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What the Papers Don't Say About Vaccines
jamie tips an article in The Guardian's "Bad Science" column which highlights recent media coverage of the MMR vaccine. A story circulated in the past week about the death of a young child, which the parents blamed on the vaccine. When the coroner later found that it had nothing to do with the child's death, there was a followup in only one of the six papers who had covered the story.
"Does it stop there? No. Amateur physicians have long enjoyed speculating that MMR and other vaccinations are somehow 'harmful to the immune system' and responsible for the rise in conditions such as asthma and hay fever. Doubtless they must have been waiting some time for evidence to appear. ... Measles cases are rising. Middle class parents are not to blame, even if they do lack rhetorical panache when you try to have a discussion with them about it. They have been systematically and vigorously misled by the media, the people with access to all the information, who still choose, collectively, between themselves, so robustly that it might almost be a conspiracy, to give you only half the facts."
It's a societal issue. Once a critical portion of the population is not immunized against a disease, then a widespread epidemic is more possible and likely. This could have severe economic impacts that go far beyond the goals of individual parents. This is why most immunization is mandatory unless there is a specific religious or health related exception. People invoking these exceptions trivially are endangering the functioning civil order. These vaccines have proven to be quite safe -- and, even if there is a risk of infection (say for example, with live polio), if the negative side-effect rate in the population is low-enough, its still something that should be mandated in order to ensure that the population as a whole is resilient to some of the Big Nasties.
When parents of my pediatric patients say they're skipping vaccines, they talk more about what they read on the Internet than what they see on television or read in the newspaper. The second most common source of information cited about how vaccines are dangerous is "people [they've] talked to." Only a small percentage make a distinction about specific vaccines; most who refuse the MMR refuse everything. So, do I have to wait until we prove another negative - autism isn't caused by DTaP - to prevent common (and sometimes fatal) whooping cough? Proving that the MMR vaccine doesn't cause autism (NEJM 347:1477-1482) hasn't been enough for my vaccine refusers so far. This is a parental issue. I think the solution is basic education in the scientific method and statistics for everyone, beginning in elementary school.
Yellow fever vaccine is a live virus (though it is attenuated).
I was born in the UK in 1961, and so grew up in the era where we weren't vaccinated against things like measels and chicken pox, and so of course we caught them, and we were fine. There may be rare side effects of these diseases, but the coincident rise in autism coupled with the rise in vaccination at least doesn't indicate autism as one of the side effects. As it happened I also almost died as an infant as a result of the DTP vaccine, and consequently wasn't given the 2nd shot of the series. I did subsequently catch whooping cough, and although it was unpleasant, it's sure better than being dead.
IAAP (I am a physician - specifically pediatrics). First off, "you" may have been "fine" when you "got measles," but the population of England wasn't. Measles isn't chicken pox - it's a LOT worse. It's pretty rare to die of pox, but measles will kill you, give you encephalitis, make you go deaf, or a lot of horrible, horrible things. It's not just a bunch of itchy spots for a month.
And second, as for your reaction to the DTaP vaccine, there is a widely known side effect of the vaccine (specifically the "P" part against Pertussis, aka Whopping Cough). We are well aware of the side effect and it is known. That is not the same as speculation about an unproven side effect believed by the public and rejected by most of the scientific community. Hmm, sounds a *lot* like the Global Warming denier community. Oh wait, but those guys are kooks, right? *You're* just being skeptical, right?
That being said, your physician is either an idiot, or to be fair, maybe this wasn't known in 1960s UK - the solution to the DTaP reaction you describe is to administer just the D and T portions and not adding the Pertussis part. Congratulations, you were not immunized against Tetanus or Diptheria.