In the Great Vaccine Debate, Parents’ Fears Should be Respected

September 18, 2012 by  
Filed under Healthy, Kids

By Mark A. Largent / Take Part

Vaccines, once the savior of an entire generation, have become a hotly contested issue in American culture, and fears that they might cause autism have dominated parents’ discussions about vaccines for more than a decade.

Parents of as many as one in 10 children refuse to vaccinate their children with a state-mandated vaccine, and more than a third of American parents may delay or outright refuse a doctor-recommended vaccine for their children. To make matters worse, officials have found that vaccine exemptions cluster in particular areas within a state and around the country, so some communities have very high rates of under-vaccinated children.

Claims about a potential link between vaccines and autism emerged in the late 1990s from two independent sources. In Britain, a group of researchers published a paper suggesting a potential link between the combined measles, mumps, and rubella vaccine [MMR] and symptoms associated with autism.

Subsequent researchers roundly rejected their hypothesis, and the journal eventually retracted the paper. At the same time in the U.S., parents learned that many childhood vaccines contained a mercury-based preservative, thimerosal, and they grew concerned about its effects on their children.

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Studies have failed to demonstrate any deleterious effects from thimerosal, but it has nonetheless been removed from most childhood vaccines. By the turn of the century, these two separate claims merged and the so-called vaccine/autism debate flowered.

Health officials aggressively defend the safety, effectiveness, and necessity of childhood vaccines, and they are dismayed by the resiliency of parents’ fears that vaccines might cause autism. Hundreds of published studies and countless authoritative statements from health authorities seem to have little influence on the debate.

Physicians and public health officials allege that ignorance and anti-science attitudes are to blame, and they worry that science alone is not enough to compel parents to vaccinate their children. Nonetheless, medical professionals continue to attack the claim that vaccines cause autism as they call for increasingly strict laws to compel vaccine compliance.

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The fear that vaccines might cause autism is in fact proxy for a complex set of concerns that many parents have about the modern vaccine schedule. Health officials have failed to address parents’ underlying fears, and most parents lack the technical knowledge to effectively parse the many intertwined concerns that they have about vaccines.

What are parents really worried about? They are worried about the high number of shots kids get in the first several months of their lives. Today, a fully vaccinated six-year-old will receive nearly three-dozen inoculations, most of them in the first 18 months of life.

The routine vaccination schedule now calls for shots at almost every well-child checkup, including four inoculations at the two-month appointment and five inoculations at both the four- and six-month appointments. As parents scramble to explain their fears, the only explanation available to them is the claim that vaccines might cause autism. But when their anxieties are carefully and respectfully examined, we see that they emerge from a wide variety of often well-informed philosophical and moral concerns parents have about their children’s health.

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The solution for the problem of vaccine non-compliance is not increased pressure on parents or more passionate rhetoric from health officials. State legislatures that have made it easier than ever for parents to opt out of mandatory vaccines and the increasing number of “vaccine friendly” doctors who authorize medical exemptions mean that most American children can be legally exempted from some or all of their vaccines.

The only way to effectively address parents’ vaccine anxieties is to admit them and respect the fact that their concerns ought to be considered alongside scientific evidence as we add new vaccines to the modern vaccination schedule. If our ultimate goal is to ensure that as many children as possible are vaccinated against as many dangerous diseases as possible, it is critical that we preserve parents’ trust in vaccines and in their medical care providers.

This requires respectful engagement with vaccine-anxious parents and careful consideration of their particular concerns and contexts. Pediatricians who kick non-compliant parents out of their practices and health officials who continue to insist that vaccine anxieties are merely the result of ignorance and anti-scientism heighten the growing tension between vaccine-anxious parents and mainstream medicine. Their actions drive parents into the arms of the anti-vaccinators and undermine their own efforts to increase vaccine compliance rates.

This article has been reposted from TakePart.com

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Two-Month Check-up

May 21, 2012 by  
Filed under Family, Kerrie Olejarz, Surrogacy

By: Kerrie Olejarz

 

 

