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Vaccines Make Kids, Communities Safe

Kaiser pediatrician Rahul Parikh says new outbreaks of whooping cough are a reminder that people should not forego vaccinations, for themselves or for their kids.

School starts in a few days, and campuses unfortunately are breeding grounds for disease. Groups of kids are brought together in classrooms, restrooms, locker rooms, cafeterias and playgrounds. It's inevitable that these kids will share not just lunch treats but illnesses, too--everything from the common cold to more serious infections.

Recent outbreaks of whooping cough have occurred, and the highly contagious respiratory infection is now an epidemic in California. The Contra Costa Health Services had confirmed 40 cases of the illness, also known as pertussis, in its county as of earlier this summer. In 2009, there were 18 cases. According to the California Department of Public Health, there were six times as many whooping cough cases in the Bay Area between January and May compared to the same time period last year.

Although whooping cough initially resembles an ordinary cold, it may eventually turn into something more more serious and potentially fatal, particularly in infants, according to the Centers for Disease Control and Prevention.

Despite outbreaks of whooping cough and other infections, some parents refuse to have their children immunized, says Walnut Creek-based pediatrician Rahul Parikh, who practices at Kaiser Medical Center. In this Q&A with Patch writer Ayako Mie, Parikh explains how vaccinations save lives and keep communities safe. 

Patch: Last month, a sixth infant fell victim to whooping cough in California. Some say whooping cough has become epidemic in California, with nearly 1,500 cases reported as of July. What are the reasons behind this?

Parikh: Several reasons, probably. One is waning immunity on the part of adults who have had the vaccine, which is why we are encouraging boosters for adults as well as kids. The second is that there has been a natural trend in whooping cough outbreaks for every four or five years, though this one is much bigger than the last one in the middle of the last decade. There is a role of parents refusing vaccines for pertussis (whooping cough) as well, but this is hard to measure.

When immunization rates in a community drop below a critical threshold (usually around 90 percent), the chance of vaccine-preventable diseases goes up substantially. The reason for this is something doctors call "herd immunity" in which a large enough population gets immunized to protect those who are too young to be immunized. Herd immunity is the key to keeping communities healthy from these illnesses. When it goes down, we are taking the chance of getting sick.

The only thing we can do is to make sure as many of us are vaccinated as possible to prevent this from spreading now and in the future.

Patch: Who are the people not getting vaccinations? 

Parikh: Studies have shown that vaccine refusal is predominantly in more affluent communities among people with higher socio-economic status. Older parents also tend to be vaccine refusers more often than younger parents.

Patch: What do you say to people's worries about vaccinating their kids? 

Parikh: First, I completely understand how confusing and emotional the information about vaccines has gotten over the past 10 years. It's hard to be a modern parent and have the time and energy to sit down and figure out what to do. But doctors and health professionals are here to help, and the good news is that when parents form a trusting relationship with their doctor, they're more likely to immunize their child.

Parents want to do the right thing for their children, but it's very hard because of all the "debate" out there, particularly about the alleged connection between vaccines and autism. The good news is that we have a decade of evidence proving no link between the two.

Parents often also express concern about the vaccine schedule or components in the vaccines used to keep them safe and effective. The schedule was designed and reviewed by experts, and a recent study showed that children who follow the schedule versus those who do not have no difference in their rates of neurological problems.

As far as components go, the main ones people bring up are aluminum and thimerasol (a mercury-based compound). In California, vaccines given to kids under age 3 are free of thimerasol. It's worth noting that a study in 2008 showed that despite our having removed thimerasol from shots in 2001, autism rates have continued to rise in California, suggesting that it's not vaccines causing autism.

Vaccines contain small quantities of aluminum (and have for a long time) to help them work effectively. While anti-vaccine folks have argued that there is too much aluminum in vaccines, and this may be "the smoking gun," the amount of aluminum in breast milk and formula is much higher than in vaccines. The aluminum in vaccines is also eliminated by the body very quickly.  

Patch: Are there any vaccines that are not absolutely necessary? Chicken pox?

Parikh: If I have to choose against any disease and a vaccine that's been proven to be safe and effective at preventing it, I would take the vaccine any day. I've done it for myself and my family.  

Patch: Who should be vaccinated?

Parikh: With very few exceptions, everybody should be vaccinated. It's the right choice for the health of individuals, families and communities.

Patch: Newborns are too young to be vaccinated against many diseases such as whooping cough (the first pertusis vaccine is given at 2 months, as are vaccines for other diseases). How can parents keep their newborns from contracting whooping cough or other illness? 

