Izizathu ezi-8 zabazali abazigonyanga (kwaye kutheni kufanele)

Umxholo

• 1. Inkxalabo: "Izitofu ezininzi kangaka kungekudala ziza koyisa inkqubo yomzimba yokuzikhusela yosana lwam."
• 2. Inkxalabo: "Ukhuselo lomzimba lomntwana wam alukhuli, ngoko kukhuselekile ukulibazisa ezinye izitofu okanye ukufumana nje ezona zibalulekileyo."
• 3. Inkxalabo: "Izitofu zokugonya ziqulethe iityhefu, ezinje nge-mercury, i-aluminium, i-formaldehyde, kunye ne-antifreeze."
• 4. Inkxalabo: "Izitofu zokugonya azisebenzi nyani-jonga kwisitofu sokugonya somkhuhlane kunyaka ophelileyo."
• 5. Inkxalabo: "Ngeke kubekho 'iinkundla zokugonya' ukuba izitofu zokugonya azikho yingozi."
• 6. Inkxalabo: "Amachiza abonakala ngathi ayindlela yeenkampani ezixuba amayeza kunye noogqirha ukwenza imali eninzi."
• 7. Inkxalabo: "Iziphumo ebezingalindelekanga zezinye izitofu zibonakala zibi kakhulu kunesi sifo."
• 8. Ixhala: "Ukundinyanzela ukuba ndigonye kukunyhasha amalungelo am."
• Uphengululo lwe

Ebusika ophelileyo, xa iimeko ezingama-147 zemasisi zasasazeka kwizithili ezisixhenxe, kunye neKhanada neMexico, abazali babengoyiki, ngokuyinxenye ngenxa yokuba uqhambuko lwaqala eDisneyland, eCalifornia. Kodwa kunokuba kubi kakhulu. Ukuba bekungekho isitofu sokuthintela imasisi, besinokuba namatyala angama-4 ezigidi eMelika minyaka le. Phambi kokuba isitofu sifike ngonyaka we-1963, phantse wonke umntu wafumana esi sifo ebuntwaneni, kwaye ngokomyinge abantwana abangama-440 bafa kuso ngonyaka kwishumi leminyaka ngaphambili. Ngethamsanqa, namhlanje phakathi kwama-80 nama-90 ekhulwini abantwana bafumana uninzi lwezitofu zokugonya. Kodwa kweminye imimandla e-US, amanani akhulayo abazali ayaphuma. Xa oko kusenzeka, banyusa umngcipheko wokuqhambuka kwindawo abahlala kuyo. Esona sizathu sixhaphakileyo sokuba abazali batsibe izitofu zokugonya? Inkxalabo yezokhuseleko, ngaphandle kobungqina obuninzi bokuba abuyongozi. Obona bungqina bwakutshanje: ingxelo egqibeleleyo ka-2013 ye-Institute of Medicine eyafumanisa ukuba ishedyuli yokugonywa kwabantwana e-U.S iyasebenza, inobungozi obuncinci kakhulu. (Kwaye siza kufika kwabo.)

Mhlawumbi eyona nto ibalulekileyo yokuqanjwa kwezempilo kwimbali, izitofu zokugonya zilixhoba lempumelelo yazo. "Zisebenza kakuhle, zithatha izifo ezinjengemasisi kude. Kodwa ke siyazilibala ezo zifo ziyingozi," utshilo uKathryn Edwards, MD, umlawuli weVanderbilt University Vaccine Research Programme, eNashville. Ulwazi olungelulo malunga nezitofu zokugonya nalo lunegalelo kuxinzelelo, kwaye ukuhlela inyani kwiintsomi akusoloko kulula.Umbono ongeyiyo wokuba isitofu sokugonya imasisi-mumps-rubella (MMR) sinokubangela ukuba i-autism ihlale ihleli kwiingqondo zabanye abazali ngaphezu kweminyaka elishumi nangona izifundo ezingaphezu kweshumi elinesibini zibonisa ukuba akukho khonkco phakathi kwezi zibini.

