Compulsory vaccines: an update on parents' questions

Vaccination against 11 diseases became mandatory on January 1, 2018. Distressed by many contradictory noises, some parents are very worried. Update on the issues that arise.

In addition to the three already compulsory vaccines (diphtheria, tetanus and poliomyelitis or DT-Polio), 8 vaccines already recommended become mandatory in 2018: whooping cough, measles-mumps-rubella (MMR), Haemophilus influenzae b, pneumococcus, meningococcus C and hepatitis B .
These eleven vaccines will be essential for the child to be admitted to the community (nursery, school ...). Some parents are very worried about the avalanche of contradictory information generated by anti-vaccine lobbies.

Why 11 compulsory vaccines?

The main argument for the move to 11 compulsory vaccinations is the drop in immunization coverage for vaccines so far non-mandatory and the resurgence of certain diseases. Coverage is good in France for diseases for which it is mandatory (polio, tetanus, diphtheria) or for those whose vaccines are almost systematically (whooping cough, Haemophilus influenzae b) combined with the compulsory vaccines.
On the other hand, for other diseases, especially measles, vaccination coverage in France is notoriously too low to protect the entire population against the disease: children die or have measles after-effects in France in 2017.

Efficacy and safety demonstrated

The 11 vaccines that are now mandatory are very effective. They protect children more than 90% against diseases and adverse effects, when they exist, are usually minor and short-term.
Some minor side effects are common to all injectable vaccines: injection site reaction (pain, redness, swelling) in approximately 10 cases in 100 vaccinated children), some general effects, also short-term (fever, muscle or joint pain) ) in 1 to 10 cases out of 100 vaccinated.
Serious allergic reactions are extremely rare (less than one case out of 450 000 vaccinated), but they are mentioned in the majority of the certificates of convenience of compliant treating physicians. But other adverse effects, sometimes attributed to certain vaccines, are scientifically unfounded and the entire scientific data has been reviewed independently by INSERM to establish the proven facts on vaccination.

No link between autism and measles immunization

The scientific evidence of the lack of link between vaccination against measles (or measles-mumps-rubella type MMR vaccines) and inflammatory bowel disease or autism are now numerous and very high scientific level.
The only study that suggested a link between MMR immunization and autism was not comparative and did not involve children: it was a scientific fraud by one of its authors, Dr. Wakefield. The co-authors have all retracted. The article was removed from the Lancet. The fraudulent doctor has been struck off the order of the British doctors.

No link between multiple sclerosis and vaccination against hepatitis B

Numerous and very large studies were conducted between 1996 and 2004: they all eliminated the suspected link between vaccination against the hepatitis B virus and autoimmune adverse effects in adults such as neurological lesions like sclerosis in plaques or other autoimmune diseases. These diseases can unfortunately occur quite by chance after vaccination in young adults, the age group where these diseases are most often reported. This is an additional reason for vaccinating infants because no link to multiple sclerosis has ever been observed during infant vaccination.

No toxicity of admixtures such as aluminum

In view of the data available to date worldwide, with a use lapse of up to 90 years for some vaccines containing this adjuvant and hundreds of millions of doses injected, the safety of the aluminum salts contained in vaccines can not be questioned. Aluminum injected with mandatory vaccines represents only 4 and 5 milligrams in total of aluminum, a drop of water compared to what it receives in drinking water and food. A team of French researchers had suggested a link between the lesion at the site of injection called "macrophage myofasciitis", which contains traces of aluminum (as a tattoo contains ink) and the existence of non-specific chronic symptoms. such as fatigue, muscle or joint pain or cognitive impairment. The independent analysis by other teams of their results has not yet made it possible to demonstrate the existence of this link. In addition, this disease has hardly been observed outside France, whereas vaccines containing aluminum are used everywhere.

No depletion of the immune system with combination vaccines

Combined vaccines have the main interest of facilitating the vaccination of infants (fewer injections, fewer medical appointments for parents).
The immune response obtained for each of the infections is not inferior to that observed when the different vaccines are administered separately. Adverse effects are no more common with the combined form than with separate (and concomitant) administration of different vaccines.
Finally, the arguments developed by the anti-vaccine lobbies, which claim that the combined vaccines would cause a "depletion of the immune system" of the infant, are not based on any scientific basis.
The stimulation of the immune system induced by a vaccine, even if it is hexavalent, is in fact negligible compared to its capacity of response and compared to the many numerous daily environmental stimulations that an infant receives from its birth (less than 0,01% d use of theoretical immune capacity according to some experts.

The natural protection transmitted by the mother is not enough

Anti-vaccines regularly rely on antibody immunity, naturally transmitted by the mother to her baby during pregnancy or breastfeeding. This natural protection is not enough because it is on the one hand temporary and too partial: the maternal antibodies diminish quickly because of their short life cycle: it is estimated that an infant loses half of the maternal antibodies every 3 weeks . Moreover, if the mother herself has not been properly protected, she may not transmit anything at all.

The protection is not better but more dangerous with the disease

Some parents consider that it is more natural and better for the child to acquire protection alone during each illness.
Besides leaving children with repetitive infections and diseases such as measles, whooping cough or mumps is very cruel, it poses a risk to other children, who could not be vaccinated because they are sick and immunocompromised. Above all, immunity conferred does not seem better and having measles, like other diseases, is a life-threatening and life-threatening risk.

The "vaccine lobby" is only looking to get rich

The announcement of the extension of compulsory vaccination has made the public and politicians hear the rumor of a "decision that would fatten the vaccine industry." This assertion deserves to be weighted because although certainly 5 laboratories represent 80% of the world market, France represents only a very small part of this market and the growth of the expected vaccination is only a few percent since most vaccines were already being made and that is to pass for measles from 79 to 95%. Finally, according to the pharmaceutical industry union, vaccines account for only 3% of the global medicines market in 2009. It seems far from the bonanza and closer to supply disruptions.

What is the risk of refusing vaccination?

Children born from 1 January 2018 and who will not be in compliance with their mandatory vaccinations will not be able to return to nurseries and school, so as not to expose other children, immunocompromised or not, to potential risks related to diseases. To allow time for compliance, the first checks will only take place on June 1st.
Until now, parents who refused compulsory vaccination risked an administrative conviction under the Public Health Code (Article L 31116-4). This law was abolished by the government and parents can be sentenced in criminal cases: Article 227-17 of the Penal Code punishes two years' imprisonment and a 30,000 euro fine "by the father or mother, to evade, without lawful reason, her legal obligations to the point of compromising the health, safety, morality or education of her minor child ".
Regarding doctors, the Council of the Order will be ruthless and a doctor has just been struck off for false certificate of contraindication to vaccination.

Compulsory vaccination is a sign of the failure of public health policies that have failed to convince society and parents of the importance of vaccination. But this obligation is now necessary to move forward.