Upping the “Anti” on Vaccines

You wouldn’t know it from much of what you read online and hear, but vaccines were created to benefit our lives and make us healthier; a study published in the November 14th Journal of the American Medical Association notes that death rates for 13 diseases preventable by childhood vaccinations are at an all-time low in the US. The study, Historical Comparisons of Morbidity and Mortality for Vaccine-Preventable Diseases in the United States, was done by the Centers for Disease Control and Prevention; historical records dating back to the 1900s were reviewed to gather estimates of cases, hospitalizations, and deaths for the diseases that children have been routinely vaccinated against. From the November 13th New York Times:

For nine of the diseases, rates of death or hospitalization had declined by more than 90 percent since vaccines against them were approved — and in the cases of smallpox, diphtheria and polio, by 100 percent.

For only four diseases — hepatitis A and B, invasive pneumococcal diseases and varicella (the cause of chicken pox and shingles) — did the rate of deaths and hospitalizations fall by less than 90 percent. Those vaccines are all relatively new — the one for chicken pox, for example, was adopted nationally only in 1995. Also, some diseases like hepatitis typically strike adults, who are less likely to have been immunized.

Dr. Paul A. Offit, chief of diseases at Children’s Hospital in Philadelphia, is quoted about who tends to get vaccinated today and who does not:

Until the 1990’s, he said, incomplete vaccination was most common among poor children with no health insurance. But the Vaccines for Children Program, created in 1994 by the Clinton administration, helped end that. It provides vaccines free to any eligible child, which includes 45 percent of American children, Mr. [Curtis] Allen [a CDC spokeman] said.

Now, Dr. Offit said, it is more common for children from wealthy or middle-class families to lack some or all shots, presumably because their parents have read about side effects or visited one of the many anti-vaccine Web sites. Most children are immunized as part of routine infant care or before they enter day care or school, but the number of states that allow religious or “philosophical” exemptions has increased.

“Anti-vaccine activists” who “contend that the shots given to children trigger autism, seizures or other serious side effects” are, notes the New York Times, in a “continuing stuggle” with public health officials. This week’s Time magazine seeks to account for distrust of vaccines:

Why, then, is there so much concern about vaccines? In the U.S., few health issues get people as riled up as the persistent, though almost completely discredited, argument that routine childhood immunizations cause autism. In the U.K., doctors and policy makers are debating whether to encourage universal vaccination against chickenpox, a step that U.S. medical authorities took in 1995. Even that debate — focused not on the vaccine’s safety, but on whether it’s really necessary — has become surprisingly bitter.

Vaccines, like any drug, do carry some risk — but in healthy children, that risk is minute. A very small number of immunized children will have an allergic reaction to the vaccine, sometimes so severe it kills them. The trouble is that people are very bad at translating the practical danger from such miniscule statistical risks. [my emphasis Most people, given the choice to vaccinate their kids and run a tiny risk of an allergic reaction, or not to vaccinate their kids and — as in the case of polio — face a risk of contracting a crippling, sometimes lethal disease, can’t figure out what to do: So, they’ll ask a doctor. And doctors know that most people can’t assess the risks clearly, which is why they get frustrated when a parent refuses to vaccinate a child.

On hearing of even a minute risk to a child’s health, the Time magazine article suggests, parents do something akin to panicking and try to avoid any dangers, even though other risks (such as catching a disease such as measles) are then possible. In our day and age, it is hard not to hear about the dangers of vaccines and autism.

My brief attendence at the National Autism Association last Saturday in Atlanta confirms this, anecdotally: There wasn’t a terribly huge crowd of parents being filmed with Jenny McCarthy about vaccines and autism, but their views why their children have autism were unanimous: Vaccines were the undeniable culprit and doctors, and pediatricians in particular, were blinded and disbelieving. The American Association of Pediatrics was referred to unfavorably amid discussion about mercury in the wicks of candles and fears that vaccines sent from “us” to “third world countries” are producing autistic children “throughout the world.” Throughout the filming, McCarthy spoke mostly in single sentences and made sure the camera and microphone were at hand.

With the combination of “vaccines and autism” getting the VJ treatment (and the top brass of various autism and “mercury causes autism” organizations meeting up in Atlanta), the “anti” about vaccines looks like it will have at least 15 more minutes of fame.