TO IMMUNIZE OR NOT TO IMMUNIZE
by Jane Katz-Field, MD (pictured in photo)

Many parents question the need for, and safety of, vaccines for their children. With all the stories on the internet claiming vaccines cause allergies, autism, and brain damage, this skepticism is understandable. Celebrities on TV talk shows tell stories that are scary. The huge profits made by pharmaceutical companies cast a shadow on their manufacture of vaccines. And since we no longer see many of the diseases that vaccines prevent, it is hard to picture their severity.

Most pediatricians in the area treasure thoughtful parents who read as much as they can, who question medical advice, and discuss these questions with their doctor. My orientation is to advise parents according to the best scientific information we have, and to offer a balanced approach. And I would never try to force anyone to do something that would be uncomfortable.  That said, we do need to maintain a healthy regard for the potential devastation of vaccine-preventable diseases. It is true that immunity from disease is generally stronger after getting the disease than getting a vaccine. But the price of acquiring immunity from the disease, which can be very severe and sometimes fatal, is a risk not worth taking. So parents need to recognize the real risk of not getting vaccinated.

Children not only can contract these vaccine-preventable diseases, but also can transmit them to vulnerable people such as infants and people with compromised immunity. Many parents say to me, "I survived chickenpox." True, most survived, but some didn’t. Most children survived car accidents before the introduction of car seats, but many deaths and injuries could have been prevented had they been available. Before the introduction of vaccines, I saw cases of serious illness: a previously healthy 6-month-old boy who died of a bacterial blood infection we can now prevent; many kids with HIB (Haemophilus Influenza type B meningitis, blood and joint infections (these diseases have declined by 98% since the vaccine was introduced); and a 12-year-old girl with strep-infected chickenpox, necessitating a two-week, stormy stay in intensive care. I have a friend whose 25-year-old daughter was born deaf, blind, and mentally retarded from German measles that my friend contracted during pregnancy. 

If the immunization rate declines even a little, diseases return. During the first six months of last year in this country, there were 131 reported cases of measles, a potentially fatal disease; this compared to 63 per year in prior years. The increase was the result of greater spread of the disease after importation from other countries. These cases largely occurred among children whose parents were opposed to the vaccine.

It’s important to use the same scrutiny in evaluating media stories as is used to evaluate American Academy of Pediatrics recommendations. For example, there were some reports that Miss America 1995 became deaf after receiving a vaccination. Her deafness actually resulted from an infection with HIB, a vaccine-preventable illness. Many celebrities who oppose vaccines are thought to be as knowledgeable as scientists who have spent years studying vaccines. Science is more than one opinion or one person’s experience.

Because of the abundance of pharmaceutical-funded research, it is very difficult for medical doctors to find information that is unbiased. Pharmaceutical companies, however, make far less profit from manufacturing vaccines than from other pharmaceuticals. Also, the bar on vaccine safety data is much higher than it is for any drug. The new human papillomavirus vaccine (HPV) was given to 30,000 girls who were followed for seven years; the pneumococcal vaccine was tested in 40,000 kids, and the new rotavirus vaccine in 70,000 kids before licensure. No drug gets this kind of scrutiny. And the reporting agency for vaccine accidents is a model system to detect rare adverse events.

What are the specific questions I hear from parents? The most common is the concern about autism. In September of last year, results from a significant study demonstrated no evidence of a link between measles vaccine and autism. Even Dr. Sears, a pediatrician often cited by vaccine-questioning parents, acknowledged that the findings of this study “should allow parents to feel more comfortable giving the Measles-Mumps-Rubella (MMR) vaccine.”

Some parents raise the question of mercury in vaccines as a cause of autism. Mercury has never been in the MMR, polio or chickenpox vaccines. Thimerosol, which contains mercury, was used as a preservative in other vaccines starting in the 1930s. Since 2001, thimerosol has been removed from most vaccines, yet autism rates actually climbed from 2004 to 2007. The preponderance of scientific studies shows no differences in the rates of autism between vaccinated and unvaccinated children.

Parents must make many decisions about their children’s healthcare. It’s often overwhelming.  Taking all the information we have into account, I believe that the enormous benefits of vaccines outweigh the potential risks. And when it came to the safety of my own four kids, I made the decision to vaccinate.

Dr. Field is a pediatrician on the Brattleboro Memorial Hospital medical staff who practices in the Just So Pediatrics group. “For Your Health” is sponsored by BMH as a community service.