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Why Vaccinate? |
When you have an infection, your body creates white blood cells that target, surround and destroy the infection. The efficiency of this process can vary from person to person, and with diet, stress, age, and general health. This explains why some people are more prone to illness than others.
The problem with developing this natural immunity is that it takes two to six weeks to code a white cell. Meanwhile the body suffers the consequences of the germ. With some infections this may result in permanent disability or death.
What is a vaccine?
When a medication triggers the immune process, we call this process vaccination. Vaccines are made by using killed germs, parts of germs, naturally occurring less severe forms of the germs, or live germs modified to be less dangerous. The vaccine is given when the body is healthy. The immune process occurs in the usual manner, but with a much lower risk of injury to the body while immunity develops.
Does vaccination work?
No medication is 100% effective. The protection triggered by vaccines varies from 50% (cholera) to 95-98% (measles). So, even if everyone in Australia were vaccinated, there would still be people who remained at risk of catching the infections.
Obviously, if the disease occurred at all, it would then be occurring in vaccinated people. However, we would lose the risk of epidemics because these people would be randomly scattered all over Australia. It would be unlikely they all would be exposed to the germ at the same time.
For instance, before 1998 the Australian rate of vaccination for measles was low. In epidemics in NSW in 1981 and 1984 there were 200,000 cases with 2,850 recorded hospital admissions. In the NSW epidemic of 1993-94, there were 271 cases of measles in the Northern Rivers with at least 15 children hospitalised.
Following the mass vaccination campaign for children in 1998, cases in the Northern Rivers fell to six. The few cases since recorded in this area have mostly been in adults who have not been adequately vaccinated and contracted the disease overseas.
Risk versus benefit
Many things in life involve risk. The chance of dying in a car accident, for example, is one in 6,000 per year, yet few of us would forego the convenience of travelling by car.
Similarly, any risks involved in using vaccines are outweighed by the benefits they offer. For example, measles is so contagious that before the measles vaccine was widely used, 90% of unvaccinated children would catch it before they reached 20 years of age. Of all these sick children:
· One in 25 developed pneumonia, often with permanent lung scarring;
· One in 2,000 developed encephalitis (brain inflammation);
· For every 10 with encephalitis, one died and up to four had permanent brain damage;
· One in 25,000 developed SSPE (progressive brain degeneration), which is always fatal;
· The overall death rate is one in 3,000 cases.
Following measles vaccination
1.78 million Australian children were vaccinated during the Measles Control Campaign in 1998 with 89 reported reactions. Of these children:
· 11 had an allergic reaction,
· 5 developed a fever,
· 3 developed a rash,
· 1 developed encephalitis.(1)
All 89 children have recovered.
Possible vaccine side effects are listed in the vaccine package insert.
Some people worry drug companies conceal bad reactions. But they should remember this would also have to involve the collusion of the World Health Organisation, parents and relatives, doctors and health workers in every country of the world. Each country that vaccinates has a system of tracking and reporting severe adverse reactions. The fact is that serious reactions are uncommon and in some cases so rare that there is debate they are related to the vaccine at all.
The risks of vaccination compared to the risks of the disease have been calculated several times (Galazka 1984, Velimirovic 1991, Koplan 1985, Holden 1987, etc). A typical vaccination program in a developing country will prevent about 45 childhood deaths and 12 serious handicaps a month, while causing one death in 22 years and one serious handicap in 7.5 years.
Do vaccines cause other diseases?
Some health concerns have been raised, and research worldwide has sought to clarify the issue.
SIDS
No evidence links cot death to vaccination, despite two generations of vaccination and studies of thousands of children worldwide. Japan ceased compensation payments for SIDS when it moved the age for first vaccination to 24 months but the rate of SIDS remained the same at 1.2 per 1,000 births. The death rate from vaccine-preventable illness rose and Japan has since reintroduced vaccination at a younger age.
The rate of SIDS in Australia was two per 1,000 until 1988 when parents were advised to put their babies to sleep on their backs. Since then the rate has fallen to 0.5 per 1,000 (2), yet our vaccination rates improved during this time. Two Australian studies of SIDS infants found more than half were either under-vaccinated, or not vaccinated at all.
Arthritis
Some vaccines cause transient joint pains, but true arthritis and other auto-immune illnesses such as lupus are not increased by vaccination.
