VACCINATIONS – friend, not foe: Dr. Amitha Jocie Mundenchira

As a physician, I have been seeing many children with school forms requiring vaccination updates in order to avoid suspension. In most cases, it is just a matter of falling behind on the vaccination schedule. However, in as many as 1 in 10 cases, it is a matter of parents declining to vaccinate due to various baseless controversies propagated by anti-vaccination activists.
Due to vaccine discoveries of the 20th century, 21st Century has limited or no experience with the devastating effects of diseases such as polio or smallpox. So, fear of disease has waned and fears about vaccine safety have taken over. Lower vaccination rates have led to growing outbreaks of certain communicable diseases, such as measles and pertussis (whooping cough).
Centers for Disease Control and Prevention (CDC) is open about the potential side-effects of vaccines. Patients are either educated at the time of the vaccinations or given resources to educate themselves. Side-effects may be worth the risk instead of contracting a morbid or fatal disease.
Some children have medical conditions that contraindicate vaccines. However, they can still be protected by herd immunity if they are surrounded by vaccinated children. As of December 2015, Ontario government proposed a new law that would force parents who want a nonmedical exemption for their children’s compulsory vaccines to take a course.

The following is the current vaccination schedule for Ontario:

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(for high resolution image, go to http://www.health.gov.on.ca/en/pro/programs/immunization/schedule.aspx and use page 1 from 1st

The following are some of the controversies surrounding vaccine safety(2):
1. There is no medical evidence to support the proposed causal relationship between receipt of the measles–mumps–rubella vaccine and autism;
2. There is a concern of thimerosal being a potential trigger for autism. Currently, with the exception of some influenza vaccines, none of the routine pediatric vaccines contain thimerosal as a preservative.
3. There is religious objection based on some vaccine viruses being grown in cell lines from voluntarily aborted fetal tissues. However, the Catholic Bishops have relieved parents of the obligation to refuse these vaccines based on the Church’s opposition to voluntary abortion.
4. There are parental worries that use of the human papillomavirus virus (HPV) vaccine may lead to youth promiscuity. However, vaccine or not, young people engage in risky sexual behavior with devastating health effects. It is also important to think about young children, who can become infected with HPV after being subjected to sexual abuse.
5. There are fears regarding the possible association between pertussis vaccination and adverse neurological outcomes. The risk of permanent brain injury from pertussis vaccine might not be zero but is still extremely low; also, the newer acellular pertussis vaccines are less reactogenic.
6. There are concerns regarding too many vaccines overloading or weakening the infant immune system. Modern vaccines contain far fewer antigens than the immune system is designed to respond to; thus, these vaccines will not overwhelm or weaken the infant immune system

I agree that patients have the right to make a decision about their own health, or in this case, about their children’s’ health. However, unlike some of the other health issues, communicable diseases have a bearing on the general public. It is not fair that the unvaccinated child is the source of an outbreak at any facility visited by the child. Parents should educate themselves better about the facts instead of blindly supporting unvalidated controversies. If after such education, they still decide not to vaccinate their children, then they should be considerate and homeschool their children. In such unvaccinated cases, schools are already suspending the children.
REFERENCES
1. http://library.cqpress.com/cqresearcher/document.php?id=cqresrre2016021900
2. http://www.medscape.com/viewarticle/722174

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