Again, Vaccines Are Safe and Necessary
Vaccinations against many childhood diseases are much needed yet often not given. Antivaccination people are creating pockets of unvaccinated children who then spread the most contagious of childhood diseases, measles, to people who are unable to receive vaccinations. In addition, the recent influx of illegal immigrants creates a large drain on health care systems.
In many countries, a second dose of a combined measles-mumps-rubella (MMR) vaccination is recommended at ages four to six years of age. Similarly, the booster of diphtheria-tetanus-and-pertussis (DTaP) and inactive-polio-vaccine (IPV) and a second dose of varicella (chickenpox) vaccine are also recommended. Implementation of universal routine vaccination programs has led to a dramatic reduction of these diseases. Endemic MMR in the US has eliminated measles and rubella while mumps has been decreased by more than 99%. The US Advisory Committee on Immunization Practice recommends giving the first shot of MMR at 12-15 months of age with a second dose given at four to six years old-usually just prior to starting school.
This study found that vaccinations were useful in causing seroconversion in all tested children (+/- 4000). It was noted; however, when DTaP-IPV and varicella are also given at the four to six-year benchmark, varicella was shown to need an additional dose to give adequate immunity. It was also noted that when DTaP-IPV was given along with the MMR there was a higher report of pain at the injection site but the seroconversion was unchanged (The MMR-158 Study Group, 2019).
Importance of Vaccinations
Vaccinations are one of the most important achievements in public health. They have led to a great reduction in morbidity and mortality in all countries all over the world. Unfortunately, there are two groups that threaten others lives because they either refuse to vaccinate their children or under vaccinate them. This practice leads to outbreaks of dangerous diseases like measles in areas that allow parents to refuse to vaccinate their children before starting daycare or school. In western educated, industrial, rich, and democratic societies, opposition to vaccination has a long history.
These people refuse vaccines because of unsafe misinformation and claims of harm related to the vaccines. It is because of this that antivaccine thinking survives today. In addition, this misinformation has led to outbreaks of vaccine-preventable diseases and deaths. Currently, the Pacific west coast in the US and sporadic areas across the country are experiencing outbreaks of measles. And there was a boy in Oregon who had to spend two months in the hospital because his parents opted out of getting him vaccinated for tetanus (lock-jaw). No press is covering the fact children with impaired immune systems are dying because of contact with healthy children whose parents refuse to have them vaccinated. To counter this, education and information should concentrate on vaccine safety and effectiveness (Baggio & Gétaz, 2019).
Testing safety of vaccinations
This study was done to evaluate the clinical consistency, immunogenicity and reactogenicity of three batches of MMR vaccine prepared with active pharmaceutical ingredients (API) compared to a vaccine for MMR with different API. Immunogenicity is the ability of a substance to provoke an immune response. Reactogenicity is a state of being able to produce adverse reactions. The combined vaccine for measles-mumps-and-rubella has been used since 2003 by the Brazilian National Immunization Program (NIP) is a mixture of attenuated a weakened or reduced strength material so it is no longer dangerous, virus strain. After 2013 it added varicella to the MMR vaccination to be given at 15 months. Participants were infants who were healthy when given MMR and MMRV vaccines. The study demonstrated the high immunogenicity of measles and rubella components and modest immunogenicity of the mumps. Reactogenicity of both vaccines manufactures was low.
The results also disclosed the poor immune response of the varicella component; which was unexpected. This one dose of MMRV at 15 months was good for MMR but insufficient for varicella. This came after children completed the basic immunization schedule in Brazil. After two doses of MMR, seroconversion was greater than 99% for all three components. Both brands of vaccines were well tolerated with no serious events had confirmed causality for the vaccine. The major side effect was fever but even that was less than described in the Adverse Event Handbook of the Ministry of Health (dos Santos et al, 2019).
