If you're a parent, you've no doubt heard multiple urban myths from other parents regarding the supposed dangers of routine childhood vaccinations. This week's Journal of the American Medical Association puts one urban myth to rest in a study of fevers and epilepsy relative to vaccinations in children. Yay! I say in this week's YouTube, and Rick and I concur in the podcast. Let's add this along with the withdrawal of the original study purporting to establish a link between thimerosol, a vaccine preservative, and autism in kids, and make sure that ALL children receive routine immunizations.
The study followed almost 400,000 Danish children born between January 1, 2003 and December 31, 2008, who were followed up until December 31, 2009. All children received a vaccine containing combined diphtheria-tetanus toxoids-acellular pertussis–inactivated poliovirus– Haemophilus influenzaetype b (DTaP-IPV-Hib). The pertussis component, which was previously associated with the development of fevers in children, now does not contain whole cells and is less likely to provoke such a reaction.
Almost 8000 febrile seizures were recorded in this cohort in children 18 months of age or younger. You've got to love those Danes and their data gathering! Of these, 17 seizures occurred in children within 0-7 days of their first vaccination, 32 children after the second, and 201 after the third. When compared to a reference group of children who were not within a week of immunization, there was no increased overall risk for febrile seizures. What about a longer term look at the risk of developing epilepsy? For this select group once again, there was no relationship between vaccination, febrile seizures, or the ultimate development of epilepsy. So parents, the message is clear: there's just no good reason for NOT having your child vaccinated.
What's the risk to your child of not being vaccinated? Episodes of the podcast in the last couple of years have described outbreaks of pertussis or whooping cough, largely in California, and deaths among children, an outbreak of measles in the Midwest secondary to an unvaccinated high school student who so graciously brought the infection back from a European sojourn, and meningitis outbreaks resulting in death. These risks are documented and real, rather than the unsubstantiated fears many parents cite as the reason they decline immunizations for their children. Such children also pose a risk for other children, since they convey infections. And finally, while I'm on my rant, unimmunized kids who develop one of these preventable infections can infect adults whose immune systems are compromised, or older people, who experience declining immunity with age. In these folks both serious infection and death are more likely, and all because of irrational and irresponsible parents. In most school systems nationally, immunization is compulsory, and it should be. Routine vaccinations are a public health success story. Rant over. But BTW, for those of you unfazed by strong language, Penn and Teller make a very persuasive argument in favor of vaccination, also on YouTube.
Other topics this week on PodMed include two from NEJM looking at the value of polyp removal in preventing colon cancer death, and two types of screening for the same, and factors related to heart attack deaths in JAMA. Until next week, y'all live well.