Are our
children getting more immunizations than we did?
The answer
is both surprising and interesting.
For reasons not fully apparent, immunizations excite our
imagination. The idea behind them is
actually fairly boring, give a person exposure to a harmless part of a germ,
and when the real germ comes along it won’t work, thereby preventing
potentially very serious illness at little cost or risk.
But that’s not how the issue is often
felt. For many decades, there has been
something about immunizations that excites fear and dread. This article is about the concern that we are giving our children a
great many more immunizations, creating a big jump in the burden to their
immune systems, and that this burden is of concern.
Recent Fears about
Immunizations that have been Resolved
In the 1970’s and 1980’s the key fear was that giving your
child the DTP shot would cause mental retardation. It took 10-15 years and hundreds of millions
of dollars to see if that fear was true, and then another 5-10 years once it
was proven not to be so before we reached our current state- essentially no one
believes or even worries that giving any immunization will cause their child to
become mentally retarded.
In the years 2000-2014, the fear was that immunizations
cause autism. The exposure to mercury,
the measles vaccine, and immunizations in general were widely feared to cause
autism. Once again, it took many years
and hundreds of millions of dollars to find out if this fear was true. And again, observations of children with and
without immunizations proved immunizations had nothing to do with autism. This time, a specific individual who helped
create the fear was exposed as a charlatan.
And as with mental retardation, it took many years for the proof that
immunizations did not cause autism to lead to our national community to drop
its fear of it doing so. We are right
now living through the collapse and resolution of that fear.
The remaining fear:
we are exposing our infants to far more immunizations than we had
That leaves the question of overload as the dominant fear
surrounding immunizations today.
The fear goes something like this. A long time ago, infants got one shot at
most at a visit, now they can be expected to receive 3 or 4 shots or
immunizations at a visit. The fear is
that this overloads their immune system, causing harm to the baby and child.
Amazingly enough, our
infants are receiving a fraction of the burden our grandparents did when they
were babies. In fact, the current immunization schedule delivers 96% less (!) burden
than it did in 1960!
Let’s take a look at how this is possible.
First of all, how many shots do our infants get compared to
our grandparents? When our grandparents
were kids, they got one shot series and one oral vaccine series. The shot was the DTP (for
diphtheria-tetanus-pertussis [whooping cough]), and the oral drops were for
polio. The DTP required 5 shots over 5
years, and the polio required 4 doses over 5 years. That made for a total of at most one shot at
infant visits, and a grand total of 5 shots, or 9 immunizations if you include
the 4 oral polio doses.
But today, there is a proliferation of diseases we now can
prevent. The list has expanded from the
starting point of diphtheria, tetanus, pertussis, and polio to now include the
following: meningitis from three
different germs (Hib, pneumococcal, meningococcal), hepatitis (A and B),
stomach flu (rotavirus), measles, mumps, rubella (German measles), and the
diseases from the HPV (genital warts, throat and cervical cancer). That’s a jump from 4 diseases, to 14 if you
count all the germs for which routine immunizations are now available.
So, how can you almost
quadruple the number of shots and immunizations and still reduce the burden by
96%?
The answer lies in a key word for this worry- antigen. At the heart of any plan to immunize lies a
neat trick. Give the body what looks
like the germ, and it might just think it’s infected and create a response,
even if the item given is a dead germ, or a piece of a germ. Then, if the real germ shows up, as noted
above, the body is ready, kills the germ rapidly, no real infections from that
germ can happen.
For example, if you give someone a polio shot, that child
receives a dead part of the virus, the body reacts as if the real thing is
there, and so if a real polio virus shows up later, the child cannot get polio.
This trick works so well that we have eliminated smallpox
from the planet, polio is almost gone, and infants almost never get meningitis
or tetanus.
For every germ there is at least 1 protein, sometimes a few
more, that give the signal to the body that this germ is here and lead to a
reaction that leaves the body protected.
Any protein on any germ that the body uses to recognize it and create a
response against it is called an antigen.
