These days in America, the vast majority of people assume a child will have his or her first immunizations before the age of two. But contrary to this belief, there are people who don’t believe in childhood vaccinations for their child out of safety concerns regarding the vaccine itself. Winners and losers in this debate? Well, that depends on which side you are on, the people who vaccinate and get vaccinated or those who choose not to inoculate their children or themselves.

Vaccines, vaccinations and immunizations – what are they?

A vaccine produces immunity from disease and is usually administered by mouth, injection or aerosol. There are three ways vaccines are created, but the result is the same -- a weakening, or “attenuation,” of the pathogen so it may be used in a vaccine.

A vaccination is the injection of a weakened or killed pathogen that produces immunity against the organism. An immunization is the process by which a person becomes protected from a disease. Vaccines cause immunization. Also, some diseases, like measles or chicken pox, cause immunization after a bout of the illness.

According to the U.S. Centers for Disease Control (CDC), vaccines have led to a 95 percent drop in vaccine-preventable deaths. The CDC considers vaccines one of the top 10 greatest achievements of the 20^th century. It is estimated that vaccinations prevented 322 million illnesses, 21 million hospital visits and 732,000 deaths in the past 20 years. And that translates to about $295 billion saved in direct costs, like hospital admittances and $1.3 trillion in societal costs.

But there are still barriers to vaccinations.  "Lack of immunization due to low socioeconomic status, lack of access to health care — those still all pose real challenges," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "But you can fix the problem," Osterholm says, with better access.


Why vaccinate?

Immunizations can save a child’s life, especially from early childhood diseases as mumps, measles and German measles. Vaccines are safe and effective. They have been vetted by physicians, researchers and health care professionals. Serious side effects are rare. By getting inoculated, you not only safeguard yourself, but you also help keep safe and healthy those who are too young or frail to get the vaccine. You won’t be a carrier with the potential to spread a contagious disease. You also can save time and money by getting immunized. Many of these pathogens will keep you at home for a few days because of the contagious nature of the disease and severity of symptoms. Moreover, vaccines have greatly decreased incidences of deadly and disabling diseases like smallpox, which has been virtually eradicated.

Then there are parents and guardians who will not immunize their child for fear of vaccine safety. Many believe vaccines cause diseases and are more problematic than health officials would have us believe.

The “Anti-vaxxers'” History and Reasons Not to Vaccinate

The term “anti-vaxxers” relates to those adults who choose not to have their children immunized for various reasons, including what they believe is an increase in the risk of autism. This belief grew out of a 1998 study, published in the Lancet, the British medical journal, by gastroenterologist Andrew Wakefield. He sounded the alarm about vaccine concerns such as genetically modified pathogens, heavy metals and other chemicals in the vaccine’s composition.

Some of the claims Wakefield made include:

• Vaccinated people are “immunocompromised,” which means that they are the ones who get the very disease against which one is immunized.
• Vaccines contain deadly additives such as aluminum, mercury, formaldehyde, MSG, antibiotics or genetically modified organisms.
  

• Vaccinations are complete failures; they don’t prevent the diseases they are purported to but continue in use because they mean big profits for the drug companies.
• Unvaccinated kids are healthier with fewer incidences of allergies, autism, behavioral problems, autoimmune dysfunction and respiratory problems.

In 2010, Lancet retracted the study, and Wakefield lost his medical license because he didn’t disclose his consultant role to lawyers for anti-vaxxers.

This anti-vaxxer sentiment has persuaded groups of people, and it shows in the rate of vaccinations of school-aged children in different states. Rhode Island had the highest 2013 immunization rate at 82 percent. Arkansas had the lowest at 57 percent. This, believe experts, is an outbreak waiting to happen.

"The bottom line is that vaccine refusers tend to cluster geographically," said Saad Omer, an epidemiologist and professor at Emory University who studies immunizations. "And what that does is it provides that critical mass of susceptible individuals that can trigger an outbreak."  About 50,000  people die of vaccine-preventable diseases a year in this country.

There are people in some communities who think that people against vaccines should be open to lawsuits for damages by a party who contracted the disease, or that criminal charges could be considered. One health care professional has said that the government’s interest in protecting children and society from these diseases should override the parent’s interest in making medical decisions for their child.

The Truth About Vaccines

Vaccines primarily are composed of suspending fluids, stabilizers and preservatives. The fluids typically include sterilized water or saline solution. Stabilizers protect the vaccine from adverse conditions such as high temperatures. They are usually sugars such as sucrose and lactose, the amino acid glycine and MSG, an amino acid salt that naturally occurs in the body. Preservatives used include phenol, a disinfectant. Another chemical related to phenol is used in vaccines and also cosmetics. Anti-vaccine believers say these mixtures cause much of the problems in vaccines. Not true, say experts.  


“There’s absolutely no linkage between cause and effect," Catherine Troisi, an infectious disease epidemiologist at the University of Texas Health Science Center, said. "If I received the flu vaccine yesterday and got hit by a bus today, I could enter that into [the CDC reporting system].  But I doubt anyone would say the vaccine caused the accident…it does not pretend to prove that the conditions entered are related to vaccination."

Thimerosal is a chemical mentioned by anti-vaxxers that allegedly causes autism. But thimerosal hasn’t been used as a preservative in vaccines since 2001 because of mercury concerns. Those opposed to immunizations say that vaccines are still dangerous and can cause unnecessary deaths and disabilities. Those who support widespread use of vaccinations advise looking at the number of deaths and illnesses prevented by widespread immunizations. The numbers speak for themselves.

If you have doubts or health conditions that may make vaccinations problematic for you, discuss these concerns with your health care provider.