Tuesday, December 9, 2008

Vaccinations and Social Responsibility

I have been trying to figure out what to do in regards to vaccinations. I know, I am already behind. There was the Hep B at birth and the 2 and 4 month immunizations LB has already missed. We are already into cold and flu season so it is time to either get it done or decide not to.

I have been relying mostly on two different books for my research: The Vaccine Book by Dr. Sears and What Your Doctor May Not Tell You About Children's Vaccinations by Stephanie Cave, MD. Neither book is an anti-vaccine book. They both talk about how vaccines have been a benefit to society, but they also look at the downsides to vaccinations.

I think the Dr. Sears book has a more balanced and up to date approach. He does a great job of summarizing the current research. He even has a website where he discusses research that was published after the most recent version of the book. I like the Dr. Cave book as a secondary resource because it points out some issues Dr. Sears leaves out. For example, Dr. Sears does a great job of summarizing the current research; but Dr. Cave points out that researchers haven't been able to get funding to actually research the safety of vaccinations. I don't like that she doesn't always support her conclusions and she can sound a bit alarmist. Again, I would describe both books as pro-vaccine.

I thought going into it, that we would be getting many vaccinations, I just didn't know which ones and if I would space them out differently than recommended. After reading most of each of the above books (focusing on the early childhood vaccines) I am leaning toward no vaccinations at all. There are four main reasons I am currently avoiding all vaccines: I either think the vaccine is not needed because it is very rare (such as the HIB) or the disease it is supposed to prevent isn't that bad (chickenpox, rubella) or the vaccine has potentially dangerous ingredients (DTaP) or because it is too new for my liking (rotavirus).

Here is my dilemma: Even if we decide not to vaccinate LB for her own health, should we have her vaccinated at a later time for the good of society?

What do you think about vaccinating? What do you think about vaccinating at a later age to protect the youngest of our society (according to the Dr. Sears book, most diseases are only very dangerous under 6 months of age)? Do you trust that the AAP (American Academy of Pediatrics) is looking out for our best interest? Do you trust that the pharmaceutical industry is giving good information to the AAP?

After you think about that last question, check out this article.

I would love to hear all thoughts, whether you are pro-vaccine, anti-vaccine or somewhere in between.


Mrs. Spit said...

Wow, this is a hard question.

I guess my perspective is this. I don't think I would immunize for Chickenpox.

I would immunize for MMR, because I know that my children would come into contact with pregnant women, and many women don't have immunity to german measels, and that can cause life threatening defects.

While I know that many vaccines are for rare diseases, I also know a polio survivor, and I know that she would give anything to have been vaccinated.

Kami said...

Those are good points. Even if we don't vaccinate LB in the next 2-10 years for the good of society (maybe sooner if she gets a sibling), I will recommend she get vaccinated for rubella before she has a chance of becoming pregnant.

I also think polio is worth vaccinating against eventually - very rare in this country, but not rare enough given the commonness of world travel and the very bad last effects of the disease.

Tracy said...

We chose to vaccinate because we felt that the benefits outweigh the risks. My concern with people choosing not to vaccinate is the potential reintroduction into society of diseases that have largely been eradicated due to vaccines.

True that diseases like Chickenpox aren't all that serious in a child, but they could be lethal in an adult. It doesn't seem worth the risk to me.

I know there are a lot of people out there that are anti-vaccine, but we just couldn't find good reason NOT to vaccinate our kiddos.

Summer said...

I am pro-vaccines. The reason all the diseases you mention are rare nowadays is because of the widespread vaccinations that have occurred. If people stop vaccinating their children, then I believe you'll start seeing an increase in those diseases again.

As for trusting the pharmaceutical company studies. I might consider trusting their studies if it were published in a peer-reviewed journal. Otherwise, probably not.

I think if you're planning to vaccinate your child then waiting until they are older may or may not be any better than vaccinating now. Let's say there are adverse affects to vaccinating at a young age. You try to avoid that by vaccinating later. But, the truth is your child is continuing to develop beyond their teen years. There could be the chance of adverse affects (although likely different ones) when they are vaccinated later in life versus when they are vaccinated now.

MrsSpock said...

I mostly gave my opinion about vaccines here:

The long and short is that J is getting most of his shots. The Hep B is deferred until he is older. Chicken pox, I'm ambivalent on. I had them- didn't we all?- and was fine. However, I've had adult patients in ICU with them as well. I've seen a 4 month old in the NICU on a vent with pertussis. Having just been through a horrible bout of a stomach virus- with J having the runs for 2 weeks, and awful painful diaper rash from it- I wish there was a vaccine for that. Watching him cry every time the diarrhea exploded out of his body 7-8 times a day made me decide he will be getting the rotavirus vaccine.

