Tag: benefits

What Are the Risks of Vaccines?

Vaccines are very safe, but they are not 100% risk free.

They are certainly not as high risk as some anti-vaccine folks will have you believe though.

“Vaccine hesitation is associated with perceived risk. Since vaccine-preventable diseases are rare, an adverse event from a vaccine is perceived by the parent to be of greater risk. Risk perception is critical.”

AAP on Addressing Common Concerns of Vaccine-Hesitant Parents

And when you consider their great benefits, it is easy to see why the great majority of parents get their kids fully vaccinated and protected against all recommended vaccine-preventable diseases.

Risk Perception and Vaccine Hesitancy

Even though the risks and side effects of vaccines are very low, some people think that they are much higher. This is often amplified because of vaccine scare stories and the misinformation found on anti-vaccine websites.

“No intervention is absolutely risk free. Even the journey to a physician’s office with the intention to receive a vaccination carries the risk of getting injured in an accident. With regards to risks of vaccination per se, one has to distinguish between real and perceived or alleged risks.”

Heininger on A risk–benefit analysis of vaccination

Other problems with risk perception include that some people:

  • can be more likely to avoid risks that are associated with an action or having to do something vs. those that involve doing nothing or avoiding an action, even if inaction (skipping or delaying a vaccine) is actually riskier
  • often think about risks based on their own personal experiences (you remember someone’s vaccine injury story), rather than on scientific evidence

These biases in the way we think about risk can actually lead us to make risky choices and they help explain why some people are still so afraid of vaccines. Parents might think the risk of a possible side effect, some of which don’t even exist, is worse than the risk of getting a vaccine-preventable disease, getting someone else sick, or starting an outbreak. Parents also often underestimate the risk of their decision to not vaccinate their child.

“As much previous research claims, this study confirms that individuals characterized by greater trust of healthcare professionals and the possession of more vaccine-related knowledge perceive higher levels of benefits and lower levels of risks from vaccinations.”

Song on Understanding Public Perceptions of Benefits and Risks of Childhood Vaccinations in the United States

So what’s the answer? It is likely for folks to get better educated about vaccines, including getting a good understanding of both their benefits and risks.

What Are the Risks of Vaccines?

Again, vaccines are not 100% safe or risk free.

Most vaccines have some common, mild side effects, which might include (depending on the vaccine):

Vaccine Information Statements from the CDC highlight the risks of each vaccine.
Vaccine Information Statements from the CDC highlight the risks of each vaccine.
  • fever, typically low-grade
  • redness or swelling where the shot was given
  • soreness or tenderness where the shot was given
  • fussiness
  • headache
  • tiredness or poor appetite
  • vomiting
  • mild rash
  • diarrhea
  • swollen glands

How commonly do they occur?

It depends on the vaccine and side effect, but they range from about 1 in 50 to 1 in 3 people. These side effects are typically mild and only last a day or two. And they don’t cause lasting problems.

While not all possible side effects are mild, those that are more moderate or severe are much more uncommon. Febrile seizures, for example, only happen after about 1 out of 3,000 doses of MMR and some other vaccines. And while scary, febrile seizures, crying for 3 hours or more, or having a very swollen arm or leg, some other uncommon vaccine side effects, also don’t cause lasting problems.

Fortunately, the most severe side effects, including severe allergic reactions, are only thought to happen in less than 1 out of a million doses. And although these types of severe reactions can be life threatening, they are often treatable, just like severe allergic reactions to peanuts. For others, like encephalitis, although they are table injuries, it isn’t clear that they are even side effects of vaccines, since they occur so rarely.

All of these side effects can be reported to the Vaccine Adverse Event Reporting System (VAERS), either by your doctor or yourself.

“No medical product or intervention, from aspirin to heart surgery, can ever be guaranteed 100% safe. Even though we will never be able to ensure 100% safety, we know that the risks of vaccine-preventable diseases by far outweigh those of the vaccines administered to prevent them.”

World Health Organization

In addition to side effects, some other risks of getting vaccinated might include that your vaccine didn’t work, after all, although vaccines work very well, they are not 100% effective. You might also, very rarely, be given the wrong vaccine or the right vaccine at the wrong time.

Many other things, including so-called vaccine induced diseases, aren’t actually a risk of vaccines at all. Remember, autism, SIDS, multiple sclerosis, and shaken-baby syndrome, etc., are not a risk of vaccines.

