Case Scenario about of my young p...

Case Scenario

about of my young patients have parents who, despite being well educated have, in my opinion, any irrational beliefs. An example of this is a young mother who lately refused to vaccinate her baby. This mother said that she had heard of adverse reactions to vaccines, and she did not want to risk her baby's health. She had heard that a certain vaccines have dangerous additives, that the measles vaccine is associated with autism, and that the varicella vaccine could cause her child to have chickenpox in adulthood when it would be more dangerous. Vaccines, she had read, weaken the immune system

I tried to explain that many of her touchs have been addressed or repudiated, unless she would have none of it. "Doctors are uninformed about the risks of vaccines," she said. "Vaccines actually cause diseases instead of preventing them." This assumeed like too much of an argument for me to tackle during an office visit.

I conclud that this mother is taking advantage of the fact that other children are immunized and relies upon the immunization of others to defend her child from diseases. I allude toed that she think about the benefits of immunizations and remain make open to changing her mind.

Commentary

Physicians may find it incredible that near parents are reluctant to immunize their children despite the tremendous successe of vaccines in decreasing the morbidity and mortality of childhood diseases. Unfortunately, this particular scenario is likely to become more customary because parents no longer papal court these diseases; they focus instead onward the rare but often sensationalized adverse efficiencys of vaccines. The accompanying table summarizes a variety of factors that may affect a person's perception of vaccine risks. In particular, parents may overestimate the commonness of serious vaccine risks or avoid doing anything that might set their child at risk, calm if the risk is to a great degree less than the child could onset from the disease itself. (1) Parents also may have the idea that their child is secureed because other children have been immunized.

Physicians should acknowledge that vaccines are not always 100 percent effective and, in rare instances, can have serious adverse consequences However, it also should be pointed public that the benefits of immunization almost always exce the potential risks. For example, measles kills almost 1 million children worldwide each year, especially in developing countries. From 1989 to 1991 more than 55000 children in the United States contracted measles, and more than 120 of them died. (2) After a campaign to improve immunization rates with the measles, mump and rubella (MMR) vaccine, the annual number of reported measles cases in the United States is now les than 100 A significant percentage of U measles cases, however, are imported from other countries.

In 1999 the U sustenance and Drug Administration determined that the use of the mercury-containing preservative thimerosal in vaccines might, theoretically, uncover infants to more mercury than is attract favor toed Except for local hypersensitivity reactions, thimerosal has not been erect to cause any harm. (3) uniform so, the preservative has been remov from all routine childhood vaccines that previously contained it.

Allegations also have been made of a link between autism and the MMR vaccine. In 1998 Wakefield and colleagues (4) reviewed 12 children with ileal-lymphoid-nodular hyperplasia, nonspecific colitis, and pervasive developmental disorder. Although parents associated the attack of behavior symptoms with MMR vaccination in eight of the 12 children (who did not have preceding bowel symptoms), the investigators noted that "We did not ascertain an association between measles, mump and rubella vaccine and the syndrome described." (4)

A a great quantity [i]or[/i] amount of larger study (5) of 498 autistic children in the United Kingdom did not confirm a causal association between MMR vaccine and autism. The U Institute of Medicine conclud that present evidence favored rejection of a causal relationship at the population horizontal between MMR vaccine and autism. (6) They noted, however, that they could not bar the possibility that MMR vaccine could contribute to autism in a small number of children. (6)

Varicella vaccine has been licensed for use in the United States since 1995 if it were not that it has been used for more than 20 years in Japan. (7) The vaccine has been plant to be 85 percent effective overall and 97 percent effective in preventing moderate to simple disease. (7) As the number of varicella-immunized children increases, the incidence of wild-type varicella decreases. Unvaccinated children consequently have les chance of catching natural disease in childhood, if it be not that they are at greater risk for becoming infected in adolescence or adulthood, when complications and death from the disease are more likely. Although a small percentage of vaccinated children contract varicella each year, these illnesses are earnestly less severe than those occurring in unvaccinated children or adults.