Dr. Nancy Grauso-Eby, Deaconess Clinic Pediatrician
Vaccines. They’re considered one of the greatest medical advancements in history, and can currently prevent 25 illnesses and diseases. This is a topic that is so important to me and fellow pediatricians, as vaccinations are crucial part of caring for children. In this article, learn more about vaccines, including why they’re important and how they work.
What’s the History of Vaccines?
The story actually began with an inoculation as early as 1,000 years ago. The Chinese figured out that exposing people to a very small amount of smallpox helped them become less likely to be infected in the future. This practice extended to Africa and Turkey before eventually coming to Europe and the Americas. Edward Jenner refined this science in the late 1700s with the use of cowpox to help create immunity to smallpox.
However, the true beginning of vaccine science as we know was in the late 1800s, when Louis Pasteur (You’ve heard of pasturization? That was his idea too!) developed the rabies vaccine to prevent the disease in humans. After that, further developments rapidly followed. Vaccines against diphtheria, tetanus, anthrax, cholera, plague, typhoid, tuberculosis, and more were developed through the 1930s.
The following decades brought about rapid advancements in vaccine science, targeting common childhood diseases such as measles, mumps, and rubella. Vaccines for these diseases reduced the disease burden greatly, not to mention costs of the care that comes from contracting those diseases. For every dollar spent on childhood vaccines, at least $10 in societal costs was saved.
Vaccines are one of the main reasons that lifespans nearly doubled between 1900 and 2000. Illnesses and diseases that killed so many young people were brought under control or even eradicated.
How Are Vaccines Approved for Use?
Before vaccines are licensed, the FDA requires testing to ensure safety. This process can take 10 years or longer. Once a vaccine is in use, the CDC and FDA monitor for any health problems after vaccination through the Vaccine Adverse Event Reporting System (VAERS). Any sign of a problem will result in further investigations by the CDC and FDA. If researchers find a vaccine may be causing a side effect, the CDC and FDA will initiate appropriate action that may include the changing of vaccine labels or packaging, distributing safety alerts, inspecting manufacturers' facilities and records, withdrawing recommendations for the use of the vaccine, or even revoking the vaccine's license.
Can a Baby’s System Handle All the Vaccines We Give?
The answer is yes.
An infant’s immune system is more than ready to respond to the very small number of weakened and killed infectious agents (antigens) in vaccines. No evidence suggests that the recommended childhood vaccines can “overload” the immune system. From the moment babies are born, they are exposed to numerous bacteria and viruses on a daily basis. Eating food introduces new bacteria into the body; numerous bacteria live in the mouth and nose. An infant places his or her hands or other objects in his or her mouth hundreds of times every hour, exposing the immune system to still more antigens. A child is exposed to far more antigens from a common cold or sore throat than they are from vaccines.
When you are in the womb, you are in a sterile environment. When you enter the birth canal and the world, you are not, and very quickly there are trillions of bacteria on the surface of your body. You have about 100,000 trillion (1014) bacteria on the surface of your body… more bacteria is on the surface of your body than the number of cells you have in your body.
One single bacteria has between 2000 and 6000 immunologic components. If you add up all of the immunologic components in vaccines that are given in the first few years of life, it comes to only about 160. Taking a cotton swab of the inside of the child's nose and viewing it on a microscope slide reveals that it’s teeming with bacteria which is much higher than what a baby receives in any vaccine.
The above information is from the CDC and WHO.
What Are Current Recommendations for Vaccinating Babies?
Children are given vaccines at a young age because this is when they are most vulnerable to certain diseases. Newborn babies are immune to some diseases because they have antibodies given to them from their mothers. However, this immunity only lasts a few months. Further, most young children do not have maternal immunity to diphtheria, whooping cough, polio, tetanus, hepatitis B, or Hib. If a child is not vaccinated and is exposed to a disease, they are very much at risk to get the disease. Some of these diseases are deadly to a young child and even an older adult.
Click for a current vaccine schedule recommended by both the American Academy of Pediatrics, and the CDC. ( http://www.cdc.gov/vaccines/schedules/index.html )
“But if Other People Get Vaccinated, Why Do I (or my Child) Need To?
Some people may be thinking that if everyone else gets vaccinated, that it’s unnecessary for them or their child. This is known as “herd immunity.” Herd immunity is when the vaccination of a large portion of a population provides a measure of protection for individuals who are not immune. This is very important for infants who are at great risk of certain diseases who are not vaccinated yet or are in the process of being vaccinated. It is also very important for the elderly who may have waning immunity, or those who are immunocompromised, such as children and adults undergoing chemotherapy or are on medications that weaken their immunity.
Vaccination acts as a sort of firebreak in the spread of the disease, slowing or preventing further transmission of the disease to others. Unvaccinated individuals are indirectly protected by vaccinated individuals, as those vaccinated are less likely to contract and transmit the disease between infected and susceptible individuals. When people who can and should be vaccinated don’t do so, they put other people who are compromised (or not yet vaccinated) at risk.
Only a few years ago there was a measles outbreak in San Diego. This was related to a California mother who didn't vaccinate her children, and she took her children to Switzerland (measles is more prevalent overseas than in the US). Her 7-year-old child got measles, came back to the US, and her mother took her to the doctor because she didn’t recognize the illness.
The child had fever and a rash, and exposed everyone in the waiting room. Measles is highly contagious. Three of the children in the waiting room were less than 1 year of age and hadn't yet been vaccinated. All were severely infected with measles, were admitted to the hospital, and one almost died. When individuals decide not to vaccinate themselves or their child, their decision doesn’t just affect them—it affects others.
To Vaccinate Or Not?
Let me start by saying that most people over the age of 50 remember so many of the diseases that can now be prevented, such as measles, mumps, rubella, diphtheria, meningitis, polio and pertussis. They remember how awful these illnesses could be, and the sometimes serious/deadly effects of the diseases. I think because these diseases have been so removed from society for so long, people now don’t appreciate the significance of these illnesses.
Because of reduced vaccine rates, children are developing these diseases at a higher rate again. I’ve been practicing pediatrics for 12 years, and I have admitted numerous children struggling to breathe because of pertussis (whooping cough) to the hospital. I’ve seen cases of Hib meningitis and pneumococcal meningitis that were quite serious. I’ve treated varicella (chicken pox) that was complicated by encephalitis (brain inflammation), and I had to admit a child who ended up being on a respirator because of tetanus. Seasonal flu (influenza) in babies is also very scary.
As a pediatrician who loves caring for children, I struggle when parents don’t want to vaccinate or challenge the recommended schedule. It scares me to send children out into the world where dangerous and deadly diseases THAT WE CAN PREVENT are waiting. There are so many things out in the world that can harm children that we can’t do anything about. These 25 vaccine-preventable illnesses ARE scary things that we can do something about.