What to Know About the Risks of Vaccines

Any small risks of getting vaccinated, including side effects that are often mild, are not a good reason to think about skipping or delaying a vaccine, especially when you thoughtfully consider all of their great benefits.

More About the Risks of Vaccines

What Are the Benefits of Vaccines?

Vaccines are safe, effective, and necessary.

They are neither 100% safe nor 100% effective.

That doesn’t make them any less necessary though.

It’s easy to see why when you look at all of the benefits that vaccines have given us.

Perceptions of Risks vs Benefits of Vaccines

One of the reasons that some parents become vaccine-hesitant is that they forget about the many benefits of vaccine.

That’s not surprising, as the better vaccines work, the less obvious their benefits are to everyone. After all, few people remember what it was like in the pre-vaccine era.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951, as this New York Times article reports.

That makes it easy to for some people to downplay the benefits of vaccines.

Unfortunately, at the same time, some parents might over-estimate the risks of vaccines. And that makes it even easier for them to justify a decision to skip or delay their child’s vaccines.

What Are the Benefits of Vaccines?

For most of us, the greatest benefit of any vaccine is that it keeps us from worrying that our kids will get a vaccine-preventable disease. If they do get sick, we don’t worry that every fever is measles or that every cough is pertussis either.

“It is also much cheaper to prevent a disease than to treat it. In a 2005 study on the economic impact of routine childhood immunization in the United States, researchers estimated that for every dollar spent, the vaccination program saved more than $5 in direct costs and approximately $11 in additional costs to society.”

NIH: National Institute of Allergy and Infectious Diseases

Among the other benefits of available vaccines are that:

The benefits of vaccines become more obvious when folks stop vaccinating.

immunization-program-stages
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

What happens?

Invariably, we start to see outbreaks.

Then they quickly remember why vaccines are necessary, vaccines rates go up, and the outbreaks get under control.

And everyone understands that all of great benefits of vaccines far outweigh any of their small risks. They also begin to hopefully understand that not everyone can attempt to hide in the herd or follow an alternative immunization schedule. That too can simply lead to more outbreaks, as the number of unvaccinated folks increases, at least temporarily.

What to Know About the Benefits of Vaccines

The great benefits of vaccines, which include that they have saved millions of lives, far outweigh any small risks.

More About the Benefits of Vaccines

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Vaccines Work

Most people understand that vaccines work.

“…for those trained in pediatrics in the 1970s, Hib (Haemophilus influenzae type b) was a horror.”

Walter Orenstein, MD

And that they work well.

The Pre-Vaccine Era

Just consider that in the pre-vaccine era, there were:

  • up to 15,000 deaths and 200,000 diphtheria cases each year until the 1940s
  • an average of 175,000 cases of pertussis each year in the early 1940s
  • 1,118 deaths from pertussis in 1950
  • 467 deaths from pertussis in 1955
  • up to 20,000 cases of paralytic polio each year until the early 1950s
  • an average of about 186,000 cases of mumps each year before 1967
  • an average of 40 deaths a year from mumps in the 1960s
  • up to 500 deaths and 500,000 measles cases each year until the early 1960s
  • a rubella epidemic in 1964-65 that caused 12.5 million rubella virus infections and “resulted in 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with congenital rubella syndrome”
  • up to 20,000 cases of invasive H. influenzae (Hib) disease each year, with more than half of them having meningitis, and about 300 to 600 deaths, mostly children under age 2 years. In 1980, 45 children died with epiglottitis and there were an additional 222 deaths from Hib meningitis.
  • up to 11,000 hospitalizations and 100 chicken pox deaths each year until 1995
  • before 2000, up to 17,000 cases of invasive pneumococcal disease in children younger than 5 years each year, including 13,000 cases of bacteria (blood infection) and 700 cases of pneumococcal meningitis, with 200 deaths.
  • just over 400,000 visits to the doctor and up to 272,000 visits to the emergency room, 70,000 hospitalizations and 20 to 60 deaths each year in children under age 5 years because of rotavirus infections until 2006

Although we are seeing more outbreaks of some of these diseases these days, it is important to remember that they in no way resemble the kinds of epidemics that we once saw before today’s vaccines were introduced.

And in addition to smallpox being eradicated, others have really been eliminated, like congenital rubella syndrome, diphtheria, neonatal tetanus, neonatal tetanus, and polio. Still others are well controlled, including hepatitis A, hepatitis B, and Hib.

