Vaccinations

Cecil's Columns/Staff Reports
1

Jill’s Mailbag response on vaccinations ( http://www.straightdope.com/mailbag/mvaccine.html ) was great. I think it dealt well with both the emotional issues and the scientific ones. (It was so good, I linked to it at Skeptic News [ http://www.skepticnews.com ].)

HealthCentral coincidentally has an article about the battle over vaccines as well: http://www.healthcentral.com/news/KidsFamilyFullText.cfm?ID=40620&storytype=ReutersNews . It’s longer and, I think, not as good, but it does provide some additional information on the way the “scared parents” tend to think.

2

… and, BTW, this is a good time to remind adults that some vaccinations require booster shots. That’s especially so if you’re in an at-risk group, travelling to certain locations, etc.

3

tetnus, for example needs to be renewed every decade or so. Found out that I now have an allergic reaction to that one.

RE: OP, I agree that it is a very well constructed, point by point, reasoned, reasonable, compassionate piece on why all of us should vaccinate our kids.

In my experience, however, the folks who tend to overlook scientific evidence also tend to overloook well construction, point by point, reasoned, reasonable compassionate pieces, with the always powerful arguement “Yea, but…”

4

I believe that vaccinations probably do more good than harm. But I am not 100% convinced. The following quote sums up the fears of many parents

I’d like to see the Science News article, but I can’t find it online.

5

bibliophage, as you have discovered, Science News doesn’t usually post the full text of its articles online.

Last week’s issue has this article, Do more infections mean less asthma?, that describes that children who don’t have as much contact with other children in the very early years (in the case of the article, children kept out of day care) had more whezing episodes by age 8 than the children who did have more contact. The article says that the “hygiene hypothesis” (the human immune system needs something to keep it busy in early childhood) is “still controversial”, but that “several recent studies have bolstered that contention”.

Even assuming this is true, I would prefer that my child skip polio and have asthma.

6

do the studies you cite adjust for the increase in diabetes and asthma as a whole?

7

I was involved in was a pretty rough-and-tumble Great Debate on vaccination in early July :
Here is the link.

The basic argument over vaccine side effects, just like the debate over breast implant effects, is that no study can be conducted which is large enough to have the resolving power to firmly answer the question. Studies which show long term side effects or studies which “conclusively” rule them out often time are at the verge of the inherent noise in the system. This, and since the human body is so multi-variate, one can pick apart any clinical study. This is exactly what happened in the above debate, which centered around pertussis vaccination and encephalopathy.

I firmly agree with the Mailbag article. It is like preaching to the choir, however, as I am a medical student. For the people out there who have children who have suffered encephalopathy around the time of vaccination, no amount of science can justify the “cost-benefit” ratio of it.

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Arnold said:

As a person who has developed asthma, I will agree wholeheartedly.

Edwino said:

Of course not. To those few people, it’s horrible. But if their child suffered from polio or some other disease, that would be horrible, too.

9

That’s one of the big problems with testing the hypothesis. Some of these people argue that vaccinations are one of the leading causes of the increase in diabetes and asthma, so it’s hard to filter out exactly what’s the cause and what’s the effect, without a really solid, really scientific study. And such a study may not be forthcoming. In the U.S. at least, something like 98% of the population gets most of the recommended vaccinations, so it’s hard to find a control population. The 2% who don’t get all their vaccinations are not directly comparable to the rest of the population. Many of them are of a lower socio-economic level, and many others are home-schooled (and so may be less likely to come in contact with a whole host of germs). In addition, many of the supposed ill effects of vaccinations may take decades to develop (such as rheumatoid arthritis), so a study would have to be decades-long as well.

10

Dex’s made a good point about adult immunizations… you can find info. on recommended vaccinations for different parts of the world for travelers at http://www.cdc.gov. If you’re going to any under-developed part of the world (or even if you’re staying here, really), the new vaccine for Hepatitis A is a good idea. It’s also interesting to note that most tetanus in the US now occurs in the elderly who often don’t get boosters for this disease. - Jill
ps – just wanted to note that the mailbag column was written by my friend Dr. David Keller, not me.

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Here is the specific link to the CDC page on recommendations for travelers: http://www.cdc.gov/travel/

12

I greatly appreciate reading the excellent comments on the value of preventing disease via vaccinations.

Let’s remember that childhood immunization rates worldwide have increased from 5% to almost 80% in the last twenty years. This has granted life to approximately 3 million kids each year who would have otherwise died from a preventable disease such as measles. The big BUT is that this effort must continue every year, children need peace and security to find vaccination services available and a way must be found to reach that other 20% who are not vaccinated.