We had been home for a few weeks and it was time for Cailyn’s two-month check up at the doctor.  We chose to stay with our family doctor and avoid a pediatrician unless absolutely necessary.  We are fortunate that our family doctor does infant care, and that we really like her.  I was excited to see Cailyn’s weight and length gains, but petrified of following through on vaccinations.  Anyone who knows me knows that I always go to my naturopath for treatments: getting a cold – I go for a vitamin and homepathic IV; feeling sluggish – I go for blood ozone treatments. So, needless to say, I feared vaccinating and Mark and I laboured over what to do.  We spent many a night discussing both the pros and cons of vaccinations, and at the end of it we were inconclusive.  Before we had left for India I spoke with the doctor about my hesitations and she made it clear that she would support our decision, whichever way we went.  After a week home, I packed up Cailyn and headed to the doctor with some anxiety.  The appointment went well; we had a general discussion on how she eats, sleeps, and poops.  Then we stripped her down to weigh her and I was pleasantly surprised to see Cailyn weigh in at 8.08lbs, up from her birth weight of 6.37lbs.  This was a perfect weight gain and put Cailyn in the fiftieth percentile.  She had also grown a whopping 4 cm in length, which also landed her in the fiftieth percentile.  The doctor did a thorough physical exam on Cailyn who did not make any fuss.  After the exam, Dr P asked me what we had decided to do with the whole vaccine drama.  She said it was her job to explain to me WHY we should vaccinate, but it was ultimately the parents’ decision on whether or not to do it.  I loved her understanding and support!  I told her we were still on the fence and needed more time.  Fortunately, Dr P totally understood and welcomed my/our hesitation.  She told me to take time to consider it further, and if we decided to vaccinate that we would use the standard vaccine schedule, just at later dates than recommended.  I felt a huge sense of relief having not been pressured into doing it right there and then.   We also discussed the craziness of Cailyn’s spitting up, and as we did so, Cailyn showed off her wonderful spitting up abilities right there in the exam room.  I was so happy she did it as she did not normally spit up a just a little bit, it was a lot.  The volume that would come out at one time was alarming , yet, not too worrisome.  The end result of the discussion was that Cailyn was gaining weight at a good pace and therefore the spitting up, at this point, was more of a laundry problem than anything. At the end of the visit I asked about the Neonatatl heel prick test as this is not standard in India.  I felt it was important to have this test to look for any rare genetic or metabolic issues. Dr P was happy to oblige and told me she would find out where we go to do this and get back to me within a few days.  Over all the first appointment at home went well, Cailyn was healthy and this is what was most important.

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To Vaccinate or Not to Vaccinate

May 4, 2011 by  
Filed under Family, Multiples, Parenting

By: Heather Somaini

When our twins were born, vaccines were very controversial.  We were obsessed and worried that anything we did could hurt our precious little babies.  We heard about some of the claims that certain vaccines cause autism in children.  We even watched an episode of Oprah that completely freaked us out.  How could we possibly do anything that could harm our kids later?  It killed me to think I could make a decision now that could hurt them and affect the rest of their lives.

I decided to just sit in that terrible place and worry.  Tere decided to actually do some reading.  She became well-versed with Dr. Bill Sears’s The Vaccine Book .  I never read it so I can’t answer many questions but what it did for Tere was awesome.  It gave her the knowledge and understanding of the controversial vaccines and allowed us to make decisions about which vaccines we were going to give to our kids and when.  It made us feel like we had some small amount of control in making good decisions for our kids.

Vaccinations have been controversial since the day they were created.  They were originally called inoculation or variolation and the first known experiment was in 1721 by Dr. Zabdiel Boylston in Boston.  He first experimented against smallpox on his 6-year-old son, his slave, and his slave’s son.  Each of the patients did miraculously well.

There has always been controversy about vaccinations.  Many object on religious grounds.  The thinking goes that God created disease to punish people for their sins so we shouldn’t try and stop it.  But what historically occurs is that a disease runs rampant through a population, vaccines become necessary, everyone vaccinates their children, and vaccines are popular.  But as disease declines because of the vaccinations, people begin to dismiss their benefits, focus on safety, and subsequently begin believing that the decline in a particular disease is not necessarily related to the vaccine at all and that the risks outweigh the benefits.  Parents then begin to vaccinate less and the disease begins to creep back into the population.

Lack of complete vaccine coverage increases the risk of disease for the entire population, including those who have been vaccinated, because it reduces herd immunity . An example: measles vaccine targets children between the ages of 9 and 12 months, and the short window between the disappearance of maternal antibody and natural infection means that vaccinated children frequently are still vulnerable. Herd immunity lessens this vulnerability, if all the children are vaccinated.

There have been a number of reoccurrences of disease after a reduction in vaccinations.  A few of the surprising ones are:

  • After an anti-vaccination campaign reduced the vaccination rate in Stockholm to just 40% in 1873, an epidemic of smallpox erupted.  This led to a rise in vaccine uptake and the epidemic ended.
  • In 1974, a report in the United Kingdom claimed that the vaccine for whooping cough was only marginally effective.  Vaccination rates declined to 31% and an outbreak of pertussis followed.  The World Health Organization estimates that whooping cough (pertussis) caused 294,000 deaths in 2002.
  • In 2005, a measles outbreak occurred in Indiana, completely related to parents not vaccinating their children.

Here in the US along with a number of other developed countries, there has been great controversy over the MMR (Measles, Mumps, Rubella) vaccine due to a paper written by Andrew Wakefield and others published in The Lancet in 1998.  The paper reported on a study of 12 children with autism spectrum disorders with onset soon after receiving the MMR vaccine.  Ultimately, it was shown that Wakefield was conflicted and unethical and in 2009, The Sunday Times reported that he had manipulated data and misreported results creating an appearance of a link with autism that just didn’t exist.

Tere and I ultimately decided to separate the MMR vaccine and it did make us feel better at the time.  We watched for any sign of anything in the babies.  We worried and worried.  Nothing happened.  If our kids are not exactly “right”, it’s certainly not because of those vaccines.

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