Paging Dr. Frischer - Vaccines

The doctor says that it's time for your vaccination. What questions does this bring to mind: Is this shot safe? Will it make me sick? Will it actually work, and protect me from something I could be exposed to? If it's for my child, might it cause autism?Vaccines, for better or for worse, have been in the news. Some claim that they are part of a plot by the "medical establishment." Others believe that they are a cause of autism. Personal stories appear on the Internet telling of vaccine tragedies. Let's discuss this difficult and controversial subject. Vaccinations are designed to prevent disease through a low exposure to the disease itself. This is accomplished by either injecting a killed form of a germ, or an attenuated (weaker) form of a living germ. As a result, the body makes antibodies that prevent you from contracting the disease upon exposure in the real world. How do we know that vaccines are safe? The United States has one of the best vaccine safety programs in the world. They are first tested in laboratory and animal studies. Clinical trials are then run on human patients in order to further evaluate safety and effectiveness before the vaccine can get approval from the Food and Drug Administration (FDA). FDA scientists are constantly monitoring information from multiple sources for any clues that a particular vaccine may cause any type of problem. Like any medicine, vaccines do have side effects. However, once a vaccine has passed through the rigorous testing process, serious adverse events are rare. Nearly 90% of problems following vaccinations are categorized as non-serious. Anyone who receives a vaccine should be informed about both the benefits and risks, and questions or concerns should be discussed with the healthcare provider. Side effects vary with the type of vaccine. In the case of the standard Td (tetanus & diphtheria) vaccine, for example, there is a small risk of a life-threatening allergic reaction, occurring in approximately one in a million doses. (Note, of course, that the number of lives saved by the vaccine far exceeds this.) Mild side effects include pain at the vaccination site in about three out of four patients, and redness in one in five patients. A mild fever up to 100.4 degrees occurs in about one in a 100 recipients. Side effects of other vaccines may include nausea, fatigue, diarrhea, and stomach ache. The most well known serious vaccination side effect is Guillain-Barre syndrome, a disorder in which the body's immune system attacks part of its peripheral nervous system. It almost exclusively affects adults. The first symptoms include weakness or tingling sensations in the legs, which may spread to the arms and upper body. These symptoms can increase in intensity until the patient is almost totally paralyzed. The patient may need to be put on a respirator, and the disorder can be life threatening. Most recover from even the more severe cases of Guillain-Barre, although some are left with residual weakness. While the exact cause is unknown, it most often occurs within days or weeks after a case of diarrhea or a lung or sinus infection, and roughly one in a million people get it in the days or weeks after vaccination. Is there a link between autism and vaccines? Dr. Andrew Wakefield published a paper in the British journal Lancet in 1998, claiming just such a link with the MMR (measles-mumps-rubella) vaccine. The well-renowned journal ultimately concluded that the study was a fraud, and neither Wakefield nor other researchers have been able to reproduce his results. Lancet retracted the study's claims in 2010, and Britain stripped Wakefield of his medical license three months later. (The majority of Wakefield's co-authors had withdrawn their names from the study back in 2004, after learning that he had been paid by a law firm that intended to sue vaccine manufacturers.) The possibility of a link between thimerosal and autism is a separate issue that became confused, by many, with Dr. Wakefield's work. Thimerosal was and is still a preservative for multi-dose vaccine packs where killed germs are used. (The MMR vaccine, on the other hand, is a live vaccine, which contains no thimerosal.) Thimerosal has been used for decades all over the world, at extremely low concentrations, and was never suspected to be a health hazard when used in this manner. However, there is a related compound, methyl mercury, which is a widespread environmental toxic pollutant that targets the central nervous system. In the 1990's, as the pediatric community increased the recommended number of vaccines for infants in the first six months of life, the total exposure to thimerosal began to exceed recommended limits. In the late 1990's, a decision was made, without much scientific debate, to eliminate the use of thimerosal as a preservative for vaccines in the United States. Even still, the Institute of Medicine concluded that there exists no evidence connecting thimerosal to autism, and the World Health Organization (WHO) continues to use thimerosal-containing diphtheria-pertussis-tetanus (DPT) vaccines throughout developing countries. Sadly, the fall-out from both the defective Wakefield research and from the thimerosal debate has resulted in a generation of people skeptical of the MMR vaccine. In the United Kingdom and in Canada, such concern has led to significantly lower vaccination rates, and resultant outbreaks of all three diseases (measles, mumps, and rubella) have been observed in the United Kingdom. Addressing every controversy regarding vaccines, especially those debated throughout the Internet, is beyond the scope of this article. Arguments about vaccine safety continue, often in spite of the facts. Take a sensible look at information as it appears, and discuss your questions with your personal physician. I continue to support vaccinating my patients. I am confident that vaccines are part of intelligent and reasonable prevention, and that prevention is the key to our good health!

********** Published: March 10, 2011 - Volume 9 - Issue 47