Public Health Mythbusters: Is there a risk in getting vaccinated?

This is the third round of our Public Health Mythbusters series where we will address another major health concern: risks associated with vaccinations. Flu season is coming up, and you may notice more coverage in the news regarding the ongoing vaccine debate. We will not only tackle the apprehension about the flu shot, but also of general and childhood vaccinations. Should you and your children get vaccinated? Are all vaccines safe? What are the consequences of not getting vaccinated?

So what are the risks associated with the annual flu shot? Every year, children and the elderly are the most affected by illness during flu season. Yet despite the risks of illness and death associated with the flu, many people choose not to get vaccinated. People cite several reasons including: the sense that the media exaggerates the impact of flu season, personal laziness, fear of immediate side effects, and concerns about the long-term safety of the vaccine.

The good news is that each year (including this year!), the flu vaccine is tested and re-tested to ensure its safety and efficacy, enabling it to reduce your risk of illness from the flu. It is important to note here that there are still some people in the population, specifically those who are allergic to eggs, who should take precautions prior to getting certain vaccinations, such as influenza or MMR. (For more information about this year’s flu shot and steps you can take to protect yourself and your family, visit www.flu.gov or www.ladydocscornercafe.com)

Medical and public health experts agree that regular vaccinations are necessary to keep you and your family protected against harmful diseases, especially the flu. They aim for “herd immunity,” which occurs when a sufficient proportion of the general population is immunized against a specific infectious disease, such as influenza. If the majority of the community is protected, then the chance of a large outbreak is minimized.

However, there are some medical personnel, anti-government theorists, and celebrities (recently, Jenny McCarthy) who believe that there are serious negative side effects to vaccinations, and are advocating against the requirement for them in childhood.

What triggered the public’s fear of vaccines? For over two centuries, the development and use of vaccines have been viewed as a basic and effective means of protecting public health. With the eradication of smallpox, the value of vaccines was evident, and medical professionals soon began winning the fight over other diseases including measles, tetanus, whooping cough, and polio. Infectious disease outbreaks were significantly reduced until fear of vaccines entered the public dialogue.

Then in 1998, Andrew Wakefield, a British doctor and researcher, published a controversial paper in The Lancet, a well-respected British medical journal, that linked the measles, mumps, and rubella (MMR) vaccine with autism in children. The paper provoked widespread media coverage and led to declines in immunization rates. Subsequently, the results of Wakefield’s research were found to be fabricated, he lost his medical license, and the paper was retracted from the journal.

However, repercussions from the publication were already evident—the lowered immunization rates led to a measles outbreak in London, and later, a surge in the cases of whooping cough in the U.S. There was an outbreak of measles at an anti-vaccine megachurch in North Texas, bringing about the first measles cases in the U.S. in over a decade. In June 2013, a family in Auckland went public with their regret for not getting their son a tetanus shot. He ended up in the intensive care unit for several weeks with severe nerve damage, had to learn how to walk and eat again, and nearly died. These are just a few examples of how vaccines could have prevented pain and potential death in a child, but were avoided even though there is no evidence to support the claim that there is a link between vaccines and autism.

So why are people still afraid of vaccines? Despite all the medical information regarding the merits of vaccines, parents of young children may allude to a whole host of reasons including religious beliefs, links between the vaccine and other diseases, and fear of repressing a child’s immune system through continuous vaccination. Studies have been conducted on the long-term effects of vaccines to determine if they induce any harmful developmental effects. Thus far, no study has concluded that delaying vaccinations, temporarily or indefinitely, is beneficial to the child. Unfortunately, even with evidence that unvaccinated children gain no benefit, some parents still continue to refuse infant vaccinations in the U.S. and worldwide.

People may also fear getting vaccinated with a live attenuated strain of a virus. These ‘live’ vaccines take an infectious agent, such as poliovirus, and alter it to make it less virulent. When administered through vaccination, these live viruses reproduce slowly, allowing the body to generate a sufficient immune response. For this reason, those who have active cancer, are undergoing chemotherapy, or taking other immunosuppressants, such as prednisone, are not given ‘live’ or ‘live attenuated’ vaccines, such as the shingles vaccine. Of course, check with your physician for specific recommendations regarding your care.

For people whose immune systems are normal, however, the major side effect is temporary arm discomfort. The goal of routine universal vaccination is to benefit the global population. Vaccines are a cost-effective, first-level defense against harmful pathogens. The potential consequences of not being vaccinated are severe since many of the vaccine-preventable diseases, such as chicken pox, whooping cough, measles, and influenza, can cause hospitalization and death among children.

What are the advantages of getting vaccinated? Outbreaks from known pathogens can be diminished with one simple, healthy solution—regular vaccinations. During infancy and early childhood, the U.S. Centers for Disease Control and Prevention (CDC) recommends getting shots (and, in some cases, booster shots) for Hepatitis B, MMR, polio, diphtheria, tetanus, pertussis, rotavirus, and, yearly flu vaccines. The CDC emphasizes that getting immunized early protects infants and children “when they are most vulnerable and before they are exposed to potentially life-threatening diseases”.

For adults, the CDC recommends a one-time dose of Tdap – a combined tetanus, diphtheria and pertussis vaccine because of the resurgence of pertussis (whooping cough), then a regular Td booster every 10 years. It can be updated after 5 years in the case of injury. The shingles vaccine should be given once either at age 50 or 60, depending on the recommendation you follow, but as above, only in those with a normal immune system. A pneumonia vaccine should be given to everyone at least once after age 65, but earlier in those with chronic illnesses. And a flu vaccine every year, unless there’s a reason not to. Males and females under age 26 should get 3 doses of the HPV vaccine, preferably before they become sexually active, to prevent cervical and head and neck cancers. Students leaving for college dorms need a meningitis vaccine before they go.

Bottom line? Talk to your doctor and make sure you and your children are up-to-date on your immunizations. As previously stated, long-term studies have deemed that vaccination of children does not affect their development later in life. Therefore, pediatricians regularly advise parents to get their children vaccinated. These vaccines are necessary to ensure the public’s health from household to community to city to nation and beyond. By vaccinating yourself, you are effectively protecting your children from possible spread of infection. Medical professionals have been administering vaccines to kids for decades, and the evidence to support this type of intervention is overwhelmingly positive.

S0, remember to get your flu shot!

For more resources on these topics, and to see where I turned for my information, please visit the following links:

CDC Vaccines: http://www.cdc.gov/vaccines/schedules
Public Fear of Vaccination: http://online.liebertpub.com/doi/abs/10.1089/vim.2005.18.307
Psych of Vaccines: http://psychcentral.com/blog/archives/2012/09/12/the-psychology-of-vaccine-fear
McCarthy: http://www.thenation.com/blog/175388/jenny-mccarthys-vaccination-fear-mongering-and-cult-false-equivalence#