To vaccinate or not to vaccinate

  • Published
  • By Col. AJ Domenichini
  • Aerospace Medicine Squadron commander
MACDILL AIR FORCE BASE, Fla. --  That is the age-old question that is resurfacing with the recent outbreak of pertussis ("whooping cough") in Hillsborough County, which is primarily due to inadequate immunity of the local population. That immunity could be corrected through vaccination. Of course, if you are active duty, the point is mute. The precedence has been set.

What about your non-active duty family members? There's some discretion in this area. In the state of Florida, as in all states, there are laws requiring school-aged children to be vaccinated. Children enrolled in public or private campus-based activities are required to have all age- appropriate vaccines. This includes children attending preschools, licensed childcare facilities and even the Florida Virtual Schools program. The only exemptions are for medical issues and religious objections. For home-schooled children, vaccinations are optional.

Why the controversy surrounding vaccines? There has been a concern about the potential side effects of vaccination; but in the past that was overridden by the fear of the disease itself. For example, when the polio vaccine first became available in 1955, families lined up to participate in the first trials, unaware of the potential side effects. Everyone knew someone who suffered from this devastating disease. Parents would not allow kids to go swimming for fear of contracting polio. People were so terrified of polio they were willing to try anything. Now that the fear of the disease has waned, the attention is shifting to the safety of the vaccines.
Why vaccinate at all? In the United States, many diseases including polio, diphtheria and measles are becoming rare, largely because we have vaccinated against them. However, the viral and bacterial agents that cause these diseases are still in our environment. It's like bailing out a boat with a slow leak. Once the boat gets filled with water, if we bail hard enough, we can nearly dry out the boat. But, if we throw away the bucket and relax, the water would start seeping in again. Before you know it, we're back where we started. Unless we can stop the leak by eliminating the disease, it is important to keep immunizing. Of interest, we have eliminated smallpox from the world population and we no longer need to immunize the general population. However, because this plague has been weaponized, military personnel are still immunized.
If vaccinations stop, diseases nearly eradicated would stage a comeback. In the early 1970s, Japan had a very successful pertussis vaccination program. In 1974, there were only 393 cases of the disease in the entire country. By 1976, fear over the vaccine spread among the population and Japanese parents stopped having children immunized. In that year, more than 13,000 cases of whooping cough occurred, and 41 Japanese infants died from the disease. Re-education of the population and establishment of an extensive vaccination campaign reversed this epidemic.
What about the controversy about vaccines that cause autism? A few years ago, a British doctor, Andrew Wakefield, observed that of the 12 children he was treating for a bowel disorder, six were also autistic. Those six had all received the Measles Mumps and Rubella vaccine. This was merely an observation and not a scientific study, but Wakefield published his findings in a prestigious British medical journal, The Lancet, and it received a lot of media attention. Extensive research by the American Academy of Pediatrics has shown the MMR vaccine does not cause autism, but this is a hard myth to erase.
Vaccines reduce the incidence of infectious diseases in the population that would otherwise harm many infants, children and adults and reduce the spread of disease from one individual to another. These diseases have many social and economic costs including lost days from school and work, as well as a rise in doctor's visits, hospitalizations and premature death. Medical and scientific evidence demonstrates the benefits of preventing suffering and death from infectious diseases far outweigh the rare adverse effects of immunization.
As parents, what should we do? The best thing to do is to stay informed. One can get information on all aspects of all vaccines from the Centers for Disease Control website, a doctor's office or the 6th Medical Group Immunizations clinic at 827-5372.