Mission

The Health Equity Blog’s mission is to contribute to the discussion of health policy using evidence and research, to explore the opportunities for health equity through policy change, to raise awareness about health disparities, and to increase public advocacy for health equality.

According to the CDC, “Health equity is achieved when every person has the opportunity to ‘attain his or her full health potential’ and no one is ‘disadvantaged from achieving this potential because of social position or other socially determined circumstances.’”

Achievement of full health potential is necessary in all aspects of life – from running errands to relationships with loved ones. Some people are born into environments that limit their ability to achieve their full health potential. We believe that because society created many health inequalities, society can also fix them.

Tuesday, March 18, 2014

Should You Vaccinate Your Children? YES

In the last few years, there has been a surge in the number of people who believe that vaccinations cause autism.  Thanks to a few celebrities, this belief continues to spread.  The celebrity most associated with this belief is Jenny McCarthy, but the most recent to espouse it is Kristin Cavallari.  So, are they right?  No, let’s look at the arguments and address them one by one.

1.) Studies show that vaccines cause autism - FALSE
The article that started this myth, “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children” by Andrew Wakefield, was originally published in The Lancet in 1998.  Not only has no-one been able to reproduce the results of that study (which by the way only had 12 participants), but investigations into Wakefield found that “he had been paid by a law firm that intended to sue vaccine manufacturers” - a serious conflict of interest.  Over the years, not only has the Lancet retracted the article (which you can see by clicking the link), but Wakefield has been found guilty of unethical behavior by the General Medical Board in Great Britain and has since been barred from practicing medicine in the UK.
You can even check out a small list of some of the studies that have shown no relationship between vaccines and autism here or here.  Finally, there have been studies on the cause of autism that point toward environmental pollution, not vaccinations.  Multiple studies have shown a strong association between children exposed to high levels of air pollution in the wob and autism.  

2.) As the number of vaccines has increased, the incidence of autism has increased - TRUE-ISH
    Yes, the number of vaccinations that we give our children has increased over time, especially in the last 70 years.  It is also true that the number of children diagnosed with autism has increased over the years; however, the CDC has only tracked autism diagnoses since 2000 which leaves more than 50 years of increased vaccinations without data to connect to.Photo: Prevalence of ASDs with 8 Year olds
Moreover, “Mark Roithmayr, president of the advocacy group Autism Speaks, says more children are being diagnosed with autism because of better diagnosis, broader diagnosis, better awareness, and roughly 50% of 'We don't know’.”  Even experts understand that at least some of the increase in diagnosed cases is not from an increases in cases but in better recognition of cases.
    It is also important to note that just because there is a correlation between two events - increased number of vaccinations and increased incidence of autism - does not mean that there is a causal link between the two.  As cases of autism have increased, sales of organic foods have increased, but no one is arguing that organic food causes autism.


On correlation, causation, and the "real" cause of autism
3.) But the Homefirst pediatric group and the Amish don’t vaccinate and have no cases of Autism. UNPROVEN and UNTRUE
    Kristin Cavallari mentioned the Homefirst pediatric group in Illinois who treat children whose parents refuse to vaccinate them (because many doctors refuse to for the safety of their other patients).  They claim to treat some 35,000 children and to have had no cases of autism in their unvaccinated patients; however, they have never published a study or proven that through data.  Moreover, Homefirst has a troubling history when it comes to financial conflicts of interest, medical malpractice and doctors lying/changing their story under oath.
    The idea that Amish children aren’t vaccinated and don’t have autism is patently untrue.  Amish parents do vaccinate their children, though potentially not on the recommended schedule.  You may be thinking “aha! that proves it!”, but no, it doesn’t.  The Amish live very different lives from the rest of us which means we can not ascribe causation to just one of the differences.  They are not exposed to the same chemicals, preservatives, and pollutants that we are and they are a fairly isolated genetic pool (not many people born outside of the Amish community decide to become Amish) which means that if a genetic abnormality causes autism, it may not be present in the Amish gene pool.

4.) The risk of the vaccine is worse than the disease - FALSE
    All medical interventions come with risks and that includes vaccinations.  The vaccine that most anti-vacciners target is the MMR, which can lead to mild forms of the diseases vaccinated against (symptoms include fever, rash, loss of appetite, swelling of glands, and painful joints); rare side effects can include bruise like spots, seizures, and allergic reactions.  
When thinking about if a medical intervention’s risks are worth it, you should look at the risks to contracting the disease.  Measles causes fever, a runny nose, a full body rash and a cough. “About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. About one out of 1,000 gets encephalitis, and one or two out of 1,000 die.”  Measles is highly contagious - 90% of people exposed who are not vaccinated will contract the disease.  The good news is that vaccines are generally 85-95% effective which means that if 100 people who were vaccinated were exposed to measles between 5 and 15 would become infected; whereas if 100 people who were not vaccinated were exposed about 90 would become infected.  

5.) “It’s our personal choice, you know, and if you’re really concerned about your kid, then get them vaccinated and it shouldn’t be a problem.” ~ Kristin Cavallari - FALSE
    Many parents who chose not to vaccinate their children say things just like this and it is completely untrue.  Diseases that had been completely or almost eliminated in the US have been making a comeback lately because of the increase in unvaccinated.  In 2010 there was an outbreak of whooping cough in California that was proven to be the spread by unvaccinated children.  9,120 people caught the disease and 10 died.  In Texas, 21 members of a church that advocated against vaccinations came down with Measles after a member brought the disease back from a mission trip.  New York City has had a recent out-break of measles as well - there have also been cases in California, Connecticut, Illinois, Massachusetts, Hawaii, Pennsylvania, Texas, Washington, Oregon, Florida, New Jersey, Virginia, Colorado, North Carolina, and Michigan since the beginning of 2013.
   

Keep in mind the vaccination schedule for children as well.  Children aren’t vaccinated against Measles (MMR) until they are a year old, which means if they are exposed to the disease before then, they could contract it when they are most vulnerable and when their parents could do nothing to protect them.  People with cancer who are currently receiving chemo, or those who are otherwise immunosuppressed are also at risk.  And, as I mentioned before, vaccinations are generally 85-95% effective, so some people who have been vaccinated can also contract the disease in an outbreak.  Of course, outbreaks are much more rare when everyone is vaccinated.

Conclusions
    Please do not take medical advice from celebrities or people who stand to make more money if you follow their advice.  It is fine to question the safety of medical interventions, and it is understandable that parents want to do anything they can to prevent their child from getting autism or any other disease/delay/health issue.  However, vaccines do not cause autism, have relatively few risks and protect not only your child but other people’s children from things far worse than those risks.

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