Getting vaccinated: Does the good outweigh any risk?


Medical assistant Daria Broom administers a vaccine to 18-month-old Nadia H. Martin, with her mother, Nisa Hussain standing by at the Children's Medical Services in Gainesville on Tuesday, April 24.

Erica Brough/Staff Photographer
Published: Tuesday, May 1, 2012 at 8:00 p.m.
Last Modified: Tuesday, May 1, 2012 at 8:00 p.m.

Eighteen-month-old Nadia H. Martin is right on schedule for her Hepatitis A vaccination — one of 24 shots the government recommends before her fourth birthday — and she endures it like a champ.

Facts

2 more cases confirmed

Two more chickenpox cases were confirmed in Alachua County Tuesday, bringing the number of people diagnosed with the virus to 80.
These latest cases do not appear to be related to the concentrated outbreak in the northwest part of the county, said Paul Myers, director of the Alachua County Health Department.
Sporadic outbreaks of the virus occur every spring, he said.
Judging by the dates of the onset of the two chickenpox cases at Santa Fe High School, Myers said he'll be able to declare that the outbreak is on the wane if no new cases occur by the end of next week.

-- Anne Geggis

The needle's prick on her leg touches off a one-breath burst of crying that's just about over when Daria Broom, a medical assistant at Children's Medical Services, announces, "All done."

But the debate over vaccines — now coming into focus with the county's largest outbreak of chickenpox in recent memory, which reached 80 cases Tuesday — shows no sign of letting up.

While the medical establishment almost unanimously endorses the immunization schedule that Nadia is following, state Health Department statistics show that the rate of Alachua County children fully immunized for kindergarten fell by nearly 6 percent between 2006 and 2010, according to the latest statistics — faster than the 2 percent decline statewide.

More parents are deciding that the risks of vaccines are more than they want for their children. It's an attitude that health officials are concerned could threaten the gains made against deadly diseases such as measles, mumps, rubella, polio, whooping cough and diphtheria — diseases that crippled generations.

For Paul Myers, director of the Alachua County Health Department, the local chickenpox outbreak that began last month is emblematic of what can happen when vaccinations fall below a certain level, allowing a disease that had almost disappeared to punch a hole in the so-called "herd immunity" and produce an outbreak.

"When the community immunity is decreased because of a lack of vaccination, what you have is exactly what we are experiencing: a focal outbreak of a vaccine preventable disease," he said. "No question about it."

But Daniel Alves, 32, a Gainesville web designer, said vaccines are a risk he doesn't think his daughters, ages 3 and 6, should have to take.

"For my parents' generation, it (getting vaccinated) was absolutely critical," he said, pointing out that his children are completely vaccine-free. "If I felt there was a high risk (for serious illnesses), I would look at it a little more."

Dr. Tom Benton, a Gainesville pediatrician for the past 24 years, says he sees the number of parents like Alves who refuse vaccines to be increasing, particularly in the last seven to 10 years. Children can be admitted to school without a full set of vaccinations if they file for a religious or medical exemption.

"People absolutely have forgotten how serious those illnesses are," Benton said. "For example, measles makes you pretty miserable and sometimes does more than make you miserable. Once you or loved ones experience that misery, you are much more motivated to do something to avoid it."

The irony of an outbreak of a vaccine-preventable disease in a county nationally recognized for its school influenza immunization program shows the problems of complacency.

"We can't stop immunizing," said Dr. Parker Small, a member of the Emerging Pathogens Institute and a professor emeritus of the Pathology and Pediatrics departments at the University of Florida College of Medicine.

Small points out the serious risk that even usually mild illness such as chickenpox can present to those with lowered immunity: pneumonia, encephalitis and sepsis, a potentially fatal blood infection.

Vaccines are still relevant, Small argues, especially when one considers measles is killing almost 10 percent of African children and that a massive outbreak of diphtheria followed the chaos of the Soviet Union's breakup — when systemic vaccinations were interrupted.

"Everyone should do their part and have their children protected," said Small, who was a charter member of the National Vaccine Advisory Committee.

For those who type "vaccine information" into any search engine, two competing versions of reality emerge. In contrast to the medical establishment's view that mass immunization has advanced human health like no other effort, another view holds that they are the source of increased chronic disease and disability among children, including attention deficit disorder, asthma, diabetes and, most famously, autism.

Even though a link between those diseases and vaccines has not been proven on a global scale, the National Vaccine Injury Compensation Program was started to help those who have injuries related to a vaccination.

Vaccine critics point out that this fund has paid out $2.4 billion for 2,893 cases since it was started in 1988.

But for Dr. Lindsay Thompson, an assistant professor of pediatrics and epidemiology and health policy at the University of Florida, that fund is not an admission that the vaccine risk outweighs the benefits, not by any means. The number of cases in that fund is dwarfed by the number vaccinated every year, she said.

"It's an important component in a massive program," she said. "It's not an admission of guilt."

Meanwhile, Nisa Hussain, 27, of Gainesville, said her only child did just fine after getting her shot, spending the rest of the day in day care.

"It's for her safety," she said of the vaccinations.

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