Multiple sclerosis
Someone who already has MS can have a relapse if their immune system is given extra work to do, such as by vaccination, but the risk of developing MS is not changed.
Cancer
There is no increased risk of cancer following vaccination. In fact, cancer rates after vaccination are sometimes lower, eg. liver cancer rates fall with hepatitis B vaccination.
MMR vaccine, autism & Crohn’s disease
Signs of autism usually develop after the child reaches 14 months. Considering that children receive their first dose of measles, mumps, rubella (MMR) vaccine at 12 months, it is understandable that parents of a seemingly normal child blame the vaccine when trying to understand why there has been a change in their son or daughter. However, several hundred million doses of the MMR vaccine have been given worldwide since its introduction and extensive data have consistently demonstrated its safety and effectiveness.(3)
The World Health Organisation, British and American health authorities, as well as independent experts and research groups, have reviewed the existing data and scientific studies and concluded that there was no link between the MMR vaccine and autism or Crohn’s disease.
Do vaccines contain mercury (thiomersal)?
Vaccines listed in the Australian Vaccination Schedule for Children have not contained thiomersal since 2000.
"A healthy lifestyle protects against illness"
While death rates from all illnesses fell with improved sanitation and health care, the actual rates of catching each illness did not fall until vaccination was introduced.
For example, before HIB vaccination was introduced in 1993, about 500 Australian children would have serious infections a year with 10-15 deaths and 60-120 cases of permanent disability. With no significant change in our standard of living, the rate has declined, with 74 cases (4) in 1995 and 30 cases (5) in 2000.
In the health conscious Northern Rivers, there were 341 cases of whooping cough in 2001. This represented 7.66% of the recorded cases of whooping cough in NSW for a region with only 2.47% of the population.
Homeopathic vaccination
Because no statutory body regulates homeopaths, practices vary widely. However, as there is no worldwide data to prove homeopathy reduces the chance of catching vaccine-preventable illnesses, many homeopaths recommend conventional vaccination with homeopathic remedies given at the same time.
Who should not be vaccinated?
Some people should not receive certain types of vaccinations or should receive modified forms of vaccination. For example, those with abnormal immune systems. It is important to discuss this with your doctor.
Despite ongoing research towards safer and more effective vaccines, adverse reactions do still occur. It is important to be aware of the risks and to comply with the guidelines to reduce the chance of these occurring. However, these reactions are usually mild, and in every instance the benefits of preventing the illness far outweigh the risk of vaccination.
References
1. 'Let’s work Together to Beat Measles’ Immunise Australia Program, Commonwealth of Australia 2000, p29.
2. Child health since Federation, Australian Bureau of Statistics http://www.abs.gov.au/ausstats/abs@.nsf/0/3CE0381F7CBAB608CA2569DE0024ED6D?Open
3. Wakefield AJ, Murch SH et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitus, and pervasive developmental disorder in children. Lancet 1998; 351: 637-41
Letter from the Chief Medical Officer, Department of Health, to all doctors. Measles, MMR vaccine, Crohn’s disease and autism. 27 March 1998 PL/CMO/98/02
4. Australian Bureau of Statistics http://www.abs.gov.au/ausstats/abs@nsf/0/DFB6E8E019FFC121CA2569BB00164F66?Open&Highlight=0,HIB
5. Australian Bureau of Statistics http://www.abs.gov.au/ausstats/abs@.nsf/0/CE17C42793B0FB16CA256B35001586D6?Open&Highlight=0,HIB
The Northern Rivers Public Health Unit supplied figures referring to the occurrence of disease in the Northern Rivers of NSW.
See also
Immunisation resources: www.nrdgp.org.au/projects/immunisation
Reasons why people choose not to vaccinate
Cochrane Collaboration Consumer Network – Understanding health research
Sue Page is the manager of the immunisation project of the Northern Rivers Division of General Practice, as well as its GP executive manager. She practises in Lennox Head, NSW, Australia. Dr Page assists in theatre weekly and is a former GP obstetrician. She is the president of the NSW Rural Doctors' Association, the Far North Coast representative of the Australian College of Rural and Remote Medicine, a supervisor for the Royal Australian College of General Practitioners and a medical assessor for the NSW Medical Board.
This article was last updated in May 2002.
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