Vaccine Safety and Individual Exemptions from Public Health Required Immunizations; where must we draw the line?

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Over the years widespread application of vaccines globally has led to significant reductions in the incidence of many vaccine preventable communicable diseases. One disease smallpox has been completely eradicated from human populations due to strong collaborative efforts across the world. Polio is another disease which could have been eradicated but unfortunately we missed the boat on that one. I feel a little disappointed  on that count because I personally was involved as a medical student and young physician on many of the efforts to eradicate Polio in Ghana.

At this time though when it comes to Polio, Ghana is doing very well, the last reported case of Polio in Ghana was in 2008 and Ghana moved to adopt the inactivated Polio vaccine in May 2018. This is one fight that Ghana appears to have won but that is not really the end of the story for Ghana or many of the other nations that have all but eradicated this disease from their borders. While we can celebrate this great work, we all have to be aware that there are still countries like Nigeria and Pakistan that still have endemic Polio, and others like Democratic Republic of Congo, Syria, Somalia, Kenya, Papua New Guinea and Niger that continue to have occasional outbreaks. The situation in these countries puts us all at risk of Polio.

In the US I am well aware of the challenges that most health workers face with immunization from most families. Unfortunately misinformation and media spin by vaccine deniers on a few problems that occur with vaccination have succeeded in giving vaccines a bad name among certain demographic groups. In the United States immunization is a requirement for School enrollment, however all but 3 states offer a mix of religious and personal belief exemptions (see map below). 


There is paradox when it comes to the benefits of vaccines, as immunization rates increase to almost close to 100% the perceived benefits of vaccines would seem to diminish.

“Why would you need to worry about how bad Polio is, if you have never seen a someone suffering from Polio?” 

So unfortunately for most of us living in the developed world today the benefits of vaccination may seem small compared to any risk, real or imagined. I have seen and personally experienced Chicken pox and Mumps because those vaccines were not available when I was growing up in Ghana. Chicken pox vaccine was approved for use in the US in 1995 and Mumps vaccine as MMR in 1971.

I was lucky with mumps because I got this in my first year in boarding school at age 12. If it had come any later it could have left me sterile for life. I still remember feeling sick and miserable from chicken pox at age 5 years but did pull through that one with no complications. Today in most countries these vaccines are widely available and these diseases are getting more and more rare. Thus the value of these vaccines may seem to diminish.

In 1998 a study which was later shown to be fraudulent published in the Lancet appeared to suggest a link between the MMR vaccine and autism. The graphs below illustrates how the report of this study affected measles immunization rates and as a result measles outbreaks in England and Wales.

Screen Shot 2018-12-13 at 8.16.23 PM
Graphs showing impact of Wakefiled’s flawed science linking autism to the MMR vaccine


We must all however be very careful how we deal with immunization because, once overall vaccination rates drop below 90% we would start seeing some of these outbreaks again. So when a friend sends me a video from on vaccination these were some of the questions running through my mind.

“Why would Mike Adams a white guy with ties to the Alt right movement make a video on the dangers of vaccines with language in there on conspiracy theories about how vaccine are the new Tuskegee for black Americans.”

I really do not believe Mike Adams cares about black America.

His video is filled with conspiracy theories and outright lies, including quoting the debunked Wakefield study which actually manipulated data towards his conclusion.

While I am aware some would believe what he is saying, I know most can tell clearly what his motives are? Sowing seeds of hatred and division to further the separatist agenda of the alt right.

My brothers, sisters and friends please be careful who you listen to, because not all advice is for your benefit.

By Dr. Leonard Sowah, an internal medicine physician in Baltimore, Maryland

Featured Image – Healthline News


A physician providing primary medical care to patients across the lifespan