Understanding childhood vaccinations

By Henrylito D. Tacio
Eighteen-month-old Jessie was an active, playful toddler.  Then, one day, he was struck down with a high fever, severe coughing, diarrhea, vomiting and a red rash on his face and chest.
When Jessie started gasping for breath on the sixth day of his illness, his parents rushed him to a hospital.  The doctor diagnosed pneumonia, a complication of measles.  Although he was given intravenous fluids and antibiotics, his condition worsened.  Two days after admission, Jessie died.
Sarah, the boy’s mother, later told doctors she didn’t realize that measles was life-threatening.  She hadn’t had Jessie vaccinated against the disease even though she lived just over a kilometer away from a health center.  “If only I had known,” she said.
With vaccine available for measles, the acute bacterial respiratory infection should have been part of history already — but such is not the case. 
It must be recalled that in 2014, the Department of Health reported a total of 1,810 cases of measles in Davao Region from January to July, with most of the cases coming from Davao City.
According to a news report circulated by the state-run Philippine News Agency, measles cases were high in Talomo North with 181 reported cases, Buhangin with 124 cases, and Talomo South with 105 cases. However, confirmed cases were high in Talomo North with 21 cases, Talomo South with 14 cases, Buhangin with 13, and District A with 13 cases.
Measles is a highly contagious, serious disease caused by a virus. It remains one of the leading causes of death among young children globally, according to the Geneva-based World Health Organization (WHO). Approximately 114,900 people died from measles in 2014 – mostly children under the age of 5.
Since the United Nations health agency launched its Expanded Program on Immunization (EPI) in 1974, millions of deaths have been prevented every year.  During 2000-2014, measles vaccination prevented an estimated 17.1 million deaths. Global measles deaths have decreased by 79% from an estimated 546,800 in 2000 to 114,900 in 2014, the WHO reports.
Unfortunately, public health experts believe that this progress is potentially in jeopardy.  “Fewer children are suffering and dying from infections, so parents are not taking the problem seriously,” says Dr. Zulkifli Ismail, professor of pediatrics and director of Hospital Universiti Kebangsaan Malaysia.  “Parents are putting their children at risk when they don’t bring them in for their shots.”
Although the global campaign for childhood immunization has been a towering success, the United Nations Children’s Fund (UNICEF) warns that there is still a long way to go.
“Nearly one in 5 infants are still left out of the life-saving benefits of vaccines and are exposed to a far higher risk of death and disability,” UNICEF deplores.  “An estimated 1.5 million unvaccinated children die each year.”
In the Philippines, over 1,000 children needlessly die each year from six childhood killers: diphtheria, measles, polio, whooping cough, tuberculosis and tetanus.  Most of those who died are children who are not immunized.
Basic medical knowledge is also low.  “Many parents do not know that the reason for decline in infectious diseases is due in a large part to vaccinations,” says Dr. Lam Mun San, an infectious disease consultant physician with the Mount Elizabeth Medical Center in Singapore.  “Even when parents know something about vaccinations, they tend to exaggerate the side effects and downplay the consequences of diseases from unvaccinated children.”
Nevertheless, the case for childhood vaccination remains overwhelming.  “Living in a time of unprecedented medical interventions, it is difficult to fully appreciate the contribution vaccines have made to human health,” wrote Leony Garcia in a special report which appeared in Business Mirror.
“In fact, the widespread adoption of vaccines was one of the greatest public-health innovations of the 20th century. Deadly and highly-infectious diseases, like small pox, whooping cough, polio and measles, have either been eradicated completely or are under control, thanks to the development and administration of vaccines,” Garcia added.
A vaccine, which undergoes several trials, is safe.  The WHO defines a vaccine as “a biological preparation that improves immunity to a particular disease.”  It further explains: “A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body’s immune system to recognize the agent as foreign, destroy it, and ‘remember’ it, so that the immune system can more easily recognize and destroy any of these microorganisms that it later encounters.”
Recently, there has been some concern about autism and vaccines.  The increase in reported autism spectrum disorders (ASDs) made some parents wonder if there is a connection with vaccines, particularly the tripe measles, mumps and rubella (MMR).  Yet, there hasn’t been any scientific proof.
In its website, the Sanofi Pasteur Inc. said: “More than 20 published scientific studies conducted in various countries have found no link between vaccination and ASDs. Moreover, a 2014 meta-analysis of more than 1.2 million children found that neither vaccines, nor vaccines components, are associated with the development of autism.”
In addition, the Journal of the American Medical Association and the New England Journal of Medicine found no link between the MMR vaccine and autism.
“Despite what you may hear or read, all current vaccines are safe,” assures Dr. Ismail.  “Vaccines have helped prevent more diseases than all antibiotics put together.”
Vaccines are effective.  Polio is a highly infectious viral disease, which mainly affects young children. It was once a disease feared worldwide, striking suddenly and paralyzing mainly children for life. In 1988, when the Global Polio Eradication Initiative was formed, polio paralyzed more than 350 000 people a year. Since that time, polio case numbers have decreased by more than 99%.
The success of trivalent oral polio vaccine is just one of many medical triumphs in recent years.
Diphtheria is a serious disease caused by bacteria. The bacteria live in the mouth, throat, and nose of an infected person.  It can be passed to others by coughing or sneezing.  In the past, diphtheria was a greatly feared illness in the United States. In the 1920s, there were between 100,000 and 200,000 cases of diphtheria each year with 13,000–15,000 deaths. Because of widespread immunization and better living conditions, diphtheria is now rare in the United States.
Vaccines are not perfect, but they are highly effective.  “Normally, vaccines are at least 80% effective — that is, eight out of 10 children vaccinated will develop antibodies against the infection and be protected,” says Dr. C. John Clemens, former EPI medical officer with the WHO in Geneva.
Although no medical intervention is 100% safe, the risk of serious side effects from vaccines, such as severe allergic reactions, is low. 
“Any vaccine can cause side effects,” the Mayo Clinic points out. “Usually, these side effects are minor — low-grade fever, fussiness and soreness at the injection site. Some vaccines cause a temporary headache, fatigue or loss of appetite. Rarely, a child might experience a severe allergic reaction or a neurological side effect, such as a seizure. Although these rare side effects are a concern, the risk of a vaccine causing serious harm or death is extremely small. The benefits of getting a vaccine are much greater than the possible side effects for almost all children.”
A warning: vaccines should not be given to children who have known allergies to specific vaccine components. “If your child develops a life-threatening reaction to a particular vaccine, further doses of that vaccine won’t be given,” the Mayo Clinic says.
Parents wonder why vaccines are given so early?  “The diseases that childhood vaccines are meant to prevent are most likely to occur when a child is very young and the risk of complications is greatest,” the Mayo Clinic says. “That makes early vaccination — sometimes beginning shortly after birth — essential. If you postpone vaccines until a child is older, it might be too late.”
In addition, the full course of immunizations must be completed; otherwise, the vaccines may not work.   For instance, two doses of the vaccine against measles are recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose.
Parents who avoid having their child vaccinated are courting for trouble. “In general, skipping vaccines isn’t a good idea,” the Mayo Clinic says. This can leave your child vulnerable to potentially serious diseases that could otherwise be avoided.
“And consider this: For some children — including those who can’t receive certain vaccines for medical reasons — the only protection from vaccine-preventable diseases is the immunity of the people around them. If immunization rates drop, vaccine-preventable diseases might once again become common threats.” (Photos from the net)