Vaccines remain our best protection against infection

As a new year – and a new administration – approaches, troubling indications are emerging that some long-standing public health policies and evidence-based health care recommendations may be weakened or completely abandoned by the newly appointed directors of the main federal ministries overseeing health, medical care. research and Medicare/Medicaid.

When it comes to well-established preventative care measures – including routine vaccinations for children and adults – you need to be armed with facts before you allow yourself to be convinced by plans to disrupt and eliminate health care requirements. vaccination requirements for school entry and ignoring scientific scrutiny of vaccine safety. and efficiency.

To help you make a decision, research knowledgeable healthcare professionals in our area. These are your primary care doctors, your advanced practice providers, and the specialists they might refer you to. Having a relationship with you and knowing your current health status allows these providers to make their best recommendations based on scientific evidence and your particular situation. This also allows them to ask relevant questions and express concerns that they can then address in detail.

Some parents and other adults believe it is best to gain immunity “naturally” only through vaccination, as if somehow “naturally” is safer or more effective. But know this: to gain immunity “naturally”it is necessary to actually be infected with a virus, with all the symptoms, long-term effects and even the risk of death that infection entails. “Natural” immunity occurs when the body’s immune system recognizes certain proteins (“antigens”) on the surface of viruses, develops anti-infection substances called antibodies in response to these antigens (which can take several days), and “remembers” this response in order to be able to quickly combat the virus in the future. Vaccines use these “same” antigens “without” the other parts of the viruses to which they are usually attached, so that the body can produce the “same” immune response “without” being infected.

Overwhelming evidence has accumulated over the past several decades demonstrating the effectiveness of vaccination, and the numbers are staggering. Smallpox, with 48,164 cases and 1,528 deaths per year at the beginning of the last century, has been eradicated worldwide. Polio, a paralyzing scourge until the 1950s (16,316 cases and 1,879 deaths each year), has essentially been eliminated in the Western Hemisphere. Annual before and after data for other vaccine-preventable diseases are similar (measles: 503,282 to 89; mumps: 152,209 to 606; rubella (German measles): 47,745 to 345; tetanus 1,314 to 34; and diphtheria: 175,885 to 1).

Faced with such spectacular success, many people wonder whether it is still necessary to systematically vaccinate children and adults. While the global elimination of smallpox means that “this” vaccination is no longer recommended or administered, effective prevention of the once-common “other” infections listed above requires maintaining a high level of immunity in the general population (“collective immunity”). Since these diseases still exist, we need to ensure that as many people as possible continue to be fully vaccinated to prevent outbreaks from occurring. Because the specific strains of circulating viruses can change each year (as happens with influenza and COVID-19), it is usually necessary to receive a new vaccine each year to protect against these diseases; in other cases, such as tetanus, immunity weakens over time, requiring “amplifier” vaccinations to stay fully protected.

Although many are concerned about the risks and side effects of vaccines, it is clear that the benefits far outweigh the risks of vaccine-preventable diseases. In the case of measles, for example, the side effects of the measles-mumps-rubella (MMR) vaccine, introduced in 1971, are infinitesimal, especially when compared to the effects of the disease. When 10,000 children receive the MMR vaccine, approximately 3 fever-related seizures can be expected, as well as 0 to 1 cases of abnormal blood clotting and 0.035 allergic reactions. For comparison, complications from 10,000 children infected with measles would include 2,000 hospitalizations, 500 cases of pneumonia, 1,000 ear infections (with possible permanent hearing loss), and 10 to 30 deaths. (Bester, J. “Measles and measles vaccination”“JAMA Pediatrics”, 2016).

It’s reasonable to question how we know vaccines are safe, especially since they are generally given to healthy people. Vaccines are not approved until they have demonstrated their safety and effectiveness in rigorously controlled clinical trials involving tens of thousands of closely monitored volunteers. Once a successful vaccine candidate is approved, three separate systems continue to monitor it to determine whether additional, very rare, safety concerns develop once millions more doses are administered to Americans. Data from other countries can help independently flag potential security issues. You may recall that at the height of the COVID-19 pandemic, U.S. safety systems quickly detected serious blood clots in 6 people (out of 6.8 million doses administered) associated with the Johnson & Johnson vaccine against COVID-19. This led to the withdrawal of the Johnson & Johnson vaccine from the US market.

Finally, what about autism? Studies of millions of children around the world have clearly shown that vaccines, especially MMR vaccines, do not cause autism. A contrary claim was made in the 1990s by a researcher who published a fraudulent scientific study to promote his own measles vaccine. That study was ultimately discredited and retracted — and the researcher lost his medical license — but the false claims persisted and were amplified over the next several years, sometimes by concerned parents and at other times, to advance certain personal or political agendas. Extensive research and expert opinion has shown that autism is a primarily hereditary disorder caused by unusual patterns of prenatal brain development (Courchesne, E. “Prenatal origins of ASD”“Trends in Neuroscience”, 2020), which occur well before the affected children are vaccinated. Studies that have carefully compared rates of autism across generations using standardized diagnostic criteria have also shown that rates of this disorder have remained stable over time, casting doubt on whether the involvement of environmental factors or vaccine exposures.

We applaud your efforts to keep your children and yourself safe and healthy, and we encourage you to continue asking questions about preventative care to your trusted family doctors, pediatricians, and other health care providers. who specialize in your case (unlike politicians and the Internet). .

Timothy M. Heilmann, MD, MHA, FAAFP, is a family physician and medical educator who is a past president of the Lycoming County Medical Society as well as the Pennsylvania Academy of Family Physicians. He is a certified leader in clinical informatics. Barbara E. Hemmendinger, MSS, a member of the Lycoming County Health Improvement Coalition and retired behavioral medicine educator, is with Let’s End COVID! a group of concerned people in north-central PA who have worked to overcome the COVID-19 pandemic through education, awareness, and mitigation.