To Your Health With Dr. Jim Morrow: Episode 12, The Case to Vaccinate

Episode 12, The Case to Vaccinate

On this edition of “To Your Health With Dr. Jim Morrow,” Dr. Jim Morrow makes the case to vaccinate, arguing that vaccines are safe, necessary, and they work. The fears “non-vaxxers” have on the side effects of vaccines are not based in any proven scientific evidence. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be.  At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!”  Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

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Dr. Morrow’s Show Notes

History of Vaccines

• Edward Jenner used cowpox material to create a vaccine for smallpox in humans in 1796.
• Louis Pasteur created a rabies vaccine for humans in 1885
• And then, at the dawn of bacteriology, developments rapidly followed.
  • Antitoxins and vaccines against diphtheria, tetanus, anthrax, cholera, plague, typhoid, tuberculosis, and more were developed through the 1930s.
• The middle of the 20^thcentury was an active time for vaccine research and development.
  • Methods for growing viruses in the laboratory led to rapid discoveries and innovations, including the creation of vaccines for polio.
  • Researchers targeted other common childhood diseases such as measles, mumps, and rubella, and vaccines for these diseases reduced the disease burden greatly.
• Innovative techniques now drive vaccine research, with recombinant DNA technology and new delivery techniques leading scientists in new directions.

Measles Has Been All Over The News

• Measles Cases in 2019
  • From January 1 to June 27, 2019, 1,095** individual cases of measles have been confirmed in 28 states. This is an increase of 18 cases from the previous week. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated in 2000.

• Why The Spread of Measles?
  • The majority of people who got measles were unvaccinated.
  • Measles is still common in many parts of the world.
  • Travelers with measles continue to bring the disease into the U.S.
  • Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated.

Common Misconceptions About Vaccines

• “Diseases had already begun to disappear before vaccines were introduced, because of better hygiene and sanitation”.
  • Statements like this are very common with the anti-vaccine crowd, the intent apparently being to suggest that vaccines are not needed.
    • Improved socioeconomic conditions have undoubtedly had an indirect impact on disease.
    • Better nutrition, not to mention the development of antibiotics and other treatments, have increased survival rates among the sick; less crowded living conditions have reduced disease transmission; and lower birth rates have decreased the number of susceptible household contacts.
    • But looking at the actual incidence of disease over the years can leave little doubt of the significant direct impact vaccines have had, even in modern times.
• For example, there have been periodic peaks and valleys throughout the years, but the real, permanent drop in measles coincided with the licensure and wide use of measles vaccine beginning in 1963.
• Other vaccine-preventable diseases show a roughly similar pattern in incidence, with all except hepatitis B showing a significant drop in cases corresponding with the advent of vaccine use. (The incidence of hepatitis B has not dropped as much because infants vaccinated in routine programs will not be at high risk of disease until they are at least teenagers. Therefore a 15-year lag can be expected between the start of routine infant vaccination and a significant drop in disease incidence.)
• Haemophilus influenzae type b (Hib) vaccine is another good example, because Hib disease was prevalent until the early- to mid- 1990s, when conjugate vaccines that can be used for infants were finally developed.
• Are we expected to believe that better sanitation caused the incidence of each disease to drop just at the time a vaccine for that disease was introduced?
  • Since sanitation is not better now than it was in 1990, it is hard to attribute the virtual disappearance of Hib disease in children in recent years in countries with routine Hib vaccination (from an estimated 20,000 cases a year to 1,419 cases in 1993, and dropping in the United States of America) to anything other than the vaccine.
• We can look at the experiences of several developed countries after they allowed their immunization levels to drop.
  • Three countries —Great Britain, Sweden and Japan — cut back the use of pertussis (whooping cough) vaccine because of fear about the vaccine.
  • The effect was dramatic and immediate.
    • In Great Britain, a drop in pertussis vaccination in 1974 was followed by an epidemic of more than 100,000 cases of pertussis and 36 deaths by 1978.
    • In Japan, around the same time, a drop in vaccination rates from 70% to 20%-40% led to a jump in pertussis from 393 cases and no deaths in 1974 to 13,000 cases and 41 deaths in 1979.
    • In Sweden, the annual incidence rate of pertussis per 100,000 children of 0-6 years of age increased from 700 cases in 1981 to 3,200 in 1985.
• It seems clear from these experiences that not only would diseases not be disappearing without vaccines, but if we were to stop vaccinating, they would come back.
  • Of immediate interest is the major epidemics of diphtheria that occurred in the former Soviet Union in the 1990s, where low primary immunization rates for children and the lack of booster vaccinations for adults resulted in an increase from 839 cases in 1989 to nearly 50,000 cases and 1,700 deaths in 1994.
  • There were at least 20 imported cases in Europe and two cases in U.S. citizens who had worked in the former Soviet Union.
• Here’s another thing you should know about vaccines. Older adults need them too.
  • Here’s why:
    • As we age, our immune system weakens. Older adults are more likely to be infected and develop complications from vaccine-preventable diseases.
    • Immunity from some vaccines can decrease over time, which means booster doses are necessary to maintain protection. Also, some bacteria or viruses change over time; this makes some annual vaccinations necessary.
    • Older adults are more likely to have a chronic condition, which can increase the risk of diseases such as influenza. Skipping a vaccine can have serious health consequences.

