Immunizations

An interesting opinion piece in the NY Times. This may be common knowledge to all my doctor and pharmacist buds, but it wasn't to me.

Nice Shot - New York Times
But the idea that illness is good for children — or anyone else — is wrong. In part, the idea of “good sickness” is a throwback to a now disproved version of the “hygiene hypothesis.”

In 1989, an epidemiologist in Britain, David Strachan, observed that babies born into households with lots of siblings were less likely than other babies to develop allergies and asthma. The same proved true of babies who spent significant time in day care. Dr. Strachan hypothesized that the protection came from experiencing an abundance of childhood illnesses.

Dr. Strachan’s original hygiene hypothesis got a lot of press, not only in the news media but in serious medical journals. Less publicized was the decade-long string of follow-up studies that disproved a link between illnesses and protection from inflammatory disorders like allergies and asthma. If anything, studies showed, early illness made matters worse.

Moreover, studies now show that the more infections a person has during childhood, the greater his or her chance of premature death from scourges of old age like heart disease and cancer. The link appears to be chronic inflammation, a kind of lingering collateral damage from the body’s disease-fighting response.

Still, Dr. Strachan’s original observation was confirmed — as a group, babies in large families and day care are less likely to develop allergies and asthma than are children born into smaller families and kept at home. The same protective effect can be seen in children born on farms and in areas without public sanitation.

But the link isn’t disease-causing germs. It’s early and ample exposure to harmless bacteria — especially the kinds encountered living close to the land and around livestock and other young children. In other words, dirt, dung and diapers. Just as disease-causing microbes clearly bring on inflammation, harmless microorganisms appear to exert a calming effect on the immune system.

A second misconception common among vaccine-shunning parents is that there’s something “natural” about the 6 to 10 respiratory infections the typical American child gets every year (or even the two to four we adults experience). Common, yes; natural no, not if “natural” represents the forces that shaped the human immune system during all but the last sliver of our 250,000 years as Homo sapiens. Colds, flus and most other contagious diseases found a central place in our lives only after we and our domestic animals began crowding together in large settlements some 5,000 years ago.

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