With back-to-school and flu-shot season upon us, the issue of vaccination is once again front and center in the news. Feelings run strong among those “for” and those “against” vaccination. But, as with many controversies fueled by passionate polarity, a lot of people feel caught in the middle, uncertain of what to believe and how to proceed. Unfortunately, even some medical professionals, including doctors, nurses, and others, harbor a lot of visceral ambivalence about vaccination.
From a fact-based, scientific perspective, however, the data leave little room for uncertainty. Nonetheless, there are some prominent public figures who are unfamiliar with the research, and who contribute to mixed messaging about vaccines that fuels a lingering popular discomfort with inoculation. Much fear was created by the now-retracted February 1998 study published in the respected medical journal, Lancet. The article famously claimed a link between childhood vaccines and autism.1 In the end, however, that report was totally discredited. Indeed, the British Medical Journal (BMJ) explained in a 2011 editorial how the spurious findings were debunked as a deliberate “fraud.”2 Sadly, though, a significant amount of damage to the image of vaccines has persisted. This has been very detrimental to public health.
So let’s try to rethink vaccination from a data-driven, fact-based perspective. Dr. Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine, writes for a New York Times column called “The Upshot.” In a recent post, he presented an analysis of the numerous studies done showing NO link between vaccines and autism: “More than 15 million children took part in this research. No one could find evidence that vaccines are associated with autism. This topic yields more evidence than any other I’ve ever written about in The Upshot. And this is one of the most studied subjects ever.”3
To be sure, vaccines do have some risks. Any medical treatment—indeed, any activity in life—has to be approached with an acknowledgement of risks and benefits. But sometimes our emotions significantly cloud reality. Consider transportation: many harbor a great fear of flying in an airplane, while being willing to ride in a car without hesitation. Yet a review of U.S. government information shows that automobiles are MUCH more dangerous than airplanes. According to the National Highway Traffic Safety Administration, the 2012 data show that there were 2,362,000 traffic-related injuries in the United States, and 33,561 fatalities.4 Contrast that with 2012 National Transportation Safety Board statistics, which show 449 total fatalities in U.S. Civil Aviation.5 These facts illustrate that sometimes lack of awareness, and/or fear, can obscure true risk.
Continuing with the transportation analogy, the good news is that in 2012, 14,681 lives were saved by seat belts, air bags, and child restraint devices.6 Yet, those lifesaving protections do have some toxicity: in an accident, a seatbelt can break bones; seatbelts and airbags can cause skin burns; and restraint devices can cause internal consequences (such as injury to abdominal viscera). But who would not advocate the overall safety benefits of these devices? So, too, vaccines do carry some risks (albeit not of autism).7 However, infections, like errant drivers, are out there all the time; and they each cause injury (ranging from minor to catastrophic) to innocent and unsuspecting victims every day. For vaccines—like with vehicle safety devices and traffic laws—the risk-benefit equation clearly tips toward using these tools to protect ourselves, the ones we love, and society in general.
At the end of the day, vaccines have been studied extensively; and the benefits to individuals and to public health (from “herd” immunity) are demonstrated in reams of reliable data. Some highlights favoring influenza vaccination include the facts that infection with influenza can trigger a heart attack8, or result in injury to someone else when they are exposed to your infection, or cause missed time at work/school. So when thinking about vaccination, Dr. Carroll sums it up very well:
“All of the vaccines save lives.
It would be better for our vaccination policy for this not even to be a topic for debate…by those who aren’t immersed in the science of vaccines.
Debating any of these facts does no one any good.”9
3 http://www.nytimes.com/2015/09/18/upshot/not-up-for-debate-the-science-behind-vaccination.html?mwrsm=Email&_r=0 4 http://www-nrd.nhtsa.dot.gov/Pubs/812006.pdf
7 For specifics, see the CDC website to review regularly updated Vaccine Information Sheet (http://www.cdc.gov/vaccines/hcp/vis/).