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Health experts: Benefits of immunizations outweigh low risks, but misinformation clouds picture

Health experts: Benefits of immunizations outweigh low risks, but misinformation clouds picture

April 21st, 2019 by Joe Gamm in News

Are vaccines safe?

The answer is “Yes,” if you ask advocates, children’s hospitals, health professionals, the World Health Organization (WHO) or the Centers for Disease Control and Prevention (CDC).

However, experts and health professionals are all too often not the sources concerned parents go to when researching medical information for their children.

More often than not, parents go online to find answers they require.

“It’s not that there isn’t good information out there,” Colorado pediatrician Sean O’Leary said. “It’s just that oftentimes, parents have trouble distinguishing between good information and bad.”

The science is overwhelming that the benefits of vaccines outweigh their low risks, said O’Leary, a member of the American Academy of Pediatrics’ (AAP) committee on infectious diseases.

People can put whatever they want on the internet, O’Leary said. People can post their personal beliefs as facts. And, there’s so much information online, “it can make your head spin,” he said.

What science says

The CDC website (cdc.gov) says the most common side effects of vaccinations are rare and mild and may include redness or swelling, while symptoms of diseases they prevent may be deadly. Serious reactions are rare.

The U.S. Food and Drug Administration must evaluate the safety and effectiveness of vaccines and approve them before they can be used in the United States.

After vaccines are licensed, they are monitored using the Vaccine Adverse Event Reporting System (VAERS), which collects reports of possible side effects.

Scientists use the CDC’s Vaccine Safety Datalink to study reported reactions and determine if possible side effects are actually related to the vaccines.

CDC data show about 90 percent of actual vaccine side effects are not serious.

The rotavirus vaccine (rotavirus causes severe diarrhea, vomiting, or fever in infants or young children) has been linked to a severe intestinal illness, but only one in every 65,000 children who received the vaccine developed the illness.

The CDC estimates vaccinations have prevented more than 300 million illnesses in children and saved the lives of more than 700,000 over the past 20 years.

The AAP has created a website to help parents find health information for children at healthychildren.org.

Going further, the Children’s Hospital of Philadelphia Vaccine Education Center website (chop.edu/centers-programs/vaccine-education-center) provides an array of details to parents about vaccinations.

The anti-vaccination argument

Despite all the science supporting safety of vaccinations, organizations like the National Vaccine Information Center (NVIC), advocate for fewer vaccinations.

And the percentage of children in the U.S., ages 19-35 months, who received no vaccinations increased from 0.3 percent in 2001 to 1.3 percent in 2015, according to the CDC.

NVIC has become a leading anti-vaccination organization, and has been criticized for providing misleading information about vaccines.

It advocates for informed consent — in which patients give doctors permission to perform treatments based on knowledge of its possible risks and benefits — specifically for vaccinations. It has been criticized for not telling readers how uncommon risks are or how beneficial immunizations can be.

Organizations like and including the NVIC have in the past cited data from a now debunked and discredited study of the Measles, Mump, and Rubella (MMR) vaccine, erroneously linking it to autism.

More than 20 studies have since found no connection between MMR and autism. The original paper from 1998, authored by Andrew Wakefield and 12 others, has been retracted by the publisher. And, Wakefield was stripped of his medical license.

Books have been written debunking Wakefield’s research, said Brian Conley, a pediatrician at SSM Health Medical Group-Pediatrics in Jefferson City.

Wakefield’s team studied a small set of children.

“If you go back and look at videos of their birthday parties,” Conley said, “the diagnosis of autism could have been made way before they even got their 15-month vaccines.”

However, the “research” and other sources attract parents who seek reasons to opt out of getting vaccinations for their children are putting them at risk, officials said.

Opting out of vaccinations

All states allow patients to opt out of vaccinations for medical purposes.

Medical purposes may include having cancer, an allergy or another illness that compromises the patient’s immune system.

In Missouri, the main reason people would be allowed to opt out of immunizations is if they are “immuno-compromised” — they have a weakened immune system caused by an illness such as AIDS, diabetes or cancer, or a genetic condition, said Jennifer VanBooven, the state Department of Health and Senior Services Bureau of Immunizations chief. There would be medical documentation of the condition.

“One of our main concerns at the Missouri Department of Health and Senior Services is the potential risk for children being exposed to diseases who are too young to be vaccinated or children who have health concerns that prevent them from being vaccinated,” VanBooven said.

Increasing numbers of unvaccinated people leave the community at risk of outbreaks of preventable diseases.

“The latest thing that we face in our practice is people are starting to look at religious exemptions,” Conley said.

In three states, California, Mississippi and West Virginia, people may opt out only for medical reasons. In the other 47 states and the District of Columbia, patients may also opt out for religious reasons.

