Anti-vaccination movement
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===Autism=== | ===Autism=== | ||
Revision as of 19:10, 22 June 2007
UNDER CONSTRUCTION
Vaccine-preventable disease has been a major cause of illness, death, and disability throughout human history. The advent of the modern vaccine era has changed this significantly. In fact, most North Americans have little memory of the pre-vaccine era. There has been much debate lately in the press and in the doctor's office regarding vaccine safety. Vaccines have been alleged to cause all manner of illnesses. Some very prominent Americans have spoken out vociferously about the supposed danger of vaccines.[1]
Contents |
Premise
There are many beliefs, not supported by scientific evidence, that vaccines are somehow harmful. Some of these beliefs are quite specific, implicating specific vaccines as the cause of specific diseases. Others are a vague discomfort for the "unnaturalness" of vaccines in general. There are, of course, well developed published data on the complication rates of vaccines. Some have argued that the reporting system is not robust enough, but serious complications, which are the important ones, are not likely to be missed. If anti-vaccine ideas are to impact vaccination policy, it must be proved that the condition caused by the vaccine is more prevalent and more serious than the disease prevented by the vaccine.
Disease Impact in pre-Vaccine Era
Complications are more likely to arise from illness than from vaccination. The current impact of vaccines on health is very simply stated here. Children who get measles have a 1 in 20 chance of developing a serious complication; however, serious complications from the vaccine is only 1 or 2 per million, according to the Institute for Vaccine Safety at Johns Hopkins University.[2] Before the introduction of measles vaccination, there were about half a million cases per year in the United States. Only 89 cases were diagnosed in 1998.[3] Historically, the mortality rate for measles in the U.S. was about 1-3 death per every 1000 cases, with young children suffering the highest mortality rates.[4] Most deaths occur as a result of pneumonia or encephalitis.[5]
After the introduction of polio vaccination, cases in the United States decreased from almost 30,000 in 1955--many of which produced paralysis or death—-to 910 cases by 1962. New cases of polio in the U.S. are now a thing of the past.[6] Of the two types of polio vaccine, the oral vaccine, while effective, is the less safe of the two. Since there are no more naturally acquired cases in the U.S., the oral vaccine had become the only cause of polio (8-9 cases). Since the vaccine risk, however small, eventually exceed the disease risk, the oral vaccine was abandoned in favor of the killed vaccine. In regions where polio is still a major problem, the oral vaccine is still a better choice, as it can enter the water supply and vaccinate others passively. In regions with high HIV rates, this may be less true, as live vaccines are usually avoided in immunocompromised patients.
In Britain, there was concern in the early 70s about the pertussis vaccine. It was blamed for several cases of encephalitis. The connection was never proved, and vaccination rates dropped from 77% to 39%. Following this drop in immunization, the UK was hit by two large whooping cough epidemics, one in 1978, one in 1982, both of which resulted in many deaths.[7]
The rates of complication from vaccines are so low, that the benefit of vaccines for each individual child is higher than the risk of a poor outcome, so it is not true that the few children with adverse events are being sacrificed for the health of others. For example, the CDC compiles rates of risk from disease vs. risk from vaccination.[8] For the MMR (measles, mumps, rubella) vaccine, this is the data:
Measles Complication Rates Pneumonia: 6 in 100 Encephalitis: 1 in 1,000 Death: 2 in 1,000 Rubella Congenital Rubella Syndrome: 1 in 4 (if woman becomes infected early in pregnancy)
MMR Complication Rates Encephalitis or severe allergic reaction: 1 in 1,000,000
Negative Effects of Currently Used Vaccines
Most commonly used vaccines have a risk of severe complications that is so low that it is impossible to tell statistically whether or not the vaccine played a role in causing these problems. Certain less commonly used vaccines are known to have greater dangers. For instance, the smallpox vaccine, which is not in wide use, has a well-quantified complication rate. Given the fact that the risk of disease exposure is almost zero, it is not worth the risk to vaccinate the population at large.
