Fear the diseases, not the vaccines

The Pediatric Insider

© 2012 Roy Benaroch, MD

About 3 million children’s lives are saved each year by vaccination. In the United States alone, 20 million cases of serious illness are prevented every single year, because of the power of immunizations. That’s why immunizations are among the greatest public health achievements of all time.

With vaccine-preventable illnesses at historic lows, some parents are becoming more fearful of vaccines than of the diseases themselves. That’s a tragedy. Vaccines are the most intensely studied and researched health interventions we have, and there is a tremendous amount of data supporting their safety. Yet, rumors and internet sites have contributed to a mistrust of not only vaccines, but to the doctors who recommend them, the governments who supply them, the scientists who invent them, and the companies that manufacture them. Somehow, the diseases themselves are no longer the bad guy.

Vaccine-refusers expose their children to a 23-fold increased risk of pertussis, a 35-fold increased risk of measles, and a 9-fold increased risk of chicken pox. You get the idea. These vaccines work. They prevent illness, and prevent death.

Refusing vaccines hurts your children and your community. There are always people in a community who are at high risk for disease. This includes the very young and old, and people who for health reasons have poor immunity or who can’t be vaccinated. It also includes some people who were vaccinated, but who didn’t develop good immunity. Though vaccines work very well, they’re not perfect, and some people don’t develop protection from their vaccinations. If almost everyone in a community is vaccinated, it helps protect the most vulnerable among us. And once enough families refuse vaccines, this protective effect will evaporate. Not vaccinating doesn’t only affect your own children. It can affect mine, and your neighbors’, and the people in the nursing home. It affects us all.

Fear of vaccines has led some parents to want to “space them out”—the exact wrong thing to do, if you want to keep your children and your community safe. One idiot doctor even made up an alternative schedule, and he’s sold a lot of books about it. But why would anyone think his made-up schedule is safer than the one recommended by every important health authority in the world? Why is that one guy more trustworthy than your own pediatrician? Think about this: if vaccines were in some way unsafe, why is making more separate visits so your child gets more days with shots better than bunching them up and getting them over with? There is no evidence, and no plausible scientific reason, to think that the stretched out schedule is safer. It just leaves your child more vulnerable, longer. Fear drives the use of this weirdball schedule—a misguided fear of vaccines, instead of a fear of disease. There are different reasons why some parents refuse vaccines, but the common thread is fear.

The media hasn’t always done a great job presenting the science of vaccines, preferring sometimes to stick with sensationalism over useful information. And the internet, by its very nature, tends to exaggerate freaky new stories over context and followup, leaving parents reeling. Parents want to keep their kids safe and healthy. But with “all those stories on the internet”, who can they believe?

I’ll tell you who to believe. Believe the doctors and scientists around the world who’ve dedicated their lives to keeping children safe. Believe the parents, the millions of them, whose children have been saved by vaccines. Believe your own pediatrician, not celebrities and fear-mongerers on the web. Believe the science that continues to study and monitor and improve vaccines. Don’t give in to an irrational, unnecessary, and harmful fears. Protect your kids and mine. Vaccinate.

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12 Comments on “Fear the diseases, not the vaccines”

  1. Anna Says:

    My reason for spacing them out for my son is because of the amount of aluminum in the vaccines. Why is that not a concer?

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  2. Dr. Roy Says:

    Anna, because the amount of aluminum in vaccines is very very tiny, and well below the levels at which any sort of toxicity have ever been observed. Aluminum is one of the most common elements in the Earth’s crust, and our children are exposed to much more aluminum through ordinary life than through vaccines.

    And: even if it were in some way toxic, why would “spacing it out” make it safer? Are four small doses better than one larger dose? There’s no particular reason to think “spacing” ought to make vaccines safer.

    For more about “The Toxin Gambit”– a detailed post exposing many anti-vaccine myths: http://www.sciencebasedmedicine.org/index.php/toxic-myths-about-vaccines/

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  3. Sue Says:

    My child has horrific eczema flares after every vaccination. How can I continue to vaccinate her knowing how devastating it is to her wellbeing? Plus the eczema flares put her at serious risk for further infection?
    She has an egg allergy that make some vaccines off limits for her.

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  4. Dr. Roy Says:

    Sue, I don’t know your child’s individual case, but you ought to work with her dermatologist to make sure her eczema is optimally controlled before and after vaccines. I’ve never seen a child with eczema who was unable to tolerate vaccination, but again, I don’t know your individual case. Some vaccine-preventable diseases (like chicken pox) can be much worse in children with pre-existing eczema, so you’ll need to carefully weigh that.

    Just for historical interest: one vaccine that was used in the past was contraindicated in children with eczema: the smallpox vaccine. That hasn’t been used routinely since the late 1960’s.

