Anti-Vaccination Movement

The decision to postpone vaccines or deny, also has an impact on public health. If the proportion of the total population, against a disease is immune (herd immunity) decreases, the disease prevalence, increasing the possibility of the disease in people with risk increases. People may have a risk because

Despite the strict security systems for vaccines in the United States, many parents are still concerned about the safety of childhood vaccines and immunization schedules. These concerns have led some parents to not allow their children to receive some or all of the recommended vaccines. In the US, the omission rate of vaccines from 1% up in 2006 to 2% in 2011; some States reported that 6% of children left out vaccinations. The rate of vaccine-preventable diseases is higher in children whose parents have rejected ? 1 vaccines for non-medical reasons. Specifically, it transferred 123 times more likely pertussis, 28.6 times more likely varicella and 36.5 times more likely to pneumococcal disease. Children in the US still die from vaccine-preventable diseases. 4im 2008, there were 5 cases (one fatal) of invasive Haemophilus influenza type B infection in Minnesota, the most since 1992. Three of the infected children, including the child who died, no vaccines had been given because their parents had postponed the vaccine or denied. The decision to postpone vaccines or deny, also has an impact on public health. If the proportion of the total population, against a disease is immune (herd immunity) decreases, the disease prevalence, increasing the possibility of the disease in people with risk increases. People may have a risk because you have been previously vaccinated, but the vaccine induces immunity has (z. B. respond to 2 to 5% of recipients not to the first dose of measles vaccine). The immunity may decrease with time (z. B. in the elderly). She (d.. H some immunocompromised patients) the vaccine can not get (eg. As measles, mumps, rubella, varicella) and rely protecting against diseases on herd immunity. Parents feel many reasons to vaccinate their children. Two of the most common parental concerns during the last 10 years have been that vaccines can cause autism. Children receive too many vaccines. 1Glanz JM, et al: Parental refusal of pertussis vaccination is associated with at Increased risk of pertussis infection in children. Pediatrics 123 (6): 1446-1451, 2009. 2Glanz JM, et al: Parental refusal of varicella vaccination and the associated risk of varicella infection in children. Arch Pediatr Adolesc Med 164 (1): 66-70, 2010. 3Glanz JM, et al: Parental decline of pneumococcal vaccination and risk of pneumococcal disease in children related. Vaccine 29 (5): 994-999, 2011. 4Invasive Haemophilus influenzae type B disease in five young children – Minnesota, 2008. MMWR Morb Mortal Wkly Rep 58 (3): 58-60, 2009. MMR vaccination and autism In year published in 1998, Andrew Wakefield and colleagues a brief report in The Lancet. This report involved 12 children with developmental disorders and gastrointestinal problems; 9 of them also had autism. According to the report, the parents claimed that 8 of the 12 children who received the combined measles-mumps-rubella (MMR) vaccine within 1 month before the development of symptoms. Wakefield postulated that the measles virus traveled in the MMR vaccine in the intestines, where it caused inflammation that proteins from the gastrointestinal tract enabled them to enter the bloodstream, travel to the brain and cause autism. This study received worldwide attention in the media and many parents began to doubt the safety of the MMR vaccine. In another study, Wakefield claimed that to have measles virus in intestinal biopsies from 75 of 90 children with autism and in only five of 70 control patients found, which led to speculation that the live measles virus in the MMR vaccine somehow with autism is to be associated. Since Wakefield’s methodology showed a temporal association only, instead of showing a causal relationship, examined numerous other researchers the possible link between the MMR vaccine and autism. Gerber and Offit1 checked at least 13 large epidemiological studies, none of which supported an association between the MMR vaccine and autism. Many of these studies showed that the national trends of the MMR vaccine is not directly related to the national trends in the diagnosis of autism. Between 1988 and 1999, the rate of MMR vaccinations in the UK, for example, did not change, while, however, autism rates increased. Other studies compared the risk of autism individual children who received the MMR vaccine or not. In the largest and most compelling of these studies Madsen et al.2 studied 537,303 Danish children born between 1991 and 1998 and of whom had received the MMR vaccine 82%. After controlling for potential confounders, they found no difference in the relative risk of autism or other autism spectrum disorders between vaccinated and unvaccinated children. The overall incidence of autism or an autism spectrum disorder was 608 of 440 655 (0.138%) in the vaccinated group and 130 of 96,648 (0.135%) in the nonvaccinated group. Other population-based studies from around the world have led to similar conclusions. In response to Wakefield increased detection of measles virus in intestinal biopsies of autistic children were Hornig et al.3 after the measles virus in biopsy samples from 38 children who had gastrointestinal symptoms and a colonoscopy; 25 children had autism and 13 do not. The measles virus has been found in children with autism not more frequently than those without autism. 1Gerber JS, Offit PA: Vaccines and autism: A tale of shifting hypotheses, Clin Infect Dis 48 (4): 456-61, 2009. 2Madsen KM, et al: A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med 347 (19): 1477-82, 2002. 