Childhood Vaccinations and Health Risks. Sarah Mullins. Research in Allied Health

Transcription

1 Running Head: Childhood Vaccinations and Health Risks 1 Childhood Vaccinations and Health Risks Sarah Mullins Research in Allied Health November 30, 2011

2 Running Head: Childhood Vaccinations and Health Risks 2 Abstract Childhood vaccinations are a very common part of the world, and some parents may feel that they are expected to get them without question. However, there have recently been questions asked about the safety and reliability of the vaccinations. This study is intended to elaborate on the risks and side effects that the required immunizations may present while also evaluating the knowledge that parents and future parents have about the subject matter. By discussing the risks and side effects such as developmental disorders in children, there should be a better understanding by everyone on whether the immunizations should continue to be administered.

3 Running Head: Childhood Vaccinations and Health Risks 3 List of Tables Appendix A Knowledge of Information Survey Page 15

4 Running Head: Childhood Vaccinations and Health Risks 4 Chapter 1: Introduction Background For the most part, childhood vaccinations are very well known and almost expected when a baby is born. There is a certain vaccination schedule that is to be followed and it becomes routine for a new parent. However, many questions have been brought up about the vaccines and they are rumored to be linked to harmful side effects. The question parents have to ask themselves would be is it safer to not have children vaccinated and risk the diseases, or get the vaccination and risk the side effects? This is the decision parents seem to be struggling with, because all they want to do is protect their children from all harm. Many people do not even question the idea of getting their children vaccinated. The thought that vaccines could be potentially harmful sparked the attention of adults everywhere, and questions began being asked. Extensive studies have been performed, but a definite answer has not been given about the effects of vaccines. Many parents choose to get their children vaccinated because solid evidence has not been shown that it they are linked to anything seriously harmful. However, some studies have shown that vaccinations could damage children in several ways by producing the infection that the vaccine is supposed to prevent (2009). One of the most important theories of vaccine damage would be when a child gets an allergic reaction to

5 Running Head: Childhood Vaccinations and Health Risks 5 the vaccine and an auto-immune response is triggered. Vaccines contain adjuvants which are substances that amplify the response to the vaccine, and are sometimes linked to allergic and auto-immune reactions (2009). Autism is said to be linked to the MMR vaccination, and a study showed that documented causes of autism include genetic mutations and/or deletions, viral infections, and encephalitis following vaccination. Therefore autism is the result of genetic defects and/or inflammation of the brain (Ratajczak). There are many theories being discussed about the possible link of vaccinations to autism and other damaging problems, and parents will forever wonder if they should or should not have vaccinated their children. Purpose The purpose of this study is to examine the effects of vaccinations and to see if there is significant evidence linking them to autism and other disorders, weigh the options of vaccinated or not vaccinating, and discuss the pros and cons of each option. Significance The study of the effects of childhood vaccinations and whether they are linked to disorders that last a lifetime will inform others about the risk factors in getting children vaccinated. Studies have shown that there is evidence stating vaccinations can cause harm to children, but other studies show that vaccines are helpful and necessary for a healthy life.

6 Running Head: Childhood Vaccinations and Health Risks 6 Research Question The main focus is deciding what would be more beneficial, getting children vaccinated or not getting them vaccinated. Information should be given about the risks and side effects of each option so that everyone will be informed and be able to make a rational decision. Through this research, a few questions will be answered: 1. What the benefits are of getting all the childhood vaccinations. 2. What the risks are of getting all the childhood vaccinations. 3. What the vaccines are said to be linked to, such as autism. Assumptions 1. Parents want what is best for their children and will do what they think is best at the time. 2. Some parents are not well informed by their health care provider about the risks involved, or do not fully understand. 3. Some religious or cultural beliefs play a role in the decision to get vaccinated or not. Limitations 1. The study cannot be tested on each case of autism or other disorder in the world, so all cases linked to vaccines might not be known.

7 Running Head: Childhood Vaccinations and Health Risks 7 Chapter 2 Literature Review Calandrillo (2005) stated that vaccinations are one of the ultimate public health achievements in history due to the fact that they prevent life-threatening diseases. Millions of premature deaths were prevented and numerous children were saved from debilitating diseases. Even though most Americans have never experienced the diseases that vaccinations guard against, antivaccination opinions are growing rapidly. Calandrillo also found that most of the ideas about antivaccination are due largely to the controversial link of immunizations and autism. Parents research online and see hundreds of websites talking about the lack of safety in vaccinations, and many are refusing the vaccines despite the risk of doing so. Nearly all states allow exemptions for vaccinations due to religious and sometimes philosophical reasons. Calandrillo also stated that in some areas only 1 in 5 children have received all required vaccinations. Calandrillo pointed out that while vaccines are relatively safe, all of them carry a risk of adverse reactions but most are minimal while some are serious (Calandrillo, 2005). Omer, Salmon, Orenstein, dehart, and Halsey (2009) found that vaccines are the most common way to prevent diseases and the complications that they can present. They also stated that high numbers in immunizations have resulted in drastic declines in diseases that are vaccinepreventable. Concerns of the public for adverse effects due to vaccines have increased tremendously, which results in an increased amount of people refusing the vaccinations. Omer et al. found that there is no scientific evidence supporting the theory of autism and vaccinations being linked, but some parents still choose to believe it and refuse or delay immunizations. Delay

