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Clinicians must continue to stress importance of vaccines, herd immunity
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Different viewpoints should be acknowledged, yet different strategies should be examined in varying populations in the US to see which is most effective for highlighting the importance of immunization against vaccine-preventable diseases.
Paul A. Offit, MD, chief of the division of infectious diseases and the director of the Vaccine Education Center at The Children’s Hospital of Philadelphia, presented a perspective on vaccines and the antivaccine movement in the US during the 23rd Annual Infectious Diseases in Children Symposium.
There were various historical vaccine tragedies that may have contributed to the birth of fear of vaccines, according to Offit.
In the 1940s, there was the yellow fever vaccine in the military. The human serum used as a stabilizer was contaminated with hepatitis B virus, and about 330,000 soldiers were infected, with 65 dying from overwhelming hepatitis.
In 1955, approximately 70,000 children who received the Cutter’s polio vaccine developed abortive polio as a result of a failure to inactivate wild-type polio; 200 children were permanently paralyzed and 10 died.
As a result, several public health campaigns were started including one for the diphtheria vaccine in the 1940s, one for the polio vaccine in the 1950s and one for the measles vaccine in the 1970s.
Fear of vaccines in the US was born of a 1-hour documentary, titled “DPT: Vaccine Roulette” that aired on April 12, 1982. This show gave birth to an anti-vaccine group called Dissatisfied Parents Together. Within a month of its formation, there was a congressional hearing to discuss vaccine safety, according to Offit. The group later changed its name to the National Vaccine Information Center (NVIC).
With the introduction of new vaccines, new concerns of adverse effects arose, including the possibility of diabetes with Haemophilus influenzae type B conjugate vaccine (Hib, PedvaxHIB ActHIB), seizures with pneumococcus vaccines, multiple sclerosis with the hepatitis B vaccination (HepB) for adolescents, and blood clots, strokes and chronic fatigue syndrome with the HPV vaccine.
In 2008, there was a measles epidemic; in 2009, there was a mumps epidemic in New York and New Jersey, and Hib deaths in Pennsylvania, and in 2010, there was a pertussis epidemic.
Concerns clinicians face include that a delay in vaccines put children at risk at a time when herd immunity has broken down and when waiting rooms become a dangerous place. Some physicians refuse to see parents who do not wish to follow the CDC/AAP vaccine schedule. The problem with that, however, is that the physician may lose any chance to convince parents of the importance of vaccines, Offit said.
For more information:
- Offit PA. Presented at: the 23rd Annual Infectious Diseases in Children Symposium; Nov. 20-21, 2010; New York.