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Vaccinations: More Important Than Ever

Measles. Whooping cough. Vaccines. Immunizations have been a hot topic with recent disease outbreaks.

The incidence rate for some of these diseases has declined as more people are vaccinated, but many are still at risk, highlighting the need for immunizations.

Listen in as Dr. Martin Bäcker discusses the importance of vaccines and why you should make sure your whole family is vaccinated.

Vaccinations: More Important Than Ever
Featured Speaker:
Martin Bäcker, MD
Dr. Martin Bäcker is a family practitioner at Pacific Crest Family Medicine and Memorial Cornerstone Medicine. He was born and raised in Buenos Aires, Argentina, where he also attended medical school. He moved to the United States in 2003 to complete his residency and a combined fellowship in adult and pediatric infectious diseases. He is fluent in English and Spanish.
Transcription:
Vaccinations: More Important Than Ever

Melanie Cole (Host):  Measles, whooping cough, vaccines, immunizations have been really a hot topic with recent disease outbreaks. The incidence rate for some of these diseases has declined as more people are vaccinating, but many are still at risk, which highlights the need for immunizations. My guest today is Dr. Martin Backer. He’s an internist and pediatrician specializing in infectious diseases at Pacific Crest Family Medicine and Memorial Cornerstone Medicine. Welcome to the show, Dr. Backer. Tell us a little bit about some of the vaccines and what you do when newborns are born. What vaccines do they get? And explain a little bit about the importance of them. 

Dr. Martin Backer (Guest):  Sure. Thank you, Melanie, for having me. From day one, we start with immunizations, and we start with hepatitis B vaccine. A lot of parents are like, “Oh, why does my child need that?” Actually, it’s one of the vaccines that can prevent cancer. Liver cancer can be caused by hepatitis B. Then most of the vaccines we give kids start at two months of age. We give vaccines against some of the most significant killers of kids for years, including polio, Haemophilus influenza, including pneumococcal vaccine. A lot of very important pathogens are prevented with the vaccines. 

Melanie:  When you give these new vaccines to a newborn, do parents ask you about giving more than one vaccine? Because I know even at two months, there’s a few. You get rotavirus or the second dose of hepatitis B, or the DTaP. Tell us about what parents ask you when there’s more than one vaccine at a time. 

Dr. Backer:  Absolutely. We do have, fortunately, vaccines against a lot of different agents. Fortunately as well, we’ve been able to combine those in fewer shots. No kid or parents like the shots, so combination means less shots at a time. Some parents do have concerns that am I not introducing too much at a time for my kid. Isn’t that too much for his or her immature defenses? The truth is, no, it’s not too much. Quite the contrary, what we’re doing is we are preventing actual infections, which would be much more burdensome for the defenses than what the vaccines are. Yes, we have antigens, which are almost like particles of viruses or bacteria against several bacteria or viruses, but in real life, kids get exposed to much more than that, tons of viruses that we don’t have any vaccines against that. This is not unnatural and not harmful, but quite the contrary. It helps prevent these infections, which can be serious and even deadly. 

Melanie:  For example, the pneumococcal vaccine, you have to have a few doses. And many of these vaccines need more than one dose. Why is that? 

Dr. Backer:  Absolutely, you are correct. The majority of vaccines we give to the young kids include a series of vaccines, a series of shots, because the defenses of the child are definitely developing and they are not as mature. First, we introduce the first vaccine, and then the body starts to learn how to respond to that. Then when we get re-exposed, then we get an anamnestic or memory response, and then we know how to respond against it much better. We do see that after one dose of vaccine, there often will be some response, but we think it might not be protective enough. But when we give more than one of those, that would have given the best response. What’s important to understand is that the number of vaccines that we give for a specific disease that we are preventing is not something random that somebody said, “Okay, let’s try three. Let’s try two. Let’s try five.” They did try different things. There’s been, first, in vitro studies, following by animal studies, usually, and then human studies that have supported the current schedule of immunization that they’ve recommended. 

Melanie:  Dr. Backer, I’d like to ask you about the measles, mumps, and rubella, the MMR vaccine, that receives a lot of press, especially lately. And measles has seen a recent [surgence], and we’ve seen measles cases breaking out all over the country. Tell us about the safety and efficacy of the MMR vaccine. Tell the listeners what you want them to know about this vaccine. 

