Are Childhood Vaccinations Safe

Vaccination is one of the best medical methods to protect children from pathogenic agents, which had caused numerous incurable illnesses before prophylactic immunization was developed. Since the time when Benjamin Jesty inoculated his family members with cowpox and Edward Jenner immunized an eight-year-old boy in the 18^th century, vaccination has been identified as the most effective way of preventing infectious diseases worldwide (Levine 2). However, although effectiveness of vaccination is related to evidence based healthcare aspects, the concepts and practice of vaccination are still controversial issues today.

Vaccination, as a way of preventive maintenance of infectious diseases, is intensely discussed by the public and scientists in scholarly publications, diverse printed sources on the Internet and TV. Opponents of vaccines blame them for such adverse effects as permanent disability, life-threatening diseases and fatalities (CDC). However, intense debates on this public health intervention are mainly based on public misunderstanding of science, contradictory facts, and unreliable information disseminated by the mass media. The mass media coverage tends to miscommunicate and amplify vaccination-associated risks to public (Leach). Moreover, discussions between supporters and opponents of vaccination are frequently characterized by pseudo-scientific nature. False stereotypes impede public health officials and international healthcare organizations “trying to increase immunization coverage … and promoting large-scale disease eradication campaigns” (Leach 5). Thus, the complete evaluation of vaccination-associated benefits and risks should focus on reliable data obtained from relevant research studies and reputable scientific sources.

The primary goals of vaccination are to increase immune response to diseases and, thus, prevent their occurrence. Immunity involves human abilities to resist pathogenic agents of different infections. Congenital immunity of newborn infants is a temporary phenomenon; it is efficacious due to antibodies transferred to a fetus through a maternal placenta. Breastfeeding also stimulates immune functioning of infants because breast milk “contains immunoglobulins, lymphocytes, and other bacteria growth retardants” (DeLaune & Ladner 325). However, the immune system of infants is not mature enough to completely protect them from infections.

Functions of the immune system are based on complex interactions between separate components of infectious agents and factors of immunity. Due to diverse characteristics of pathogenic agents and their abilities to adapt for changing environmental conditions and preventive measures, it is impossible to develop “the vaccine against all diseases”. Moreover, a vaccine can appear to be insufficient to protect a child because of modifications in infectious agents. The immune system of humans is able to distinguish various pathogenic agents and products of their activities (toxins) and develop factors of protection (antibodies and active cells), which neutralize viruses, microbes, and other disease-causing agents and block their toxins before they produce detrimental impacts on an organism.

Children are especially vulnerable to pathogenic agents of infectious diseases; in order to provide them with acquired immunity, immunizations in the form of vaccination are performed. Children, whose immunity and protective abilities are weakened, owing to different congenital or evoked diseases, are especially susceptible to infections; they are frequently severely ill and suffer from numerous complications. Such children require additional protection against infectious diseases. Medical professionals should promote parents’ awareness of the importance of vaccines and confirm that infants receive all necessary immunizations.

Vaccination is the process of development of acquired immunity against specific diseases such as smallpox, diphtheria, measles, tuberculosis, tetanus, parotitis, cholera, typhoid, malaria, poliomyelitis, etc. Although these illnesses are preventable today, they have been associated with the ravages, sufferings, disabilities, incurable diseases, and enormously high rates of mortality since medieval times. Vaccination makes an organism unreceptive to infections or considerably increases its immune response. Therefore, research studies, scholarly sources, state and local public health agencies, empowered officials, and medical professional generally identify the mass childhood immunization as an effective method to reduce rates of infectious diseases prevalence and prevent their potential occurrence (Levine).

The following types of vaccines can be used to provide a child with acquired immunity:

1. Dead organisms, which are used to prevent typhoid fever, diphtheria, and whooping cough.
2. Inactivated toxins, which are inoculated to protect a child from occurrence of tetanus and botulism.
3. Attenuated live organisms; those that are used to form acquired immunity against yellow fever, poliomyelitis, smallpox, measles, and other viral diseases.

Taking into consideration differences in children’s growth and development predetermined by their ages, vaccination and immunization schedules have been designed specifically for children, teens, and adults by the US Centers for Disease Control and Prevention (DeLaune & Ladner 662). Special vaccination and immunization schedules are designed and implemented in each country separately and reconsidered annually, with introduction of necessary changes, depending on the current epidemiological situation in a country. Strict control over recommended age characteristics, intervals between doses of the same vaccine, thorough examination of children before vaccination, and procedures of immunization provide optimum efficiency and safety of vaccination. Parents should be educated on schedules and possible contraindications. Furthermore, despite some widespread misconceptions, children being born prematurely have to be vaccinated in compliance with vaccination and immunization schedules and the same contraindications and cautions, as well as other infants.

Utilization of new vaccines is performed in compliance with regulatory guidelines and recommendations of the US Food and Drug Administration (FDA), Advisory Committee on Immunization Practices, the Institute for Vaccine Safety, and Centers for Disease Control and Prevention (CDC). Since 1994, more than 20 novel vaccine products “against pediatric pneumococcal disease, meningococcal disease, and human papilloma virus” have been approved by FDA (IOM 5). Mass immunizations are strictly monitored processes. The Vaccine Adverse Event Reporting System (VAERS) was founded in 1990 in order to detect unknown side effects of vaccines, specify potential risk factors, evaluate safety of new vaccine products, and monitor “increases in adverse events” (CDC). Reports on findings of pertinent epidemiologic studies and vaccination-related adverse effects are assessed by the Clinical Immunization Safety Assessment (CISA) Network; complaints and reports from the public on side effects of vaccines are monitored by VAERS (IOM). Thus, vaccination is strictly controlled by governmental and public organizations.

