When we think about the history of the world within the past three centuries, it is difficult to forget about the many diseases that swept entire continents and killed large numbers.  Without previous contact to these diseases, individuals’ immune systems were unable to successfully fight off the invasion they caused within the body and hundreds of thousands quickly fell drastically ill.  It was not until the discovery of vaccinations that medical professionals were able to help build immunity towards these awful diseases and begin to decrease the overall infection rate.  Since their original invention, vaccinations have undergone numerous improvements and have greatly benefitted many nations.  Even today, vaccines continue to be a vital contribution.  Without them, populations would still be suffering from many deadly, communicable diseases and the overall community health would be considerably worse than any current situation seen today.

Despite the advances and medical benefits that vaccines have brought to modern society, there is an increasingly large number of individuals who are uncomfortable with and do not trust the vaccination process.  However, each time a parent decides to delay or completely exempt their child from their recommended vaccines, the size of the population that can still carry and circulate these harmful diseases increases.  In order to protect our children, those with an immunodeficiency, and our society as a whole, this denial cannot continue to occur.  It must be established that vaccines are a safe and reliable source to strengthen the immune system, that the minor side effects that do accompany vaccines in no way undermine the necessity of them and that the vaccination of the vast majority of a community serves as the greatest form of protection humans have against these harmful and deadly diseases. 

There is no question that vaccines have successfully eradicated many diseases, which is apparent when comparing morbidity rates prior to and after the wide-spread usage of a disease’s corresponding vaccination.  According to statistics published by the United States Center for Disease Control, five diseases have a greater than 99% eradication rate within the U.S. as well as a 100% eradication of polio and smallpox (Vaccinations Work!).  An in-depth look into a specific disease may better explain how these statistics are concluded.  The CDC reported that the morbidity rate of diphtheria was estimated to be 21,053 individuals per year prior to the introduction of the diphtheria vaccination.  The CDC’s most recent report of annual estimated cases was one individual in 2015, resulting in an eradication rate of 99.995% (Vaccinations Work!).  Diphtheria is just one of many diseases that can attest to the effectiveness that vaccinations have within the United States.

But how do vaccines actually work?  One cannot accurately make their own opinions on the debate that surrounds vaccinations without a full understanding of what a vaccine does once injected into the body.  The first successful vaccine was developed in 1796 by Edward Jenner, an English physician who noticed a relationship between exposure to cowpox and a lack of susceptibility to smallpox (Zielinski).  Though the methods for creating a vaccine have changed slightly since this time, the first vaccination worked the same as its modern counterparts.  Today, vaccines contain a weakened or deactivated form of the viruses they are creating immunity against.  Some also contain an adjuvant, which is a substance that increases the accuracy of the vaccine (Zielinski).  After the injection, the immune system immediately recognizes the vaccine as a foreign body and sends immune cells called macrophages to destroy the substances from the vaccines.  The macrophages are left with antigens, whose job it is to remember the foreign substance that entered the body, and transfer them to lymphocytes, which are a type of white blood cell located in the lymph nodes.  These lymphocytes induce a minor immune response which, in essence, teaches the immune system how to respond to any future substances of similar nature without allowing the body to become sick (Zielinski).

Without this knowledge, it is all too easy to become swayed by the mass of misinformation available regarding vaccines and the threats that they pose.  According to physicians Matthew Daley and Jason Glanz, 2010 and the beginning of 2011 saw much larger than normal outbreaks of diseases currently preventable by vaccination due to a higher rate of parents refusing to vaccinate their children.  They stated that, “This sad state of affairs exists because parents have been persistently and insidiously misled by the press and information on the internet and because the healthcare system has not effectively communicated the counterarguments” (Straight Talk About Vaccination).  Unfortunately, but understandably so, this has left many parents on the fence as to the best way to protect their children.  Because it cannot be expected that each parent completely understands the vaccination process or otherwise has the available time to effectively research it, there must be a considerable effort to make accurate information without difficult-to-decipher medical jargon easy to access for all parents.

