Vaccination a victim of its own success

Comeback ... measles is making a reappearance in some areas of Australia.


In a piece in Life&Style last month, Vaccination's vexed link to autism, freelance journalist Marj Lefroy once again resurrected the 'controversy' regarding autism and vaccines.

To me, a busy GP with a big paediatric practice in the inner-west of Sydney, servicing a largely middle-class and well-educated patient base, there doesn't seem to be much controversy at all. The vast majority of my patients are happy to follow the recommended immunisation schedule; perhaps one in 100 isn't.

I'm also better qualified to write on this subject than most doctors because I have a 10-year-old son with autism.

Ms Lefroy says that we still don't know 'what exactly causes autism'. This is true only to a point. Autism is strongly genetic in origin; a recent study found that if you have one child with an autism spectrum disorder (ASD) you have an 18 per cent chance of having another, a much higher figure than previously thought.  Researchers have also identified a number of risk factors: older mothers, older fathers, birth complications, low-birth weight babies and twins, all factors that point to ASDs developing in utero, even though symptoms may not become apparent until many months after birth.

And yes, scientists are looking closely at environmental contributors such as pesticides and infections in pregnant mothers. Vaccines are only one environmental factor under investigation but are by far the best studied. When, several years ago, concerns were first raised that childhood vaccinations may be linked to autism the mainstream medical community took these worries seriously and conducted study after study around the world: these were consistent in their outcomes: no link, no link, no link, no link.

When deciding whether to vaccinate their children or not parents have to weigh up the risks (of side effects) and benefits (prevention of disease). Unfortunately, vaccines have become a victim of their own success and younger parents are unable to remember the days when infectious diseases such as polio terrorised communities.

That's tipped the balance, leading some parents to worry (sometimes excessively) about side effects.

If one parent, or two or even three elects not to vaccinate their kids that's fine; their children are still protected because there's not enough unvaccinated individuals in their community for an infectious disease to take hold.  If, however, vaccination rates drop below a certain level, as has happened in some areas, such as after the autism scares, then it becomes a real problem and illnesses we thought we'd eradicated can make a comeback.

That's happening right now.

Over the last 12-18 months or so, I have personally diagnosed and confirmed by throat swabs 30 or so cases of whooping cough, mostly in children. This is not unusual or exceptional; GPs all around Australia are doing the same. In the last few years, we have been in a large upswing of whooping cough case diagnoses, numbering in the tens of thousands. In fact, in other areas, particularly the eastern suburbs of Sydney and the far north coast of NSW, where immunisation rates have dropped to alarming levels due to vaccination scares, the rates of diagnosis of whooping cough are far higher than where I work. As of a few years ago, I had never seen a case of whooping cough (despite having working as a doctor in Australia for twenty-one years).

Also, just last week, I received yet another notification from the Public Health Unit of measles cases being diagnosed in the south west areas of Sydney and the Southern Highlands. This is real, this is dangerous, and yes, this is scary.

Why? Whooping cough in an infant is terrifying, a medical emergency. They can damage their lungs permanently, get brain damage from lack of oxygen to their brain, and they can die. In all, five Australian babies have died from whooping cough since 2008. Imagine being the parent of one of these children.

As for measles, well, don't get me started. Measles is just plain bad. One in 20 children who get measles get pneumonia as a complication. For every 1000 cases of measles, one to two children will die. Yes, die.

So, where do we go from here? Do you vaccinate your child? Well, of course, the choice is yours.  If it were me, (and remember, if I had another child he or she would have a higher chance of having autism) it would be a no-brainer—vaccinate away.

Dr James Best is a GP and the father of three boys, one of whom has autism. All three of his sons have been completely vaccinated. This is an edited extract from his full article which you can read at Life & Style.