Some things I have heard and read lately make me think we
have been so busy debunking spurious claims about vaccine side effects that we
have not been doing a very good job of educating people about basic vaccine
facts, how they work, and why we give them.
Vaccines incorporate microorganisms (bacteria and viruses)
or pieces of microorganisms which are given orally or through a shot. If a
whole virus is used, it is “attenuated” (weakened) so it does not produce
illness. The recipient’s immune system mounts a response to the weakened germ
or pieces of germs in the vaccine so that when it encounters the real thing, it
has a response in place to fight it off before it can produce illness.In 1921, there were over 200,000 cases of diphtheria in the United States and over 15,000 deaths from it. I do not know any doctors who have ever seen a case of diphtheria, though it is still present in some parts of the world. What was previously a feared and deadly illness was eradicated from the United States in the 20th century.
When I was a child, I remember asking my father once about why a man was limping and had a leg that did not seem to be formed quite right. My father’s reply was that the man had had polio as a child. I have never seen a case of polio and probably (hopefully) never will. Vaccine campaigns have eliminated it from everywhere in the world except a couple of pockets in Africa and the middle east and the hope is that total eradication is not far off.
Smallpox is another disease I have never seen and we do not
even immunize against it anymore because it has been eradicated from the entire
globe through immunization. The last known case was in 1977.
A now-retired colleague of mine used to talk about how
common Haemophilus meningitis used to be and how it was something that kept
pediatricians awake at night worrying that they could have missed a case in a
child who appeared to have a more benign illness. I have only ever seen one
case of Haemophilus meningitis and that was with a strain not included in the
vaccine which was introduced in the mid 1980s. This same germ can also cause a
condition called epiglottitis. The memories of children being strangled by
their own swollen airways led the older pediatricians who trained me to spend a
significant amount of time teaching about this. Fortunately, having graduated
from medical school in 1993, I have never seen a case of epiglottitis.
The measles vaccine was also introduced prior to my medical
training and I have never seen a case of measles. However, recent outbreaks in under-vaccinated
parts of the United States are a warning to us not to become complacent about
immunizing.
I have also seen the effects of the introduction of new
vaccines during my career. When I was a resident physician, it was not unusual
for us to care for children hospitalized with complications of chicken pox.
Most people do not realize that prior to the introduction of the vaccine, about
100 children in the United States died each year from complications of the
disease. Now I can’t even remember the last time I saw a child with chicken
pox.Similarly, the Rotavirus vaccine was introduced since I have been in practice. We used to see a lot of this illness in the winter time and often had children admitted to the hospital for dehydration resulting from it. But it has basically disappeared since the introduction of the vaccine.
So it is important to remember that we do not give vaccines
just for something to do. They are given to prevent real diseases, with real
consequences, in real people.
