The Truth About Vaccines
Robert P. Lindeman, MD, PhD
Natick Pediatrics, PC

Controversy regarding vaccines is nothing new. Our ancestors vehemently decried the idea of inoculation in the Massachusetts Bay Colony in 1721, although hundreds of colonists – mostly children – were dying during a smallpox epidemic.

There is something about our human nature that is repelled by the idea of powerful authorities trying to inject our bodies with foreign substances. This is especially true when those substances are made from dangerous bacteria and viruses, which is what vaccines are.

It’s no different today than it was in 1721; I don’t expect that our fear of vaccines will ever go away. But this does not relieve me of my responsibility to say what I know to be true:

Truth #1: The Public is Overly Suspicious of Vaccines
Today we have a controversy over the measles-mumps-rubella (MMR) vaccine. There are numerous large-scale studies denying the link between MMR and autism, but the controversy refuses to go away. Part of the reason stems from the very real pain parents of autistic children feel. These families desperately want to find the cause for their children’s disease. With the best of intentions, some have seized upon the MMR vaccine. I fear that no amount of evidence to the contrary will change their minds.

Truth #2: Vaccines are Safe
Most people don’t know about the enormous hurdles a vaccine manufacturer must jump to get a vaccine approved. After approval, vaccines are very closely monitored. If strange, unexpected side effects begin to appear, the vaccine is quickly pulled from the market.

Vaccines are not only safe they are effective. Childhood vaccines have saved thousands, perhaps millions, of lives in the last century. Vaccines certainly make my job as a pediatrician easier. I don’t have to worry that my fully immunized children are going to die of overwhelming bacterial infections, or that polio would paralyze them.

If it is not obvious thus far, I will state outright that I am strongly in favor of childhood vaccinations. There is one particular vaccine, however, about which I do not feel strongly, and that is the vaccine against hepatitis B. Here’s why:

Truth #3: School Children Do Not Get Hepatitis B
In this country, hepatitis B is a disease of adolescents and adults, and yet we are immunizing our infants! For the most part, there are only three ways to become infected with hepatitis B: having sex with someone who has hepatitis B infection, being stuck with a needle (accidentally or intentionally) that is contaminated with blood containing hepatitis B virus, or being born to a mother with active hepatitis B infection.

Massachusetts law requires a series of three hepatitis B shots for entry into the public school system. Many private schools, pre-schools and childcare centers have followed suit. The only plausible explanation for these requirements is that school officials believe that a child with hepatitis B infection could infect his/her classmates. But unless that child is engaging in the behaviors that are known to transmit the disease, this is extremely unlikely. So why is hepatitis B vaccination required for entry into kindergarten?

Another mandatory childhood vaccine about which I don’t feel strongly is the chicken pox vaccine. In order for my patients to attend school in our Commonwealth, I must document that they have either had chicken pox, or that they have been immunized. Because of this, an interesting and largely unknown change in the history of chicken pox has occurred:

Truth #4: Children Are Not Getting Chicken Pox Anymore
I used to counsel my patients’ parents to delay chicken pox shots for their children, hoping the child would get the disease the so-called ‘natural way.’ I knew that getting chicken pox was the best way to become immune to it, and I wasn’t convinced that the vaccine was very effective. After a year I gave up; none of my patients were getting chicken pox from their friends and neighbors. At school enrollment time, I’d have to immunize the children anyway! So I ‘threw in the towel’ and started immunizing toddlers at their 1-year well-child visit.

One more truth:
The more things change, the more they stay the same. I suspect that years from now, our descendants will shake their heads and cluck their tongues at our 21st century anxieties and confusions over vaccines, in much the same way that we regard our ancestors’ 18th century anxieties and confusions over smallpox inoculation.

Unfortunately our anxieties are about to intensify, as our own smallpox inoculation debate heats up.

It would be a terrible irony if smallpox became the next major battlefield in the public opinion war over vaccination policy.

The smallpox vaccine represents the single most important victory of humans over an infectious disease in the history of public health. As a result of a thorough and relentless inoculation campaign, the last case of smallpox on earth was reported in 1977.

For more information about Natick Pediatrics, or to talk to the doctor, please call the office at (508) 655-9699.

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Medical Office Building
MetroWest Medical Center
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67 Union Street, Suite 305
South Natick, MA 01760

(508) 655-9699
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Posted: February 5, 2003

©2003. Robert P. Lindeman, Natick Pediatrics. All rights reserved.