Applied Evidence

When the answer to vaccines is “No”

J Fam Pract. 2018 June;67(6):348-351,359-364

From The Journal of Family Practice | 2018;67(6):348-351,359-364.

References

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10. Agency for Toxic Substances & Disease Registry. Minimal risk levels for hazardous substances. Available at: https://www.atsdr.cdc.gov/mrls/mrllist.asp#34tag. Accessed April 8, 2018.

11. US Food and Drug Administration. Thimerosal and vaccines. Available at: https://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228. Accessed April 8, 2018.

12. Hviid A, Stellfeld M, Wohlfahrt J, et al. Association between thimerosal-containing vaccine and autism. JAMA. 2003;290:1763-1766.

13. Centers for Disease Control and Prevention. Thimerosal in vaccines. Available at: https://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html. Accessed May 8, 2018.

14. Autism Speaks. Frequently asked questions. Available at: https://www.autismspeaks.org/what-autism/faq. Accessed April 8, 2018.

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16. Children’s Hospital of Philadelphia. Vaccine ingredients-aluminum. Available at: www.chop.edu/centers-programs/vaccine-education-center/vaccine-ingredients/aluminum. Accessed April 8, 2018.

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20. The National Academies of Sciences Engineering Medicine. History of U.S. water and wastewater systems. Privatization of Water Services in the United States: an Assessment of Issues and Experience. Washington, DC: The National Academies Press; 2002:29-40. Available at: https://www.nap.edu/read/10135/chapter/4#35. Accessed May 7, 2018.

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10. Isn’t vaccination a personal choice? How does my health/illness impact the community?

Patients may not realize that most viruses are contagious from 1 to 2 days before symptoms appear, which means we can spread an illness before we even know we have it. Protecting oneself also protects those around us.

While the whooping cough that a healthy 35-year-old gets may be a prolonged annoyance or prompt some time off from work, it can kill the baby sitting next to the adult on the plane or bus.

Economic concerns. There’s also the economic impact of these illnesses to consider. This includes the personal cost of being out of school or work for an extended period and the cost of a patient’s care, which can become astronomical if hospitalization is required and which can become the country’s problem if a person lacks sufficient health insurance coverage.

A study looking at the cost of 4 major adult vaccine-preventable illnesses (influenza, pneumococcal disease, shingles, and whooping cough) in the United States in 2013 estimated the annual cost for these illnesses in adults ≥50 years to be $26.5 billion.²⁸ And that doesn’t include the cost of childhood vaccine-preventable diseases.

Countering 3 concerns about childhood vaccinations

1. I can’t afford vaccines for my child.

The Vaccines for Children program is a federally-funded program that covers the cost of all vaccines for children younger than 19 years of age who are Medicaid-eligible, American Indian, Alaskan Native, uninsured, or underinsured.²⁹Although there may be a small administration fee charged by the provider’s office, the vaccine is free.

2. Don’t all of the vaccines recommended for children overwhelm their immune systems?

Children are exposed to so many more proteins on a daily basis (by crawling around on the floor, putting their hands in their mouths, attending school or day care, etc) than they are ever exposed to in a series of vaccines.³⁰ Exposure to these proteins in their environment and to those in vaccines only serves to boost their immunity and keep them healthier in the long run.

And thanks to advances in vaccine production, the immunologic load in vaccines is far less than it used to be. The 14 vaccines given today contain <200 bacterial and viral proteins or polysaccharides, compared with the >3000 of these immunologic components in the 7 vaccines administered in 1980.³¹

Continue to: Influenza vaccine: Patient-friendly talking points