The “do we or don’t we” debate – your vaccine questions answered.
Vaccines have probably been regarded with suspicion since the first was developed in 1796. Modern-day fears include the toxicity of some preservatives, whether routine shots cause autism, if Africa inherits the first world’s out-of-date, cast-off drugs and even religious persecution through poisonous medication. You couldn’t be blamed for being confused as a mother, but you may be doing more harm than good if you opt out of immunisation programmes.
Just a few months ago, the US government acknowledged that the health of a nine-year-old girl from Georgia, who had a pre-existing cellular condition, had been worsened by vaccinations she received aged one. It was accepted that her condition was “significantly aggravated” by the immunisation, which resulted in a brain disorder with autism-like symptoms. The government agreed to pay the Poling family for injuries caused by vaccines. This landmark case, seen by the medical community as a rare and unique event, has reignited the “do we or don’t we” debate.
“Vaccines are about a balance of risk,” says infectious disease specialist Professor Keith Klugman. “The risk is extraordinarily low (and strictly monitored by regulatory bodies). There’s a perception of the risks and problems of vaccines; but there’s no perception of the diseases, because they have largely been eradicated by vaccines.”
For example, smallpox was stamped out during the 1960s and 70s and in 1980, the world was declared smallpox-free. The disease no longer exists. This makes the pro-vaccine argument easy. Polio, transmitted the oral-faecal route through poor hygiene, today exists in only four countries on earth (India, Pakistan, Nigeria and Afghanistan).
Efforts to eradicate polio were hindered in Nigeria, when in 2006, religious leaders convinced parents they shouldn’t let their children be immunised. 888 cases of polio were recorded in 2006, compared with fewer than 30 in 2000. This pause was largely responsible for 25 countries becoming reinfected, and 1500 children becoming paralysed, in Africa, Asia, and the Middle East through importations of the virus, reported the British Medical Journal.
“When people stop immunising their kids, outbreaks occur, so it’s essential to maintain a vaccination programme,” says Dr Anne von Gottberg of the National Institute for Communicable Diseases in Johannesburg.
While we’ve made significant progress in paediatric health (84 percent of children under the age of one were immunised in SA in 2006, compared with 63 percent in 2000, according to the Health Systems Trust), there are still too many children dying from and being disabled by preventable illnesses. Professor David Bloom, economist from the Harvard School of Public Health, says: “Two thirds of the nearly 10 million child deaths worldwide each year are preventable.”
Instead of reaching our UN Millennium Development health goals of reducing child mortality, we’re in fact losing the battle. “In 1990, 60 children in every 1000 live births died before the age of five. In 2006, 69 per 1000 died,” says Von Gottberg. She adds that vaccines could prevent many of these deaths. “We reduced at least 71 percent of Hib (haemophilus influenzae type b) in children as a result of introducing a vaccine — and that’s a clear underestimation of the true impact of this vaccine.”
Experiences like that of the Poling family may be one in a million — but what if your child is the oneo Like thousands of others, Johannesburg mom Paula Parker gave her son a routine mumps, measles and rubella (MMR) vaccination at 15 months. “Ethan-Sean’s speech, hearing, attention span, social and behavioural development had been perfectly normal. But after the shot, there were significant changes. He no longer learnt new words, laughed spontaneously or clapped his hands. He even forgot words he already knew. It wasn’t just that he wasn’t developing normally — he was actually regressing. It may sound strange, but even his smile changed. After the jab, he only had three expressions: happy, sad and angry.”
By the age of three, Ethan-Sean was constantly crying and would wake up in the night anxious and frightened. Tests confirmed that he was behind developmentally, and a diagnosis confirmed that he had the autism-spectrum disorder Asperger’s Syndrome. Paula left her job to care for her son full time. Now nine, Ethan-Sean takes three sets of medication a day, including a high dosage drug for hyperactivity, and Prozac for anxiety. “I believe the onset of Asperger’s Syndrome could be a result of the MMR vaccine,” says Paula.
Paula is not alone. Many mothers share her feelings and experiences. Until genetic testing is available for underlying conditions, we just won’t know how great the risk is. This fear is prompting parents to ditch vaccines altogether. While they might argue that their children are unlikely to contract polio or rubella, the greater danger is to the community at large.
THE HERD EFFECT
If enough children are immunised (eg: 50 percent), the disease is reduced faster than the rate of immunisation (eg: 80 percent), because the disease virus or bacteria can’t circulate anymore — giving what is called herd — or community — immunity, explains Prof Klugman. This protects even those who have not been immunised.
But when people stop being vaccinated, the opposite is true, and it opens up the door for contagious diseases to flourish.”Routine vaccination programmes have greatly reduced mortality worldwide,” re-iterates Prof Klugman. “Vaccination is one of the few preventative health measures that directly saves lives. Prevention is always better than cure.”
YOUR QUESTIONS ANSWERED
Is there mercury in my child’s injection
A mercury compound (thimerosal), first used as a preservative in some vaccines in the 1930s, was found to be damaging to brain tissue, and has since been removed from vaccines, except those for flu.
The Centers for Disease Control and Prevention (CDC) in the US released an official statement saying: “There is no convincing scientific evidence of harm caused by the low doses of thimerosal in vaccines.” However, public health agencies and manufacturers agreed the compound should be reduced or eliminated in vaccines as a precautionary measure.
Dr Allan Puterman, a paediatrician in private practice, says: “Although some traces of an excretable mercury are present in some vaccines, no modern infant vaccines contain thimerosal.”
Do vaccines cause autismt
Recent estimates from the CDC’s autism monitoring network found that about 1 in 150 children have an autism-spectrum disorder. This estimate is higher than those from the early 1990s, and some believe increased exposure to vaccines explains the higher prevalence. “However, evidence from several studies examining trends in vaccine use and changes in autism frequency does not support such an association,” says the CDC.
“There is no doubt that the child in Georgia would have developed those symptoms anyway. They could just as easily have been triggered by a painkiller,” says Dr Puterman. The experts are unanimous: vaccines do not cause autism.
Can a vaccine give my child a disease “The whooping cough vaccine can cause some symptoms of the disease, but this affects only one in a million,” says Prof Klugman. Generally, vaccines contain only a portion of a weakened disease molecule, so there’s no chance of it causing disease, says Dr Puterman.
Aren’t our own immune systems able to fight diseasee
“It’s proven that our bodies haven’t got enough anti-bodies — otherwise outbreaks wouldn’t occur. It would be cruel not to give your child immunisations, you’re not the one who would suffer from the disease, ” says Sister Leanne Davies of Grassroots Clinic in Johannesburg. She adds that the absolute essential shots are polio and tetanus.
How our immune systems work
We have both innate (mucus, tears, skin, saliva) and acquired mechanisms. Acquired immunity can be either active or passive.
Active When our bodies build their own defence systems by making anti-bodies in response to a foreign body, bacteria or virus. This option offers longer-lasting protection, and occurs when a small molecule of a disease is shown to the body — as in most vaccines.
Passive When we’re given the anti-bodies. This protection lasts a maximum of three months.
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