Monday, November 22, 2010

Rational Questions About Vaccines

I want to start by saying both my kids have received their age-appropriate vaccines (except for chicken pox), so far. My husband and myself both had all our childhood vaccines and my mother was a firm believer in the yearly flu vaccine so I got one every year too... and I still got the flu every year growing up. I also managed to get the mumps when I was 20. The mumps, seriously, who gets the mumps anymore? So I've always had a few questions about vaccines. Lately, I'm finding I have more.
At varrious health care facilities and public offices I see the flu vaccine touted as anywhere between 60% and 90% effective. But a meta analysis by the Crochane institute places it's effectiveness at just 1% for healthy adults, and warns that, since most of the studies were carried out by the vaccine's makers that 1% might be overstated. 1%, really? For a disease like small pox that, even among healthy individuals, has a 1 in 3 chance of death even a 1% effectiveness would certainly be worth it, but the flu? The point, realistically, seems to be little beyond a feel-good placebo effect. A placebo that does have known side effects.
And about that...I always throught double blind studies with vaccines (any drug really) vs placebo to test for side effects and efficency the placebo was supposed to be some sort of harmless 'sugar pill'. Yet now I'm reading that placebos, to maintain the 'blindness' of the study are things meant to mimic expected side effects. Yet then they epress the likeliness of side effects in compairison to the 'placebo' users in the drug trials. I honestly don't know if I believe it, but I've read it from more than one source and it is both despicable and sounds likely (realisticly how else WOULD you keep a study double blind if only one group was getting side effects?)
Another thing, the CDC says doctors woefully underreport minor side effects. Which makes sense. When I call the peds office to ask for proper dosing for weight because my infant/toddler has a minor but annoying fever after a vaccination I don't expect them to call and report that to the CDC. And what parent is going to call themselves and say their babe is cranky and feverish. We've already been told to expect that. The paperwork says minor fever/crankiness has a 1 in 3 chance of occuring after vaccinations but in 12 years of childcare I've NEVER met a kid that didn't have that reaction. It seems more likely that 1/3 of parents/doctors are apt to report.
So dragging myself towards my point...I have some questions that I feel are valid, reasonable, and logical questions about vaccines.
1) if vaccines are as effective as touted why do health officials say unvaccinated kids put 'others' (who are vacconated) at risk? I've heard/read it so many times it's apparently a mantra, unvaccinated kids in our schoools put all the students at risk. Only, wait, the kids are vaccinated they are supposed to be immune to the diseases they are vaccinated against, so how could being around kids who aren't vaccinated, and who could potentially have the sickness, possibly put them at risk??? I've had chickenpox, I'm immune so I have no fear of being around someone who has it. I've been vaccinated against measles as a child, and had my booster as a young teenager, can I, as an adult say the same? Could I even as a child? It doesn't make sense. So, are they lying when they say vaccines produce immunity to the diseases they vaccinate against? Or are they lying when they say unvaccinated children put vaccinated children at risk? Is there a third option?
2) If I catch a 'one time' sickness like chicken pox, mumps (seriously, MUMPS!) etc, I'm immune for life. I can, twenty years from now, take care of another with the disease without any risk of becoming sick (well, theoretically. I know a whole family, 4 kids, who ALL got chicken pox twice. Yes, it was 'really' chicken pox, confirmed by a doctor both times. On rare occassions you can get one time diseases a second time.) Yet the vaccines 'wear off'. Vaccines require multiple shots and even, years later, boosters. Why? If they actually produce immunity, why is it temporary? How can the (hypothetically) same antibodies produced by the vaccine not stick around when the antibodies from the disease sticks around? What's more, many of these sicknesses are known to be less severe when caught as children, so are we, as adults, all wandering around at risk for significantly worse cases of something if we happen to get exposed to it in our 30's, 40's, or, worse, 70's? Is this really worth it when the diseases as children are (usually) merely annoying? (The paperwork I received about the chicken pox vaccine when it was offered to my eldest child actually stated 'chicken pox is a painful childhood disease that can cause life long scars' really? States are making a vaccine that has only been around for a few years mandatory because they are afraid kids might get a scar?) Are required vaccines for our children putting us at risk as adults because they don't really produce immunity? Or are we being used as pin cusions for the money with unnecessary booster shoots?
3) What are the actual effectiveness vs side effects? I remember learning about Pastuer and his small pox vaccine. Long before 'double blind' trials he had real world proof his vaccine worked. Children receiving the vaccine were less likely to die from small pox. (did you catch that, it didn't provide immunity to small pox, it lessened it's severity) The trade off was they had a mild case of a different version of pox, which was non deadly. That makes sense. Deadly disease significantly less deadly for the price of a couple of sick days. But what about today's vaccines? What are their side effects? The real side effects, as in, take a 1000 kids, what side effects will they have, not what side effects are reported via doctors or what side effects are worse than those that had a 'placebo'. But what side effects do they actually have? And how effective is it? This relates back to a previous question. Can a vaccinated person really safely be around the disease without catching it? Does the vaccine just provide for a milder form of the disease? And I want to see the actual numbers. When the public health office says the flu vaccine is 70-80% effective to keep people from catching the flu, but the Cochrane institute says it's 1% effective, and that's questionable, it's clear us parents are not getting the correct/full information. When I looked at the papers on the Cochrane site I see lots of studies about different vaccines effectiveness in the elderly, or in children with specific health problems, but nothing (other than the one about the flu) about the effectiveness and side effects of the vaccines towards regular kids.
Alright, when I started this I know there was a fourth point, but I've been interupted in writing this so many times that now I can't remember it. So I suppose those three will work for now.
Do YOU have any questions about vaccines? Have you found any answers you would like to share?

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