Intro

All content of this blog is my own opinion only. It does not represent the views of any organisation or association I may work for, or be associated with. Nothing within this blog should be considered as medical advice and you should always consult your Doctor.

Why Parents Are Confused About Vaccinations...

I have always been confused about vaccines, to be honest attempts to pick fact from fiction turn my brain to mush.  I frequently feel like I'm reading propaganda from both sides, and whilst for some there is no debate to be had, and that's fine either way (I envy parents who are so certain about these things), many more tell me they are utterly confused.

Many falsely believe people are reluctant to vaccinate solely because of Dr Andrew Wakefield and the whole MMR affair,  but I think that's really quite untrue.

 Today we are in the position of being able to draw information from across the globe; the internet connects people worldwide and parents are no longer solely influenced by their pediatrician, health visitor or doctor.  Instead debate rages on social media, links are pulled from a vast array of medical journals and websites as the discussion ping pongs back and forth.

My mum often comments that things were simpler in her day, "when we didn't know so much", and in a way I understand what she means. On the one hand having access to medical texts, studies and cross cultural opinion to allow choice is enlightening. On the other there is a strange comfort in just doing what an "expert" says and the blame sitting squarely with them should anything not pan out as expected.  But the more people know, the more they question - and this is where vaccination is running into problems.

Profit/Trust.

Firstly we have the problem of profit, and the fact many more parents are now aware what some will do for it; manufacturing and selling vaccines has to be extremely profitable.  The number given has sky rocketed since the 1980's and before reaching a year old children in the UK will have had at least 20 vaccinations if the full schedule is followed. For those who appreciate companies can and do take risks with the health of our children, it's hard to blindly trust what we are told.

As an example, baby food manufacturers wont increase the age on their jars of food from 4-6 months (despite contradicting The World Health Organisation and UK guidance), despite the health implications, because of profit. Formula companies employ insidious marketing techniques, whilst producing a product often loaded with aluminium and dubious iron levels.

The Politics of Breastfeeding (when breasts are bad for business), perfectly highlights how when something makes that much money, it's incredible influential.

But where things get really confusing is when one starts comparing the information from countries that don't vaccine against a specific disease, to those that do.  For example Chickenpox (Varicella)

The US vaccinates against Chickenpox

The CDC say (quotes from various pages in no particular order):
"Chickenpox Can Be Serious. Protect Yourself and Your Child."
"The best way to prevent chickenpox is to get the chickenpox vaccine. Before the vaccine, about 4 million people would get chickenpox each year in the United States. Also, about 10,600 people were hospitalized and 100 to 150 died each year as a result of chickenpox." 
"Chickenpox is a very contagious disease caused by the varicella-zoster virus (VZV). It causes a blister-like rash, itching, tiredness, and fever. Chickenpox can be serious, especially in babies, adults, and people with weakened immune systems. It spreads easily from infected people to others who have never had chickenpox or received the chickenpox vaccine."
"Once it gets going, chickenpox is very contagious and can catch up with anyone in its path who’s not received chickenpox vaccine. Before the vaccine was available, about 100 people in the U.S. died each year from chickenpox. Fortunately, you can make yourself nearly invincible against chickenpox if you get the vaccine." 
"Chickenpox is a very contagious disease. You or your child may be at risk if you have never had chickenpox or gotten the vaccine."
"Varicella (chickenpox) is a highly contagious disease that is very uncomfortable and sometimes serious. The chickenpox vaccine is the best protection against chickenpox."
WebMD tells us:

Vaccine Refusal Raises Chickenpox Risk
Kids Are 9 Times More Likely to Get Chickenpox if They Don't Get Vaccinated

""Many parents refuse the varicella vaccine because they think of chickenpox as a mild illness, but this is not necessarily true," study investigator Jason M. Glanz, PhD, of Kaiser Permanente tells WebMD.

"Before the vaccine there were 100 deaths and 10,000 hospitalizations a year due to varicella. It can cause very severe illness in newborns and adults and in children with compromised immune systems."

Shit right! I've had chicken pox, so have my kids, so have 99% of people I know, I don't know anyone who has had severe complications, nor died - yet I'm nearly queuing up for a vaccine after reading that!

Now in contrast lets examine guidance from the UK, a country that doesn't vaccinate against Chickenpox
"Chickenpox is a mild and common childhood illness that most children catch at some point."
"Chickenpox is most common in children under 10. In fact, chickenpox is so common in childhood that 90% of adults are immune to the condition because they've had it before." 
"Chickenpox in children is considered a mild illness, but expect your child to feel pretty miserable and irritable while they have it." 
"Complications of chickenpox are rare in healthy children. The most common complication is where the blisters become infected with bacteria.  A sign that the blisters have become infected is when the surrounding skin becomes red and sore.  If you think that your child's blisters have become infected, contact your GP as the child may need a course of antibiotics."
It's hard to believe we are talking about the same illness.

