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CHU Sainte-Justine
Friday, February 13 2009

Vaccines: Putting an end to the debate

Opinion letter written in response to the film "Silence on vaccine" published in 2009

Bruce Tapiéro MD, Director, Department of Infectious Diseases, UHC Sainte-Justine; and Associate Professor of Pediatrics, University of Montreal.

Cosigners and members from the Department of Infectious Diseases of the UHC Sainte-Justine: Cybèle Bergeron, MD; Denis Blais, Nurse, B.Sc; Chantal Buteau, MD; Sandra Caron, Nurse, B.Sc; Jean-François Chicoine, MD; Anne-Marie Demers, MD; Pierre Gaudreault, MD; Céline Laferrière, MD; Valérie Lamarre, MD; Marc H. Lebel, MD; Philippe Ovetchkine, MD; Céline Rousseau, MD; Maude Saint-Jean, MD.

As pediatricians and infectious disease specialists from the Sainte-Justine University Hospital Centre, it is our duty to make a statement in response to media reports about vaccines, following the release of the NFB-produced film “Silence, on vaccine.”

From a medical point of view, the film paints a false and dangerous image about vaccines. This unreliable anti-vaccination documentary film was based on no scientific evidence, but rather used and exploited family tragedies, playing on emotions, to get people to believe without any proof that vaccines have a direct causal relationship to the development of serious neurological disorders. Such an alarmist approach, along with all its publicity, could have harmful consequences on the health of our children.

It is important to remember that vaccines are one of the greatest scientific developments of the 20th century; and that many deadly childhood diseases have been eradicated thanks to this incredibly revolutionary discovery. Based on our clinical experience, cases of diphtheria, poliomyelitis, tetanus and smallpox have not reappeared in our daily practice for many years now. Today, thanks to new and improved vaccines, we have been privileged to witness the disappearance of most cases of meningitis, septicemia, severe whooping cough, measles and complicated chickenpox, which unfortunately still appear but only in children who have not been vaccinated.

Side effects caused by vaccines are known and well-documented. Serious adverse effects are extremely rare, and are much less severe than those related to the natural disease1. Spreading fear about them, or creating them where they do not exist, can have very serious repercussions. For example, Great Britain is currently experiencing an epidemic of measles following the creation of an anti-vaccination movement by a group of individuals who promote their beliefs based on no scientific evidence. The consequence of this has led to a large number of children having to be hospitalized, and many of them have died as a result of not being vaccinated against the disease. Sweden and Japan have also had a similar experience with regard to whooping cough. In the Former Soviet Union, the drop in vaccination coverage against diphtheria resulted in 160 000 cases and 4 000 deaths between 1990 and 2001.

Both past history and recent events clearly demonstrate that vaccines continue to be the best method for preventing infectious diseases. Parents, families, health care professionals and journalists all play an important role and cannot afford to be complacent about a film production that spreads confusion about the effectiveness and safety of vaccines without taking into account the hundreds of internationally-recognized scientific studies that have systematically confirmed the absence of a causal relationship between immunization and a number of clinical disorders whose causes remain unknown (pervasive developmental disorders, cerebral lesions, diabetes, multiple sclerosis, cancer, chronic fatigue syndrome, etc.). 2-5.

No relationship between vaccines and autism

This matter is now clear. Current medical findings, consistently kept updated through clinical monitoring and advanced daily research, absolutely rejects the notion that the Measles-Mumps–Rubella (MMR) vaccine is the cause of autism. Studies conducted on hundreds of thousands of children in Quebec, Canada, USA, UK and Denmark have clearly shown that autism does not appear more often in MMR-vaccinated children than in children who do not receive this vaccine.

Autism is usually diagnosed between the ages of 18 and 30 months. Because children receive the MMR vaccine at 12 and 18 months of age, some people wrongly believe that the MMR vaccine causes autism, even though all published and unpublished findings on autism and the MMR vaccine have been subject to independent reviews conducted by committees made up of experts from the Institute of Medicine of the National Academy of Science in the US, and from the American Academy of Pediatrics. These groups have concluded that “there is no scientific data to support the theory of the MMR vaccine being the cause of autism, pervasive developmental disorders or intestinal inflammatory disease.”6 It is unfortunate that the film did not bring up any of this scientific evidence, but rather only made room for an alarmist message supported by family tragedies.

Thimerosal: a derivative of mercury

The subject of the potential toxicity of this derivative of mercury contained in certain vaccines (and in other drugs) is a rumour supported by blogs created by the anti-vaccination and alter vaccination movement of the last decade. In the US, the hepatitis B vaccine originally contained thimerosal, an organic compound of mercury that was used for an excellent reason: as a preservation agent. With regard to any toxicological effects, ethylmercurey has never, in any way, been link to the well-known effects of the methylmercury that is found in traditional thermometers or that contaminate our fish. The “Silence, on vaccine” film failed to point this out. In fact, there is no evidence to indicate that the presence of thimerosal in vaccines lead to brain damage in children. Extensive research has shown that there is no neurological difference between children who received vaccines containing thimerosal and those who received vaccines containing no thimerosal.

Since March of 2001, all routine vaccines used to immunize children across Canada and the US are produced without thimerosal. This product is, however, still contained in certain vaccines such as the influenza (flu) vaccine. In Canada, the National Advisory Committee on Immunization (NACI) rendered a decision that it is not unsafe to use products containing thimerosal on children and adults, including pregnant women. The removal of thimerosal from vaccines was an effort meant to maintain the public’s trust: to have trust in vaccines and to participate in vaccination campaigns, essential to the effectiveness of immunization programs7.

Vaccines are safe

Vaccines comply with the highest of safety standards. They are among the safest treatments of modern medicine. To be available in Canada, the product must meet high safety criteria reviewed by federal authorities. In addition to this, each batch of vaccines undergoes an evaluation before distribution. Administered by the Canadian Pediatric Society, the Active Immunization Monitoring Program of Canada (IMPACT) is an active monitoring network for adverse events following immunization, which covers more than 90% of tertiary pediatric hospital beds in the country. In spite of systematic screening of each pediatric hospitalization for acute neurological disorders (more than 1500 cases each year), no evidence of vaccine-induced cases of encephalopathy has been found.8

Not everyone is equal in terms of scientific understanding and interpretation, therefore parents and the general public should continue to have trust in their health care professionals who are at the core of the action and who are able to provide reliable and honest responses based on the most up-to-date scientific evidence and clinical experience. We must collectively reject these age-old conspiracy theories about academic, scientific and economic systems.

Let’s stop spreading fear and confusion about vaccinating our children so that we can lower the number of victims.

For information
  1. Vaccines: Getting the Shot for the Health of Your Child. Canadian Pediatric Society Edition, 2006.
  2. World Health Organization: www.who.int/immunization_safety/fr/index
  3. Institute of Medicine (IOM): www.iom.edu
  4. Canadian Coalition for Immunization Awareness and Promotion: www.immunize.cpha.ca
  5. Canadian Immunization Guide, 7th edition, 2006.
  6. Vaccines and Autism: A Tale of Shifting Hypotheses. Clinical Infectious diseases, p. 456 - 61, February 2009.
  7. Canada Communicable Report, July 01, 2007, volume 33, DCC-6.
  8. IMPACT After 17 Years: Lessons Learned about Successful Networking. Pediatrics and Child Health, January 2009, p 36.

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