Tag: risks

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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Six People Who Should Be Vaccinated

Even the staunchest anti-vaccine advocates, even if they want to believe that some vaccines are optional, must admit that there are some kids that really need to be vaccinated.

After all, there can’t be anyone so anti-vaccine that they wouldn’t allow their child to get the rabies vaccine after they were bitten by a rabid dog, right?

Optional Vaccines

Wait, some vaccines are optional?

“The main reason I feel that vaccines should be optional for parents is that every vaccine has the potential to cause a fatal reaction… And no government should be able to force parents into putting their child through something that puts that child at risk of dying. I think that’s just a fundamental right that every parent should have.”

Dr. Robert W. Sears on Why Partial Vaccinations May Be an Answer

Parents do sometimes ask about optional vaccines.

Which vaccines can they safely skip or delay?

That’s easy to answer.

Which disease do you want to risk your child getting?

Which disease, if more and more parents decided to make that vaccine optional, would you like to see come back?

“And if parents want to accept the disease risk because they don’t trust the vaccines, I think they have the right to make that choice.”

Dr. Robert W. Sears on Why Partial Vaccinations May Be an Answer

All vaccines are important and none are optional, despite what you might read on those so-called alternative immunization schedules that have been pushed by ‘vaccine friendly’ or disease friendly pediatricians for years.

Of course, parents do have the option of skipping one or more vaccines, even if the great majority of pediatricians advise against them doing so. That’s the fundamental flaw in Dr. Bob’s reasoning. The government, even with mandates to attend daycare and school, isn’t forcing parents to vaccinate their kids.

It’s not the only flaw though…

Essential Vaccine Situations

Do parents who delay or skip vaccines worry that their kids might get sick?

Some likely do, especially those who have been on the fence about vaccinating their kids.

For others, it is likely easier to be anti-vaccine when you think that you are hiding in the herd – you don’t get vaccinated and you don’t vaccinate your kids, and instead, you simply rely on the fact that everyone else around you is vaccinated to get protection from vaccine-preventable diseases.

That gamble doesn’t always work though.

“I think our Constitution guarantees parents the right to make health care decisions for their children, as long as they’re not putting their children’s life in danger. And by not vaccinating, you’re not putting your children’s life in immediate danger. Yes, you are taking some risk with diseases, but it’s not such a high risk where that should counteract or take away your freedoms as a parent to make your own health care decisions.”

Dr. Robert W. Sears on Why Partial Vaccinations May Be an Answer

So how high a risk are you taking by not vaccinating your kids?

It depends, but there are certainly special situations in which you would be putting your children’s life in more immediate danger if you didn’t get them vaccinated, including:

  1. a child bitten by a rabid dog, coyote, or bat – needs HBIG and a rabies vaccine series
  2. a completely unvaccinated teen who gets a deep puncture wound while playing in a field – needs TBIG and a tetanus vaccine (keep in mind that a child might still need a booster if they are up to date, but it has been more than five years since their last tetanus shot)
  3. an unvaccinated older teen living in a dorm on a college campus where there is an ongoing outbreak of meningococcemia – needs the meningococcal vaccine
  4. a preschooler with a cochlear implant – needs the pneumococcal vaccines because of an increased risk of pneumococcal meningitis
  5. an unvaccinated 1st grader who’s sibling is starting chemotherapy for leukemia – needs to get caught up on all age appropriate vaccines, including live vaccines
  6. unvaccinated kids traveling out of the country to parts of the world where vaccine-preventable diseases are still endemic – needs to get caught up on all age appropriate vaccines, but especially the MMR vaccine and likely needs more travel vaccines depending on the destination

What if a family member with chronic hepatitis B was going to be visiting or moving in with you? What if you had hepatitis B and you were having a baby? Would you get your baby vaccinated?

Polio Vaccine - don't wait until it's too late.
Who are you going to listen to?

Would you still skip or delay your child’s vaccines in any of these situations?

If you believe one or more anti-vaccine talking points or believe in any of the “experts” of the anti-vaccine movement, then you might.

Of course, none of the vaccines on the childhood immunization schedule are optional and delaying or skipping any of them increases your child’s risk of getting a vaccine-preventable disease.

The problem is that many vaccine hesitant parents greatly underestimate the risk of getting a disease and overestimate the risks of side effects from the vaccines.

And often, the immediate danger isn’t so obvious.

So instead of a dog who is obviously rabid, foaming at the mouth, what if your child was scratched by a stray cat that had never been vaccinated against rabies, or:

  • instead of a deep puncture wound, what if he just gets pricked by a thorn and gets tetanus?
  • instead of a possible exposure in an ongoing outbreak, what if your child is exposed before the outbreak of meningococcemia is widely known to be happening?
  • your unvaccinated child gets chicken pox and exposes a classmate who is immunosuppressed because they are being treated with chemotherapy?
  • your unvaccinated child gets measles after being exposed to an unvaccinated friend who had recently traveled to Europe, where there are many ongoing outbreaks?

The bottom line is that you can wait too long to get your child vaccinated and you may end up regretting your decision to skip or delay those vaccines. Partial vaccinations aren’t the answer.

The answer is to get educated about vaccines and to understand that vaccines are safe and necessary and that vaccines work.

What To Know About Kids Who Should Be Vaccinated

Whether you are anti-vaccine, on the fence, or a vaccine advocate, you should understand that there are some high risk situations in which kids can be in immediate danger if they weren’t vaccinated. And many other situations in which you may regret skipping or delaying your child’s vaccines.

More About Kids Who Should Be Vaccinated

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.

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