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Are vaccines dangerous?
The High Council of Public Health (HCSP) has published the suspension of its recommendation to vaccinate all infants under 6 months against rotavirus gastroenteritis. As a reminder, this decision was taken in 2014 with the aim of reducing the number of hospitalizations for acute gastroenteritis, at the same time limiting the risk of contracting a nosocomial infection. But after the death of two babies following the administration of the vaccine, the health authority preferred to go back on its recommendation. The problem is that such a change of course would not be without consequences on the image of vaccines. And some doctors fear that this casts further doubt on their benefits. Even if, today, nearly 80% of French people are in favor of vaccination – they were only 61% in 2010 * – and that only 2% are unfavorable to all vaccinations, vaccines are regularly at the heart of virulent debates as evidenced by the latest controversy on the petition of Professor Joyeux. And the fears persist.
Repeated controversies
So, during the 60s to the 80s, it was said that the pertussis vaccine would promote unexpected infant death (MIN). “A false rumor, explains Professor Joël Gaudelus, because it has since been shown that lying on the stomach was the main cause of these deaths, and that there was no link between vaccine and MIN. NID has even been shown to be less common in very well vaccinated infants. ” Another case that made noise in the late 90s: MMR, accused of causing autism. However, this rumor is not based on any scientific evidence. Moreover, for ten years, many studies in different countries have exonerated this vaccine. Not to mention the controversies around hepatitis B vaccines which would increase the risk of multiple sclerosis, or the recent questioning of the vaccine against papillomavirus. All of these examples highlight how often vaccines are singled out. And it’s not easy to find your way around. Moreover, faced with these fears, some parents sometimes make a radical choice: not to have their child vaccinated., even with DTPolio (Diphtheria-Tetanus-Poliomyelitis). However, this vaccine is compulsory in France for any registration in a community. In case of non-presentation of the proof of this vaccination, the child is excluded from the reception structures. Some parents even find themselves in court to try to have their free will recognized in matters of vaccination. But for now, these families have not been successful. Clarification: France is one of the last European countries to maintain the distinction between vaccines. “Recommended” and “mandatory”. Suddenly, that creates confusion, because for some, it means that the “recommended” would not be essential. ” On the contrary, these vaccines are just as important », Answers Professor Gaudelus. To avoid confusion, a European project aims to do away with this distinction. In countries where this has been done, the vaccination coverage rate is as good, and sometimes even better. The fact remains that having fears about vaccination is quite legitimate. Are the components safe? Do we have enough perspective? Is the legislation strict enough? So many questions that often remain unanswered.
Vaccines are tested, their safety confirmed
However, the surveillance system still seems to be well established. ” You should know that before being put on sale, a vaccine must obtain a marketing authorization given by the European Medicines Agency (EMA). This implies that studies on tens of thousands of people have been carried out ”, specifies the specialist. Then, once marketed, there is a whole pharmacovigilance system : Doctors report any side effects that occur after a vaccine. If many cases are reported, the National Medicines Agency (ANSM) launches an epidemiological study and may withdraw the vaccine from sale. “And even if, as with any drug, there are risks, this does not make them lose their interest in saving lives and protecting young people from potentially serious diseases,” adds Dr Gaudelus. According to the World Health Organization (WHO), vaccines save 2-3 million lives each year. Vaccination also helps eradicate diseases such as smallpox, which has been eliminated globally. We hope that it will soon be the same for polio. But, all this takes time, because for the disease to disappear, a certain number of people must be vaccinated! For example, for measles, vaccination coverage must be 95%, but in France, in children of 2 years, it reaches 92% for the first dose, and only 66% for the second dose.
