Saturday, December 18, 2010

Vaccinations

I've had at least one request to write this post. Unfortunately, that was ages ago and I still haven't written it. But here goes: my opinions on vaccinations, and what we've decided to do.

My overall rule of thumb for vaccinations is that I won't let the baby have a vaccination unless the risks of not getting it are worse than the risks of getting it. That should be obvious, I guess, but it was very important for me to do this risk-benefit analysis with every shot offered to my baby, instead of just getting all of them because they are "recommended."

There's a lot you can read on the internet about vaccinations in general, so I'll just direct you to a few links:

This one is really great, well-reasoned and providing plenty of citations. I found her statistics to be extremely convincing.
Similar statistics with less commentary. Though correlation does not necessitate causation, I think I would demand some correlation between vaccines and disease reduction in order to accept that there is any causation. In other words, I would expect vaccines to hasten the decline in disease -- not leave it the same or, in cases, slow it.
This is a blog post a lot like mine, with some good points:
And this one's a pretty good summation, with helpful links:

Before I was finished with this post, the baby got sick. It was a little scary to hold my burning-hot baby in my arms while reading Wikipedia articles about diphtheria and tetanus (complete with pictures). Luckily, he only had roseola, a very minor virus, and was quickly better. And I'm realizing how fraught with emotion the vaccine debate is. However, we can't make these decisions out of fear. YES, I am scared of serious diseases, and YES, I would do whatever I could to keep my son from getting them. But I need to think of the actual risk of the disease, the actual risk of the vaccine, and the actual efficacy of the vaccine against the virus. I mean, my emotional fear of disease doesn't lead me to give him a bottle of hand sanitizer to swig ... I need to use only things that are safe and effective.

What doctors usually say to convince parents are things like, "Back in the day, we had kids in iron lungs from polio and dying of diphtheria -- and that's exactly what you'll get if you don't vaccinate!"

The fact, however (as shown in some of the links above) is that serious diseases like polio and diphtheria were declining long before the vaccine was introduced. The introduction of the vaccine makes barely a blip on the graph! The same is true for measles, and pertussis is actually rising nowadays, after declining in the early 70's, before the vaccine was introduced. Sanitation, better nutrition, and medical treatment for those infected have drastically reduced mortality from these diseases, even apart from vaccination.

As far as the risks of vaccines go, the studies done so far have been insufficient. I'm not going to say there is any link proved between autism and vaccines. What I will say is that those studies that have been done, as well as quite a bit of anecdotal evidence, suggests that there is a link, and there has been no satisfactory study proving otherwise. I think the burden of proof is on the medical community to prove there is no such link before recommending these vaccines. Autism is just one example. Other diseases that may be linked to vaccines include allergies, sudden infant death syndrome, auto-immune diseases such as Guillan-Barre syndrome, and cancer. And this is no surprise, seeing as vaccines contain not only mercury, but other harmful substances like aluminum and formaldehyde. When vaccines are tested, they are usually tested against a "placebo" which includes all the other ingredients of the vaccine with the virus omitted. This means that reactions against these additives are often left completely out of the studies.

Another important fact about vaccines is that many more are recommended than ever before. Around when I was born, the official vaccination schedule contained 10 doses of various vaccines: diphtheria, tetanus, and pertussis (whooping cough); polio; and measles, mumps, and rubella; with boosters of these. Today, the schedule recommends 36 doses of vaccines, including vaccines for the chicken pox and flu. This is the highest of any country -- most recommend 10-15 shots, and are not noticeably less healthy than Americans. Vaccines are tested individually, but given in large combinations. A child who misses vaccinations might be given 10 shots in a single office visit! That's a lot for a 10 or 15 pound baby.

Despite all of the above, I decided to consider each vaccine individually, to see if there would be any I chose to get for my son. To even be considered, a vaccine had to have these four qualities:

1. The disease it prevented must be very serious, i.e. life-threatening or having serious complications.

2. There must be some chance of actually contracting the disease.

3. There must not be a high occurrence of complications from the vaccine. Some vaccines are riskier than others, and the very riskiest would be skipped.

