If you’ve ever hesitated to have your child vaccinated, you need to keep in mind the risks of not getting these vaccines. The immunization of US children is so widespread and successful that the serious diseases that once caused severe illnesses and lasting disabilities have, in some cases, disappeared. That has left some parents asking, “If the disease is wiped out, why should I immunize my child against it?”
Here’s what you need to keep in mind. If the rates of immunizations decline even a little, it can cause a comeback of the infectious diseases that have nearly been wiped out in the United States. Remember, even though many vaccine-preventable illnesses now occur in extremely low numbers, the germs that cause them are still around us, particularly in other parts of the world that are as close as a jet plane ride away.
Because of the success of immunizations, most parents have never seen a child with whooping cough or tetanus, so they aren’t aware of how serious these diseases can be. They probably don’t know of anyone who has died from these diseases. As a result, they may not feel it is as necessary to get their kids vaccinated as their own parents might. But not vaccinating one’s children can be very dangerous. In 1999, when rates of immunization were lower, there was a measles outbreak in the United States, and one out of every 500 people who developed the disease died. If we stop vaccinating children, the epidemics of previous eras will quickly return, causing serious illnesses and taking lives.
Meanwhile, researchers are looking at ways to make sure that vaccines are as safe as possible. For example, many parents may worry about the pertussis (whooping cough) part of the DTP vaccine. It’s important for parents to know that the older version of the DTP vaccine is no longer used. It has been replaced by a newer DTaP vaccine (the a stands for acellular pertussis). In this vaccine, only a segment of the pertussis bacteria required for immunity is used. The old vaccine used whole cells of the bacteria responsible for pertussis. This is a significant improvement in vaccine safety. In 2005, a new vaccine, Tdap, was licensed for use in teenagers and adults. It has a smaller amount of the diphtheria and pertussis portions of the vaccine. The reason for the smaller amount is that less is needed to boost immunity in teenagers and adults because they received several doses of vaccine as young children.
Meanwhile, from time to time, adjustments are made in the immunization recommendations by public health agencies and the AAP to increase effectiveness and safety. For instance, in the past, the oral polio vaccine was associated with a very rare complication in which a few children actually developed polio after being immunized. (How rarely did this happen? In about one of every million children receiving the live oral doses.) In recent years, the recommendations have changed. Only the use of the inactivated polio vaccine (IPV), which carries absolutely no risk of causing polio itself, is advised. The evidence could not be clearer—your child is at much greater risk from the infectious diseases themselves than from the vaccines.
Some parents choose not to immunize because they don’t want to take any risks. But choosing not to immunize your child is not without risk. Your child can contract the illness and suffer problems. Your child can transmit the disease to others, including those who may be particularly vulnerable, like young infants or relatives with immune problems (many cancer patients, for example, can’t be immunized). And your child will need to stay out of child care or school during disease outbreaks, even if she doesn’t have the disease.