Monday, April 6, 2015

Infectious Diseases: What Price Will We Pay?

            This paper discusses the controversy surrounding vaccinations, and gives a brief history about immunizations and the impact they’ve had in preventing infectious disease. This discussion includes three different topics surrounding this issue: The link between vaccines and autism, the difference between natural immunity and artificial immunity, and the importance of medical ethics. My own argument will also be included based on the information I’ve acquired through my research.

 The Reason behind Vaccines
An argued topic in the world today is that of vaccinations, and the role of individual rights when it comes to be immunized. Many believe vaccines are saving us from the devastating impacts of disease and should be required, while others refuse, and argue they’re harmful and a matter of personal opinion. Questions are being asked, such as: are they really preventing diseases?  Or, exactly how dangerous are they? Perhaps taking a look back in history can give us a grasp of how far vaccinations have brought us.
Back in the 1950s, polio was widely feared and was seen as the worst threat to the public. It produced more than 300,000 cases, resulting in 58,000 deaths each year (Opposing Viewpoints, 2015). “Diseases like whooping cough, polio, measles, Haemophilus influenzae, (HIBS) and rubella struck hundreds of thousands of infants, children and adults in the U.S. (Centers for Disease Control and Prevention [CDC], 2014).
Vaccinations are used to avoid and hopefully eradicate many of these infectious diseases that have spread throughout the world and taken the lives of thousands of people. From the CDC’s definition, vaccines contain the same virus they’re trying to prevent, but the difference is that these viruses are weakened to the point that they will not cause the full-blown illness. However, they are still strong enough to cause an immune response against the disease. Because of this, “a vaccine is a safer substitute for a child’s first exposure to a disease” (CDC, 2014).
This method was started by Edward Jenner, a physician and scientist, who created the first vaccine for smallpox by using cowpox (a similar disease that affects cows) in 1796. (Vaccines Pros and Cons, 2015). Because of vaccine developments, diseases like Diphtheria, Rubella, Polio, and more “are becoming rare . . . because we have been vaccinating against them” (CDC, 2014). However, by choosing not to vaccinate, we’re again putting ourselves at risk for an outbreak.           
For example, In Japan in 1974, about 80% of children were getting the vaccine for pertussis, or whooping cough. Only 393 cases were reported that year, and there were no pertussis related deaths. Over the next few years, the vaccination rates began to drop, until only about 10% were being vaccinated. By the year 1979, more than 31,000 people had contracted whooping cough and 41 deaths were reported (CDC, 2014).
Great Britain, had a similar problem when fear of the pertussis vaccination led people to avoid immunizations. The affects were “dramatic and immediate” with more than 100,000 cases and 36 deaths. From these situations “it seems clear . . . if we were to stop vaccinating, [these diseases] would come back” (Opposing Viewpoints, 2015).
Understanding the reasoning behind those that refuse vaccines can help us come to a conclusion of whether or not we should mandate them, and also help us find a way to avoid future outbreaks. In this essay, I will discuss three important points made by those opposed to vaccines, and address the opposite views as well before concluding with my own thoughts.

