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Sarah Fagan

Professor Stalbird

English 1201

31 July 2019

Validity of Vaccines

While sitting in the chairs of the Saint Louis University School of Nursing, I listened to

my professor lecture my classmates and me on the prerequisites needed before we began our

clinicals. She told us that we needed to upload our vaccine records, have a titer performed to

make sure we are still immune to hepatitis B, and receive a Tuberculosis screening among other

requirements. As she was explaining this to us, she emphasized the importance of understanding

what vaccines we needed to get and why we needed to get them. As a future nurse, I need to be

able to advocate for myself and be able to explain to my patients the importance of vaccination.

Even though medical advances and new technological treatments are being discovered at a

record pace, people are still often cynical about vaccines, specifically with their safety,

relevance, and effectiveness. However, all children should be vaccinated because immunization

helps with global and individual disease prevention, vaccines are safe and effective, and vaccines

can reduce preventable disease medical expenses.

Historically, vaccines have revolutionized medicine and eradicated deadly diseases.

Vaccines originated in 1000 AD in India and evolved from traditional medical practices. People

would pay to have their upper arm scratched and have smallpox scabs applied to their skin,

which acted as a primitive vaccine. This technique later spread to England, and the number of

children infected by smallpox decreased from 30 percent to 2 percent. Dr. Edward Jenner, a
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British medical professional, discovered that cow pox also protected against smallpox, and

named his procedure of applying scabs from cows a vaccine, with the root “vaca” coming from

the Latin word for a cow. In 1955, the first polio vaccine was announced in Ann Arbor,

Michigan. There were two versions, the injectable Salk vaccine or the Sabin oral polio vaccine.

The oral vaccine carried the chance that for 1 in every 2.4 million doses the virus would mutate

which left a small risk of contracting polio. In 2000, the oral vaccine was replaced by injectable

vaccine entirely and is the only one administered today (Pemberton and Rosenfeld).

As for scientific background, vaccines are a weakened or dead part of the virus injected

in the body to trigger an immune response. Vaccines can be given in three different forms, live-

attenuated, inactivated, or subunit vaccines. Live-attenuated vaccines are weakened but intact

viral particles mutated and selected for poor growth in humans. Inactivated vaccines are the

dead version of the virus that are inactivated by chemical or physical treatment. Subunit

vaccines are a part of the virus that has been modified by genetic engineering. When one of

these types of viruses is injected in the body, the pathogen is detected by the immune system.

The immune cells tag the pathogen with antibodies, and B and T cells replicate. Once the

infection is fought off, memory cells remain (Pemberton).

First, vaccines are an essential part of reducing the possibility of a preventable disease

outbreak globally and the risk of an individual contracting preventable diseases. They can help

protect entire communities, providing herd immunity. Herd immunity helps babies and people

who cannot be vaccinated by minimizing the amount of people who are infectious. The

decreased rate of vaccination puts those who cannot be vaccinated at a higher risk of getting an

infection (Thomsen). Herd immunity is integral to protect the global population and a goal

continually strived for as currently, approximately 1 in 8 children is under-vaccinated (Facciolà).

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For example, in the United States, only almost 90 percent of parents fully vaccinate their

children, while the remaining 10 percent delay or skip shots, including 1 percent of parents who

elect to avoid vaccines entirely. (Pemberton).

According to a study done by Alessio Facciolà and his colleagues in Messina, Italy,

vaccination rates have been decreasing since 2013. They explained that in recent years, Italy’s

vaccination schedule was updated to include newer vaccines such as the HPV, meningococcal,

and pneumococcal vaccines; however, the results of this study showed that many children were

vaccinated against MMR and DTP, but only a small percentage were also protected against

pneumococcal, meningococcal, HPV and HiB. Many parents also viewed the pneumococcal,

meningococcal, HPV and HiB as favorable but not necessary. It was recorded that any parents

who did not vaccinate their children against certain diseases believed their child will be protected

from these diseases through herd immunity or thought the disease no longer exists.

Vaccine hesitancy is a problem leading to decreased vaccination rates, especially in Italy.

