• Linda Von Zeuner

Vaccines: facts over fears

Updated: Oct 13, 2020

By Dr Linda von Zeuner

MBChB, DCH (Diploma in Child health)


This post is for every mom who have ever felt confused, overloaded with information or scared about the concept of immunisations. I am here for you, and I would love to help you.


I know that every mom wishes their children well and want to protect them from harm. That I know is true. Information is overwhelming and scary with words thrown in like autism, anaphylaxis, mercury, encephalitis, anaphylaxis, thimerosal - how on earth should one filter through all of that and how can one distinguish between what is true and what isn't?



Proverbs 27:12
The prudent see danger and take refuge, but the simple keep going and pay the penalty.




I want to start off by showing you a picture of the hierarchy of information. This is boring, please bear with me. But this is a very useful picture to keep at the back of your mind when faced with information overload, even testimonials or case reports, as described by the story above.







What it means is, that not all information one receives weighs equally, and that not all research is science. I am not going to go into data in detail because that is not the point of this post. What I mean is, that all information that proves that vaccines are safe and necessary, come from meta analyses and systematic reviews, which are at the very top of the hierarchy. That is the highest form of credible evidence as both are basically results of multiple studies, all asking the same question, with each study reporting all forms of bias (anything that can cause errors in a study). ANY other information is inferior.






Vaccines are a global success story in medical history, saving millions of lives every day. Vaccines reduce the risk of getting an infection by building your body's natural immunity to a foreign 'bug'. When you get a vaccine, your immune system responds when faced with the specific bacteria or virus it was made 'alert' to recognise. Immunization currently prevents

3 million deaths

every year from diseases like diphtheria, tetanus, pertussis, influenza and measles, and is a key component of primary health care.





I want to look at a few statements that has been made about vaccinations, and look at the facts behind them.


1. Vaccines cause autism


The original notion of this came from a study that was published by Andrew Wakefield in 1997, stating, that the MMR vaccine was causal to autism. The study was later discredited due to procedural errors, ethical violations and financial conflicts of interest. He later admitted to fabricating the facts and his medical license was revoked, but unfortuntely, the damage he did was indelible.


While it is true that there are more children are currently diagnosed with Autism than 10 and more years ago, it is because diagnosti


Last year, the largest study up to date was done in Denmark with a study sample of over

500 000 (yes,that is HALF A MILLION) children,showing NO evidence of any link between the MMR vaccine and autism.


This is an excerpt of the study that was published in the BMJ (British Medical Journal)



The study reviewed records of 537303 children born in Denmark between January 1991 and December 1998, representing almost 100% of children born in that period. Of these children 440655 had been vaccinated. Records were retrieved from three sources: the unique identification number assigned to each child at birth; MMR vaccination data reported to the National Board of Health by general practitioners, who give all MMR vaccinations and are reimbursed for their reports; and diagnoses of autism recorded in the Danish Psychiatric Central Registry. Only specialists in child psychiatry diagnose autism and related conditions.
The study considered the children's sex, weight and gestational age at birth, and age at diagnosis of autism or of a related disorder; the socioeconomic status of the parents; and the mother's education.
The authors found that “There was no increase in the risk of autistic disorder or other autistic-spectrum disorders among vaccinated children as compared with unvaccinated children (adjusted relative risk of autistic disorder, 0.92; 95% confidence interval, 0.68 to 1.24; adjusted relative risk of other autistic-spectrum disorders, 0.83; 95% confidence interval, 0.65 to 1.07).”

BMJ. 2002 Nov 16; 325(7373): 1134


2. Vaccines contain harmful heavy metals





This statement kind of links to the previous one, as many parents believe that it is specifically the metal content in the vaccines that are causal to neurodevelopmental problems, autism, Tic disorders and encephalitis.


If you are concerned or scared about these allegations, I don't blame you, and I am going to sum everything up for you.


It is true that vaccines contain certain ingredients like Thimerosal (ethylmercury), formaldehyde and aluminium salts that are used to preserve it. The doses of these are still lower than what we are exposed to in the natural environment and in a different form.


Thimerosal (which consists of 49% Ethylmercury) is used as a preservative in multi dose vaccines. Ethylmercury is not the same as Methylmercury which is found in seafood, milk and certain canned foods. Ethylmercury is hydrophilic (meaning it absorbs in water) as opposed to Methylmercury which is lipophilic (meaning it dissolves in fat). Ethylmercury is therefore broken down very quickly and there is no chance of it accumulating in the body.


