A physician's guide for anti-vaccine parents

In the limited time of an office visit, how can a primary care physician make the case to parents that their child should be vaccinated? During National Infant Immunization Week, a Mayo Clinic vaccine expert and a pediatrician offer suggestions for refuting three of the most common myths about child vaccine safety. Their article, The Clinician's Guide to the Anti-Vaccinationists' Galaxy, is published online this month in the journal Human Immunology.

"Thousands of children are at increased risk because of under-vaccination, and outbreaks of highly transmissible diseases have occurred" says lead author Gregory Poland, M.D., Mayo Clinic vaccinologist. "Primary care physicians have less time than most to explain the scientific case for vaccination. This article gives them the background and tools to debunk some of the major myths."

Dr. Poland and Mayo pediatrician Robert Jacobson, M.D., review the three immunity-related misconceptions that they say "fuel patient and parental concerns, questions and fears about vaccines." Those myths are:

Babies' systems aren't ready for the number of vaccines given today.
Vaccines can cause autoimmune diseases.
Natural immunity is safer and better.

The Mayo experts explain that the number of active molecules in infant vaccines is far lower than ever before, so while vaccines are not only safe, each child is receiving a fraction of actual antigen compared to children in the past. Among other evidence, they point to a recent review of 1,200 articles by the Institute of Medicine that failed to find any autoimmune side effect from vaccines. They make the point that there is either no impact or that any relation to autoimmune conditions is not causative. Finally, they make the case that while natural immunity does protect as well, the risk of illness and death is far higher than with a vaccine.

The article also includes background on the anti-vaccine movement and outlines the harm it has done by spreading inaccurate information.

"We want to offer a user-friendly guide for doctors, but also issue a call to action," Dr. Poland says. "We can now show that children have died because of under-vaccination and that diseases have spread needlessly because of this trend."

Dr. Poland says lack of vaccination has put many children at risk for diseases that are avoidable, including whooping cough and measles. He emphasized that the risk of death for measles is three in 1,000 without vaccination, while the risk of death from the measles vaccination is zero.

Dr. Poland is the chairman of a safety evaluation committee for investigational vaccine trials being conducted by Merck Research Laboratories. Dr. Poland offers consultative advice on new vaccine development to Merck & Co., Inc., Avianax, Theraclone Sciences (formally Spaltudaq Corporation), MedImmune LLC, Liquidia Technologies, Inc., Emergent BioSolutions, Novavax, Dynavax, EMD Serono, Inc., Novartis Vaccines and Therapeutics and PAXVAX, Inc. Dr. Jacobson is a member of a safety review committee for a post-licensure study funded by Merck & Co. concerning the safety of a human papillomavirus vaccine. He is a member of a data monitoring committee for an investigational vaccine trial funded by Merck & Co. He is principal investigator for two studies, including one funded by Novartis International for its licensed meningococcal conjugate vaccine and one funded by Pfizer, Inc. for its licensed pneumococcal conjugate vaccine.