Published: July 19, 2008 12:00 am            

Shots or not: Weighing the risks

EDITOR'S NOTE: This is the first in a series of articles examining issues surrounding immunizations.



Parents have questioned the side effects of vaccines for years, but the number of parents nationally who opt out of getting their children vaccinated appears to be rising.

The percent of children ages 19-35 months who are up-to-date on their recommended immunizations nationally decreased from 80.8 percent in 2006 to 80.6 percent in 2007, according to the United Health Foundation.

Currently, nearly 0.5 percent of kids enrolled in U.S. schools are unvaccinated under a medical waiver; 2 to 3 percent have a nonmedical one, according to a June 2 Time Magazine article.

There are some risks to vaccinations, but it's important also to compare those with the risk of contracting the disease, said Dr. Gary E. Raskob, dean of the University of Oklahoma College of Public Health and professor of biostatistics, epidemiology and medicine.

"Most public health professionals would say that the downside of withholding the vaccine from your child is much bigger than the (vaccine's) risk," he said.

One of the main risks that critics of immunization point out is the link between vaccines and autism.

It has long been suspected that thimerosal, which was used as a preservative in some vaccines, caused autism. In 2001, thimerosal was taken out of all vaccinations except traces in some flu vaccines.

But the prevalence of autism hasn't decreased.

In 2003, a committee from the Centers for Disease Control and the National Institutes of Health researched the alleged link between thimerosal and autism and concluded that there was no scientific evidence to support it, according to the Time Magazine story.

The committee also said it did "not consider a significant investment in studies of the theoretical vaccine-autism connection to be useful."

Raskob cautioned that when assessing the risks of immunization, one shouldn't just look at the possible side effects of the vaccine. One should also examine the possible consequences of catching the disease that the shot vaccinates against.

Most parents today who are faced with the question of immunization have not seen the devastating effects of diseases such as measles or polio.

Parents may not know what these diseases are because the vaccinations have virtually eradicated them, Raskob said.

"We have eliminated what have potentially before been devastating diseases through vaccinations."

Vaccinations are highly successful, especially when they are mandated across-the-board by the government, he said.

One specific case in Oklahoma is a good example.

In 1998, the state legislature began to mandate Hepatitis A vaccinations for entrance into day cares and school.

As a result, the number of new Hepatitis A cases per year dropped from 667 in 1998 to just 11 new cases in 2006.

Now everyone benefits from the lower incidents of Hep A, as with the other diseases that have been virtually wiped out from vaccines, Raskob said.

"That's just a very modern illustration of what these programs can do."

But some parents resist vaccine mandates because they believe they infringe on their personal rights. Inevitably, the question of the rights of the child versus the good of the whole comes up, Raskob said.

"The side effects (of vaccines) are confined to the child, so it does become a little bit of a discussion of the trade-offs between individual rights and the public good."

The benefits of vaccinations for society, however, are based on getting as high a percentage of the population vaccinated as possible, Raskob said.

For example, although measles is not nearly the health threat it was before its vaccine was mandated, individual cases or small outbreaks still happen in those who aren't vaccinated.

"The more people we don't vaccinate, the more chances we'll have these pockets of outbreaks," Raskob said.

Oklahoma has become better in this category in recent years.

About 70 percent of Oklahoma children ages 19-35 months had all the recommended immunizations in 2000, according to the United Health Foundation. But the percentage of immunized children increased to 80 percent by 2007.

The state's health as a whole is ranked at 47 out of 50 by UHF. But Raskob pointed out that Oklahoma's record of mandating immunization has increased the state's rank in applicable areas.

The high percentage of children immunized in Oklahoma brings the state up to the rank of 25 in that category.

Another statistic provided by the UHF shows one of the results of the increase in immunization. In 2000, Oklahoma had 42.4 cases of infectious disease per 100,000 people. That ranked the state at 42 of 50.

By 2007, the incidences of infectious disease had decreased to 13.8 cases per 100,000. The state is now ranked 24 of 40 in that category.

That change is exceptional, Raskob said, and brings the discussion back to the reason for vaccines: To prevent the incidence of diseases.

"I think there's no question that vaccination is having an impact on that (statistic)," he said.

And although 80 percent of children immunized is much better than 70 percent, it's not enough, Raskob said.

The government needs to take away the financial barrier to vaccinations, he said, so families without health insurance can still afford the sometimes-expensive vaccines. He also said the government should continue to invest in research and development of new vaccines.

Parents should be aware of the advantages of immunizing their children, he said. If they have questions about the risks, they should ask their health care professional, who will welcome the discussion, Raskob said.

"Parents are completely right to have questions and concerns about the health of their child."

Julianna Parker 366-3541 jparker@normantranscript.com

        

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