Izitofu zinomngcipheko, kodwa ingqondo yethu kunzima ukubeka umngcipheko ngokwembono, utshilo uNeal Halsey, MD, ugqirha wabantwana kunye nomlawuli weZiko loKhuseleko kuThintelo kwiYunivesithi yaseJohn Hopkins, eBaltimore. Abantu basenokoyika ukubhabha ngaphezu kokuqhuba kuba ukuqhuba kuqhelekile kwaye kuqhelekile, kodwa ukuqhuba kuyingozi ngakumbi. Ukutofa abantwana ukuze ubakhusele kwizifo ezisongela ubomi kunokubangela iziphumo ebezingalindelekanga zexesha elifutshane, ezinjengobomvu nokudumba kwindawo ebekutofwe kuyo, ifiva, nerhashalala. Kodwa eyona micimbi mibi kakhulu, enjengokungalungelelani komzimba, inqabile kunaleyo yokuthintela izifo. Amaziko oLawulo lweNtsholongwane kunye noThintelo aqikelela ukuba umngcipheko wempendulo eyoyikisayo evela kulo naliphi na ugonyo yenye yeedosi ezisisigidi esinye.

Nokuba kusemngciphekweni omncinci, abanye abazali basenokuba nexhala, kwaye oko kuyavakala. Nantsi into kunqabile ukuba uyive kwiingcali zokugonya: kuhlala kukho into eyinyani kwinkxalabo yabazali, nokuba abaziqondi ezinye iinyani, utshilo uGqirha Halsey. Oko kwenza ukuba kube nzima ngakumbi ukuba ugqirha wakho uyaluchitha uloyiko lwakho okanye unyanzelisa ukugonya ngaphandle kokuphendula yonke imibuzo yakho. Ngamanye amaxesha, amaxwebhu ayala ukunyanga abantwana abanabazali abangagonyiyo, nangona iAmerican Academy of Pediatrics (AAP) ingayicebisi loo nto. Ke sikunika ezantsi ezona zoyiko zixhaphakileyo.

1. Inkxalabo: "Izitofu ezininzi kangaka kungekudala ziza koyisa inkqubo yomzimba yokuzikhusela yosana lwam."

Inyani: Abazali abazalwa ngoo-1970 kunye nee-80s bagonyelwa izifo ezisibhozo. Umntwana oneminyaka emi-2 ogonywe ngokupheleleyo namhlanje, kwelinye icala, unokubetha izifo ezili-14. Ke ngeli lixa abantwana ngoku befumana izithonga ezingakumbi-ingakumbi njengoko isitofu sokugonya ngasinye sifuna iidosi ezininzi-bakwakhuselwe kwizifo eziphantse zibe kabini.

Kodwa ayilo nani lokudubula elibalulekileyo; yinto ekuzo. Iantigens zizinto eziyintsholongwane okanye ibacteria yeyeza lokugonya elenza amajoni omzimba ukuba akhe izilwa-buhlungu kwaye alwe nosulelo oluzayo. Zonke iantianti abantwana abazifumanayo kwizitofu zokugonya namhlanje ziyinxalenye yento abantwana ababeqhele ukuyifumana, kubandakanya nezitofu zokudibanisa.

"Ndiyingcali yesifo esosulelayo, kodwa andiluboni usulelo ebantwaneni emva kokuba bebefumene zonke izitofu zokugonya ezi-2, 4, kunye neenyanga ezi-6 ubudala, ezinokwenzeka ukuba amajoni abo omzimba ayalayishwa," Utsho uMark H. Sawyer, MD, unjingalwazi wezifo zabantwana kwiYunivesithi yaseCalifornia iSan Diego School of Medicine kunye neSibhedlele saBantwana iRady.

2. Inkxalabo: "Ukhuselo lomzimba lomntwana wam alukhuli, ngoko kukhuselekile ukulibazisa ezinye izitofu okanye ukufumana nje ezona zibalulekileyo."

