In this EarthSky’s Clear Voices for Science interview, EarthSky’s Jorge Salazar speaks with Claire Broome, a public health at Emory University. Dr. Broome chaired a committee for the U.S. Institute of Medicine, which looked at the National Vaccine Plan and ways to improve it.
Claire Broome: I really want parents to appreciate that vaccines provide the opportunity to protect their children from truly deadly diseases. The fact that we no longer have hospitals full of iron lungs, that pediatric residents today have not even seen Haemophilus meningitis, is something that is a true success story for parents, for physicians, and for those of us in public health.
She told EarthSky that coordination among the many agencies involved is key to improving vaccine use in the U.S.
Claire Broome: I had the honor of chairing a committee for the National Institute of Medicine, which looked at a draft plan that had been developed by a number of different government agencies. We were taking a step back and looking at what were the most important issues that the plan should tackle. For the general population, the plan is important because vaccines are very complex entities. It takes a lot collaboration between the pharmaceutical companies that produce the vaccines, the Food and Drug Administration, which regulates them, the National Institutes of Health, which support the basic research, and the Centers for Disease Control, which actually help physicians get the vaccines to individuals. The plan tries to encourage both better communication, on the part of government agencies, on the medical profession, but also an attempt to encourage people, parents particularly, to look for credible sources of information when they’re making decisions for their children.
Dr. Broome spoke more about vaccine safety.
Claire Broome: We have a number of systems to identify any possible safety effects from vaccines. First of all, any vaccine before it’s licensed, goes through what are called clinical trials, where there is a very careful evaluation of whether the vaccine works to prevent the disease. But they also look very carefully to document its safety profile. Most vaccines will have been received by tens of thousands of individuals before they are licensed. Once it is recommended for use, the government continues to have multiple systems to evaluate whether it is as safe as expected. And specifically, the systems try to look for rare or unusual or unexpected reactions that might have occurred due to the vaccine. There are then, if there is a concern, then the system will go ahead an do a formal research study, because of course, many things happen to young children. It’s an age when children are developing and diseases first come to light. And since children are getting vaccinated at that age, someone might think that because they developed a seizure around the time they received a vaccine, someone might think that it was associated with the vaccine.
Dr. Broome gave her thoughts on past reports in the media and elsewhere on blogs about the possibility of a link between autism and vaccines.
Claire Broome: That certainly has been a very important issue. I think it’s important for people to understand the background. It appears that there has been an increase in autism spectrum disorders over the past twenty years. There’s a lot of effort to try and define whether it’s a real increase. But there are many suggestions that there has been a real increase. And public health authorities think it is extremely important for there to be better understanding of what is going on with this apparent increase. There needs to be excellent scientific research to look at the causes and possible risk factors as to why there should be this increase. It’s also very important that there is attention to early diagnosis and to looking at what can be done to help children with this disorder do as well as possible.
Dr. Bloome said that at one point, about fifteen years ago, there were allegations that the increase in autism spectrum disorder was related to vaccines.
Claire Broome: The Institute of Medicine, which is this formal body, independent and held to the highest standards of scientific evidence, was asked to look at the possible association between autism and vaccines, specifically – the measles-mumps-rubella vaccine, or the preservative that was used in some vaccines, thimerosal. They did a multi-year review where they looked at a number of scientific research studies, and came to the conclusion that there was not credible scientific evidence to support what they call a causal relationship between the measles-mumps-rubella vaccine and autism. Nor did they find any evidence to support a thimerosal and autism association. I think it’s very important for people to recognize that there are a lot of assertions made in the media, but it’s important to look at the credibility and the basis for those assertions, and to look at what an independent body has done to evaluate the question and conclude that there is not an association.
Critics of the way vaccines are done today say that they just want them to be proven safe and effective before they’re released, with accurate monitoring and response to side effects, and that ultimately, parents should decide for their children, and people should for themselves. Dr. Broome gave her perspective.
Claire Broome: Well, I think everyone would love to have vaccines which are 100 percent safe. However, what I think I would go back to is the issue that the diseases are not safe. Let’s take for example, the measles vaccine, which basically 90 percent of the children in the U.S. get. Before there was a measles vaccine, basically every child in the country got measles, because it’s very transmissible. Two of 1,000 measles cases die. So this is not a benign disease. Lots of kids do just fine, but two of 1,000 die. Now the vaccine is very safe. But there probably is a frequency of one in a million children who get the vaccine who may have a severe allergic reaction. Would you say that we shouldn’t have a measles vaccine, that two of 1,000 children getting measles should die because there could be one in a million chance of an adverse event from the vaccine? I think that’s what people don’t really see, is that there’s continued effort to try to make the safest vaccines possible. But if you don’t have a vaccine, then you have people getting a disease, which can be fatal.
In his years with EarthSky, Jorge Salazar conducted thousands of in-depth interviews with scientists. He knows a lot about as diverse as nanotechnology, ecosystem-based management, climate change, global health, international environmental treaties, astrophysics and cosmology, and environmental security. Jorge currently works as a Technical Writer/Editor for the Texas Advanced Computing Center, which designs and deploys powerful advanced computing technologies and innovative software solutions for scientific researchers.