Even in a time defined by amazing technological advances, the practice of medicine is arguably just as much an art as it is a science – a fact that irritates both patients and doctors. For a vast number of conditions, the solutions are often not simple answers. Perhaps the most significant exception to this is the success of vaccines.
Until recently, in Australia and other developed countries, diseases such as pertussis, rotavirus and measles – which claimed the lives of hundreds and thousands of infants in developing countries each year – had essentially disappeared. Both pertussis and measles are now back, mostly because of the ever increasing number of children who remain unvaccinated. Vaccines are perhaps the most power full public health tool. Unfortunately, there is a group (a minority, but a dangerous one) who just do not care.
Many of those do not approve of the vaccine schedule set out by the government, and wish to spread out shots over a longer period of time than is recommended. This has presented Australian doctors with a new challenge to their Hippocratic Oaths. Which is more harmful? delaying scheduled vaccines and reducing effectiveness, or refusing to delay and run the risk of parents simply not vaccinating their child at all?
It’s an awful choice to have to make, forced mostly by the idea (a verifiably false one) that if a child received ‘too many vaccines too soon’ it could prove too much for their tiny immune systems. A study published this month in the journal Paediatrics provides the most startling proof yet that a large majority of doctor’s agree to the delays. A staggering ninety-three per cent of those surveyed for study reported that they had been asked to delay at least once. Two thirds of those doctors admitted to delaying occasionally – even if most of them do not think it is right, and even though they were aware of the data that clearly proves the risks that delays put on patients and those around them.
No-one can argue that the number of vaccines has increased significantly. Just one hundred years ago, a child would receive just one vaccine: smallpox. By 1962, that number had increased to five (pertussis, tetanus, M.M.R, dipheria and polio). Today, it is recommended that children be vaccinated against 14 diseases by the age of 6, on a schedule that includes some twenty-nine shots, sometimes several at once. Vaccines scare parents, in part because of an old, now discredited theory that children who receive the measles vaccine develop autism at higher rates than other children (they don’t for the record, with dozens of studies carried out worldwide discrediting the theory).
That flimsy concern, pushed by activists such as Jenny McCarthy, evolved into a movement to spread out the timing of vaccines in order to ‘protect’ children from the possible overload to their immune system. But there is no such threat. Because developments in molecular biology has made it possible to create vaccines with fewer and fewer antigens, children’s immune systems are exposed to far less toxins then were the case a few decades ago. The smallpox vaccine for example, used to contain two hundred proteins, all separate molecules. Today, children all together receive fewer that a hundred and fifty molecules in their vaccines combined.
The number of bacteria that live on the face of every newborn is in the trillions. “Those bacteria have been 2000-6000 immunological components and consequently our body makes grams of antibody to combat these bacteria,” says Paul Offit, the chief of the infectious-disease division at the Children’s hospital of Philadelphia. “The number of immunological challenges contained in vaccines is not figuratively, it is literally a drop in the ocean of what you encounter every day.”
Paediatricians spend an average of twenty minutes with each patient – often far less – and there is a lot of ground to cover in that time. Finding the time for lengthy discussions over vaccines is not easy. Further, a recent study suggests that efforts to correct false perceptions about the dangers of vaccines actually makes people less likely to get vaccinated. It appears, for no logical reason, that simply knowing more does not do enough to convince people to get vaccinated.
The days when patients stood by passively and accepted what doctors tell them are long gone, and this is largely a good thing. We are far more capable of analysing information and deciding whats best for ourselves and our kids than ever before. And we certainly possess the energy to fear diseases (anyone who saw New York display hysteria over their ‘ebola epidemic’ which killed two people in a nation of three hundred and thirty million can see that).
But doctor’s widespread surrender on vaccines is deeply concerning. And it all but promises that preventable diseases will continue to put lives in danger. An internet connection does not make us all experts, and it doesn’t make it easier to tell the difference between good and bad data. That’s why trained medical professionals are even more important.
Unfortunately this is not a universally acknowledged fact – even by doctors