Inyani: Oku kokona kungaqondani kukhulu phakathi kwabazali namhlanje, utsho uGqr. Halsey, yaye kukhokelela ekubeni babe sesichengeni sezifo ezifana nemasisi. Kwimeko ye-MMR, ukulibazisa isitofu sokugonya nokuba ziinyanga ezintathu kancinane kunyusa umngcipheko wokuxhuzula yifebrile.

Akukho bungqina bokuba ukwahlula izitofu kukhuselekile. Into eyaziwayo kukuba ishedyuli yesitofu esicetyiswayo yenzelwe ukubonelela ngokhuseleko olukhulu. Ngapha koko, uninzi lweengcali zezifo ezosulelayo kunye nezifo ezivela kwi-CDC, iiyunivesithi kunye nezibhedlele zase-US ziphonononga amashumi eminyaka zophando ngaphambi kokwenza izindululo.

3. Inkxalabo: "Izitofu zokugonya ziqulethe iityhefu, ezinje nge-mercury, i-aluminium, i-formaldehyde, kunye ne-antifreeze."

Inyani: Izitofu zokugonya ubukhulu becala zingamanzi ane-antigens, kodwa zifuna izithako ezongezelelweyo ukuzinzisa isisombululo okanye ukwandisa ukusebenza kwesitofu sokugonya. Abazali bakhathazekile malunga ne-mercury kuba ezinye izitofu ezisetyenziselwa ukuhambisa i-thimerosal yokulondolozwa, eyehla iye kwi-ethylmercury. Ngoku abaphandi bayazi ukuba i-ethylmercury ayiqokeleli emzimbeni-ngokungafaniyo ne-methylmercury, i-neurotoxin efumaneka kwezinye iintlanzi. Kodwa i-thimerosal isuswe kuzo zonke izitofu zokugonya iintsana ukusukela ngo-2001 "njengesilumkiso," utshilo uGqirha Halsey. (Ugonyo lomkhuhlane we-Multidose lusene-thimerosal yokusebenza kakuhle, kodwa iidosi enye ngaphandle kwe-thimerosal ziyafumaneka.)

Izitofu zineetyuwa zealuminium; ezi zisetyenziselwa ukomeleza impendulo yomzimba yokuzikhusela, ukuvuselela imveliso enkulu ye-antibody kunye nokwenza isitofu sokugonya sisebenze ngakumbi. Nangona i-aluminiyam inokubangela ububomvu obukhulu okanye ukudumba kwindawo yokutofa, isixa esincinci se-aluminiyam kwizitofu zokugonya-ngaphantsi kunento abantwana abayifumana ngobisi lwebele, ifomula, okanye eminye imithombo-ayinasiphumo sexesha elide kwaye isetyenziswe kwezinye izitofu ukusukela oko. ngeminyaka yee-1930. "Kusemhlabeni wethu, emanzini ethu, emoyeni. Kuya kufuneka ushiye iplanethi ukuze ugweme ukuvezwa," kusho udokotela wabantwana kunye Bazali Umcebisi uAri Brown, M.D., waseAustin, eTexas.

Landela izixa ze-formaldehyde, ezisetyenziselwa ukuthintela usuleleko olunokubakho, lunokubakho kwezinye izitofu, kodwa ngamakhulu amaxesha ngaphantsi komyinge we-formaldehyde abantu abayifumana kweminye imithombo, efana neziqhamo kunye nemathiriyeli yokugquma. Umzimba wethu nkqu ngokwendalo uvelisa i-formaldehyde ngakumbi kunaleyo itofwayo, utshilo uGqirha Halsey.

