Vaccines Make Kids, Communities Safe
Kaiser pediatrician Rahul Parikh says new outbreaks of whooping cough are a reminder that people should not forego vaccinations, for themselves or for their kids.
School starts in a few days, and campuses unfortunately are breeding grounds for disease. Groups of kids are brought together in classrooms, restrooms, locker rooms, cafeterias and playgrounds. It's inevitable that these kids will share not just lunch treats but illnesses, too--everything from the common cold to more serious infections.
Recent outbreaks of whooping cough have occurred, and the highly contagious respiratory infection is now an epidemic in California. The Contra Costa Health Services had confirmed 40 cases of the illness, also known as pertussis, in its county as of earlier this summer. In 2009, there were 18 cases. According to the California Department of Public Health, there were six times as many whooping cough cases in the Bay Area between January and May compared to the same time period last year.
Although whooping cough initially resembles an ordinary cold, it may eventually turn into something more more serious and potentially fatal, particularly in infants, according to the Centers for Disease Control and Prevention.
Despite outbreaks of whooping cough and other infections, some parents refuse to have their children immunized, says Walnut Creek-based pediatrician Rahul Parikh, who practices at Kaiser Medical Center. In this Q&A with Patch writer Ayako Mie, Parikh explains how vaccinations save lives and keep communities safe.
Patch: Last month, a sixth infant fell victim to whooping cough in California. Some say whooping cough has become epidemic in California, with nearly 1,500 cases reported as of July. What are the reasons behind this?
Parikh: Several reasons, probably. One is waning immunity on the part of adults who have had the vaccine, which is why we are encouraging boosters for adults as well as kids. The second is that there has been a natural trend in whooping cough outbreaks for every four or five years, though this one is much bigger than the last one in the middle of the last decade. There is a role of parents refusing vaccines for pertussis (whooping cough) as well, but this is hard to measure.
When immunization rates in a community drop below a critical threshold (usually around 90 percent), the chance of vaccine-preventable diseases goes up substantially. The reason for this is something doctors call "herd immunity" in which a large enough population gets immunized to protect those who are too young to be immunized. Herd immunity is the key to keeping communities healthy from these illnesses. When it goes down, we are taking the chance of getting sick.
The only thing we can do is to make sure as many of us are vaccinated as possible to prevent this from spreading now and in the future.
Patch: Who are the people not getting vaccinations?
Parikh: Studies have shown that vaccine refusal is predominantly in more affluent communities among people with higher socio-economic status. Older parents also tend to be vaccine refusers more often than younger parents.
Patch: What do you say to people's worries about vaccinating their kids?
Parikh: First, I completely understand how confusing and emotional the information about vaccines has gotten over the past 10 years. It's hard to be a modern parent and have the time and energy to sit down and figure out what to do. But doctors and health professionals are here to help, and the good news is that when parents form a trusting relationship with their doctor, they're more likely to immunize their child.
Parents want to do the right thing for their children, but it's very hard because of all the "debate" out there, particularly about the alleged connection between vaccines and autism. The good news is that we have a decade of evidence proving no link between the two.
Parents often also express concern about the vaccine schedule or components in the vaccines used to keep them safe and effective. The schedule was designed and reviewed by experts, and a recent study showed that children who follow the schedule versus those who do not have no difference in their rates of neurological problems.
As far as components go, the main ones people bring up are aluminum and thimerasol (a mercury-based compound). In California, vaccines given to kids under age 3 are free of thimerasol. It's worth noting that a study in 2008 showed that despite our having removed thimerasol from shots in 2001, autism rates have continued to rise in California, suggesting that it's not vaccines causing autism.
Vaccines contain small quantities of aluminum (and have for a long time) to help them work effectively. While anti-vaccine folks have argued that there is too much aluminum in vaccines, and this may be "the smoking gun," the amount of aluminum in breast milk and formula is much higher than in vaccines. The aluminum in vaccines is also eliminated by the body very quickly.
Patch: Are there any vaccines that are not absolutely necessary? Chicken pox?
Parikh: If I have to choose against any disease and a vaccine that's been proven to be safe and effective at preventing it, I would take the vaccine any day. I've done it for myself and my family.
Patch: Who should be vaccinated?
Parikh: With very few exceptions, everybody should be vaccinated. It's the right choice for the health of individuals, families and communities.