Specific Concerns
Autism
There has been much concern about a possible link between autism and vaccines, particularly the MMR vaccine.[9] Part of this concern is due to a possible rise in autism over the last few decades. Much of the concern has been raised by parents of autistic children, and by prominent Americans with no scientific or medical training. Often, evidence given is indirect, citing links between ethylmercury exposure and other neurologic problems outside the setting of vaccine administration. For instance, according to one source "In 1977, a Russian study found that adults exposed to much lower concentrations of ethylmercury than those given to American children still suffered brain damage years later"[10] This un-cited statement give anecdotal evidence of a link between ethylmercury and "brain damage". It is hard to evaluated without a citation, but the overwhelming evidence from the medical literature is clear. From the same article:
"You couldn't even construct a study that shows thimerosal is safe," says Haley, who heads the chemistry department at the University of Kentucky. "It's just too darn toxic. If you inject thimerosal into an animal, its brain will sicken. If you apply it to living tissue, the cells die. If you put it in a petri dish, the culture dies. Knowing these things, it would be shocking if one could inject it into an infant without causing damage."
This statement works to increase levels of fear, but makes no mention of actual vaccines or actual patients. It certainly doesn't mention statistics. Several very well done population-based studies have been conducted. These studies have looked at actual populations in real-life conditions, exposed to the actual substance in question; none have shown any connection between autism and thimerosal preservative or the MMR vaccine. There is overwhelming evidence that the MMR and thimerosal-containing vaccines play no role in the development of autism.[11][12][13][14][15]
References
- ↑ http://dir.salon.com/story/news/feature/2005/06/16/thimerosal/index.html
- ↑ Aaron Levin. Vaccines Today. Ann Intern Med, Oct 2000; 133: 661.
- ↑ Aaron Levin. Vaccines Today. Ann Intern Med, Oct 2000; 133: 661.
- ↑ S J Engelhardt, N A Halsey, D L Eddins, and A R Hinman. Measles mortality in the United States 1971-1975. Am J Public Health. 1980 November; 70(11): 1166–1169.
- ↑ Jacqueline Gindler, Sarah Tinker, Lauri Markowitz, William Atkinson, Loring Dales, and Mark J. Papania. Acute Measles Mortality in the United States, 1987-2002. The Journal of Infectious Diseases, volume 189 (2004), pages 69–77.
- ↑ Aaron Levin. Vaccines Today. Ann Intern Med, Oct 2000; 133: 661.
- ↑ Aaron Levin. Vaccines Today. Ann Intern Med, Oct 2000; 133: 661.
- ↑ http://www.cdc.gov/vaccines/vac-gen/6mishome.htm#Diseaseshadalready
- ↑ http://www.huffingtonpost.com/robert-f-kennedy-jr/attack-on-mothers_b_52894.html
- ↑ http://dir.salon.com/story/news/feature/2005/06/16/thimerosal/index.html
- ↑ Anders Hviid, MSc; Michael Stellfeld, MD; Jan Wohlfahrt, MSc; Mads Melbye, MD, PhD . Association Between Thimerosal-Containing Vaccine and Autism.JAMA. 2003;290:1763-1766.
- ↑ Uchiyama T. Kurosawa M. Inaba Y. MMR-vaccine and regression in autism spectrum disorders: negative results presented from Japan. Journal of Autism & Developmental Disorders. 37(2):210-7, 2007 Feb.
- ↑ Afzal MA. Ozoemena LC. O'Hare A. Kidger KA. Bentley ML. Minor PD. Absence of detectable measles virus genome sequence in blood of autistic children who have had their MMR vaccination during the routine childhood immunization schedule of UK. Journal of Medical Virology. 78(5):623-30, 2006 May.
- ↑ Honda H. Shimizu Y. Rutter M. No effect of MMR withdrawal on the incidence of autism: a total population study. Journal of Child Psychology & Psychiatry & Allied Disciplines. 46(6):572-9, 2005 Jun.
- ↑ Smeeth L. Cook C. Fombonne E. Heavey L. Rodrigues LC. Smith PG. Hall AJ. MMR vaccination and pervasive developmental disorders: a case-control study. [Journal Article. Research Support, Non-U.S. Gov't] Lancet. 364(9438):963-9, 2004 Sep 11-17.