Fear Of Vaccines
Unwarranted; Health Scares Not Proven
Pediatricians seem to encounter skeptical parents almost
daily asking the same questions:
“Is it really safe for our child to take all these
vaccinations in such a short period of time?
“Does my child really need these vaccinations since the
diseases are so rare?”
Their concerns reflect a genuine fear factor.
“How to deal with parental fears? That’s the $64 question,”
said Dr. Samuel Katz, 81, a pioneer in the development of vaccines and related
research since the days when polio ravaged so many people across the United
States. He also is dean emeritus of the pediatric school at Duke University.
His most important response:
“You must have faith and trust in your physician.”
Dr. John Rusher of Raleigh Pediatrics who attended medical
school at UNC-Chapel Hill agrees.
“That’s what I tell parents all the time. We are not here to
cause disease. We are looking for ways to prevent disease.
“We think that one of the best things we can do for children
is preventive care, and vaccines in my opinion are one of the most unheralded
breakthroughs we’ve had in the last 50 years,” said Rusher, who has practiced
for 11 years. “We have seen in our practice a decrease and even disappearances
of some diseases that we had had to deal with in previous years.”
Conversely, the success of virtually eliminating polio and
wiping out smallpox has triggered complacency. Rusher counters that attitude by
warning about potential risks.
“My answer is: No. 1, the diseases are still there. They
could still get whooping cough or chicken pox. No. 2, these infections can
re-emerge. They may be dormant now, but as the rates of vaccination go down,
they can re-emerge. The third reason is to prevent infections that are common
in the rest of the world.
“Because of international travel, we are a hub. Too many
people are NIMBYs — not in my backyard. They say an outbreak is not going to
happen here. That’s not necessarily true. It can happen here, and in fact it has.
Now we are seeing more international scares of some illnesses that have been
around for a while. The risk is still there.”
Despite assurances and warnings, concerns and complacency
among parents continue to challenge pediatricians.
Do Vaccines Cause Autism
Or Other Diseases?
Day after day, year after year stories surface linking
vaccines — or ingredients in them, such as mercury — with an increase in autism
or other afflictions, even diabetes.
“One thing they have to have is confidence in their physicians,
particularly their pediatricians,” Katz repeated for emphasis. “We have the
results of study after study that have disproven the relationship between
autism and vaccines.
“On the other hand, we are still handicapped by the
question, ‘Well if it’s not the vaccine then what causes it?’ We don’t know.
“We do know from a number of good studies that there are
genes that cause autism. What we don’t know is what causes them to turn on or
to turn off. For example, there are very strong connections between identical
twins. If one has autism, there’s an 80 percent chance both will. If they are
not identical twins, there’s a 20 percent chance. At least that gives you some
clue to the genetic aspects.”
Reacting to concerns about the mercury preservative known as
Thimerosal, pediatricians recommended in 1999 that it be removed, Katz said. By
2001, all of it had been removed with the exception of some adult influenza
vaccines. But that move didn’t end the autism surge.
“Despite removing the Thimerosal, over the next seven years,
autism continued to occur more frequently,” Katz said. “We’ve been very
succinct in disproving what causes autism. Unfortunately, we have not been able
to determine what causes autism to express itself. Until that happens,
lingering doubts will remain.”
Rusher encounters similar concerns about autism but said he
and his fellow doctors feel confident the Thimerosal and vaccine cocktail
questions have been answered.
“There have literally been dozens of studies that refute
measles, mumps and rubella vaccines cause autism, both overseas and the US,”
Rusher said.
“What do we rely on in making our recommendations? We look
at the evidence to determine as a practice and as individual doctors,” he said.
“We certainly believe these claims are worth investigating, and we believe they
have been or we wouldn’t continue to give these vaccines.”
If not the mercury, could autism then perhaps be triggered
by the cocktail of vaccines for measles, mumps and other maladies?
No, Katz insisted. Those connections “all have been proved
to be fallacious.”