Dutch Reformed Congregations have a tradition of declining immunizations because they say immunizations interfere with divine providence, according to a report from the Vanderbilt Medical Center.

Faith healing denominations — whose basic tenets include the belief that disease can be cured or prevented by focused prayer — may oppose vaccinations.

Conley said he looked at the concerns within the Roman Catholic Church, Islam, Budhism and other churches.

“The only thing I could find was the Church of Scientology. This is the only church I could find that had an actual religious reason for not vaccinating their children,” he said.

The Catholic Church has objected to using vaccines that were created using cells from two aborted fetuses (one in Norway and one in the United Kingdom), Conley said. Vaccines are no longer produced from fetal cells.

“The Catholic Church has given pretty clear guidance that children’s need to be protected against potentially deadly diseases is paramount,” he said. “Actually, if you look at some of the popes, Pope Benedict XIV was inoculated in 1757 against small pox.”

Pope Francis has been very supportive of South Americans receiving the polio vaccine, Conley added.

There are fact sheets on the state health department’s website (health.mo.gov) that can provide information for parents and health care workers on the state’s medical or religious exemptions, VanBooven said.

A new reason to opt out arises

Anti-vaccination supporters have shifted to the argument that they should be allowed to opt out for philosophical reasons.

Seventeen states now allow patients to opt out based on philosophy. Missouri is not one of them.

It might be if House Bill 711 were to pass.

A premise behind HB711, said its sponsor, Rep. Lynn Morris, R-Nixa, is that he wants to eliminate mandates.

“I’m just against mandates. I don’t like mandates,” Morris said.

The bill would prohibit public schools, day care facilities and doctors’ offices from preventing a child from attending the facility if the child’s parent has received a legal exemption.”

“I want people to be vaccinated if they want to to be vaccinated,” he said. “I was vaccinated. My wife was vaccinated. My children were vaccinated. My grandchildren were all vaccinated.”

Now, children receive about 70 vaccinations, he added.

However, studies show without the bank of vaccinations children receive, their health could be burdensome to communities.

There are about 4 million children born every year in the U.S., Conley said. A study looked at the children born in the U.S. in 2009. If they did not receive vaccines, he said, there would be 42,000 early deaths, 20 million cases of disease and a net direct cost of $13.5 billion and $68.8 billion in societal costs.

“For every dollar we spend on vaccines, we reap the benefits of $3-$10,” Conley said. “A lot of things in medicine get down to cost-benefit ratio.”

He tries to share what he has witnessed in a long career as a pediatrician.

“I’ve been doing this for 32 years,” Conley said. “I’ve given thousands and thousands of vaccines, and I’ve never seen a complication.”

Back when doctors used to give the live polio vaccine, they knew that one in 2 million patients would develop polio from the live vaccine.

Fortunately, Conley said, he never had a patient develop polio. However, when he was working at Boone Hospital in Columbia, he saw an 18-year-old who had polio. He saw a 67-year-old woman with tetanus. He saw measles.

“The thing my partners have never seen because we now vaccinate for it is hib meningitis,” Conley said.

The head of infectious diseases at Children’s Mercy Hospital in Kansas City recently published an article about Mennonite children who developed the infection because they had not been vaccinated, he said.

“Parents have a right to make decisions for their children,” Conley said. “But, we want to make sure they’re good, informed decisions.”

HPV is one of the recent breakthroughs in medicine. It is capable of preventing more than 90 percent of cervical cancers. And, it has been found very effective in preventing specific cancers in men.

However, there is opposition to it.

In the U.S., opposition appears to be based either on the concern it is unsafe or on the premise that without the fear of genital warts or cervical cancers, children would be more promiscuous, according to the American Medical Association.

There is confusion for adolescents about HPV vaccine, which was developed in 2006 to prevent cervical cancer in women, Conley said.

“(Consumers) see that in 2009 — it was FDA-approved for men to prevent penile, anal and head and neck cancer,” Conley said.

Just before Christmas, the FDA widened the recommended ages for women to use the vaccination from 9-26 years old to 9-45 years old, because there is less cervical cancer.

“The vaccine is working,” Conley said. “There’s no reason any woman should die of cervical cancer when you have a vaccine to prevent the cancer.”

With all the misleading information available, it’s difficult for doctors to get through to parents about the importance and safety of vaccinations, he said.

Health and Senior Services provides training that helps health care providers make strong recommendations to parents and address their concerns, VanBooven said.

“The department has a number of campaigns that supply reliable information,” she said.

This weekend, it launched a campaign in conjunction with the Kansas City Zoo supporting National Infant Immunization Week (April 27-May 4). The campaign is a play on “herd immunity,” which is the concept that when enough people are vaccinated, they protect those who cannot be vaccinated for medical reasons.

“We really do care about individuals across the lifespan,” VanBooven said. “That’s why one of our main goals is to increase immunization rates.”