SEPTEMBER 23, 2004

...about childhood vaccines

Anita Black is your average Canadian mum. She has two kids, Jefferson who's four and two-year-old Britney, a dog named Spike and a busy husband. She's the matriarch of the clan and takes charge of almost everything, including her kids' health. Mrs Black keeps up to date on health information and often scans the internet in the evening to keep on top of the news.

Recently, she's been reading up on the alleged side effects of certain vaccines. Reports linking the MMR vaccine to autism was enough to cast a shadow of doubt over whether she should keep to the immunization schedule or let her kids skip their routine shots. Confused and undecided, she turned to her family physician for the straight goods on childhood vaccines.

Many concerned and misinformed parents like Mrs Black might show up at your office with questions about their kids' vaccines. Here are a few tips to help you assuage their fears and encourage them to get their kids immunized.

Better safe than sorry A recent study published in the August 25 issue of the Proceedings of the National Academy of Sciences looked at the drop in immunization following the MMR vaccine scare. Although this may sound like a natural reaction, it's not the safest one. "As health professionals we have the legal and moral responsibility to advise parents on how important vaccines really are," says Dr Danielle Grenier, director of public affairs with the Canadian Paediatric Society. After weighing the risks, many parents are likely to opt not to vaccinate their kids, sometimes without consulting their doctor. Give parents the basics when they come in and tell them that by the time vaccines get approval in Canada, they've likely been around for at least 10 years and their safety is no longer in question.

Parents, it's important "What is hard for parents these days is that the amount of vaccines have nearly doubled in the last five years," says Dr Grenier. "Parents need to know that routine immunizations are still very important." Tell them that the old standard set of vaccines ? DTaP, IPV, MMR ? have all but wiped out diphtheria, pertussis, polio, measles, mumps and rubella in Canada. Also, clarify some common misconceptions about these shots. Assure parents that the MMR vaccine doesn't cause autism or Crohn's disease; that the hepatitis B vaccine isn't behind multiple sclerosis; that the pertussis shot doesn't cause brain damage; and that vaccines don't lead to sudden infant death syndrome.

• New vaccines on the block There are four new vaccines available and they're quite an achievement, according to Dr Grenier. Explain to parents that the two anti-meningitis vaccines ? pneumococcal vaccine and meningococcal vaccine ? have helped bring the number of cases down from 200 annually to only four. The acellular vaccine for pertussis in adolescents also marks a big step in preventive treatment. Stress to parents that "if we protect the older children we then protect the younger ones," says Dr Grenier. The fourth vaccine is the annual flu shot that's particularly important for children between six and 23 months of age who are at higher risk of getting influenza.

• A pox on chicken pox parties "The belief out there is to have a chicken pox party to get it over with," says Dr Grenier. But parents rarely realize that their kids can get severe complications from the infection. The disease can also reactivate later in life in the form of shingles. Dr Grenier suggests you tell parents that chicken pox isn't a mild disease. According to her, in Canada there's an average of 5.8 deaths due to chicken pox every year. Chicken pox can cause serious inflammation that destroys joints and even encephalitis. The vaccine doesn't prevent all kids from catching it ? about 90% of individuals are protected. Those that do contract it, however, suffer only minor symptoms. New research also points to evidence that the vaccine is a cost effective step in the right direction. A study published in the September issue of Pediatrics showed that since the vaccine was introduced in the US in 1995, the healthcare system has saved close to $100 million US due to fewer complications and hospitalizations.



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