Less Than Perfect Vaccine Better Than None At All
May 24, 2013

I’m a glass-half-full kind of person.  That’s why it’s frustrating to hear people reject vaccines on account of the fact that they aren’t “perfect”.
The fact remains that nothing (as far as I know) is perfect.  And when it comes to vaccines, there will always be those who argue that they aren’t worth getting if they aren’t 100% guaranteed safe or effective.
IStrive-for-Progress-Not-Perfectiont’s true that being vaccinated doesn’t ensure immunity, and there are times when a vaccinated person can still fall victim to the disease that they have been vaccinated for.  Additionally, there have been documented instances when a vaccine has triggered an adverse event that has resulted in unintended harm.  However, statistics show that it’s far more likely that a vaccine will be effective at preventing disease than not, and that millions upon millions of vaccines are administered without any serious adverse side effects.
While I accept that vaccines are not perfect, I’m still grateful that they are so widely used and accepted.  The fact that no one can guarantee 100% safety or efficacy doesn’t mean vaccines are ineffective or dangerous.  As with all other medical interventions, accepting vaccination is a matter of evaluating the relative risk and benefit.
First, we need to understand the dangers of the diseases we vaccinate for.  Knowing that these diseases can cause permanent health problems, hospitalizations and in some cases even death is essential to understanding that the diseases themselves are far more dangerous than the vaccines.   There is an abundance of scientific evidence that proves that vaccines are effective at reducing the risk of disease.  And, as we continually evaluate the safety and effectiveness of vaccines, experts analyze new and ever-changing data and use it to improve vaccination policies and protocols.
Take for instance the pertussis vaccine and the past and present research that has helped to evaluate the safety and effectiveness of this vaccine over the years.
In a nutshell, concern about the pertussis vaccine began years ago.  When adverse events were being reported that concerned the public and threatened to undermine parental confidence in vaccines, a new acellular version of the pertussis vaccine was developed to replace the older whole-cell version of the vaccine.  It was believed that this new vaccine would reduce the risk of adverse events, since it contained significantly less antigens, which are the components in the vaccine that help elicit the immune response.  In fact, the new acellular vaccine had as little as three to five antigens compared to the older vaccine which contained between 2,000 to 3,000 antigens.
While the risk of adverse events may have been reduced with the introduction of a new vaccine, years later we are now seeing a rise in the number of pertussis cases which has sparked research into the efficacy of the new acellular pertussis vaccine.   Just this week,  a new Pediatrics study confirmed that the increase in whooping cough cases in the United States could be attributed to the introduction of the acellular vaccine as a replacement for the whole cell pertussis vaccine. The findings confirmed that the older whole cell vaccine for whooping cough, which was phased out in the late 1990s, was more effective than the current acellular vaccine.
Tara Haelle’s recent article in Scientific American discusses the study in great detail and suggests that there is now

“more precise evidence that the earlier pertussis vaccine was superior to the current one, building on previous research that had already shown that the newer vaccine’s effectiveness wanes sooner than expected.”

Not only does this article summarize the background concerns with the whole-cell pertussis vaccine, but it also addresses the steps that are being taken to address policy changes in light of the waning immunity observed with the acellular vaccine.
The article, entitled “Shooting the Wheeze”, quotes Dr. Paul Offit as saying,

“The bright side is that this vaccine is much safer, but the price you pay is that you traded efficacy for safety.  The surprise is how big that trade was, which I don’t think anyone anticipated.”

Vaccines may not be perfect.   But, as Dr. Offit’s comments suggest, they are a constant work in progress.  This ongoing critical analysis of the pertussis vaccine demonstrates how today’s challenges will hopefully lead us to tomorrow’s solutions.
In response to the recent studies on pertussis, we can expect there will be discussion regarding new immunization policies to help prevent gaps in pertussis immunity. In fact, there are plans to discuss pertussis epidemiology at an upcoming meeting of the National Vaccine Advisory Committee meeting in June.  And it’s even probable that, in time, scientific developments and ongoing research will lead to a new and more effective pertussis vaccine.   That is, of course, the goal.  While scientists may never achieve 100% perfection in any vaccine, it is still something they strive for.
In the meantime, it’s important to emphasize that the current vaccine is the best available and even if it’s not perfect, it’s still an important preventive measure that can significantly reduce one’s risk of pertussis.  If nothing else, we must continue to educate the public that pertussis immunity does wane, that booster shots are needed to maintain protection through both our adolescent and adult years and that cocooning infants by immunizing those around them will provide them with the best possible protection.

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