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Written by Steven Burns
From his column To Your Health

I have always supported vaccination—wholeheartedly—without reservation. So imagine my consternation when I got a text from our daughter-in-law saying they had just returned from the emergency room where my 5-year-old grandson was diagnosed with mumps. Ollie had a high fever and swelling on the left side of his face in the parotid, a saliva gland just in front of the ear. The illness hurts, with high fever and body aches.

Ollie is fully immunized, meaning that my son and his wife are responsible regarding vaccinations. But he was one of the approximately 12% who do not become immune despite vaccination. Rather, he was the victim of someone else’s decision not to vaccinate their child.

In medicine, we talk about a concept known as “herd immunity.” This means if a group (herd) is immunized above a certain percentage, infectious diseases cannot cause an epidemic. Since vaccination is imperfect, reliance on most members being immunized is necessary to protect those who either cannot take the vaccine, or if the vaccine fails to immunize them.

Depending on the disease, between 85% and 95% must be vaccinated to achieve herd immunity. Measles, for instance, requires a 94% vaccination rate to prevent outbreaks like the one that occurred at Disneyland in 2015. In that case, 80% of those infected were not immunized—their parents chose not to protect their children.

In some American cities, vaccination rates approach those of third-world countries.

In some American cities, vaccination rates approach those of third-world countries. Boulder, Colorado; Scottsdale, Arizona; Boise, Idaho; and Los Angeles, California—are among the 10 worst cities for vaccination of children entering kindergarten. You might notice they are not among the poorest cities in the nation. By not immunizing their children, many affluent parents have decided they are more educated than the Centers for Disease Control (CDC), physicians, scientists, and immunologists. In doing so, they place the health of their own children and those around them at risk because of unscientific ideas.

Baseless fears about vaccines are nothing new. In the late 1700s, Edward Jenner, originator of the vaccine for smallpox, was widely ridiculed for inoculating humans (including his own 11-month-old son) with material from cowpox sores to induce immunity. He then proved they were immune by injecting them with smallpox, showing they did not get sick. While his methods were dangerous, by 1979 smallpox was eradicated from the entire world. By the way, the term vaccine comes from the Spanish word vaca, meaning “cow.”

So, what vaccinations do we older adults need? First and most important is for the flu, which requires 80% to 90% vaccination rates in healthy/high-risk populations for herd immunity. Second, pneumococcal vaccines protect individuals from Strep pneumoniae, a major cause of pneumonia. Third, is the shingles vaccine, which occurs from reactivation of the chickenpox virus that resides in the nerves after we get chickenpox earlier in life.

Now I can hear some of you saying, “But I get sick when I have a flu shot.” My answer is, “not likely.” The only ones getting seriously sick are those who are unable to eat eggs because of severe allergic reaction (think swelling up and stopping breathing), which is extremely rare. As far as getting the flu from the vaccine, that is impossible. The virus is not alive, so it cannot infect anyone. When the flu vaccine is compared to a placebo (no virus, just sterile saline solution), there is no difference in reactions. There are rare instances of Guillain-Barré syndrome following flu shots, but this more often results from the flu than from the vaccine.

Sometimes my patients tell me, “I never get the flu. Why should I get a shot?” I tell them, “It’s not about you. You might get a mild case and, not realizing you’re sick, give it to someone who could die.” The CDC estimates that in recent years, between 12,000 (2011-2012 flu season) and 56,000 (2012-2013) die from influenza in the United States. That means in 2012-2013, flu deaths exceeded those from automobile accidents.

In my hospital, all staff are required to get a flu shot by December 1 annually, or we cannot enter the facility. It is unethical to do otherwise. You see, medical people believe in the value of the flu vaccine.

So, what should you do about all this? You should get a flu shot every year, around Halloween. You should get at least one immunization for Streptococcus pneumoniae (Pneumovax) after age 65. And you should get a shingles shot (Zostavax) after age 60.

One more thing—your children should not allow you to see your grandchildren unless you have had a repeat injection for whooping cough (pertussis). There are infant deaths every year from this devastating and preventable illness.

I have only hit the high points. Visit the CDC website for information on other vaccinations that are recommended.

Dr. Steven Burns is board-certified in family medicine and has been in practice for more than 30 years.

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