Addressing Past and Present Concerns
By Carol M. Steiner, MD, FAAP
During the COVID-19 pandemic, two terms have come to the forefront – “vaccine hesitancy” and “herd immunity.” While these concepts are new to many, they are familiar to pediatricians. Using herd immunity and effective vaccines to help control disease can be difficult for the public to understand. Let’s discuss some common concerns and how to address them.
Many people are questioning the use of aborted fetal cells in the production of vaccines and the possibility of DNA from vaccines changing our DNA. It is true that fetal fibroblast cell lines are used to make varicella, rubella, and Hepatitis A vaccines. It is also true that fetal retinal cells are used to make the Johnson and Johnson (J&J) COVID-19 vaccine; however, exploring the history of vaccine production can help clarify concerns.
The fetal fibroblast cells used to produce vaccines were originally obtained from two elective terminations in the early 1960s and maintained in laboratories for the last 60 years. No new fetal cells have been needed to continue these cell lines. The fetal retinal cells used in the J&J COVID-19 vaccine were obtained in 1985 from a single elective termination and have been grown in labs since then. Viruses grow better in human cells than animal cells and can be produced in larger amounts for more rapid and efficient vaccine production. DNA from fetal cells is removed during processing and cannot affect our DNA. Adenovirus vaccines, like J&J, cannot affect our DNA because they lack the necessary enzyme, integrase.
Measles was eliminated in the U.S. by 2000 due to the MMR vaccine, which offered 93-97% protection. Unfortunately, the decline in MMR vaccinations has led to several outbreaks since 2015. Without immunization, a person exposed to measles has a 95% chance of becoming infected.
Haemophilus influenza B (HIB) was a frequent cause of meningitis and epiglottis. In 1992, when I was a third-year medical student on my Pediatric rotation, we admitted kids with HIB meningitis every week. Some children didn’t survive, while others suffered hearing loss or mental disability. The following year, the HIB vaccine was introduced and was 90% effective in preventing disease. I have not seen a case of HIB meningitis or epiglottis since then.
I’ve received many questions from parents about vaccines for breastfeeding moms and children. Early studies have shown that maternal antibodies to COVID-19 do pass through breast milk, supplying passive protection. In May, the Food and Drug Administration (FDA) approved the Pfizer vaccine for children ages 12-15. Moderna plans to seek approval from the FDA in early June for adolescents as well. With continued studies, younger children (ages 2-11) may be able to be vaccinated this fall and infants should be eligible to receive protection by early 2022.
The efficacy of COVID-19 vaccines over the last few months has helped with vaccine acceptance. With increased COVID-19 vaccinations, we’ve seen improvements in case numbers, hospitalizations, and deaths. Vaccination is the key to ending the pandemic.
Carol M. Steiner, MD, FAAP, is a pediatrician, with over 22 of experience, at TPMG James River Pediatrics. mytpmg.com