“People are even writing with pride about not vaccinating their children.” Why is vaccination important?

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In the 20th century, vaccination made a major contribution to extending human life. Typically, any vaccination is much safer than the disease it protects against. Nevertheless, debates surrounding vaccination have never ceased. In any country, in any era, there have been people who consider vaccines harmful and claim that it is possible to live without them. However, the history of medicine and humanity shows the opposite. Rustam Norboyev, oncologist and chairman of the board of the “Ezgu Amal” charitable foundation, noted that the number of parents proudly writing on social media about not vaccinating their children has increased, emphasizing that this could also pose a risk to others.

### Why is vaccination necessary?

Preventive vaccinations are important for both children and adults. Certain diseases are very difficult to treat or can lead to severe complications. Vaccination is one of the primary protective measures in preventing diseases such as hepatitis B, diphtheria, tetanus, and pertussis (whooping cough).

Vaccination is especially important for young children, as their bodies are much more vulnerable to various infections. If a mother was vaccinated in a timely manner or has previously had a specific disease, antibodies passed from the mother can protect the child to some extent during the first months of life. However, this protection weakens over time. For this reason, vaccination must be started at an early age, in accordance with the preventive immunization schedule.

Protection against vaccine-preventable diseases is a right of every human being. A vaccine triggers the body's defense mechanisms, preparing the immune system to fight against a specific infection. As a result, the body develops protection against the disease for which it was vaccinated.

It is important to understand that the body may react to some extent after vaccination. In some cases, a rise in body temperature or other reactions are observed. Serious adverse reactions are very rare. For example, seizures or fever may occur in very rare cases after measles vaccination. However, measles itself can also cause severe complications. For this reason, it is important to decide on vaccination in consultation with a doctor, taking into account the person's health and individual condition.

Despite this, some parents perceive vaccination as a mere formality imposed by medical workers. A lack of sufficient understanding of the importance of vaccine prevention in protecting health can lead to an unjustified increase in cases of vaccine refusal.

### Problems in the vaccination system

“It is no secret to anyone, I think, that there are problems in our vaccination system and in the reliability of statistical data. But we are only now beginning to feel the consequences of these problems. And I fear that the situation could get even worse in the future.

To understand this, one does not even need to look at statistics. Sometimes, it is enough just to read comments on social media. People write openly, sometimes even with pride, about not vaccinating their children. But I do not want to blame only the parents for this,” writes doctor Rustam Norboyev.

According to the specialist, the biggest problem is the lack of normal and understandable information. If people do not get answers to their questions from doctors and the state, they start looking for answers themselves. This is where various “experts”, bloggers, healers, and other people who have absolutely nothing to do with medicine appear.

“The saddest part is that we—the medical community—also often simply remain silent. As if this problem does not concern us. But now it concerns all of us. After yesterday's meeting, I saw comments on Facebook and Instagram claiming that vaccines are the cause of SSPE. This is where the situation becomes truly dangerous. Because we might draw the completely opposite conclusion from this event,” he says.

SSPE (subacute sclerosing panencephalitis) is a very severe complication that can develop years after contracting measles. The measles vaccine does not cause SSPE. On the contrary, the best way to prevent SSPE is to prevent measles itself.

The specialist also emphasized that simply telling people to “get vaccinated” is not enough; this no longer works. He stated the need to gather infectious disease specialists, neurologists, epidemiologists, and pediatricians in one place to answer people's questions calmly and clearly.

“Which vaccines do we use? Where do they come from? How is their quality checked? What side effects can they have? What are the real contraindications? Why can a vaccinated child still get sick in some cases? Even so, why is it necessary to get vaccinated? People have these questions. This means they need to be answered,” he writes.

Rustam Norboyev noted that today there is no cure that completely heals developed SSPE. Such treatment does not exist not only in our country, but also in other countries of the world. But the fact that we cannot cure it does not mean we cannot help. On the contrary, a lot can be done for these children: controlling seizures and spasticity; ensuring proper nutrition; providing respiratory support if necessary; preventing bedsores; and providing care products and necessary equipment.

“Particularly, making anti-seizure medications available in child-friendly forms. Teaching parents how to care for such a child at home. And of course, these children need to be enrolled in the palliative care system early. Because palliative care is not 'a place where a person is sent to die.' It is helping the patient and their family in a situation where the disease cannot be cured,” he writes.

Addressing the issues of SSPE treatment, the specialist says he reviewed the national clinical protocol for this disease and saw that it includes intravenous immunoglobulin (IVIG). According to him, there is not enough reliable evidence confirming the effectiveness of IVIG specifically in SSPE.

“It is very important here to prevent the emergence of false hope among parents that 'there is an expensive medicine, the state is not buying it, and if we get this medicine, the child will recover.' Unfortunately, everything is much more complicated than that. Various antiviral and immunomodulatory treatments have been used in SSPE and are still used in some places. Perhaps in some patients, they can help slow down the progression of the disease. This can be discussed with specialists and applied in justified cases. But recovery cannot be promised,” says Norboyev.

