As a parent, chances are at some stage you will have had a discussion about vaccination with another mum or dad. And it’s likely that someone will have expressed a concern about the safety of vaccines, or even said that they are refusing to let their child be immunised.
The scientific research tells us that vaccines are safe, and the government goes to great lengths to promote immunisation to as many Australians as possible. So why are some parents choosing not to follow the advice of the medical community?
Australia’s recommended program of childhood vaccination provides protection against 13 specific diseases, including rubella, chicken pox and whooping cough (pertussis).
“It is very important that children are vaccinated,” says Sydney-based paediatrician Dr Scott Dunlop. “Firstly, to protect them from potentially life-threatening diseases, and secondly to promote herd immunity, whereby individuals can prevent the spread of disease throughout the population by being immunised themselves.”
Herd immunity is especially important when very young children are involved. If a child is too young to be immunised, ensuring that everyone in his family has been vaccinated drastically reduces his chances of coming into contact with the disease.
It works on a larger community scale as well. When enough people are vaccinated against a disease, it’s more difficult for it to be picked up and passed on. However, when vaccination rates in a particular community fall, the likelihood of an outbreak increases.
Australia is currently in the grip of a pertussis outbreak and even though national vaccination rates are around 90 per cent on the whole, there are some communities where immunisation levels are well below this.
In Mullumbimby in northern New South Wales, for example, 21 per cent of families are refusing to immunise their children. In nearby Byron Bay, 16 per cent don’t vaccinate. This area is believed to be the source of the pertussis outbreak that led to the tragic 2009 death of four-week-old Dana McCaffery. Read her story here.
There are a number of reasons why parents choose not to vaccinate their children. When it comes time to make the decision for your own child, you’ll probably do what every other parent does: get the opinions of family and friends, and maybe head online to do some research yourself.
The issue with researching online is that there is a lot of divided opinion and in the rough-and-tumble of the internet, not all of the information being presented as fact is, unintentionally or not, entirely true. Add to that the fact that when Australian parents type 'vaccination' into Google, one of the first search results returned is that of the Australian Vaccination Network (AVN) – a group that purports to give parents the chance to “take back [the] right to free and informed choice” in relation to vaccinations.
The AVN’s president and spokesperson is Meryl Dorey, a mother of four from the New South Wales north coast. In regards to the pertussis outbreak in the state’s north, she claims that “the epidemic is occurring not because of a drop in the vaccination rates, but because the vaccine no longer matches the strain of the pertussis bacteria. The vaccine is no longer effective.”
However, according to Professor Peter McIntyre, Director of the National Centre for Immunisation Research and Surveillance (NCIRS), that simply isn’t true. “There is no evidence to support this statement,” he says. “The pertussis vaccine is still working well in those who are getting it.”
The AVN website contains a lot of information which, to parents looking for answers, can seem quite authoritative. However, parents have been warned to be wary of the contents of the AVN site.
It’s a characteristic of the anti-vaccine movement to claim to look very extensively at the scientific evidence, Professor McIntyre said in a recent interview, “but if you’re someone like me, whose job it is to spend time going through a lot of this evidence, then you realise that
it really is a complete misinterpretation.”
The AVN website has come under heavy scrutiny over the information it provides on its website and in July 2010, the Health Care Complaints Commission (HCCC) took the extraordinary step of issuing a public warning about the AVN and its message.
An investigation by the HCCC found that the AVN website “provides information that is solely anti-vaccination”, “contains information
that is incorrect and misleading” and “quotes selectively from research to suggest that vaccination may be dangerous”.
But it’s not just the AVN website that is leading parents not to immunise their children. Parents around the country offer
a number of different reasons why their children won’t be getting their vaccinations.
IT’S NOT THAT BAD
A relaxed attitude to potentially serious illnesses is one reason why some parents choose not to vaccinate. It’s not uncommon to hear someone say, “I had measles when I was a kid, and I was fine” – the inference being that measles simply isn’t a big deal.
However, the statistics for measles tell a different story. The World Health Organization classifies measles as a leading cause of vaccine-preventable childhood mortality. In 2008, the highly contagious disease was responsible for nearly 450 deaths around the world every day – around 18 deaths per hour.
This figure represents a huge drop from pre-vaccine days, though, and since 2000, the measles mortality rate has fallen 78 per cent.
Another relatively common perception is that many of the diseases we vaccinate against are so rare, it’s unlikely that our children will ever come into contact with them. This is, in a sense, true – but only because of the effectiveness of vaccination campaigns. Polio is a classic example.
As author and journalist Seth Mnookin explains in his book The Panic Virus: Fear, Myth and the Vaccination Debate, (Black Inc., $32.95) this is “one of the most vexing paradoxes about vaccines: the more effective they are, the less necessary they seem.”
Parents often worry about side effects of vaccines – and yes, though typically mild, potential side effects do exist. However, the government’s Immunise Australia Program website sums it up best: “It is important to remember that vaccines are many times safer than the diseases they prevent.”
