Doctor, what is your philosophy on vaccines?
This is one of the most frequent questions I get asked from soon-to-be parents during their prenatal visit or from new parents when I first bring up the topic. Given the volume of material already published about vaccines, yet another article may seem redundant at first pass. However, parents like to hear from their own pediatrician about what they may have read or heard on their own, I thought this blog maybe helpful to you.
We know that while improving the health of children in any community involves numerous items including access to care, appropriate diagnosis and treatment, the highest form of quality medical care is disease prevention. While advances in medical science and technology have vastly improved our ability to treat diseases, prevention is still the best strategy. So, how can we prevent disease? The good health that is enjoyed by children in the Western world has largely been achieved through better socioeconomics allowing for resource allocation towards preventive care including clean drinking water, plentiful supply of nutritious foods, product safety, prevention of injury, and the advent of vaccines. A list of diseases prevented in children by vaccination over the years is available here. Since vaccination efforts in the U.S. have been so successful in eradicating serious childhood illnesses, many parents wonder if vaccinating their children is necessary any longer. What we sometimes forget is that a reduction in ‘herd immunity’ can lead to a resurgence of these illnesses. We live in a global society, and these diseases still occur in other countries. So, if we were to let our guard down and not vaccinate our children, we would begin to see these terribly debilitating diseases affect our children. This is not just a theoretical fear. The 2010 pertussis epidemic in California showed that counties with lower rates of vaccination had more cases. So, my “philosophy on vaccines” is that vaccinating your child, barring specific contraindications, equals providing protection for your child from serious infectious diseases.
But what about vaccine safety?
Media coverage about vaccines and possible links to autism have created fear and doubts in the minds of some parents particularly those who have not had the opportunity to experience life in the developing world. While a detailed discussion of autism and vaccines is not possible here, I encourage you to look up several well-designed studies referenced in Dr. Paul Offitt’s article below. These studies have not confirmed that such a link exists.
Obviously when offering any preventive therapy to children, one has to weigh the risk/benefit ratio of that treatment. I found one of the most honest assessments about risks and vaccine safety here. Dr. Paul Offit states that “few things meet the definition of ‘harmless’. Even everyday activities contain hidden dangers. For example, every year in the United States, 350 people are killed in bath- or shower-related accidents, 200 people are killed when food lodges in their windpipe, and 100 people are struck and killed by lightning. However, few of us consider eating solid foods, taking a bath, or walking outside on a rainy day as unsafe activities. We just figure that the benefits of the activity clearly outweigh the risks.”
Is using an alternative vaccine schedule safer, and is there such a thing as giving too many vaccines and overwhelming a baby’s immune system? The article, “Immune system, Infants and Immunization” available here, is an excellent review. In addition, I encourage all parents considering a vaccine schedule different from the one recommended by the CDC/AAP to read “The problem with Dr. Bob’s alternative vaccine schedule” available here.
Although we accommodate other vaccine schedules when requested by parents on a case-by-case basis, we highly recommend using the CDC/AAP vaccine schedule, which is based on the recommendations of the Advisory Committee of Immunization Practices, a large multidisciplinary committee versus the recommendation of 1 or 2 individuals.
I hope the above is helpful. For further reading I suggest visiting the vaccine education center here and www.immunize.org. You may enjoy the videos “Vaccines and your baby” and “Separating facts from fear.”