It used to be a no-brainer: if you were a responsible parent, you automatically took your child for shots against the diseases that crippled or killed entire communities before the advent of vaccinations, which the World Health Organisation (WHO) says save three million lives a year.
But in 1998 a study appeared in The Lancet medical journal suggesting a possible link between the MMR vaccine (for measles, mumps and rubella) and autism. And several celebrities, including actor Aidan Quinn and Jim Carrey’s (now ex) girlfriend Jenny MCCarthy, appeared on talk shows with other parents, sharing anecdotal evidence suggesting an autism link in susceptible children. Important to note that this tiny, single article was proven to be untrue and unscientific all together and results thereof should not be advocated.
Social media lit up and fears have resonated since for some parents, who are delaying having children vaccinated – or not having it done at all. And this, say health authorities, has contributed to recent outbreaks of diseases that had been virtually eradicated by vaccinations – including measles, mumps, whooping cough and diphtheria – in Europe, the US, Australia, New Zealand and South Africa.
“The trouble is, when parents reject vaccination, herd immunity breaks down,” says Prof Rosemary Burnett, head of the South African Vaccination & Immunisation Centre in the department of virology at the Sefako Makgatho Health Sciences University, Pretoria. “In order for a community to be properly protected against measles, for instance, at least 93% of its members need to have been vaccinated. When fewer have their shots, babies too young to get them, or those with immune conditions or allergies that prevent having them, are put at risk.”
From 1 January to 24 November 2017, 203 laboratory-confirmed measles cases were detected in South Africa. “The Northern Cape was the only province not affected,” says Burnett. Before that, in a major outbreak from 2009 to 2011, nearly 18 500 cases were confirmed, with 18 deaths at Cape Town’s Red Cross War Memorial Children’s Hospital alone.
So what are the facts behind the fears driving some parents to question vaccinations?
Fear 1: The autism link
The facts
It turned out that the Lancet study was based on just 12 autistic children with no control group, and many had signs of autism even before being vaccinated, says Burnett. All but two of the 12 authors went on to retract their names from the article, The Lancet withdrew it and the main author, a UK gastroenterologist (not a virologist or autism specialist), was dropped by the British Medical Council for falsifying data.
Five years later, one of the most comprehensive studies conducted was published in The New England Journal of Medicine, analysing the MMR-autism connection. Its conclusion? There was no difference whatsoever in the autism rates of children given the MMR vaccine and those not. “Since then, numerous studies conducted on more than a million children have found no evidence that the MMR or any vaccine causes autism,” says Burnett.
Yet fears persist, fuelled by some parents of children with autism noting that the first signs appeared after their babies’ MMR shots. This is entirely coincidental, say medical researchers – children are given their first MMR shot between 12 and 24 months, the age when signs of autism usually first appear.
Fear 2: Other possible side effects
The facts
Vaccines have the potential to cause side effects, says Cape Town paediatrician Dr Paul Sinclair. “They constantly become safer through improved technology and formulation.” The effects are mostly short-lived and mild, such as redness, tenderness or slight fever. Only one in many thousand is serious, says Burnett. For instance, the risk of a child having a serious reaction to the measles vaccine is one in a million. But contracting measles carries a one in 20 risk of pneumonia, one in 2 000 of encephalitis, one inâ¨3 000 of death in an industrialised country – and an alarming one in five of death in a developing country such as South Africa.
Fear 3: Harmful ingredients
The facts
Anti-vaccination websites claim vaccine ingredients include mercury, formaldehyde, antifreeze and human foetal cells. But this is untrue, or at best a misrepresentation, says Burnett. For example, some viruses are cultured in laboratories on cells originally taken years ago from aborted foetal tissue, but the virus is purified and passes through numerous stages in the preparation of a vaccine.
As for mercury, from which the preservative thiomersal is derived, this has not been used in infant vaccines in South Africa since 2009, she says. Thiomersal is used in the multidose vials of the vaccine against tetanus and diphtheria (Td), which is given to children at six and 12 years of age. “Td contains much less ethyl mercury than your child would get from exposure to methyl mercury, a toxic form of mercury to which your child is exposed in everyday life – for example, through drinking water and breast milk. Ethyl mercury is quickly removed from the blood and excreted and numerous studies have shown the amounts used in vaccines to be safe,” says Burnett.
Fear 4: Overburdening an immature immune system
The facts
Even giving your child the full raft of inoculations exposes them to fewer bacteria, viruses and other antigens than one day of breathing, eating and playing, says Dr Paul Offit, director of the Vaccine Education Centre at the Children’s Hospital of Philadelphia and author of Autism’s False Prophets. Some parents are putting off vaccinating babies until they are a year or two old and their immune systems have matured, but this leaves them unprotected from serious diseases at the time when they are most vulnerable, says Burnett.
Fear 5: Effects on the body’s natural immunity
The facts
It’s true that the body creates its own immunity through contracting a disease, making it less likely to succumb a second time, or at least as severely, and some parents still have “chicken pox” parties to “get it out of the way”. But this approach has huge risks. For example, measles poses a serious danger to very young or malnourished children and those with weak immune systems, and can lead to complications ranging from ear infections to blindness, encephalitis or death, says Burnett. Mumps can result in meningitis and male infertility, whooping cough can cause brain damage and death, and pneumococcal diseases include meningitis and severe pneumonia – the top causes of death in children aged five and younger worldwide. “In contrast, the vaccines that prevent these diseases are safe, and the risks for severe outcomes associated with them are extremely low.”
It’s not just mainstream medical practitioners who see it that way. “Our members have diverse opinions on vaccination,” says Dr Neil Gower of the Homeopathic Association of South Africa. “But most advocate weighing the costs of taking a vaccine with the risk of that particular illness and its severity, as well as your social responsibility not to spread infection.”
The bottom line?
The decision to vaccinate is entirely yours. You will need proof of vaccinations to enroll your child in school, and if you don’t have it the principal must refer you to a clinic, but can’t refuse to admit your child. In the interests of your child’s wellbeing, however, and that of other children in the community, it’s vital to make that choice responsibly.
The accuracy of this information has been verified by Dr Ilana Joubert.
IMAGE CREDIT: 123rf.com