Thinking About Vaccination
When I was a new parent I became aware that some people chose to not vaccinate their children. I remember thinking “Are they crazy? Everyone gets vaccines, who wouldn’t?” It had never occurred to me that vaccinations were controversial; I had been raised among traditional medicine.
Still, being exposed to that concept started me thinking and questioning. I did more research and reading and began to realize that many of the vaccinations were for diseases that had been considered a normal part of childhood for my parents’ generation: chicken pox, measles, and mumps. I of course wanted to make good decisions on behalf of my baby.
Considering ceasing all vaccinations was overwhelming and not a choice I was ready to make. However, I had realized by this point that vaccinations were medical procedures about which the recipient needed to make informed decisions. I would not begin any other medical treatment without investigating risks and side effects, and I felt like a wise consumer would follow similar processes with vaccinations.
Thinking about vaccinations as a whole was not logical: each disease is different, with different risks, and so is each vaccine. Here is the process by which I approach my vaccination decisions – and it is an ongoing process that we revisit frequently.
- Risk/Benefit Analysis. Everything has a risk, even drinking too much water. It is simply not credible for a doctor to tell me that all vaccines are equally important and that there are no risks. I created a spreadsheet on which I compiled information on each disease and vaccination: risk of the disease, risk of the vaccine, ages and races most likely to get the disease, conflict of interest from the manufacturer, number of annual adverse reactions to the vaccine, what the adverse reactions are, temporal pattern and occurrence, how the disease is transmitted, disease trends, and what the contraindications are (which allergies and concerns the Centers for Disease Control – CDC – states are contraindicated for each vaccine).
- In analyzing the risk v. benefit of the vaccination, do not assume the vaccine is effective. Vaccines are not as effective as many people think – consider the booster shots we must get to maintain immunity. The pertussis vaccine is only about 40% effective. The tetanus vaccine has actually never had its efficacy tested and some assert it actually increases one’s risk for tetanus. The chicken pox vaccine increases one’s risk for shingles, and it wears off as children become young adults – when contracting the disease is truly more dangerous.
- Do not assume that the vaccine is safe. The new Rotavirus vaccine has been approved with death as a known complication. It may be more dangerous than the actual disease – or it may not. You don’t know unless you investigate.
- Do not assume that because a disease has a vaccine for it, it is a dangerous disease. Money is a big factor. The creators of the chicken pox vaccine have publicly acknowledged that money was a driving factor in that vaccine: preventing loss of work for parents caring for sick children. The child’s welfare should be the primary deciding factor.
- Consider whether the child is even in the risk group for the disease. For example – from www.cdc.gov, the risk groups for Hepatitis B are: men who have sex with men, sex contacts of infected persons, injection drug users, household contacts of chronically infected persons, infants born to infected mothers, health care and public safety workers, hemodialysis patients, infants/children of immigrants from areas with high rates of HBV infection (view map at
http://www.cdc.gov/ncidod/diseases/hepatitis/slideset/hep_b/slide_9.htm – US is at “2% – Low”).According to the CDC, these are the people most at risk for this disease – for which EVERY child born in a hospital is vaccinated at time of birth, unless the parent declines.
- Be aware of the seasonal rise and fall of the diseases. For example, the pneumococcal disease (Prevnar vaccine) has a temporal pattern of winter and early spring. Do I really need to begin that vaccine in summer? Or can I delay it until fall and vaccinate for a disease that has a more urgent need? www.cdc.gov has this information. We may not trust everything the CDC says, but it is a starting point. If the figures from the CDC, which promotes vaccination, indicate a low risk level for the disease, I feel safe in delaying that vaccination.
- Local incidents: Statistics are important, but I want to know what is happening in my area. A medical acquaintance advised me that I can contact the infectious diseases laboratory at my county public health office. Hearing her findings about local tetanus incidence led me to research tetanus more thoroughly and I learned that there were about 180 cases in an 18 month period in the United States, and that kitchen injuries were the most common cause – not rusty outdoor tools. That is not at all what I was expecting to find having grown up hearing about the rampant threat of tetanus surrounding me.
- Interview the pediatrician: I always interview my prospective pediatrician by asking which vaccinations he/she feels are most important, and how many cases of the diseases he/she has seen. I do this to get the vaccination information and also to select pediatricians: if a pediatrician tells me the vaccinations are equally important, he or she is either being condescending or is not very medically astute, and I leave immediately. No pediatrician I’ve utilized has ever had a problem ranking the vaccinations and sharing that information. If the doctor is defensive about this, he or she obviously doesn’t view me as a peer capable of critical thought and again I leave immediately. In our various moves, we have been with four pediatricians and none of them have seen a case of diphtheria in the past 25 years of practice, but they have seen HIB and meningitis. That counts when I am weighing the likelihood of encountering the disease against the likelihood of vaccination reactions.
- Consider our biology: Getting sick is actually an important part of immunological health, a sort of “use it or lose it” methodology (assuming that the immune system is essentially strong). Evolution has designed our bodies to work toward healing themselves. I trust my children’s bodies to process a natural case of chicken pox far more than I trust them to process bovine serum, sodium chloride, monosodium L-glutamate, potassium phosphate monobasic, potassium chloride, neomycin and Residual components of MRC-5 cells including DNA and protein, which are some of the ingredients in the vaccine. (http://www.rxlist.com/varivax-drug.htm) The list of ingredients was not found at www.cdc.gov, as I would have expected.
- Vaccination Schedule: For any vaccinations that make it past the elimination process, I would most definitely determine my own vaccination schedule. There is no legal or health obligation to follow the official schedule. This schedule is created for the efficiency of the medical office and based on the low likelihood of parents bringing babies in for checkups as the babies get older.For example, I do not believe babies should be vaccinated at birth. Newborns have just completed an exhausting and draining process (being born) and need to recover. A newborn baby is not going to crawl over a rusty nail or engage in risky sex. Vaccinating for diseases the baby is not at risk of encountering results in more risk than benefit.
As part of a custom vaccination schedule, only allow a doctor to administer one vaccination per visit. The primary reason is based on our biology. Our bodies are not designed to encounter multiple viruses “in the wild.” Scientists are working to make vaccines more like the “wild” viruses, but we are not there yet. We usually get one ailment at a time, unless our immune system is compromised. Administering three vaccinations (or more) at a single visit is an enormous assault on a baby or child’s immune system. Parents are often careful to introduce a single food at a time – why would a parent not introduce a single vaccination at a time? The second reason for individual vaccination is for tracking any adverse reactions. If I have allowed the doctor to administer six vaccinations in one visit, it is very difficult to identify the culprit should there be an adverse reaction. Knowing which vaccination the child is sensitive to is imperative so the parent can avoid that vaccination in the future. For every vaccination, write down the lot number and watch the nurse draw the dose.
My child’s safety is worth the inconvenience of my scheduling nurse appointments to receive vaccinations singly.
Finally – if a child has any compromised immunity at the time of a planned vaccination, delay it until he or she is well. This includes colds and coughs. This is stated at www.cdc.gov and is also stated on vaccine inserts, but is not often conveyed at the doctor’s office. The parent can always schedule a nurse visit for when the child has recovered.