UK media reports:
"During the first half of the 20th-century it made sense to be introducing vaccines against whooping cough, diphtheria and tuberculosis, all of which were killing thousands of children every year. But nowadays, the vogue is to recommend immunisation for diseases that are either relatively harmless, or serious but rare."
"Chickenpox falls firmly into the former category; most children suffer only a few uncomfortable days. Yet we are being told that it is a serious disease against which we need to vaccinate. These recommendations are based on research that actively looked for serious complications of chickenpox in all children admitted to hospitals in the UK and Ireland over a 13-month period. The researchers found 112 children who had serious complications of chickenpox, most often a secondary infection treatable with antibiotics. Six deaths were reported. Excluding one baby that died in the womb, four had a chronic health problem, such as HIV or cerebral palsy. Only one previously healthy child died, out of a total population of over 10 million. Chickenpox causes serious complications in less than 1 in 10,000 children.  Telegraph.co.uk "
jab
Image used in newspaper article
"Children might soon be vaccinated against chicken pox, according to recent reports. But some experts question the need for a vaccine against an infection that's so mild - especially when it could put thousands of elderly people at greater risk of shingles."
"Chicken pox causes up to 50 deaths a year, 40 of them children, and it seems the Government's Joint Committee on Vaccination and Immunisation is considering adding a vaccine against it to the MMR jab."

"But there is widespread concern about this. First because a similar MMR super jab now used in America has been found to double the risk of fits in some children."

"Also the jab has raised the rate of shingles among the old - according to one U.S. study, cases have risen by 90 per cent. Here even the Government health watchdog, the Health Protection Agency, has predicted that a vaccine could cause a 20 per cent rise in shingles cases." Daily Mail.

More here

You can see why parents are confused? 

Notice the different language used to describe the same disease and statistics when trying to promote vaccine use, compared to that where it isn't available.  The US make no reference to any potential links with shingles whatsoever, the UK highlights this as reason the vaccine isn't given to all.

Who should parents believe?

The other big problem I find with those promoting vaccine use, is the distinct lack of acknowledgement of risks.  

Now I'm not a doctor, but even a paracetamol tablet carries potential side effects, I look at what those are, weigh up the pros and cons and decide whether to take the tablet - I struggle to believe something injected to alter the immune system doesn't carry any.  Yet how many parents are given these details or perhaps vaccine pack insert beforehand so they can be informed?

How many debates go along the lines of yes there is a X% risk of ABC, but the reduction in illness is XYZ?

No, instead we get told how people die without vaccines, that we should be grateful as some countries would love them, that how could someone forgive themselves if their child caught a disease they weren't vaccinated against?

We are told herd immunity is vital to protect the vulnerable, and as one article recently discussing the flu vaccine how selfish the non vaccinating were.  At the same time the author (without a hint of irony) tells us that the vaccine is only 60% effective, (and even that figure varied depending on one’s age group and other factors), but apparently we should all rush out and get it anyway because of herd immunity, and because the protection isn't 100% the non vaccinated are putting those who have had the shot at risk.  The fact everyone vaccinated could merrily pass it among themselves without needing an unvaccinated person if it's only 60% reliable doesn't seem to matter.

A quick Google on the subject of herd immunity turns up this and this, which means pretty soon parents need  a medical degree to pick apart the facts.

If we are assuming vaccine is risk free, 60% protection is a bonus, but this again is where we hit a bump in the road. As highlighted above parents are connecting at a level unseen before - they hear stories from others who have a vaccine injured child, they see that the UK Government offers a "vaccine damage payment".
"1. Overview If you’re severely disabled as a result of a vaccination against certain diseases, you could get a one-off tax-free payment of £120,000. This is called a Vaccine Damage Payment."
In fact by 2005 the vaccine damage scheme had paid out 3.5 million for injuries that had occured in just the previous 8 years.

But hang on where did anyone mention becoming severely disabled was a risk of vaccinating?   So now along with imagine how bad you would feel if your child caught the disease, we have to throw in imagine how bad you would feel if you gave your child a vaccine that resulted in disability.  Google vaccine injury and there are pages of results - a point which of course is not even touched upon by the author above beyond "there is proof vaccines don't cause autism", yawn, next.

In the UK there is no such debate to be had about flu as only the vulnerable and now children are offered the vaccine, the NHS instead tells us:
"If you are otherwise fit and healthy, there is usually no need to see a doctor if you have flu-like symptoms.
The best remedy is to rest at home, keep warm and drink plenty of water to avoid dehydration.
You can take paracetamol or ibuprofen, to lower a high temperature and relieve aches."
Of course, no vaccine piece would be complete without at least a mention of Wakefield and autism.  An outbreak of measles in Wales prompted "The Independent" to provide a platform here where he published a full statement..

Take Wakefield out of the equation and Google autism and measles, and this piece that lists "22 medical studies that show possible connections to vaccines and autism" soon appears.

