Truths and myths about childhood vaccinations: doctors' answers to parents' fears

Why vaccinate children?

Because vaccinations protect the baby from terrible diseases, the consequences of which can be death or disability for life. Vaccines introduce the baby’s immune system to extremely weakened or even dead pathogens and train it to fight these dangerous enemies. As a result, after each vaccination, a new detachment of immune special forces is formed in the child’s body, ready to deal not only with a “training” infection, but also with a real infection.

In addition to personal immunity, vaccination forms collective immunity to contagious (transmitted from person to person) diseases. Thanks to this interesting effect, when several infectious carriers of the infection appear in a population, it does not spread due to the low probability of their meeting with unvaccinated people. Herd immunity allows those who cannot be vaccinated for medical reasons to remain healthy. And, most importantly, your baby until the age when he can undergo routine vaccination. Here's how it works:

How herd immunity works.

Thanks to mass vaccination, it has been possible to completely eradicate some diseases in individual countries or even on a global scale. In 1980, the World Health Organization (WHO) declared the complete eradication of smallpox throughout the world, and now the causative agent of this most dangerous disease has been preserved only in medical research laboratories.

Finally, according to WHO and the United Nations Children's Fund (UNICEF), vaccination against just four diseases - diphtheria, tetanus, whooping cough and measles - saves up to 2.5 million lives every year. In our opinion, this argument alone is enough to once and for all close the debate about the benefits of vaccinations.

Should I vaccinate my child?

The World Health Organization emphasizes primary health care interventions to address the leading causes of childhood morbidity, mortality and disability. Currently, there are effective methods for the prevention and treatment of some of the most important childhood diseases, including infections controlled by specific prevention methods.

The goal of the Expanded Program on Immunization is to reduce and eliminate infectious diseases through vaccination, including the elimination of polio, measles, and the reduction of diphtheria, whooping cough, hepatitis B, mumps and other infections through specific prophylaxis.

To achieve these goals it is necessary:

• achievement in all administrative territories of at least 95% vaccination coverage of children;
• providing the population with the necessary number of effective vaccines;
• creating a robust healthcare and vaccine transportation system.

Today in developed countries, thanks to specific immunization, practically no cases of polio are recorded, and the incidence of diphtheria and whooping cough has decreased to minimal levels. An active fight against hepatitis B has begun.

In Russia, due to refusal of vaccinations, even fatal cases of diphtheria have been recorded among children and adults. And this is in the 21st century!

So should you vaccinate your child?

First, let's figure out what a vaccine is?

Vaccines are immunobiological preparations consisting of live or killed microorganisms. Both types of vaccines - killed and live - stimulate immunity in the body, that is, intolerance to the infectious agent. However, the antigen from the killed pathogen is quickly eliminated from the body. To maintain a sufficient concentration of antigen in the body (and this is the key to the success of good immune function), they resort to repeated administration of vaccines (re-vaccination).

Modern technology for the preparation and purification of vaccines makes it possible to produce them completely safe. Vaccinations with such vaccines practically do not cause serious adverse reactions.

Despite the carefully developed vaccine production technology, some of them can cause mild and short-lasting reactions in a small number of vaccinated people: fever, pain at the injection site.

Some parents are wary of any reactions of their children to vaccination, which leads to their refusal to carry them out further. They have a negative attitude towards vaccination. But is it possible to compare these minor side effects with the possible consequences of an infectious disease for which no vaccination was given?

Just remember that the cause of pneumonia is often whooping cough, and cirrhosis of the liver is hepatitis B. An adult man diagnosed with infertility will be tormented by the question of whether everything could have been different if he had been vaccinated as a child and had not suffered mumps (mumps) . It’s quite sad to talk about immobilized children due to polio.

It should be noted that scientific research to improve vaccine preparation technology is constantly being carried out. Each country regulates state control of vaccines, which guarantees the release of preventive drugs that meet international requirements.

