Diagnosed: Vaccines - How Do They Work? Who Do They Help? Are They Safe?

Jun 25, 2019

Vaccine hesitancy is a growing phenomenon across the United States and in Utah in particular.  According to the Utah Department of Health, Utah ranks 41st among for the percentage of children who have received the complete set of recommended childhood vaccinations.

Vaccines work by tricking a body into thinking it has an infection.

“It’s a characterization of a replicate of a protein that, when it is injected in the body, the body says ‘Oh! Yup, I don’t like this thing here. Let’s build up some memory cells so if we ever see it again we can destroy it," said Rich Lakin, the immunization program manager at the Utah Department of Health.

 

To defend itself against this trick infection, the body’s immune system kicks into gear and produces special white blood cells called lymphocytes, which produce antibodies that attack the infection and unhealthy cells that are infected.  

When the infection is cleared away, the body retains a few lymphocytes as “memory cells” so if that infection is ever encountered again, the body will recognize it quickly and destroy it.   

For people with healthy immune systems, vaccines rarely cause any symptoms of the infections they mimic, though sometimes people have allergic reactions to some ingredients. 

Kristen Chevrier believes that vaccination should be a personal choice: “My position is that everybody deserves to have complete accurate information, and then deserves to have the chance to make up their mind based on that information.”

 

She is a vaccine-choice advocate, often referred to as a anti-vaxxer in popular media.

Chevrier chose to stop vaccinating her children completely early in their lives. Her oldest child was seven years old when she stopped vaccinating. Her fifth child has never had any vaccines.

I asked her:“Do you believe that all vaccines are dangerous, or are some safer than others?”

She responded: “I can’t really answer that question because none of the safety studies have actually been done.”

Lakin says that isn’t true.  

“When they develop new vaccines it goes through exploratory stage, and pre-clinical stage," he said. "Then it goes through clinical development, then it goes through a regulatory review and approval, then it goes through manufacturing then it goes through quality control.”

He describes the human trial phases of vaccine testing as very thorough.

“So the Food and Drug Administration are really the ones who look at the clinical trials to make sure that the safety is there. They kind of look at that in three phases.”

Each phase increases in size, until the third phase, when the largest group of volunteers is included.

“Phase three they’re going to have hundreds of thousands of volunteers. So what they’re doing is a study of people who get the vaccine and people who don’t get the vaccine. And the questions they’re going to ask is number one, is the vaccine safe? Number two, is the vaccine effective, and number three, what are the most common side effects? This is the way the FDA does everything.”

Once the vaccine is approved as safe by the FDA, the Advisory Committee on Immunization Practices, or the ACIP, decides if it should be added to the recommended vaccine schedule.

"This is a group of medical and public health experts. Then what we do is we continue to monitor, the FDA and CDC together,” Lakin said.

The CDC is the Center For Disease Control.

Chevrier does not trust these organizations to regulate vaccine safety.  On her website, she highlights an anti-vaccine film that accuses the CDC of falsifying data that proves the MMR vaccine does not cause autism. But there have been several large studies that indicate the MMR vaccine does not cause autism. The most recent study, published in the Annals of Internal Medicine in April of this year, included over 650,000 children in Denmark. In the conclusion of the study the authors wrote “The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination.”

However, in very rare cases, some people may have extremely severe reactions to vaccines.

This may have happened to one child in Utah name Colton Berrett.  13 days after receiving his third dose of a vaccine, Berrett developed Accute Transverse Myelytis, or ATM, a very rare and very severe condition that is caused by an adverse auto-immune reaction.

Chevrier met Berrett after the onset of his condition.

“His mom went in to try to wake him up because he hadn’t gotten up, and he was paralyzed. He couldn’t move," Chevrier said. "She got him to the hospital where they intubated him so he could breath because his lungs had become paralized. He spent quite a while in the hospital. I can’t remember exactly how long he was in the hospital, but a long long time in the hospital. Then he spent the next four years trying to be rehabilitated. And after four years of therapy, he killed himself.”

It is possible that stimulation of the immune system by vaccines could trigger a pre-existing condition that leads to ATM. One study from England found that 28% of patients under the age of 18 with ATM had received vaccines within 30 days of onset of the condition. But the study was small, only 47 cases, because ATM is so rare, especially in children.  

All vaccines have risks, just like any medicine.  The reason they continue to be used is because the risks of using the vaccine are greatly outweighed by the risks of contracting the disease that it prevents. Lakin says vaccines have been so successful that some people have forgotten how devastating vaccine-preventable diseases can be,

“You’re seeing this across the country, not just in Utah, and there’s a number of reasons, perhaps, why. One is that we don’t see the diseases anymore, like we used to. People used to line up for measles, mumps, rubella, diphtheria, tetanus, all these vaccines, because they were prominent in our society. Well public health is its own worst enemy. We’ve gotten rid of so many childhood diseases that we think they don’t exist anymore. However, I think this is a prime example of as you’re seeing vaccinations decrease, your seeing measles, mumps, pertussis all increase, and it’s a pretty darn close correlation.”

For more information about the advantages and risks of any particular vaccine, visit https://www.cdc.gov/vaccinesafety/vaccines/index.html.