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To Vaccinate or Not to Vaccinate

Vaccines are one of mankind’s greatest scientific discoveries, saving billions of lives. Why are they so controversial?

Vaccination is considered one of the greatest medical achievements in history; it is also one of the most controversial. There are twelve childhood diseases that are preventable by vaccination: Varicella, Mumps, Tetanus, Polio, Diphtheria, Pneumococcal disease, Rubella, Pertussis, Measles, Hepatitis A, Hepatitis B, and Haemophilus Influenzae Type B. The vaccines for these diseases are given at various times over the course of a child’s life, and stimulate the immune system to create antibodies and immune cells that readily fight the virus or bacteria, should it invade the body. 

The number of parents refusing to vaccinate their children is on the rise. Blue Cross Blue Shield, a health insurance company, reported that among its members, 3.3 percent, or 27,839 children, had a refusal code on their medical claim from a doctor. That number rose from 2.5 percent, and is still on the rise. Parents should be better educated about the safety and efficacy of vaccines, so that they can make more informed decisions and protect their children from preventable diseases. 

Children should be vaccinated for a number of reasons; even though the diseases vaccines fight are preventable, they are still prevalent and on the rise. The ingredients used in vaccinations are not harmful, and the vaccines themselves are constantly monitored for adverse reactions. There are a handful of side effects that can occur with inoculation. These, however, are very minor, and autism is not among them. Overall, the benefits of vaccination highly outweigh the risks. 

Preventable diseases are still prevelant and on the rise.

One major argument for not vaccinating children is the belief that many of the diseases vaccines fight are no longer prevalent. This belief is incorrect, as many of the diseases vaccines prevent are on the rise because the number of unvaccinated children has increased. Measles is one of those diseases. 

Children with measles experience gastrointestinal symptoms along with red, watery eyes, a rash, and a high fever, which if untreated causes severe dehydration and even brain damage and deafness. Younger children are much more likely to experience serious symptoms and outcomes from getting measles, as their immune systems are not as strong as the children old enough to receive the vaccine. A child with measles could shed germs and is highly contagious for four days before the rash appears and for up to four days after the rash is gone. This means that the child could be spreading the disease before he even showed symptoms of having measles, and could cause harm to other children, especially those too young to receive the vaccine. 

The number of reported measles cases has been steadily increasing for the past few years. From January 1, 2018 to July 14, 2018, there have been 107 cases of measles from 21 different states. In 2017, 118 cases were reported from 15 different states. In 2016, 86 cases from 19 states were reported. 

Another disease that is still very much present is varicella, or “Chicken Pox.” While considered to be mild, it is highly contagious and have long term consequences. Children who contract varicella in youth carry the virus with them their entire lives. This virus can reappear and wreak havoc on the immune system in elderly individuals as shingles. Shingles is a very painful virus that can cause scarring, permanent nerve damage, and even death. If a child is vaccinated against varicella, not only will they not get the virus, they will not get shingles as older adults. 

The diseases that vaccines prevent are still around and can harm not only unvaccinated children, but also children too young receive the vaccines and those who are immunocompromised. Unvaccinated children are 23 times more likely to contract pertussis, 8.6 times more likely to contract varicella, and 6.5 times more likely to contract pneumococcal disease. 

In 2008 there were five cases, one fatal, of Haemophilus influenzae type B, or Hib, in Minnesota; the most since 1992. Three of the infected children, including the one who died, did not receive the vaccination because their parents refused it. The decision to refuse vaccines affects public health overall. Those who are unvaccinated are at risk and also put others at risk, including young children, the elderly, and the immunocompromised. Children in the United States still die from vaccine-preventable diseases. 

On June 30, 2018 in Virginia, a 4-month-old infant died of meningitis, which is a preventable disease that causes inflammation of the brain and spinal cord. Health officials told the parents that the most obvious cause was an unvaccinated child at the infant's day care. The vaccine to prevent meningitis is recommended for children ages 11 to 12, meaning the 4-month-old was too young to receive it. 

Immunization against preventable diseases saves the lives of 3 million people around the world, every year. The more people in a community get vaccinated, the more those who cannot get vaccinated are safe from preventable illnesses. Since viruses and bacteria spread easily, passing from person to person through air, fluids, and water, if enough people are immunized, many viruses and bacteria cannot spread because they have nowhere to spread, thus decreasing the ability of these diseases to infect people. Like with smallpox, if people vaccinate themselves and their children against preventable illnesses, the diseases can be eradicated, improving the public health of future generations.  

Vaccines and their ingredients are safe and effective.

Another common argument against vaccinating children is that vaccines contain harmful ingredients that can cause a number of adverse effects and health problems. The ingredients that parents are concerned about are thimerosal, mercury, aluminum, and formaldehyde. There are some vaccines that contain minute amounts of these ingredients, but they are so minor that they will not cause any problems. 

Thimerosal is a preservative that was introduced in 1942, after multiple deaths caused by staphylococcal contamination of the tetanus vaccine. It is used to prevent microbial growth, stabilize the vaccine, and prevent it from breaking down or losing its strength over time. According to the FDA, all vaccines recommended for children 6 years of age and younger are available in thimerosal-free formulations. There are also thimerosal-free vaccines for teens and adults. There have been a number of peer-reviewed scientific studies over the course of the past 15 years that show thimerosal does not cause harm, including serious neurodevelopmental disorders. 

