Recently I was asked to comment on alternate immunization schedules. Having addressed immunizations previously; truthfully it wouldn’t be too hard to devote the entire blog to this subject. Let’s review a few important points.
The above chart is a few years old, but it makes an important point: each vaccine preventable disease had peak occurrence before the introduction of its corresponding immunization. The “anti-vaxxers” claim that it is “improved public health standards” rather than the vaccine that caused the above change in disease occurrence. But this is completely circular logic. The immunization is the public health standard. If public health stardards like cleaner water, better hygiene, improved nutrition, new medications, or healthier lifestyles were responsible for the great drop in infection rate, then all diseases would become less common at the same rate and at the same time. But that is not what happened. Rather, pertussis dropped in the 40’s, polio in the 50’s, measles in the 60’s, chicken pox in the 90’s and pneumococcal meningitis in the 00’s: each one immediately following the specific immunization’s introduction. The correlation is clear and the conclusion inescapable. The shots did it.
Also recall that most of these diseases still occur with some frequency worldwide. Like most Americans, I value living in an open society with the ability to move about freely. But as Spiderman’s Uncle Ben told him, “with great power comes great responsibility.” We must protect ourselves–and in particular our most vulnerable fellow citizens, very young children–from the infections that can be born by people on the move. Given the huge upside noted on the chart and the very positive benefit:risk ratio its a small price to pay.
Another anti-vaxx assertion is the “wait” argument: start the vaccines later, they say, when the children are “stronger.”This is an equally specious assertion. As it is the youngest children who suffer the most from these diseases, putting the shots off until later in life only leaves those most vulnerable at greatest risk. That’s not circular logic–its counter-logical, completely backwards. To protect the youngest at greatest risk we must immunize them.
Finally, we should consider the “stretched out” schedule. 2 “cons” and a “pro” here. The scientific evidence for any immunologic benefit is completely lacking. Also, we must keep in mind that every car ride and every doctor visit carries with it a hypothetical but demonstrable risk of accident on the road or infection from office contact. So, given the phantom benefits vs. real risks, this seems kind of pointless to me. Having said that, I do feel that those risks are very small; the advantages of greater trust and assurance for those parents requesting such an approach is a real benefit that deserves consideration. I am very comfortable making reasonable adjustments whenever asked.
So I always urge my patients: bring your immunization questions and concerns to me. As the Beatles sang “We Can Work It Out” (you know I love quoting Lennon and McCartney).
I’m here to help. We’ll get it done. Thanks for following