By Dr Mohamad Kamal Mohamad Akram
Have you ever wondered about the surge of vaccine hesitancy and refusal in recent years?
Vaccines have been the same if not even better today than they were in the past. Adverse effects following immunisation (AEFI) were experienced even then, probably even more. Yet, people were ever so grateful to vaccines for protecting them from infectious diseases which killed in the millions and maimed many of the survivors.
They would stand in long winding queues to get their children immunised against smallpox and polio.
Unfortunately, this perception does not hold true for a growing number of parents, and this includes the current resident of the White House.
Vaccines have been portrayed as an evil causing autism and many AEFIs, an intrusion on individual rights, going against religious beliefs, a western conspiracy involvig big pharma ghouls.
What has led to this hostile and toxic opposition to vaccines?
Regrettably, we have become victims of our vaccine successes. George Santayana, the Spanish philosopher correctly reminded: “those who cannot remember the past are condemned to repeat it”.
None of us have seen the scourge of smallpox and polio. The World Health Organisation (WHO) announced the eradication of smallpox in 1980.
Probably, only our grandparents have seen some of their friends die or become paralysed from polio infection. Polio is now only endemic in two countries, Pakistan and Afghanistan.
Some of our parents who studied medicine in the west, probably never saw a case of measles while in medical school because it was virtually eliminated in the western world.
Our ancestors witnessed tragically the scourge of vaccine preventable disease (VPD) before the advent of vaccines and the major reductions of deaths, physical and neurological disabilities following the widespread introduction of vaccines through the WHO’s Expanded Programme of Immunisation (EPI).
Influenza alone infected one-fifth of the world’s population and killed more people than World War I in 1918. Smallpox killed a third, disfigured another third and only the remaining third of the world’s population survived the disease unscathed. Smallpox was responsible for an estimated 300–500 million deaths in the 20th century alone.
In the 1940s, parents would not allow their children to go to church, theatres, swimming pools or summer camps, and schools were even closed for fear of children being infected with polio. At its peak in the 1940-50s, polio would paralyse or kill half a million people worldwide each year.
Thus, they are ever so thankful to the miracles of vaccines in protecting them, their families and communities from the killer VPDs.
Balance of benefits and risks
The average person would not be able to remember any of these human tragedies inflicted by killer diseases, let alone know about Acute Flaccid Paralysis (AFP) caused by polio. But they probably would be able to rattle about the rare AEFI of vaccines and equate (erroneously) the MMR vaccine as the cause of autism.
Our everyday living is a balance of benefits and risks. Statistically, 200 people choke and die each year after eating their breakfast. That has not stopped us from enjoying our breakfast every morning.
Statistics also show that 350 people drown and die each year in the bath-tub, but we still continue to take our daily bath.
We all know of someone who has been killed in a motor vehicle accident, or have suffered permanent injuries. That hasn’t stopped us from driving our cars because we recognise that the benefits far outweigh the risks. And we manage the risk by wearing seat belts and buy cars fitted with airbags.
Since vaccines are administered to healthy children and adults, they are strictly regulated to satisfy the most stringent and highest standards of safety. To guarantee safety and efficacy, at least 10-15 years of research, clinical trials and testing is required before a vaccine can be licensed.
Like most medicines, vaccines are not spared from adverse effects. These AEFIs are usually mild such as tenderness, swelling or redness at the inoculation area, low grade fever or malaise.
Serious AEFIs like anaphylaxis, an allergic reaction causing difficulty in breathing, low blood pressure and loss of consciousness are extremely rare, probably about one per million.
Many of the anti-vaccine websites provide unscientific, misleading and alarming information on vaccine safety. They propagate myths and misinformation about vaccine safety which raise undue fears among parents.
As individuals, parents and guardians we should feel reassured by the initiative of these world health agencies and not be swayed by the anti-vaccine news on social media.
Much of the misinformation on vaccine safety has been addressed and debunked by WHO, Unicef and key NGOs who initiated the Vaccine Safety Net Project (VSN) to respond quickly and scientifically to safety issues.
Visit the Vaccine Safety Net page on the WHO website for more information.
Dr Mohamad Kamal Mohamad Akram is a spokesman for the Malaysian Pre-Houseman Joint (MPHJ).
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