By Dr. Vivek Sinha (Courtesy photo)
Few topics have evoked as much emotion and discussion in healthcare lately as the question: “Should I have my child vaccinated?” If you were to perform an Internet search on the topic, you would find strongly worded opinions originating from either side that argue their respective points.
As a primary care physician and a father of two young boys, this topic is one that is close to my heart.
Let’s review the facts: There are two main types of vaccinations — live, attenuated (weakened) vaccines and inactivated vaccines. The purpose of vaccinations is to stimulate our body to produce antibodies against a particular disease. It is possible to build immunity by contracting and recovering from the illness, like chickenpox, but since there is potential for dangerous outcomes to these illnesses, vaccines allow our immune system to build the proper antibody without having to be exposed to the actual disease.
Live vaccines contain a safe, weakened form of the virus. Its purpose is to show the immune system what the “enemy disease” looks like so it can build up protection against it. Live vaccines include MMR (measles, mumps and rubella) and Varicella (chickenpox). It is highly unlikely that these live vaccines will give a person the actual infection. However, in an abundance of caution, people with certain immune-compromising conditions should not receive these vaccines without being specifically cleared by their physician.
The inactive vaccines contain a killed version of the virus. This stimulates the immune system to build antibodies so the body can be protected against the disease. Examples of inactivated vaccines include the Tdap (tetanus, diphtheria and pertussis), and Polio vaccines. These inactivated vaccines can be given to immunocompromised patients as well as pregnant females.
Primary care physicians follow the guidelines set forth by the Advisory Committee on Immunization Practices (ACIP). Per the CDC website, “The ACIP consists of 15 experts who are voting members and are responsible for making vaccine recommendations.”
The American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Physicians are the three main organizations for pediatrics, family medicine and internal medicine, respectively. Each board also gives its recommendations on the vaccination schedule, which usually follows suit with the ACIP guidelines.
This provides standardization among physicians. There are evidence-based guidelines that are readily available to assist the physician in deciding the best vaccine practices for individual cases, like with a patient who needs catch up vaccinations or a patient who has special circumstances and the like.
There are risks associated with any procedure. When faced with a medical intervention, whether it is vaccinations, medications or surgery, I always advise my patients to look at the benefits-versus-risk ratio. In other words, I ask if the benefits of the intervention outweigh the risks of the intervention. If the answer is yes, then the patient should usually proceed. It is the opinion of most health care professionals that the benefits of vaccinations far outweigh the risks.
Parents occasionally ask me if vaccines are linked to autism. I tell them that while we do not know exactly what causes autism, we do know that vaccines do not cause autism. Multiple documented scientific studies have provided proof of this fact.
I am also often asked why there are so many more vaccines now, than compared to 30 years ago. My answer is that medical science is advancing each day and we are finding better ways to stay healthier. While there have been great advancements in treatment for diseases, there are certain infections that still can pack a punch.
While a large number of viral and bacterial infections come and go, there are a select few that can cause significant morbidity and mortality; therefore, prevention is the best treatment. For example, measles is a viral illness that can cause significant complications in young children and adults. Ear infections leading to hearing loss, pneumonia and encephalitis — swelling of the brain — are all side effects of measles. Chickenpox also has potential for serious complications. Encephalitis, sepsis, pneumonia and toxic shock syndrome are all potential complications of chicken pox.
I am a firm believer in “practicing what you preach.” Is there the potential for side effects? Yes. Do the benefits of vaccines outweigh the risk? Absolutely. That is why I am up to date on all of my vaccinations, and more importantly, that is why both my 6-month-old and 5-year-old sons are vaccinated on schedule per ACIP guidelines.
The writer is the chief medical officer of Belleview Medical Partners.