This article was written by Lindsey Bunin for the Fall 2014/Winter 2015 issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre. World-leading IWK immunization expert, Dr. Noni MacDonald, shares insight on a complex and timely topic.
The digital age in which we live has greatly changed the way we gather and process information. If we have a question these days, most of us just “Google it!”
While the convenience of immediate information can suit our desire for instant gratification, it’s not necessarily the most accurate approach. This is especially true when it comes to the often-controversial topic of vaccines.
Dr. Noni MacDonald is a professor of pediatrics at Dalhousie Medical School with an appointment in Pediatric Infectious Diseases at the IWK Health Centre, and her expertise has afforded her opportunities to teach and practice in countries around the world. One of MacDonald’s major research interests is vaccines, particularly in the areas of safety, hesitancy, pain mitigation and policy issues. She is a key member of the research team at the Canadian Center for Vaccinology at the IWK, has published more than 300 papers on such topics and has long been recognized in Canada as an advocate for child and youth health and as a leader in pediatric infectious disease.
In an effort to help clarify vaccination information for families, MacDonald has provided insight into some commonly asked questions.
Aren’t my children safe if everyone else’s children are vaccinated?
“Some vaccines work better when everyone is vaccinated,” MacDonald says. “This is called ‘herd’ or ‘community’ immunity. If everyone is vaccinated for measles, for example, the virus will stop circulating. However, herd immunity doesn’t work for other diseases, such as tetanus, because the tetanus bacteria are in the environment, in soil and dust.
“Besides, you don’t know if everyone around you is vaccinated, and people travel far and wide in our mobile society. You’re taking a huge risk if you’re depending on everyone else to be vaccinated to protect you or your child from measles, for example.”
Aren’t vaccines only for infants and children?
“Most vaccines are for infants and children because there is no natural protection from many serious vaccine-preventable diseases such as pertussis, tetanus, diphtheria, measles, some strains of influenza, meningitis, etc. While a mother transfers some of her antibodies to the infant during pregnancy, these do not last very long after the baby is born. Similarly, the antibodies in breast milk are not enough to protect the infant from many of these diseases.
“An increasing number of vaccines are being developed for adults so they will be protected into old age, the shingles vaccine is one example. It’s also been proven that immunizing adults can help protect infants and children. For example, re-immunizing adults (a booster) for whooping cough prevents infected adults from passing this terrible disease to infants: parents and grandparents take note!
Wouldn’t natural immunity be better?
“Immunity induced by vaccines is effective and much safer than natural infection.
Vaccination is a better choice because it avoids the risk of getting some terrible disease complications, like brain damage with measles, deafness with mumps, death with tetanus and pertussis, and more,” MacDonald explains. “We’re also learning more about boosting childhood vaccinations with repeat vaccinations later in life, to ensure immunity doesn’t wane as we get older.”
Now that major illnesses have largely disappeared, we really don’t need vaccines anymore, do we?
“The success of vaccines makes it appear that many infectious diseases have disappeared, but sadly that’s not true,” she clarifies. “There are outbreaks of measles and whooping cough throughout North America, and a resurgence of polio in Asia, Africa and the Middle East. Vaccination rates must be very high (over 90 per cent) to stop the spread of these viruses and bacteria, so when not enough people are vaccinated outbreaks can occur. Today, people travel far and wide and may not be aware that they’re not just bringing luggage with them.”
Do vaccines cause autism and other disorders?
“Vaccines do not cause autism. The increased rates of autism are in part the result of changes in the way the condition is assessed or recognized. Autism is known to be a genetic disorder with other contributing factors, but vaccines are not a factor. There is no proof that vaccines cause autism or any other diseases, like multiple sclerosis, but
there’s plenty of proof that vaccines prevent very serious infectious diseases.”
Is it true that vaccines have damaging and long-term side effects that are yet unknown?
“Vaccines have been used over many decades in millions of people around the world.
Extensive global networks track reactions to vaccines known as ‘adverse events following immunization,’ to find out which events are due to vaccine, and which are just coincidence (not caused by vaccine).
“There are now many years of data that prove the safety of vaccines. The global networks alert health professionals to any new concerns about a vaccine. The most commonly reported reaction is a sore arm. The risks of serious complications from contracting diseases like measles, whooping cough and hepatitis are much more common and can be far more serious than any adverse event from a vaccine.”
Why don’t we consider vaccine preventable childhood illnesses as just an unfortunate fact of life?
“They used to be, and millions of children died from diseases that are now prevented
with vaccination,” MacDonald says. “Thousands of children still suffer from these diseases because they don’t have access to the range of vaccines we have in North America. We’re privileged to live in a country where so much serious illness, disability and death can be prevented with a few doses of vaccine”
Can’t the flu vaccine give you the flu or make you sick?
“The flu vaccine cannot give you the flu. The flu virus used in the vaccine is killed or broken when the vaccine is manufactured. The flu vaccine is given when many flu-like illnesses are already circulating in the population so, if you get sick following your flu shot, it isn’t from one of the infl uenza strains contained in the vaccine. The ‘real’ influenza is a very serious illness and not to be confused with a cold or stomach illness.”
Do you think the flu vaccine is really effective?
“Influenza is a very sneaky virus that changes its outer coat every year. This is why a new version of influenza vaccine has to be made and given each year. Sometimes the experts are able to make the vaccine match well to the new influenza strain, other times the match is not so good. When the match is spot on, the vaccine is very effective; when it is less well matched, it is less effective BUT still far better protection than if no influenza vaccine is taken.
“Antivirals and other off -the-shelf medications are not very effective against influenza, so the treatment for influenza is simply bed rest and lots of fluids. Influenza is quite contagious. If you’re not protected by vaccine when exposed to someone incubating or having influenza, you easily become infected and then spread it to others who are not immunized in your family, at work, at school, etc. For many people, the extreme fatigue from influenza is very debilitating and disruptive to their lives, even if they do not get one of the more serious complications. It’s so much easier to just get a flu shot.”
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