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Vaccine Debate: Why Are Vaccines A Hot-Button Issue?
There’s been a lot of hubbub about vaccinations in the past several years — rare side effects, evidence linking shots to autism, and then a lack thereof, and the reemergence of measles due to underimmunization.
But why do we even give shots? Are they worth the risk? “We immunize to prevent common and severe diseases,” says Federico Laham, MD, a pediatric infectious disease specialist at Orlando Health. “They are the most effective way to deal with diseases you can actually prevent.”
To breakdown the buzz around the vaccine debate, we asked a couple docs to help us take a look at the pros and cons.
Vaccine Debate: The Positives
“Immunization is perhaps one of the most underrated wonders of modern medicine,” says Alix Casler, M.D., F.A.A.P., Medical Director of Pediatrics at Physician Associates – Orlando Health. “Vaccines show bits and pieces of germs to our immune systems so that we can build our own defenses against diseases that used to kill hundreds, thousands or more.”
Perhaps most important for concerned parents, it’s quite safe, especially when you compare to the effects of contracting one of the illness a vaccine is meant to prevent. Smallpox, polio and measles are three examples of diseases that have been (or had been) virtually wiped out, in the United States and beyond due to immunization. “Prior to introduction of the measles vaccine in 1963, now given as part of the MMR, three to four million people in the U.S. got measles each year, 48,000 were hospitalized, and 4,000 suffered from measles encephalitis, or brain swelling,” says Casler. Four or five hundred died due to measles every year.”
That’s why earlier this year, when measles reemerged due to undervaccination, many were concerned; it’s dangerous, yet preventable. Doctors have come up with a carefully-curated vaccination schedule. “There are pragmatic, biological and epidemiological reasons for the schedule,” Laham says. “We’re constantly evaluating it, and have studied it in such a way that a shot is given when the antibody response is optimal.”
A shot or booster is given, ideally, when the body will best respond to the vaccine and before a person is likely to contract a disease or when its at its deadliest. “For instance, the pneumococcal vaccine is given very young, because it is most severe in young children, but there’s no need to give the HPV vaccine before the teenage years, when a person might become sexually active. We want to provide lifelong protection have to balance with the effectiveness of the body’s response to the vaccine.”
Rest assured, a lot of thought goes into making shots the safest and best form of disease prevention on the planet. Although some doctors will prescribe a progressive approach to vaccination schedule for concerned parents, Laham says it’s usually unnecessary. “We’re very cautious about deviating, because it’s created in a way that makes sense, and there’s less of a chance for the disease to disseminate into the community if you don’t alter the schedule.”
Vaccines are also for everyone. “Immunization is easy and readily available for everyone in the United States — it is covered by insurance and is covered by the government for those who do not have insurance,” says Casler. “Safe, effective, available protection of life, like seat belts and bike helmets, immunization makes sense.”
Vaccine Debate: The Negatives
“Though the pros of immunization far outweigh the cons, there is still resistance to immunization, mostly due to misunderstanding,” Casler says.
The most common negatives are reactions at the injection site, including the classic “pinch” to the arm and sometimes-achy muscles following the shot. “There are some minor systemic side effects associated with them, as well, such as low grade fever and malaise for a day or two in some patients,” says Casler. You also might see some redness or hardening at the injection site.
There are some rarer side effects, too. For instance, Casler says the MMR vaccine can cause a decrease in the platelet count in about one in 40,000 vaccinated people, but that condition resolves in time without treatment. Laham notes some serious side effects of the MMR vaccine are deafness and brain damage, but these are “difficult to anticipate” and so rare that, as the CDC notes, “it is hard to tell if they are caused by the vaccine.”
Casler encourages parents and patients to ask their doctors for accurate information on vaccines, and Laham says to check cdc.gov/vaccines if you want to look at reliable reports on your own.
“Vaccines are less risky than a ride in the car or playing a team sport,” Casler says. “The biggest ‘con’ to vaccines is actually another kind of ‘con’ — patients and parents have been misled for years by uninformed people posting disinformation on the web and in print, leading to some people choosing not to be immunized.”