Finding facts in the vaccine controversy

News February 28, 2013 6 Comments

by Sue Ann Rybak

- The first of a two-part series on the vaccination controversy.

While the debate about whether vaccines cause autism rages on, no one would argue that vaccines do not save thousands of lives a year. Before the advent of vaccines, parents in the United States worried that their child might fall victim to diseases that are now preventable thanks to widespread vaccination.

• Polio would paralyze 10,000 children;

• Rubella (German measles) would cause birth defects and mental retardation in as many as 20,000 newborns;

• Measles would infect about 4 million children, killing about 500;

• Diphtheria would be one of the most common causes of death in school-age children;

• A bacterium called Haemophilus influenza type b (Hib) would cause meningitis in 15,000 children, leaving many with permanent brain damage;

• Pertussis (whooping cough) would kill thousands of infants.

Recent concerns about vaccine safety have caused many parents to decide not to vaccinate their children. As a result, “herd immunity” or community immunity has decreased. Unvaccinated people are protected – indirectly – by vaccinated people. Herd immunity is important because there are people who cannot be vaccinated.

“There are roughly 500,000 people in the United States who cannot get the vaccine,” said Dr. Paul Offit, chief of the Division of Infectious Diseases and director of the Vaccine Education Center at Children’s Hospital in Philadelphia.

He said people may not be able to receive the vaccine because they are getting chemotherapy, receiving immune suppressant therapy or they are too young.

“They need those around them to protect them,” Offit said.

Offit said for herd immunity to work against highly contagious diseases, such as chicken pox, measles and whooping cough, 90 to 95 percent of the population must be immunized.

“A perfect example would be the measles epidemic in January 2008 in San Diego,” Offit said.

Offit said a mother took her child to Switzerland, where he contracted measles and later infected 11 other people. He said the mother didn’t know what measles looked like but 50 years ago we all would have known.

“The mother takes her child to the pediatrician’s office where she proceeds to expose everyone in the doctor’s office to the measles virus,” Offit said. “Three of the children in the office were less than a year of age. So, they hadn’t gotten the vaccine, yet. All of them got the measles. One of them was hospitalized and almost died.”

Vaccine fears vs facts

“There is an underlying readiness to distrust who ever is saying this is okay – especially pharmaceutical companies,” said Susan W. Nordolf, a nurse practitioner at Mt. Airy Pediatrics. “People want a guarantee, and in science there is no guarantee. It’s about the process.”

Nordolf, who lives in Mt. Airy, said the idea that vaccines cause autism and other diseases is a myth.

“The evidence so far proves that’s not the case,” she said. “Vaccines are sometimes the victim of their own success. We justify our risks according to what we’re afraid of. Who’s afraid of polio here? But, people who lived through the ’50s will tell you about it. The problem is that people are more afraid of the vaccine than the disease.”

“I think its OK to be skeptical about anything you put into your body,” Offit said. “But if you look at the data about vaccine safety, you’ll get vaccines every time assuming you don’t have a severe allergy or other medical health problem. The problem is when people decide they want to make their own decision, they typically get their information from the Internet, which can be a terrible source of information.”

“A choice not to get a vaccine is not a risk-free choice,” Offit said. “It’s just a choice to take a different risk.”

The anti-vaccine movement

Offit has been accused by critics of having a financial motive for supporting vaccines, as a co-inventor of the rotavirus vaccine, RotaTeq, recommended for universal use in infants by the CDC. He is also the author of “Deadly Choices: How the Anti-Vaccine Movement Threatens Us All.”

Offit said any royalty he gets from his books are donated to charity.

“I am co-inventor of a vaccine,” Offit said. “I mean that’s a good thing. It shows I have an expertise in vaccines. It tells you I care about children. I am sorry it upsets people, and it does upset some people that there is a financial component. It was never the motivation for what I did. It certainly wasn’t the reward for what I did. I am proud of it.

“It amazes me actually that people will listen to people like Jenny McCarthy, who gets paid to write books, and say that’s the person who I am going to trust,” Offit said. “I am not going to trust the experts. I am going to trust this former playmate model.”

Preventable diseases on the rise

Pertussis, a respiratory illness commonly known as whooping cough, is a highly contagious disease causes by a type of bacteria called Bordettal pertussis. Pertussis is usually spread through the air by respiratory droplets, such as those generated by coughing or sneezing while in close contact with others. The disease is often mistaken for the common cold in the beginning stages. The infection starts with a mild cough, runny nose and slight fever. But after one to two weeks, a severe cough, often accompanied by a “whooping” sound. It is typically characterized by episodes of multiple, rapid coughs without any break.