Vaccines To Stop
Cervical Vaccines, Liver Disease
Questions also continue to be raised about recently
developed vaccines to prevent cervical cancer in young girls. The vaccine
Gardasil from Merck helps prevent the human papillomavirus, which is linked to
cervical cancer. GlaxoSmithKline is also seeking US approval for a similar
vaccine called Cervarix.
But Katz said people wanting iron-clad proof that the
vaccines work will have to wait years for such data.
“We don’t have absolute proof because it’s going to take
many years having prevented infections to say that the vaccines prevented
cervical cancer,” Katz said. “It’s going to take 20 to 30 years from now before
we can say so absolutely.
“We had the same thing with hepatitis B and liver disease.
We couldn’t say it prevented cancer of the liver because it didn’t occur for
another 20 or 30 years. Now, it is possible to show cancer of the liver is not
occurring.
“Hopefully, we’ll have the same thing in 2035 to say about
cervical cancer. But until then, all we can say is that the vaccines are very
effective at preventing the infection.”
Is Mandating
Vaccinations the Answer?
Texas Gov. Rick Perry discovered in 2007 that mandating use
of vaccines is not the answer to overcoming parental concerns. Perry issued an
executive order requiring 11- and 12-year-old girls receive the cervical cancer
vaccine. After howls of public protest, the state’s legislature overrode his
order.
Katz numbers himself among those who don’t believe mandates
are the answer.
“Until the vaccine has been used a number of years and we
feel comfortable with the total safety of the vaccine and that the immunity
generated is persistent and prolonged, I think it’s premature to say you have
to be vaccinated before you can go to college,” Katz said.
However, he also pointed out that rules requiring
vaccinations of children before they attend school, such as for measles, have
proved effective.
“We used to have several million cases of measles,” he said.
“Now, it’s a rarity. In contrast, there have been so few over the last 15
years, and in almost every one of the cases they occurred in children whose
parents elected not to have him or her vaccinated. That’s very unfortunate.”
Many Americans also have grown complacent about the need for
such vaccines, including polio. But Katz warned the diseases have not been
eradicated.
“We still have importations of the diseases,” he said.
“There are still places where measles exist.”
Why So Many
Vaccinations So Soon?
Parents who consent to vaccines still may not embrace the
schedule as prescribed by physicians. Rusher sees that trend growing among the
25,000 patients seen by the 14 doctors of Raleigh Pediatrics.
“Yes, it’s no fun to watch a 2-month-old receive four or
five shots, but the amount of exposure to antigens in the shot is miniscule
compared to what they already face in the real world,” Rusher said. “When kids
are born, they are faced with literally thousands of bacteria and viruses. If
it’s a healthy child, they already have a functioning immune system that has
billions of cells working to prevent infections. Giving them vaccines within
the first two years of life is like a raindrop in the ocean of bugs already out
there bombarding the baby’s immune system.”
Fears and anxiety run in cycles, Rusher added, and he blamed
the media in part.
“About every two or four years there will be a show on Oprah
or an article in a publication in which somebody claims their child was harmed
or has developed a delay of some kind because of vaccines,” he said. “We are
answering more questions and spending more time explaining our opinions and our
feelings about the benefits of vaccines.
“We are not alone in this. I know pediatricians in the state
who are currently dealing with an increased level of fear.”
Part of the problem is that young parents today have not had
to experience diseases that were common not that many years ago, Rusher added.
“It is sometimes hard to rationalize why their infant should
receive a vaccine against diseases they have no perspective about. We have in
my opinion been very successful in eliminating or decreasing significantly many
of these diseases so they are not at the forefront of anxiety for young
parents.”
Rusher recalled with passion the vaccines he received as a
child — and praised Katz who continues to travel the world as an advocate for
vaccinations in a continuing bid to eradicate diseases just as smallpox was
finally eradicated.