At the same time, the doctor said it might be more effective to spend part of the funds on things that definitely improve the quality of life of these children: anti-seizure medications, special nutrition, anti-bedsore mattresses, aspirators, oxygen and respiratory support, care products, and palliative care.

“Sometimes it is easier for a chief physician to show a high vaccination rate than to admit there is a problem with vaccination. And for a family doctor, it is easier to get a written refusal from a parent and end the conversation than to spend hours explaining why the vaccine is needed. Especially if they hear insults or threats in response to the explanation. As a result, everything may look good on paper...”, he says.

Rustam Norboyev did not rule out that some of today's SSPE patients might have contracted measles before reaching the scheduled vaccination age or during periods of disruption in vaccination.

“When a parent decides not to vaccinate their child, this does not only affect their child. A child infected with measles can infect another child. For example, an infant who has not yet reached the age to receive the vaccine. Or a child with a weakened immune system. Or our oncological patient undergoing chemotherapy, whose immune system may not be able to respond normally to the infection. Therefore, vaccination is not just a matter of 'my child—my decision.' It is also a matter of responsibility to one another,” he says.

### Vaccination schedule in Uzbekistan

At birth, newborns are given a “Vaccination Passport” in the maternity hospital, which indicates the vaccinations they must receive and the timeframes for administering them. The vaccination passport records each administered vaccination and those scheduled for the future.

Children must undergo a medical examination before vaccination. Before preventive vaccination of children, the general condition of the child being vaccinated is evaluated first. In doing so, the parents or the person who brought the child are asked about the child's health. Through this, it is determined whether there are contraindications to vaccination and whether any adverse reactions were observed during previous vaccinations.

### What does UNICEF say about vaccination?

For more than 75 years, scientists have carefully analyzed the short- and long-term health and development of hundreds of millions of vaccinated children worldwide. Over these years, studies of millions of vaccinated children have found no reliable link between vaccination and autism, autoimmune diseases, or other long-term health disorders. Also, vaccination does not increase the risk of contracting other infectious diseases. Furthermore, there is evidence that vaccines can help the immune system fight against viruses for which they were not specifically vaccinated.

Any risks associated with vaccination must be compared with the risk of contracting the diseases that existing vaccines protect against. For instance, if an unvaccinated infant contracts pertussis, the probability of developing severe complications that can lead to death is 1 in 20. If an unvaccinated child contracts measles, and they are in a middle- or high-income country, their probability of dying is 1 in 500. This means that the risk of complications caused by the disease is several times higher than the risk of complications caused by vaccines.

### If the vaccination schedule is delayed...

Because children's immune systems are still in the early stages of development, infants and older children are not as protected from viruses and other diseases as healthy adults. A child's body and internal organs are still developing, and a disease that causes mild symptoms in a healthy adult can lead to serious complications in a child. By “teaching” children's immune systems to recognize and fight specific diseases, vaccines help overcome this vulnerability.

This is why the majority of deaths from diseases like pertussis and measles occur among young children and infants. Vaccines are the best protection against complications and death from these diseases. By delaying the vaccination of children against infectious diseases, you increase the risk of severe illness or even death if they become infected.

To understand how vaccinations have affected saving children's lives, it is enough to look at overall child mortality rates. In 1990, approximately 93 out of every thousand children died before reaching the age of five. Today, the mortality rate is about one-third of the initial figure: 37 out of 1,000 children die. The reduction in child mortality is largely attributed to global vaccination programs.

Over the past 50 years, vaccines have saved the lives of 154 million people. The majority of them, namely 101 million, are infants who were saved.

The younger children are, the more susceptible they are to diseases, which is why it is very important that they are vaccinated on schedule and that vaccination dates are not delayed.

Some people mistakenly believe that if the routine vaccination schedule is followed, an infant or young child receives too many antigens at once, and this can be dangerous for them. But this is a misconception.

Antigens are tiny pieces of viruses or bacteria that trigger an immune response when they enter the body. This is exactly how a vaccine works. Antigens are everywhere. They even accompany a baby through the birth canal. In fact, the amount of antigens a child receives when any vaccine or recommended combination of vaccines is administered is much smaller than the amount of antigens a child encounters in their environment every day.

An infant's immune system is extremely resilient and can respond to hundreds and thousands of antigens, bacteria, and allergens every day. Administering several vaccines at the same time is easily accepted by a child's immune system and poses no danger to it. Experts estimate that an infant's immune system is so perfectly designed that it can safely and effectively respond to 10,000 modern vaccines administered at the same time.

Studies show that this is why vaccinated children have the same level of overall exposure to antigens as unvaccinated children. Vaccines do not overload the immune system; they simply help the child's immune system recognize and fight specific diseases without creating an additional immune burden.