Patch: Newborns are too young to be vaccinated against many diseases such as whooping cough (the first pertusis vaccine is given at 2 months, as are vaccines for other diseases). How can parents keep their newborns from contracting whooping cough or other illness?
Parikh: My wife and I are expecting a baby soon, and we have told our parents to get vaccinated for whooping cough. So, first, make sure anybody who is coming into close contact with your baby be immunized. Second, encourage other families in your community to immunize not just against whooping cough, but against other deadly and serious diseases as well. As individuals and communities, we can choose health or we can take our chances. My family is choosing health. I would prefer the same for my community and those that surround it.
Rahul K. Parikh is a pediatrician at Kaiser Permanente Medical Center in Walnut Creek. He contributes to publications such as The New York Times and Salon.com.
For more information about whooping cough, visit the website for the Centers for Disease Control and Prevention.
Mom of the Horde
11:36 pm on Saturday, August 21, 2010
The changes in the vaccination schedule between when my 13 year old was an infant and now (I have an 8 month old)... is honestly kind of shocking. The number of vaccines that are recommended have doubled at some ages. I'm honestly considering delaying or outright declining some. How much is too much at once for a still maturing immune system?
tony bateson
3:46 am on Sunday, August 22, 2010
In the UK we have a substantial vaccine schedule already for infants and school age children but it is nowhere near as extensive as the USA. But something else we have is a complete absence of autism in the unvaccinated population (some 2-3 millions). I have made this claim extensively in any media that will print it but hugely in sub mainstream media. No official source will comment except that I did manage to put this claim to the UK Head of Vaccine Policy who notably refused to be drawn upon whether he agreed or not. But he did agree that possibly as many as 10% to 12% of British kids are not vaccinated since the late 80s - in a 600,000 annual birthrate that's a lot and figures go back to 1966. I have never had this claim repudiated despite it appearing in every form of national and local media. I believe it is also true in the USA and everywhere else. It's not MMR it's vaccination per se.
Tony Bateson, Oxford, UK.
Martha Ross
9:06 am on Sunday, August 22, 2010
Do you know anyone who doesn't vaccination their kids. When we lived in Humboldt County, i was part of a mom's group, and there was one mom whod wouldn't vaccinate her kids. Then, there was another one who invited us to a playdate at her house when one of her kdis had chicken pox, so that all our other kids could get it, and get it out of the way. I'm glad Ayako asked about chicken pox because that was always one of those that I wondered, is that necessary. I had it when I was a kid. I remember when it was tearing through my neighborhood, and I don't remember it being that big of deal. Then again, my husband never had it. So if my son got it, and gave it to my son---adult cases are supposed to be fore more serious, right?
Martha Ross
9:07 am on Sunday, August 22, 2010
There is also a Kaiser researcher living in Walnut Creek who is involved in national studies on autism, and I hope to get her for a Q&A on the latest theories on the causes of autism. She did tell me that, just as Parikh says, there has been no scientific link connecting vaccines and autism.
Jojo Potato
11:07 am on Sunday, August 22, 2010
Congratulations to Martha. You have reached some sort of global scope to have been noticed by Tony Bateson. A well known internet troll, he has been pushing his combination of pseudo science and conspiracy theories all over the web. The one scientific paper these types always point to for evidence was recently retracted by the Lancet. It seems part of the study was paid for by lawyers looking for evidence to sue vaccine makers and that the author, a Dr. Wakefield had his own vaccine patented and ready to go if he could knock out the current producers. The dramatic increase in whooping cough cases is a real tragedy and one that could so easily be avoided.
tony bateson
3:19 pm on Sunday, August 22, 2010
Your correspondent is both inarticulate and seriously uniformed. I have never attributed autism to MMR and it's not pseudo science it is math. Neither am I 'these types' instead it's simple = where are the unvaccinated autistic people in the UK? Perhaps you noticed too that he didn't answer that question. But then no one ever does.
The manufacturers of DPT do not claim that the pertussis component confers immunity but that it mitigates the symptoms. Before he challenges me in such a nonsensical way JoJo Potato should carry on reading - not enough done there. Incidentally as he/she has come across me before perhaps he/she should respond to my challenge to any informed person to debate this question in open forum anywhere in the world - I will pay my own expenses subject to the venue being open to the general public.