    RE: egg allergy, the only commonly-used vaccine that can be an issue in those with egg allergy are influenza vaccines. Both the “mist” and “shot” versions are made in a process that involves chicken egg. People with mild-to-moderate egg allergy can tolerate influenza vaccines without risk of serious reactions, and can be safely vaccinated. Those with severe or life threatening egg allergy should not receive an influenza vaccine. The yellow fever vaccine (given to some international travelers, not routinely to anyone else in the USA) may also be contraindicated in egg allergic-individuals. There are no other vaccines that are a problem in egg allergy.

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  5. Dr. M Says:

    I just recently found your blog through your article on Vitamin B12 fetishes, and I have been perusing your blog since reading that article, despite not having any kids, and saying Yes! YES! to basically, virtually, really everything you have said here. Finally someone blogging with real sense!

    I am a veterinarian and many pet owners have similar fears about vaccinating their dog or cat. I keep saying the same thing you have said here, the disease being prevented is WORSE than any (rare) side effects from the vaccine! Why can’t people understand that? And why, indeed, do they trust random weirdos more than their educated veterinarian or doctor? I don’t get it either, but then again, we are on the same side of the fence.

    Thanks for all of your great articles, you have a new devoted follower.

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  6. Ally Says:

    I am not very impressed with the rationale you describe condoning alternate vaccination schedule. The reason that 4 spaced out doses of a substance may be better for a child is because, when introducing a substance to the bloodstream – the DOSE DEFINES THE POISON – the smaller the dose, the better equipped your body is to deal with that foreign substance. Please reference any studies that compare these less aggressive vaccination schedules vs conventional schedules. I would be curious to see whether such a study has ever been conducted and whether the amount of stress on an infants body has ever been compared between these schedules… I think it is also important to recognize that medical doctors will always have a bias towards believing that the diseases to which we are preventing through vaccination are worse than the risk of complications, because you are the experts on disease – a toxicologist on the other hand may have a different perspective on the impacts of chronic exposure to the substances found in vaccines…

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  7. Dr. Roy Says:

    Ally, no vaccines are introduced “into the bloodstream.”

    As Dr. Sears himself said, there are no studies comparing his made-up schedule with the recommended schedule– in fact, there are no studies of his schedule at all. He made it up. I suppose anyone could make up any schedule, and then someone could be critical that the made-up schedule hasn’t been compared to the recommended schedule. Is that progress?

    Medical doctors are both the experts on the diseases, and the experts on the complications or adverse events following vaccines. We see them both. I don’t think that creates a bias, as you say, for or against either side of the equation. I suppose my bias is that I want to keep children healthy– that’s my bias, my career, the point of this blog, and the purpose behind all of my professional activities. I am anti-disease and pro-health.

    Toxicologists certainly add their expertise to vaccine development and safety issues. Have I suggested otherwise?

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  8. RH Says:

    “But why would anyone think his made-up schedule is safer than the one recommended by every important health authority in the world?”
    What a grotesquely inaccurate statement! There is one vaccination schedule created by the U.S. CDC, which includes age ranges of when specific vaccinations might be given (i.e., it’s flexible in its own right). The UK disseminates a different vaccine schedule. Sweden’s is yet different. So on and so forth throughout Europe, and I would imagine (but don’t know) worldwide.

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  9. RH Says:

    I should have added that my comment is NOT in favor of Dr. Sears’s schedule (at least, I’m assuming that’s who you’re referring to). It’s toward your bias of “There is no evidence, and no plausible scientific reason, to think that the stretched out schedule is safer. It just leaves your child more vulnerable, longer.” There isn’t just one schedule, and there’s no scientific evidence to support any one over the other, at least not in aggregate. Unfortunately, a huge part of the pro-/anti- vaccination arguments are based on falsehoods that there is a right and wrong, when really there’s still huge elements of subjectivity involved.

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  10. Dr. Roy Says:

    RH, you’re correct that the US schedule includes a lot of flexibility, but it does not encourage delaying or spacing out vaccines or leaving children vulnerable.

    When people speak of “the schedule”, that means “vaccinating within the guidelines established by the ACIP/CDC.” That’s an awkward, though more technically correct phrase.

    Other countries do have slightly different schedules. These account sometimes for local prevalence of disease, and sometimes for varying formulations that are dosed differently. There are no countries that come close to Dr. Bob’s space-em-out-and-skip-some-schedule.

    It’s ironic that you mention Sweden, a country with great vaccination coverage and a very strong public pro-vaccine stance: http://www.pri.org/stories/2015-01-29/what-sweden-can-teach-america-about-measles-vaccinations. The Swedes feel that vaccination is a public good, and that everyone ought to be vaccinated especially to protect the vulnerable. Too bad we don’t all feel that way.

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