Immunizations: Risks and Benefits. Are they good? Are they bad? What?!

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By Karim Hackler

There are both minor and serious side effects that have been seen with immunizations. The Institute of Medicine (IOM) as mandated by the Childhood Vaccine Injury Act of 1986 review the information of adverse reactions to vaccinations and write a detailed report and give recommendations on vaccinations. The report details which populations should get vaccinated for certain vaccines and which populations shouldn’t.

There are some vaccines that should not be given to pregnant women or women who are considering becoming pregnant within the next 3 months for the theoretical risk of fetal infection. It is routine to ask women before vaccinating them if they may be pregnant and excluding them if they confirm that they might. Children who have febrile illnesses should wait to be vaccinated until they have recovered from the acute phase of the illness.

Hyper sensitivity reactions are rare with vaccinations and most of them are minor and usually consist of a rash or wheal and flare around the site of injection. Anaphylactic reactions are very rare, but have been reported with certain vaccinations. Children and adults who are immunocompromised with diseases such as leukemia, lymphoma, generalized malignancy or who are receiving therapy with alkylating agens, antimetabolites, radiation or large doeses of corticosteroids should check with their physician before receiving any vaccinations due to the possibility of infection and death.

Other vaccinations often will cause a local reaction that consists of erythema and induration which may or may not be accompanied by tenderness at the site. There may also be a nodule felt that may last for several weeks and very rarely sterile abscesses occur. Frequently there are mild systemic reactions characterized by fever, drowsiness and anxiety. Infrequently moderated to severe systemic events with a high fever, persistent, inconsolable crying, collapse and short-lived convulsions will occur and also reported rarely are more severe neurologic events such as acute encephalopathy have been reported. These reactions appear to be more common in children with a serious acute neurologic illness.

Vaccinations have had many positive effects on society. Because of vaccinations the eradication of smallpox was possible. A disease that during the 20th century was responsible for an estimated 300-500 million deaths was eliminated. Vaccinations have also been responsible for making what once were common childhood diseases such as Pertussis, Polio, Measles, Mumps, Rubella, Varicella and others, uncommon. This immunity that has been provided to many members of society has reduced mortality of the population and helped to make society more productive.

Sources:

Centers for Disease Control. (1996). Update: vaccine side effects, adverse reactions, contraindications, and precautions recommendations of the advisory committee on immunization practices (acip) . Morbidity and Mortality Weekly Report, 45(12), 1-35.

Barquet N, Domingo P (1997). Smallpox: the triumph over the most terrible of the ministers of death. Ann. Intern. Med. 127 (8 Pt 1): 635–42.