The Hot Debate: To Vaccinate or Not

As Director of Hospital Epidemiology for Cedars-Sinai, Rekha Murthy, MD, has led innovative programs to reduce the spread of hospital-acquired infections and communicable diseases. Dr. Murthy directed Cedars-Sinai’s widely imitated initiative to increase hand hygiene compliance among patient caregivers, including physicians. She also led a program to reduce environmental contamination, including using bacteria-resistant materials such as antimicrobial curtains to retrofit patient rooms. She also has led Cedars-Sinai’s proactive efforts to respond to emerging public health threats like bird flu, Ebola virus and severe flu seasons. Today, Dr. Murthy takes a moment to answer some of the vaccine safety questions she gets asked most often.

How did vaccination become such a hot-button issue?

Many people believe that parents began questioning vaccines in the late 1990s when a highly respected medical journal published a study that linked vaccines to an increase in autism. That doctor’s studies have now been proven to be fraudulent, but many people continue to believe this myth. I also think there is another factor at work. As certain diseases become more rare thanks to vaccines, people forget just how terrible many of these illnesses are. Sometimes, it isn’t until there is an outbreak of a disease like measles that we get a wakeup call to remind us of how vulnerable we are.

But many people think that diseases like the measles are just a childhood inconvenience that everyone gets and a week later, they’re fine. So what’s the big deal?

The big deal is that for the majority, measles can be a relatively minor illness, but for an important minority of patients, there can be serious and even life-threatening complications like brain swelling or pneumonia and even ear infections that can lead to permanent hearing loss. In the early-1960s, before the measles vaccine became widespread in the U.S., 450 people, mostly children, died of measles every year.

The longer we have a vaccine, the more we forget the serious complications that can occur. One example of this is pertussis, which is also called whooping cough. In the 1940s, 200,000 U.S. children came down with whooping cough every year and 9,000 died every year. Today, we see fewer than 40,000 cases and about 20 deaths each year. That progress is due to the vaccine.

If we have eradicated some diseases in the U.S., then why does my child need to be vaccinated?

The fact is that these diseases have not been eradicated from the world. Even polio has made a resurgence in the Middle East and in Africa, and there are many epidemiologists who believe a resurgence of polio in the U.S. is only a plane ride away. Vaccines prevent you from getting a disease and also protect those in our community who can’t get vaccinated. For example, a child with leukemia can’t be vaccinated against the measles while undergoing leukemia treatment. When enough people in a community are vaccinated, diseases can’t spread like wildfire.

Even though the vaccines and autism link has been proven false, isn’t it true that there can be complications from vaccines?

No doctor can guarantee that you won’t ever experience a complication, but most are minor and disappear within hours or, at most, a few days, such as a sore arm at the vaccination site or a low-grade fever. For example, the Centers for Disease Control and Prevention estimates just one child out of a million would have serious complications from a whooping cough vaccine. You can’t say there are absolutely no risk factors but we physicians need to do a better job of informing parents that the risk is tiny and the benefit, both to your child’s personal health and to public health, are huge.

Are vaccines just for kids?

There are vaccines recommended for every age group. Everyone should get a flu shot every year – even pregnant women. For children, the common vaccinations are against measles, mumps, rubella, tetanus, diphtheria, polio, chicken pox, meningitis and pneumonia. For adults who can’t remember whether they had certain illnesses, a simple blood test in your doctor’s office can reveal what vaccines you need. Adults also should talk to their physicians about getting vaccinated against hepatitis and shingles.

Why do some parents believe that a vaccine changed their child?

It’s a very personal experience. It’s very hard when you are a parent, and you are trying to pinpoint when and why your child might be going through behavioral changes. As a doctor, I know that I can’t dispute a parent’s individual perception, but I also know that science is fact and not a matter of opinion. In America, we are fortunate to have a really good public health system that was built on the foundation of vaccines. It’s important that we keep that foundation solid so we can continue to have the ability to protect all of us.

-This information provided courtesy of Cedars-Sinai Medical Center


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