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Saved by the Dr. Bell

Vaccines - Miracle of the 20th century

salk-newspaper2My Irish grandmother from Staten Island, NY told me three stories in my childhood that influence my practice of pediatrics and position on vaccines. The first story was how her only brother died at 4 years of age from an ear infection (perhaps pneumococcus bacteria). The second story involved a boy down the street from her, in 1953?, who was healthy on a Tuesday and in an iron lung machine on a Thursday, eventually dying from paralysis due to polio. The last story was the day her mother gathered her 4 daughters around her to tell them the news of the Salk vaccine breakthrough, and they danced and cried tears of joy.

Sadly, I do not have parents crying tears of joy when I give vaccines to their children. Quite often I am confronted with questions regarding the science and safety of these vaccines: "Why now?" "Why so many?" "Is this really necessary?" "Doesn't that cause autism?"

To reassure parents, I have summarized my thoughts on these questions:

1. Many vaccine preventable diseases children contract are difficult or impossible to treat once contracted. For example, polio causes paralysis, measles causes neurological complications, including death.

2. Vaccines for serious diseases have been developed over the decades to prevent children from ever contracting these serious diseases. The Salk polio vaccine developed in 1952, when there were 58,000 cases that year. The measles vaccine was licensed in US in 1964, yet world wide caused 630,000 deaths in 1990.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm#fig1

3. Vaccines stimulate our immune system to recognize the disease virus or bacteria by developing memory antibodies, which will prevent the disease from ever entering the body.

http://www.healthychildren.org/English/safety-prevention/immunizations/pages/How-do-Vaccines-Work.aspx

4. All of these diseases are still around and causing outbreaks around the world. (diphtheria - Russia 1990-1993) (Polio outbreaks in Somalia, Kenya and Ethiopia in 2013)(8 outbreaks of Measles in the US from Jan to August in 2013). Smallpox, a deadly disease, is no longer around BECAUSE of everyone's compliance with getting the vaccine.

http://www.cdc.gov/measles/outbreaks.html

5. Vaccines may have risks, but everything we do is a calculated risk. Driving children to school, eating food at a restaurant, taking a new medication, etc. The calculated risk of a child contracting and being impacted by meningitis, pertussis or measles is far greater than any real risk from the vaccine. There are documented possible side effects from vaccines, but the protective benefits significantly outweigh the potential risks.

http://www.cdc.gov/vaccines/vac-gen/side-effects.htm

6. There is too much false information about vaccines: myths, anecdotal stories, alarmist websites and outright lies regarding vaccines as the cause of autism or other issues. English "scientist" Wakefield set the stage for MMR controversy with his flawed study which has since been disproven:

.http://en.wikipedia.org/wiki/Andrew_Wakefield A good summary of the controversy

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(97)11096-0/abstract The Lancet retraction.

http://pediatrics.aappublications.org/content/108/4/e58.short A study in American Academy of Pediatrics Journal disproving Wakefield

http://www2.aap.org/immunization/families/autismwakefield.html A better explanation of the controversy by the AAP.

7. The vaccine schedule was developed to protect infants and children from these diseases at the earilest possible ages. Epidemiological studies have been done to determine the best time to give the shots and how often to give them to provide the highest proportion of community protection. (We need a community with greater than 90% protection to prevent the given virus or bacteria from surviving in our population.

http://www.chop.edu/service/vaccine-education-center/vaccine-schedule/history-of-vaccine-schedule.html

8. Vaccines are tested and verified by the Federal Drug Agency,( FDA), the Center for Disease Control (CDC) with the Advisory Committee on Immunization Practices, (ACIP), and US Department of Health and Human Services - National Institute of Health (NIH), and approved by the American Academy of Pediatrics (AAP)

AAP http://www2.aap.org/immunization/

CDC http://www.cdc.gov/vaccines/

ACIP http://www.cdc.gov/vaccines/acip/index.html

FDA http://www.fda.gov/BiologicsBloodVaccines/Vaccines/default.htm

NIH http://www.niaid.nih.gov/topics/vaccines/Pages/Default.aspx

The development of vaccines - "The History of Vaccines"

http://www.historyofvaccines.org/content/articles/vaccine-development-testing-and-regulation

Vaccines and "overwhelming the immune system"

http://www.cdc.gov/vaccinesafety/Vaccines/multiplevaccines.html

I hope this helps. Remember that as pediatric physicians, we have trained and studied to provide the best care and protection for your child. This does come down to a question of trust. Do you trust your doctor and science, backed up by years of documented studies, experience and experiments? Or do you believe something you read on a website with no scientific studies or verification?

We doctors give these vaccines to our own children, and we want the best for your child. Our creed is "Do No Harm." There is no global conspiracy regarding vaccines. It is proven science. Delaying or changing the vaccine schedule for your child puts your child at more risk for disease, and puts every other child in our community at added risk.

A few other helpful links:

Vaccine Schedule: http://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

Top Parental Concerns: http://www.cdph.ca.gov/programs/immunize/Documents/IMM-917.pdf