Dr. Backer:  Absolutely. I’m glad you bring this up. Something good comes out of everything bad and vice versa. It’s tragic that we are having so many kids get measles in the United States when we have had an effective and safe vaccine for several decades. Most of the kids that have gotten measles—not all of them, but most—have been unvaccinated kids, and even the ones that have been vaccinated usually have been in a setting where unvaccinated kids have facilitated the introduction of the virus again in the community. The vaccine works very well. Typically, we recommend two doses. The first dose is given usually at the first year or thereabout, and the second one is typically given at four years of life, though it can be given at any time after one month after the first dose. We believe you get protection after the first one, but you get much better protection after two doses. In an outbreak setting, if your kid is between one and four and has only gotten one dose, they might benefit from getting a second dose, something to talk about with your child’s doctor. There has been a huge spread in the number of cases, many of these associated with one very large outbreak seen across the nation related to Disneyland. But there has been a number of other outbreaks. The cases of measles have been going up over the last few years, and that has to do with the number of parents choosing not to vaccinate their kids. Unfortunately, there have been some concerns raised about the safety of the vaccine, not based on any science whatsoever. There has been one study published 25 years ago, almost, that all of the authors in the medical journal except one of the authors have retracted in saying, “You know what? The data we had was no good,” or this was fraudulent. “We do not support this publication anymore,” Except one of the original author, which linked the vaccine with autism. There are more than a couple of dozen studies that have found no association between the measles, mumps, rubella vaccine and autism. The vaccine has been given to millions of kids worldwide and is considered to be very, very safe and effective. Measles can not only be serious, but as we suggested before, it can be deadly. It is a vaccine-preventable condition. 

Melanie:  Measles is a nasty disease. Is it ever too late to get the vaccine? 

Dr. Backer:  No, it’s never too late to get the vaccine. If somebody has not had the vaccine and has not gotten the disease, no evidence of having defenses, they can get it no matter young or old, even the really old. Typically, we’re seeing that people born before 1952 or ’57 are believed to be immune or have defenses just because it was so universal that it is pretty much everybody had been exposed to it back then. Since the vaccine became more common, then the disease became less common. 

Melanie:  There is so much information about vaccines, Dr. Backer. We could do a lot of topics on this. Now, talk about the HPV vaccine because that’s been in the news a bit lately too. This is now given to teenage or preteen girls and boys. Explain a little bit about this vaccine. 

Dr. Backer:  Sure. The HPV or human papillomavirus vaccine is a great vaccine. It’s not a live virus. It’s a very cool technology. And yes, we don’t have time to go into how they make it, but it’s a very safe vaccine that helps prevent infection with this virus that can cause not just genital warts but also cancer, cervical cancer, but also penile or anal cancer. The virus that causes these infections is a very, very common virus, and the vaccine works really well. Studies show that perhaps the best response is when we give it as young as nine years of age. The current vaccination calendar calls for giving the vaccine—it’s a series of three shots—at age 11, and that is because we are already having kids going to see their pediatricians or their doctors at the age of 11. For other shots, we combine it at that point. Also, because a lot of parents say, “Why do my kids need the vaccine for a virus that’s transmitted sexually at age 11? They are not having sex.” Certainly, we don’t think and we don’t hope that they’re having sex at that age, but precisely giving the vaccine way before they have exposure is the best way to make sure they are protected. If we wait until they’ve already had exposure, the vaccine does not work. We really want to give it clearly before they’ve had any exposure and the vaccine works best at a young age and it’s believed to have a very long-lasting immunity or defense. It’s important to bear in mind this really helps prevent cancer, and we can offer our kids the vaccine that prevents cancer and not have regrets that way down the road. Another thing many parents will say, “Well, this is a vaccine for a sexually transmitted infection. Will it encourage my child to have sex or unprotected sex?” There are many studies that have looked into this question and have shown that it doesn’t. It doesn’t make a difference in whether the child is having sex or not or having unprotected sex. It just protects them against one virus that can be acquired that way that can cause cancer. 

Melanie:  In just the last minute if you would, Dr. Backer, give the listeners your best information and advice what you tell your patients every day about the importance of vaccinations. 

Dr. Backer:  Yes, those vaccines have been around for several decades, many of them. Some of them are new ones. They are very safe, given to millions of patients. And the healthcare community, as a whole, it’s unanimous in its recommendations. They save lives. They prevent diseases. They keep us healthy. They work and they are safe. Everything has risks, but we need to think not just the risk of doing but the risk of not doing. The risk of giving vaccines is exceedingly low. Serious consequences are almost unheard of, while our risk of not giving them are quite common. If you have questions, I encourage everybody to talk to his or her doctor and ask those questions  to help keep us safe. It not just keeps me and my family safe but you and your family. We help protect each other. 

Melanie:  Thank you so much, Dr. Backer. You are listening to Healthy Yakima. For more information, you can go to yakimamemorial.org. That’s yakimamemorial.org. This is Melanie Cole. Thanks so much for listening.