Thursday, October 15, 2009

Vaccine "Controversy"

First of all, let me say that not all vaccines are vegan, and if you are not at high risk the benefits may not outweigh the harm caused by supporting these vaccines. While I may not support getting some vaccines in their current state it is important that we, as vegans can express legitimate reasons why instead of spreading misinformation. Every person who catches you in a lie will permanently associate that lie with the vegan message you are also attempting to support.

We have all heard the purported benefits of vaccines growing up. You receive a shot and become immune to the disease you have been vaccinated for. What then are the claims against vaccination? Those who oppose vaccination claim that vaccines are ineffective, cause unnecessary side effects, or that they are contradictory to their personal religious views.

Unlike what we are told growing up, vaccines are not actually 100% effective. While in the vast majority of cases they prevent the disease they are intended to, people with jeopardized immune systems or people who simply could not develop an antibody to the particular infection may still be at risk.

How do we know vaccines are really effective? While those who oppose vaccinations often imply that the only evidence is rates of disease dropping after the introduction of vaccination and that this can also be credited to hygiene improving at a similar time, this is not the only source of evidence we have. All vaccines go through numerous double blind trials before being given to anyone.

Double blind trials give the vaccine to some people in the trial and a placebo to others, where neither the person administering the shot nor the person receiving the shot know whether they have received the actual vaccine or the placebo. Examples of two such double blind studies on the rotavirus vaccine are:
Study 1
Study 2
As you can see in the first study the authors do not “cover up” any side effects at all, but rather talk quite frankly about the five patients who experienced severe side effects during the study, and explain that five children out of 2200 having pre-existing conditions like leukemia or epilepsy is hardly out of the ordinary. The first study had a very low incidence of rotavirus infection in either group, and while the vaccinated group seemed to fare better they were not able to draw any statistically significant conclusions from the data. The second study however draws very statistically significant conclusions in favor of the efficacy of the vaccine.

We have more than the fact that infection rates drop when vaccines start to be administered and double blind trials showing their efficacy, we also have cases of vaccination ceasing and infection returning.
In 1974 in the UK a prominent public-health academic claimed that the pertussis (whooping cough) vaccine was only marginally effective and questioned whether its benefits outweigh its risks causing a scare. Vaccine uptake in the UK decreased from 81% to 31% and pertussis epidemics followed, leading to deaths of some children. Mainstream medical opinion continued to support the effectiveness and safety of the vaccine; public confidence was restored after the publication of a national reassessment of vaccine efficacy. Vaccine uptake then increased to levels above 90% and disease incidence declined dramatically. Source
Measles is another disease that is nearly nonexistent in the developed world due to vaccination. In the UK however Measles vaccination dropped sharply after 1996 due to vaccination controversy. From late 1999 until the summer of 2000, there was a measles outbreak in North Dublin, Ireland. At the time, the national immunization level had fallen below 80%, and in part of North Dublin the level was around 60%. There were more than 100 hospital admissions from over 300 cases. Three children died and several more were gravely ill, some requiring mechanical ventilation to recover. Source
In the early 2000s, conservative religious leaders in northern Nigeria, suspicious of Western medicine, advised their followers to not have their children vaccinated with oral polio vaccine. The boycott was endorsed by the governor of Kano State, and immunization was suspended for several months. Subsequently, polio reappeared in a dozen formerly polio-free neighbors of Nigeria, and genetic tests showed the virus was the same one that originated in northern Nigeria: Nigeria had become a net exporter of polio virus to its African neighbors. People in the northern states were also reported to be wary of other vaccinations, and Nigeria reported over 20,000 measles cases and nearly 600 deaths from measles from January through March 2005. Source

Vaccines, like all other effective medical treatments, are not without risk of side effects. Since vaccines are usually given to healthy individuals, people are rightly less tolerant of side effects from preventative medicine, like vaccines, than from standard medical treatments. The question is, when is more harm coming from the vaccine than good? Many opponents of vaccination claim that vaccines are solely given so that the manufacturers of them can make profits regardless of how much harm they cause and that the manufacturers have immense influence in all levels of government so that they can control whether the products are recommended or not. If this was true we would see drugs getting pulled from the market only as they became unprofitable and drugs being given out long after they are useful. This is, however, the exact opposite of what we witness.

The disease smallpox killed over 300 million people in the 20th century alone. Due to a widespread campaign by the WHO targeting outbreaks the disease was successfully eradicated by 1977. While the smallpox vaccine could very well have remained part of the vaccinations given out in this country after eradication it was removed for all but first responders. A new, safer version of the vaccine, ACAM2000, was developed in 2007 and is now only given to those at high risk of exposure to smallpox.

It makes sense for a company producing a vaccine to stop producing it as it becomes unprofitable. From a medical standpoint however, we may still want to prevent disease in all people despite it not being profitable to produce the vaccine on a large enough scale at a price where people can afford it. Often manufacturers will stop production, facilities will shut down, or other factors will cause temporary shortage of a vaccine. Instead of allowing vaccination to cease when this happens, the government steps in and forces manufacturers to maintain production until the shortage situation can be resolved. Source

If the risks truly outweighed the benefits, we would also see the medical professionals who understand these products best and have the largest hand in their distribution avoiding them to a large extent themselves. Is this what we see? In a study done in Switzerland, 92% of pediatricians were found to have followed all official immunization recommendations for their own children. In addition to the vaccines currently recommended in Switzerland most physicians added hepatitis A, influenza, and varicella vaccinations to the list of vaccines given to their own children. Source