Vaccinations protect millions of people from infectious diseases and prevent thousands of deaths. Parents should be aware of this and take care in order to promptly vaccinate their children as part of the existing immunization program.

Of course, vaccination does not guarantee safety. But even with the disease, vaccinated children tolerate the infection much more easily and suffer from complications much less often.

Why do myths about vaccinations arise?

In fact, most modern myths about vaccines are almost exactly the same as the arguments of anti-vaxxers of the past. They just became more vibrant today through the use of video, social networks and other technologies that did not exist in the 19th century. Some platforms are trying to fight this movement, for example, since September 2019, the VKontakte network began to show a warning before opening pages with calls to refuse vaccination.

Some countries have declared a fight against anti-vaxxers at the state level. In particular, vaccination is mandatory in China, Argentina, and most European countries, and refusal to vaccinate faces severe penalties. Here are just a few examples:

• In the United States, with limited individual exceptions, vaccination is required for school attendance.
• In Argentina, without vaccination certificates you cannot get not only an education, but also a marriage certificate, passport and driver's license.
• In Australia, there is an initiative called “No Jab, No Pay” (No vaccination, no subsidy), which deprives anti-vaccine parents of tax benefits and makes the child’s education very expensive.
• In France, failure to immunize is considered a form of child abuse and can lead to prosecution.

Russia treats anti-vaxxers more than liberally. In accordance with Federal Law No. 157 “On the Immunoprophylaxis of Infectious Diseases,” unvaccinated children can be suspended from classes only if there is a threat of mass disease. And the Ministry of Education is even forced to deny the news about mandatory vaccination to attend school.

So far, the percentage of conscientious mothers and fathers in our country remains high, and herd immunity is still working. We hope that this will continue to be the case, and we believe that with this article we will convince at least a few parents who are asking the question of why vaccinations are necessary. And at the same time, we’ll give you some arguments for discussions with fellow anti-vaxxers.

Vaccination: pros and cons.

Vaccination of children raises a huge number of questions and disputes among parents. To vaccinate or not to vaccinate a child? How to choose the optimal moment for vaccination? Which vaccine should I choose? Anastasia Vitalievna Starostina, a pediatrician at the DIALINE multidisciplinary clinic network, answered these and many other questions.

How to strengthen a child's immunity?

One of the methods of specific prevention of infectious diseases is vaccination. Vaccines reduce the risk of infection by strengthening the immune system. When germs (bacteria or viruses) invade the body, they cause an infection, i.e. disease. The human immune system begins to fight microbes. This is a real war inside our body. How it will end, with what complications and outcomes, is not known.

Vaccines help develop immunity by mimicking an infection, but this “mimicking” infection does not cause disease. Thanks to vaccination, the immune system receives protection against infection. This protection is strictly specific. For example, the DTP vaccine only protects against whooping cough, diphtheria, and tetanus. The flu vaccine provides protection against the flu, but does not protect against most colds.

Undoubtedly, vaccination, imitation of infection can cause minor symptoms such as fever, swelling, pain at the injection site. This is the norm, this is how the body creates immunity. A distinctive feature of vaccines is protection against the infection itself and its complications.

Isn't it better to get over the infection and develop natural immunity?

Many infectious diseases such as measles, diphtheria, whooping cough, and tetanus are deadly. Children in the first 2 years of life and infants are especially susceptible to these diseases and the risk of complications.

Thus, without vaccines, a child runs the risk of becoming seriously ill, experiencing complications, disability, and even death from diseases such as measles, whooping cough, tetanus, and hemophilus influenzae. The main risks of vaccination are associated with side effects such as fever, redness, swelling, and pain at the injection site, which disappear on their own within a few days.

Serious side effects from vaccination such as a severe allergic reaction are very rare, occurring in 1-2 cases per million. The preventative benefits of vaccinations are much greater than the possible complications from a real infection . It is important to start vaccinations in a timely manner and protect your baby from infectious diseases and the risk of complications.

