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.

Vaccines, what's a parent to do?

A reader writes:

I was wondering if you would post information or discussion about vaccinations or what you have learned with your kiddies. I wrestled with my first one about them and after research, prayer, and conversation decided to continue with them. Lately, I have some friends who are very ANTI-vaccine and have pushed the issue with me. I have heard a lot lately in the media with the link to autism and then was sent this article today (article omitted). Reading this makes me NOT want to continue....but very curious to know other discussion or views on it. Thanks...and God Bless and thanks to all of you for your open blog where we can share and learn from one another!

The vaccine topic is huge. HUGE. There is a tremendous amount of information out there about vaccines, and unfortunately, much of it is sensationalized and lacking in useful or accurate information for parents. I’m going to humbly attempt to address this topic by breaking the issue down into two distinct topics: 1) What does the Church teach about when a parent can ethically vaccinate their children? and 2) Should parents vaccinate their children, from a medical/health perspective?

This post will address only issue #1 and I will save issue #2 for another post. Please keep in mind that I am not a doctor, nor do I have any formal training in moral theology. I am simply a mom who has read a lot about this topic and, like the rest of you, is trying to make decisions in the best interests of my children.

As some of you may already know, various vaccines are derived from the use of aborted fetal tissues. In the United States, the vaccines for Rubella, Hepatitis A, Chicken Pox, Polio, Rabies, and Smallpox are all derived from aborted fetal tissues. In the US, (as of 2005) there are no options for ethically acceptable vaccinations against rubella, chickenpox, and hepatitis A. (Ethically produced alternatives do exist for polio, rabies, and smallpox.) Ethically produced alternatives also exist for rubella and hep. A in other nations, but not in the US. As of 2005 there was not an ethically produced vaccination for chicken pox anywhere.

In light of these facts, the Pontifical Academy for Life, a commission of the Congregation for the Doctrine of the Faith, issued a statement in 2005 entitled Moral Reflections on Vaccines Prepared From Cells Derived From Aborted Human Foetuses. To date this is the best and most relevant church document on the topic of vaccinations, and in my humble opinion, a must read.

In regards to doctors and parents who use the vaccines, the document states:

...doctors or parents who resort to the use of these vaccines for their children, in spite of knowing their origin (voluntary abortion), carry out a form of very remote mediate material cooperation, and thus very mild, in the performance of the original act of abortion.

Put simply, the Church teaches that by using these vaccines, you are not intentionally advancing the evil of abortion, and your unintentional contribution to the problem is very minimal. At the same time, however, we have a duty to combat the evil of using babies to make vaccines.

Therefore, doctors and fathers of families have a duty to take recourse to alternative vaccines (if they exist), putting pressure on the political authorities and health systems so that other vaccines without moral problems become available. They should take recourse, if necessary, to the use of conscientious objection with regard to the use of vaccines produced by means of cell lines of aborted human foetal origin.

So obviously, if alternative vaccines are available, we should use them. But in the US, alternative vaccines are not available for rubella (found in the MMR shot), chicken pox, and Hepatitis A. So what is a parent to do? The document addresses this issue next:

As regards the diseases against which there are no alternative vaccines which are available and ethically acceptable, it is right to abstain from using these vaccines if it can be done without causing children, and indirectly the population as a whole, to undergo significant risks to their health.

So the document, in effect, provides a balancing test of sorts for parents questioning the use of an unethically produced vaccine. The more serious the disease, the more morally justifiable is the parents’ decision to vaccinate. The less serious the disease, the more likely a parent should choose an alternative route, such as conscientious objection.

This distinction has played out in our personal family decisions. We chose (or will choose) to vaccinate our children against rubella (although for medical reasons I will discuss in a future post, not until they are older than 3), because we feel that rubella poses a significant health risk to the general population. Luckily, my pediatrician does not routinely recommend the Hep. A vaccine for children, so I don’t have to make a decision on the Hep. A vaccine.

By contrast, we have decided against giving our children the chickenpox vaccine because we do not feel the disease is a grave enough threat to public health to warrant cooperation in the evil of abortion. Although, I will confess that I did give the vaccine to Gianna prior to my knowledge of this issue. Charlie did not receive the vaccination, Augustine will not receive the vaccination, and none of my future children will receive the vaccination, unless the drug companies develop a line of vaccines that are not derived from aborted fetal tissue—or our conscience changes through more prayer and research.

Our family has made this decision in light of this Church document, other information we have gathered about vaccinations (topic of a future post), consultation with our pediatrician, and prayer. And of course, we make no claim of infallibility. I think this is one of those issues where there isn't necessarily a "right" choice that applies to every family, particularly since individual health concerns are going to be different for each family, and perhaps different among siblings of the same family.

In summary, I think it is important that all parents take this issue seriously. We, as Catholics, have a duty to properly form our conscience. Just following the vaccine schedule of your pediatrician, no questions asked, is probably not enough to properly form your conscience on this issue. While it may not be possible to read every document on a given topic, and it may in fact be difficult to wade through the sea of information about vaccines, we must at least make an effort to educate ourselves about the moral issues involved in the debate. Then, through prayer and consultation, make the best decision for each of our children.

In the coming weeks I will do another post on the health/medical concerns involved with vaccinations...stay tuned!