Rebecca Bell, MD, MPH, is a pediatric critical care physician at The University of Vermont Medical Center.

Rebecca Bell, MD, MPH, is a pediatric critical care physician at The University of Vermont Children’s Hospital.

This past New Year’s Eve I was on my way home from work at the UVM Children’s Hospital when I passed a public transit bus pulling into a stop at the hospital entrance. On the side of the bus was a large, eye-catching anti-vaccination advertisement. As a pediatrician who has seen children become ill and die from vaccine-preventable infections, I was horrified. An anti-vaccine ad on a bus that services the hospital? That sends a very confusing message. The organization that bought the ad has a formal-sounding name with a formal-looking website meant to confuse parents into thinking they present unbiased information. They don’t. Their information is rife with conspiracy theories and emotionally-charged unsubstantiated claims. But their PR campaign is slick and their ads look legitimate.

The organization is part of a small but vocal minority of people who have made up their minds about vaccines and no amount of scientific evidence will convince them otherwise. But they are the minority. Most parents just want to do the right thing for their child and are looking for real answers to their questions. The good news is that vaccines have been widely studied and we have lots of data showing they are safe and effective. The bad news is that there is a lot of scary and inaccurate information about vaccines on the internet. With this kind of misinformation out there, how do parents find answers to their questions?

As a start, here are answers to some common questions parents have asked me over the years along with links to helpful sources.

PrintDon’t so many shots at once overwhelm the immune system? Why do you have to give them all at once? Shouldn’t we spread them out? 

As scientists develop more vaccines to prevent disease, some parents are concerned that their infants are receiving too many vaccines at once. Not to worry: studies have shown that giving multiple vaccines at once to infants is safe and effective. You can read a paper here that discusses infant immune responses to multiple vaccines. Advancements in science have also reduced the number of antigens (substances to which the body reacts) in vaccines so that despite receiving more vaccines today, children are actually exposed to far fewer antigens than previous generations.

The immunization schedule was designed to provide the most protection for children as early as possible. Delaying vaccines leave children susceptible to infection during their most vulnerable time – infancy and early toddlerhood.

I’m afraid that vaccines cause autism.

Parents worry about autism, and for good reason. It’s a disorder that creates immense challenges for families and we don’t yet know the cause. But there is one thing we do know: vaccines do not cause autism. This has been one of the most widely studied questions in recent years and not a single scientific study has shown a connection between vaccines and autism. Many families of children with autism are looking for answers and are frustrated by the misguided call to continue to look for a link between vaccines and autism despite the many studies that show no link exists. For more information, check out the Autism Science Foundation, an organization started by parents of autistic children to support scientific research into the possible causes of autism and potential therapies.

I heard the flu shot doesn’t work this year. 

The effectiveness of the influenza vaccine in any given year depends on how well the circulating flu viruses match the vaccine. One of the circulating viruses this year (H3N2) does not match the vaccine completely and so the vaccine will not protect as well against that strain of flu. However, it does provide protection against other circulating strains and prevents severe cases of H3N2 so it is still important to get the flu shot. You can think about the flu shot in the same way that you think about seatbelts. We know seatbelts won’t prevent every child from being injured in a car accident, but that doesn’t mean we don’t bother to buckle them in. Why not do everything you can to protect your child?

What’s the big deal about the flu anyway?

The flu can cause a range of symptoms, from very mild illness to severe illness and even death. I work in a pediatric intensive care unit and have taken care of many children with flu-related illnesses. Some children need breathing tubes and a ventilator. Some have massive bleeding from their lungs from the flu. I’ve seen children whose lungs and heart are so damaged from influenza that they require a heart and lung bypass machine. One of my patients needed a lung transplant. Another child died from organ failure. Even though many cases of influenza are mild, there are some very severe consequences to influenza infection, especially among young children.

I’ve heard the HPV vaccine isn’t safe. And why should my kids get it if they’re not sexually active anyway?

The HPV vaccine has been shown to be as safe as other childhood vaccines. In order to be effective the vaccine needs to be given well before individuals become sexually active. The HPV vaccine prevents infection with the virus that causes certain types of cervical cancer in women and oral, throat and genital cancer in both men and women.

Let’s talk about cancer for a moment. It’s a horrible disease that has affected all of us. We talk a lot about beating cancer; we wear pink ribbons and walk, run, bike and race for cancer research. We talk about one day finding a cure. We don’t talk nearly enough about the fact that we have vaccines that prevent cancer. In addition to the HPV vaccine, the Hepatitis B vaccine also prevents viral infection leading to cancer (in this case liver cancer). These vaccines have given us victories over cancer that are worth celebrating.

But aren’t doctors paid to push vaccines?

No! In fact, recent studies have shown that doctors are under-reimbursed for vaccine administration. But vaccination is the most important preventative measure we can offer to children and pediatricians will continue to provide this service. An economic analysis showed that for children born in the US in 2009, routine childhood immunization will prevent 42,000 early deaths, 20 million cases of disease and save $13.5 billion in direct costs and $68.8 billion in societal costs. Those are some impressive savings for all of us.

The Vermont Department of Health has a fantastic website for parents that provides helpful and accurate information about vaccines. There’s even a question and answer section where parents can send in their questions to be answered by a local pediatrician. In addition, the CDC has very good information as do the American Academy of Pediatrics, Healthy and the World Health Organization.

Despite all the misinformation out there, accurate information is available if you know where to look. Don’t rely on bus ads or unfounded anti-vaccine stories. Ask questions. Look at the evidence. Most importantly, talk to your doctor. We’re here to help.

Rebecca Bell, MD, MPH, is a pediatric critical care physician at The University of Vermont Children’s Hospital. 

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