The Issue of Autism
It has become increasingly common for people to refuse vaccinations because of their potential risks. The first example involves Andrew Wakefield, a former physician in the United Kingdom. Wakefield claimed that MMR Vaccines were not tested adequately for safety, and consequently cause Autism. He argues that single vaccinations for Measles, Mumps, and Rubella are safer than the grouped MMR vaccine. After being published in a popular magazine titled The Lancet, the British Medical Council disqualified him from practicing medicine when no evidence could be found to support his claim. It was also discovered that he “altered the medical histories of all 12 of his patients,” making him guilty of scientific fraud. The remaining stories floating throughout the media have continued to damage public health. (CNN, 2011). Many still advocate that the MMR vaccination is linked to Autism, and argue parents should be allowed to choose the separate vaccinations they wish for their children (Wakefield, 2014,).
Autism is one main concern to parents above all else, and though autism isn’t completely understood, it is known that “Autism is not a disease, but a syndrome with multiple non – genetic and genetic causes” (Muhle, Trentacoste, Rapin, 2004). One non – genetic cause it’s referring to is being exposed to toxic substances that can be found in vaccines (Muhle, Trentacoste, Rapin, 2004).
In 1999, it was recommended that that “thimerosal [an organic mercury compound] be removed from vaccines.” Though the American Academy of Pediatrics (AAP) and the US Public Health Service (PHS) never stated there was any evidence of harm caused by the ingredient. They also emphasize “that the large risks of not vaccinating children far outweigh the unknown and probably much smaller risk, if any, of cumulative exposure to thimerosal-containing vaccines over the first 6 months of life” (ProCon, 2015).
A second case of autism and vaccines involved a twenty-month old toddler who, after receiving five vaccinations, stopped making eye contact, lost her ability to speak, and withdrew socially. Within a few months, she was diagnosed with autism. In court seven years later, they ruled that her autism had been caused by her vaccines.
Many parents were relieved to hear the government had finally acknowledged the link between autism and vaccinations. But the court’s ruling was misunderstood, and the “Clinical Immunization Safety Assessment (CISA) . . .  within the CDC . . .  pointed out that officials had decided Hannah’s underlying mitochondrial dysfunction was aggravated by her vaccines, leading to fever and an ‘immune stimulation that exceeded metabolic reserves’” (Opposing View Points, 2015). In other words, it was an underlying genetic disorder that already existed before the vaccines were given.
Though it is true the vaccinations aggravated the pre-exiting disorder, it is still arguably more important for these children to be vaccinated, “because a vaccine is less taxing on the immune system than a full-blown illness”(Opposing View Points, 2015).
In the end, there is no scientific evidence that claims vaccines cause autism, but many still doubt. David Tayloe, a pediatrician and president-elect of the American Academy of Pediatrics, says “[Autism is] a terrible condition. It upsets families, and it upsets me. But all the fear and anger about vaccines is misplaced . . . there's just nothing there" (qtd. Downs, 2008). 

Natural vs. Artificial Immunity
            Others argue that natural exposure to a disease is more beneficial than receiving an artificial injection. There are even pro-vaccine organizations that explain the effectiveness of natural immunity by claiming that “natural infection . . . causes better immunity than vaccines.” And rather than needing several doses from a vaccine, natural immunity can easily occur after only one exposure (Is Natural Infection Better than Immunization?, 2013).
It’s also argued that vaccines put dangerous substances into your body, such as formaldehyde and aluminum, in addition to the virus itself. Kurt Perkins, a Chiropractor and wellness expert notes, “This process would never occur in building natural immunity” (Vaccination vs. Immunization, 2013).
Though I agree natural immunity is more effective to prevent us from disease after the first exposure, I do not agree that it’s the safest way to gain immunity. As stated before, these diseases have caused many deaths throughout history before their vaccinations had been created; these illnesses are not the common cold or a sore throat.
In a book written by the US Department of Health and Human Services titled Understanding Vaccines What They Are and How They Work, it’s stated that “with naturally acquired immunity, you suffer the symptoms of the disease. . . . Which can be quite serious or even deadly” (Understanding Vaccines, 2008, p. 4). For example, HIBS, a bacterial infection that that is usually seen in young children, “can lead to a potentially deadly brain infection” and can also cause diseases like “meningitis (inflammation of the coverings of the brain and spinal column), bloodstream infections, pneumonia, arthritis and infections of other parts of the body” (New York State Department of Health, 2014). Also, you carry the risk of passing the disease on to someone else. (Understanding Vaccines, 2008, p. 4).
            Because of vaccinations, gaining immunity to disease is less risky and easier to achieve without the risk of coming in contact with the full-disease. Vaccines also “prevent a disease from occurring in the first place, rather than attempt[ing] a cure after the fact. It is much cheaper to prevent a disease than to treat it” (Understanding Vaccines, 208, p. 4).

