By Dr. Jack Skowron
I have been a practicing pediatrician for over 30 years now. While I have seen significant changes throughout the years, the most dramatic has been the drop in severe, life threatening infections.
I often used to care for patients hospitalized with meningitis, pneumonia, measles and other major infections. Now, I rarely see patients with these serious illnesses. The primary reason for this drop is the immunizations that we provide to our patients starting at a very young age, when they are the most vulnerable to dangerous infections and don’t yet have a mature immune system to protect themselves.
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This success has had a downside as well. As parents have less first-hand contact with serious infection and the internet has trumpeted the untrue “dangers” of vaccines, caregivers have understandably become more concerned, even resistant, to immunizing their babies. I’ll try to address some of the questions and concerns I have heard from parents in recent years.
“There are so many injections. Won’t they overwhelm the baby’s immune system?”
Because there are so many infections that CAN be prevented with immunizations, an infant will receive about 20 vaccines, up from the handful many parents remember from when they were young. This increase is a major reason for the decline of serious infections.
It is not true that “too many” vaccines overwhelm the immune system, as our bodies are constantly exposed to germs. The number of germs, or “antigens,” a baby is exposed to and fights off each day ranges from about 2,000 to 6,000. By contrast, the total number of antigens in all the vaccines a baby receives by age 2 amounts to only 150, split over many doctor visits – a small number compared to everyday exposure. Some may counter that, “my baby is too young for those immunizations.” On the contrary, the most dangerous period of a child’s life is the first two years. That is when a child is most prone to these severe infections that are vaccine-preventable.
”I’ve heard (or read) that vaccines cause autism.”
“Vaccines have mercury, which causes autism in children.”
These popular misconceptions started in England, where a researcher published an article linking autism and the measles vaccine. Subsequent investigation found the paper to be fraudulent, and the doctor lost his accreditation while the publication disavowed the article. This connection in the minds of many, though, won’t go away.
Many studies have been done, and no link has ever been found between any vaccines and autism. As for mercury, the version used in vaccinations as a preservative in years past, called thimerosal, was chemically different from the one in fish (and old thermometers) known to be toxic. The preservative version has been studied, and no medical problems have been connected to it. Nonetheless, manufacturers have removed thimerosal from almost all vaccines at present, so there is no longer any exposure. Of note, if thimerosal was related to autism, we could have expected fewer cases once it was removed from vaccines. This has not been the case.
Is there any truth to these old wives tales:
“It is better to get the infections naturally.”
“I’ve had the flu and did fine.”
“My mother used to bring us to the house of someone with chicken pox so we could catch it and develop natural immunity, and we did fine.”
The idea that flu and chicken pox are mild illnesses that one needs to get and develop a natural immunity to is inaccurate. The flu causes 36,000 hospitalizations a year in the United States, some resulting in death. While many more than this catch the flu and recover, I’m sure you’d agree this is not insignificant.
Chicken pox, before widespread immunizations, was known to cause brain infections, flesh eating strep and staph infections, toxic shock syndrome and pneumonia. About one child a week was reported to die from chicken pox as recently as 1999.
“I’ve heard that Gardasil, the vaccine for HPV (human papilloma virus), is being recommended as it prevents cancer. But my daughter is only 11 years old. Isn’t it too early to give her a vaccine for a sexually transmitted disease (STD)?”
This is generally a common response, and has to do more with worries about adolescence and the great unknown than the vaccine. There is a fear that receiving the vaccine will make the child feel that they can safely participate in sexual activity, causing them to become active earlier and more frequently than if they weren’t vaccinated. There are also vague concerns that, since the vaccine prevents an STD and cervical cancer, it must have some adverse side effects on fertility. The reality is that the vaccine causes no adverse effects on sexual function – only a decrease in cancer.
These worries are unfounded. There are studies that show no increase in the amount of sexual activity or earlier sexual activity in those that received Gardasil. The idea of waiting until one is sexually active to give HPV vaccine is like waiting until after you have chicken pox to get vaccinated for it. Once you’ve been exposed, your odds of catching HPV are very high, as the virus is very common in teens, adolescents and young people in their 20s. Also, studies have indicated that giving the vaccine at age 11 actually provides the best immunity. Later administration causes the antibody levels to be lower, meaning resistance to the infection is reduced.
In closing, I’d say that the success of immunizations has become part of the problem. In the 1960s, parents lined their children up to receive polio vaccine because they’d all seen for themselves the devastation of the polio virus. Since today’s vaccines protect our children so well, most of us don’t have first-hand knowledge of a child who has suffered from a serious infection such as meningitis. But, as recent news has demonstrated, while these infections are no longer common, they haven’t disappeared. When immunization rates drop, they return, as seen in recent measles outbreaks.
It is very important for your child’s health – and the health of the community – to keep their immunizations up to date. I did this with my two daughters, and recommend it strongly to all my patients.
Dr. Jack Skowron specializes in Pediatrics for AdvantageCare Physicians, one of New York’s largest physician-led multi-specialty practices and partner of EmblemHealth. ACP serves half a million patients in 36 locations throughout New York City and Long Island. Find out more at acpny.com.