Vaccine coverage: France can do better
However, the latest inventory of vaccination coverage among the youngest is still encouraging. For the first time, more than 90% of infants 6 months old received at least one dose of hepatitis B vaccine. Regarding pneumococcus, more than 95% of infants less than 6 months old received at least one dose. If the progress in vaccination is clear in babies, on the other hand on the side of older children, the results are less convincing. In particular concerning vaccination coverage against meningococcus, still very insufficient. “This vaccine against meningitis (it is an inflammation of the meninges, the membranes which protect the brain and the spinal cord) is still too often considered superfluous”, adds the doctor. However, even if in the majority of cases, children recover within a few days when meningitis is viral, this disease should not be taken lightly.. Because when it comes to meningitis linked to bacteria, in particular pneumococcus or meningococcus C, it can give rise to complications and disabling sequelae in the baby. The best prevention is therefore to have children vaccinated., against pneumococcus and haemophilus influenzae type b and against meningococcus C. As for the vaccination coverage of adults, it is far from optimal. Yet, it plays an important role in the protection of toddlers. This is called the practice of “cocooning” and it is the main solution to limit exposure to viruses in babies who have not yet been vaccinated. This is especially true for whooping cough, for which the vaccine is not given until 2 months, and for measles and rubella, since MMR does not come until 12 months, then a second dose between 16 and 18 months.
Not all vaccines are useful
But if the benefits of vaccines are obvious, there is no question of falling into the opposite excess either by wanting to be vaccinated against everything. Some vaccines are not helpful for all children. For example, the one against chickenpox is not necessary for young children without a medical recommendation. It may seem surprising, but if you don’t vaccinate enough people to completely eliminate the disease, the virus continues to circulate: you risk contracting the disease at a later age, with more neurological complications. And you can also get shingles earlier, because it’s the same virus.
Sweep away preconceived ideas
Useful or not, the fact remains that many received ideas circulate around vaccination. Some parents are sometimes tempted to think that it is better for their child to be immunized by the disease than by the vaccine.. We think of the American fashion of “chickenpox parties”, in which a child with chickenpox and healthy children are brought together so that they catch the disease and thus escape vaccination! However, this method has its limits, because by contracting certain diseases – measles or whooping cough for example – there is a risk of complications or sequelae. While with a vaccine, there are no such
inconvenience. In addition, the immunity acquired by the disease is not better than that obtained by vaccination. Moreover, contrary to popular belief, vaccines do not weaken the immune system. On the contrary, they stimulate it. The principle of vaccination is to inject very attenuated fragments of virus or bacteria so as not to trigger the disease, but which will allow the body to develop antibodies. Thus, the immune system will know how to defend itself if one day it is exposed to it.
Another misconception: we cannot vaccinate babies from the first months. “False,” says the doctor. In general, it is at 2 months that the first injections are recommended. It is important to respect this timing and not to postpone it too much, as some diseases are more serious in toddlers, such as whooping cough, which can be fatal. However, by making a first injection at 2 months, we reduce by half the risk of catching it. In some cases, babies can even be vaccinated from birth. If the mother is a carrier of the hepatitis B virus, the newborn baby can be vaccinated immediately after delivery. Ditto for BCG – against tuberculosis – if the child is considered at risk, that is to say if he lives in a highly affected region such as certain departments of Ile-de-France, or if one des parents comes from a region of the world where tuberculosis is more common, such as Central Europe, Asia, Africa …
Convenience, there is nothing wrong with administering several vaccines at the same time, and it would even be more efficient to produce antibodies than if they are administered one by one. Opting for a “cocktail” also reduces the number of bites. Because the injection of certain vaccines hurts more than others, without knowing why. To relieve the little one, give him the breast, bottle or pacifier: many studies show that sucking helps reduce the sensation of pain. Anesthetic patches can be used.
Finally, another misconception: there are many contraindications to vaccination. “These contraindications are very rare,” assures Professor Gaudelus. These are basically serious allergies to one of the components. In addition, a mild illness such as a rhino is not a contraindication, but generally, the doctor prefers to postpone the vaccination because the child is not in the best of shape. ” After the injection, be aware that your child may have a fever.. Because his immune system is stimulated and he makes antibodies, it can cause a slight rise in temperature within 24 to 48 hours. One exception, however, with the measles vaccine: fever can occur within 7 to 12 days because there is a longer incubation period. Your child may also have a little pain at the bite site, and have a little redness or swelling. He is also often more irritable and has more difficulty sleeping. No worries: everything will be back to normal in a few days.
* Inpes health barometer, 2014.