Medical Ethics
            The last topic discussed is medical ethics. By mandating vaccinations, the private decisions made between patients and doctors is compromised. This violates the “very clear language in the Informed Consent section of the AMA Code of Medical Ethics” (Adams, 2015).
            The AMA Code also states that physicians must honor the decisions of their patients, and patients possess the “right of self-decision.” Mike Adams, an editor of Natural News, and activist in many different aspects of health argues: “every medical intervention comes with some level of risk, even if that risk is small. [But] it is not zero, as is routinely and repeatedly claimed by vaccine fanatics” (Adams, 2015). The problem Adams is addressing, is that most patients are never told about the risks involved in vaccinations, which interferes with their right to make the informed choice.
My concern with medical ethics, is how unaware people are of the risks and the benefits of vaccinations. From my research I believe many hear the controversial debates of the dangers of vaccinations, and neglect to take the time to do any research themselves. I agree with Adams, and the AMA Code of Ethics, that "Physicians should sensitively and respectfully disclose all relevant medical information to patients" (Adams, 2015). If people remain un-educated we will be put at greater risk. It’s disconcerting to imagine that suffering another Polio pandemic could possibly be the only way to remind people of the enormous benefits of vaccines. What I’m arguing, is that something needs to be done to lessen the ambiguity surrounding vaccines to avoid these diseases from bouncing back again.
To give one more example, I found a study which included parents who had vaccinated their children, and parents that had not. From the study, 51% of those who refused vaccines believed that the severity of these diseases was low, while only 18% of those who had chosen vaccines agreed with them. From this research, we see that most who choose to unvaccinate their children, are dramatically unaware of the diseases and the impact they have on individuals and societies (Omer et al., 2009).
            After spending the time I did on this research, I strongly believe vaccinations need to be carried out by individuals to avoid the risks to themselves, and the rest of society. I stand behind the CDC when they caution: “if we let ourselves become vulnerable by not vaccinating, a case that could touch off an outbreak of some disease that is currently under control is just a plane ride away” (2014). I agree that “Vaccines are held to the highest standard of safety” (CDC, 2011). And I also agree that the risks of vaccinations are “extremely small and less than that of the risk of serious complications from the disease itself” (Wilson, 2001).
            We live in a time now, where most of these diseases occur so rarely, it’s impossible to know for ourselves how devastating they are. Unlike those affected by Polio, we don’t see our friends and family members dying left and right. This is concerning, because it gives people a false sense of security. These diseases still exist, and if we choosing not to vaccinate “we could soon find ourselves battling epidemics of diseases we thought we had conquered decades ago” (CDC, 2014).
             I argue that doctor’s need to disclose all information about vaccines to patients so they can exercise their own right to choose. To be clear, I will use these words from an article in the New England Journal of Medicine which says:
            The committee . . . recommends that clinicians address vaccine refusal by respectfully listening to parental concerns, explaining the risk of non-immunization, and discussing the specific vaccines that are of most concern to parents. . . Continued refusal after adequate discussion should be respected unless the child is put at significant risk of serious harm (e.g., as might be the case during an epidemic)’ (Omer et al., 2009).
            As parents are given the chance to openly discuss their concerns, and know the facts surrounding vaccines, I believe they still have the right to choose not to vaccinate. But they need to be made clear about what risks are involved by remaining unprotected. They need to understand how their choice will affect those around them in the event they contract one of these preventable diseases and risk passing it onto another unvaccinated individual, or to a child who is not yet old enough to receive their own vaccinations.
            I conclude that vaccines have greatly impacted the health of the public, and they need to be carried out by all individuals that are medically able. I argue, that even though vaccines and their risks are not completely understood, the risks of choosing not to vaccinate are far greater than if we keep ourselves protected from these devastating diseases. In the end, vaccinations are the best way to keep our society safe, and it’s time we make sure others understand the importance of vaccinating themselves and their children.  

Adams, M. (10 Feb, 2015). American Medical Association opposes mandatory vaccines: medical ethics statement. Retrieved from
CNN News. (2011). Retracted autism study an 'elaborate fraud,' British journal finds. Retrieved from
Downs, M. (2008). Autism-Vaccine Link: Evidence Doesn’t Dispel Doubts. Retrieved from
Muhle, R., Trentacoste S. V., Rapin, I. (May 2004). The Genetics of Autism. Proquest, 113.5, 472-86. Retrieved from
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Omer, S. B., Salmon, D. A., Orenstein, W. A., deHart, P., Halsey, N. (May 7, 2009). Vaccine Refusal, Mandatory Immunizations, and the Risks of Vaccine-Preventable Diseases. Retrieved from
Perkins, K. (2013, June 12). Why I Will Never Choose to Vaccinate my Own Son and Any Future Kids my Wife and I Have. Health Impact News. Retrieved from (2015). Should Any Vaccines Be Required for Children? Retrieved from
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Wakefield, A. (2014). The Link Between the MMR Vaccine and Autism Is Real. In C. F. Naff (Ed.), At Issue. Why Is Autism on the Rise? Farmington Hills, MI: Greenhaven Press. (Reprinted from Transcript: Statement from Andrew Wakefield, Age of Autism, 2013) Retrieved from
Wilson, J., Jenner, E. A. (2001). Infection control in clinical practice (2nd ed.). London, UK: Harcourt Publishers.

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