The disease literally leaves its victims literally gasping for air.

According to the Center for Disease Control (CDC), more than 41,000 people contracted pertussis in 2012. As of Jan. 5, 2013, 18 pertussis-related deaths during 2012 were reported to the CDC. More than half of infants less than 1 year who get whooping cough end up requiring hospitalization. Children less than 3 months are at highest risk of complications and death. According to the Children’s Hospital of Philadelphia (CHOP) about 7 out of 10 deaths occur after the infant gets pertussis from a parent.

The most effective way to prevent pertussis is through vaccination with DTap for infants and children. The CDC recommends that preteens, teens and adults get vaccinated with DTap because protection from the childhood vaccine fades over time.

According to the CDC, the number of measles outbreaks reported in the United States in 2011 jumped to more than four times the usual number, leading to a 15-year high of 222 people contracting the infectious disease. Of those 222 cases, 90 percent were related to foreign travel and 86 percent were not vaccinated against measles or did not know if they were vaccinated.

“No vaccine is 100 percent effective,” Offit said.

“The measles vaccine protects 95 percent of those immunized,”according to the The National Network for Immunization Information (NNII). “It is important to understand that when a vaccine fails (which happens 5 percent of the time for measles), the chances of being infected are reduced if everyone nearby has also received that particular vaccine,” an NNII article entitled “Community Immunity” pointed out.

According to the CDC, measles elimination has been maintained in the United States for more than a decade through high population immunity.

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  • Philly Skeptic

    Vaccination is so important for everyone. It is good to see this discussion in CHL. Keep up the good work!

  • Bob105

    The San Diego measles outbreak in 2008 cost $10,736 per case to contain according to the public health twits. In 1964 my entire elementary school came down with measles. We had over 200 cases. Not one kid had to see a Doctor. Not one kid had to go to the hospital. We had to stay home for 4 whole days! Thank God for “Leave it to Beaver” because it was hard to stay home for 4 days. So let me get this right, today a harmless outbreak like this would cost over $2,000,000.00 to contain? Is it any wonder our health system is the worst in the world.

    What this article also fails to mention is that out of the 10,000 cases of Pertussis in the California outbreak, 90% of the cases were in fully vaccinated kids. They all had over 7 shots for pertussis. Sounds like a great product. I’ll take mine with organic mercury please!

    • http://www.facebook.com/heatherjohnson.parentingpatch Heather Johnson

      You are missing the point.

      First, how many kids died before vaccination versus after?

      Second, herd immunity works only when the majority of the herd is vaccinated. Herd immunity protects both those who are vaccinated and those who are not. No vaccines is 100% effective. However, the more people who are vaccinated, the less likely everyone will stay healthier.

      You are part of the problem. You are one of the reasons why vaccines are not working as well anymore.

    • Philly Skeptic

      Measles killed 421 people in the U.S. in 1964. Other complications from measles include diarrhea, otitis media, pneumonia, encephalitis and seizures. That’s not exactly a “harmless” disease. Before the vaccine was introduced there was an average of 530,217 cases of measles in the U.S. every year. When vaccination was introduced that number immediately plummeted below 100,000 and continued to drop. In 2010 there were 61 cases of measles.

      All of Bob105′s “facts” are wrong. People who are not vaccinated are at a much higher risk for vaccine-preventable disease. Pertussis is a 5 shot series not “over 7 shots.” And there is no mercury in any U.S. pertussis vaccine.

      • Bob105

        Wow. Are those the best numbers you can pull out of you butt? I had measles. My only serious symptom was boredom because I had to stay home from school for 4 days. Sorry to rain on your $100 billion parade.

        Heather, I know thousands of vaccine injured children and their parents. It’s just tragic what has happened to them. Maybe I’m a problem to you and the other pushers, but if I can help one family avoid what we’re going through I’ll at least feel some relief..

        • Philly Skeptic

          Sorry to rain on your parade, but these numbers are published in the clinical vaccine textbook “Epidemiology and Prevention of Vaccine-Preventable Diseases, 12th Edition, Appendix G.” It’s nice that you had a mild experience with measles, but that’s not the case for everyone. Typically it is younger children under 5 years old who experience the more serious complications of measles. Mortality rates can be even higher in nations with less developed health and sanitation systems. Immunization in Nigeria dropped measles morbidity 92% and mortality from 20% to 2% in a matter of years.