 Vaccine Safety: The Facts

• ​​Many people have expressed concerns about vaccine safety.
  • The fact is vaccines save lives and protect against the spread of disease.
  • If you decide not to immunize, you’re not only putting your child at risk to catch a disease that is dangerous or deadly but also putting others in contact with your child at risk. Getting vaccinated is much better than getting the disease.
  • Indeed, some of the most devastating diseases that affect children have been greatly reduced or eradicated completely thanks to vaccination.
  • Today, we protect children and teens from 16 diseases that can have a terrible effect on their young victims if left unvaccinated.
• Your healthcare provider knows that you care about your child’s health and safety. That’s why you need to get all the scientific facts from a medical professional you can trust before making any decisions based on stories you may have seen or heard on TV, the Internet, or from other parents.
• Vaccines work.
  • They have kept children healthy and have saved millions of lives for more than 50 years.
  • Most childhood vaccines are 90% to 99% effective in preventing disease.
  • And if a vaccinated child does get the disease, the symptoms are usually less serious than in a child who hasn’t been vaccinated.
  • There may be mild side effects, like swelling where the shot was given, but they do not last long. And it is rare for side effects to be serious.
• Vaccines are safe.
  • Before a vaccine is licensed in the United States, the Food and Drug Administration (FDA) reviews all aspects of development, including where and how the vaccine is made and the studies that have been conducted in people who received the vaccine.
  • The FDA will not license a vaccine unless it meets standards for effectiveness (how well the vaccine works) and safety.
  • Results of studies get reviewed again by the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, and the American Academy of Family Physicians before a licensed vaccine is officially recommended to be given to children.
  • Every lot of vaccine is tested to ensure quality (including safety) before the vaccine reaches the public. In addition, FDA regularly inspects places where vaccines are made.
• Vaccines are necessary.
  • Your doctor believes that your children should receive all recommended childhood vaccines.
  • In the United States vaccines have protected children and continue to protect children from many diseases.
  • However, in many parts of the world many vaccine-preventable diseases that are rarely seen in the United States are still common.
  • Since some vaccine-preventable diseases still occur in the United States and others may be brought into the United States by Americans who travel abroad or from people visiting areas with current disease outbreaks, it’s important that your children are vaccinated.
• Vaccines are studied.
  • To monitor the safety of vaccines after licensure, the FDA and the CDC created the Vaccine Adverse Event Reporting System (VAERS).
  • All doctors must report certain side effects of vaccines to VAERS. Parents can also file reports with VAERS.
• Some parents are requesting that we space out their infant’s vaccinations because they are concerned that receiving multiple vaccinations at a single office visit might overwhelm the infant’s immune system.
  • Vaccine recommendations are determined after extensive studies in large clinical trials. They include studies on how vaccine recipients respond to multiple vaccines given simultaneously.
  • The overall aim is to provide early protection for infants and children against vaccine-preventable diseases that could endanger their health and life.
  • No scientific evidence exists to support that delaying vaccinations or separating them into individual antigens is beneficial for children.
  • Rather, this practice prolongs susceptibility to disease, which could result in a greater likelihood of the child becoming sick with a serious or life-threatening disease.
  • There could also be added expense (e.g., multiple office visits), additional time off from work for parents, and increased likelihood that the child will fail to get all necessary vaccinations.
• Many patients are reading The Vaccine Book, in which the author, Dr. Bob Sears, cites studies that he interprets as showing that the amount of aluminum found in certain vaccines might be unsafe.
  • He thinks it is better to separate aluminum-containing vaccines, rather than give them according to the recommended U.S. immunization schedule. There is no science behind this.