Thimerosal was removed from vaccines after an amendment to the Food and Drug Administration (FDA) Modernization Act was signed into law on Nov. 21, 1997. The amendment arose from a long-standing interest in reducing human exposure to mercury, a known neurotoxin (a substance that harms the nervous system) and nephrotoxin (a substance that harms the kidneys).


At the time the FDA Modernization Act was passed, infants were recommended to receive three different vaccines that contained thimerosal — diphtheria-tetanus-acellular pertussis (DTaP), hepatitis B and Haemophilus influenzae type b (Hib). Infants receiving all of these vaccines could have been exposed to a cumulative dose of mercury at 6 months of age that exceeded guidelines recommended by the Environmental Protection Agency (EPA) Thimerosal, as a preservative, is no longer contained in any childhood vaccine, with the exception of the influenza vaccine, which still contains trace amounts.








Aluminium is the most common metal in the earth's crust and we are exposed to it continually. It reacts with other elements to form aluminium salts and is present in the food we eat and water we drink.


It is not absorbed by the body but excreted by the kidneys. Aluminium is present in amounts of 0.125g - 0.625 g per dosage. Aluminium acts as an adjuvant, strengthening and lenghtening the immune response to a vaccine. It also stops the protein in a vaccine from sticking to the sides of a container that it is placed in .

An infant consumes 10 mg of aluminium through breastmilk in the first 6 months of their lives. A formula fed infant consumes 90 mg of aluminium in the first 6 months of lives. Aluminium is also present in cookingware, utensils, toys and even in play sand.



Formaldehyde is also a preservative found in cosmetics, arts and crafts, medicine in the form of syrups, soaps and lotions and wipes, to name a few. The amount of formaldehyde in vaccines is much lower than any of of these mentioned.





3. Vaccines are not necessary as hygiene practices and sanitation has improved



The role of improved sanitation, nutrition and antibiotics are undispitable in the role of disease elimination, but the role of immunisations can not be scrutinised. To give an example, the first measles vaccine was developed in 1963. Hygiene has not changed much since then, but the rate of measles has still dropped dramatically.


This is an excerpt on the vacccine information portal of the World Health Organisation:




Finally, we can look at the experiences of several developed countries after they allowed their immunization levels to drop. Three countries —Great Britain, Sweden and Japan — cut back the use of pertussis (whooping cough) vaccine because of fear about the vaccine. The effect was dramatic and immediate. In Great Britain, a drop in pertussis vaccination in 1974 was followed by an epidemic of more than 100,000 cases of pertussis and 36 deaths by 1978. In Japan, around the same time, a drop in vaccination rates from 70% to 20%-40% led to a jump in pertussis from 393 cases and no deaths in 1974 to 13,000 cases and 41 deaths in 1979. In Sweden, the annual incidence rate of pertussis per 100,000 children of 0-6 years of age increased from 700 cases in 1981 to 3,200 in 1985.


4. The risk of anaphylaxis is too great to risk vaccinating my child



There is a risk of anaphylaxis, as with most things, food and medicine related. The chance of an allergic reaction to a vaccine is 1/1000 000. Your chance of dying if you catch measles is 1/500. You do the math.


Vaccines are also unable to cause auto immune disease or cause allergies later in life. They 'train' your body how to react to a foreign antigen, but the can not change the way your immune system reacts.


Literature proved over and over again that autoimmune diseases and nervous system syndromes that had been reported as adverse events following vaccinations were no longer evidenced when WELL CONDUCTED epidemiological studies were carried out.

Although the rarity of autoimmune diseases makes it difficult to strictly exclude that, albeit exceptionally, some vaccines may induce an autoimmune neurological disease, no definitive demonstration of a potential role of vaccines in causing autoimmune neurological syndromes is presently available. Consequently, the fear of neurological autoimmune disease cannot limit the use of the most important preventive measure presently available against infectious diseases.




5. Infection rates are already so low, therefore vaccination is not necessary


Herd immunity means, that as long as a large majority of a population is immunised, those who are not immunised will be protected.


We firstly vaccinate to protect ourselves from disease. The second is to protect those around us, for example a small baby less than 6 weeks old and pregnant women. These people are susceptible to disease, and their only hope of protection is that people around them are immune and cannot pass disease on to them. So no. Infection rates are currently low in areas where immunisation rates are high. Let's keep it that way.


6. If you have an egg allergy, you can not be immunised


The Allergy Foundation of South Africa (and globally) are unanimous that all egg allergic children can receive ALL vaccines safely without a test dose or supervision EXCEPT:

YELLOW FEVER (if you are planning an East Africa trip) and RABIES where they will need to consult a specialist before having these done.