8 Running Head: Childhood Vaccinations and Health Risks 8 of vaccinations is another choice that some parents make, according to Omer et al., and the delay could be harmful to the health of the child. Another path that some parents choose to take is following the vaccination schedule made by individual doctors, not the routine vaccination schedule, the authors found. Most of the alternate schedules involve the vaccinations being given or a longer period of time than what is recommended by the AAP, or some of the vaccines might be skipped all together, stated the authors (Omer et al., 2009). Luman, Barker, Shaw, McCauley, Buehler and Pickering (2011) found that only 18% of children in the United States at the appropriate age receive all vaccinations at the recommended times. Vaccination doses routinely recommended in early childhood by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians include 4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine; 3 doses of poliovirus vaccine; 1 dose MMR; 3 or 4 doses of Haemophilus influenzae type b vaccine; 3 doses of hepatitis B vaccine; and 1 dose of varicella vaccine, states Luman et al., (2011). More than one in three children are undervaccinated for more than six months during the first two years of life. Luman et al., also found that one in four children were delayed for at least four vaccines (Luman et al., 2011). Cox (2011) writes about a nationwide survey which found that more than one in ten parents vaccinated their children outside of the recommended vaccination schedule. Many parents that were a part of the study showed that they did not trust the official schedule, and they chose to go with an alternate schedule. Cox also found that Dr. Paul Offit, who was a part of the survey, stated that vaccines are safe and that delaying vaccines does not protect a child against rare side effects. Cox stated that researchers asked 748 families with children with ages ranging from six months to six years about vaccine choices, education, income, and demographics. The

9 Running Head: Childhood Vaccinations and Health Risks 9 result of the poll concluded that the most commonly skipped vaccines were the flu and varicella, also known as chicken pox, shot. MMR (mumps, measles, and rubella) vaccine was the most commonly delayed vaccine, instead of being skipped all together, Cox found. The MMR vaccine is what is said to be linked to autism, so parents sometimes choose to delay the vaccine until the child is two to four, when the signs of autism begin to become apparent (Cox, 2011). DeStefano (2007) stated that autism is a serious, life-long developmental disorder that is characterized by obvious impairments in social interactions, common skills, and repetitive or stereotyped behaviors. There are many causes of autism but in only a few select cases the cause has been identified for certain, and it is usually not detected until later in life. In a very small amount of cases, children can seem to be developing normally and then they can begin to regress and eventually develop characteristics that are linked to autism, according to DeStefano. DeStefano pointed out that theoretically, the cases of regression are what biologically link autism to vaccines, and therefore is why parents believe that the vaccinations cause autism. Concern began in the 1998 publication of The Lancet which told about twelve children with inflammatory bowel conditions and regressive developmental disorders, mostly being autism, which was discussed by DeStefano. The author went along to discuss the study further and stated that in eight out of the twelve cases, the parents believed that MMR vaccine contributed to the behavioral problems that developed after the vaccine was given (DeStefano, 2007). DeStefano went on to say that one key piece of evidence in support of the MMR vaccine and autism being linked was the identification of measles virus nucleic acid sequences that were found in the blood cells of some children that were affected. Independent investigators have been unable to find evidence of a regression in autistic children that have been vaccinated with MMR, DeStefano found. The author also stated that Thimerosal, a preservative found in vaccines since

10 Running Head: Childhood Vaccinations and Health Risks 10 the 1930s, is 49.6% mercury by weight and as more vaccines became necessary, exposure to mercury began to be more abundant. DeStafano pointed out that concerns about the possibility of Thimerosal causing autism began to rise but there was no direct evidence proving the concerns to be true. The only studies that show an association between preservatives in vaccinations and autism have been conducted by the same group of researchers and have many flaws that label them inaccurate (DeStefano, 2007). Dales, Hammer and Smith (2011) stated that a medical investigative group from Great Britain speculated that measles, mumps, and rubella vaccines that were given together at the same time might be linked to autism. Autism is a developmental disorder that has never been completely understood that varies from case to case so diagnosis is not always clear. According to Dales et al., associations between MMR vaccines and the onset of autism can occur by chance, since MMR vaccinations are typically given during the age of twelve and fifteen months. Autism can first be detected by underdevelopment by 18 and 19 months of age (Dales et al., 2011). MacIntyre and Leask (2003) explained that the onset of autism linked to MMR vaccines may appear associated over time because the average age that parents reported concerns child development and autism is 18 to 19 months and around 90% of children receive MMR shots before they reach the age of two. MacIntyre and Leask conducted a study that was designed to follow children for fourteen years to see if there was a direct correlation between MMR vaccine and autism, but not a single positive association was documented. They went on to say that no evidence of vaccines containing very low doses of mercury is toxic to the body. The very small amount of mercury is turned into ethylmercury and is broken down and excreted by the body before harm can be done (MacIntyre & Leask, 2003).

