~by Jennifer Hanrahan, D.O.
Whenever I talk to healthcare workers about vaccines, there is always a group of people waiting to inform me of the dangers of vaccines. The first time this happened, I was surprised. It seemed strange that people whose lives are dedicated to helping others based on science would become part of the anti-vaccine movement. I am going to speak about this topic, knowing that there will be some negative responses.
Nothing in modern medicine has saved as many lives as vaccines. Debilitating, fatal diseases are now often a thing of the past. The great success of vaccines has allowed us to forget about horrible diseases that used to occur regularly. Because we don’t have to see these diseases, we have the luxury to debate the merits of vaccines. Every time a new epidemic occurs, the first question is whether there is a vaccine or whether one could be developed. Thousands of lives and untold human suffering would have been spared if a vaccine for Ebola were available.
Before routine vaccination, there were 13,000-20,000 cases of paralytic polio in the U.S. every year. The last case occurred here in 1979. There were 20,000 cases of congenital rubella syndrome annually prior to rubella vaccination. Before routine measles vaccination, almost everyone in the U.S. got measles. Some went on to have terrible complications such as subacute sclerosing panencephalitis, which ended in death. Fortunately, measles is uncommon in developed countries now. In 2004, there were an estimated 454,000 measles deaths, which translates into more than 1,200 deaths every day or 50 people dying every hour from measles. In 2013, this number decreased to 16 deaths per hour from measles, due to ongoing vaccination efforts. Almost 16 million deaths were averted due to measles vaccines administered from 2000-2013.
Bacterial meningitis used to be an early childhood illness. Due to vaccination programs for H. influenzae type B and pneumococcus, the average age of bacterial meningitis is now 41.9 years.
Measles, Rubella, Smallpox, Polio, bacterial meningitis in children- all of these are almost diseases of the past, because vaccines work. Despite their great success, people are eager to believe myths about vaccines, and choose not to get themselves, or their children vaccinated. Keeping all of these diseases in the past requires herd immunity. Even a small decrease in herd immunity leads to reemergence of disease.
After the publication of a paper in Lancet in 1998 by Wakefield, et al. vaccination rates decreased, and in 2008, measles and rubella were declared endemic again in the U.K.
This paper was fabricated by the author and was retracted by Lancet. The authors were investigated and barred from practicing medicine in the U.K. Still; many people choose to believe that there is a link between vaccines and autism, as well as myriad other ailments.
How people make decisions has little to do with data, and more to do with emotions. This topic is investigated and described in a great book, “Mistakes were made, but not by me,” by Carol Tavris and Elliot Aronson. Once a decision is made, all additional data is used to support the decision. Even data that clearly goes against the opinion is used as further support. Physicians are, unfortunately, not immune to this phenomena.
A new vaccine was just released for prevention of HPV. Gardasil 9 includes five additional strains of HPV. Many of the patients I see, who would have been eligible for vaccination, have not received HPV vaccines, and by the time I see them, they are older than 26, and no longer eligible. I am hoping that doctors will think more about immunizing adults, and help to prevent suffering.
What are your experiences with anti-vaxxers? Do you find it difficult to keep up with all of the changing recommendations for vaccinations?
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3. Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, et al. Emerging Infections Programs Network. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2011;364:2016-25.
Jennifer Hanrahan, D.O. is an infectious disease physician at MetroHealth Medical Center and is medical director of infection prevention at MetroHealth Medical Center. She has served as co-medical director of the Cleveland Department of Public Health, and has extensive experience teaching residents, fellows and medical students. Her areas of expertise include influenza, hospital-acquired infections, legionella, HIV/AIDS, and hospital preparedness for infectious diseases.