Nevertheless, although vaccination leads to eradication of numerous infectious diseases, vaccines are not held in all countries. For instance, in the USA, infants and children are not vaccinated with bacille Calmette-Guerin (BCG) vaccine, despite the fact that approximately one-third of the world's population has latent tuberculosis (WHO). According to the official data of the World Health Organisation and pertinent scientific publications, nearly 9 million people were diagnosed with tuberculosis and approximately 1.4 million patients died from it in 2010 (WHO). Tuberculosis (TB) is a contagious and potentially fatal infectious disease, which afflicts humans of all ages and nationalities. Tuberculosis is triggered by bacteria of the Mycobacterium tuberculosis complex, a specific type of the fungus-like pellicles formed by tubercle bacilli in fluid medium. The causative agents of tuberculosis are easily transmitted from a person with infectious pulmonary tuberculosis to those who come in contact with him/her through air. Consequently, the disease frequently afflicts all family members, irrespective of their age and gender. High rates of tuberculosis-related mortality, severity of manifestations, multi-drug resistance, and prevalence of the illness identify crucial aspects of obligatory vaccination in order to prevent occurrence of tuberculosis. According to Artenstein, “although imperfect, BCG remains a relatively inexpensive, safe, available agent that is still the only vaccine effective for the prevention of human tuberculosis” (137). Therefore, benefits of this vaccination are far more significant in comparison with its possible adverse effects.

Immunization safety and risks of adverse effects comprise factors contributing to numerous disputes and inconsistent statements. It is authentically known that any vaccine is absolutely safe and does not guarantee absolute protection against infections. However, negative impacts of vaccination on a child are often exaggerated. Healthcare publications on immunization often involve contradictory findings. The given facts require medical professionals to be able to evaluate published results of conducted studies in conformity with the world health care standards based on evidence, authenticity, validity, statistical interrelations, and scientific methodology. Evidence-based medicine is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” (Greenhalgh 1). According to the principles of evidence based medical practice, a medical professional should identify important concepts in each case, precisely define appropriate interventions for the specific patient or demographic, and consciously use the best existing data of vaccines and results of clinically relevant research. Therefore, vaccination-related risks should be accurately recorded and comprehensively assessed.

Adverse effects of vaccination vary from insignificant and local side effects to rare and life-threatening conditions. Various vaccines pose various risks, which depend on a vaccine’s type, origin, structure, chemical properties, and technological characteristics. Therefore, it is absolutely wrong to refuse all vaccines at once, referring to their equal danger. Actually, negative impacts of vaccines are not connected with their toxicity; they are generally predetermined by specific abilities of an individual (hypersensibility to specific components of a vaccine, conditions of immunity, allergies, and so forth). Thus, individual predisposition to negative reaction to vaccination should be accurately documented in order to avoid potential adverse effects.

Sudden unexpected death in infancy, anaphylactic reactions, neuroregulatory abnormalities, bacterial contamination, and other complications comprise the major public concerns related to obligatory mass immunization. In accordance with the classification provided by Levine (131), vaccine-associated risks and adverse effects can be divided into the following groups:

1. Injection related adverse effects include head traumas resulting from fainting, predisposition to poliomyelitis, damaged peripheral nerves, and adjacent inflammatory responses.
2. Adverse effects of contamination can be expressed in the forms of abscesses, cellulitis, or sepsis due to insufficient sterility and technological errors.
3. Inflammatory responses such as local swelling, pain, and tenderness; those can be provoked by adjuvants of vaccines (Levine 132).
4. Replication of live agents can cause different complications including arthritis, infections of the horn cells of the spinal cord, and local infections.
5. Hypersensitivity reactions include angioedema, urticaria, and anaphylaxis which can be induced by individual responses to vaccines’ allergens.
6. Immunologically mediated reactions can be caused by influenza vaccines, measles-containing vaccines, and quadrivalent meningococcal conjugate vaccines and result in Guillain-Barre syndrome (GBS), thrombocytopenia, and myopericarditis.
7. Unknown mechanisms of adverse effects of vaccination are still under thorough scrutiny due to their understudied nature.

Thus, in order to determine if vaccination is the most effective method of infection prevention, it is necessary to consider evidence-based information. All contradictory arguments should be confirmed by scientific data. Potential findings in favour of mass immunization grounded on relevant research studies and reliable facts can change existing misconceptions and false stereotypes. Although utilization of adjuvants and other recently developed vaccines remains challenging due to concerns of possible adverse effects, “the more we understand the mechanisms of actions of these novel molecules the more likely we will be able to effectively evaluate their efficacy and safety” (Artenstein 383). Therefore, additional strategies should be developed by governments in order to improve populations’ awareness of vaccination risks and benefits. Parents should be completely aware of all aspects of vaccination including precautions, contraindications, potential outcomes, healthcare efficacy, and possible side effects. Health care providers, empowered officials, scientists, and responsible professionals should develop and implement the most effective methods in order to promulgate mass immunization globally.

In conclusion, despite today’s curability of infectious diseases, advanced means of diagnostics, new efficient medications, and methods of treatment, humans are still fighting a losing battle against their pathogenic agents. Taking into consideration the indisputable importance of human life and health, each medical worker is obliged to promote evidence-based information on the effectiveness of vaccination. This intervention is designed to induce “host immune responses to mount preventive or therapeutic defenses against diseases of varying etiologies, including those of infectious, and potentially autoimmune or neoplastic origin”.