Parikh: My wife and I are expecting a baby soon, and we have told our parents to get vaccinated for whooping cough. So, first, make sure anybody who is coming into close contact with your baby be immunized. Second, encourage other families in your community to immunize not just against whooping cough, but against other deadly and serious diseases as well. As individuals and communities, we can choose health or we can take our chances. My family is choosing health. I would prefer the same for my community and those that surround it.  

Rahul K. Parikh is a pediatrician at Kaiser Permanente Medical Center in Walnut Creek. He contributes to publications such as The New York Times and Salon.com. 

For more information about whooping cough, visit the website for the Centers for Disease Control and Prevention. 

Martha Ross August 30, 2010 at 05:28 AM
PART VI (Alison Fujito): The current pediatric vaccine schedule was designed and reviewed by "experts" who are/were consultants to the companies manufacturing the vaccines. That's a bit like having the tobacco companies be in charge of safety studies on cigarettes. They recommend flu shots for everyone, especially for babies as young as 6 months old, and to the elderly. But they don't tell us that the flu shot package insert says that "effectiveness has not been determined in pediatric and elderly populations," nor do they tell us that the Journal of the American Medical Association and the British Medical Journal have gone on record saying that the flu shot is not effective for these populations. Yet it continues to be on the recommended vaccine schedule, and some states (New Jersey, for example) are mandating it for all children who attend public school or daycare. I would like to suggest that you look at www.fourteenstudies.org, www.safeminds.org, and www.nvic.org. I wonder if your questions for Dr. Parikh might have been different had you known of these websites. It would be wonderful if you were able to interview one of the many doctors and researchers who is concerned about the current vaccine schedule and the problematic effects on so many children. Sincerely, Alison Fujito
lmm September 03, 2010 at 04:32 PM
Adult chicken pox can be serious. I had chicken pox twice, which can happen if the first outbreak is mild; once as an infant and again at 13. It was dreadful--high fever and intense, severe itching all over my body (from literally the top of my head to the bottom of my toes). I missed a bit of school and I had scars for years. I can see where an elderly person might have a tough time with chicken pox, especially with the initial fever. I knew a mom who wouldn't vaccinate her kid and I was always nervous when she brought him over for playdates in our mom's group. I didn't want to catch anything from him. Families who won't vaccinate don't take into account that everyone around them has to be up on their boosters to avoid childhood diseases that their kid might be carrying.
Kim Kovalchik-Ii July 25, 2011 at 01:12 AM
If the vaccines work, then you should have no fear as to un-vaccinated children. Vaccines are drugs and as with any other drug, they can, and have, caused damage and even death in some who may be more prone to reactivity than others. I am the California State Director for the National Vaccine Information Center. Link to the National Vaccine Information Center: http://www.nvic.org/Vaccines-and-Diseases/Whooping-Cough.aspx SNIP: It is important o be equally concerned and knowledgeable about the risks of pertussis disease as we are about the risks of pertussis vaccine. Both B, pertussis whooping cough and the pertussis vaccine carry risks. Pertussis disease has the potential to cause seizures, brain damage, and even death, just as the vaccine can. Most of America’s medical community believes that the risk of serious injury or death from pertussis is greater than the risk of injury or death which can be caused by pertussis vaccine. However, recognition of and concern about the risks of pertussis disease does not diminish our need and responsibility to acknowledge the need to minimize pertussis vaccine risks. The challenge today is for parents, physicians, scientists, manufacturers and health officials to recognize the risks of both the disease and the vaccine and work to protect the health and well being of every child.
Kim Kovalchik-Ii July 25, 2011 at 01:14 AM
I would urge all of whom responded with comments as to the above article, to please visit the National Vaccine Information Center's website. Educate yourself about disease and vaccines. Yours and your children's health, depends on it.
Kim Kovalchik-Ii July 25, 2011 at 01:22 AM
I read through all the above posts; very informative comments, Ms. Ross, with one caveat: The current flu vaccines which most pediatricians are now telling parents they must give to their six month old children (and up), contain mercury. Please see the Cochrane Collaboration's study regarding flu vaccine/safety/efficacy studies: http://www.healthychild.com/flu-vaccine/studies-fail-to-demonstrate-safety-or-effectiveness-of-influenza-vaccine-in-children-and-adults/ SNIP: "There is a big gap between policies promoting annual influenza vaccinations for most children and adults and supporting scientific evidence," said epidemiologist Tom Jefferson, Cochrane Vaccines Field, Rome, Italy, who coordinated the comprehensive analysis for the prestigious Cochrane Collaboration. "Given the significant resources involved in annual mass influenza campaigns, there is urgent need for re- evaluation of these strategies."

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