Berlin (dpa) - Vaccinations are a blessing, boosting immunity to
many infectious diseases, but they often come under criticism because
they can have side effects. These are occasionally so serious that
some people refuse to be vaccinated.
"Vaccinations act on our immune system, which is necessary for
them to work. This sometimes causes unwanted side effects, however,
as does any effective medicine," noted Jan Leidel, chairman of the
Standing Vaccination Committee (STIKO) of the Berlin-based Robert
Koch Institute, the federal institution responsible for disease
control and prevention in Germany.
The most common side effects, Leidel said, are what are called
vaccination - or immunization - reactions. They occur in several per
cent of vaccinees, are nothing to worry about and include both
localized and general reactions that are mild and short, such as pain
at the injection site or flu-like symptoms.
"If the symptoms exceed those of vaccination reactions - for
example, if they are very strong or prolonged - they are called
postvaccinal complications and the person should see a doctor,"
Leidel said.
A lengthy, high fever or the formation of an abscess at the
injection site fall under this category. Postvaccinal complications
are rare, occurring in less than 1 per cent of vaccinees, and usually
require short-term treatment only.
Among the millions of people vaccinated each year, there are also
some who contract a chronic illness from the vaccination. These are
known as cases of vaccine damage.
"Probably one of the best-known of these illnesses is
Guillain-Barre syndrome, an inflammatory disorder affecting the
peripheral nervous system that can cause paralysis and muscle
weakness," remarked Martin Hirte, a member of Doctors for a Personal
Vaccination Decision, an association of physicians in Germany that
supports continuation of the individual's right to voluntary,
informed consent to vaccinations.
Originally a possible after-effect of certain infectious diseases,
the syndrome has appeared after various vaccinations, including
against influenza and early-summer meningocephalitis (ESME) - also
known as tick-borne encephalitis (TBE) - Hirte said.
Under Germany's Infection Protection Act, physicians must report
suspected cases of postvaccinal complications to local health
authorities.
The cases are then thoroughly examined by the Paul Ehrlich
Institute (PEI), a German federal health body whose responsibilities
include ensuring the safety of vaccines, as well as the Robert Koch
Institute.
This is important so that risks are detected and countermeasures
can be taken, if necessary. Depending on the extent and seriousness
of the complications, a notice is included in the patient information
leaflet, the medical indications for the vaccine are reduced or the
vaccine is taken from the market.
If the complications are due to a vaccination recommended by
STIKO, the affected person is entitled to government benefits. "This
holds even if the causal link between the vaccination and illness is
merely probable," said PEI spokeswoman Susanne Stoecker.
The PEI is tasked with evaluating all reports of suspected links.
It checks, among other things, whether the symptoms are already known
to be a side effect or postvaccinal complication and whether the
unwanted reaction can be scientifically explained.
It also sees if it can rule out other possible causes, such as a
predisposition to the illness or to an infection that can result in
the illness.
"Real detective work is often involved," Stoecker said, adding
that the work was especially difficult when the interval between the
vaccination and the appearance of the illness is long.
This, according to Hirte, is the likely reason that the long-term
effects of many vaccines are still debated even when various studies
have deemed the effects to be probable. To increase clarity, he said
he would like to see more long-term studies and greater readiness to
report vaccine damage.
"I'd currently put the reporting rate at 10 per cent," he said.
"That's much too small to get a representative picture." As a result,
he pointed out, possible causal links remain unknown.
Neither STIKO nor PEI rule out occasional casual links either.
"But there still hasn't been clear evidence for or against," Leidel
said. He strongly discourages people from deciding whether to receive
a vaccination on the basis of possibilities - for the sake of their
own health as well as that of others.
Hirte, too, is not against vaccinations in general. He advocates
that a person's decision to have a vaccination should be personal.
Copyright 2011 dpa Deutsche Presse-Agentur GmbH