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Vaccination Controversies
Understanding the facts
Think of vaccination as a dress rehearsal. It allows the body’s immune (defence) system to practice for the day when it encounters the real disease. When exposed to the disease itself, the immune system is better able to deal with the stress of the illness. It has seen the disease before and already has the tools to respond.
Doctors and health care providers around the world support immunization. However, other groups question the value and safety. With information coming from so many sources, it can be difficult for parents to know what to believe. Much controversy about childhood vaccination still exists.
As a parent, your job is to protect your child from danger. You make decisions every day that weigh risks versus benefits. Should I take my child to the skateboard park? Should we drive to the mountains on a snowy day in winter? Should I put sunscreen on my one year-old? At one time, immunizing a baby was not questioned. Then, a few high-profile people started claiming that vaccinations are dangerous. Parents started to ask the question: Should I immunize my baby?
In the past, doctors spent little time explaining vaccination. Parents accepted that vaccinations as safe and worthwhile. Evidence from around the world overwhelmingly supports that vaccines are the right choice.
However, doctors may not take the time to explain why this is so. Communication breaks down between parents and their doctors, while anti-vaccination messages make headlines in the media. As a result, some parents do not trust the medical system and are reluctant to immunize their children.
Many parents who question vaccinations are not opposed to giving them to their kids. However, the conflicting messages parents receive make it harder to feel confident about this choice.
The debate about whether to immunize or not can be an emotional one. Some discussions take on a good versus evil tone, making it a taboo topic at dinner parties. It has been the subject of debates on talk shows and angry on-line videos made by doctors. Parents are caught in the middle.
When making decisions about health care, it is necessary to rely on fact rather than emotion. Reviewing a few of the concerns about vaccines, along with some of the history of immunization in North America, can help.
Vaccines safeguard health
Vaccination, along with other public health measures, such as cleaner drinking water and the development of antibiotics, has dramatically lowered death rates and illness from infectious diseases. In fact, smallpox and polio are so rare now that parents do not fear them as they might have in the past. Other diseases such as whooping cough (pertussis) and measles are still present, but some parents are not concerned about them.
Immunization rates for whooping cough and measles have declined. However, the number of cases of both illnesses has increased in North America and around the world.
Rare communicable diseases
Some parents who decline immunization do so because certain diseases such as polio are now very rare. In the 1940s, polio ravaged the country. Many young children and adults died. The effects are long-lasting – thousands of people still have permanent disabilities due to polio. You may remember photos of children in the ‘iron lung.’ This early respirator (breathing machine) helped children whose breathing muscles were damaged by polio. Once, the whole country was terrified of the disease. That generation of parents celebrated the polio vaccine. We see very little polio now because of this vaccine.
Although the last outbreak of polio in North America occurred in 1979, the disease still exists. In 2014, 410 cases were recorded worldwide. The countries at highest risk are Pakistan, Nigeria, and Afghanistan. The risk of polio in North American is very low, but it still poses a risk to people who are not vaccinated.
Hundreds of millions of people have been killed by smallpox over several centuries. Smallpox can only be passed by person-to-person contact. Enough people were vaccinated at once, smallpox was wiped out and no longer exists. The last recorded case was in 1977. Children are no longer vaccinated against smallpox.
Diseases on the rise
In contrast, pertussis (whooping cough) is a more common condition. It poses a threat to our young people. This respiratory illness causes fever and prolonged cough. In children and infants, there is a characteristic ‘whoop.’ It is the sound of the child taking an enormous catch-up breath after coughing for so long. In adults, the cough often does not come with a whoop.
About 5000 pertussis cases were documented in Canada in 2012. The death rate is one to four each year, mostly amongst babies. Though pertussis can be treated with antibiotics, permanent lung damage can occur.
The first vaccine for pertussis did have a higher risk of reactions, like allergic reactions, seizures, and fever. About 15 years ago, a new pertussis vaccine was introduced. Since then, the risk of side effects has dropped and the newer vaccine is well tolerated.
Due to decreasing immunization, outbreaks of pertussis are becoming more common again. In the first year of life, pertussis can cause serious damage to the lungs, require hospital admission, or cause permanent brain damage. Pertussis is passed from person to person. It circulates among people whose vaccine has worn off. Immunization for pertussis in babies cannot begin until the age of two months. For this reason, a booster dose is recommended for adults, including pregnant women. The ‘herd immunity’ achieved by immunizing adults protects babies and other vulnerable people.