Now we come to how is
it possible to give so many more shots, but reduce the burden so dramatically.
Yes, we give 14 rather than 4 immunizations, but each
immunization contains far, far fewer antigens.
Consider the pertussis, or whooping cough, vaccine. Prior to the 1980’s that immunization was
made by taking the whole pertussis bacteria and grinding it up. The pertussis shot contained hundreds, if not
thousands, of antigens. The current
pertussis immunization has only those proteins from the germ that actually make
the immunization create a response that leaves one protected, which turns to be
only 3-4 antigens.
The same is true for nearly all immunizations. Today’s immunizations contain as few antigens
as possible, and in most cases that means a massive reduction in the number of
antigens. Fewer antigens means fewer
responses in your child’s immune system, a lighter load, a reduced burden,
while at the same time getting a lot more protection. We are actually able to protect our children
from many more deadly diseases, but with a tiny fraction of the antigens being
delivered.
What does this mean
for the worry about giving so many immunizations at one time?
If you think about it, the reason given for wanting to spread
out the immunizations, to give as few as possible at one time, is to reduce the
burden on your baby’s immune systems.
But now we know that even giving 3-4 immunizations
protecting against 7-8 illnesses, at one time, actually injects 96% fewer items
than the single DTP shot and polio drink.
Further, there is no evidence at all that babies who get 3-4
immunizations at once suffer any harm compared to those who get 1.
Another item to keep in mind is that immunizations actually
do serve a purpose. People who get
immunized for meningitis by and large do not get meningitis, whereas people who
do not get this protection can get meningitis.
The same is true for each disease we immunize for: polio, measles,
whooping cough, tetanus, etc.
What that means is that a decision to delay an immunization, is a decision to extend the time
your child is at risk for very serious diseases.
To make that last point more clear, we
all know if someone decides not to immunize their child against measles, they
could get measles. What is not so well
appreciated is that if one decides to delay the 1 year old measles immunization
to age 3 years, then that child is put at risk to develop measles from age
1-3.
Given that we are now exposing our infants and children to
96% fewer antigens, the argument to spread out immunizations offers no benefit
and exposes children to needless risks.
BOTTOM LINES
1. Immunizations should be yet another boring
science event. A harmless part of a
germ is given, the body thinks the real germ is in the body and creates
defenses against it, and when the real germ shows up, it can do no harm. A disease is prevented or wiped out.
2. Public reactions to immunizations have been
very dramatic, over many, many years.
3. Two waves of profound concern have come and
gone since the 1970’s The first was the
fear that giving the DTP vaccine would cause a child to become mentally
retarded. The second was the fear that
giving the child the MMR vaccine, or other vaccines, would cause a child to
become autistic. Both of these
propositions have been soundly disproven.
The fear of retardation from vaccines has since completely disappeared,
and the fear of autism from vaccines is rapidly disappearing right now.
4. The main worry about vaccines that persists
is that we are exposing our babies and children to a huge increase in germs and
their components in today’s immunization schedule. Surprisingly, that fear turns out to be
dramatically untrue. In fact, just the
opposite is true- our children are exposed to 96% fewer types of proteins from
germs in today’s immunizations compared to those few shots in 1965.
5. Delaying immunizations provides no known
protection against any known harm, but does expose our children to prolonged
periods of risk during which they can come down with quite serious diseases- in
fact, that unnecessary risk lasts as long as one chooses to delay the
immunization.
6. The common practice of spreading out
immunizations is actually a very specific choice based on a fear that is likely
the next to fade away. As we all become
more familiar with just how dramatically the burden on the immune system has
disappeared, even with a full schedule, this fear will also go the way of other
past fears.
7. We at Advanced Pediatrics will of course be
most interested in addressing all your questions regarding immunizations, and
will respect parents’ choices about them.
We look forward to working with parents to discuss and implement
approaches that maximize the well-being of your children, and minimize the
risks they face.
To your health,
Arthur
*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.