The more folks that refuse vaccines, the fewer the rest of us who will be protected via herd immunity, since only about 85-90% of those vaccinated will develop immunity.

1.4 million kids die every year from vaccine preventable illnesses. We don't see deaths like that because of of vaccination programs here. Polio, measles, mumps, and whatnot are so rare to us because of those shots.

Do I trust the FDA? No. Do I trust the drug industry? No. The AAP? Maybe. The vaccines that have been around for 30-40 years? Yes.

Leigh Anne said...

saw your blog on tracy's...(wonder twins)...

we chose to follow dr. sears' delayed schedule omitting rotavirus (too new, too many deaths w/ the previous one), vacirella (side effects...1/1000 chance of seizures...same risk as SIDS and we all worry about that) and hpv (too new, linked to adverse effects as child ages, and religious reasons as well)...whew. anyway, we have had no issues w/ the delayed sched. we plan on also splitting up the mmr.

our reason for using this are twofold:

1. I believe that a lot of the effects of vax are from getting so many at once.

2. if my child did have an adverse effect, the most shots she has at once are two, so it wouldn't be hard to figure out which one caused the reaction.

I know many moms also choose to only give the vax that are required for public school attendance.

hope you don't mind me commenting...

~Leigh Anne

Sky said...

I'm pro vaccine and I think my having been raised by a mother who had Polio at the age of 2 and lived her live with a pronounced handicap made me face on a daily basis how badly things can go when they go wrong.

True, that was 1936 and the Salk vaccine for Polio wasn't developed (too bad for my mom) but had it been, she would have had such a better life, in proportions and magnitudes that I couldn't even describe adequately.

There is the other point too. In the U.S. we're relatively healthy and that's good. That means that while LB is in the U.S., she's likely to be fine. Let's face it, most of her classmates will have been vaccinated and, therefore, she won't be faced with ill children who can pass those illnesses on to her.

But what about later? What if she travels abroad as a teenager - would she then have to be inundated with vaccinations or would she travel to, let's say, the African continent or to Asia or to South America without being vaccinated for viruses that are far more prevalent (and serious) there?

Now, I'm not so aligned with the orthodox that I don't think it makes sense to space them out as much as possible (even though it's a hassle and means more shots and doctor's visits) and maybe I'd not vaccinate against Chickenpox since most kids get them anyway and many unvaccinated children go through the illness with no problem.

As long as you do your homework (and it looks like you've done a lot), no answer will be "right" but just right for you and your family.

And that has to be good enough sometimes. :)

Leah and Maya said...

Well you know where I stand I'm pretty much following your other people here, after working in a peds office they are just important, the first case of Pertussis in Spokane when it came back out a few years back was at our office, that little girl did live and had started her vaccinations but you need all 4 before you have mostly full protection at 18months, come to find out her dad had not had the DTaP as a child so thats where she got it from. The new DTaP is not like that old one DTP we didn't see reactions to the new one but definetly to the old one. Now adults are given a TDaP instead of a TD (plain tetnus booster) to protect children from pertussis. Forget the chickenpox since that vaccine came out we started having chi8ldren come into the office with shingles although not painful for them still wierd since they were kids, plus most shots like Hep A etc really are only good for about 20 years or so depending ont he shot so if the varicella vaccine where's off thats a deadly time to not be protected but it is a great shot if you are someine even any early teen who has not had the disease. OK enough by me you've heard my opinion before its a danger to my child that your lovely little girl is not immunized so of course that makes me nervous.

Lorraine said...

I guess I'm in the middle - we did end up with most of the vaccines, but spaced way out and never anything new. We travel a lot, and my husband especially travels to places where he could end up as a carrier for some diseases that are rarely seen here. It just made sense to vaccinate.

I got whooping cough (pertussis)three years ago - I had been vaccinated as a child - and it was awful. I broke ribs from the coughing, and I am still on an inhaled steroid to calm the ongoing inflammation in my lung lining. I'm so glad my daughter didn't have to go through any of that!

All that said, we were very careful not give more than one at a time. Sometimes that meant paying out-of-pocket, since we weren't on the prescribed visit schedule - but it wasn't much, so we were happy to do it.

Anonymous said...

Another reader in favor of vaccines, for the social good. Or at least, the MMR and DTaP vaccines. I would-- and have -- skipped the chicken pox.

