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Michael Abrahams | The unfair vilification of vaccines

Published:Monday | May 23, 2016 | 5:05 AMMichael Abrahams
Abrahams

Vaccines are biological preparations that provide active acquired immunity to particular diseases, and can provide years of protection from them. A vaccine typically contains a substance that resembles a disease-causing virus or bacterium, and is made from weakened or killed forms of the micro-organism, its toxins or one of its surface proteins. The substance stimulates the body's immune system to recognize it as a threat, destroy it, and keep a record of it, so that the immune system can more easily recognize and destroy the actual germ in its natural state should it be encountered.

Immunisation, the process by which a person is made immune or resistant to an infectious disease by vaccination, has been one of the best tools used to prevent disease. It is one of the most cost-effective health investments, and it has been estimated that the procedure averts two to three million deaths annually. The World Health Organization (WHO) reports that licensed vaccines are currently available to prevent twenty-five infections.

One of the greatest successes of the process of immunisation is the eradication of smallpox. Smallpox is a devastating acute contagious viral infection, which caused skin rashes, disfiguring scarring, limb deformities, blindness and many deaths. The epidemic of 735–737 in Japan is believed to have killed as much as one-third of the population. In 1980, the disease was declared eradicated following a global immunisation campaign led by the WHO.

Poliomyelitis (polio) is another infectious disease whose impact has been significantly attenuated by immunisation. The disease mainly affects children under 5 years of age, with 1 in 200 infections leading to irreversible paralysis, killing 5 per cent to 10 per cent of those paralysed when their breathing muscles become immobilised. As a result of a global effort to eradicate the disease, polio cases have decreased by over 99 per cent since 1988, from an estimated 350,000 cases then, to 74 reported cases in 2015.

Unfortunately, the anti-vaccination movement (anti-vaxxers), which blames modern vaccination for a wide range of health problems, has influenced many to be suspicious of vaccines and to reject them for their children. The most vocal members of the movement have little or no medical or scientific credentials, but speak convincingly about the ‘evils’ of vaccinations. Their concerns are, however, understandable, as children constitute the most vulnerable among us, and it is our duty, as adults, to protect them.

One of the biggest concerns expressed is the possible association between vaccines and autism. Autism is a developmental brain disorder, characterized by difficulty in communicating and forming relationships with other people, and in using language and grasping abstract concepts. The disorder has many variants, presenting with a spectrum of behaviours ranging from mild eccentricity to severe impairment, requiring life-long care. A study published in the respected medical journal The Lancet, in 1998, reported that eight families claimed that their children develop signs of autism within 14 days of receiving the MMR (measles, mumps and rubella) vaccine. However, inconsistencies were found in the author’s research methods, and he was eventually found guilty of professional misconduct and struck off the medical register. The Lancet later withdrew the paper 12 years after the study was first published. Since then, no researcher has been able to replicate the findings of the study and prove a link between vaccination and autism. But many persons remain sceptical, partly as a result of mistrust of the pharmaceutical industry, as some drug companies have been found guilty of suppressing information exposing side effects or complications associated with their products which may place consumers at risk.

The fact is that vaccines, like any other pharmacological agents, can cause side effects. Typically these are mild, and include soreness at injection sites, headaches, and low-grade fever. Allergic reactions are also possible. But the negative effects from vaccinations pale in comparison to the possible devastating sequelae of the infections that they prevent. What people also need to understand is that vaccination does not only protect those being vaccinated, but also the communities that they are in.

Herd immunity, also known as community immunity, refers to the protection offered to everyone in a community by high vaccination rates. With enough people immunised against a given disease, it is difficult for the disease to spread in the community. This offers some protection to those who are unable to receive vaccinations, including newborns and individuals with chronic illnesses, by reducing the likelihood of an outbreak that could expose them to the disease. So, if a child who is immunocompromised with a disease such as cancer or leukaemia is sitting in an emergency room or the waiting room of a paediatrician’s office, and a child with measles enters that space, the first child is at serious risk, as contracting the infection may cause serious debilitation or death. A population therefore needs to be immunised to protect the people who cannot be immunised.

Measles vaccination resulted in a 79 per cent drop in measles deaths between 2000 and 2014 worldwide. However, spring 2015 saw the first death from measles in the United States in 12 years. At that time, measles infections in the country were at their highest since the disease was supposedly eradicated, and this was associated with a decrease in the numbers of people being vaccinated.

Most of us have never seen someone disfigured by smallpox, on life-support for tetanus or poliomyelitis, or suffering from brain damage from rubella or measles, but many of us have seen autistic children, so that condition is real, and frightening, for us. But the benefits of immunising our children far outweigh the risks. If you are a parent or guardian and have declined it for your child or ward, please reconsider. You will be protecting not only the child, but also your community.

- Michael Abrahams is an obstetrician and gynaecologist, comedian and poet. Email feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or tweet @mikeyabrahams.