The Idea That Vaccines Don’t Work

Could it be that vaccines don’t work and that it was hygiene, sanitation, and better nutrition that caused the decline in many of these cases?

Of course not, but if they did, then why did pertussis cases decline in the 1940s and it wasn’t until the late 1960s and early 1970s that mumps started to decline.

“From the 1930s through the 1950s, state and local health departments made substantial progress in disease prevention activities, including sewage disposal, water treatment, food safety, organized solid waste disposal, and public education about hygienic practices (e.g., foodhandling and handwashing). ”

CDC on Achievements in Public Health, 1900-1999: Control of Infectious Diseases

That’s not to say that we didn’t see a big drop in mortality in nearly all conditions in the first half of the 20th century.

We did have big improvements in sanitation, nutrition, and health care that helped folks survive if they got sick. After all, this was the time that:

  • penicillin was discovered
  • testing could be done to detect and diagnose many infectious diseases
  • they began fortifying milk with vitamin D
  • we had the establishment of hospital blood banks

But even with all of these improvements, people continued to die of diphtheria, measles, and pertussis, etc., even if it wasn’t at 18th or 19th century levels.

Measles mortality was decreasing after the beginning of the 20th Century, but eventually leveled off to about 400 deaths each year in the pre-vaccine era.
Measles mortality was decreasing after the beginning of the 20th Century, but eventually leveled off to about 400 deaths each year in the pre-vaccine era.

In addition to the idea that better sanitation and nutrition got rid of vaccine-preventable diseases, another idea that anti-vaccine folks push is that these diseases disappear because we simply change their names after a vaccine is introduced.

So polio didn’t go away, it became acute flaccid paralysis and Guillian-Barré syndrome.

Measles became roseola.

Smallpox became monkey pox.

And pertussis became croup.

Of course, these ideas are silly.

If better sanitation and nutrition got rid of vaccine-preventable diseases, then why didn’t it get rid of all of them at the same time? And is it just a coincidence that chicken pox, rotavirus, polio, measles, hepatitis B, and Hib all started to decline at about the same time that a vaccine against each disease was introduced?

Also, why hasn’t hygiene, sanitation, and better nutrition helped RSV, HIV, West Nile virus and other non-vaccine preventable diseases disappear

And if we just change the names of diseases to prove that vaccines work, why don’t we change the name of the flu? Or why don’t we introduce an RSV vaccine that doesn’t work and then just change the name of RSV to something else?

Lastly, where are all of the people with monkey pox?

Vaccines Work

Vaccines aren’t perfect. We need boosters for some and are dealing with problems of waning immunity with others.

“The science is clear: The earth is round, the sky is blue, and #vaccineswork. Let’s protect all our kids. #GrandmothersKnowBest”

Hillary Clinton on Twitter

Vaccines aren’t 100% effective. That’s one of the reasons that intentionally unvaccinated people put all of us at risk.

Vaccines are safe though and work very well to protect us from vaccine-preventable diseases.

Without these vaccines, we would be seeing much larger outbreaks of measles, mumps, and pertussis, etc. that are harder to contain. We would also be seeing more deaths and other serious complications from these diseases.

What To Know About How Vaccines Work

Vaccines are safe, effective, and necessary. Vaccines work very well to protect us from the vaccine-preventable diseases that have now either been eliminated or are well controlled at much lower levels than they were at in the pre-vaccine era.

More About Vaccines Work

Immunization Posters and Slogans

Getting your kids vaccinated and protected is a good idea.

Vaccines are safe, necessary, and they work.

Why do we need posters and slogans to help educate people about their benefits?

A billboard in Minnesota educates parents about the benefits of the chicken pox vaccine.
A billboard in Minnesota educates parents about a benefit of  vaccines – protecting those who rely on herd immunity.

Maybe because as long as there have been vaccines, there have been anti-vaccine slogans scaring parents away from them.

Immunization posters are also a good way to raise awareness of new vaccines and new  recommendations for getting vaccinated.

Educating Parents About Vaccines

This slogan, during a whooping cough epidemic, reminded parents to get their kids vaccinated now.
This slogan, during a whooping cough epidemic, reminded parents to get their kids vaccinated now.

In the early 1980s, vaccine preventable diseases had come roaring back as folks in England and other countries got scared to vaccinate and protect their kids with the DTP vaccine.

It is reported that “public confidence in the pertussis vaccine collapsed in the early 1970s as a result of widely publicised concern about its safety and campaigns for compensation for children damaged by the vaccine.”

