Measles and hepatitis A have made comeback appearances in Ohio in recent years. And just months ago, a chickenpox outbreak in Walton, Kentucky, resulted in a quarantine of unvaccinated students. Still, some parents are uneasy with the recommended immunization schedule from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). Dr. Robert W. Frenck Jr., infectious disease specialist at Cincinnati Children’s Hospital Medical Center, addresses concerns and explains the facts about pediatric vaccines.
Why the controversy?
There’s no controversy, there’s misinformation. Vaccines have been so effective that many young parents have never seen the diseases. But the reason they haven’t seen the diseases is because of vaccines. Vaccines have been so good, and they are so good that they keep the diseases away, so parents see the perceived adverse events and they don’t see any perceived benefit.
What are the specific misconceptions about pediatric vaccines?
One piece of misinformation is that you can overwhelm the immune system [with many vaccines in the first years of life] and that’s been shown to not be true. If you look at the number of antigens—the things that our body is responding to—in the total vaccine series, it’s around 110 or 120 antigens. In the 1960s and 1970s, we used a whole-cell pertussis; now we use the acellular pertussis. [That’s why it’s called TDaP.] When we used the whole cell, there were around 3,000 antigens in the pertussis vaccine alone. So if the body responded perfectly fine to 3,000 antigens, it’s a hard argument to make that 100 overwhelms their bodies.
Also, a cold has around 8–10 antigens in it. A baby, on average, gets 8–10 colds a year. They get exposed to almost as many antigens from colds in the first year of life as they do from a whole immunization series.
Which vaccines are particularly problematic for some parents?
First is the u vaccine. Every year, somewhere between 40 and 50 children die from the u. In bad years, hundreds of children die from the u. Most people don’t realize that the majority of these children were perfectly normal kids with no underlying immune problem. Most people do OK, but you can’t tell who that is going to be.
The other vaccine is for measles. All of the arguments are incorrect. It’s hard to explain the difference between association and causation. With association, two things happen at the same time. If you look at kids who have received the measles vaccine and those who haven’t (about 5–10 percent of the population), the rate of autism is almost identical. If the measles vaccine was causing autism, you should have a much higher rate of autism in the group of kids that have received the measles vaccine. But it’s the same.
Some parents suggest delaying vaccines. What do you think about this?
There’s no data to show that it’s safer to split the vaccines. Actually, there is data that shows your child is at risk of infection for longer. Also, there is clear data to show that if a child leaves the once unimmunized, it’s going to increase the likelihood that they’ll never catch up, because parents are busy, and they just don’t get back in the once.
What key point do you want parents to take away?
Parents want to protect their kids. If you look at all the preventive things that we do, such as mammograms and prostate exams and colonoscopies and other things, all of those added up don’t save as many life years as vaccines. The two most important things we’ve done in medicine—and I admit I’m biased because I’m an infectious disease specialist—but number one is we wash our hands, and number two is vaccines.