Answering questions about vaccination
1 If I immunize my young baby, will it overwhelm her immune system?
Many parents delay giving immunizations. They worry that the baby’s immature immune system will be overwhelmed if many immunizations are given at the same time.
However, a baby’s immune system can handle the vaccine load. The immune system is exposed to millions of bacterial and viral components every day. The part of the bacteria or virus that the body reacts to is called an antigen. The additional burden on the immune system from antigens in vaccines is extremely small compared to what the immune system is exposed to on a daily basis. Babies receive more vaccinations than they did 20 years ago, but there are actually fewer antigens in those vaccines because the vaccines have become more sophisticated.
Remember, immunization is a dress rehearsal. A vaccine introduces a small amount of a new virus, such as pertussis. If and when the real disease hits, the immune system has practiced and is ready to respond quickly. This means the child will not become sick or only has a mild illness. Delaying a pertussis immunization is not wise, since the worst cases happen in children less than one year of age.
2 Will children who are immunized become developmentally delayed?
A 1998 study published in England suggested a link between the measles, mumps, and rubella (MMR) vaccine and autism. Enormous problems existed with this study. First, the author falsified the results. He lost his job and his medical license. Support for the study was withdrawn by the prestigious medical journal that had published it. As well, the study only involved 12 children. Since then, several studies on hundreds of thousands of children have not found any link between autism and measles vaccine. Nevertheless, the original study ignited a fierce debate about the pros and cons of vaccination. While the incidence of autism has increased, experts believe it is caused by other factors that are still unknown, not by vaccinations. Yet, the idea that this vaccine is harmful persists.
3 Do vaccines contain dangerous chemicals and minerals?
Next is the concern about minerals and chemicals. It is true that they are added to vaccines to increase their effectiveness or to act as preservatives.
Thimerosal – This ingredient does contain mercury. In high doses, mercury is unsafe for the nervous system. The human body filters out mercury, but very slowly. However, the tiny amount of thimerosal in vaccinations has been used without ill effect since the 1930s. Public pressure resulted in pharmaceutical companies removing thimerosal from pediatric vaccines. These vaccines have contained no thimerosal since the late 1990s. The MMR vaccine has never contained thimerosal.
Formaldehyde – This antiseptic may be used during manufacturing to remove contamination from the vaccine. It is then filtered out. Most of the formaldehyde is gone once the vaccine is ready to transport. Keep in mind that formaldehyde is also used in the clothing and furniture industries. It is produced naturally in the human body and plays a role in metabolism. Immunize Canada states that there is about ten times more formaldehyde in a baby’s body at any one time than there is in a vaccine.
Aluminum – Aluminum salts are added to a vaccine to strengthen the immune system’s response. This type of addition is called an adjuvant. Adjuvants allow the vaccine to contain fewer antigens. Aluminum has been used in vaccines for over 70 years. It is an abundant mineral in the environment, and is found in our air, food and water. The amount in vaccines is similar to the amount found in breast milk and infant formula.
4 Do vaccinations cause terrible side effects?
Vaccines can cause side effects, sometimes for a few days. The most common ones are inflammation at the injection site, and flu-like symptoms like fever, fatigue, crankiness, and loss of appetite. Severe reactions of the nervous system, such as seizure, are uncommon. Allergy to immunizations is also uncommon, with the exception of egg allergies. As some vaccines are grown in an egg culture, people with this allergy should mention it before vaccination to avoid a possible reaction.
5 Is immunization a conspiracy to make money?
Some people believe that doctors somehow benefit from convincing parents to vaccinate their children. It is very important to know that Canadian doctors are not paid by drug companies to vaccinate children or adults. Your doctor makes no money by recommending vaccination. Nor does the government, apart from the money that is saved when fewer people need treatment or hospitalization due to illnesses that could be prevented by vaccines.
6 Are vaccines effective?
Some parents feel that that their child can still get a condition such as influenza (the flu) despite receiving a vaccine. While vaccinations are very effective in preventing many diseases, they are not 100 per cent effective. Nor should we expect them to be. However, the severity of illness is often reduced in those who have been immunized.
Parents are wired to protect their children. In an age of information and misinformation, it can be very difficult to know what to believe. Know that it is okay to discuss immunization with doctors. Ask questions, so you better understand the conflicting messages around you.