A letter from your GP saying Andrew Wakefield has been disproven and so here is your appointment for the MMR, just isn't going to cut it for many.

I personally think we need to be exploring what impact vaccine have on gut flora, just like scientists have done with antibiotics.  We know disturbed gut flora is linked to not only autism but a whole host of problems, see here and here.  New studies also suggest gut flora plays a key role in vaccination - could it be there are people with a certain genetic makeup that have a gut bacterial profile that may be at increased risk of vaccine damage?   We simply don't know because it seems you have to sit in the "pro" or "against" camp and take the hard line either way.

Surely we should be trying to understand all and any possible implications of vaccines, both good and bad?

No it hasn't been proven it's dangerous for certain subgroups to be vaccinated, but nor has evidence proved they're safe for everyone either.  In fact a total of 917 payments from the UK vaccine injury scheme since it started in 1979 (with no doubt thousands more who couldn't provide a compelling enough case for a payout) would suggest otherwise.

If there is a case to be had for vaccinating, health care professionals need to recognise the shift that has taken place in obtaining advice - and realise that "because we recommend so", is no longer good enough.

10 comments:

  1. All children in Scotland are now being offered the flu vaccine, I have refused for various reasons. I am glad someone as well read as you is as confused as me!

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  2. http://www.huffingtonpost.com/jj-keith/vaccines_b_3829948.html

    This goes a long way to explain why herd immunity is important.

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  3. Herd immunity is a myth. Also, two of my children had vaccine reactions and injuries. I wish I had done my homework in advance. Now that I know better, I do better for my family. Even my immune compromised husband refuses vaccines.

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  4. Recently in the US I have been seeing commercials claiming chicken pox vaccine *prevents* shingles. They keep saying if you've had chicken pox, you're more likely to develop shingles. The first time I heard that, I thought I remembered shortly after the vaccine came out that shingles was on the rise as a result, but of course no one remembers that.

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  5. As far as I understand, when the chickenpox vaccine was going through the approval process at the FDA, the manufacturer used an economic argument rather than a medical one -i.e. the vaccine will prevent the loss of workers' productivity when they have to take care of their children with chicken pox. I can see how this may even be a selling point for some parents, especially in the US with its abysmal family leave policies, but please be honest about that and don't create a medical emergency where none exists.

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    1. The American creed taken to insane levels - profit first, people last. Thank goodness the rest of the developed world has some sanity when it comes to human beings and how they work and live.

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  6. One quick comment on your last point.
    I believe that very few believe there is a link between MMR vaccine and autism, but that doesn't mean there aren't studies that seem to prove it. After all, if you look hard enough (it doesn't have to be THAT hard... :D ) you will be able to find articles that prove and articles that disprove the same proposition.
    In any case, the articles have to be analysed, we have to see where have been published (Science is not the same as some mickey mouse journal), then they have to be discussed in the scientific community etc. etc.. To give you an example, you can find papers that say that homoeopathy exists (and some even in serious journals), but nobody has collected a Nobel prize for proving that homoeopathy does have any measurable effect. The reason for that is that the reviewers are not infallible, or there could be a statistic aberration, or the paper is being published in a "friendly" journal, etc. etc.

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  7. I know a number of people who refuse some or all vaccines. Most do not do so because of autism/Wakefiled. I started questioning more because of noticing the difference in vaccine schedule between the US and UK (I'm from the US, but gave birth to my first two in the UK). Nevertheless, I decided to follow the NHS schedule. And then my son had a reaction - signs of encephalitis. Thank God, he's ok, but he isn't supposed to have a pertussis jab again because of the reaction. With the second child I decided I'd just delay vaccines and space them out more. She had an intolerance to bovine proteins, and I didn't realise until after that first jab that the 5-in-1 has bovine proteins. Ten again, how should I have known, since the HV never gave me the insert before the jab? I noticed the reaction and looked it up. My third has the same intolerance, only more, so he hasn't had that. I also research everything now and assess risk for everything. It can be maddening. It's then worse to be told I'm ignorant or just following some celebrity or scared of autism. I almost had to laugh when a doctor told me my son would be heavier if fully vaccinated (he's rarely ill) and then went on to say that you have to weigh risks/benefits of antibiotics. I agreed to the latter statement, but thought it somewhat ironic he didn't see the need to weigh risks/benefits of vaccines, too. Thankfully my son's regular doctor is quite happy to just discuss things with me.

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  8. Oh, and I've also noticed a marked difference in how diseases are talked about when there is a vaccine available, versus when there isn't within the US. For example, influenza is seen as horrid, and a school outbreak would be met wi calls to vaccinate and/or telling unvaccinated students to remain home. Recently a local school had a TB outbreak. We don't vaccinate for that here, and the attitude was very relaxed. They tested other students, but did not close the school, quarantine anyone, etc. the disease itself was downplayed, too.

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