdpepr-sTU2xw-rSU693-rEHEe3-qt77us

Solomon, A. (2019, August 22). Vaccinations: It’s Not YOUR Choice [Blog post]. Retrieved from //fivethirtyeight.blogs.nytimes.com/2013/07/15/senate-control-in-2014-increasingly-looks-like-a-tossup/

Vaccine Safety. (2015, November 23). Retrieved from https://www.cdc.gov/vaccinesafety/concerns/autism.html

U.S. Department of Health and Human Services. (2006, October 11).  Vaccines Protect Your Community.  Retrieved October 27,2018, fromhttps://www.vaccines.gov/basics/work/protection/index.html

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