Ezinye izithako, nangona kunjalo, zibeka umngcipheko othile. Amayeza okubulala iintsholongwane, anjenge-neomycin, asetyenziselwa ukuthintela ukukhula kwebhakteria kwezinye izitofu, kunye ne-gelatin, ehlala isetyenziselwa ukuthintela izinto zokugonya ekuthotyeni ngokuhamba kwexesha, kunokubangela iimpembelelo ze-anaphylactic ezinqabileyo (phantse kube kanye okanye kabini kwisigidi esinye sedosi). Ezinye izitofu zokugonya zinokuqulatha inani leeprotein zeqanda, kodwa uphononongo lwakutsha nje lubonise ukuba abantwana abanokungezwani neqanda banokuhlala befumana.

Ngokubhekisele kwi-antifreeze, ayikho kwizitofu zokugonya. Abazali banokudida amagama eekhemikhali-zombini i-ethylene glycol kunye nepropylene glycol-kunye nezithako ezisetyenziswa kwinkqubo yokuvelisa isitofu (njenge-polyethylene glycol tert-octylphenyl ether, engenabungozi).

4. Inkxalabo: "Izitofu zokugonya azisebenzi nyani-jonga kwisitofu sokugonya somkhuhlane kunyaka ophelileyo."

Inyani: Uninzi lwazo luyi-85 ukuya kuma-95 epesenti esebenzayo. Isitofu sokugonya somkhuhlane sikhohlisa ngakumbi, nangona kunjalo. Nyaka ngamnye, iingcali zezifo ezosulelayo ezivela kwihlabathi liphela ziyadibana ukuze ziqikelele ukuba zeziphi iintlobo ezinokujikeleza ngexesha lomkhuhlane olandelayo. Ukusebenza kokugonya kuxhomekeke kubunzima obukhethiweyo kwaye ngamanye amaxesha bayaphazama. Isitofu sokugonya sexesha lonyaka ophelileyo sisebenze ngama-23 ekhulwini kuphela ekuthinteleni umkhuhlane; uphando lubonisa ukuba isitofu sokugonya sinokuwunciphisa umngcipheko malunga neepesenti ezingama-50 ukuya kuma-60 xa kukhethwa uhlobo olufanelekileyo.

Ke, ewe-iyeza lokugonya lomkhuhlane ebusika ophelileyo lousy, kodwa kwaneepesenti ezingama-23 iimeko ezimbalwa zithetha ukuba amakhulu amawaka abantu abasindisiwe. Eyona nto iphambili kukuba izitofu zokugonya zithetha ukusweleka okumbalwa kakhulu, ukulaliswa esibhedlele, kunye nokukhubazeka kunalo naliphi na elinye ixesha embalini.

5. Inkxalabo: "Ngeke kubekho 'iinkundla zokugonya' ukuba izitofu zokugonya azikho yingozi."

Inyani: Nangona izitofu zokugonya zikhuselekile, kunqabile ukuba iziphumo ebezingalindelekanga zenzeke, utsho uGqr. Halsey. "Kwaye abantu akufuneki bathwale umthwalo wemali onxulumene noko." INkqubo kaZwelonke yokuXhasa uNyango yokuThintela ukuThintela ukuNyanga (i-NVICP) ibonelela ngemali ukuze babhatalele iindleko zonyango kunye nezinye iindleko ezinxulumene nokwenzakala kwimeko engalindelekanga apho umntwana wabo afumana khona ugonyo olubi. (Babhatala nabantu abadala abonzakeleyo zizitofu zokugonya.)

Usenokuzibuza, kutheni ungamangaleli iinkampani zoxubo mayeza? Yiloo nto kanye eyenzekileyo ngeminyaka yoo-1980, xa iinkampani ezilishumi elinambini ezazisenza izitofu zijongene nokugwetywa. Uninzi lwala matyala aluphumelelanga, nangona kunjalo; ukuphumelela kwakufuneka abazali babonise ukuba isitofu sokugonya sabangela ingxaki yezempilo kuba sasinesiphene. Kodwa ke izitofu zazingenasiphako; babephethe umngcipheko owaziwayo. Okwangoku, amatyala amatyala athatha ityala. Iinkampani ezininzi ziye zayeka nje ukwenza izitofu, zikhokelela kunqongophalo.

"Abantwana babeshiywa bengenazo izitofu zokugonya, yangena ke iCongress," utshilo uDorit Reiss, unjingalwazi ogxile kumgaqo-nkqubo wokugonya kwiYunivesithi yaseCalifornia Hastings College of Law. Kuqala kwandise ukhuseleko kubavelisi ukuze bangamangalelwa enkundleni ngenxa yokonzakala kwisitofu ngaphandle kokuba ibango liye laya kwi-NVICP kuqala, elabavumela ukuba baqhubeke nokuvelisa izitofu. ICongress ikwenze kwalula kubazali ukuba bafumane imbuyekezo.

Iinkundla zokugonya zisebenza "kwinkqubo engenasiphoso." Abazali akufuneki babonakalise ukungalunganga kwicala lomenzi kwaye akukho mfuneko yokuba bangqine ngaphandle kokuthandabuza okuqinisekileyo ukuba isitofu sibangele ingxaki yezempilo. Ngapha koko, ezinye iimeko ziyahlawulwa nangona inzululwazi ingakhange ibonakalise ukuba isitofu sibabangele ngokuqinisekileyo. Ukusuka ngo-2006 ukuya ku-2014, amabango ali-1,876 ahlawulwa. Oko kubiza umntu omnye ukuba ahlawulwe nge-1 yezigidi zeedosi zokugonya ezisasaziweyo, ngokweZiko lezeMpilo noLawulo lweeNkonzo.

6. Inkxalabo: "Amachiza abonakala ngathi ayindlela yeenkampani ezixuba amayeza kunye noogqirha ukwenza imali eninzi."

Inyani: Iinkampani ezixuba amayeza ngokuqinisekileyo ziyayibona inzuzo kwizitofu zokugonya, kodwa ayingomachiza anqabileyo. Kukwanengqondo ukuba iinkampani ezixuba amayeza zenze imali kwiimveliso zazo, kanye njengokuba abavelisi bezihlalo zemoto befumana inzuzo kwezabo. Ngokuchasene nenkolelo eqhelekileyo, ezi nkampani azifane zifumane inkxaso-mali kurhulumente wobumbano. Phantse yonke imali ebekelwe uphando lwezitofu ngamaZiko ezeMpilo kaZwelonke iya kwiiyunivesithi.

Oogqirha babantwana abenzi ngeniso, nabo. UNathan Boonstra, MD, ugqirha wabantwana kwiSibhedlele saBantwana esingenanto, eDes Moines uthi: "Enyanisweni, abanye bakufumanisa kubiza kakhulu ukuthenga, ukugcina, kunye nokulawula amayeza okugonya, kwaye kufuneka bathumele" izigulane kwisebe lezempilo lesithili.

7. Inkxalabo: "Iziphumo ebezingalindelekanga zezinye izitofu zibonakala zibi kakhulu kunesi sifo."

Inyani: Kuthatha iminyaka elishumi ukuya kweli-15 kunye namaphononongo amaninzi kwizitofu zokugonya ezitsha ukuze ziphumele kuzo zone izigaba zovavanyo lokhuseleko kunye nokusebenza phambi kokuba zivunywe. Isitofu sokugonya ngasinye esitsha esilungiselelwe abantwana sivavanywa kuqala kubantu abadala, emva koko ebantwaneni, kwaye zonke iimpawu ezintsha kunye nemixube kufuneka ihambe ngenkqubo efanayo. I-FDA emva koko iphonononga idatha ukuqinisekisa ukuba isitofu sokugonya senza into eveliswa ngumenzi-kwaye ngokukhuselekileyo. Ukusuka apho, i-CDC, i-AAP, kunye ne-American Academy yoGqirha boSapho bathatha isigqibo sokuba bayayincoma. Akukho arhente okanye nkampani eza kutyala imali kwiyeza lokugonya elibangela iingxaki zempilo ezibi kunaleyo liyithintelayo, utshilo uGqirha Halsey: "Zonke izifo zinxulunyaniswa neengxaki ezinokubangela ukulaliswa esibhedlele okanye nokufa."