4. The vaccine must actually prevent the disease.

Further, every vaccine that would be given should be given as late as possible, giving the baby's immune system time to develop. I have heard that the blood-brain barrier is not completely formed till the age of two. And all of the systems of the body, particularly the brain, are growing so much in infancy that I want to disturb them as little as possible.

Ruled out under #1 are all the most recent vaccines, like the chicken pox. I have no objection to my kid getting the chicken pox, the flu, and so forth. Complications from these illnesses are quite rare.

The first vaccine offered to us was Hepatitis B. Hep B is offered in the hospital after delivery. However, I never heard of newborns engaging in risky sex or shooting up on illegal drugs. The only way they can get Hep B is from their mothers. I was tested for Hep B prior to delivery, and unsurprisingly came up clean, so there was absolutely no need to get it. If Marko grows up to enter a high-risk profession, such as medicine, he'd probably end up getting the shot, but there's absolutely no need for it in childhood.

Polio is offered at two months, but it was an obvious pass. There have been no cases of polio in the US in years -- and the most recent ones (all since 1979) were caused by the polio vaccine. (This is no longer a risk, since the live polio vaccine is no longer used.) Of course the CDC claims the vaccine is responsible for eliminating polio; however, cases of polio started declining in 1952, three years before the vaccine was even introduced, and long before it became universal. It may have a part in eliminating polio, but in any event, Marko is at virtually no risk of polio here in the US.

Next is DTaP, diphtheria, tetanus, and pertussis. Diphtheria is now quite rare; since 1980 only 55 cases have been reported in the US. 55 cases in 30 years, in a country of hundreds of millions ... the risk is just not high. Not only that, but treatment with diphtheria antitoxin is quite effective.

Pertussis is one disease that actually is in circulation. Periodically there are outbreaks, such as one in California this year. However, 80% of pertussis cases are in vaccinated individuals. Even after 3-6 doses of the vaccine and multiple boosters later in life, the shot does not give complete immunity. One likely reason is that the pertussis bacterium has mutated to the point that it is not recognized by the body. There are many strains, and the one we are vaccinating for isn't the one that keeps breaking out. The vaccine has too many side effects for me to want to give it just to prevent an obsolete strain of the disease. Fortunately, Marko is past the 6-month mark, before which pertussis is the most dangerous. In older children and adults, it varies from a severe cold to a minor nuisance.

Tetanus is one I will have to research further. I do not know how effective the vaccine is. I do know it can be given after a puncture wound and still be effective. The one thing I do know is that the baby is not at much risk for puncture wounds when he is indoors all the time and can't walk. So I have some time to do further research before making my decision on that one.

The measles, mumps, and rubella vaccine was another easy choice. It's made with fetal cells -- that is, cells from aborted babies. I believe it would be unethical to use these vaccines. Unfortunately, ethical versions are not available (source).

Those are the most commonly accepted vaccines. The newer ones, such as rotavirus, pneumococcal pneumonia, and haemophilius influenza B can surely be omitted -- I never had them, nor did anyone in my generation, and infant mortality wasn't significantly higher back then.

Of course I intend to keep an eye on changing trends, such as outbreaks, and changing situations, like moving to a third world country. My decision is based on current conditions in our current situation.

What I wish most of all is that people would understand that the decision we have made for our son is based on reason, not fear. Yes, John knows more than one child who developed autism immediately after receiving vaccines. But even though this anecdotal evidence is strong (and the more moms you know, the more you hear about this happening, as I have through the blogosphere), it's not the only reason we are delaying vaccines at this time. There is lots of scientific evidence -- not new studies, just carefully looking at old data -- which suggests vaccines are neither as safe or as effective as we have been led to believe. Of course I want to protect my son from illness, but it looks like right now we will have to use other means to keep him well.

Any questions or comments?

P.S. Unfortunately we were just told by our doctor that he will not provide well-baby care to our unvaccinated child. Sadly, this happens all the time. If you don't believe people who choose to decline or delay vaccines are bullied by their doctors, check out this page!

7 comments:

Heather said...

