Vaccinations

Measles and whooping cough are on the rise

 
 
Dr. Marcelo Laufer vaccinates Gabriela Cuba, 11, at Miami Children's Hospital on Tuesday, August 6, 2013.
Dr. Marcelo Laufer vaccinates Gabriela Cuba, 11, at Miami Children's Hospital on Tuesday, August 6, 2013.
AL DIAZ / MIAMI HERALD STAFF

Resources

To be sure you are getting the necessary vaccines at the most auspicious times, look to the American Committee on Immunization Practices (ACIP).

This is a group of industry and government representatives as well as a wide variety of doctors who look at the vaccines approved by the FDA and then make their recommendations. Learn more at http://www.cedc.gov/vaccines/acip.

And for more information about autism and vaccines, there’s ‘Autism’s False Prophets’ by Paul Offit.

Source: Dr. Marcelo Laufer


Special to The Miami Herald

Vaccinations against childhood diseases tend to be just another part of the back-to-school routine.

But for some parents, they are anything but routine.

“There are still a fair percentage of people out there fearful and concerned about vaccine safety,” said Dr. Lawrence Garter, a physician with Pediatric Associates in Plantation.

Vaccines are made up of antigens, inert particles of bacteria or weakened viruses that teach your body’s immune system how to produce antibodies to fight a particular infection. Today there are vaccines that help foil polio, measles, mumps, diphtheria, whooping cough (pertussis), pneumonia, chickenpox, hepatitis A and B, rotavirus, rubella and tetanus.

“Vaccines are the greatest discovery of the 20th century,’’ Garter said.

Before vaccines, the United States had as many as 200,000 cases of diphtheria and pertussis as well as hundreds of cases of tetanus each year. Since then, tetanus and diphtheria cases have dropped by about 99 percent and pertussis by about 92 percent, according to the Centers for Disease Control and Prevention (CDC).

“Today we don’t often see these illnesses, but they are definitely still out there,” said Garter, who is affiliated with Joe DiMaggio Children’s Hospital in Hollywood.

In fact, an outbreak of measles now occurring in Wales is a cautionary tale for parents. In 1998, Dr. Adam Wakefield, a London researcher, published a paper in a scientific journal, The Lancet, that linked gastrointestinal problems and even autism to the measles vaccine (MMR).

After further study, the scientific community virtually disowned Wakefield. In 2004, after further research, the U.S. Institutes of Medicine found no evidence linking the vaccine to autism. And by 2010, The Lancet retracted the paper.

But many parents, fearing for their children’s safety, refused the measles vaccine for their children. And today, as a consequence of those children growing up without having been vaccinated, Wales is suffering a measles outbreak.

According to a report in the Wall Street Journal, the disease infected more than 1,200 people in southwest Wales between November 2012 and early July, compared with 105 cases in all of Wales in 2011.

“It’s very sad, because it’s a disease that is severe. It’s a disease that you can be protected against. And you can be killed by it or you can kill another person by giving him the disease,” said Dr. Marcelo Laufer of Miami Children’s Hospital’s Division of Infectious Diseases.

But many parents remain concerned about a connection between autism and vaccine. That may be because most cases of autism are diagnosed in children between 1 and 2 years old. That’s when children also receive a good number of vaccines.

“But association doesn’t prove causation,” Garter said.

Instead, parents should be concerned about leaving their children unprotected against many diseases that can lead to cancer, pneumonia, death, brain damage, paralysis, meningitis, seizures, deafness and more, physicians say.

“Once you’ve seen someone suffering from whooping cough, measles or any other of these diseases, you’ll want to do all you can to protect your child,” said Laufer, who had both his daughters vaccinated as well as himself.

“When it comes to vaccines, I think doctors need to lead by example,” he said.

Most people have never experienced these diseases. As a result, some think they — or their children — need not be concerned about them.

“These illnesses are uncommon because we do vaccinate,” Laufer said.

If you have 100,000 people and 99,000 get vaccinated against a disease, the other 1,000 benefit from the vaccine. This is called “herd immunity.” When 95 percent of the people are vaccinated, your risk of getting the disease is low even if you aren’t vaccinated, Laufer explained.

However if more and more people take advantage of herd immunity and refuse vaccines, eventually only 90 percent of the population will be vaccinated.

“That’s when your exposure rate to the disease itself is higher and you start seeing cases,” Laufer said.

And that’s when an unvaccinated tourist or child infected with the disease can quickly spread it.

“Diseases don’t need visas to enter our country. You don’t know when you are going to be exposed to one,” Laufer said.

For example, on average, 60 people in the United States contract measles each year. But in 2011, there were 222 people who had the disease. Nearly 40 percent of the cases were contracted in other countries. On returning to the U.S., the infected citizens spread the disease, resulting in 17 measles outbreaks across the U.S., according to the CDC.

Today, Southeast Florida is seeing a surprising number of whooping cough cases. According to Garter, there have been 26 cases in Broward and 32 in Miami-Dade through July 9, 2013. Compare that to 2012, when there were only 41,000 cases in the entire nation.

And, of course, those who haven’t been vaccinated are of greater risk as are people with immune-system disorders and those undergoing chemotherapy.

Besides being concerned about the safety of vaccines, some parents worry their children are receiving too many antigens at one time. They worry that their child’s immune system will be overwhelmed.

But since the late 1990s, vaccines have been made with fewer antigens. In fact the whooping cough vaccine used to contain the whole bacteria; today it has only five antigens.

To protect their children from system overload, parents may opt to have them immunized later in life. But, according to Laufer, postponing vaccinations can slightly increase the chances of your child having side effects.

“People worry about vaccines and think about their risks, but they are more at risk driving to the grocery store than they are getting a vaccine,” Garter said.

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