11 Running Head: Childhood Vaccinations and Health Risks 11 Chapter 3: Research Method Research Design The study is intended to collect information about childhood vaccinations and the hypothesized link to autism and health risks, and assess whether parents prefer to vaccinate or not vaccinate their children. The researcher will present written questionnaires to women in pediatrician offices that have small children, as well as to women in OBGYN offices who are pregnant. The written questionnaire will address the subject of vaccinations, and whether they chose or will choose to vaccinate their children, along with opinions and how informed they might be about health risks and vaccines being linked to autism. The surveys will be anonymous and the women will be expected to answer honestly and return the questionnaires back before they leave the office. Research Questions The questionnaires will contain both open-ended and closed-ended questions. Questions will be asked regarding whether the benefits of receiving all of the immunizations are known. Also, questions about whether knowledge of the risks of receiving all of the immunizations are made aware. Questions will be asked about the link of vaccinations to disorders such as autism to see how extensive the knowledge of the subject is. There will also be questions about whether they have already chosen or will choose to vaccinate their children.

12 Running Head: Childhood Vaccinations and Health Risks 12 Participants All OBGYN and Pediatric offices in Johnson City that choose to be a part of the study will be participating. The written questionnaire will be handed out in waiting rooms to women that are expecting, along with women who already have children. There will be no age limit but the women will be asked to supply their name on the questionnaire, but their name will not be required. The only requirements will be that the women already have children or are pregnant, and they must answer and return the questionnaire before they leave. Data Collection Methods The questionnaires will be collected by the researcher before the women leave the office. The goal of the questionnaire is to get a general knowledge of how many parents choose to vaccinate or not vaccinate their children in the Johnson City area, and how informed they are about the issue as a whole. The information that will be collected from the questionnaire will give a better understanding of whether the majority of mothers choose to vaccinate their children, or whether they choose to skip or delay any vaccinations. It will also help to understand which areas of vaccination education for parents needs the most improvement.

13 Running Head: Childhood Vaccinations and Health Risks 13 Data Analysis After the questionnaires are completed and returned, the results will be analyzed. The answers will be broken down and categorized using a priori coding method. Word coding will be used and the answers will be broken down by their similarities through wording. Different correlation patterns include: Women who chose to vaccinate their children. Women who did not vaccinate, or chose to delay or skip vaccines. Correlation between areas that knowledge is not substantial about the subject or is widely researched.

14 Running Head: Childhood Vaccinations and Health Risks 14 References Calandrillo, S. (2005). Vanishing Vaccinations: Why Are So Many Americans Opting Out of Vaccinating Their Children?. American Law and Economics Association Annual Meetings, 24, Cox, L. (2011). More parents think it's safer to delay vaccines - Health - Children's health - msnbc.com. msnbc.com - Breaking news, science and tech news, world news, US news, local news. Retrieved October 21, 2011, from Dales, L., Hammer, S., & Smith, N. (2011). Time Trends in Autism and in MMR Immunization Coverage in California. The Journal of the American Medical Association, 306, DeStefano, F. (2007). Vaccines and Autism: Evidence Does Not Support a Causal Association. NCBI, 82(6), Luman, E., Lawrence, B., Shaw, K., McCauley, M., Buehler, J., & Pickering, L. (2011). Timeliness of Childhood Vaccinations in the United States. Journal of the American Medical Association, 306(20), MacIntyre, C., & Leask, J. (2008). Immunization Myths and Realities: Responding to Arguments Against Immunization. Journal of Paediatrics and Child Health, 4, Omer, S., Salmon, D., Orenstein, W., dehart, P., & Halsey, N. (2009). Vaccine Refusal, Mandatory Immunization and the Risks of Vaccine-Preventable Diseases. The New England Journal of Medicine, 14, 360.

15 Running Head: Childhood Vaccinations and Health Risks 15 Appendices Appendix A: Do you have children and/or are you expecting? Yes/No Did you vaccinate your children? Yes/No Do you plan on vaccinating your children if you are expecting? Yes/No Did you/will you follow the recommended vaccination schedule? If not, why? Yes/No Why? Are you aware of any risks associated with vaccines? Yes/No What risks have you been told about? Are you concerned about the possible link between autism and vaccinations? Yes/No Are you aware of the option to delay vaccines? Yes/No Do you feel your physician could better inform you about vaccines? Yes/No What concerns do you have about vaccinations for your children?

16 Running Head: Childhood Vaccinations and Health Risks 16 Did you choose to delay or skip any vaccines? If so, which one(s) and why? Yes/No Explain: