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Immunization Mythsby Steve Sainsbury, MDThe "swine flu," or H1N1 vaccine, will be available in October. Yet over half of those polled are questioning whether they will line up for this valuable protection from this deadly strain of influenza. It is crucial to remember that millions of lives have been saved since the advent and worldwide utilization of immunizations is nothing short of miraculous. Whether administered to a Masai warrior roaming the Serengeti Plain or the golden child of a Hollywood mogul, vaccines protect us all from an expanding list of life-threatening and disabling illnesses. Yet amazingly, many people refuse vaccinations, putting themselves, their families, and others around them at risk. It is high time to debunk some immunizations myths, so that we will bare our arms for the miraculous protections offered by vaccines. Myth #1: An immunization can actually cause the disease.It is impossible to get a disease from vaccines made from killed bacteria and viruses, or vaccines made from benign pieces of these germs. For those few vaccines made from weakened live organisms, there is an extremely low risk of developing a much milder form of the disease. This myth may have stemmed from the older polio vaccine, in which a few unvaccinated parents or children with weakened immune systems (one in over 2 million vaccinations) developed polio. A newer vaccine has eliminated this risk. The bottom line is that vaccines do NOT cause the disease they are protecting you against. Myth #2: Immunizations are no longer necessary because most childhood diseases have been eradicated.Smallpox is the only disease truly eliminated from the world - no cases have been reported for many years. But all the other communicable diseases covered by vaccines, such as measles, polio, or diphtheria, are still present and active. Some skeptics have pointed out that, for many diseases, outbreaks in the developed world are rare. "Why should I worry about my children," they ask, "if polio only occurs in Somalia and Yemen?" The answer is that we live in a huge melting pot of cultures and nationalities. For example, during one week in the ER, I treated patients who had recently arrived from the Congo (yellow fever), Bangladesh (polio), and Guatemala (hepatitis). Fifty years ago, the notion that you or your children would be rubbing shoulders with someone from East Africa or Cambodia would be extremely unlikely. In today's world, it is practically inevitable, exposing you to communicable diseases that you perhaps thought were someone else's problem, Myth #3: Immunizations have dangerous side effects.Do vaccines have side effects? Yes. Dangerous ones? Very, very rarely. A small percentage of children may develop a temporary soreness at the site of the injection. Even fewer may come down with a fever in the first 24 hours, which resolves quickly. Yet more serious side effects are so rare that scientists have not been able to determine the exact risk for any individual child. The overriding fact to remember is that the risk of serious side effects from vaccines is dramatically less than the risk of the disease itself. Compare it to the risk of airbags in your automobile. Very rarely, the airbag deployment will cause injury. In the vast majority of cases, they dramatically protect the occupant from harm. No one worries about the airbag being more dangerous than it is helpful. The same principle applies to vaccines— they protect far, far more than they hurt. MYTH #4: Immunizations do not always work.What does? Nothing in medicine (or life) is a sure thing - there are too many variables to contend with. Let me ask you: Did your watch ever stop or malfunction? As a result, did you forever give up wearing a watch? I doubt it. Vaccines are 85-99% effective, considerably better odds than that lottery ticket you bought yesterday. Consider the Hib (Haemophilus influenza, type b) vaccine, which was introduced in 1985 to combat the 20,000 infections (and 400 deaths) caused annually by these deadly bacteria. I used to diagnose and treat this deadly meningitis in children on a regular basis in the ER. I would see dozens of cases each year. Yet thanks to the vaccine, Hib cases today are a rarity—I haven't seen one in many years. Or look at Great Britain. In the early 1970's an "expose" of the complications of the whooping cough vaccine prompted many parents to stop letting their children become immunized. By 1974 in England, only a fraction of children were routinely given this vaccine. By 1978, a rebound epidemic of over 100,000 whooping cough cases resulted in 36 deaths. Other countries had similar experiences. Immunizations do work and they save lives. MYTH #5: Immunizations cause SIDS and autism.Detailed studies have shown that un-immunized kids are just as likely to develop SIDS (Sudden Infant Death Syndrome) as immunized kids. This myth developed because SIDS and the first set of immunizations occur in the same age group. But no cause and effect link has ever been found. On the contrary, despite the fact that the number of recommended immunizations for children is rising, the SIDS rate is dramatically decreasing. The causes for SIDS are many, but immunizations is not one of them. Nor do vaccines cause autism. A 1998 report in the British journal Lancet raised the possibility that the MMR (measles, mumps, rubella) vaccine was linked to autism. This was thoroughly reviewed, and no cause and effect could be found. No one is sure what causes autism, but it seems to be a condition that begins developing before birth, not after. MYTH #6: Getting the flu is safer than receiving the vaccine.Have you ever had the flu? I mean the true flu, not a cold, or bronchitis, or some slight fever illness that so people call the "flu." True influenza is a serious, 5-10 day illness characterized by a high fever, dry cough, headache, and severe body aches. In the elderly, infirm, and very young, influenza can kill. Thousands succumb every year. Millions die around the world when flu epidemics hit. Contracting the flu is serious business. Receiving the vaccine is benign and usually protective.
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