GP gets straight to point in the vaccination debate
THE Sunshine Coast recently had the dubious honour of having one of the lowest levels of vaccination in Australia.
This places us at risk of seeing a resurgence of diseases, such as measles, that we never thought would be seen again.
The loss of trust in time-poor doctors, the misinformation from the internet and the rise of the alternative practitioners are all contributory factors.
Having worked in places in the world where children die of vaccine-preventable diseases on a daily basis, I am appalled at our level of vaccination and wonder what on earth has happened to undermine one of the greatest contributions to public health.
Surprisingly, many of those choosing not to vaccinate are the educated middle class. This group will claim to have "done their research".
But what does this mean?
Not vaccinating has almost become trendy, with Facebook posts and online discussions sowing seeds of doubt in those who feel they have done the right thing.
In the past decade, the surgery I work in has given roughly 30,000 vaccines. I have never seen a serious side-effect that resulted in a permanent disability.
The occasional expected rash after the MMR vaccine, and sometimes a lump at the site of the needle, are expected and minor.
If the outlandish claims about vaccination were true, doctors would simply cease to vaccinate for fear of litigation.
A small percentage of those against vaccination will never be swayed. They will argue black and blue there are sinister government and pharmaceutical forces at work covering up data about the evils of vaccination. This minority group cannot be talked to, or swayed, even when presented with irrefutable data.
However, this minority will make a lot of noise and somehow cast doubt in those who have "done their research".
When I meet these parents, I ask some basic questions about their research to ensure they have the facts. For instance, do they know about the diseases we are vaccinating against?
What do they know about measles, which killed 158,000 children worldwide in 2011?
Do they still believe MMR vaccine causes autism, despite all the evidence to the contrary? Do they have scientific evidence for the outlandish claims made by websites and alternative practitioners, which have "swayed" them not to vaccinate?
In nearly all cases, the answer is in the negative.
This is not research. This is canvassing and surfing. These parents are seduced by sensational, incorrect, anti-vaccination beliefs at the expense of facts.
By using famous people, stories, sensationalism and anecdotes, the anti-vaccination movement will garner enough doubt for otherwise intelligent parents to question vaccination.
Getting advice regarding vaccines from those who have no training in medicine, public health or science is equivalent to me getting taxation and financial advice from a gardener.
Science must use facts. Confusing graphs, figures and statistics will struggle against websites and posts using emotional, anecdotal arguments.
The media has not helped over the years with its reporting. Giving both "sides" of the argument has legitimised the anti-vaccination stance. Do we give equal billing to those who believe the Earth is flat versus those who believe it is round?
Every drug has the potential for side-effects and there is no 100% safe drug or vaccine. I cannot guarantee 100% you will not be struck by lightning on walking out the surgery door, but the chance is infinitesimal.
Recently, the polio vaccine was changed from oral drops to the injected form. Why? Because the drops had the potential to cause polio in one to two children every decade in Australia, whereas the injectable form had no risk.
This is the kind of risk analysis that should help people realise there are no hidden "side effects" or data corruption. Leave that to conspiracy theorists.
Science is racing to develop vaccines against malaria, tuberculosis and HIV. How we struggle now with these three is how we used to struggle with diphtheria, tetanus and whooping cough.
I can guarantee that 20 years after the HIV vaccine has worked "miracles", there will be groups campaigning against the HIV vaccine.
Analysing some of these myths should be part of "doing research". For instance, the claim that we only vaccinate against diseases that have virtually disappeared. This is untrue.
Vaccination also protects against commonly encountered bacteria such as tetanus and pneumococcus. This latter bacteria is commonly found in the general population but in certain circumstances can invade and cause serious disease such as meningitis.
The vaccine Prevnar has plummeted the incidence of invasive pneumococcal disease in infants and children since its introduction in 2001.
The recent deaths of newborns in Australia have underlined how prevalent pertussis is in the community. The vaccine we have at present, though not ideal, is far better than returning to the years where one infant a week died from whooping cough.
Another claim is that vaccination weakens the immune system. What does this actually mean?
To weaken an immune response would suggest that the ability to mount an immune reaction has somehow been compromised. This would mean an increase in the incidence of infections or illnesses.
There is no scientific evidence either epidemiologically or laboratory-wise to support this claim. By the very nature of vaccination, the opposite has occurred.
Decisions on health used to be the domain of the doctor. Nowadays there are myriad health "experts", alternative practitioners, well-meaning opinionated friends and family and, of course, the internet.
Immunisation remains one of the most astonishing public health achievements of the last 100 years, but despite overwhelming epidemiological and scientific support, it has somehow become a topic of debate and controversy.
For those who "want to do their own research", may I suggest they look at the diseases, their incidence, the effectiveness of the vaccinations and the risks, and be cynical and sceptical of anecdotes, unproven statements and websites that have no supporting evidence.
Are you for or against vaccination?
This poll ended on 09 June 2014.
For vaccination, it's vital and safe
For vaccination, there are risks but they're worth it
Against vaccination, I heard the risks aren't worth it
Against vaccination, 'big pharma' and the government are brainwashing us
This is not a scientific poll. The results reflect only the opinions of those who chose to participate.