7. You can't immunise your child if he or she has a fever


Several studies confirmed that it is safe to vaccinate your child if he or she has a mild illness and a low grade fever. Deferring vaccination may be prudent for the febrile and acutely ill child, but this is unnecessary for children with minor illnesses without fever, when inactivated vaccines are indicated, as it leads to missed immunisations.




8. My child is at risk of seizures after receiving a vaccination


Vaccines can cause fever, and fever in young children can lead to febrile seizures; these facts are not new.

There is a very small chance of your child developing a febrile seizure 8-14 days after an MMR vaccine. There was no link between seizure syndromes or long term epilepsy found with any vaccine.

The administration of Influenza vaccine on the same day as either Prevenar or a DTaP-containing vaccine was associated with a greater risk of Febrile seizures than when it was given on a separate day.

Does this mean we should stop giving these vaccines together or stop giving them at all? We say, emphatically, no. Febrile seizures, although frightening to parents, rarely have any long-term sequelae.


The benefits of giving these vaccines simultaneously include decreased clinic visits associated with painful vaccines and the assurance that children will be fully immunized and protected from infections that carry real morbidity and mortality. It goes without saying that influenza, diphtheria, tetanus, pertussis, and pneumococcal infections may result in serious illness. These infections also have the potential to cause fevers and febrile seizures. Only 2% of febrile seizures were vaccine related, where the rest were caused my mostly vaccine preventable diseases.





This is an excerpt on the vacccine information portal of the World Health Organisation:




Finally, we can look at the experiences of several developed countries after they allowed their immunization levels to drop. Three countries —Great Britain, Sweden and Japan — cut back the use of pertussis (whooping cough) vaccine because of fear about the vaccine. The effect was dramatic and immediate. In Great Britain, a drop in pertussis vaccination in 1974 was followed by an epidemic of more than 100,000 cases of pertussis and 36 deaths by 1978. In Japan, around the same time, a drop in vaccination rates from 70% to 20%-40% led to a jump in pertussis from 393 cases and no deaths in 1974 to 13,000 cases and 41 deaths in 1979. In Sweden, the annual incidence rate of pertussis per 100,000 children of 0-6 years of age increased from 700 cases in 1981 to 3,200 in 1985.


4. The risk of anaphylaxis is too great to risk vaccinating my child



There is a risk of anaphylaxis, as with most things, food and medicine related. The chance of an allergic reaction to a vaccine is 1/1000 000. Your chance of dying if you catch measles is 1/500. You do the math.


Vaccines are also unable to cause auto immune disease or cause allergies later in life. They 'train' your body how to react to a foreign antigen, but the can not change the way your immune system reacts.


Literature proved over and over again that autoimmune diseases and nervous system syndromes that had been reported as adverse events following vaccinations were no longer evidenced when WELL CONDUCTED epidemiological studies were carried out.

Although the rarity of autoimmune diseases makes it difficult to strictly exclude that, albeit exceptionally, some vaccines may induce an autoimmune neurological disease, no definitive demonstration of a potential role of vaccines in causing autoimmune neurological syndromes is presently available. Consequently, the fear of neurological autoimmune disease cannot limit the use of the most important preventive measure presently available against infectious diseases.




5. Infection rates are already so low, therefore vaccination is not necessary


Herd immunity means, that as long as a large majority of a population is immunised, those who are not immunised will be protected.


We firstly vaccinate to protect ourselves from disease. The second is to protect those around us, for example a small baby less than 6 weeks old and pregnant women. These people are susceptible to disease, and their only hope of protection is that people around them are immune and cannot pass disease on to them. So no. Infection rates are currently low in areas where immunisation rates are high. Let's keep it that way.


6. If you have an egg allergy, you can not be immunised


The Allergy Foundation of South Africa (and globally) are unanimous that all egg allergic children can receive ALL vaccines safely without a test dose or supervision EXCEPT:

YELLOW FEVER (if you are planning an East Africa trip) and RABIES where they will need to consult a specialist before having these done.




7. You can't immunise your child if he or she has a fever


Several studies confirmed that it is safe to vaccinate your child if he or she has a mild illness and a low grade fever. Deferring vaccination may be prudent for the febrile and acutely ill child, but this is unnecessary for children with minor illnesses without fever, when inactivated vaccines are indicated, as it leads to missed immunisations.




8. My child is at risk of seizures after receiving a vaccination









Vaccines can cause fever, and fever in young children can lead to febrile seizures; these facts are not new.

There is a very small chance of your child developing a febrile seizure 8-14 days after an MMR vaccine. There was no link between seizure syndromes or long term epilepsy found with any vaccine.

