A vial containing the MMR vaccine is loaded into a syringe before being given to a 1-year-old baby at the Medical Arts Pediatric Med Group in Los Angeles on Feb. 6, 2015. Mel Melcon TNS
A vial containing the MMR vaccine is loaded into a syringe before being given to a 1-year-old baby at the Medical Arts Pediatric Med Group in Los Angeles on Feb. 6, 2015. Mel Melcon TNS

Health & Family

What experts say about vaccination

By Karen Garloch

kgarloch@charlotteobserver.com

February 28, 2015 04:54 PM

UPDATED February 28, 2015 11:48 PM

When health officials say vaccines are safe, they mean they’re safe for most people. Even if they don’t mention the rare cases of injury, they know that vaccines, like any drug, can have side effects.

“I never mean to suggest that there aren’t risks with vaccines,” said Art Caplan, a medical ethicist at New York University. But he said bad reactions are “very, very rare.”

He likened refusing immunizations out of concern about vaccine injuries to not wearing seat belts for fear of getting injured from wearing seat belts. Far more people are saved by seat belts, he said.

Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention, declined to be interviewed by the Observer. In an email she said the MMR (measles, mumps, rubella) vaccine has been used in this country for 50 years and is “safe and effective. … The evidence about the vaccine’s safety and benefits is strong and consistent.”

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At a news conference in January, Schuchat said children should get vaccinated to “prevent measles from getting a foothold in the United States.” The disease was declared eliminated in this country in 2000, but it’s “still around and it can be serious,” she said.

Dr. Jeffrey Engel, former North Carolina health director and current executive director of the Council of State and Territorial Epidemiologists in Atlanta, said: “Nothing is 100 percent safe. … You take risks all the time. In North Carolina, we love to go to the beach. You could lose a child in a shark attack. But that’s rare.”

In the decade before the measles vaccine became available, about 500 U.S. residents – about 1 in 1,000 who got measles – died from the disease each year, Engel said. But the number of vaccine-related injuries is “nowhere near that order of magnitude,” he said.

Health officials often say vaccines are a victim of their own success. Most of today’s parents have never seen the childhood diseases that vaccines prevent so they “just don’t have any knowledge about what it was like,” said Dr. Stephen Keener, Mecklenburg County Health Department medical director.

Dr. Jean-Ronel Corbier, a pediatric neurologist with Brain Restoration Clinic in Indian Land, S.C., has testified on behalf of parents who’ve made claims to the federal vaccine court about vaccine injuries in their children and has treated children who have had adverse vaccine reactions.

“We’re not anti-vaccine,” he said. “If someone has no risk factors, they should be vaccinated. But some children may have some genetic or metabolic derangement that could make them regress after they receive certain types of vaccines.”

Corbier said he saw a child recently who had “significant changes post-vaccine” and whose cousin had had a similar experience. With that family history, he said, it would make sense for parents to be cautious. He often advises parents to get fewer vaccinations at one time for children who are at risk.

“Parents should know that we’re trying to understand their fears,” he said. “It’s better to come up with a reduced schedule than nothing at all. … In science, things will (often) be re-evaluated years later. But kids have one chance. Parents want to be cautious.”

Barbara Loe Fisher, president of the National Vaccine Information Center, a nonprofit charity she co-founded with parents of vaccine injured children, said public health officials underestimate the risk of vaccine injuries because they haven’t studied the effects of combining so many vaccines in single patient visits.

Under the current immunization schedule recommended by the CDC, Fisher said a child could get 25 to 35 vaccines in its first year of life. “It’s one thing to make a risk estimate for a single vaccine,” she said. “It’s very different to make a risk estimate based on the recommended schedule, which sometimes includes 8 to 10 vaccines given on the same day.”

Fisher said she has been asking for years for a long-term study of health outcomes in children who get all the government-recommended vaccines compared to those who don’t.

A 2013 Institute of Medicine report “found no significant evidence to imply that the recommended immunization schedule is not safe.” But it also said studies to examine long-term effects of cumulative vaccines “have not been conducted.”

“Although health-care professionals have much information about individual vaccines, they have much less information about the effects of administration of multiple vaccines at a single visit or the timing of the immunizations,” the report said. “Some might believe that a serious adverse event that occurs once in 1 million doses is ‘safe enough’ relative to the benefit of preventing a serious disease, whereas others may consider that risk unacceptably high.”