To vaccinate or not to vaccinate? | Science| In-depth reporting on science and technology | DW | 24.02.2015
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Science

To vaccinate or not to vaccinate?

Measles are raging in Berlin right now. Politicians have even discussed making vaccination mandatory, because more and more parents refuse to vaccinate their children - and that's allegedly dangerous.

An 18-month-old boy died in the most recent measles outbreak in Berlin. Around 575 cases of the infectious disease have been reported in the German capital since October 2014. That's the largest outbreak there since 2001.

The current spread of measles is all the more disheartening because it probably could have been prevented. There's a vaccine that protects against the illness. Germany's Vaccination Committee recommends that every child receive a first immunization shot between the age of 11 months and 14 months and a second one between 15 and 23 months.

But a number of parents refuse to have their children vaccinated. They fear the consequences of the immunization more than the potential to contract measles. Their arguments against the vaccination, however, haven't gained much traction among medical professionals.

Anti-Vaccination argument 1: The vaccine causes autism

One of the greatest fears of measles-immunization opponents is that their child could contract autism. They believe that components in the combined MMR vaccine against measles, mumps and rubella trigger the neuro-developmental disorder. Among the well-known vaccination opponents in the US, where the movement has attracted quite a bit of attention, is model and TV show host Jenny McCarthy. She claims that her son's autism was caused by vaccination and has been very vocal in her distrust of immunization. In 2009, she told Time Magazine "If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the measles."

But this is not a choice parents have to make. Andrew Wakefield, the British doctor who made the claim that autism is directly related to the MMR vaccine, was struck off as a medical practitioner. That means he was banned from practicing medicine in the UK ever again. His paper in question, published in 1998, was refuted and has been shown to be based on manipulated data and fraudulent research. The assertion that the vaccine leads to autism "has been proved wrong," emphasized Jan Leidel, head of Germany's Vaccination Committee.

Anti-Vaccination argument 2: Children can get inflammation of the brain from the vaccine

Some parents who don't have their infants immunized point to side effects of the vaccine they want to avoid. Chief among them is encephalitis, an inflammation of the brain, which can cause permanent brain damage and - in the worst case - death. Anti-vaccination parents prefer their children to get immunized the natural way: by catching the disease from infected friends on purpose, for example. "I don't want to artificially intervene with my son's immune system while he's growing up," one vaccination opponent told DW. Better to let children go through a "children's disease" than injecting them with chemicals, these parents think.

But the risks of the actual disease are much higher than those of the vaccine. Only one person in one million develops a brain inflammation from the MMR immunization, but one in one thousand catches it as a side effect from the measles, so the risk is 1,000 times higher with the disease.

In Western countries, one person in 3,000 infected with measles will die. In developing nations, the numbers are far worse, mostly due to malnutrition. Pediatrician Dieter Knöbel especially warned against subacute sclerosing panencephalitis (SSPE), a measles complication that attacks the central nervous system. "As the disease progresses the infected children physically and mentally deteriorate. They can't speak, they are paralyzed and at the end, they just lie there and gasp for air. It is a wretched death."

"Some people believe that it will strengthen children's immune system if they go through the disease," Leidel said. "But there's no indication for that."

Anti-vaccination argument 3: If I don't want my child to be vaccinated, that's my call!

Another argument used by vaccination opponents is privacy - they say that whether or not they vaccinate their children is a personal decision. No one, not doctors, not vaccination committees, should intervene in an issue as important as their children's health. A mandatory vaccination like it was suggested by a US Senator or like the one that was discussed by German politicians after the death of the toddler is a no-go for vaccine opponents. They can't force anyone not to vaccinate, but in turn believe they want to be allowed to go through with their decision as well. They don't approve of many institutions' expectations to vaccinate, either. "There should be some vaccines that we can go 'Hmm, maybe not'", Jenny McCarthy said in a 2010 PBS documentary.

The problem with this logic: vaccination only works to prevent or even eradicate a disease when it's done with blanket coverage. If a significant number of children aren't vaccinated against measles, they're putting everyone else at risk to catch the disease as well. This is especially dangerous for newborns, because a child cannot receive the MMR vaccine before the age of nine months. The full protection only sets in after the second shot. So parents who voluntarily forego the immunization for their kids also put other children at risk who are still too young to be protected, or pregnant women, who cannot be vaccinated either. Those who cannot be immunized are only safe when 95 percent of the population around them is vaccinated against measles.

"It's a societal obligation for as many people as possible to get vaccinated," Charlotte, mother of a small daughter in Bonn, told DW. "This way, the youngest aren't at risk to catch measles."

Pediatrician Dr. Knöbl agrees. He strongly encourages all parents he sees in his practice to vaccinate their children, because he's seen so "many children suffering from measles and many from measles complications."

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