The National Academy of Medicine, a non-profit, non-governmental health organization focused on the safety and efficiency of health care practices, concluded that evidence shows no link between autism and thimerosal. It has a long record of safe and effective uses in preventing bacterial and fungal contamination in vaccines, with no adverse effects other than hypersensitivity and minor local reactions at the injection site.

Another ingredient parents are concerned with is mercury. The type of mercury used in vaccines is ethylmercury, a main component of thimerosal, which is different from methylmercury, the type of mercury found in fish. High amounts of methylmercury is toxic; the amount of ethylmercury in vaccines is minute and harmless. Methylmercury also lingers in the body longer than ethylmercury, and mercury in a vaccine does not translate to mercury in the blood or in the brain.

Aluminum is another ingredient causing concern. According to the CDC, only some vaccines contain aluminum. Small amounts of aluminum are needed to help the body build a stronger immunity against the bacteria or virus in a vaccine. The amount of aluminum in vaccines is very low and regulated by the FDA. Adults ingest about seven to nine milligrams of aluminum per day. It is found in fruits, vegetables, beer, wine, flour, cereals, nuts, dairy, baby formula, and honey. While infants receive about 4.4 milligrams of aluminum from vaccines in the first six months of life, they ingest 7 milligrams of aluminum from breast milk, while formula fed infants ingest 38 milligrams. Infants who are fed soy formula ingest even more, averaging 117 milligrams in their first six months of life. There are no pediatric vaccines that contain 1 milligram or more of aluminum.

The chemical formaldehyde is always present in the human body as a part of the natural metabolic process. Formaldehyde is needed for the synthesis of proteins and DNA; the amount our body produces is significantly more than what is in some vaccines and is still 1000 times smaller than the levels shown to have damaging effects with chronic exposure. There are 12 to 240 times more formaldehyde in the average newborn's body than in a single dose of any vaccine. Formaldehyde is used in minute amounts to inactivate the viruses and bacteria used in vaccines. While many vaccines contain no formaldehyde, some have a residue of 0.005 to 0.1 mg, while an infant on average has about 1.2 milligrams in his or her blood naturally. 

While the ingredients in vaccines are not harmful, vaccines like any medical product or drug are tested in randomized, controlled trials and compared to a placebo or previous vaccine to ensure safety and efficacy. They are also constantly monitored for safety and adverse effects post licensure. 

Studies show there is no link between childhood vaccinations and Autism.

CDC Recommended Vaccination Schedule from Birth to 18-years-old

Another area of concern for parents is the adverse effects of vaccines. Like with any drug, vaccines do have side effects; however, the most common side effects are a mild fever and injection site pain. Serious adverse reactions to the vaccine are rare, well-documented, and tracked by a safety monitoring program.

The belief that vaccines cause autism is spreading and remains one of the main reasons why people hesitate to in inoculate their children. Some parents believe that the ingredients in vaccines and the amount of vaccines kids receive play a role in the development of an Autism Spectrum Disorder, or ASD. Extensive research has been conducted over recent decades, which produced clear results: vaccines and vaccine ingredients do not cause autism. Twenty epidemiological studies, performed in several different countries by many different investigators, have shown that neither thimerosal nor MMR vaccines cause Autism and have no serious effects on children’s mental health.

Vaccines do not overwhelm the immune system, even in infants. While their immune systems are new and devolving, they are capable of generating a vast amount of protective responses. The 14 vaccines on the schedule today contain less than 200 bacterial and viral proteins compared to the number used in 7 vaccines on the schedule in 1980, which was greater than 3000. Vaccines sold represent a small fraction of what a child’s immune system routinely navigates. The average child is infected with 4 to 6 viruses annually. On average, by the time they turn 18, children will have contracted over 72 viruses and illnesses, which is substantially more than the 14 recommended vaccines.

Autism is not an immune-mediated disease, as there is no evidence that the immune system is activated or of any inflammation in the central nervous system. Scientists believe that brain development issues and the factors that cause them is the main cause of autism. While there has been a worldwide increase in the amount of ASD diagnoses, this however is likely due to the broadened diagnostic criteria and increased awareness of ASD. There is also clear evidence of a strong genetic influence on the development of Autism. For example, if one identical twin is diagnosed with Autism, the other twin is 60 to 90 percent more likely to be diagnosed. Males are also more likely to be diagnosed with an ASD. Certain gene changes that occur during conception or early embryo development can increase the risk of a child having an ASD. There are also risk factors that play a role in a child having Autism; advanced parental age, pregnancy or birth complications, and pregnancies spaced less than one year apart are just a few. It is still not totally known what specifically causes autism, but enough research has been conducted regarding the link between vaccines and autism that scientists can definitively say vaccines and autism have no correlation. 

Vaccines may be the most controversial medical discovery in all of human history, but the benefits highly outweigh the risks. Parents should have their children inoculated because the diseases they prevent are still very much prevalent, and it could save not only their child’s like but the lives of others who are immunocompromised, elderly, or too young to receive their vaccinations. The vaccines are safe and effective, and the ingredients used to make them have no long term health effects. While vaccines do have side effects, they are minor and do not cause or increase the chances of a child developing autism.

Health care providers, such as doctors and nurses, should spend more time educating parents about vaccines and their benefits, while discussing any concerns about vaccine. Health care providers should educate themselves further on the subject so they can adequately discuss vaccination with patients. Information about vaccines should also be made readily available to parents so they can make informed decisions regarding their child’s health.

References

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