Are there any contraindications to vaccination?

Of course, there are contraindications to vaccination. Based on an examination of the child and a conversation with the parents, the doctor determines whether the vaccination is allowed or not. In the case of an acute illness, for example, ARVI, it is reasonable to postpone vaccination until the recovery period. This is not due to the fact that vaccination can cause harm, but to the fact that in the event of a complication of ARVI, it can be interpreted as a consequence of the vaccination, which will frighten parents and lead to an unjustified refusal of vaccinations in the future. In case of exacerbation of chronic diseases, bronchial asthma, atopic dermatitis, vaccination should be postponed until the period of maximum complete remission.

Very often, parents refuse vaccination if their children have allergies or chronic diseases, but this is fundamentally wrong. Children with allergies, as well as children with chronic diseases, need vaccinations, because... Infectious diseases in them are more severe than in healthy children. For example, whooping cough is very dangerous for a patient with bronchial asthma. Chickenpox can cause endocarditis in patients with heart defects.

Which vaccines should you give preference to, Russian or imported?

All vaccines are safe and effective in producing immunity. Convenience of foreign ones in their combination. For example, the Pentaxim vaccine protects against 5 diseases at once: whooping cough, diphtheria, tetanus, polio, and hemophilus influenzae. When choosing domestic vaccinations, the child is forced to receive 3 injections, because DTP is one vaccine, one syringe, polio, the second and the vaccine against Haemophilus influenzae infection, the third injection. Most vaccines work well together. It is acceptable to administer several vaccines at the same time. This reduces the number of visits to the clinic. The combination of vaccines allows you to protect your baby from diseases in a timely manner and in a short time. By delaying vaccination for long periods of time, we increase the child’s chance of encountering a real virus or bacteria and getting sick with a serious infection.

Are there any seasonal vaccinations?

Autumn is approaching, which means it's time for colds and flu. The flu vaccine is a good idea for the entire family. It is important to protect your family from the flu and get vaccinated together.

Infants under 6 months of age cannot receive the vaccine due to their early age, but if parents and older children are vaccinated, it will protect not only them, but also the baby. This is important because Infants are more at risk of serious complications from the flu, such as pneumonia, for example.

It is important to understand that the flu shot itself does not cause illness. Yes, it is possible to get sick from ARVI during the autumn-winter period. But the flu is not a common cold. This is a severe infection that occurs with minimal catarrhal symptoms, i.e. runny nose and cough will be less pronounced, but fever, poor general health, headache and muscle pain will predominate. A common complication of influenza is pneumonia, which is very difficult to treat. Therefore, it is easier to prevent the development of these events than to let the situation take its course.

Flu season runs from October to May. Vaccination can begin from the end of August - beginning of September. But it is permissible to get vaccinated during the flu season, up to April - May.

Who is eligible for the flu vaccine?

• All children over 6 months old.
• Parents and guardians of children who attend kindergartens and schools.
• Persons over 65 years of age.
• Pregnant and planning pregnancy, as well as lactating women.
• Persons with immunodeficiencies, cancer patients.
• Military personnel, as well as children in closed groups (orphanages, boarding schools)
• Adults, teenagers and children with a chronic condition such as asthma.

If you have any questions about vaccination, if you doubt whether or not to vaccinate your child, which vaccinations to start with, we will be happy to answer your questions and help you with your choice.

How to separate the truth and myths about vaccinations?

In short, any argument in favor of refusing vaccinations other than for individual medical reasons is a myth. But let’s look at the “hot seven” arguments of anti-vaccinators in more detail.

Myth 1. Many diseases do not require vaccination. They are only a consequence of poor sanitary conditions, so they disappeared in developed countries by themselves.

Yes, such diseases do exist, but not on the vaccination schedule. Diphtheria, measles, mumps, chickenpox and other dangerous diseases were common in dirty medieval cities, but they also feel great in modern cities. The anti-vaccination movement in Great Britain, Sweden and Japan in the 70s of the last century led to outbreaks of whooping cough with hundreds of thousands of cases of the disease in these quite sanitary countries.

