Let’s emphasize the benefits of vaccinations

Once again, I was disappointed to read an extensive article in the Daily Inter Lake (Feb. 26) giving a local physician and now member of the Flathead County Board of Health the opportunity to emphasize the risks rather than the benefits of vaccination. At a time when the United States Center for Disease Control is racing to spin up a new vaccine for the COVID19 (Coronavirus) outbreak, as well as new drugs and screening tests, and being widely criticized for not responding fast enough, I find it ironic that we in Flathead County should be reading about the risks rather than the benefits of vaccination.

As a cardiac surgeon I always discussed the risks and complication of any surgery with my patients and always emphasized that they were rare. If I felt an operation’s risk was warranted based on its potential benefit, I recommended it and emphasized the benefit to allay fear. To repeatedly remind a patient of the risk of a treatment rather than the benefit is not allowing informed decisions but rather scaring them into poor decisions.

Dr. Bukacek says that she advises “guardians of children to educate themselves about the risks as well as the benefits” of vaccination. I wonder if Dr. Bukacek recommends that her patients have their children and themselves take advantage of the extremely low risk vaccinations that have changed the face of medicine in the 20th century, or if she leaves that up to the patient after telling them that their child may be permanently damaged or die.

Dr. Bukacek in the past has accused me, as a retired physician, of having the leisure to do literature searches. That is correct. In addition, however, though not required by the state of Montana, I read multiple medical websites almost every day and continue to do continuing medical education online in my specialty and medicine in general and use my extensive medical and scientific background as a former practicing surgeon, researcher and author as a basis for my opinions. She should do the same if she wishes to contribute her opinions to the public domain.

She claims that the existence of the National Vaccine Injury Compensation Program (VICP), which she discovered in 2009, “made it clear to me that these vaccines are not as safe as I was taught.” She feels that “if a manufacturer puts an unsafe product out on the market that harms consumers of that product, shouldn’t the maker be held accountable?” Perhaps she should look a little closer at the reason for the program’s existence.

The VICP was begun in 1988 after a number of lawsuits over the pertussis portion of the DPT (diphtheria, pertussis, tetanus) childhood vaccination drove all but one manufacturer out of production and the last remaining manufacturer threatened to stop making the vaccine.

To maintain a supply, Health and Human Services set up this panel to eliminate lawsuits that were chasing manufacturers out of the litigious and lower profit (estimated at 5% vs. 65% profit for Apple on your iPhone) vaccine business. Vaccines are more complicated to make than other drugs, have limited shelf life and require much more strict and expensive quality control. Does Dr. Bukacek believe that a reasonable manufacturer with shareholders to answer to would rush to develop a Coronavirus vaccine and put it out with minimal testing if they would be held liable for problems discovered months or years later? How about providing unproven cancer therapies that desperate patients are willing to try even though not fully tested without some protection?

Over the past 31 years, 21,000 petitions have been filed, 18,000 have been adjudicated and 7,000 have been given awards. Over $4 billion have been awarded, one award for every million vaccinations. Many awards are for injuries which have no cause and effect or scientific basis (such as 350 claims for autism comprising nearly a quarter of the filings ) and includes 1,200 claims for injury that occurred before the program was established. Lawyers also sued the manufacturers of thimerasol, a preservative in vaccines in the early 2000s and no longer used which also had no scientific link to autism. This was also finally ended in 2010 with a court opinion that, “The overall weight of the evidence is overwhelmingly contrary to the petitioners’ causation theories.” In fact the rate of autism continues to rise despite thimerasol no longer being used as a preservative in vaccines. Many other unproven claims for injury have received compensation, including for diseases such as fibromyalgia and multiple sclerosis.

I should also mention that often lawyers’ fees are paid even if there is no award for injury. Injured parties and their lawyers are free to file civil suits if their claim is denied, but that is rarely done, lending credibility to the thoroughness of the process.

It is estimated that there are two to three million deaths each year worldwide as a result of vaccine preventable diseases with 90,000 from measles, 160,000 from pertussis, 70,000 from tetanus, a million from hepatitis B and 826,000 from pneumococcal infections to name some. Do we really want to see these numbers here in the United States and Flathead County?

Finally, Dr. Bukacek says she has qualms with the concept of herd immunity. This widely accepted theory says that when a high enough percentage of a population (95%) are protected from infection by having been vaccinated, the disease is less likely to spread, especially among the old, the sick and the very young who may not yet have been immunized or are vulnerable due to failing natural immunity. I wonder how she explains the disappearance of polio with only 21 cases in 2017 in two countries, Afghanistan and Pakistan or the eradication of smallpox. Since we live in cattle country, I wonder what she thinks of the state law requiring all sexually intact female cattle and bison be vaccinated for brucellosis, a policy which has greatly decreased the incidence of the disease in cattle herds since the 1940s?

As physicians, patients rely on our knowledge and advice to make informed decisions regarding their and their families’ care. All treatments have some risk. But we have not increased life-expectancy in this country by over 60% (from an age of late 40s to an age of late 70s) since 1900 by avoiding the addition of new treatments to our arsenal. Scaring patients away from vaccination by emphasizing extremely rare side effects rather than the very real benefits is wrong. Placing others at risk because your physician has “qualms” about the scientifically accepted (by nearly all except anti-vaxxers) concept of herd immunity is wrong and at the very least will result in exclusion of your unvaccinated child from school or group activities for days to weeks should an outbreak occur at their school.

Flathead County and their Health Department need to continue to advance the need for more widespread childhood immunization. If Dr. Bukacek disagrees, she is free to advise her patients any way she wants. It is their choice to go to her as a physician. But as a member of the Board of Health, she should not use her bully pulpit to continue to emphasize the extremely rare adverse side effects of vaccination but rather support their use to prevent disease.

Dr. David Myerowitz is a retired cardiac surgeon and former chairman of the Flathead County Health Board. He lives in Columbia Falls.