Safer than Driving to the Doctor

Safer than Driving to the Doctor

I am 31 years out of medical school. In my internal medicine and infectious disease training there was little emphasis on vaccines.

In part this was due to the nature of internal medicine education, which concerns the diagnosis and treatment of adults.  Vaccines were in the domain of pediatricians. 

 It was perhaps in part as the triumph by vaccines over the worst diseases of childhood. The attitude was that infectious diseases were heading towards extinction, in part due to the somewhat infamous proclamation of Dr. Petersdorf in Whither infectious diseases? Memories, manpower, and money, and the opinion of the Surgeon General that

It is time to close the book on infectious diseases, and declare the war against pestilence won,

 

a statement that is apparently an urban myth.

Attribution to Dr. Stewart of a belief that it was time to close the book on infectious diseases is an urban legend; he never made any such statement. Numerous other verifiable sources, however, confirm that other people in academia adopted this belief.

It never occurred to me in my training that measles, polio, mumps, and the rest of the preventable infectious pathogens would be anything but occasional curiosities, imported from counties where vaccination rates were low. Until this century that was true. The few cases of childhood vaccine preventable infections I saw in my fellowship (Harbor County in Los Angeles) were in brought in from South of the border.

Of course this century has been different. For a variety of reasons vaccine-preventable illness has been a growth industry. For a sobering map, go to http://www.cfr.org/interactives/GH_Vaccine_Map/#map.

One of the driving forces is the manufactured fear that vaccines, especially the MMR thanks to the 'elaborate fraud' of Andrew Wakefield, causes autism.

No medical intervention is 100% safe. However vaccines are remarkably safe as evidenced by Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review.

It is risk vrs benefit and in that calculus vaccines win:

We found evidence that some vaccines are associated with serious AEs; however, these events are extremely rare and must be weighed against the protective benefits that vaccines provide.

It is important to put risks into perspective, something humans are not particularly adept at.

Nearly 38,000 children under age 4 were injured in car accidents in 2012, and 523 died, according to the CDC.

"The most dangerous aspect of giving your child vaccines is driving to the office to get them," Offit says.

More importantly the paper revelated that

They found the evidence “favors rejection” of a causal relationship between MMR and autism...We identified 5 postlicensure studies of childhood MMR vaccination published after the IOM searches. In a case– control study of 189 young adults with autism spectrum disorder and 224 controls, Uno et al found that childhood receipt of MMR vaccine was not associated with an increased rate of new-onset autism (OR 1.10, 95% CI 0.64–1.90).

There are rare complications from vaccines but autism is not one of them. And the diseases they prevent are worse.

Points of Interest 07/02/2014
Points of Interest 7/1/2104

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