It got so bad that as vaccination rates fell to less than 30% in 1978, there were at least 154 deaths and 17 cases of brain damage in the UK because of pertussis infections, even though the concerns about the pertussis vaccine were widely unfounded.

“While You Make Up Your Mind About Whooping Cough Vaccination, Thousands Of Children Are Holding Their Breath” was an effective poster at this time. It highlighted the fact that you could sometimes wait too long to get your kids vaccinated, as pertussis cases and deaths grew during the outbreaks.

Vaccination rates eventually went up again, as parents made up their mind to vaccinate and protect their kids.

Immunization Posters and Slogans

Other immunization slogans and posters that have been used, including many historical posters, include:

Is your child vaccinated against smallpox? Diphtheria strikes unprotected children. Fight Polio Poster
Immunization Saves Lives Diphtheria is Deadly Be Well - get your polio vaccine
Let your child be a rubella hero Polio Vaccine - don't wait until it's too late. Stop Rubella
Whooping Cough is not a bird... Keep Measles a Memory poster. Be Wise - Immunize Your Child
MMR is a cheap shot that can millions. Parents of Earth, are your children fully immunized? MMR Shot - three way protection.
Are your kids fully immunized? Can you prove it?
Before it's too late. Vaccinate. Whooping cough is back! Which vaccines do kids need? All of Them. And on Time!
Shots might hurt for a moment, but they can protect for a lifetime.
Hepatitis B can be prevented. Stop measles with just one shot, well two... different-folks-posters
Dr. Seuss said Don't Wait: Vaccinate! Vaccines give all kids a chance A child's health is as precious as a work of art: immunize your child today
 HPV vaccines prevent cancer Know. Check. Protect. World Immunization Week 2014 She got her flu shot, not the flu.
Think Measles Don't Wait. Vaccinate. Psy helping get the word out that we are close to ending polio.
Jull got the Mumps. Meningitis B vaccination poster during an outbreak at Princeton. Mumps is not just for kids anymore

Although you hopefully already know all about all of the vaccines that your kids need, if you see a new immunization poster or slogan, ask your pediatrician for more information.

​Get Educated. Get Vaccinated.

What To Know About Immunization Posters

Although immunization posters won’t ever replace the information you get from your pediatrician, they can help you get educated and raise awareness about new vaccines and new recommendations.

More About Immunization Posters and Slogans

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Vaccinated vs. Unvaccinated Studies

Are unvaccinated kids healthier than those who get their vaccines, as some folks propose?

No.

As expected, they are just at more risk for vaccine-preventable diseases.

What about the folks who report that there are studies that prove that without a doubt that unvaccinated children are healthier than their peers?

They are talking about a 1992 survey, not a research study, from the Immunization Awareness Society, an anti-vaccine group who surveyed their own members.

On the other hand, a large study, “Vaccination Status and Health in Children and Adolescents Findings of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS),” which looked at “whether unvaccinated children and adolescents differ from those vaccinated in terms of health,” found that:

  1. …vaccinated children and unvaccinated children differed substantially only in terms of the lifetime prevalence of vaccine preventable diseases; as is to be expected the risk of such diseases is notably lower in vaccinated subjects.
  2. In the largest study in children and adolescents so far none of the often anticipated health differences—such as allergies and the number of infections—were observed in vaccinated and unvaccinated subjects aged 1–17 years.

So they didn’t find more cases of “obstructive bronchitis, pneumonia and otitis media, heart disease, anemia, epilepsy, and attention deficit hyperactivity disorder (ADHD” among the vaccinated kids.

The unvaccinated kids just had more measles, mumps, rubella, and pertussis.

For more information:

Natural Immunity

Is natural immunity – the kind of immunity you get from actually getting a disease – better than immunity from a vaccine?

All things being equal, sure.

Unfortunately, all things aren’t equal when it comes to the question of natural immunity vs ‘artificial’ immunity. Vaccines are safe and have few serious side effects, while vaccine-preventable diseases are life-threatening and can leave survivors with serious disabilities.

For most of us there is no question. Our kids are fully vaccinated and we are very glad that they have artificial immunity against measles, Hib, pneumococcal disease, and hepatitis B, etc.

And people shouldn’t get confused about natural immunity. It doesn’t mean that you just wake up one day have immunity against a disease one day naturally. You have to earn that immunity, by getting sick with the disease and hoping you don’t have any complications, some of which can be life-threatening.

For more information: