By Jacob Osborne, PharmD, Infectious Diseases Pharmacist
Infectious Diseases and the practice medicine have been revolutionized in the last 100 years: from the discovery of penicillin in 1928, to the development of a mass-produced polio vaccine in 1954, to the approval of zidovudine to treat HIV at the height of the AIDS epidemic in 1987. In that time (and before), there have been many disproven studies, misunderstanding, and outdated wives tales that still persist to this day to confuse and misguide public opinion. In this article, I’ll highlight six of the most widespread misconceptions related to the treatment of infectious diseases, and what the data ACTUALLY says.
- MYTH: Vaccines can cause, or are linked to a higher risk of autism
In the late 1990s, Andrew Wakefield, a physician at Royal Free Hospital in London, published an article in The Lancet, claiming to have found the explanation for autism in the measles virus. Initially, Wakefield reported that the measles virus was responsible for the colonic lesions seen in Crohn disease. Although this theory was soon disproved and put to rest, Wakefield was impressed by cases brought to his attention in which apparently normally developing children manifested autistic symptoms shortly after administration of the MMR triad vaccine. Despite his previous blunder with Crohn disease, he hypothesized that the measles virus had triggered inflammatory lesions in the colon, disrupting the permeability of the colon through which neurotoxic proteins reach the bloodstream and the brain, thus causing autism. Eight out of eight autistic children on whom he had performed colonoscopies exhibited the hypothesized lesions, leading him to assert that the measles vaccine virus caused autism.
Since this study has been published, dozens of studies have failed to replicate this finding. In fact, a 2014 meta-analysis of 1.25 million children failed to find any link between childhood vaccination and autism. This allowed for the strongest conclusion that vaccines and any of their components (thimerosol, mercury, etc) CANNOT cause autism. In 2005, Wakefield’s original study and another 2002 study that found similar findings was retracted from The Lancet due to an extensive internal investigation finding that Wakefield’s study had been flawed by severe research misconduct, conflict of interests, and probably falsehood. In 2010, Wakefield was struck from the UK Physician Registry for deliberate falsification of data, mistreatment of developmentally delayed children (in an effort to collect said falsified data), and failure in his duties as a responsible consultant.
Since the publication of that article, measles outbreaks have become more common in 1st world countries where vaccines are more readily available. This an be attributed to the falling rates in childhood vaccinations. Consequently, in 2024, there have been 284 cases of measles. 90% of affected individuals were unvaccinated. Well how about autism rates since vaccination rates have gone down? They are up 310%. Clearly, vaccines do not cause autism. If you would like to read more on actual autism science and findings, check out the Autism Science Foundation.
- MYTH (in 99.9% of cases): The flu vaccine can give you flu
Many people report fever and fatigue following flu vaccination that they often attribute to contracting a “light case” of the flu. However, in most cases, this is impossible as the flu vaccine given to most people is inactivated flu virus. These inactivated particles CANNOT cause infection.
This may make it confusing why some people get fever and fatigue following the flu vaccine. Simply, however, it is your body reacting to the dead virus and ramping up your immune system. Like a fire drill, this is practice for the immune system so that when a live flu virus shows up, it can take care of it efficiently. Sticking with the fire drill analogy, if the flu virus is present in a non-vaccinated immune system, the immune system may make critical mistakes as it is unprepared and “panics.” This results in worse, and sometimes deadly, illness.
So what did I mean when I said “in most cases?” There is a flu vaccine that does possess live flu particles. For those afraid of needles, there is a nasal spray vaccine that contains live flu particles. Since it is live, it CAN cause flu, technically. However, this vaccine is not given to elderly people or anyone with a weak immune system, essentially making infection from the vaccine nonexistent.
- MYTH: Natural immunity is superior to vaccine or passive immunity
Some who have taken immunology or biology may understand natural immunity is often considered to produce a greater immune response. Some have mistaken this to mean that naturally contracting and clearing infection was superior to vaccine or passive immunity. There is just one [HUGE] misconception here: vaccination IS active immunity.
