DEAR DR. ROACH: My good-hearted friend is very concerned about vaccines, particularly those given to infants. She has a long list of about 40 different vaccines that are given to infants. I know that the number of vaccines have increased since my children were babies, and both of my daughters asked their pediatricians to space out the vaccines more widely for my grandchildren than what they routinely do. Both doctors complied, and all grandchildren were vaccinated.

My friend does not believe in vaccines generally. She believes that polio, for example, was on a downhill trend in the U.S. before vaccines for it became available. I know there is evidence worldwide on the importance of vaccines. My husband is a Rotarian. Rotary International has worked with others for decades in the fight to eradicate polio.

My friend also does not believe that the Food and Drug Administration requires testing for safety and effectiveness for flu vaccines. She does not believe the vaccines actually prevent flu and death. I personally get a flu shot every year. I read that the U.S. had over 80,000 deaths last year as a result of complications from the flu. I also recently read that over 100 children died of flu complications in the U.S. last year, and most of these children were not vaccinated.

What are the facts on vaccines? Can you substantiate the importance of vaccines generally? — C.A.A.

ANSWER: I write often about vaccines because they have had a profound beneficial impact on the health of the world, and continue to be among the most important and cost-effective preventives we have — and because vaccine hesitancy is a growing problem.

I don’t agree with spacing out vaccines beyond the standard schedule. The standard has been carefully scheduled so that babies and children are vaccinated when it is safe and effective to do so. Delaying vaccines leaves children at risk for getting the diseases. There are vaccines for 14 diseases as part of the standard schedule. Some require multiple doses, and some are given as a combination. There is not an illness among the 14 you would want your child or grandchild to have if it could be helped.

Apart from polio, I have seen all of these diseases and am very glad they have become less common to nonexistent. Children’s immune systems are very robust and can handle the vaccine. In the current schedule, children are exposed to about 320 antigens from vaccines up to age 2 (in 1980, it was over 3,000 from vaccines; current vaccines are more efficient). They see many times more antigens from germs in a day.

Before the polio vaccine was available, there were tens of thousands of cases of poliomyelitis (at its peak in 1952, over 52,000). After the vaccine was introduced in 1955, the number of cases fell to negligible levels — no more than 100 cases per year after 1964. The Rotary club, among others, has been instrumental in nearly ending polio worldwide. However, without continued vigilance, polio could make a comeback, as measles is poised to do.

You also are right about the importance of influenza. Over 80,000 people died last year of influenza — most of them seniors, but small children as well. The flu shot, while not perfect, reduces risk of severe disease and death.

All vaccines are tested for safety and effectiveness by the FDA.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

Dr. Roach