This misfortune did not spare us either. In the 1990s, against the background of mass refusal to vaccinate, a diphtheria epidemic occurred in the countries of the former USSR, as a result of which more than 150 thousand people fell ill and more than 5 thousand people died.

Myth 2: Pharmaceutical companies lobby for vaccinations to make extra profits.

How many times does a person get vaccinated in his life? And how many take pills, give injections, apply ointments, buy medications on their own and implicitly pay for them from their health insurance? In 2010, WHO estimated the share of vaccine sales in the pharmaceutical industry's turnover at only 2-3%. So convincing people to get vaccinated is not a good business strategy. They generate income, but not nearly as fantastic as anti-vaxxers believe.

Myth 3. Vaccines are dangerous to health. Many children who fell ill or died in infancy had been vaccinated several days or weeks earlier.

Any mathematician will immediately understand what is wrong with this statement. And he himself will compose a lot of similar ones. For example: many people who have been injured on ice had brushed their teeth within 24 hours prior. Or this: many motorcyclists involved in accidents used the Internet several hours before the accident. All these statements contain two parts: the first describes a random event, and the second speaks of regular, characteristic actions. And they are not connected to each other in any way.

The first year of a baby’s life is full of vaccinations, and, regardless of this, is a period of risk for SIDS (sudden infant death syndrome). But this is nothing more than a coincidence: doctors do not consider vaccinations to be the cause of SIDS and have proven this more than once. Moreover, studies even show a decrease in the number of sudden infant deaths as vaccination coverage increases.

Myth 4. Vaccines place an increased burden on a fragile child’s body, and this is dangerous to health.

Immediately after birth, the child’s immune system is faced with a huge amount of pathogenic microflora. And, according to the most conservative estimates, it is capable of simultaneously coping with thousands of new viruses. Even complex vaccines, such as DTP or MMR, cannot put too much stress on the baby’s immune system.

Myth 5. The safety of vaccines is questionable due to their aluminum and mercury content.

These metals are contained in microscopic quantities in vaccines and are actually needed there. Recently, in order to dispel consumer doubts, manufacturers have been removing components that cause concern from the composition of drugs. For example, the mercury-containing preservative thimerosal was excluded from some vaccines, and then a study was conducted to determine how its presence or absence affects the baby’s health. It turned out that there is no difference.

Myth 6: Vaccines cause autism.

This myth even has a specific author - British gastroenterologist Andrew Wakefield. In 1998, he wrote an article in which he argued that the MMR (measles, mumps, rubella) vaccine can cause autism in a child. It soon became clear that Wakefield was sponsored by an anti-vaxxer organization, and the findings of his “research” were influencing people to buy a biological test produced by a company co-owned by Wakefield.

The point is not only that the author of the scandalous material hid his interest in the panic around MMR. The lack of connection between vaccination and autism has been convincingly proven by many studies.

Tests instead of vaccinations: when possible

There have been serious debates about the benefits and harms of vaccinations in recent decades. In fact, the anti-vaccination movement has existed since the invention of the smallpox vaccine, and then the main argument of the “opposition” was religion. Today it has been replaced by complications, “false” statistics and even a conspiracy by pharmacists. So is there any real reason for concern? And when is vaccination really contraindicated?

A little history

The world first heard the word “vaccination” at the turn of the 19th century.

At that time, the smallpox virus killed up to half a million people every year, and the survivors were left with scars for the rest of their lives. For years, doctors tried to find a life-saving cure for the infection, but an accident helped put an end to this “war.”

English doctor Edward Jenner once witnessed an interesting conversation about smallpox. The milkmaid assured that she could not become infected with smallpox, since she had cowpox. And that her fellow countrymen have known this for a long time.

Jenner decided to test this statement in practice and infected an 8-year-old boy with cowpox. The child not only remained alive, but also actually became immune to smallpox, despite numerous attempts to infect him.