Vaccine hesitation is an umbrella term referring to all parents that delay vaccines or refuse

certain vaccines and accept others (Facciolà). This is problematic because herd immunity relies

on the foundation that the majority of the population, around 95 percent, is vaccinated. If every

parent relies on herd immunity and does not vaccinate their child, the vaccination rate will

decrease to a point where herd immunity no longer exists to protect those who cannot be

vaccinated. Herd immunity is especially important in urban settings where people live in close

proximity to each other, and vaccine hesitant people tend to live together or adjacent to each

other which allows for a rapid spread of disease (Thomsen).

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Fig. 1. This image shows the importance of herd immunity because one person infected with

measles can transmit the airborne virus for up to two hours, and the protected immune population

can help stop the spread of the infection (Pemberton).

Furthermore, in order to maintain a level where diseases, such as smallpox, are

eradicated, 95 percent of the population needs to be vaccinated against the disease. Large groups

of unvaccinated people present a threat to the entire population. In New York, New York, there

was an outbreak of measles in 2013 that was recorded. The outbreak was traced to a man

traveling from London who unknowingly spread the virus globally to the United States

(Pemberton). The diffusion of diseases globally through different forms of transportation such as

airplanes, private jets, cargo planes and ships, is only increasing the ability of these deadly

diseases to find potential victims faster. Measles was declared eliminated in 2000, but it is now

coming back because the rates of MMR vaccination-- measles, mumps, and rubella-- have

decreased globally and at a high rate in several countries including Denmark, Austria, Belgium,

France and Switzerland. This is alarming because it is estimated that the measles vaccine alone,

has prevented over 17.1 million deaths (Thomsen).

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Grignolio writes in the novel, Vaccines: Are they Worth a Shot?, that “in the twentieth

century, almost 1.7 billion people died from infectious diseases […] 400 million deaths from

smallpox, 96.7 million deaths from measles, 38.1 million deaths from pertussis, more than 37

million deaths from tetanus, 12.7 million deaths from hepatitis B and almost 22 million deaths

from meningitis” (Grignolio 51). He also states that vaccinations have prevented the deaths of

more than 500 million people, and that in the future they will save countless other lives. For

example, he gives that during the decade from 2011 to 2020, vaccines will prevent the death of

over 25 million people, which is “2.5 million people a year, 7000 a day, 300 every hour, 5 every

minute”, a staggering statistic (Grignolio 52). Mortality rates from all these deadly diseases

have decreased with the availability of these vaccines. Vaccines have helped to create a healthier

global population full of individuals who are immune to certain pathogens, therefore, to fully

eradicate other deadly diseases, it is necessary to have a fully vaccinated youth population.

However, many parents are worried about the safety of vaccines and their children’s

reactions to the vaccines. Stories that circulate and go viral about the danger of vaccines do so

because they target people’s emotions. These heart-wrenching stories add to parents’ paranoia of

vaccines. This cynical mindset is developed from parents thinking, “If this happened to their

child, it could also happen to my child.” For example, one family thought that vaccines were

causing their child to have seizures. Doctors later proved that the seizures were actually related

to a rare state of epilepsy where the vaccine was a trigger to the seizures. They were not the

cause of the seizures. Other common symptoms of vaccines include slight swelling at the place

of injection or a mild fever, and these are two common immune responses to any foreign

pathogen (Pemberton). Grignolio, in his novel, further debunks the misconception that vaccines

weaken one’s immune system and gives insight to alternative philosophies to vaccinations such
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as homeopaths and naturists. He states how these alternative philosophies are not effective as

they are not based off scientific evidence (Grignolio 94). Moreover, Facciolà’s survey results

showed that the most common reason parents opted out of vaccination included fear of side

effects and poor information about the vaccine. Many parents’ perspective on vaccines were

also influenced by the physician’s opinion and knowledge of vaccinations (Facciolà). Another

concern held by many parents is that getting multiple vaccines in the same shot or multiple

vaccines on the same day can be dangerous to their child’s immune system. However, vaccines

only are a minuscule percentage of all of the pathogens the immune system fights off in one day.