There is no greater piece of evidence to prove this mass of misinformation than the case surrounding Andrew Wakefield and an article he published in the British journal, The Lancet, in 1998.  In this article, Wakefield proposed a relationship between the measles, mumps and rubella (MMR) vaccine and the rise in autism diagnoses.  Vivian Chou, a Harvard Medical student, credits the “immediate controversy” to the article and notes the usage of the article’s points by those already opposed to vaccinations (To Vaccinate or not to Vaccinate?).  Immediately after the article’s publication, scientists began to conduct their own studies to test a relationship between the MMR vaccine and the onset of autism.  Studies were conducted for years all around the world, yet none of them supported the claims originally made by Wakefield.  It was later found that Wakefield had falsified the studies he incorporated into his article and The Lancet quickly retracted the publication.  Andrew Wakefield was tried for misconduct and stripped of his medical license in the United Kingdom (Chou). Although there has been a rise in the number of children diagnosed with autism, this is largely accredited to the broadening of the definition of autism, allowing for more children to fall under the autistic realm (Chou).  Despite the tests that disprove Wakefield’s claim and the retraction of his article, it is still a commonly circulated belief that vaccines cause autism, giving misinformed parents all the more reason to refuse to vaccinate their children.

One of the next most common arguments against vaccinating a child is that children are no longer at risk for these diseases that seem outdated.  In order to back their argument with data, Daley and Glanz conducted a study on hundreds of thousands of children in Colorado to compare those who had and those who had not received their vaccines.  They found that children whose parents had delayed or completely denied vaccinations were between six and a half to twenty-three times more likely to contract a vaccine-preventable disease, depending on which disease was being looked at (Straight Talk About Vaccinations).  In other words, children who had not been vaccinated were at a much higher risk of contracting these diseases, which often led to hospitalizations, while some caused life-long ailments and even death.  During her TedTalk, Dr. Lindsey L. Diamond, compared a vaccine to a child’s car seat.  She stated that in the event of an accident, a child in a car seat is safer than a child without a car seat.  This is same for vaccinations; a vaccinated child is better protected in the event of an outbreak than an unvaccinated child (Vaccination: A Story of Risk and Community).  Even though the United States is doing its best to eliminate these diseases, an influx still occurs through international travelers carrying particular diseases and then spreading them through an unvaccinated community.  It only takes one diagnosed case for an epidemic to begin.

Further preventing many parents from feeling comfortable vaccinating their children are the ingredients used.  It is commonly advertised that two major ingredients used are harmful to the human body.  However, this is not the case.  Dr. Lindsay L. Diamond explained to her audience the usage of these two ingredients during her TedTalk.  The first ingredient, aluminum, is used as an adjuvant.  Dr. Diamond states that it is the most common element in the world and is found all around us, including within the food we eat.  She states that the amount of aluminum in a single vaccine is less than the amount present in a serving of breast milk.  Furthermore, she points out that the human body gets rid of aluminum within the body very easily (Vaccination: A Story of Risk and Community).  Dr. Diamond explains that the second questionable ingredient, thimerosal, was used to help preserve vaccines and does contain mercury.  She notes that no studies have proven the dosage of thimerosal used in vaccines to be harmful to the human body.  Even so, thimerosal was removed from all vaccines that contained it by the year 2000.  Most importantly, the majority of vaccines never contained the ingredient to begin with (Vaccination: A Story of Risk and Community).  The ingredients used in vaccinations are not harmful to children, but the misinformation portrayed through the media creates distrust among parents.

However, the debate regarding vaccines is not limited to the level of the individual.  Although, according to the CDC, vaccinations are the number one preventative measure for infectious diseases in individuals, they are also incredibly important in the overall health of any given community (Song 541).  This is the idea of herd immunity, which assistant professor Song defines as the phenomenon that occurs when “vaccinating a large percentage of the population protects even unvaccinated people from becoming infected, as the disease remains restricted within a small part of the community” (542).  For various reasons discussed later, certain members of each community are not able to receive vaccinations and are subjected to an elevated risk of contracting these infectious diseases.  However, when most of a population (around 95% according to Song) is vaccinated, the idea of herd immunity is able to occur (542).  Dr. Diamond explains that this severely limits the amount of the population the disease can spread through, as those who are vaccinated are protected.  Therefore, it is much more difficult for the disease to reach those who could not receive a vaccine (Vaccination: A Story of Risk and Community).  However, many communities do not reach the 95% vaccinated mark and therefore create larger populations that infectious diseases can travel through.  For the overall health of our nation, it is important that this unvaccinated 5% is saved for those who must be exempt.

