Vaccines: Keep up the good fight!

“We are worried about the side effects”. “Natural disease is healthier”. “Vaccination is against God’s will”. “The concept of giving an infection to prevent an infection is counterintuitive”. While many (all?) of these comments could be from current groups against vaccination; they actually were made in the early 1800’s in response to Edward Jenner vaccinating with cowpox to prevent against smallpox. I point this out to demonstrate the long standing fear some people have displayed against vaccines. For those of us who are proponents of vaccines, it is incomprehensible as to why people would not want to receive such life saving measures that vaccines have provided.

In 1900, one in five (yes, 20 PERCENT) of children in the US died before 5 years of age. In 2000, less than 1% of children die before five years of age. The biggest reason for the change in death rates is the prevention of infection related deaths. AND, vaccines have been the biggest weapon in the fight against infections. Infections that had been rampant, such as smallpox, polio, have been eradicated from the US. Other infections such as measles, pertussis and a host of other vaccine-preventable infections have been decreased by 99% or more from peak levels in the US. Most parents, and even young health care providers, have not seen many of the infections that use to be common in the US. That is a GOOD thing. I remember about 15 years ago, I was asked by a resident physician to help him identify the cause of a rash. I took one look and said; “chickenpox.” I still remember the look on the young doctor’s face as he turned to me and said; “Oh, THAT’S what chickenpox looks like!” When I was a child, your mother made the diagnosis! This transformation occurred due to vaccines. As I don’t want to bore you, I won’t provide more examples of the wonders of vaccines but believe me that there are dozens more stories that could be provided.

So, if vaccines have been so phenomenal, why does vaccine hesitancy continue? One major reason is that vaccines have done SUCH a tremendous job that parents have not seen the diseases the vaccines are preventing. Thus, they do not realize the pain, suffering and death that the vaccines are preventing. Many vaccine hesitant parents only hear of the potential side effects of vaccines and come to the conclusion that vaccines cause more harm than good. The truth is that only ONE vaccine-preventable disease (smallpox) has been eradicated from the world. ALL the others are there, ready to infect. Vaccines are the things that are keeping them at bay. Unfortunately, we have seen this play out many times over the last few years with outbreaks in the US of measles, mumps and whooping cough (pertussis). The other truth is that the common side effects of vaccines are mild (redness, pain and swelling at the injection site) and the more severe side effects are incredibly rare (less than 1 in a million).

Vaccine hesitant parents also argue that we are giving too many vaccines and this will “overload” our immune system. While it is true that we do give many more vaccines today than even 20 years ago, the number of antigens in the vaccines have dramatically dropped. Up to the 1990, we used whole cell pertussis vaccine in the US. As the name implies, the whole pertussis bacteria was used in the vaccine resulting in the child being exposed to over 3000 antigens. Currently, the ENTIRE CHILDHOOD VACCINE SERIES contains only 340 antigens. If a child tolerated 3000 antigens AT ONE TIME from the pertussis vaccine, how can 340 antigens OVER FIVE YEARS overload the immune system?

Vaccine hesitant parents argue that vaccines are “impure” and point to the small amounts of aluminum that are added to vaccines to make the vaccine produce a stronger immune response. However, people seem not to realize that breastfed babies receive more aluminum in breast milk than is contained in vaccines. We ALL know the incredible benefits of breast milk and CERTAINLY NEVER would advocate mothers not breastfeed!

Vaccine hesitant parents may still think it is healthier to get natural infection. A few years ago, people purposefully were contaminating lollypops with chickenpox and then selling them on the internet. The idea was that parents could have their children lick the lollypops and contract chickenpox and thus not need vaccine. I am not even going to address my thoughts of parents thinking this is a good idea. I bet you can guess them. However, it does point out the lengths people will go to avoid vaccines. People say, “It’s only chickenpox”. Granted, the vast majority of children (myself included) handled the infection just fine. However, before the chickenpox vaccine, 30-40 children a year would die from complications of chickenpox. Why take the risk if we have a safe way to prevent the infection?

A last example I will mention (trust me, I have A LOT more!) raised by vaccine hesitant parents is the reluctance to administration of HPV vaccine. I commonly hear that vaccinating the children against HPV will lead them to start having sex. This is absolutely not true and has been demonstrated in numerous studies. The ONLY thing HPV vaccine does is prevent cancer. Universal immunization of our children against HPV would result in a 90% decrease in cervical cancer and a 60-70% decrease in head and neck cancer. WOW! What other measure do we have that is so effective in preventing cancer? And who among us doesn’t know someone who has had cervical or head and neck cancer?

So, what do we do to help vaccine hesitant parents decide to vaccinate their children?

A first step is trying to understand. What scares the person about vaccines? What have they heard? Next, ask if you may share some facts with them. Don’t lecture. Don’t be condescending. THOSE techniques will shut people down in a heartbeat. Use stories to provide information. People relate to stories. Have good stories of how vaccines have led to healthy lives. Have sad stories of children who have suffered from vaccine-preventable infections. If you need some stories, I would be happy to share. But, I bet you have your own stories and those are much more powerful as they are YOUR truth.

If parents want to learn more about vaccines, direct them to reputable sites such as CDC.gov, AAP.org or www.vaccineinformation.org. A helpful handout can be found at https://www.immunize.org/catg.d/p4012.pdf

Finally, realize this will take time. Beliefs are not developed in a day and they won’t be changed in a day. But, with persistence, you will find some people who will change their minds. And, then, those people can help change the minds of others.

Keep up the good fight. It is the right thing to do.