This is how the very first vaccine in human history appeared, and one of the most dangerous infections began to lose its potency.

But that's not the whole story.

With the “birth” of vaccination, its opponents also appeared. Members of the clergy and doctors demanded that people stop receiving the vaccine, claiming that it could make them “bull-like.” And when it became obvious that no one had turned into bulls, the inadmissibility of interference in matters of life and death came into play.

Subsequently, vaccination was adopted at the legislative level, and at the same time its opponents united in organizations.

In the mid-19th century, they even managed to achieve legislation, after which the mortality rate from smallpox jumped sharply.

This law has never been repealed, but the anti-vaccination movement has not ceased to exist to this day.

Modern arguments

Today, the anti-vaccination movement appeals to facts, albeit taken from history or isolated cases.

Thus, the opinion about the low quality of vaccines first appeared back in 1955, when there were no strict regulations for the development of such drugs, and an unfinished polio vaccine actually came into use.

The outcome of this story became the greatest drama, because out of 200 thousand vaccinated, 40 were paralyzed. The vaccine was withdrawn from production, and the creation of new ones froze for many years.

However, polio continued to cripple the lives of hundreds of thousands of people, mostly children. Therefore, the creation of a safe drug did take place, but even here the “opposition” found arguments.

In very rare cases, vaccines still cause complications today. Like, for example, damage to the nervous system after the administration of a “live” polio vaccine (in the form of drops). Nowadays, a “killed” (inactivated) polio vaccine is used for the first injection, administered by injection and incapable, in principle, of leading to the disease.

Vaccine complications do occur, as some people's individual reactions are not predictable. True, the frequency of such complications cannot compete with the benefits of containing crippling epidemics.

Thus, complications of the same polio vaccine are observed in 1-3 cases per 1 million administrations. An abscess from ADS-M administration occurs in 6-10 vaccinated people. And the frequency of encephalitis due to anti-measles drug does not exceed 1 case.

At the same time, without mass immunization, for example, in third world countries, these infections continue to destroy and disable the population. And the statistics of such morbidity are always open on the WHO portal.

Vaccines and autism

At the end of the 20th century, British scientist Andrew Wakefield published a high-profile article linking the MMR (measles, mumps, rubella) vaccine to autism.

The work instantly became widely known and became a new argument against vaccinations.

The article was later retracted because it contained significant statistical errors. But this news never reached the ears of the public. And anti-vaccination articles still “scare” about the connection between autism and vaccinations.

When it really is “not possible”

Of course, vaccines, like any drug, have contraindications.

Common ones include:

• acute inflammatory processes,
• exacerbation of chronic diseases,
• recovery period,
• immunosuppressive conditions
• and oncology.

Among the specific ones:

• a history of episodes of febrile seizures and progressive pathologies of the nervous system - for DPT;
• severe allergy to chicken egg white – for measles, mumps and influenza vaccines;
• allergy to baker's yeast - for hepatitis B drugs
• and some others.

Each of the contraindications is specified in the instructions for the drug and is available for viewing by anyone.

Such cases are the basis for a medical exemption from vaccination, which can be either temporary or lifelong.

Tests instead of vaccinations

You can use a blood test for antibodies instead of a regular vaccination if information about vaccinations is lost, or the patient is sure that he has already had an infection before.

The degree of protection against infection can be assessed by the concentration of IgG in the blood to a specific pathogen.

This way you can check your immunity to:

• measles,
• mumps,
• rubella,
• diphtheria,
• tetanus,
• chickenpox
• and even meningococcus.

But most often it is Mantu who causes the “debate”.

Only the Diaskin test is considered an officially recognized reaction replacement. However, by agreement with the child care center, you can take a T-SPOT blood test or a quantiferon test.

Thus, whether to vaccinate or protest is a personal decision for everyone, but before making it, it is worth carefully weighing all the reasonable pros and cons.