Many years ago, babies surviving childbirth often died from infectious diseases such as smallpox, polio or whooping cough within their first year, explains Professor Rose Burnett, head of the South African Vaccination and Immunisation Centre, Department of Virology, Sefako Makgatho Health Sciences University. “Today, thanks to vaccination against these vaccine-preventable diseases (VPDs), VPD-related infant deaths are rare occurrences in countries with high vaccination coverage and diseases such as smallpox have been eradicated worldwide, with polio almost there.”
Despite all the current hype, adds Lee Baker, managing director and medicine information pharmacist at Amayeza Information Centre, “Vaccines remain one of the safest and most effective tools available in controlling and preventing many infectious and life-threatening diseases. When the Expanded Programme on Immunization (EPI) was established by the World Health Assembly (WHA) in 1974, only 5% of the world’s children were immunised against polio, diphtheria, tuberculosis, measles, pertussis and tetanus. By 2014, this figure had jumped to 83%, with the World Health Organization (WHO) estimating that the EPI was saving the lives of two to three million children annually. Rose continues, “Ironically, it is due to this huge success that parents seldom see a child with a VPD, which has led many to believe that childhood vaccination is unnecessary. Others think VPDs are mild illnesses and maintain that the side effects of the vaccines are far more dangerous than the diseases themselves. Unfortunately, it’s misconceptions such as these that have led to the global resurgence of VPDs − often with serious consequences.”
The 4 biggest vaccination myths
According to Rose and Lee, there are four major myths that have contributed to the continuous outbreaks of dangerous VPDs, like measles, around the world (and in South Africa).
Myth1: There are too many vaccines and they’ll compromise my baby’s immune system.
The facts: Vaccines contain either the whole causative organism (either killed or weakened so that it can’t cause disease), or non-infectious parts of the organism, which stimulate your child’s immune system in the same way as natural infections. A healthy baby’s immune system is capable of dealing with the many different micro-organisms that he or she comes across on a daily basis. In fact, the amount of bacterial and viral antigens in all the vaccines received during the first year of life is far smaller than the amount of naturally occurring bacterial and viral antigens an average baby is exposed to in a single day. Unvaccinated and vaccinated children respond to non-VPDs in the same way, demonstrating that vaccines don’t compromise the healthy functioning of the immune system.
Myth 2: VPDs are mild and the risks associated with vaccination are far greater than the risks associated with infection.
The facts: Diseases targeted by the free vaccinations South African babies receive are all diseases that can potentially cause severe illness and death. Common complications of measles, for example, include painful ear infections, bronchopneumonia and diarrhoea, while less common complications include encephalitis (which can result in permanent brain damage) as well as respiratory and neurological complications that could lead to death. Serious reactions to the vaccines that prevent diseases, such as measles, are extremely rare and result from rare contraindications including unknown or undisclosed allergies or diseases of the immune system. Common side effects like tenderness, redness and mild fever are not severe and are short-lived.
Myth 3: VPDs are virtually eradicated, so why should I bother?
The facts: Diseases don’t just disappear and it’s due to “bother” that they are eradicated. When most of the population is vaccinated against a viral or bacterial disease, it’s very difficult for the disease to spread. For example, diphtheria, which killed thousands of children (and adults) before the 20th century, is now considered rare − thanks to high coverage with the diphtheria vaccine.
However, this disease made an appearance on our shores with 15 cases reported in KwaZulu-Natal in 2015, resulting in four deaths. It takes just one unvaccinated individual exposed to the disease to become infected and start an outbreak in other unvaccinated people. If we don’t continuously immunise against a disease until it’s eradicated (as was the case with smallpox), we could see diseases that were previously under control causing epidemics once again.
Myth 4: The MMR causes autism.
The facts: Many serious illnesses will occur in children whether or not they have been vaccinated, which is why it’s important to understand that “following immunisation” does not mean “caused by immunisation”. The first signs and symptoms of autism coincidentally appear at around the same age when children in the UK receive their measles, mumps and rubella (MMR) vaccine, which is why the link was originally conceptualised. The autism myth was based on a small 1998 study of 12 UK children and has since been fully refuted by many large independent studies following millions of children.
The article was withdrawn from The Lancet in 2010 and the author was struck off the medical register by the UK General Medical Council. However, although the Strategic Advisory Group of Experts (SAGE) on Immunization has stated that there is no evidence of serious adverse events following immunisation, the public needs more convincing.
According to Lee, vaccination, as opposed to vaccines, saves lives and high vaccine coverage is required to have a positive impact on the burden of disease. The WHA has declared 2011 to 2020 “The Decade of Vaccines” with a vision to achieve universal access to immunisation. The WHO recently voiced concerns about vaccine hesitancy, which is defined as people delaying or refusing vaccines for their children or themselves. Globally, one in five children still don’t get routine immunisations, with an estimated 1.5 million children dying every year from VPDs. “The issue is complex and influenced by factors including misinformation, concerns regarding vaccine safety, myths, mistrust and complacency.” She adds “much of this is fuelled by the anti-vaccine lobbyists and the easy access to internet propaganda. However, the fact is that without vaccination there’s no protection.”