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Current data reveals that multitudes of people with access to the internet rely on virtual media as a go-to when they experience any health issues. If anyone out there was to search information online on vaccines they are bound to stumble across pages that are filled with anti-vaccine opinions. It is easier to convince a sick patient that they need medication or surgery than encourage a perfectly healthy person to protect themselves against harmful diseases that they do not have or have not heard of. So then why do doctors recommend and insist on vaccinations rather than leaving it up to the individual? Simply, because a better vaccine uptake helps to stem the spread of vaccine-preventable diseases.

We met with Dr Ajanthan Rajaratnam, the eminent Consultant Pediatrician and he talked about the importance of vaccines and the danger of anti-vaccine brainwashing posts that scares parents more about the vaccines than about the diseases they prevent.

Sri Lanka’s vaccine uptake

As a country, Sri Lanka is commendable in our vaccine uptake in comparison to other developing countries. “Sri Lanka has the best vaccine uptake in the world. Nearly 95% of vaccines are given in the public sector and 5% from the private sector. The vaccine uptake has vastly improved after 2009 in the North and Eastern Provinces as well” states Dr Agnathan. Vaccines such as BCG have been statistically proven to be at 100% in uptake in Sri Lanka which is commendable compared with countries that are experiencing shortfalls in the percentage of population vaccinated.

Whilst there currently is not a widespread public concern over vaccine damages, there is however a rather niche community that tend to miscommunicate the benefits of immunization. “If the public was concerned about any damaging effects of the vaccine the uptake would never be so good,” says Dr Ajanthan.

Measles, for instance, is a childhood infection that’s caused by a virus. The most common statement made by an anti-vaccine parent is that they would rather let their child get the disease and fight it with natural immunity than getting vaccinated. This endorses the success of the MMR vaccine for this disease as anti-vaxxers are simply unaware of what measles can “do” since it’s prevented via proper vaccine uptake. “We as medical professionals need to educate the public on the advantages of and show proof on the vaccine uptake. We need to counter-argue and show research data on the advantages. List out the diseases that have been eliminated by vaccination and our present issue with the Corona Virus.” Dr Ajanthan further explains.

Anti-Vaccine anecdotes that touch emotions

There is much controversial information/misinformation about vaccines out there - these suggest that vaccines cause everything from autism to diabetes to autoimmune diseases. It has been proven, however, that much of this controversy is fueled by unsupported anecdotal evidence.

Nevertheless, anti-vaccine movements continue to make strides by fearmongering. Therefore, in the minds of many parents who have fallen to this brainwashing void, to trump these anecdotes with scientific facts and studies is an uphill task as these anecdotes are powerful, emotional, and personal.

Vaccines stand the test of evidence-based medical science. Prior to getting a vaccine licensed, approximately tens of thousands of children will be tested - no other medical drug goes through this extensive level of testing. So, if there is a problem (a side effect, lack of efficacy) the vaccine is not released to the market at all - which is why it takes so many years to release any new vaccine. On average it takes 7 years to get a vaccine to market – the fastest vaccine to date (not including the Coronavirus vaccines) was for mumps which took 4 years from conception to market.

“Sri Lanka is a country with literate people, and they believe in the free health care system. Over the years we have not seen Diphtheria, Polio, Pertussis and Neonatal tetanus thanks to our Immunization programme. I always talk to the parents on the advantages of vaccination and it’s like an insurance scheme. If you have your children vaccinated regularly then they can be prevented from having undue illnesses” concludes Dr Ajanthan.

After that, we headed over to the Government Sector. Dr Omala Wimalaratne is a Senior Consultant Vaccinologist and Virologist and very patiently explained to us the immunization protocol in the Public health sector in Sri Lanka. Soon after childbirth and before leaving the hospital, in both government and private sector hospitals, the Child Health Developmental Record (CHDR) book is given to all. This has the standard immunization schedule given for infants, children and adolescents recommended by the Ministry of Health which are given free of charge. This gives all new parents a clear idea of the types of vaccines that are expected to be given to safeguard against and therefore eliminate vaccine-preventable diseases.

In more technical terms, these vaccines are broken down into 2 categories – live (attenuated) vaccines and inactivated vaccines. Dr Omala explains that "in Live vaccines, the organism which causes the disease is attenuated using different methods. One disadvantage is, in certain persons who are having immunological diseases or during pregnancy, these live vaccines are not recommended. These vaccines are very immunogenic and therefore gives a strong immune response." Such vaccines are what we know as BCG, MMR, Varicella (chickenpox), Japanese encephalitis vaccines and so on.

Moving on to inactivated vaccines, Dr Omala states that "The organism concerned is killed using different methods during the manufacturing process. Not as immunogenic as live vaccines. Therefore, one may have to administer several doses to achieve long term protection. Rabies, Triple vaccine, Tetanus toxoid vaccines fall into this category.”

Young children are far prone to infectious diseases as their immune systems have not built up the needed defences to overcome these dangerous infections and diseases. Therefore, in certain vaccines, a booster dose is required. "A booster dose is an additional vaccine dose given after primary immunization, to boost up the immunity of a person for long term protection from that disease" clarifies Dr Omala.

A common concern raised by anti-vaccine propaganda is that vaccines carry harmful ingredients or preservatives such as aluminium and mercury. According to Dr Omala, "These chemicals may be included in certain vaccines as preservatives or as adjuvants to boost up the immunity. These substances are present in very small amounts (micro quantities) in certain vaccines only. Research studies have shown that they have no proven harmful effects so far. One may be exposed more to these harmful substances in our day-to-day life than following vaccination"

Addressing the issue of vaccine allergies as depicted again from anti-vaxxers, Dr Omala clarifies that such instances are rarely seen following vaccination, as most of the vaccines are of high quality and safe. She further stresses on the fact that getting vaccinated at a reliable health care provider or clinic is of high importance to avoid negligent mishaps. "One can get side effects even from a tablet of Paracetamol which is treatable, but the most severe side effect of an injection (may it be a vaccine or any medicine) is a severe allergy which is called anaphylaxis. But all health care providers know how to prevent and treat this condition."

In conclusion, we as responsible parents or guardians of young children need to understand that social media should not be the source of information regarding vaccines and deprive your child of the recommended immunization. Instead, discuss your concerns with qualified medical personnel whom you trust and have confidence in. Whichever end of the Vaccine spectrum you side with, it cannot be denied that vaccines and solid immunization campaigns have protected societies from deadly diseases such as polio smallpox etc.

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