The administration of Influenza vaccine on the same day as either Prevenar or a DTaP-containing vaccine was associated with a greater risk of Febrile seizures than when it was given on a separate day.

Does this mean we should stop giving these vaccines together or stop giving them at all? We say, emphatically, no. Febrile seizures, although frightening to parents, rarely have any long-term sequelae.


The benefits of giving these vaccines simultaneously include decreased clinic visits associated with painful vaccines and the assurance that children will be fully immunized and protected from infections that carry real morbidity and mortality. It goes without saying that influenza, diphtheria, tetanus, pertussis, and pneumococcal infections may result in serious illness. These infections also have the potential to cause fevers and febrile seizures. Only 2% of febrile seizures were vaccine related, where the rest were caused my mostly vaccine preventable diseases.





Psalm 91:4
He will cover you and completely protect you with His pinions,
And under His wings you will find refuge;
His faithfulness is a shield and a wall.

Additional sources for reading:



World health organisation:
https://vaccine-safety-training.org/(free downloadable booklet which is very comprehensive!)
https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1
 
Allergy foundation South Africa
https://www.allergyfoundation.co.za/patient-information/en/allergens/egg-allergy/ 
Children's hospital of Philadelphia page
https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-ingredients/sv40 
American Academy of Asthma, Allergy and Immunology
https://www.aaaai.org/conditions-and-treatments/library/allergy-library/vaccine-myth-fact 
https://www.publichealth.org/public-awareness/understanding-vaccines/vaccine-myths-debunked/


In my next post I will be giving general advice as to how to make immunisation day as non traumatic as it can possibly be for mom and baby, with general tips on how to prevent post vaccination fever.


I will also be sharing more on the HPV vaccine as there is also quite a lot of information and since it is not really applicable to young children I did not want to make this post too long.


Thank you for everyone's stories they have shared so far with me. I am always here to learn, stay open and comfort as best I can.





Bibliography:


World health organisation vaccine portal

https://www.who.int/vaccine_safety/initiative/detection/immunization_misconceptions/en/index1.html

https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-ingredients/thimerosal

Pediatrics May 2001, 107 (5) 1147-1154; Ball, L; Ball R; Pratt, D. An Assessment of Thimerosal Use in Childhood Vaccines

BMJ. 2002 Nov 16; 325(7373): 1134 . Meldgaard Madsen et al. A polulation based study of measles, mumps,and rubella vaccination and autism.

Immunology.org https://www.immunology.org/celebrate-vaccines/public-engagement/guide-childhood-vaccinations/vaccine-myths

https://vk.ovg.ox.ac.uk/vk/vaccine-ingredients https://www.immunology.org/celebrate-vaccines/public-engagement/guide-childhood-vaccinations/vaccine-myths

(publichealth.org)

https://www.who.int/vaccine_safety/initiative/detection/immunization_misconceptions/en/index1.html

https://www.allergyfoundation.co.za/patient-information/en/allergens/egg-allergy/

Lapphra, K: Scheifele, D. Can children with minor illnesses be safely immunised? Paediatr Child Health. 2011 Oct; 16(8): 463.

Vaccine 2015 Jul 17;33(31):3636-49.Risk of febrile seizure after measles-mumps-rubella-varicella vaccine: A systematic review and meta-analysis

Shu-Juan Ma 1Yi-Quan Xiong 1Li-Na Jiang 1Qing Chen 2

Febrile Seizure Risk After Vaccination in Children 6 to 23 Months

Jonathan Duffy, Eric Weintraub, Simon J. Hambidge, Lisa A. Jackson, Elyse O. Kharbanda, Nicola P. Klein, Grace M. Lee, S. Michael Marcy, Cynthia C. Nakasato, Allison Naleway, Saad B. Omer, Claudia Vellozzi, Frank DeStefano and on behalf of the Vaccine Safety Datalink

Pediatrics July 2016, 138 (1) e20160320; DOI: https://doi.org/10.1542/peds.2016-0320

Pediatrics. 2016 Jul; 138(1): e20160976. Vaccines and Febrile Seizures: Quantifying the Risk

Mark H. Sawyer, MD, FAAP,a Geoff Simon, MD, FAAP,b and Carrie Byington, MD, FAAPc

https://www.cdc.gov/vaccinesafety/concerns/febrile-seizures.html#:~:text=other%20two%20vaccines.-,Studies%20have%20not%20shown%20an%20increased%20risk%20for%20febrile%20seizures,vaccine%20is%20given%20by%20itself.

https://vaccine-safety-training.org/

https://www.frontiersin.org/articles/10.3389/fpubh.2020.00361/full

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