A Middle Ground

One of our readers saw the article, "Strife over shots, should our kids play together?" on the front page of msnbc. This article follows another similar article, "Vaccine-wary parents spark public health worry." According to the first piece, the vaccine issue is now causing such heated emotions and debates that some playgroups are asking unvaccinated children to leave the group. The second article provides a bit more background information and a nice overview of the debate.

The vaccine topic has been a regular discussion in our household. Yet unlike many of the mothers interviewed for these articles, we have followed a more middle-of-the-road approach to vaccinations. Both sides seem to be full of propaganda, fear mongering, and catch-all one liners. Throughout the past 4 years, I have been at my wits end trying to discern what is true and what isn't, trying to make the best health decisions for our children and family.

First, I have a hard time trusting anti-vaccine advocates, many of whom are very individualistic in their thinking and indifferent to herd immunity.

Scientists worry that vaccine resisters increasingly are breaching "herd immunity," the necessary level of protection that keeps disease from spreading. When enough people in a community are immune to a disease, they provide a buffer that keeps germs from infecting those too vulnerable for vaccination, or those for whom a vaccine doesn't work or wears off.

Some diseases, such as mumps, can tolerate a herd immunity threshold as low as 75 percent. But other, more virulent diseases, such as measles or pertussis, also known as whooping cough, require collective immunity of up to 94 percent to avoid infection, according to the federal Centers for Disease Control and Prevention. (emphasis added)

It is a fact that when we choose not to vaccinate, we are putting the community at risk. A small risk, but the risk grows with each family that makes this choice. This fact is often neglected by anti-vaccine advocates, and even if they acknowledge it, they claim that catching these diseases isn't such a bad thing. For some measles cases this may be true, but what about other diseases like rubella--which can actually kill or permanently disable an unborn child? Even the Church (CDF) has emphasized the dangers of contracting rubella and not vaccinating against it. (See my previous blog post on vaccines.) And what about those vulnerable members of our community that are immune suppressed? Isn't there any ethical duty to care about the herd?

On the other hand, I don't trust the pharmaceutical industry, and sadly, I don't always trust my doctors, who regularly try to downplay the negative individual side effects of vaccines:

The federal Vaccine Adverse Event Reporting System, a voluntary program that records bad reactions to immunizations, receives about 30,000 reports a year, with between 10 percent and 15 percent classified as serious, according to the CDC. Though rare, severe problems can occur, including serious allergic reactions, long-term seizures, coma or permanent brain damage.

That is at least 300-350 serious vaccine side effects per year. While small, this number is much higher than the number of children coming down with measles or whooping cough. In addition, both measles and whooping cough will result in a full recovery for most children. Sadly, this isn't the case for a child with a serious adverse vaccine reaction. It is important to remember that our government has set up a national vaccine compensation system for those families injured by vaccines.

Combine these reactions with the feared, although unproven risks of disorders like asthma, attention deficit disorder, autism, diabetes, and childhood cancers, and a parent begins to worry that a shot may cause more problems than the initial sting from the needle. Are we trading measles for autism? There is no scientific proof, but my mother's gut is loudly telling me that it isn't a good idea to inject a child with 32 different immunizations before the age of 2 (the standard number of immunizations including boosters).

It's a hard call, and each parent's decision will no doubt be influenced by such things as the following: previous vaccine reactions (like most things these run in families), individual health issues, your child care scenario, and even your doctor.

In our particular case, I am most concerned with the very aggressive nature of the typical vaccine schedule. A child may receive vaccinations for up to 12 different diseases at one appointment. If my child suffers a reaction, how do I even know what shot caused the problem? This and other concerns led us to adopt the following plan.

We delay all vaccines until 4 months. We then vaccinate one shot at a time, delaying some shots until our children are older than 2. Some vaccines we choose to avoid altogether because they don't seem worth the risk, examples of this include Hepititis B (sexually transmitted), Hepititis A, flu shots (many of which still contain mercury), and chicken pox (posing ethical issues, see my previous post). My children receive DPTa, MMR, HIB, Polio, and Prevnar.

I have worked out this alternative vaccine schedule with my pediatrician. I would highly recommend that all families find a pediatrician that is willing to listen to your vaccine concerns, address those concerns, and then work with you on a vaccine schedule that suits your individual needs. Far too many pediatricians REFUSE to listen to parent concerns, and then dismiss a parent as ill-informed or unintelligent when they have questions. Balancing the needs of the herd with the needs of individual patients is crucial here. I had to shop around for a pediatrician that would do this, and I am very pleased I took the time to do so. I know this isn't always possible for every family, but it makes a big difference when making such difficult decisions. My doctor is willing to discuss the issue, call me back at home to answer questions, and is VERY respectful when I let him know I am uncomfortable with the regular vaccination schedule.

In the end, I don't think there is a right answer for every child or family. I'm not a doctor, just a mom. A mom who has done her research and is trying to find a middle ground as I make informed decisions about the health of my children. Ultimately, I think it is a real shame that we have two opposing sides that can't give us the facts without a serious spin. It is my hope that someday the medical community will at least entertain a more cautious approach to vaccine administration.