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Vaccines, Public Health and Mr Trump: Good Policy Prevents Outbreaks

In the last several years, there have been clusters of outbreaks of once eradicated diseases such as measles and, most recently, mumps. This year, we have seen nearly 4,000 cases of mumps—the worst in a decade and this was triple the number of cases reported in 2015.

There is a rising number of misinformed Americans who are refusing to vaccinate their children due to unfounded fears–A complete refusal to accept the overwhelming data in the current medical literature in support of vaccines.  While in the minority, these members of the “anti-vaxer” movement are putting large populations at risk for diseases with potentially fatal complications.

There are typically two reasons that outbreaks occur:  (1) Fading Immunity and (2) Collections of people who chose not to vaccinate.

Many of the recent mumps cases have occurred on college campuses. All universities have required vaccinations that include measles and mumps, but many grant vaccine exemptions to some students who request them. The majority of students must have two doses of a measles, mumps and rubella vaccine (MMR) and these vaccines are very effective. In the case of mumps, there are reports of “fading” immunity after decades and some officials at the CDC are considering a requirement for a third mumps booster to prolong immunity. This fading immunity may play a role in some of the mumps outbreaks. Measles outbreaks, by contrast, are almost entirely due to large populations or clusters of people who choose not to vaccinate.  In fact, until recently, it was assumed that measles had been effectively eradicated from the United States.  Now, as these populations emerge without vaccinations, the potential for devastating outbreaks continues to increase.

How Do Vaccines Work?

Vaccines are typically given by injection to children and teens on a schedule that is determined by the Centers for Disease Control (CDC). These vaccines often contain attenuated virus (live but inactive such as the measles vaccine) or killed virus (inactive virus such as the flu vaccine). Vaccines work by stimulating our immune systems to produce antibodies that protect us from specific diseases such as measles and mumps. For example, it is recommended that the MMR vaccine be given to infants at age 12 months and again at age 5 or 6 (in order to boost immunity).  When an immunized person is exposed to a particular pathogen–like measles virus–they have the antibodies in place and are able to avoid contracting the illness.

Vaccines ARE Safe–

There is a large body of data that supports the safety and efficacy of vaccinations.  Vaccines have significantly reduced infections that once were deadly—killing millions of infants, children and adults throughout the world. Measles was considered eradicated in the United States in the year 2000 but outbreaks have reappeared due to clusters of individuals who have chosen not to vaccinate. Unvaccinated travelers have gotten measles while abroad and infected large unvaccinated populations in the US. Vaccinations protect not only YOU but others—including the very young—who are more susceptible to the severe complications of these illnesses. The FDA regulates vaccines and evaluates every single vaccine prior to approving them for sale. The approval process requires rigorous randomized controlled clinical trials. Vaccines do have side effects—most are very mild—including soreness or redness of the injection site, low-grade fever and rash. Severe side effects are exquisitely rare.

In the 1998, there was a study published that suggested that vaccines were associated with autism. Following the publication of this study, it was found that the study’s author, Dr Andrew Wakefield had falsified the data and his findings were unsupported. The prestigious medical journal, The Lancet, that published his work ultimately retracted it and called it fraudulent. Other subsequent investigations found absolutely NO LINK between vaccines and autism. Unfortunately, the hype surrounding the false study conclusions continues and many misinformed parents continue to put their children at risk for potentially deadly disease—2 in every 1000 children who contract the measles will die.

The POLITICS of Vaccinations and How Trump Can Help Promote Public Health

President Elect Trump will have a powerful role to play in the vaccine debate. It is essential that the new President support mandatory vaccinations for ALL Americans. Some physicians and public health officials are concerned about the fact that Mr. Trump met with prominent anti-vaccination activists in the last month. In addition, Mr. Trump made comments earlier this year in a Republican debate where he mentioned his concerns over a potential link between vaccines and autism—an association that has no scientific basis and has been disproven multiple times. However, Mr. Trump stopped short of coming out against vaccines—he has made comments that he believes that there should be more study of vaccine practices and suggested that the number and timing of vaccines should be altered.  President Elect Trump has made and will make many more appointments in the days leading up to his inauguration. Those picks such as Tom Price to lead HHS, as well as the yet to be named head of the CDC, Surgeon General and head of the FDA have the potential to significantly impact how vaccines are recommended and regulated in the future. It is my hope that President Trump will listen to leaders in Science and Medicine and continue to mandate vaccines based on the overwhelming body of scientific data that supports their use. Hollywood activists (such as the outspoken Jenny McCarthy) who are not scientists and have absolutely no medical training have no role in making public health recommendations. We need a Surgeon General who will be a vocal advocate for vaccines and other public health issues. The FDA must continue to ensure that vaccines are safe and effective and should continue to monitor those vaccines once they reach the market. In addition, we must fund studies at academic institutions designed to improve our vaccination practices.

We MUST Continue to Vaccinate in Order To Prevent Disease

In my opinion, there is no reason that ANYONE should be granted an exemption for any reason other than a medical—no longer can we tolerate a religious or philosophical belief to be granted an exemption. Medical exemptions are rare and dictated by the CDC. If we allow widespread exemptions, we will continue to see outbreaks of measles and other PREVENTABLE diseases in the United States—and we will put innocent children at risk for severe disease related complications. The science is clear—there is absolutely NO association between vaccines and autism. President Trump must lead and in order to lead effectively he must choose his public health officials wisely. It is vital that we continue to mandate vaccines and that we continue to develop new and better ways to eradicate disease. If not, the days of devastating outbreaks are likely to return. We do not need to learn another harsh lesson at the expense of our children’s health.

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