Combination vaccines allow for fewer trips to a doctor and less vaccines administered to a young

child. Delaying or spreading out the vaccine schedule only increases the risk of the child

contracting a preventable disease (“Vaccine Safety.”).

It has also been previously thought that Autism and vaccines were linked. This theory

was made popular by Dr. Andrew Wakefield who published a study in a prestigious medical

journal, the Lancet, saying the MMR vaccine was linked to Autism; however, this study was

retracted as it was shown to be fraudulent and unethical. A woman named Jenny McCarthy also

published a book that included a personal anecdote of how she believed vaccines led to her son’s

Autism diagnosis. It is now known that Autism begins in the womb and is unrelated to vaccines

(Pemberton). Some still believe there are links between the hepatitis B vaccine and multiple

sclerosis and the MMR vaccine and Autism even though there is no scientific evidence

(Thomsen). Multiple reputable sources have released reports of their studies confirming that not

only is there not a link between vaccines and Autism, but there is also actually strong evidence

against vaccines causing Autism. For example, a branch of the National Academy of Sciences

stated that there is no evidence linking Autism and the MMR vaccine, and they encouraged
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people to look for other causes of Autism such as genes and prenatal infections. Furthermore, a

Danish study found that there was no difference in the Autism rates between unvaccinated and

vaccinated children, thus showing no relationship between vaccines and Autism (Pierceall).

Vaccines are not only effective at saving lives, but vaccines are also safe and held to

certain standards by the United States Department of Health and Human Services, the Center for

Disease Control, and the Food and Drug Administration. In an article published in 2017, the

United States Department of Health and Human Services discussed the reasons why vaccines are

safe and effective. For example, they stated that every vaccine is licensed by the FDA and tested

by the CDC. Each vaccine is also monitored after it is recommended. The FDA spends several

years completing clinical trials with the vaccines to test the vaccines’ effectiveness, quality and

safety. The vaccine batches are tested to make sure that they are potent, pure, and sterile before

they are administered to the general public.

To monitor the vaccines, there are different systems in place including VAERS, VSD,

PRISM, and CISA. VAERS, or Vaccine Adverse Events Reporting System, tracks reported

cases that unusual or unexpected symptoms that could allude to a possible concern with the

safety of a vaccine. If this is found, it leads to further evaluations and experimentations of the

vaccine. VSD, or the Vaccine Safety Datalink, uses large quantities of data to analyze if vaccines

are actually linked to the reported side effects experienced. PRISM, or Post-licensure Rapid

Immunization Safety Monitoring System, uses health insurance claims to check for possible

concerns with vaccines. CISA, or Clinical Immunization Safety Assessment Project, researches

reported cases of side effects of vaccines. Only after all of these regulations are met are vaccines

released to be given to the public (“Vaccine Safety.”).

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Not only are vaccines a safe medical procedure that benefits the health of the global

population, but they also have had a positive impact on the economy. For example, an article

published by the Centers for Disease Control and Prevention explains the cost benefits of child

vaccination programs. In this article published on April 23, 2014, the Center for Disease Control

and Prevention analyzes direct and societal costs of routine childhood vaccination on

hypothetical US birth cohorts from 1994 to 2013. The estimates from the birth cohorts were

taken from the National Immunization Survey. Direct costs encompass treating an initial

infection and further complications that can arise from it. The direct non-medical costs comprise

travel expenses and different supplies. Indirect costs include productivity losses and permanent

disability due to vaccine-preventable diseases. The prices were adjusted due to inflation.

Estimations were then taken of the burden of diseases with and without vaccinations, and the

results showed that the average cost of receiving a vaccine was far less than the average cost of

medical treatment for the preventable disease contracted (“VFC | Publication on Cost-Benefits |

Vaccines | CDC.”).

In the article “Childhood Immunization, Vaccine Hesitancy, and Provaccination Policy in

High-Income Countries,” by Frej Klem Thomsen, he writes that the United States will save an

estimated 13.5 billion dollars in direct costs and 68.8 billion dollars in societal costs with routine

immunization for children. He also discusses the ethics behind a provaccination policy.