Monitoring for potential adverse events following immunization (AEFI) is the core of post-marketing vaccine safety surveillance. The background rate of disease that could be AEFI can be used to estimate the number of expected events within a known population over a period of time. Knowledge of background rates are especially useful when a new vaccine is introduced or a schedule change is made. Several studies during and following the 2009-2010 H1N1 pandemic addressed the importance of understanding the existing background rates of relevant rare and serious medical conditions that could be reported as AEFI, like Guillain-Bárre Syndrome after influenza immunization (H1N1), when assessing the safety of a mass vaccination campaign. Calculation of background rates serves to further strengthen vaccine safety surveillance systems. Despite limitations including lack of clinical validation, this study provides an example of how health administrative data can be used to determine background rates and possible assistance in the interpretation of passive vaccine safety surveillance knowledge of the expected incidence of possible AEFI is essential to investigating vaccine safety (Wormsbecker et al, 2019).
Continued Issues With Those Not Vaccinated
Immigrants are under-immunized and a higher risk of vaccine-preventable diseases. Even when equipped with that information there has been no comprehensive look at what policies are in place targeting the migrant population. Outbreaks of measles and hepatitis A have been documented in migrant populations. There are significant variations in policies for vaccinations in migrant groups across the US.
There are considerable variations across the US concerning vaccinations are mandatory or voluntary for migrants. So-called sanctuary cities for illegal immigrants are now faced with measles outbreaks that are causing a major health care drain. Part of the reason for this is the continued lack of vaccinations stems from the fear of being discovered by officials as being here illegally and deported. It is felt the minimum vaccinations should include MMR, DTaP, polio, Hib, and hepatitis B. Even in the European Union they are facing health issues due to the influx of unvaccinated migrants from Iraq, Syria, and Afghanistan. Prior to conflict, these areas were current with vaccinations; now not so much (Ravensbergen et al, 2019).
In local news feeds over the past few days, multiple articles concerning measles outbreaks are a big problem and how antivaccine people refuse to accept the scientific evidence that there is no connection between vaccinations and autism. One article that illustrated the closed-mindedness of these people was one that told of an 18-year-old boy who spoke before Congress about how even when he tried to show his mother the scientific evidence about the safety of vaccines, she refused to believe it. This shows just how much damage was done by the one study in 1998 that fraudulently reported a connection between vaccinations, particularly the measles, mumps, and rubella vaccine, and autism.
There has never been a demonstrated link between these two items. The danger of contracting measles is that one in twenty develops pneumonia and one in 1000 can develop brain swelling that leads to seizures, deafness or intellectual disability or even death. It is one of the most contagious viruses known to medicine. This is truly sad as the vaccination is completely safe. A study done in Denmark followed 657,461 children born between 1999 and 2010. Using a registry they followed which of the children received the MMR vaccine. They looked at many factors in the children of the study as if there were siblings with autism or other health issues before the vaccination was given. This study found 95% of the children followed received the vaccination with less than 1% of them diagnosed as having autism; the majority of them had siblings or blood relatives with autism. Of course, none of these articles take into account the number of illegal aliens who have never been vaccinated and their effect on the surrounding communities.
Baggio, S. & Gétaz, L. (2019). Current gaps in vaccination coverage: A need to improve prevention and care. International Journal of Public Health.
dos Santos, E.M. et al. (2019). Immunogenicity and safety of the combined vaccine for MMR isolated or combined with the varicella component administration at three month intervals; randomized study. Institudto Oswaldo Cruz, Rio de Janeiro.
Ravensbergen, S.J. et al. (2019). National approach to the vaccination of recently arrived migrants in Europe: A comparative policy analysis across 32 European countries. Travel Medicine and Infectious Disease.
The MMR-158 Study Group. (2019). A second dose of MMR vaccine administered to healthy 4-6 yr old children: A phase III, observer-blind, randomized safety and immunogenicity study comparing GSK MMR and MMRii with and without DTaP-IPV and varicella vaccines co-administration. Human Vaccines & Immunotherapeutics.
Wormsbecker, A.E. et al. (2019). Demonstration of background rates of three conditions of interest for vaccine safety surveillance. PLoS ONE, 14(1).