Why Is There Now Confusion After Two Hundred Years of Evidence on Vaccines

When Angela, a pediatric PA, told a parent that their child was due for a booster, the parent replied, “But I heard the CDC is not even recommending vaccines anymore.” The parent wasn’t refusing care, wasn’t even against vaccines—just unsure what to trust after weeks of news the CDC and vaccines.

It’s September, the beginning of cold and flu season. This year, the leaders at the CDC are doing something unprecedented—creating confusion about vaccine safety.

The use of modern vaccines goes back  over two centuries. Edward Jenner’s smallpox vaccination was developed in in 1796. Since that time mortality from diseases like measles, influenza mumps, smallpox and polio. According to the World Health Organization, vaccination prevents approximately 3.5–5 million deaths annually.

A vaccine is designed to prevent disease by stimulating the immune system to defend against a particular organism (pathogen). Vaccines can be created using an inactivated version of the pathogen, or using parts like  proteins and polysaccharides that our immune cells can recognize.

When a vaccinated individual is later exposed to the pathogen, their immune system is prepared to generate a strong defense that prevents the disease or reduces its severity.

Because vaccines cause the immune system to respond as if the pathogen is present, some people will have symptoms similar to those caused by the pathogen. These symptoms are usually mild and short lived.

Since the first vaccine, thousands of studies have been done around the world both to develop new vaccines and to investigate vaccines in use for side effects and unintended consequences. The Covid-19 pandemic highlighted something new that some have called an infodemic.  For the first time on a large scale, there were arguments about vaccines not based on their effects or effectiveness but based on politics.

This is extremely challenging for scientists and clinicians as we are trained to base our decision making on evidence. The following remains true:

• Vaccines prevent disease and disability
• With very limited, well known exceptions, there is no evidence vaccines cause disease
• Uncertainty about vaccines lead to delayed vaccinations and low vaccination rates in communities leaving them vulnerable to outbreaks of preventable diseases
• There are individuals in every community (including newborns) who can’t have a vaccine or don’t respond to vaccines and have to rely on “herd’ immunity for protection. These people will be unprotected when vaccine rates in a community are low.
• Regardless of their personal religious, political or ethical beliefs, clinicians should still provide information to patients based on the best scientific data

You can expect your providers to:

• Stay updated on guidance and recommendations from medical associations
• Listen to patient concerns without judgment
• Use a robust approach to diagnosis
• Continue to recognize the data showing age appropriate vaccination as a highly effective way to prevent infectious disease

Politics is a major part of modern American life but it is an unfortunate part of modern healthcare. The best way forward is to stick to the evidence we have and continue to use a scientific approach to answer new questions as they arise. Science definitely does not have all the answers to important questions but the subject of vaccines is not a new or uncharted area.  Let us continue to use the best information we have available to save lives. Click here for more information age appropriate vaccine recommendations.