There are so many times in my work as a doctor that I yearn for prevention, whether in the case of leukemia, a drowning, a car accident, or a teen suicide. We doctors (perhaps more than pharmaceutical companies) place a high value on prevention. It’s great to be able to treat diabetes, stop heart attacks or strokes, but isn’t it even better to understand and, if you can, eliminate the root causes of health problems?
We can do things like eat fruits and vegetables, manage stress, get exercise, check our cholesterol, blood pressure and blood sugar. But what would you think has prevented more illness and saved more lives than any other preventive measure recommended by doctors?
Depending on how you look at the data, the most effective of all preventive health measures doctors recommend is the immunizations on the childhood vaccination schedule. This schedule specifies the dosage, intervals and number of shots that children get from birth through adolescence. This schedule works. That’s why scientists have identified vaccines as the single most effective public health intervention we have next to clean water and sanitation.
We are all relieved when we can identify a baby with meningitis early and give brain-protecting antibiotics, but it is so much better to prevent that bacteria from infecting our baby in the first place.
My Dad was a pediatric resident in the 1970s. As I told him about my first career case of Hemophilus meningitis, 9 years after graduating from medical school, he began telling me about his time as an intern when it was routine to care for a baby or child with meningitis nearly every week. The difference was the vaccine that came out in 1985.
Today, children and parents worry little about diseases that used to be just as common as the flu, RSV or strep throat. These are yesterday’s diseases such as the crippling polio virus, the deadly Hib bacteria, devastating pneumococcal sepsis, the extremely contagious measles virus, the cancer-causing Hepatitis B virus, even Chickenpox, which for many of us parents over the age of 25-30 was almost a childhood rite of passage (little did we know at those “chickenpox parties” that some of our cohorts died every year from it). See this slideshow of the graphic proof of vaccines’ success. (Source link here)
But vaccines are also victims of their own success. Parents ask me why I feel it necessary to protect their kids against these illnesses. They think these diseases never really happen. Until they do. Measles is making a resurgence throughout the globe, and pertussis, or whooping cough, has been steadily increasing as well.
We are starting to see the downsides of parents giving their children shots on a delayed or partial schedule. Scientists have recently warned us that if we don’t reverse the growing trend of vaccine refusal, we could go backwards several decades in terms of infection control. Diseases that are now rare will become much more common. Vaccine refusal has recently reported by the World Health Organization to be one of the top 10 threats to global public health.
The real end goal of vaccinating is not just protecting a child from disease, it is eliminating it once and for all. That’s what we did with smallpox. That’s what we are now close to doing to polio, and were close to doing to measles 20 years ago, before people started believing a fraudulent study about the cause of Autism. We can’t hope for the elimination of these illnesses without adherence to the childhood vaccine schedule.
The decision to delay or skip vaccines is dangerous not only for the unvaccinated child, but for others around us that are too young, too old or too medically fragile to get immunizations of their own. A community of immunity protects the most vulnerable among us.
Unfortunately, there are plenty of people out there who, for various reasons (some of them financial or political), are willing to cast doubt on the life-saving vaccine schedule. This is accomplished by appeals to fear and distrust through the sharing of horror stories of children that were assumed to be harmed by a vaccine. Also, it was recently confirmed that Russian bots and trolls have spread some of these anti-vaccine messages globally via social media. These malicious foreign actors are playing to the fact that the vaccine debate has become a polarized hot-button emotional issue, along with many other topics, in our country. It also goes to show that we have to be critical of the source when it comes to consuming information, especially in the age of social media.
Skepticism about vaccines is nothing new, however. Edward Jenner met with fierce detractors in 1798 after he created the first smallpox vaccine after discovering that material from the cowpox virus induced immunity against the smallpox disease. This cartoon called “The Cow Pock- or the Wonderful Effects of the New Inoculation!” was published in 1802 demonstrating the “reported” side effects of the vaccine, including the spontaneous eruption of literal cows and cow-like parts from various parts of the body.
Today we are (hopefully) long past the fear of our children growing horns and hooves from their shots, but we would all do well to ratchet down the emotional temperature of the vaccine debate, take a deep breath, and take a look at the science behind our vaccine practices. Because the science is very clear: the vaccine schedule is effective and safe.
Did a vaccine cause a child’s condition? Maybe, maybe not. Kids get shots frequently enough that vaccines are an easy place to pin the blame. But the only way to know (and to be sure, we need to know) is through research. And we have lots of it.
If we are fortunate enough to have rational conversations with neighbors, family members and friends about vaccines, then we can emphasize that this kind of decision should be made based on scientific evidence, not emotional impulses.
In a future post, I will provide answers from science to many common questions I hear about vaccines from parents who are considering a delayed, alternative or “spaced out” vaccine schedule or not immunizing at all. I present evidence they will want to consider before they abandon the decades of scientific research behind an important preventive measure for their children.
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