When it comes to vaccines, I honor parent choice. I encourage parents to make informed decisions, but I recognize that it can be difficult to know where to find accurate, unbiased data. There are statistics, persuasive arguments, and personal stories on both sides of the vaccine debate. Unarguably, some children have suffered sad complications from vaccine-preventable diseases (even death); unarguably, some children have had serious reactions to vaccines (even death). So what is a parent to think?
Looking at the data with a medical background and some understanding of statistics, I see that comparing risks and benefits of vaccination is not exactly straightforward. For one thing, much data has to be extrapolated or estimated from previous times or different contexts. Also, not surprisingly, biased reporting can be found on both sides of the issue. On the anti-vaccine side, I found several websites with anecdotal claims and references to articles that were inaccurately summarized. On the other hand, certain pro-vaccine websites made seemingly exaggerated or oversimplified claims–the CDC reports a mortality rate of approximately 2-3/per 1,000 cases of measles, which likely overestimates the modern-day risk (a recent outbreak in France showed a mortality rate that was lower by ten-fold). Still, even a death risk of 1/10,000 from measles (only one of the vaccine preventable diseases) is much higher than the death risk from receiving vaccines (estimated to be <1/several million).
As I take into account the multiple studies, reports, & inherent biases, my conclusion is that vaccination is the statistically safer option, both from a standpoint of individual risk AND population risk. This conclusion has led me to vaccinate my own children and to recommend vaccination for my patients. Yet we all know that this is more than a game of numbers; we are talking about children here. As parents, all we can do is choose what we believe to be in the best interest of our children and gain peace knowing we have done so, come what may.
What about mercury? Currently, every major vaccine is available in a thimerosal-free form. (Feel free to ask ahead of time about which brands your clinic uses!) Only certain multi-dose influenza vaccine preparations contain thimerosal, which has a breakdown product of ethylmercury. Though most studies conclude that small amounts of thimerosal are not toxic, organizations such the American Academy of Pediatrics called for its removal from vaccines in 1999. (Feel free to ask your provider about which brands your provider uses).
What about adverse reactions to vaccines? Significant vaccine reactions are uncommon, but they do occur. These may include anaphylaxis (severe allergy), autoimmune-mediated CNS damage (such as ADEM), or febrile seizures. In general, doctors need to do better at explaining these possibilities and acknowledging that vaccination is a choice.
What about the pain or trauma vaccines cause to children? Though we as parents worry about our child experiencing several “pokes” at once, the introduction of several vaccines at once is not likely to overwhelm the system; the immune system fights simultaneous multiple exposures on a regular basis. There are ways to decrease a child’s discomfort with vaccines using relaxation or sensory-altering techniques.
Is there any magic in following the recommended schedule? Yes and no. The recommended intervals between vaccines give a scheduled re-exposure to optimize the body’s immune response. This decreases the chance of waning immunity and infection risks that may be present during periods of long delay. Standardizing the recommendations also helps with tracking. That being said, a customized schedule is better than no schedule.
Resources
http://www.who.int/vaccine_safety/initiative/detection/immunization_misconceptions/en/index4.html
https://www.historyofvaccines.org/content/articles/vaccine-side-effects-and-adverse-events
http://www.immunize.org/
Though I do not offer vaccinations, I do generally recommend them. If you would like to discuss vaccines or ways to improve your child’s experience receiving them, I am happy to help!
–Dr. Mary
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