For example, under the National Immunisation Program Schedule it is recommended that at 12 months, children be vaccinated against meningococcal C. In terms of side effects, one in every ten kids who have the needle will develop local inflammation at the injection site, fever, irritability, loss of appetite or a headache.
But compare this to the disease itself: one in 10 people who contract meningococcal C die. Of the 90 per cent who survive, one in 30 suffer severe skin scarring or the loss of limbs, and one in 30 have severe brain damage. It’s a similar case with the pertussis vaccine. Local inflammation and fever occur in at least one in 10 who receive the needle; one in every 200 children under six months who catch the disease die.
HOW DO THEY WORK?
Another thing parents may express concern about is the possibility that a vaccine could actually give their littlie the illness it is supposed to protect against, because the vaccine contains the virus or bacteria responsible for the disease.
This is, you may be surprised to learn, technically true. The Immunise Australia Program website notes that vaccines contain either “a very small dose of a live, but weakened form of a virus”, “a very small dose of killed bacteria or virus, or small parts of a bacteria” or “a small dose of a modified toxin produced by bacteria”. (To preserve the vaccine, there may also be a small amount of preservative or antibiotic and some shots include a small amount of aluminium salt to produce a better immune result.)
This being said, the viruses, bacteria or toxins in vaccines have been modified or very greatly weakened to the extent that they can’t cause full-blown disease reactions.
“THEY’RE FULL OF MERCURY!”
One of the more common reasons parents give for choosing not to immunise is that vaccines are “full of mercury”, and are therefore harmful. Again, part of this is technically true – there are some vaccines that contain mercury, but nowhere near enough of it to cause harm.
In some vaccines, the preservative used is called thiomersal, which is 49.6 per cent ethyl mercury, by weight. Ethyl mercury is a much less toxic compound than methyl mercury, the culprit that is the topic of all the health warnings about mercury toxicity. Ethyl mercury is broken down by the body and excreted pretty quickly.
Thiomersal has been phased out of nearly every vaccine given to children. This is not because studies have shown any negative effects, but because of the suggestion that giving very young, particularly premature, children many different needles could lead to potentially exceeding recommended safe levels of mercury (also set many times below the limits known to cause harm).
According to the NCIRS, the only shot part of the childhood immunisation program to contain thiomersal as is one vaccine for hepatitis B. It contains only trace amounts of thiomersal, equivalent to less than 0.5 micrograms of ethyl mercury per dose.
The most conservative safety estimates, provided by the US Environmental Protection Agency, state the safe level of mercury consumption is 0.7 micrograms, per kilo of body weight, per week. That means, for a newborn tipping the scales at four kilos, the safe level is 2.8 micrograms – several times the dose received from the vaccine.
A thiomersal-free hepatitis-B vaccine is also available for infants.
DO VACCINES CAUSE AUTISM?
The alarm about a possible connection between autism and vaccines began in 1998, when Dr Andrew Wakefield co-published a paper in The Lancet, a prominent medical journal, asserting a link between the Measles, Mumps Rubella (MMR) vaccine and the condition.
This research has been systematically discredited in the years since. Dr Wakefield has since been struck from the medical record and, in 2010, The Lancet took the major step of retracting the paper and apologising for its publication. But the damage was done and in the public’s mind, a link between vaccines and autism had been made.
So is there any link at all between autism and vaccines? Dr Dunlop offers an emphatic, “Absolutely not.” Professor McIntyre agrees, answering with a simple, “No!”
According to the NCIRS, “Numerous carefully performed studies and reviews have now been done that have found no relationship between [the] MMR vaccine and autism.” And, to date, no study has ever proven a link between any vaccine and the condition. The exact cause of autism still is not known, but the NCIRS tells us that “current research links it to developmental, genetic and environment factors.”
As a parent, it’s your responsibility to your child to make sure that he gets the very best care. It’s important to do your homework, then, before making any decisions that you aren’t sure about.
The NCIRS has a series of extremely helpful fact sheets available on its website, as well as a decision-making tool to help parents make up their minds about vaccination. The Immunise Australia Program website, has a lots of material as well.
If you’re in doubt, talk to your GP or healthcare provider, and don’t ever be afraid to seek a second opinion.
A COMMON SIDE EFFECT
- Fever is among the most common side effects that littlies can experience when they get their vaccinations, and it can be a bit unpleasant for them. Here’s how to deal with a fever:
- Offer your child plenty of soothing, cool drinks – breastmilk is best for bub, if it’s available. Water is the next best option.
- Make sure your child is comfortably dressed – if he’s sweating, remove a layer of clothing. If he’s chilly, add a layer.
- If the fever is climbing, you can cool him down with a lukewarm (not cold!) bath. You can also try sitting him in front of a gently blowing fan.
- You can help to reduce a fever with paracetamol – ensuring that the dosage you give is correct for your child’s weight.
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