“It’s interesting to talk to grandparents today who thought,
‘Darn right we’ve got to get every vaccination we can’ for their kids because
they knew neighbors or had cousins who suffered with polio or died of
diphtheria or had a bad case of the measles,” Rusher said. “Dr. Katz travels
all over the world, and he can tell you that outbreaks in poorer countries are
still at the forefront of world health concerns.
“The schedule every pediatrician in this state uses is
developed by a combination of the Centers for Disease Control and others. The
schedule that was developed does have some leeway, but the schedule is there
for many reasons. It was developed by people who put a lot of thought into when
is the best time to prevent specific illnesses, as well as the best time to get
the immunization system geared up to prevent a particular virus.
“We are passionate about vaccines because we think this is
one of the best things we can do for our patients — preventive care.”
Where To Go for More
Information About Vaccines:
NC INFORMATION
The North Carolina Immunization Branch focuses on increasing
immunization rates of children. North Carolina provides vaccines for children
from birth to 18 years old.
Go to www.immunizenc.com for more information.
RECOMMENDED READING
Dr. Samuel Katz, dean emeritus of pediatrics at Duke
University, recommends a recently published book, Do Vaccines Cause That?!, for
people seeking answers about questions surrounding vaccines and possible links
to other diseases. Dr. Martin Myers and Diego Pineda, the editor and science
writer for the National Network for Immunization, co-authored the book. Go to
www.dovaccinescausethat.com for more. The immunization group also maintains a
Web site: www.immunizationinfo.org.
National Network for Immunization Information
UNIVERSITY RESEARCH
Both Duke University and UNC-Chapel Hill operate institutes
that are focused on vaccine research: Duke Human Vaccine Institute,
www.humanvaccine.duke.edu, and Carolina Vaccine Institute, www.med.unc.
edu/cvi.
MEDICAL BRIEFS
Organ Donor Changes
Name
The North Carolina Coalition on Donation has changed its
name to Donate Life North Carolina to identify with the national organization,
Donate Life. The organization is seeking to add new donors to the DMV and
online registries and other outreach to ensure that an organ, eye or tissue
transplants are available.
North Carolinians are urged to say yes to donation at their
local DMV office or to join the recently created online donor registry. To
register or for additional information, log on to www.verybigheart.com.
Hands of Health
Nominations
The John Rex Endowment invites nominations for the fifth
annual Hands of Health Award, established to recognize individuals who
demonstrate innovation in efforts to improve the health of children and youth
in Wake County. The deadline for entries is Sept. 5.
The winner will be announced at the annual Hands of Health
program, an invitation-only breakfast to be held Oct. 21. A specially
commissioned bronze sculpture by artist Ruth Burink will be presented to the
winner, and the John Rex Endowment will make a donation of $10,000 to the
winner’s charity of choice.
Nomination forms and guidelines are available at
www.rexendowment.org/about/ hoh.html.
Past winners of the award include: Peter Morris, MD; Don
Rosenblitt, MD; Mark Piehl, MD; Yo Sobha; Kathy Higgins and Lillian Berman.
WakeMed Wins Award
For Diabetes Program
The American Hospital Association bestowed its NOVA Award to
WakeMed Health & Hospitals for its ENERGIZE! program, a pediatric nutrition
and fitness education plan designed to help curb diabetes. The program is one
of only five collaborative hospital-led programs in the nation recognized this
year for collaborative efforts toward improving community health. The John Rex
Endowment, which invests in the development and support of activities, programs
and organizations that improve the health of children in Wake County, has
supported WakeMed’s ENERGIZE! and other components of the WakeMed Children’s
Diabetes & Endocrinology Program with over $1.7 million in grant funds.
Pitt Trauma Unit
Certified
The North Carolina Office of Emergency Medical Services has
re-designated Pitt County Memorial Hospital as a Level 1 Trauma Center with
verification by The Committee on Trauma of the American College of Surgeons.
PCMH, which admits 2000 trauma patients each year, was
designated a Level 1 center in 1985. The American College of Surgeons committee
verified certification in 2005. The new certification is effective until August
2013.