Tony Bateson, Oxford, UK.
Martha Ross
10:22 pm on Sunday, August 29, 2010
A reader, Alison Fujito, contacted writer Ayako Mie, and raised the following concerns with the story and with Dr. Parikh's position. Here is the email she send which we may have to submit, on her behalf, in two or more parts:
PART I
I wonder if you might consider looking into the "other side" of the vaccine issue you wrote about in "Vaccines Make Kids, Communities Safe," August 23, 2010. You may not be aware that the "decade of evidence proving no link between vaccines and autism" consists of studies entirely funded by, directed by, interpreted by, and marketed by the vaccine manufacturers. Moreover, these studies are limited to ONE vaccine (the MMR) and ONE preservative (thimerosal). There have been no studies on the cumulative effect of 36 vaccines by the age of 18 months, which is the current recommended schedule in the US.
Martha Ross
10:22 pm on Sunday, August 29, 2010
PART II (Alison Fujito):
By contrast, in Japan, the current recommended schedule is 6 vaccines in the first year of life, followed by 3 the second. Dr. Parikh is apparently unaware that most children's vaccines contained thimerosal until at least 2007. Yes, production of thimerosal-preserved children's vaccines stopped in 2002--but what had already been produced was in use for several more years, as the shelf life was at least 5 years. It was far less expensive for doctors to use the old stores rather than to use the single-use vials that replaced the thimerosal-preserved ones. Our pediatrician was still using old stores in 2004. The 2008 study Dr. Parikh quotes looked at autism rates in children who were born--and vaccinated--in years when the vaccines were still thimerosal-preserved. That study didn't look at children BORN in 2008--autism is not diagnosed until children are at least 3 years old, and many are even older by the time they are diagnosed. In addition, 90% of both the flu shot and the h1n1 shot are preserved with thimerosal--and these are recommended for pregnant women (in spite of no safety studies on these vaccines for pregnant women) and for all children 6 months old and up. In other words, infants and children have been receiving vaccines that DO have large amounts of thimerosal. And the 2008 schedule called for MORE vaccines than the 2001 schedule did. So it's no surprise that autism rates in California have continued to rise! .
Martha Ross
10:24 pm on Sunday, August 29, 2010
PART III (Alison Fujito): Current research has shown some children to be unable to excrete heavy metals such as aluminum and mercury, yet there is no screening done to determine which children might have this difficulty before they receive vaccines. It appears that there are many factors at play here, including vitamin D deficiency, yet children aren't screened for that, either. Although the MMR is supposed to confer lifetime immunity on 95% of those who get the first dose (according to Merck's website), there is no screening to see if a second dose is necessary, even though it would call for only a simple blood test. Instead, all children are required to have a second dose, even though only 5% seem to need it. And there are NO studies showing that those 5% develop antibodies from the second dose, so we don't even know if that second dose is effective..
Martha Ross
10:25 pm on Sunday, August 29, 2010
PART IV (Alison Fujito): The bottle of thimerosal comes with a clear warning label that states "do not mix with aluminum?" Yet, many vaccines contain both. And with children getting several vaccines at once, the two metals are mixing in the bloodstream. The US is the only nation to require the Hepatitis B vaccine in ALL newborns, on the first day of life. Other countries only require it for children of mothers who HAVE Hepatitis B. A 2009 study published in The Annals of Epidemiology concluded that infant boys who receive the Hepatitis B vaccine are 3 times as likely to be diagnosed with autism. Why doesn't Dr. Parikh mention this? There have been cases won in court, proving that vaccines caused autism. Look up Bailey Banks and Hannah Poling--those are the most recent, and their parents were able to go public. Other cases were subject to gag orders. It sounds like Dr. Parikh believes that only ignorant, confused parents believe that there is any problem at all with vaccines.
Martha Ross
10:27 pm on Sunday, August 29, 2010
PART V (Alison Fujito): But there are many doctors and scientists who DO feel that many of the current vaccines, especially in the context of the current vaccine schedule is causing harm, perhaps more harm than many of the diseases they are supposed to protect us from. And this harm is not limited to children--vaccines are now being linked with many autoimmune disorders, including MS. The hepatitis B vaccine has been discontinued from the recommended schedule in France, after a patient proved in court that it caused MS. Gardasil, a vaccine against venereal warts thought to be a factor in cervical cancer, has one of the highest adverse effect rates ever seen in a vaccine, yet it is not only recommended for 9-year-old girls, but for boys now as well.
