The controversy behind vaccine safety

My kids and I decided to pick up “The BFG” by Roald Dahl for our bedtime reading. I noticed the dedication on the first page: “For Olivia. 20 April 1955-17 November 1962.” Intrigued, I looked her up and learned that Olivia was Dahl’s eldest daughter.

She contracted measles from an outbreak at school. The measles eventually caused inflammation in her brain (encephalitis), which caused her to go into a coma. She died within 12 hours after.

Over 20 years after his daughter’s death, Dahl wrote a short essay, “Measles, a Dangerous Illness.” He noted that in 1962, there was nothing doctors could do to save Olivia from measles encephalitis, and they still could not save a child who developed the same deadly reaction from measles as Olivia did in 1986.

Today, 34 years later, there is still no specific treatment for measles. There is still limited knowledge about how measles causes encephalitis, or how to save someone who develops this condition.

Today, even previously healthy children who are not immune may need hospitalization from measles, and one in 20 of infected kids develops pneumonia while one in 1,000 of them has brain inflammation, causing permanent brain damage or death.

We are fortunate today that despite being a potentially deadly disease and the most contagious disease known to humankind, measles was practically eliminated in most places thanks to a high majority of children being protected through national vaccination programs. Vaccines help save the lives of many children who often face the highest danger from infectious diseases, because otherwise their immune system is less prepared to fight off invading germs.

Before vaccines were available, millions of children all over the world died from infectious diseases like measles before reaching their fifth birthday.

Unfortunately, the measles vaccine, usually given in a combination of live weakened measles-mumps-rubella virus (MMR) vaccines, is one of the vaccines that continue to be embroiled in one of the most misguided controversies in medical history.

Loss of confidence in this vaccine means many children are unvaccinated and remain vulnerable to measles. Often, people who are skeptical of or refuse vaccines are concerned about safety.

Vaccines are produced with the highest safety standards—even when their production is expedited, like the COVID-19 vaccines. But out of the billions of people given many vaccines over many years, there will be rare instances when side effects more severe than the common temporary soreness at the injection site occur.

Scientists continue to find ways to reduce the risks of adverse events following immunizations (AEFI), and they continuously monitor AEFI for all vaccines. However, fevers, rash, and even seizures, as uncomfortable and frightening as they may be for parents to experience with their children after vaccination, are not dangerous in and of themselves, and they do not mean vaccines are not safe.

We need to reconsider what our idea of safety is.

Safety does not mean absence of pain or discomfort—it means being protected from danger, risk, or injury.

Similarly, we need to reconsider our idea of protection. Vaccines protect us from getting sick from infectious diseases, but they are not shields that stop people from catching germs.

Instead, vaccination is a martial arts training course for the immune system to be more prepared to fight germs.

But a vaccine can’t shield a person from being exposed to or infected with a germ, any more than martial arts can prevent someone from running into a thug picking a fight on the street.

However, in both instances, having been trained makes you more prepared, stronger, and less likely to get hurt from the encounter.

Discomfort from vaccination is common.

Serious side effects are very rare, but they do occur.

There have been extremely rare tragedies in areas with limited resources and less robust health care systems, where contamination and human error in administering vaccines have caused illness and death. Indeed, vaccines and vaccination are not perfect. But their value in reducing human suffering from the clutches of dangerous diseases cannot be understated.

From a public health perspective, vaccines are sufficiently safe and effective to give to everyone except those for which clear contraindications to the vaccines are known. Preparedness and transparency in communicating about vaccine shortcomings are important, especially before vaccination by health care providers.

Most parents only want to make the best decisions for their children. We all need to be empowered with the understanding that sometimes we should choose the best option we have based on the best evidence we know. Even if it is not perfect, the alternative is far deadlier. The Star/Asia News Network

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Dr. Khayriyyah Mohd Hanafiah is senior lecturer in Medical Microbiology at Universiti Sains Malaysia, and an affiliate of Young Scientists Network-Academy of Sciences Malaysia.

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The Philippine Daily Inquirer is a member of the Asia News Network, an alliance of 22 media titles in the region.