Re. deciding to not vaccinate Mark for various viruses, at least you're doing it based on analysis and reason, not fear. And he'll be homeschooled and likely around other kids whose parents are more likely to have taken the same vaccination path as you and John.

The only concern I'd think of is Mark's exposure later in life to other kids who may carry certain germs around without knowing it and not being affected by it. Or vice versa. But that's later on, so more time then for him to develop and you to decide if anything new is needed.

Re. your doctor, I haven't read the page you linked to describing bullying, but it could be that he's just not insured for treating unvaccinated babies, so he's looking out for himself, not necessarily placing personal ideological pressure on you. Although I see how it can come off that way.
Or, he knows that vaccinated kids enter his office all the time and the office may not be the cleanest (ironic!) of places for an unvaccinated baby. Or that he is used to providing later treatment to vaccinated babies, so he doesn't have an alternative on hand (unfortunate, but possible) for unvaccinated babies.

Anyway, thanks for the post! It's refreshing to read something on vaccination from this point of view that isn't riddled with knee-jerk anger and accusations that have data from people with conflicts of interest and no flexibility in thinking at all... that are written by people who seem more entranced by fear and being on a bandwagon than actually protecting their baby from both disease and overzealous pharma.

Enbrethiliel said...

+JMJ+

I had no idea that the vaccines for measles, mumps and rubella were made from aborted babies. =( What a convenient thing for medical professionals to leave out, aye? And refusing to treat a baby who hasn't been vaccinated? What a bullying jerk! Of course, he can't be the only one . . . =S

Oh, my . . . I just went to the site you linked and read about the Vit K vaccine and childhood leukemia. One of my brothers was diagnosed with leukemia in nursery school; my other brother, still in the sixth grade, has it now. I'm going to look into this. =(

Sheila said...

I have not heard of that connection outside of that website, so you'll have to see what you find elsewhere. I do know Vitamin K is not necessary ... why do we assume a level that would be low for an *adult* is too low for a newborn, since they ALL have low K levels? (One reason is that newborns' blood does not clot very well, and so K is necessary if circumcisions or other operations are going to be done.) But in the absence of these, it's unnecessary -- K levels will slowly rise with age in a healthy breastfed baby (and I believe formula is K fortified, not sure though).

I'm pretty sure Marko did have K when he was born, because I hadn't researched it ... sigh.

Fidelio said...

Have you considered that, should a childhood-disease-of-yore (such as polio or smallpox, for example) have a resurgence in the U.S., you have put your child at a much greater risk by not having him vaccinated? These diseases are still rampant in third world countries around the globe. How hard would it be for something like that to be imported? Especially if the carrier had malicious intent?

Sheila said...

Of course I have considered that -- I'm a mom and bound to worry. In the case of smallpox, it truly has been eradicated worldwide, except in labs, and as a result, hardly anyone is vaccinated against it nowadays. I know I wasn't. Our generation has the immunity of pre-Columbian Americans. But I don't really think we should mass vaccinate everyone on the grounds of potential terrorist attack. In the event of an outbreak, of course we would be lining up to get our shots like everyone else. But the risk is vanishingly small, less than the risk of complications -- which is why doctors don't recommend it.

Polio, again, is highly unlikely to break out again. Seeing that in THIRTY YEARS there has not been ONE wild case imported, the risk of infection is lower than the risk of complications.

In the case of true childhood diseases, like measles and mumps, they are pretty benign. Complications are very few and rare, especially with medical care (though even that is rarely necessary).

None of these are risk-free -- but I've determined the risks are lower than the risks of the vaccines against them, so we'll take our chances with the disease for now.

Fidelio said...

But what happens when the majority of people decide not to get vaccines, and when the disease resurfaces, it reaches epidemic proportions again since there are fewer resistant people than non-resistant people?

Sheila said...

I am not relying on the vaccinated to protect my son -- I'm relying on his healthy immune system, modern sanitation, and modern medical care. If you look at the charts of statistics I linked to, these caused the decline of virulent diseases and deaths from them before vaccines were introduced. Without vaccines, those same causes will continue to keep the rate of disease low.

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