3Hornig M, et al: Lack of association between measles virus vaccine and autism with enteropathy: A case-control study. PLoS ONE, 3 (9): e3140, 2008. thimerosal and autism Thimerosal is a mercury compound, which was formerly used as a preservative in many multi-dose vials of vaccines; Preservatives are not required in single-dose vials, and may not be used in live virus vaccines. Thimerosal is metabolized to ethyl mercury that is rapidly eliminated from the body. Because ethyl mercury, which occurs in the environment (which is another compound which is not rapidly eliminated from the body), is toxic to humans, there was a concern that the very small amounts of thimerosal used in vaccines could cause neurological problems in children, particularly autism. Although no studies have shown evidence of harm, thimerosal was removed in the US, Europe and other countries in 2001 due to these theoretical concerns of routine pediatric vaccines. However, thimerosal is in these countries continues in certain influenza vaccines and in several other vaccines that are intended for use in adults, used (s. Thimerosal Content in Some US Licensed Vaccines). It is also used in many other vaccines produced in developing countries; WHO has not recommended its removal because there are no clinical signs of toxicity due to the routine use. Despite the removal of thimerosal autism rates have continued to rise, strongly suggesting that thimerosal does not cause autism in vaccines. In addition, two separate Vaccine Safety Datalink (VSD) studies led to the conclusion that there is no link between thimerosal and autism. In a cohort study of 124,170 children in three managed care organizations (MCOs) found Verstraeten et al.1 no link between thimerosal and autism or other developmental conditions, although unstable relationships (ie found in a MCO, but not in the other) between thimerosal and specific language disorders were seen. In a case-control study of 1,000 children (256 with an autism spectrum disorder and 752 controls without autism) Price et al.2 found a regression analysis no association between exposure to thimerosal and autism. Practitioners who work with parents who are worried still about thimerosal in influenza vaccine can use single-dose vials or administer the live attenuated influenza vaccine; both do not contain thimerosal. 1Verstraeten T, et al: Safety of thimerosal-containing vaccines: A two-phased study of computerized health maintenance organization databases. Pediatrics 112: 1039-1048, 2003. 2Price CS, et al: Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism. Pediatrics 126 (4): 656-664, 2010. use of multiple, simultaneous vaccines A nationally representative survey, which was conducted in the late 1990s, found that nearly a quarter of all parents felt that their children receive more vaccines, than they should. Since then more vaccines were added to the immunization schedule so that is now recommended that children up to the age of 6 years received several doses of vaccine for 15 different infections (see table: Recommended vaccination schedule for the age of 0-6 years). To minimize the number of injections and visits, doctors administer many vaccines as combination products (eg. As diphtheria-tetanus-pertussis, measles, mumps and rubella). However, some parents are concerned that the immune system of their children (especially infants) can not deal with multiple concomitant antigens. This concern has led some parents to ask for alternative vaccination schedules, delaying certain vaccines and completely rule out sometimes. A recent, nationally representative survey found that 13% of parents use such a vaccination plan. The use of alternative plans is risky and not scientifically supported. The official plan is designed so that children are protected from diseases when they are most vulnerable. The delay of vaccination extends the time during which children are at risk of acquiring these diseases. Although parents may plan only to delay vaccination increases the rising number of visits required for alternative schedules, beyond the difficulty to comply with the plan, and the risk that children do not get the full vaccination series. In terms of immunological challenges parents should be informed that the amount and number of antigens contained in vaccines, compared to those that occur in everyday life, are tiny. Even at birth the immune system of an infant is ready to respond to the hundreds of antigens against which is exposed to an infant as it travels through the birth canal and is handled by the (non-sterile) parent. Children come and generally react immunologically easily dozens, possibly even hundreds of antigens to a normal day. A typical infection with a single organism stimulates an immune response to multiple antigens of this organism (possibly 4 to 10 at typical cold symptoms). Because the current vaccines contain less antigens (because key antigens have been better identified and purified), children are also exposed to less today vaccine antigens than they were for most of the 20th century. In summary alternative vaccine schedules are not evidence-based and put children at increased risk of infectious diseases from. More importantly, they offer no advantage. Using data from the VSD Smith and Woods1 neurological development results compared in a group of children who received all vaccines up to date, with such in which this was not the case. The children in the delayed group performed better in any of the 42 tested results. These results should reassure parents who are concerned that their children receive too many vaccines too soon. 1Smith MJ, Woods CR: On-time vaccine receipt in the first year does not adversely affect neuropsychological outcomes. Pediatrics 125 (6) 1134 -1141., 2010

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