Addressing Parents’ Concerns: Do Vaccines Cause Allergic or Autoimmune Diseases?

Abstract

ABSTRACT. Anecdotal case reports and uncontrolled observational studies in the medical literature claim that vaccines cause chronic diseases such as asthma, multiple sclerosis, chronic arthritis, and diabetes. Several biological mechanisms have been proposed to explain how vaccines might cause allergic or autoimmune diseases. For example, allergic diseases might be caused by prevention of early childhood infections (the "hygiene hypothesis"), causing a prolongation of immunoglobulin E-promoting T-helper cell type 2-type responses. However, vaccines do not prevent most common childhood infections, and large well-controlled epidemiologic studies do not support the hypothesis that vaccines cause allergies. Autoimmune diseases might occur after immunization because proteins on microbial pathogens are similar to human proteins ("molecular mimicry") and could induce immune responses that damage human cells. However, wild-type viruses and bacteria are much better adapted to growth in humans than vaccines and much more likely to stimulate potentially damaging selfreactive lymphocytes. Consistent with critical differences between natural infection and immunization, well-controlled epidemiologic studies do not support the hypothesis that vaccines cause autoimmunity.Flaws in proposed biological mechanisms that explain how vaccines might cause chronic diseases are consistent with the findings of many well-controlled large epidemiologic studies that fail to show a causal relationship.

Public Misunderstanding of Science? Reframing the Problem of Vaccine Hesitancy

“…He has been celebrated for his outreach efforts to correct misperceptions of vaccine safety (George 2011). In his abundant writing on the subject, which include numerous editorials in biomedical journals (2007b;2008c) and news sources (Offit 2007a;2008b;, parenting books (Offit and Bell 1999;Offit and Moser 2011), practical guides for physicians (Offit et al 2002;Offit and Hackett 2003;Offit and Jew 2003;Gerber and Offit 2009), and popular science books (Offit 2008a; with such inflammatory titles as Deadly Choices: How the Anti-Vaccine Movement Threatens Us All (Offit 2011a), he has framed the defensive strategy now emulated by others, including Michael Fitzpatrick (2004a;2004c), his British counterpart.…”

Early Vaccinations Are Not Risk Factors for Celiac Disease

“…15,16,22 These mechanisms are partly the same as proposed for how infections and microbiota might affect the risk for autoimmune diseases. 16,23,24 …”

“…12 Since initiation of the first program, changes have been made regarding types of vaccines used, age at administration, and number of doses. 13 Because vaccines modulate the immune system, they have been proposed to be causal risk or protective factors for autoimmune diseases [14][15][16] (eg, type 1 diabetes [T1D]). Because CD has autoimmune traits and shares several features with T1D, this may also apply to CD.…”

What do we know about how to improve vaccine uptake?

“…Providers should be well informed to address parents' questions, as research indicates that vague responses do not engender confidence; an excellent series of public domain articles is available in Pediatrics (30,31,32,33). Providers should also be careful not to "oversell" immunization, to outline expectations and management of common adverse events, including local injection site reactions and fever in infants and young children, and to address parents' fear of their child's pain associated with injectable vaccines and to offer methods to reduce it (13).…”