Martha Ross
10:28 pm on Sunday, August 29, 2010
PART VI (Alison Fujito): The current pediatric vaccine schedule was designed and reviewed by "experts" who are/were consultants to the companies manufacturing the vaccines. That's a bit like having the tobacco companies be in charge of safety studies on cigarettes. They recommend flu shots for everyone, especially for babies as young as 6 months old, and to the elderly. But they don't tell us that the flu shot package insert says that "effectiveness has not been determined in pediatric and elderly populations," nor do they tell us that the Journal of the American Medical Association and the British Medical Journal have gone on record saying that the flu shot is not effective for these populations. Yet it continues to be on the recommended vaccine schedule, and some states (New Jersey, for example) are mandating it for all children who attend public school or daycare. I would like to suggest that you look at www.fourteenstudies.org, www.safeminds.org, and www.nvic.org. I wonder if your questions for Dr. Parikh might have been different had you known of these websites. It would be wonderful if you were able to interview one of the many doctors and researchers who is concerned about the current vaccine schedule and the problematic effects on so many children. Sincerely, Alison Fujito
lmm
9:32 am on Friday, September 3, 2010
Adult chicken pox can be serious. I had chicken pox twice, which can happen if the first outbreak is mild; once as an infant and again at 13. It was dreadful--high fever and intense, severe itching all over my body (from literally the top of my head to the bottom of my toes). I missed a bit of school and I had scars for years. I can see where an elderly person might have a tough time with chicken pox, especially with the initial fever.
I knew a mom who wouldn't vaccinate her kid and I was always nervous when she brought him over for playdates in our mom's group. I didn't want to catch anything from him. Families who won't vaccinate don't take into account that everyone around them has to be up on their boosters to avoid childhood diseases that their kid might be carrying.
Kim Kovalchik-Ii
6:12 pm on Sunday, July 24, 2011
If the vaccines work, then you should have no fear as to un-vaccinated children.
Vaccines are drugs and as with any other drug, they can, and have, caused damage and even death in some who may be more prone to reactivity than others.
I am the California State Director for the National Vaccine Information Center.
Link to the National Vaccine Information Center: http://www.nvic.org/Vaccines-and-Diseases/Whooping-Cough.aspx
SNIP: It is important o be equally concerned and knowledgeable about the risks of pertussis disease as we are about the risks of pertussis vaccine. Both B, pertussis whooping cough and the pertussis vaccine carry risks. Pertussis disease has the potential to cause seizures, brain damage, and even death, just as the vaccine can.
Most of America’s medical community believes that the risk of serious injury or death from pertussis is greater than the risk of injury or death which can be caused by pertussis vaccine. However, recognition of and concern about the risks of pertussis disease does not diminish our need and responsibility to acknowledge the need to minimize pertussis vaccine risks.
The challenge today is for parents, physicians, scientists, manufacturers and health officials to recognize the risks of both the disease and the vaccine and work to protect the health and well being of every child.
Kim Kovalchik-Ii
6:14 pm on Sunday, July 24, 2011
I would urge all of whom responded with comments as to the above article, to please visit the National Vaccine Information Center's website. Educate yourself about disease and vaccines. Yours and your children's health, depends on it.
Kim Kovalchik-Ii
6:22 pm on Sunday, July 24, 2011
I read through all the above posts; very informative comments, Ms. Ross, with one caveat: The current flu vaccines which most pediatricians are now telling parents they must give to their six month old children (and up), contain mercury.
Please see the Cochrane Collaboration's study regarding flu vaccine/safety/efficacy studies: http://www.healthychild.com/flu-vaccine/studies-fail-to-demonstrate-safety-or-effectiveness-of-influenza-vaccine-in-children-and-adults/
SNIP: "There is a big gap between policies promoting annual influenza vaccinations for most children and adults and supporting scientific evidence," said epidemiologist Tom Jefferson, Cochrane Vaccines Field, Rome, Italy, who coordinated the comprehensive analysis for the prestigious Cochrane Collaboration. "Given the significant resources involved in annual mass influenza campaigns, there is urgent need for re- evaluation of these strategies."