Thomsen explains that this policy would be accepted if it was better than all of the alternative

solutions, and the largest argument against it would be that it would infringe on a person’s

autonomy, a debate extremely popular in media today (Thomsen).

In contrast, people who support the anti-vaccination movement have made claims that

vaccines are a ploy by large pharmaceutical companies as a way to earn money. Grignolio
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investigates this myth and provides reasoning as to why this is a hollow argument. He states that

the foundation behind the argument is questioning the efficacy and actual need of administering

vaccines. Grignolio goes on to state that some individuals who support the antivaccination

movement say that because society today is not plagued by infectious diseases, vaccines are a

hoax created by large pharmaceutical companies who have a monetary motive. All of these

pharmaceutical companies are surrounded by a negative connotation and given the name Big

Pharma (Grignolio 46). This claim has been further supported by different medical professionals

and people in the medical field as they are involved in the pharmaceutical industry. Anti-vaxxers

have claimed that these professionals are hiding the truth that vaccines are a hoax because they

directly benefit from the vaccine industry which is also incorrect. Historically, there have been

“numerous humanitarian and philanthropic examples of waiving the patent to reduce the price

and reach the highest number of people,” however these feats are ignored (Grignolio 48). An

example of this philanthropy effort is with the polio vaccine. In 1995, Jonas Salk introduced the

first vaccine against polio that with a patent would have been worth 7 billion dollars. He elected

against the patent and so did Albert Sabin who produced the oral polio vaccine. This shows that

their efforts did not have a monetary motivation behind them but rather a humanitarian one.

Abandoning the patent has correspondingly been seen with more modern vaccines such as the

HPV, or Human Papilloma Virus, vaccine. Grignolio writes that the HPV vaccine, which helps

protect against cervical cancer, was donated by a well-known pharmaceutical company to an

African country free of charge for 3 years (Grignolio 51). These various examples demonstrate

how these large pharmaceutical companies are manufacturing drugs that have and will continue

to save millions of lives across the globe.

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Even still, many people hold uncertainties of the honesty and integrity of these large

pharmaceutical companies. For example, an anti-hepatitis drug was being retailed at an

expensive price which provoked some criticism. Grignolio explains that customers must factor

in the potential of lifelong care for chronic hepatitis when deciding whether of not to buy the

hepatitis prevention drug (Grignolio 53). Criticism of high prices for different pharmaceutical

drugs including the mass production of vaccines can be viewed as hypocritical when compared

to any other field. For instance, many people expect the flu shot to be administered for a

discounted price or even for free. This is an unrealistic expectation as there are costs for the

medical supplies needed to give the shot for these health care companies. Grignolio goes on to

explain, “nobody asks an engineer to be charitable […] and of course we do not ask Apple for

free iPhones” (Grignolio 53). Even though vaccines do not come free of charge, they have saved

an enormous amount of money for both individuals and governments. When smallpox was

eradicated from 1978 to 1997, globally, 168 billion dollars were saved from being spent on

different medical expenses, travel expenses to medical centers, and other miscellaneous expenses

(Grignolio 54). By not choosing to vaccinate a child, there is a both a biological and economic

consequence on society.

The idea that vaccines are harmful is a shared public opinion adopted by many parents

and celebrities that has led to vaccine hesitancy. To eliminate this problem, it is important to

increase the information available about the benefits of vaccines and encourage primary care

physicians and pediatricians to have parents vaccinate their children. Health education is

essential to combat vaccine hesitancy and increase awareness of the benefits of vaccines for all

children.
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One main opposing perspective to continuing the administration of vaccines is the anti-

vaccination movement. Grignolio discusses the roots of the anti-vaccination movement in his

novel, Vaccines: Are They Worth a Shot? He states that in the twentieth century, there were

large advances with the discoveries of the polio, MMR, and DPT vaccines. Moreover, Grignolio

says that there are three primary reasons that parents do not want to vaccinate their children.

