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Monday, April 11, 2011

Vaccination: Not Always an Easy Decision.

Photo: John Richards; Feb 2011
  The decision whether or not to vaccinate one’s child is an ongoing debate.  There are many books and articles about this important parenting decision, and depending on one’s lifestyle and belief’s children are the one’s who bear the result of that choice. In the United States, the threat of a child contracting a contagious disease like measles has been so dramatically reduced that more and more parents are sometimes hesitant to deal with the potential side effects of these vaccines.   Having not lived through the horrifying epidemics of years gone by,  they may not feel that the threat of infection is a real one. However, in many cases this is a false sense of safety. 

Contagious diseases spread quickly, and those children who are not vaccinated are very much at risk.  In the case of measles, for example, over 80% of the cases in young non-vaccinated children are the result of contact with a carrier outside the USA.  International travel and immigration into the USA are not likely to end, so this threat to our nation’s children still exists. 

According to the Center for Disease Control and Prevention (CDC), children should receive the first MMR vaccine dosage at age 12-15 months, preferably as soon as they reach their first birthday.  The booster should be administered by 4 to 6 years old. This is particularly important for children that travel internationally, or live in a high-risk area. 

High-risk areas would include a country where an outbreak of measles in non-vaccinated preschoolers has been reported; or where six cases of measles in school-age children have been reported in every year of a five-year period.  A country that has a high inner city population is also considered to be high risk.

CDC data shows that eighty-seven percent of measles cases reported between 2001 and 2010 were related to international travel.  This means that the cases were attributed to child or someone within that child's immediate contact being exposed to measles outside the USA for all or part of the twenty-one day exposure period.  For this reason it is strongly recommended that children under the age of one year, who will be traveling outside the USA, be immunized with two dozes of the MMR vaccine, each dose twenty-eight days apart. 

The MMR vaccine along with the cooperation of American Academy of Pediatrics, the Advisory Committee on Immunization Practices and pediatricians across the United States has been credited with virtually eliminating measles in the United States since 2000.  Despite that, parents still have the option of not vaccinating their children.  For this reason, there are some children in our kids’ circle of friends who could inadvertently transmit a dangerous contagious disease.  Having the majority of children vaccinated against these diseases helps to keep the lid on the epidemics that years ago used to threaten the health of our children.


Let’s take a modern day example.  On April 7, 2011 an Olympus High School teen became  the first case of measles in Utah since 2005.  One day later two more youths were diagnosed with this highly contagious disease.  Three days later 7 more cases were either diagnosed or suspected; six of those cases occurred in ages that range from toddlers to teens.  Over a four-day period, the number of schools involved leaped from two to four.   Although ninety-seven percent of all school-age students in Utah schools have received the MMR immunization, all of those infected and diagnosed in this Utah case had never been immunized.  
Photo: Highlighthealth.com
 Some question those who choose not to vaccinate their children.  Unfortunately these parents are often angrily classified as ignorant, thoughtless, or even selfish, endangering the lives of society as a whole. Perhaps it could be said that choosing not to vaccinate because you want to jump on a “naturalist” bandwagon, or have chosen to be non-conventional as an act of rebellion – to these parents perhaps a more complete education about the benefits of vaccinations might be key.  In many cases their children could be better protected from harm by vaccinating – particularly if they intend to EVER travel outside the USA (now or in the future). 

But before we jump to convict those who choose not to vaccinate, let’s be aware of some facts.   Some children may be unable to be vaccinated due to allergies, fragile health or chronic illness.  These children will always remain at risk of either being infected, or being a silent carrier of a contagious disease.  They have no choice about this, and the fact that they remain a threat to other children is a fact that we as a nation must bear.  This is no fault of their parents, or the children themselves.

There are real potential side effects with some vaccinations that range from mild fever to brain damage or death.  The Measles vaccine has a superb safety record, but children with a severe egg allergy, a compromised immune system, or high fever could have adverse effects and parents should consult their pediatrician before administering the vaccine. The risks of moderate to severe side effects of each vaccine are very low, but they do exist.  For this reason, choosing to vaccinate can be a difficult decision for new parents.  Take the case of the Rotavirus vaccine.

This malicious, potentially deadly virus is most predominant in hospitals or day care centers where poor hand sanitation is found.  It is a germ that thrives in the stool of the infected person, and is passed on to children rather easily via contact, since toddlers and preschoolers are constantly putting their hands in their mouth.  Rotavirus causes severe gastroenteritis that produces vomiting and diarrhea in babies and young children, and can lead to extreme dehydration. Today there is a safe Rotavirus vaccine (approved in 2006) that can protect children from this disease.  But before that vaccine came into being, the virus had a global impact.  It was responsible for the death of over one-half million children per year around the globe.  Studies now show that this 2006-approved vaccine has the potential to reduce the number of cases by 75%; and can decrease the number of serious side effects by an amazing 98%.   

Though the current vaccine is extremely effective now, the original version of the vaccine had some significant potential health threats.  In about one of every 10,000 children who received the vaccine, intussusception occurred.  This is a very painful and potentially fatal condition in which the small bowel folds back on the intestine, creating a bowel obstruction.  It took two years to recognize this connection, and once it was discovered it was removed from the market and reformulated.  As a parent back in 2006, recognizing that your child could be that one in 10,000, this gives one pause to condemn too quickly those who hesitate vaccinating their children.



North Kivu, Democratic Republic
of the Congo.  UN Photo/Marie Frechon

Still, the safety record of immunizations shows that incredible progress has been made toward eliminating contagious diseases in the United States.  Having seen the devastating (and very preventable) effects of these diseases on the children in less advantaged countries, one may begin to realize how fortunate those of us who live in the USA really are.  We have a nation that has conquered many of these dangerous diseases through science, research and technology.  We are also a wealthy enough nation to provide this safety net to our children.

For further educational information on vaccinations, their benefits and potential side effects, try these websites below.  Get informed before deciding, read the science, talk with a trusted physician, and leave the emotion and sensationalism out of the process.  The science and studies show that today’s vaccinations benefit society as a whole.

 CDC report on vaccines:  http://www.cdc.gov/vaccines/ 
Fraudulent MMR vs. Autism claims: