Vaccines are a key to public health, but there are many people who are distrustful of their effectiveness and hold lingering doubts that they are safe. Their decisions to delay or refuse to accept vaccines for their children are the reason for the resurgence of measles, as well as increases in these type of diseases that are preventable and many times very serious, and rarely but sometimes deadly. I will explain that vaccines are safe, with rare side effects, and that we all need to do our part in order to protect the health of everyone, especially that of our children.
Vaccines protect public health, just like having clean drinking water, sewer systems, emergency services, building codes, and traffic safety rules. Since we first discovered that we could prevent the dreaded smallpox by administering vaccines, we have been able to prevent countless cases of pertussis, tetanus, diphtheria, meningitis caused by HIB, pneumococcus, and meningococcemia, influenza, measles, mumps, and rubella, polio, hepatitis B, rotavirus, chicken pox, Hepatitis A, and human papillomavirus. Each of these diseases has a unique strategy of replication and harm to the body, and scientists have found unique ways to make vaccines for each one.
For example, the toxin that is produced by the tetanus bacteria is chemically changed to remove its destructive power, but still stimulates the immune system to remember this toxin, providing a defense against it if it gets into a wound in the future.
Occasionally, a person will have a reaction to the vaccine, usually a fever, a rash, or swelling at the site. Rarely a person could have a rare but serious reaction. The benefit to each person and to the community has to be weighed against any potential harm. We accept risks when we drive on the road, climb on playground equipment, cut up vegetables with a sharp knife, or take an antibiotic or other medicine that rarely triggers immediate allergic reactions in some people. Halacha is clear that we must accept the small risks of vaccines if the risk is similar to the common risks we face in our daily lives.
Every vaccine is tested extensively in order to make sure that it is both safe and effective. If a vaccine is found to be ineffective in post-release studies, it is removed from our arsenal, and then reformulated. The nasal spray against influenza was removed from use for a few years for this very reason. It has been reformulated and is now used again.
If a vaccine is found to have a problem after it is released, it is then removed promptly from the pharmaceutical market. In my experience, the first rotavirus vaccine, released in 1998, was found to rarely cause intussusception, a potentially serious bowel condition. I read about this side effect in The New York Times, and the vaccine was halted in my office that very morning, and nationally that day as well, in 1999. A newer, safer vaccine came out in 2006, and has saved countless lives since then.
The anti-vax movement has been around since the 1700s and is still here. Benjamin Franklin refused to inoculate his children against smallpox, and in his memoirs, sadly regretted this decision after the subsequent loss of his son to smallpox. Smallpox killed 20%-30% of the people it infected, and the inoculation with the weakened but occasionally still virulent virus killed 0.5%-2% of those infected. Inoculated people could spread smallpox as well. Edward Jenner in the late 1700s developed a vaccine which was safe and didn’t lead to smallpox, but prevented it. However, smallpox was not eradicated all over the world until 1980.
Today, the anti-vax movement has led to a resurgence of measles, and a growing number of people who are not vaccinated. Their reasons are varied, but many share a distrust of pharmaceutical companies and feel they place a stronger emphasis on profit over patient safety. Many people feel that vaccines are related to autism, thanks to a flawed, debunked, and retracted paper in The Lancet, by Andrew Wakefield in 1998. Families with children with autism were looking for a cause for autism. This study seemed to make a connection with vaccinating babies, and families began to refuse vaccines as a way of trying to prevent autism. No studies have replicated the flawed findings, and study after study have shown that vaccines are not the cause of autism. Researchers and doctors are still working furiously to find the cause of autism to improve treatments, but vaccines are not the cause.
Prior to 1963, there were millions of cases of measles, including my case at age five, in 1963. Unfortunately, one in 1000 children die of complications of the disease, and a precious child died in Israel in 2018, after just under 1000 cases were reported. We thought we had conquered the measles, but due to pockets of unvaccinated families, it is back. Measles is wildly contagious – just passing an infected person in a hallway is enough contact in order to contract it 10-12 days later, even after you have flown to another part of the world. Once enough people are unvaccinated the “herd immunity” breaks down and the disease can spread across continents and among your child’s friends or through schools, threatening pregnant women, pre-immunized infants and people with compromised immune systems, who cannot take the vaccine.
The flu vaccine is not widely accepted in Europe, nor here in Israel, but I highly recommend it. Flu kills about the same number of people that are killed in car accidents each year. In the US, this is about 30,000 people – enough to fill a stadium.
We all must do our part and get vaccinated, which the many in the public health sector have recommended. Just as we accept the building codes and traffic rules for the good of the community, we also have to accept vaccinating ourselves and our children.The author is a pediatrician and recent oleh from the Detroit area.
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