WE refer to the letter “Why parents fear vaccines” (The Star, Feb 22), which states that parents’ fear of vaccine or vaccine hesitancy and refusal is related to cases like Hannah Poling’s. We find that the points raised were scientifically poorly evidenced at best and extremely naive at worst.
Firstly, most parents here would not have heard of Hannah Poling or Dorothy Werderitsch, let alone the National Vaccine Injury Compensation Programme (NVICP), commonly known as the Vaccine Court.
Reviving the Poling case illustrates the desperate attempts of anti-vaccine activists to resuscitate the “greatest medical hoax of the 20th century” – that vaccines might cause autism, in this case through mitochondrial disorders.
The Polings had gone to town with the NVICP verdict in 2008, declaring “the results in this case may well signify a landmark decision with children developing autism following vaccinations.”
And the writer’s reference to Andrew Wakefield to theorise her “trigger, unmask and manifest hypothesis” is most unfortunate and discreditable, considering he was a fraud whose paper was withdrawn by the Lancet and his results were never reproduced.
Nothing could be further from evidence-based medicine than the NVICP compensating Werderitsch in 2006 following her claim that a hepatitis B vaccine caused her multiple sclerosis. Several studies debunked this association and the Institute of Medicine concluded that “evidence favours rejection of a causal relationship between hepatitis B and multiple sclerosis”.
Similarly, the NVICP 2008 decision on the Poling case was difficult to rationalise clinically, i.e. it was bad science.
Any infection can exacerbate encephalopathy in children with mitochondrial disorders. The proponents of the theoretical risk of “trigger, unmask and manifest” would therefore advocate the spacing out, delaying or withholding of vaccines, which would actually increase the real risk of these children being exposed to natural infections that would trigger their encephalopathy.
This unknown and theoretical risk of “dormant underlying diseases” (which the writer admits is extremely rare) suffering from vaccine injury as hypothesised is being prioritised over the known and real risk from vaccine-preventable diseases.
Real world experience archived that smallpox killed 300 million people in the 20th century before it was eradicated by the World Health Organisation global vaccine campaign in 1980. Vaccines prevent 2.5 million deaths and 3.4 million disabilities each year. And there is an opportunity to save another 2.5 million lives annually if the routine and new vaccines are used more widely.
If anything, such children with “dormant underlying diseases” should be immunised since they are very susceptible to infections. And there is no evidence to suggest that vaccines trigger these exacerbations.
Poling had many other immune challenges that would likely exacerbate her encephalopathy. She had frequent episodes of fever and ear infections, requiring ear grommets to be inserted into her ear drums. Any of these could have triggered her encephalopathy.
How about otherwise healthy children then? They are normally exposed to millions of germs every day!
The antigens in the five vaccines administered to Poling are minuscule in comparison. The concern that multiple vaccine administration would weaken and overwhelm the immune system of the susceptible child is scientifically flawed.
The child’s immune system is much more robust that you might imagine, since the cells are constantly restored. It is estimated that if all the scheduled vaccines were given to infants at one time, only 0.1% of the immune space would be used up.
And the vaccines currently available also contain fewer antigens. In the past, a single smallpox dose had 200 antigens. Today, there are only 150 antigens in the 14 vaccines given to young children.
In the late 1970s, vaccine manufacturers were sued by American lawyers for vaccine injuries which ranged from epilepsy to mental retardation, sudden infant death syndrome, unexplained coma and etc.
In 1986, the US government passed the National Childhood Vaccine Injury Act to eliminate the potential financial liability of vaccine manufacturers due to vaccine injury claims. This was done to ensure a stable market supply of vaccines and to provide cost-effective arbitration for vaccine injury claims. This act also established the NVICP.
Moving forward, the Health Ministry might consider a similar vaccine court model, but one that is better grounded and more rigorous in its criteria unlike the American NVICP, which turned its back on science in the two mentioned cases.
By not vaccinating your child, he/she has 23 times increased risk to pertussis and nine times to chicken pox.
For smokers, the Health Ministry rules that they take their smoke elsewhere and do not share it with others. Similarly, innocent children have the right to play without the fear of catching measles, pertussis, chicken pox, etc, from friends whose parents believe everything they read on the Internet.
Freedom of choice is a good thing, but the freedom to harm others is not. And you don’t have to wait for a vaccine court to do the right thing.
DATUK DR MUSA MOHD NORDIN
Consultant paediatrician & neonatologist Damansara Specialist Hospital and
CHAN LI JIN
Founder, MyHealth Outreach and Parenting2U