Nditsho nenkuku yenkukhu, abazali abaninzi ababenayo njengabantwana, babulala malunga ne-100 labantwana ngonyaka ngaphambi kokuba kuqaliswe iyeza lokugonya i-varicella. Kwaye yayiyeyona nto ibangela ukuba i-necrotizing fasciitis, okanye usuleleko lweentsholongwane ezityiwa yinyama. UGqr. Halsey uye weva abazali besithi ukutya okunesondlo kuya kunceda abantwana babo balwe nezi zifo, kodwa akusoloko kunjalo. Abantwana abasempilweni basemngciphekweni weengxaki ezinkulu kunye nokufa kwezi zifo. Ngokomzekelo, i-80 yepesenti yokufa kwenkukhu yenkukhu kwenzeka kubantwana abaphilileyo, wathi.

Kuyinyani ukuba iziphumo ebezingalindelekanga ezithambileyo neziphakathi-ezifana ne-febrile seizure kunye ne-high fever-ayiqhelekanga, kodwa iziphumo ebezingalindelekanga ezimandundu zinqabile. Umzekelo, esona sisiphumo sokuqina sokugonya kwe-rotavirus yi-intussusception, isithintelo samathumbu esinokufuna utyando kwaye senzeke kube kanye kuzo zonke iintsana ezingama-20,000 ukuya kwi-100,000 zigonyiwe.

8. Ixhala: "Ukundinyanzela ukuba ndigonye kukunyhasha amalungelo am."

Inyani: Imithetho yokugonya yelizwe ngalinye yahlukile; iimfuno zokugonywa ziqala xa ilixesha lokuya kukhathalelo lweentsuku, isikolo sabantwana abasaqalayo, okanye isikolo sikarhulumente. Yaye ngesizathu esivakalayo: Zikhusela intwana encinane yabantwana abasenokuba banenkqubo yokuzikhusela komzimba ebuthathaka okanye ekusenokwenzeka ukuba izitofu zokugonya zingasebenzi kubo. Wonke urhulumente uvumela ukukhululwa ukuba abantwana banesizathu sonyango sokungagonyi, njenge-leukemia okanye isifo esingaqhelekanga somzimba. Ngaphezu koko, onke amazwe avumela inkolo kunye / okanye ukukhululwa kwinkolelo yobuqu, eneemfuno ezahlukeneyo, ngaphandle kweCalifornia (ukuqala ngoJulayi 2016), eMississippi, naseNtshona Virginia. Ngeli xesha, amazinga okuxolelwa-kunye namazinga esifo-aphezulu kwezo zizwe apho kulula ukuba abantwana banikwe ukhululo.

"Uluntu ngalunye lunelungelo lokugcina amanqanaba aphezulu okukhusela abo bantwana abangenako ukugonywa," kusho uDkt. Halsey. Ukubaluleka kokukhuselwa koluntu, okwabizwa ngokuba ngumhlambi we-immunity, kwacaca ngakumbi ngexesha lokuqhambuka kweDisneyland. Ngenxa yokuba imasisi iyosulela kakhulu, isasazeka ngokukhawuleza kuluntu olunogonyo olusezantsi. I-Disneyland ihleli entliziyweni ye-Southern California, enezinga eliphantsi kakhulu lokugonya kurhulumente, kwaye uninzi lwamatyala ayephakathi kwabantu baseCalifornia kwezo ndawo.

"Umfanekiso obalaseleyo," ushwankathela uGqr. Halsey, "ugonyo luluncedo kwaye lugcina abantwana besempilweni. Kwaye yiloo nto kanye esiyifunayo sonke-abazali, ababoneleli bezempilo, kunye nabantu abenza izitofu."

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