When Edward Jenner discovered that smallpox could be prevented through a new technique he introduced in 1798, known as vaccination, he began a medical revolution. Vaccines are responsible for eradicating and controlling some of the most deadly diseases of our time. And vaccinated children are growing up without the imminent threat of polio, hepatitis B, chicken pox, measles and rubella, to name just a few.
However, several years ago, a much-hyped study by British researcher Dr. Andrew Wakefield indicated a potential link between childhood vaccines and autism, causing some parents to decline vaccines for their children. That study recently was exposed by the British Medical Journal to be an ‘elaborate fraud,’ and much of the concern has been dispelled.
“A few people still ask me about vaccine safety, but that worry seems to have peaked a few years ago,” says Dr. Colleen Seematter, a pediatrician with St. John’s Mercy Medical Group. “As soon as babies are born, they’re immediately exposed to multiple viruses and bacteria, and their immune systems can handle vaccines. The newest formulations of vaccines expose kids to fewer antigens while still providing disease protection.”
For instance, in 1996, the combination vaccine for diphtheria, tetanus and pertussis (whooping cough) was reformulated, resulting in fewer side effects, such as fever. In 2001, the Food and Drug Administration approved another DTaP vaccine, this time formulated without the preservative thimerosal. “Although no harmful effects have been reported from thimerosal in vaccines when used at the recommended dosages, federal public health agencies, the American Academy of Pediatrics and vaccine manufacturers have agreed to reduce or eliminate its use in vaccines to protect children against the potential cumulative health risks of mercury,” according to a 2001 World Health Organization report.
Another vaccine debate occurred around the 2006 release of Gardasil, which targets human papillomavirus (HPV) and prevents cervical cancer and genital warts. Cervarix is another HPV vaccine now available, although it is only effective against the two HPV strains that cause cervical cancer but not genital warts.
The U.S. Centers for Disease Control and Prevention recommend that all girls age 11 or 12 get a three-dose course of the HPV vaccine, which is approved for ages 9 to 26. “Girls and their parents should discuss the HPV vaccine with their physician and then make an informed decision based on factual information,” says Dr. Diane Merritt, a pediatric and adolescent gynecologist with Washington University Physicians.
“We also recommend that all girls have an initial reproductive health visit between the ages of 13 and 15 with their pediatrician or gynecologist to review development as well as menstrual and behavioral issues,” Merritt adds. “This would be an appropriate time to discuss giving the HPV vaccine if it has not already been administered.”
The most widely reported adverse event following the HPV vaccine has been fainting, although many physicians note that this may occur following any type of injection. “With each dose of the HPV vaccine, the immune response is enhanced, so potentially the final injection could be more tender than the first,” Merritt says. “I recommend icing the injection site for 10 minutes to decrease redness and discomfort and timing the injections for elite athletes so that they’re not using that arm for important sporting events or competitions for 48 hours after receiving the vaccination.”
“All the childhood vaccines are important, and some have made diseases virtually disappear, but parents shouldn’t assume that just because there are fewer reported cases of a disease, their child is safe without the vaccine,” Seematter says. “It’s important to stay current and have your child vaccinated on the recommended schedule.”
Maintaining the safety of vaccines, the CDC and FDA operate the Vaccine Adverse Event Reporting System, a surveillance program that collects information about vaccine side effects. “Any major side effect is reported, and when the system finds problems, vaccines are reformulated for improved safety,” Seematter notes.
Current recommendations for childhood, adolescent, teen and adult vaccines are listed by the CDC at http://cdc.gov/vaccines">cdc.gov/vaccines.