Debate Between Supporters and Opposers of Vaccines
By the time a child in the United States reaches the age of two years, it is recommended that they have fourteen different types of vaccines which amounts to twenty-six different injections in total (Chaterjee, 2010). Vaccines are a biological preparation administered to humans (or other animals) to cause immunity to a particular disease (Merriam Webster’s online dictionary, 2019). The United States started using vaccines widely in the 1990’s to combat bacterial infections in children. The Advisory Committee on Immunization Practices (ACIP), a subdivision of the United States’ Center for Disease Control and Prevention (CDC), creates the recommended immunization schedule for children and reviews it annually (Ventola, 2019). Due to the health benefits vaccines provide, many believe that some or all recommended vaccines should become mandatory to protect not only individuals, but society as a whole. Many people find problems with the idea of mandated vaccines, with reasons ranging from safety to religious views. It seems the majority of the medical community, as well as global health and government organizations, support the notion that the benefits of vaccines outweigh the risks, basing their stance on empirical data. However, many people are not willing to take the word of these assorted experts at face value when it comes to the safety of their children and themselves.
Safety, or the perceived lack thereof, is one of the major reasons people are hesitant to trust vaccines. A vaccine normally includes some form of the microorganism that is believed to cause the targeted disease, a type of preservative that makes the vaccine stable and/or sterile, and a foreign material that will elicit a response from the immune system (Brewitt, 2003). These additives are referred to as an adjuvant. Thimerosal is a preservative commonly used in vaccines that is made up mostly of mercury. Parents and even the U.S. Food and Drug Administration (FDA) have become concerned that the levels of mercury that children are receiving from vaccines are unsafe (Chatterjee, 2010). This concern stems from the fact that Mercury is linked to toxicity of the kidneys, the central nervous system, and the entire immune system. Aluminum is another heavy metal adjuvant that can be toxic to humans, specifically to their kidneys, and has causal relationships with encephalitis, bone disease, and anemia. When mercury is added to aluminum the consequences can include metal toxicity and autoimmune reactivity. The Health and Medicine Division of the National Academies of Science, Engineering, and Medicine (HMD), previously known as the Institute of Medicine (IOM), actually recommended that manufacturers remove mercury from vaccines altogether. However, there are no regulations in place to enforce this recommendation (Brewitt, 2003).
A variety of adverse reactions have been reported as side effects for different vaccines. One of the most common is an anaphylactic, or allergic, reaction. Sometimes patients react to the actual immunizing agent of the vaccine (the form of the microorganism) but often the allergen responsible for the reaction is one of the additives in the vaccine. For example, gelatin is an additive in the measles-mumps-rubella (MMR) vaccine that is a potential allergen. Additionally, the influenza vaccine contains a small amount of egg which has been recorded as causing an allergic reaction. Neomycin is yet another additive used in vaccines as an antibacterial agent that has been identified as an allergen. The smallpox vaccine is no longer used in the United States, but when it was on the recommended immunization schedule some patients experienced eczema vaccinatum as a side effect. Cases of this form of atopic dermatitis ranged from mild to fatal (Kelso, 2003). Another example is the diphtheria-tetanus-whole cell pertussis (DTwP) vaccine which has been connected to cases of seizures, hypotonic-hypo responsive episodes, and acute encephalopathy. A variation of this vaccine, diphtheria-tetanus-acellular pertussis (DTaP), is recommended in the United States and has links to febrile seizures, hypotonic-hypo responsive episodes, and persistent crying in infants. Vaccine-associated poliomyelitis is a possible side effect of the oral poliovirus vaccine (OPV) which is still being used in developing countries across the world. Lastly, some less threatening, but very common side effects of vaccines are pain, swelling, or redness at the injection site (Kimmel, 2005).
Aside from fear of the side effects of vaccines, religion plays a role in some people’s decision to not vaccinate themselves or their children. Parents of preadolescent girls that have religious affiliations sometimes find issue with the human papillomavirus (HPV) vaccine because it protects against a sexually transmitted disease, and they do not believe that the vaccine is age-appropriate or relevant for a child that is not sexually active (Ventola, 2019). Some fear that receiving this vaccine will encourage girls to become prematurely sexually active or promiscuous. Another example is the several vaccines that have utilized aborted fetuses in the vaccine development process, including vaccines targeting MMR and hepatitis A. Members of some religious communities have moral objections to these vaccines because of their views or beliefs concerning abortion (Chatterjee, 2010).
Vaccines have had a large influence on global health. The utilization of vaccines over the past few decades has resulted in a decrease of incidences of deadly diseases, hospitalizations, and deaths. Vaccines protect the individual against disease, but they also protect the rest of the community and future generations from illness. The more people that are vaccinated in the population, the lower the risk of contracting the disease is for those that are not vaccinated due to barriers ranging from age to health to money. This concept is called “herd immunity”. As time goes on and vaccines cause a decrease in incidences of disease it becomes more likely that future generations will not contract those diseases at all (Ventola, 2019).
Scientists and doctors argue that ingredients in vaccines are generally safe and adverse reactions to vaccines are very rare. Anaphylactic reactions are the most common of the few adverse events associated with vaccines. These particular reactions occur when the person receiving the vaccine is allergic to something in it. The allergens, or substances causing the reaction, are not necessarily poisonous or unsafe, but a portion of the population may react negatively to them. A large amount of cases of vaccine-associated anaphylaxis can be avoided by simple allergy screenings with a healthcare professional prior to any vaccinations. In 2013, HMD released a report that concluded the recommended immunization schedule is not unsafe (IOM, 2013). With this in mind, the small fraction of patients who suffer adverse reactions due to vaccines must be weighed against the overarching benefits vaccines have provided to the world. Vaccines have caused a significant decrease in rates of mortality and morbidity due to infectious diseases (Kelso, 2003).
On May 8, 1980, the World Health Organization (WHO) concluded that smallpox, a deadly infectious disease, was eradicated. This was a huge success for the world and a momentous achievement for medicine, as the eradication could not have been achieved without the vaccine against smallpox (Fenner, 1998). Smallpox is not alone, vaccines have almost completely diminished neonatal tetanus and polio in the majority of developed countries. They are also responsible for a major drop in deaths caused by measles as well as incidents of whooping cough, diphtheria, Haemophilus influenzae type B infections, Neisseria meningitidis serogroup C, and streptococcus pneumoniae (Doroshenko, 2007). Though the medical community has had great success in eliminating infectious diseases, their causative agents are still present and dangerous. Vaccines are a crucial part of achieving the goal of eradicating more infectious diseases in the future (Nathanson, 2016).
There will always be people on either side of the fence when it comes to vaccines, and especially mandated vaccines. Those against vaccines, or the requirement of them, believe that they are dangerous, unnecessary, and that an individual should be able to decide for themselves which vaccines (if any) to get. People with opposing views think that vaccines are effective, generally safe for the human population, and that any associated risks are a small price to pay for the positive impact they have had on global health. In my opinion, we must question and challenge the information that is presented to us regarding our health and acknowledge that some of the concerns of ‘anti-vaxxers’ may be valid. With that being said, I feel reassured by the empirical data and studies that confirm that vaccines are innocuous and save lives. Science has made such impressive progress and it seems foolish to ignore it; however, I agree that there are situations that should allow for exemptions from recommended vaccines, like health or religion. I believe that if we follow recommended immunization schedules now, someday future generations will never have to suffer from preventable diseases and vaccines will no longer be needed.
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