I don't think you can say that you would have LB vaccinated against rubella before she reached a certain age without considering the fact the chance that she would get the disease in the intervening period and pass it on to a pregnant woman. That's where the social good comes in. If these diseases are worse in small children, many are terrible when the mother gets them while pregnant. And the only way to help other women from going through that misery -- and you of all women know something about that -- is to vaccinate our own children against those diseases.

I live in Western Europe, and have recently moved to Holland from France. Holland is less pro-vaccine than France; our son's day care has a policy of chicken pox contamination, for example. (It worked.) But except for a small religious community -- people who are opposed to any medical intervention -- other vaccinations are still more standard than they are becoming in the U.S. I am grateful, and grateful on behalf of all those Dutch pregnant women whose own immunizations may not have worked and who will not have to go through the misery of becoming ill and worring about their unborn child.

stacyb said...

it would be great if we could cherry pick vaccines and say yes to say whooping cough and no to chicken pox but legally you can't. at least not in the state we live in. you either buy into the whole thing or not.

i think what you can do -- should you decide spaced out vaccines are the way to go - is question the need for boosters AND always have the titers (measure of how much of the vaccine is still in ones body) checked. if the titer level is high there is no need for a booster.

sometimes too much of a vaccine is not a good thing.

Anonymous said...

As a parent of adult children. vaccines were really not debated when they were younger. I would like to tell you though of two of my experiences as a special education teacher. When I began teaching there was no vaccine for meningitis. I am a teacher of the hearing impaired, birth to three. There was a time when I was first teaching when 30-40% of the children I taught had been normal hearing children who contracted meningitis and became profoundly deaf. (I know that other areas can also be affected but I only say the ones who were only deaf). It was so heartbreaking for these children and their families to have had a normal child who would now face a lifetime of challenges. When the HIB vaccine became available, I was the first one in line at my pediatrician’s to get that vaccine; I had seen first hand the devastating consequences. The second story has to do with children in school today. So many children are not getting vaccinated and it’s becoming a real problem. We had an outbreak of whopping cough last year and every child who hadn’t been vaccinated was excluded from school. Some children missed over 4 weeks of school because just when it seemed it was safe to come back we’d have a new outbreak.
Not trying to make you decision for you just wanted to possibly give you a different perspective.

Ryan's Mommy said...

Pro-vaccine here, especially for those diseases that can be life-threatening. My father is an immunologist and a brilliant scientist, and I trust him when he says the risks are minimal compared to the advantages. My son has had all vaccinations.

midlife mommy said...

My daughter had all her vaccinations, and we adhered to the usual schedule, up until she had her four-year visit. I was uncomfortable with the number of shots that were recommended, and the doctor said they could be split between the fourth and fifth year.

For us, it all boiled down to trusting our pediatrician, and we do. We do believe that the risk of not getting them outweighs the risk of getting them, but I understand not everyone agrees.

At one point, I think at 18 months, we went to the local health department for vaccines, because our annual vaccine allotment was used up on our insurance (and it is much, much cheaper there).

One of the FIVE(!) vaccines they recommended was the chicken pox vaccine. To this day, I wonder about that one. Kids can die from the chicken pox, and if they catch it when they are adults, it's worse, but it kind of bothers me that I have now subjected my daughter to boosters for the rest of her life. But, I suppose it's like that with most of the vaccines.

Hmmm . . . I wonder if I should be asking about boosters for myself!

Dramalish said...

This is such a charged issue, and I hate to be as blunt as this, but you asked, right?

Every mother that chooses not to vaccinate is putting my child at risk. The reason these diseases are rare now is because we, as a society, have bought in to vaccinations.

Fertilized said...

I have mixed feelings on vaccines but really had to get my son vaccinated due to my husbands job. He is around criminals all day and they are not the clean/healthiest of our society. I did not want to expose my child to something that a vaccine could help so after much thought and debate we decided to vaccinate ..but I know that my situation is very different than most people making these decision

EL said...

Wow, this is definitely a hot topic! I am somewhere in the middle on the vaccine issue. We have a 7 month old son and I too read "The Vaccine Book" by Dr. Sears before his birth. We are currently following his selective vaccine schedule, which includes what he views as the most crucial vaccinations. That means there are some my son won't get and the ones he does receive are spaced out and no more than two per visit. We feel comfortable with this right now. When he's older, we may do more vaccinations before he enters public school but right now i'm taking it 'one vaccine at a time' i guess you should say and sticking with the selective schedule. I totally get why some parents don't do ANY and why other parents do ALL. We all have the same goal and that is doing whats best for our child.