So what is passive immunity then? The most common way passive immunity occurs is when mothers pass antibodies on to babies via placenta blood flow during pregnancy. Another way is through antibody infusions for a specific disease. This type of immunity is immediate, but very short lasting. Passive immunity often dissipates after a few weeks or months. In contrast, active immunity via vaccination or infection lasts years and sometimes for the entire life of an individual.
On the subject of active immunity methods, natural infection does NOT increase antibody titers or last longer when compared with vaccination. During the COVID-19 pandemic, titers between natural infection and vaccination were monitored, finding inconsistent data on if one was superior to one another . Therefore, natural infection has no advantage, but does put you at a higher risk of severe illness, hospitalization, and death. Short, but decisive point: get vaccinated when possible.
- MYTH: Smelly urine and confusion are symptoms of a urinary tract infection
As an Infectious Disease practitioner, one of the most common complaints I see in patients self-diagnosing a urinary tract infection (UTI) is strong-smelling urine and confusion. However, these symptoms alone or together are often not indicative of a UTI. Medical data and guidelines show a UTI is only suspected if those symptoms are present with painful or uncomfortable urination, increased urinary frequency, fever, or tenderness in the lower back or side.
Strong-smelling urine is a non-specific finding and can be indicative of many non-infectious causes, many of which are harmless. These include:
- Certain types of food and drink, like asparagus or coffee
- Dehydration
- Some medications
- Vitamin B6 supplements
How about confusion? While confusion can be a sign of infection (not necessarily just a UTI), it can also be a sign of a multitude of things. Patients sometimes demand an antibiotic for a loved one who is confused suspecting a UTI, however if that loved one hasn’t complained of any of the UTI symptoms I mentioned early, it should be conveyed to your healthcare provider that those signs are not present. That way, your loved one can be worked up for more serious or permanent causes of confusion (ie brain diseases, dehydration, thyroid disorder, or medication side effects).
- MYTH: Some antibiotics are harmless
Since the introduction of penicillin to the market in the 1940s, patients have been going to their doctor’s office demanding an antibiotic for every cough and sore throat they develop. Since then, many antibiotics have hit the open market, and some of them are widely known to carry some risks if taken. However, even a single course of antibiotics can have lasting consequences.
The haphazard use of antibiotics in prior decades have led to the emergence of highly dangerous antibiotic-resistant bacteria. In 2010, an estimated 162,000 people died from antibiotic-resistant bacterial infections. Depending on the antibiotic and bacteria, resistance can develop after a single course of antibiotics.
Another concern is the depletion of your body’s “good” bacteria with each course of antibiotics. The use of ANY antibiotic for ANY period of time drastically increases your risk of a deadly bacterial diarrhea known as Clostridium difficile (CDI).
However, you shouldn’t be afraid of an antibiotic if you receive a prescription. The main point you should take away is to never demand an antibiotic as they are never risk-free. As such, you should only take antibiotics when your healthcare provider is certain that the risk of untreated infection is higher than that of antibiotic treatment.
- MYTH: I have a penicillin allergy
It is estimated that 10% of the country reports an allergy to penicillin. This has led to the utilization of antibiotics that have a higher risk of side effects and development of antibiotic-resistant bacteria. However, recent studies have found the true incidence of penicillin allergy is likely less than 1%, meaning most of those consequences mentioned earlier were avoidable.
The main reason penicillin allergy is overreported is simply because most people do not understand what an allergy is. Simply, an allergy is an overreaction of the immune system to a substance, most often presenting as swelling or trouble breathing. The following are NOT an allergy:
- Rash, especially if reported in childhood (cause is virus, NOT penicillin)
- Stomach upset, nausea, vomiting
- A family member with an allergy (allergies are NOT genetic)
If you have a reported penicillin allergy that you may now know is NOT an allergy, it may also be helpful to talk to your family doctor and follow up with an allergist. They will be able to simply administer a penicillin skin test. This low-risk test will allow you to know if you have a TRUE penicillin allergy in just a few minutes. If you do have a reaction, a trained allergist will be able to interpret and give you a definitive answer to if you are allergic.
This has been just a few of the many myths we hear from patients (and sometimes doctors) in everyday Infectious Diseases practice. Got any other myths you’d like to bust or have me cover? Leave a comment here or on the official social media sites for this blog.
Faith, Food and Pharmacy 