• Does the thimerosal in some vaccines pose a risk?
  • Thimerosal, a very effective preservative, has been used to prevent bacterial contamination in vaccine vials for more than 50 years.
  • It contains a type of mercury known as ethylmercury, which is different from the type of mercury found in fish and seafood (methylmercury). At very high levels, methylmercury can be toxic to people, especially to the neurological development of infants.
  • In recent years, several large scientific studies have determined that thimerosal in vaccines does not lead to neurologic problems, such as autism.
  • Nonetheless, because we generally try to reduce people’s exposure to mercury if at all possible, vaccine manufacturers have voluntarily changed their production methods to produce vaccines that are now free of thimerosal or have only trace amounts. They have done this because it is possible to do, not because there was any evidence that the thimerosal was harmful.
• Some have expressed concern that some vaccines have been produced in fetal tissue.
  • The production of a few vaccines, including those for varicella, rubella, and hepatitis A, involves growing the viruses in human cell culture.
  • Two human cell lines provide the cell cultures needed for producing vaccines; these lines were developed from two legally aborted fetuses in the 1960s.
  • These cell lines are maintained to have an indefinite life span.
  • No fetal tissue has been added since the cell lines were originally created.
  • Some parents are concerned about this issue because of misinformation they have encountered on the Internet. Two such untrue statements are that ongoing abortions are needed to manufacture vaccines and vaccines are contaminated with fetal tissue.
• The Failed Threat of Autism
  • An article linking autism to the MMR vaccine was retracted for fraud, but this misinformation persists and has caused long-lasting public health consequences.
  • Multiple studies have found no causal link between vaccination and autism, but the falsified report continues to cause parental concern.

Why Vaccinate?

• Vaccination’s immediate benefit is individual immunity:
  • It provides long-term, sometimes lifelong protection against a disease.
    • The vaccines recommended in the early childhood immunization schedule protect children from measles, chicken pox, pneumococcal disease, and other illnesses.
    • As children grow older, additional vaccines protect them from diseases that affect adolescents and adults, as well as for diseases they may encounter during travel to other regions.
    • Travelers to certain parts of South America and Africa, for example, are required to receive the yellow fever vaccine, as the disease is still prevalent there.
• The secondary benefit of vaccination, however, is herd immunity, also known as community immunity.
  • Herd immunity refers to the protection offered to everyone in a community by high vaccination rates.
  • With enough people immunized against a given disease, it’s difficult for the disease to gain a foothold in the community.
  • This offers some protection to those who are unable to receive vaccinations—including newborns and individuals with chronic illnesses—by reducing the likelihood of an outbreak that could expose them to the disease.
  • It also protects vaccinated individuals wh may not have been fully immunized against a disease (no vaccine is 100% effective)
• When community vaccination rates drop below the threshold of herd immunity, widespread disease outbreaks can occur.
  • The threshold of herd immunity for polio, for example, is estimated to be between 80% and 86%;[1]if the vaccination rate drops significantly below this level, the level of community protection may not be enough to prevent the disease from spreading—primarily to those who have no prior immunity because they haven’t been vaccinated (due to chronic illnesses or vaccine refusal) or because they were vaccinated, but it was not effective.

• This is precisely what happened in England when MMR (measles, mumps, and rubella) vaccination rates dropped.
  • Measles is extremely infectious; therefore, it has a higher herd immunity threshold than most other diseases.
  • In the late 1990s, MMR vaccination rates began to drop from more than 90% to 80% or lower—well below the level required for herd immunity against measles.
  • In response, the number of cases began to rise: while only 56 cases were confirmed in Wales and England in 1998, 1,348 were confirmed by 2008.
  • A disease whose spread in the country had been halted more than a decade prior was once again endemic.
• Vaccination does more than just protect an individual; it protects entire communities. Sufficient vaccination levels can provide protection against disease for members of the community who would otherwise be left vulnerable.

            The best reason to vaccinate yourself or your child is, well, SCIENCE!!