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Sunday January 13, 2013

Clearing up doubts

Are there any dangers from vaccinations? Should you get your child vaccinated?

VACCINES have reduced the number of deaths and disabilities caused by diseases that were at one time considered incurable, let alone preventable. Even today, vaccine-preventable diseases still account for 1.5 million deaths worldwide. With vaccination, these unnecessary deaths could have been avoided, yet many parents still harbour doubts about whether their children should be vaccinated.

Their worries include the possibility that their children could have adverse reactions, side effects, or even fall sick because of the vaccine.

There are many controversies surrounding vaccines, with many fanciful claims to confuse parents.

With the millions of doses already given worldwide, vaccines represent a safe and effective means to protect your child from infectious diseases, and even, some cancers (eg hepatitis B, liver cancer, HPV and cervical cancer).

Young children are especially vulnerable as they have an immature immune system and are at higher risk of suffering complications if they are infected by diseases. It is thus much better to prevent these diseases than to regret the consequences that could follow.

How vaccines work

When your child is exposed to a disease, her immune system will try to defend her body against it. If the body successfully defends against the disease, this results in immunity to future infections of the same disease, due to activation of memory cells.

This happens because her body produces antibodies that target that specific disease, which are available the next time your child encounters the same disease again; the antibodies will either prevent the disease, or reduce the severity of the disease.

Vaccines work in a similar way, but with an added bonus; instead of having to suffer through the course of a natural infection and risk its complications, a vaccine allows your child’s body to achieve immunity against a specific disease without actually experiencing it.

Benefits of vaccination

Vaccination has been proven to successfully reduce, and even, eliminate diseases. Not only does vaccination prevent the recipient from becoming infected, it also protects the people who come into contact with the vaccinated person.

This effect is also known as the “herd effect”, whereby people who are not vaccinated against a particular disease are sheltered from it by virtue of being surrounded by people who have been vaccinated.

When the pneumococcal conjugate vaccine (PCV) was introduced in the US, other than finding a reduction of more than 90% of invasive disease among the recipients, a 34% reduction in disease was found among the aged who did not receive the vaccine.

Vaccination pre-empts the mental and physical trauma of suffering a disease and enduring its complications. It is crucial that you take vaccination seriously and ensure your child receives his/her vaccines according to the National Immunisation Programme (NIP), as well as other recommended vaccines at the appropriate ages.

Thanks to vaccines, diseases that were previously rampant have been eradicated or reduced. These include:

Smallpox: Completely eradicated worldwide in 1979.

Polio: In 1978, 120 cases were recorded in the country, but by 1992, the figure dropped to only four cases that were “imported” from other countries. There have been no cases since 2010 in Malaysia.

Diphtheria: In 1976, 250 cases were recorded, but by 2007, there were no cases. There were a few diphtheria cases in the 1980s among children in religious communities that rejected vaccination.

Pertussis: The number of cases from 1975 to 2008 dropped by over 90%. However, waning immunity and the need for adult pertussis vaccination has led to its reappearance. The US declared a pertussis epidemic on April 3, 2012, and it was their nation’s worst case of pertussis in half a century.

Misconceptions about vaccines

1. Vaccines cause side effects (either immediate of long-term), diseases or death.

Vaccines are safe. Some children may have minor symptoms after vaccination, such as a sore arm or mild fever, but adverse effects occur very rarely.

Continuous surveillance carried out by the Center for Disease Control and Prevention (CDC) in the US shows little or no evidence that the deaths reported to the Vaccine Adverse Event Reporting System (VAERS) were due to vaccines (CDC continuous surveillance between 1990 and 1992).

2. Giving a child multiple vaccines for different illnesses at once can overburden the immune system.

Combination vaccines will not be too much of a burden for children’s immune systems. Research has shown that children’s immune systems are able to cope with even more antigens than those contained in combination vaccines.

3. Some diseases have already disappeared from Malaysia, so why vaccinate my child against it?

Certain diseases are rare in our country due to effective compulsory vaccination. However, family or friends who travel to countries where these diseases still exist might unknowingly bring these diseases back. Having your child vaccinated helps prevent him/her from catching these diseases.

Vaccine myths and controversies

1. The MMR (measles, mumps, rubella) vaccine causes autism and bowel disease.

The link between MMR and autism is completely baseless!

In 1998, British researcher Dr Andrew Wakefield published a paper in the medical journal The Lancet, claiming a link between the MMR vaccine and the development of autism and bowel disease.

This paper has since been discredited by many experts as it was based on a small case study with no controls that linked three common conditions, and relied on parental recall and beliefs.

Journalist Brian Deer subsequently showed evidence that Dr Wakefield falsified patients’ medical histories in order to support his claim of discovering a new syndrome.

Following this, 10 of the study’s authors subsequently went on to withdraw their support of the study, and it was also retracted by the editors of The Lancet.

Unfortunately, by the time the article was retracted, the damage had been done, as many parents in the UK decided not to vaccinate their children against MMR. The results were disastrous as it led to a measles outbreak in the UK that caused fatalities.

2. The polio vaccine causes paralysis.

Reports of live oral polio vaccines causing vaccine-associated paralytic polio (VAPP) have been going on for many years; but despite the hype, actual occurrences are very, very rare. The Malaysian NIP administers the injected inactivated polio vaccine (IPV), which does not cause VAPP.

Vaccination is a hassle-free and cost-effective method of primary prevention for children. Compared with the risks of vaccinations, the complications of actually suffering vaccine-preventable diseases are much worse.

The bottomline is that vaccination is a simple, safe and effective way of protecting your child and yourself against diseases that can potentially cause serious illnesses, and may sometimes even lead to death.

By vaccinating your child, not only will she be protected, she will also not pass the infection on to other people, children or babies. So if your child has yet to be vaccinated, get it done now! Don’t neglect booster shots either, as they must be completed in order to effectively protect your child.

> Datuk Dr Zulkifli Ismail is a consultant paediatrician and paediatric cardiologist. This article is courtesy of Positive Parenting Programme by the Malaysian Paediatric Association, supported by an educational grant from Sanofi Pasteur. The opinions expressed in the article are the views of the author. For further information, please visit www.mypositiveparenting.org. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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