The September 2000 issue of Scientific American has an article on the development of edible vaccines. Whoa, does that bring up a bunch of ugly or fascinating issues: genetically modified bananas, feasibility of successfully vaccinating anyone who can eat a banana or tomato, getting rid of the cumbersome vaccination needles/seringes and the ‘cold chain’ which protects the efficacy of the vaccine, and taking it a stretch further, developing vaccines which may suppress autoimmune conditions such as Type I diabetes, MS and rheumatoid arthritis. Maybe these genetic immunizing bananas would deliver such a low dose of the vaccine that many of the severe adverse vaccine reactions would disappear.

Check your hepatitis B vaccination status.

13

I agree, it was a great mailbag response.

14

Just speaking from personal experience.

Having been born in 1959, I was born before most of the vaccinations for “common” childhood diseases were developed. I had most of them - chicken pox, mumps and the big one, red measles. I got the measles in 1962 and it nearly killed me. I ran a fever of 104 F and my mother had to bathe me with rubbing alcohol to keep my fever down. My doctor visited daily. Neither of them had anything to fear from me, they had been through the same thing.

The measles vaccine was developed in 1963. Since that time, hardly any child in North America has developed the disease, vaccinated or unvaccinated. However, a few adults who skipped vaccinations as children were exposed to it as adults. As an adult, measles can be even more life threatening than it was to a 3 year old child. Moreover, every doctor back then could diagnose measles instantly. Nowadays, even a skilled young dermatologist might be stumped (although a 60 year old G.P. would recognize it instantly).

To see how measles can paralyze a society, you can look at the Faroe Islands. The Faroes are too small (70,000 people) to have maintained a constant presence of the wild virus. Instead, it would visit every 30 years or so and wipe out part of the population in one fell swoop. They all get vaccinations now.

The chances of your being exposed to measles during your lifetime is almost certain. It is still common overseas and it is highly contagious and virulent. The longer you wait, the greater the risk.

Case in point, my young first cousin (age 7) once removed came to our family Christmas party after having gotten over the chicken pox. My mother (61) and cousin (22) caught it. My mother had it before and had a mild reaction. However, my cousin, who didn’t have it as a child, became severely ill and was out of commission for four weeks. A lousy way to celebrate Christmas.

I was immunized against the childhood diseases that ravaged the generation before mine - polio, diptheria and tetnaus. I’ve never had any of them.

Nowadays, epidemics are rare. We forget what having a disease is like unless you’re my age. 20 year olds don’t have memories of childhood diseases (except maybe chicken pox which was only recently vanquished).

15

Jill said:

Yeah, but you’re the official staff member and you thought to ask him, so you still deserve credit. :slight_smile:

16

On a related note, what about “natural immunities”

I was born in 68, and got the usual round of vaccines for the time - but this didn’t include a chicken pox vaccine. I have never had chicken pox, even when friends and relatives were dropping like flies from it. Is it possible to be naturally immune to something or have I just been incredibly lucky?

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[[I was born in 68, and got the usual round of vaccines for the time - but this didn’t include a chicken pox vaccine. I have never had chicken pox, even when friends and relatives were dropping like flies from it. Is it possible to be naturally immune to something or have I just been incredibly lucky?]]

You may have had an asymptomatic infection, but don’t count on it. Merneith, If you’re female and planning ever to have babies, you should probably get vaccinated against chicken pox. Acquiring this disease during pregnancy can cause some real problems for the fetus. Regardless, it’s a more serious disease to suffer through as an adult than as a kid.

18

Is it still even possible to get vaccinated against smallpox? OK, so we’re pretty sure that we’ve eradicated it in the wild. There’s still those two vials at the CDC and in Russia, though, and Russian biologists have admitted to doing research on smallpox as a biological weapon. Or suppose that a freak eathquake hits either lab, or that terrorists capture one, or perhaps there’s still a very small pocket of it in the wild. If a person is really paranoid about such things, and was born too late to get it normally, is it still possible to get a vaccination?

On another note, one bout of chickenpox doesn’t necessarily confer immunity. My sister and myself had it twice each.

19

My vote is for incredibly lucky. I agree with Jill. If you’ve never had chicken pox, a vaccine is a good idea. Lots of people don’t realize that the chicken pox virus can set housekeeping in your body and live for your whole life. In aged people, it rexpresses as shingles, a somewhat nasty disease.
Chronos is also correct. Immunity, whether from vaccinations or from infection, varies in length. Depending on lots of things, you may be immune for life or just a few months.

As I understand it, there are a few thousand doses lying around, and we could make more, but it’s not currently being produced, since there’s no market for it. That’s one reason the thought of its use as a weapon is so scary - a lot of people would die due to lack of vaccine before it was being produced at high levels again.
If you wanted to get a vaccine today, you’d probably have to have a good reason - like you were going to work for the CDC in a biolevel 4 facility.

20

Because wild smallpox has been eradicated, there is no routine vaccination for it anymore. There are many very rare diseases for which vaccine could be produced, but it would not be cost-effective to vaccinate everyone against these.