These explanations are the foundation of the anti-vaccination movement and include various

neurocognitive, social, and evolutionary motives. For neurocognitive, he says that education and

risk led to a decrease in immunization rates, and for social, he says that the doctor-patient

relationship has evolved. People are now more suspicious of doctors and do not trust everything

that doctors recommend as they can do their own research online and find information to support

what they believe to be correct (Grignolio 26-30).

The movements in the twentieth century have largely been linked to media and political

catalysts. The anti-vaccination movement has also gained such a widespread foundation and

support group as a result of the internet and celebrities with a large social influence. People now

have the ability to find information online that supports any false beliefs they hold about

vaccinations. Well-known celebrities such as Kat Von D have publicly condemned vaccinations.

People who look up to celebrities like this as role models or as trustworthy, knowledgeable

individuals are putting their own children at risk by mimicking the same actions. This is

concerning because it has the potential to increase the percentage of the population who are not

vaccinated. The decreased rate of vaccination puts those who cannot be vaccinated at a higher

risk of getting an infection, as it limits herd immunity (Thomsen). By reiterating the fact that all

information published on the internet is not valid, and just because a celebrity or social

influencer is doing it does not make it correct, health education levels will increase. It is
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important to remind individuals to speak to a medical professional or consultant to receive

accurate information on childhood immunizations.

Ultimately, despite past and present controversy with vaccination, it is important to recognize

how they have revolutionized medicine and the health of the global population. With new

technological advances and medical discoveries, new vaccines will be developed as a way to

combat different diseases and be potential therapy solutions for degenerative diseases such as

Parkinson’s and Alzheimer’s. Vaccines not only prevent a global disease outbreak and protect

those who cannot be vaccinated through herd immunity, but they have also saved millions of

lives from being taken due to disease. Studies have proven that they are effective in combating

against these preventable diseases such as polio and the measles, and vaccines have allowed for

the eradication of a once deadly disease, smallpox. Adverse side effects are extremely rare and

supposed links to other medical conditions such as Autism have been confirmed as fraudulent.

Vaccines undergo a series of tests and must pass regulations enforced by the CDC and United

States Department of Health and Human Services before they are permitted to be administered to

the general public, thus proving their safety. Also, as a result of vaccines, there has been

numerous economic benefits. These include saving individuals, countries, and the entire global

various medical expenses associated with preventable diseases. Vaccines have the power to

change the public health situation globally by saving millions of lives and eradicating more

potentially deadly diseases in the future.

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Works Cited

Facciolà, Alessio, et al. “Vaccine Hesitancy: An Overview on Parents' Opinions about

Vaccination and Possible Reasons of Vaccine Refusal.” Journal of Public Health

Research, vol. 8, no. 1, 2019, pp. 13–18., doi:10.4081/jphr.2019.1436.

Grignolio, Andrea, and Joan Rundo. Vaccines: Are They Worth a Shot? Springer International

Publishing, 2018.

Pemberton, Sonya and Michael Rosenfeld, directors. Vaccines-Calling the Shots. PBS, Public

Broadcasting Service, 9 Oct. 2014, www.pbs.org/wgbh/nova/video/vaccinescalling-the-

shots/.

Pierceall, Kimberly. “Vaccine-Autism Link Is Discounted; Panel Finds No Connection But

Some Interest Groups, Congressmen Don't Agree.” Wall Street Journal, 19 May 2004, p.

D.3. ProQuest, vaccines.

Thomsen, Frej Klem. “Childhood Immunization, Vaccine Hesitancy, and Provaccination Policy

in High-Income Countries.” Psychology, Public Policy, and Law, vol. 23, no. 3, Aug.

2017, pp. 324–335. doi:10.1037/law0000126.

“Vaccine Safety.” Vaccines, United States Department of Health and Human Services, Dec.

2017, www.vaccines.gov/basics/safety.

“VFC | Publication on Cost-Benefits | Vaccines | CDC.” Centers for Disease Control and

Prevention, Centers for Disease Control and Prevention, 23 Apr. 2014,

www.cdc.gov/vaccines/programs/vfc/pubs/methods/index.html.