Dr. Troy on Vaccines

Answers to Parental Concerns

I want to wait until her immune system is stronger (or more mature):
We give vaccines to make the immune system stronger.  We give a small part of a killed virus or bacteria to trigger the immune system to make antibodies.  It’s like reinforcing an army.  The younger a child is, the more immature her immune system is, the more at risk she is of getting very sick or dying from things we can vaccinate against.

I want to spread out the shots:
This will delay protecting him/making his immune system stronger.  Also, there will be more trips to the doctor’s office and more episodes of pain..

Children get too many vaccines:
Children are lucky we can protect them against so many bad diseases.  Older pediatricians have seen children die, here in California, of diseases we can now prevent.  The incidence of meningitis caused by pneumococcus and HIB has fallen by 95% in the US since the introduction of these two vaccines.  Children’s immune systems are exposed to hundreds of antigens every day and can easily handle the vaccines.  The immune system is like a muscle, it gets stronger by being used.  This is why small children get sick so often and when they are older they hardly ever get sick.

Children don’t need the vaccines.  These diseases are rare:
They may be rare but they’re not gone.  There were several cases of polio in Minnesota a few years ago.  There was a recent case of someone with measles riding BART and potentially exposing 1,000s of people.  Every year there are several cases of meningococcal disease (the worst bacteria known to man) as well as pertussis (whooping cough) and hepatitis A in the Bay Area.  These diseases may be rare but if your child gets one of them, who cares what the statistics are.

We don’t go out; she’s always with us:
What if the person in line next to you at Safeway has flu or pertussis and coughs in your air space?  Someone may have been there a few minutes ago.  What if you get flu or pertussis?  Your child could get it from you (you are most contagious before you realize that you have it).  At least vaccinate yourself.

Mercury in vaccines:
There has been no mercury (thimerosal) in pediatric vaccines as of January 2001.

Aluminum in vaccines:
Aluminum is an “adjuvant” which causes an increased immune response and the amount in vaccines is minuscule (e.g. 0.085 mg/dose).  Aluminum is the most common metal on earth and it’s in everything, including food, breast milk, and formula.  A baby who gets all of the recommended vaccines during the first six months of life will get a total of 0.4 mg of aluminum from the vaccines and 7 mg from breast milk, 38 mg from milk based formula, and 117 mg from soy based formula.  Adults think nothing of taking antacids that have up to 400mg of aluminum hydroxide per tsp but worry about 0.085 mg in a vaccine: it makes no sense.

Formaldehyde in vaccines:
A minuscule amount (e.g. 0.1mg) is found in vaccines and is harmless.  Formaldehyde is made by the liver as part of certain metabolic processes and occurs naturally in the body at a concentration of about 2.5 mg/liter.

Vaccines can cause autism:
This has been disproven over and over in many well done studies.  The man who propagated this myth lost his medical license and ended up in jail.  We don’t know what causes autism but it is not vaccines.  There are many children with autism who were never vaccinated.

Specific Vaccines: Things to Consider

Pertussis (DTaP and Tdap)
Pertussis destroys the hair cells that line the upper part of the airway, causing severe coughing that can last weeks and weeks and weeks.  Infants are at highest risk.  In 2010, 11 infants died in California and most of them got it from their mothers or adolescent siblings.  Even in adults it can be awful, causing paroxysms of coughing bad enough to cause cracked ribs and intracranial hemorrhages.  People are most contagious when they have only mild symptoms e.g. clear runny nose, no fever, and only a little cough.  By the time the diagnosis is made, the damage is done.

Chicken Pox (Varicella)
People with chicken pox are most contagious before the onset of the rash and remain contagious until the pox have crusted over.  Chicken pox can be life threatening for children or adults who are immunocompromised (e.g. are on steroids or have cancer—and that could be you, your child or someone else in your family).  It can result in pneumonia, encephalitis, and life threatening skin infections.  At the very least, it can mean missing a week or two of school (and Mom or Dad missing work).

Measles
Measles, like chicken pox, is most contagious before the rash appears i.e. for a few days where it looks like a bad upper respiratory infection.  The virus can remain in the air for over an hour after the person with measles has left the area, potentially exposing hundreds of people.  Measles can cause encephalopathy, blindness, deafness, seizure disorders, mental retardation and death.

HIB and Pneumococcus (HIB and Prevnar)
These are two bacteria that can cause meningitis and other serious infections.  Meningitis can cause blindness, deafness, seizure disorders, brain damage and death. The incidence of meningitis caused by these two organisms in the U.S. has decreased 95% since we started giving these two vaccines.

Hepatitis B
Babies can get hepatitis B from their mothers (who may be newly infected and not know that they have it).  This is why we give the vaccine asap after birth.  There are between 1 and 2 million carriers in the U.S. and the virus is in all their body fluids.  It is very virulent and can live on a surface e.g. a toy for up to 7 days.  If that toy goes into the mouth of an infant who is teething or has a sore in his mouth, it can enter the blood stream.  It is also spread through sexual contact (including sexual abuse).  Hepatitis B is a serious illness and can cause liver failure, liver cancer, and death.