Vaccinations: What You Need to Know
by Cheryl Alberty, MBA, MHA, PCMH CCE
One of the greatest stories in public health can be traced back to the use of vaccinations to prevent disease. The Chinese introduced the first inoculations as early as 1000 A.D. Throughout history, and especially during the 1700’s with the discovery of vaccinations, epidemics of infectious disease that once ravaged populations of people have been stopped. Today, vaccinations have eradicated diseases like smallpox and nearly eliminated the wild polio virus. Because of the widespread use of vaccinations in the United States, many infectious diseases that were once very common are relatively non-existent. For example, prior to the Measles vaccine development in 1963 measles was estimated to cause 3-4 million cases of measles annually in the US and it was declared eliminated (absence of continuous disease transmission for >12 months) from the US in 2000 with approximately 100 cases or less annually. However, this is not the case in many low-income countries around the world and cases of measles continue to be brought into the US making it important to maintain adequate vaccination levels in the US.
In the United States recently, a nationwide outbreak of childhood communicable diseases once thought to be nearly erased is currently being reported, including diseases such as measles, mumps, and whooping cough. In fact, almost 700 cases of measles (rubeola) have been reported in the U.S. to the Centers for Disease Control and Prevention (CDC) so far in 2019, which is the highest yearly total since 1994, and it is only April. While North Carolina has not yet reported an outbreak, it is important for healthcare providers to quickly identify and isolate patients suspected of being infected.
Childhood vaccinations, especially those for the measles, mumps, and rubella (MMR) viruses, have been hypothesized to be linked to an increased risk for autism. This was predominantly due to a study published in 1998 that reported a correlation between the two. This study has since been retracted due to multiple ethical violations including falsification of data.
In fact, many reputable studies have concluded that there is no link between vaccination and autism. Not only is safety considered during vaccine development, safety monitoring for vaccines is never stopped in order to ensure that any possible risks from a vaccine are identified and addressed quickly. In recognition of the benefits and safety of vaccination, all of the major US medical organizations including but not limited to the CDC, American Academy of Pediatrics, American Medical Association, American College of Obstetrics and Gynecology, and American Academy of Family Practitioners support vaccination. Still, physicians must work closely with parents to dispel the false perceptions and negativity and communicate the importance and safety of vaccines.
Parents who decide not to vaccinate their children due to religious or personal beliefs put not only their own child, but the community as a whole at risk. When the choice is made not to vaccinate a child, there are risks and responsibilities that must be considered. Risks include:
A child can catch diseases from people who do not show symptoms.
A child can pass the illness on to others which is especially concerning for high risk populations that cannot receive the vaccine, such as young infants and those who have certain immune deficiencies.
Traveling with an unvaccinated child may open them up to possible risks of diseases that are common throughout the world.
If there is a case of vaccine-preventable disease in their community, a parent may be asked to take their child out of school.
State or local health departments are tasked with tracking disease outbreaks in communities, and they may contact families if a child has an exposure.
While responsibilities include:
All medical staff should be told that the child has not been vaccinated, including when visiting the doctor or the ER, when riding in an ambulance, and when calling 911.
The child’s school, daycare facility, and all caregivers should be notified about his/her vaccination status.
The benefits of vaccines far outweigh the risks of contracting the disease. First and foremost, immunizations save lives. Diseases that once injured or killed thousands of children and adults are now nearly non-existent, primarily due to safe and effective vaccines with relatively few side effects.
Another important reason to vaccinate is that immunizations can save families time and money. Children with a vaccine preventable disease can be denied attendance at schools and child care facilities for not having required immunizations. The cost of contracting one of these diseases can result in increased medical bills, loss of work, and long-term disability care. Getting vaccinated is covered by nearly all insurance plans. For those without insurance, the Vaccine for Children program is a federally funded program for low income families that offers vaccines to children at no cost.
No medical intervention is ever 100% effective or completely free of side effects; however, vaccines are safe and are the best defense we have against multiple serious life-threatening infectious diseases. As health providers and advocates, we all should take the time to understand the risks versus the benefits so that we can best counsel our patients.