All Your Burning Vaccine Questions, Answered! Part 1
All Your Burning Vaccine Questions, Answered! Part 1: Most Frequently Asked Questions
Being a parent in the present day and age is not simple to say the least. Parents constantly question themselves more than ever. “Am I doing the best thing for my child? Is this the right option?” The internet doesn’t make it easier with millions of thoughts and opinions ion what parents “should” be doing for their children.
Vaccines, which were never a topic of controversy when I was a child, have long since morphed into a new subject riddled with speculations and theories. As a board-certified pediatrician and child wellness expert, I’m here to put your questions to rest in a three-part series of posts on vaccines. Today, we’ll cover the most common questions I get from parents on vaccines.
What exactly are vaccines?
By definition any vaccine is a biological product designed to prevent disease(s) by prophylactically or sometimes therapeutically stimulating the body's own immune response to the different diseases. That is to say, if somebody becomes exposed to one of these diseases, the immune system has already developed the ability to protect the individual from whatever the disease is. This is a crucial advantage that the vaccine provides for the population; it develops an immune response without having the patient actually have to undergo the disease, so it’s a much safer way to develop protection.
Most of our current vaccines are targeted toward infectious diseases (invasive bacteria and pathogenic viruses), but there’s also amazing research being done in the field of vaccine development against cancers.
What does the term “Herd Immunity” mean?
This is a long answer but an incredibly important and key concept! Most of the infectious diseases that vaccines protect us against are transmitted from person to person (versus a number of bacteria and infectious organisms transmitted from animals or insects to persons). So, if you can reduce the outbreaks of these infectious diseases to a very small limited number of people who are capable of transmitting the particular virus or bacteria to another individual, you are essentially decreasing the risk of larger outbreak.
(An example of this is what happened at Disneyland a few years back with measles. There were multiple areas of outbreaks that were related to the fact that there were low numbers of vaccinated individuals in the community. Therefore, they were able to continue transmission). The less unvaccinated individuals, the less the infection is going to progress and spread like wild fire throughout the population. That is essentially what the term “herd immunity” is referencing. In fact, we are moving away from “herd immunity” and instead, using the term “community protection.” They share the same concept-You have a certain level of individuals who are protected so they can eliminate the risk of further transmission. Going back to the Disneyland measles reference in the 2017 outbreak, the virus actually didn’t get transmitted very much in other areas of the country beyond California because we did have this community protection with enough people who were immunized against measles.
Community protection and herd immunity both underline this important principle: protecting individuals in our society who cannot receive vaccinations. These are children who are either too young (infants or neonates) or children whose immune system isn’t strong enough or are unable to either respond to the vaccine or get the vaccines. One of the most important public health measures we can do as members of the human population is to make sure that there are enough people in the communities that are immunized so that they can protect the more vulnerable children. Community protection or herd immunity cannot work if we include large numbers of individuals who refuse to vaccinate by choice. The odds of pathogen transmission would exponentially increase.
Are these diseases really a problem still today?
People are absolutely correct that we don't really see anymore, and that is actually thanks to the development of vaccines. When we did see them, it was before the era of modern medicine. Unfortunately, while they are not common in the US, they are still very common in third world countries where access to basic medical care isn’t guaranteed. In Southeast Asia, polio still affects many individuals, and if a child survives, they can be paralyzed in adulthood. According to UNICEF, the measles death toll in Africa is so high – every minute one child dies – that many mothers don't give children real names until they have survived the disease. I completed my pediatric residency training in Washington D.C. at Georgetown University Hospital. D.C. is a hub for international travel, and it wasn’t uncommon to question all of these infectious diseases when a patient from a foreign country walked into the ER.
So there's no question that these disease would still be as dangerous. We have no specific anti-virals to treat these viral diseases in the current era of modern medicine. While there may probably be a slightly high number of children who would survive than in the 1930’s, they may still go through a tremendously difficult and painful disease progression and could still end up with significant health complications even if they did survive.
While we may be more capable of “managing diseases,” the scary reality is the mortality (or death rate) of some of these diseases, such as meningitis, hasn’t decreased. Part of the reason is that the diseases we vaccinate against progress so rapidly, the situation quickly reaches a point where it can't be reversed or too often, the child comes in to the emergency room close to death.
So these really are diseases that we don't want to come back and have to deal with, and there's a cost involved that goes beyond finances if a child dies from a disease. For the sake of a child’s comfort and a family’s ability to never have to worry about your child being at risk from these deathly diseases, these vaccines are still very important today.
Are their better ways to keep by baby safe?
Speaking as a mother and turning the pediatrician side of my brain off, honestly-no. I was still nursing my daughter at 2 months. At that age, she had antibodies transferred from me during the pregnancy via placenta, not to mention also from nursing, but the immune system is incredibly complex. We refer to that immunity as “passive” in the medical world. The type of response the body develops after a vaccine is called “active” immunity. Active immunity is by far universally more reliable than passive immunity. So while breastfeeding has many benefits and may offer some temporary immunity for certain illnesses, experts agree that it is not an effective means of protecting a child from the specific diseases prevented by vaccines.
Likewise, vitamins won’t protect against the bacteria and viruses that cause these serious diseases. High doses of some vitamins in IV form can decrease the risk of sequelae (or downstream effects) of certain infectious diseases, but it is by no means a “treatment.”
Despite what media and random parenting sites on the internet say, chiropractic remedies, naturopathy, and homeopathy are totally ineffective in preventing vaccine-preventable diseases. Some parents think that getting the “natural” disease is preferable to “artificial” vaccination, leading to a “natural” immunity. Some parents even arrange chickenpox “parties” to ensure their child gets infected. It’s true that for some diseases, getting infected will lead to immunity, but the price paid for natural disease can include severe pneumonia, paralysis, serious brain injury, liver cancer, deafness, blindness, or even death.
Can I, as a parent, do my own research?
In my practice, I have the luxury of taking the time to talk to parents and answer any questions they have regarding their child’s health. If I don’t know the answer, you bet I will find out and reach back out to you. However, there is a difference in “research” and “knowledge” when it comes to medicine. In my opinion, research is reading chapters, articles, websites, etc about a particular topic to simply learn more about it. These sources can be written by anyone who may or may not have a background in medical field. They may not know your child, your family history, or your beliefs. They may have a bias or an investment in the topic discussed, or simply don’t have any training in complexities of pediatric medicine, period. Knowledge, on the other hand, is taking the information that’s out there and applying it in an evidence-medicine based manner, weighing the risks and benefits of each strategy, considering the best option for each patient based on exposures and medical history, understanding studies for their strength-not their bias or if they agree with you. For example, if a study is done on 100 patients, those results carry much more weight than a study done on 10 patients. That’s just one way your medical provider considers the facts and information presented in front of him or her before they make a decision.
So if you prefer to do your own research as a parent, that is your right, but just understand that your physician has done that and more to provide you with the best knowledge they have at their disposal. We only want the best for our patients.
As a parent, I actually remember breathing a sigh of relief after my daughter had her first set of vaccines at 2 months. It put my mind more at ease when it came to air travel, sitting in waiting rooms in doctors’ offices, and even just going out to a restaurant. Yes, we are surrounded by infectious bacteria and viruses. Of course, I know I can’t keep her from getting sick ever…but the diseases our children’s vaccines prevent against are not just the common cold or a stomach virus. They are much more serious and deadly.
Stay tuned for All Your Burning Vaccine Questions, Answered! Part 2: Controversies Regarding Vaccinating