There are currently three legal types of exemptions; medical, religious and philosophical.  Medical exemptions are only available to children whose bodies are unable to receive the vaccination.  According to The History of Vaccines.org, these reasons may include an immunodeficiency disorder, a serious allergy to an ingredient used in the vaccine or a previous, serious reaction to a vaccine (Vaccination Exemptions).  Because these are the most serious exemptions, these children strongly rely on the vaccination of others to protect them from vaccine-preventable diseases by decreasing the population size able to transmit diseaeses.  By withholding vaccines from a healthy child, both the healthy child and all unhealthy children are put at a greater risk.  Religious exemptions are available in all but two states and must be defended by the patient (Frequently Asked Questions about Vaccine Exemption).  The National Vaccine Information Center states that religious exemptions are an aspect of the freedom of religion.  Therefore, it is important that these exemptions are respected just as much as medical exemptions are.  Finally, parents are also able to exempt their children from vaccinations for philosophical reasons in some states, although the requirements do vary (Frequently Asked Questions about Vaccine Exemption).  However, this is the most commonly abused form of exemption, greatly leading to the large percentage of populations without vaccinations.

Overall, it is an increasing problem that less and less children are being vaccinated on time.  There are many things that need to occur in order for this to become less of a national problem.  First and foremost, the media must eliminate the mass of misinformation that is portrayed throughout the country.  When this information is spread and then supported by popular press outlets and celebrities, parents have no way of determining what information is accurate.  However, on that note, pediatricians need to start to inform parents to be hesitant to any information they hear regarding vaccines and should encourage them to research any claims before forming an opinion of their own.  Steve Calandrillo, author of Vanishing Vaccinations, proposed a couple of solutions to help increase the vaccination rate as well.  The process for obtaining a religious exemption from vaccinations need to revised.  The process needs to be strict in order to deter without a true religious background from applying for the exemption.  Calandrillo quoted a New York court that “separation of church and State does not mean that every State action remotely connected with religion must be outlawed” (430).  This is important, because while it is necessary for the government to respect each religion in the same way, the health of the nation cannot be put in jeopardy at the same time.  Although religious exemptions should still be kept, philosophical exemptions need to should no longer, under any circumstances, be allowed.  Calandrillo points out that these exemptions lead to parents declining their children’s vaccinations out of convenience and without a good purpose (432).  This again puts the health of the entire community at risk, especially since there is no documentation necessary to prove a philosophical dilemma (432).  Even though these exemptions are not legal in over half of the states, the nation cannot afford to allow those without medical or religious reason to abstain from vaccinations.  Exemptions cannot be completely done away with, but the principles outlining their regulations can be thoroughly revised.  An easily accessible educational program put in place to teach parents the accurate statistics and risks involved would also greatly benefit parents and relieve some of the stress of pediatricians.  Most importantly, if parents follow the recommendations provided by their general practitioner, their children are ensured to grow up healthy.

The importance of the proper use of vaccinations must begin to be recognized within the United States.  In order to protect entire communities, especially those with immunodeficiency disorders and severe allergies, newborns and the elderly and those with religious complications, it is imperative that the overall rate of vaccination increases to near 95% for each recommended vaccine.  Herd immunity is the only chance for some to live a healthy life.  Keeping perfectly healthy children from being vaccinated not only hurts them, but hurts those who cannot protect themselves as well.  The influx of misinformation must stop; the idea that vaccines cause autism cannot continue.  Parents must realize that these infectious diseases prevented by vaccines are still a risk to those without protection.  America needs to become comfortable with vaccinations before a serious outbreak occurs; because without vaccines, we would still be suffering from the measles, polio and a hoard of other diseases.
