Dear Dr. Roach: I know people who home-school their kids because they won鈥檛 allow them to be vaccinated as required by the schools. There must be studies that show the percentage of children who are adversely affected by vaccinations as听opposed to those who are听adversely affected by having the diseases. Can you discuss this?
M.F.
Vaccine requirements differ from state to state for school-age children, but in California, a bill recently was passed mandating vaccines for polio; diphtheria, tetanus, pertussis (DTP); measles, mumps, rubella (MMR); hepatitis B; and varicella (chickenpox). Children who are not fully vaccinated will be unable to听attend public school unless they have a medical reason not to be.
Some of these conditions are now quite rare in the U.S. and Canada, so adverse events from vaccine-preventable diseases are rare. In fact, the United States was declared measles-free in 1990. However, children and adults still can be exposed to measles, and recent outbreaks show that transmission still can occur, probably from a visitor from a country that still has听measles, especially as听immunization rates in the听U.S. have decreased in听certain communities. There have been about 800听cases of measles in the听U.S. in 2014 and 2015 so听far, with one death.
These vaccines are very, very safe. While minor side-effects occur occasionally, serious side-effects occur very rarely. For the MMR vaccine, the rate of a serious reaction, such as severe allergic reaction, are less than one per million. Autism, once incorrectly claimed to听be triggered by the MMR听vaccine, has been shown in many studies to have no association with the听vaccine.
The vaccination rate is听still very high, and for this reason measles has not spread widely in the U.S. Until measles is eradicated from the world the way smallpox was, measles vaccination still is required to prevent a devastating outbreak, since measles is remarkably contagious. The arguments are identical for polio, diphtheria, rubella and mumps. Varicella is still endemic, and a vaccine helps protect against serious complications.
Being compliant with recommended vaccines is very safe, it protects you and your children and it听protects people with immune system disease who cannot protect themselves with vaccines.
听
Dear Dr. Roach: I have noticed that my 22-year-old granddaughter鈥檚 eyes are bulging more than in the past. She has not had a recent thyroid test. Can you help me understand the cause of this?
She is also addicted to table salt. What problems will this overuse of salt cause her? Are the two conditions connected? L.M.
Exophthalmos, the bulging appearance of the eye, is a classic sign of Grave鈥檚 disease, an autoimmune stimulation of the thyroid gland, where antibodies bind to receptors in the thyroid, stimulating it to produce more hormone. The bulging is not a result of thyroid excess, but rather a cross-reaction of the antibody to fat cells behind the eye, causing the eye to bulge out. Treatment for excess thyroid hormone doesn鈥檛 reverse this, because the antibodies are still present. Your granddaughter needs to be tested for Grave鈥檚 disease.
I have seen people whose eyes just appear to bulge. They have sometimes had dozens of thyroid tests, as every doctor they see checks their levels. Other conditions that can simulate exophthalmos include obesity, Cushing鈥檚 syndrome, inflammation of the eye muscles and other inflammatory diseases.
Excess salt may increase blood pressure, and may even increase stroke risk in people with normal blood pressure, but I can鈥檛 think how it could be related to the appearance of her eyes.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Email questions to [email protected]
