Wednesday, March 18, 2009
Several years ago, Sam and I met a new couple at church who had just had their first baby. During our first conversation, and apropos of nothing, they informed us that they weren't vaccinating her.
Sam and I nodded and smiled and edged away, then looked at each other out of their line of sight and mouthed "Cuckoo" while doing the appropriate hand gesture.
OK, I might be exaggerating our response, but we did think they were nuts. We couldn't figure out why not vaccinating was a choice anyone would make. We didn't know people who thought that way existed. Don't vaccinations save lives, and why would we want those icky poor-country diseases around here?
Fast forward to now, and you'll find that we're the crazy ones. I had a very awkward conversation with our 21-month-old toddler's preschool teacher when he looked at our state-mandated vaccination form and found that all we'd signed was the personal exemption on the back. (Washington state is one of the states that allow for an exemption based solely on personal conviction, not religious or medical.) I found out that it's hard to defend your position in a fumbling, three-minute conversation. So far, Mikko's still enrolled, but the teacher advised us that it really is better to vaccinate, you know.
Sigh. I guess I didn't get my point through in my little unprepared speech.
In light of that, I thought I'd try to articulate our position on vaccination. We're actually quite reasonable about it, and not a little ambivalent.
Vaccination is one of those issues that engender a lot of heat, pro and con. People who are for vaccination tend to be heated that people who are against it are ruining the herd immunity and endangering their children. People who are against vaccination are really, really against it, for a whole host of reasons. Of course, then there are the majority of parents, who are for vaccination in a completely unheated, no-duh manner, as counseled by their pediatricians, their own experiences growing up, and, apparently, their children's preschool teachers — everyone gets vaccinated.
It's hard, when you're a new parent, to make sense out of the war between the factions. And it's hard, too, when you just don't care all that much. No, it's true — for me, vaccination was one of those topics I'd rather have just avoided. It sounded so tedious and mind-numbing (and was) to wade through all the hype and jargon and data to try to formulate some sort of conclusion. No one in either of our families had had an acute adverse reaction to a vaccine that we knew of. Many of the diseases the vaccinations are supposed to protect against sounded pretty gnarly but were unfamiliar to me and needed to be researched just as much as the vaccinations themselves.
It made me want to pull my hair out.
But I dutifully checked out books from the library and started scouring websites and asking questions on forums. Our pediatrician is a naturopath who lets parents make their own decisions regarding vaccination, and I really can't figure out where she stands — I appreciate that, but I would have welcomed a little guidance, to be honest.
What I researched only made me more ambivalent — but this time, leaning away from vaccinations, not toward.
I think the first incisive moment was when I was being urged, by state mailings and PSAs, to get a flu vaccine when I was pregnant. I looked into it, which I had never received before, and found out that the flu vaccine had mercury in it. Wait — wasn't I avoiding certain species of fish and varying the type of fish I ate each week specifically to avoid mercury, and now they wanted me to inject it directly into my bloodstream? Does Not Compute (read that in a robot voice, 'k?). Speaking of computing, if you follow those links and I'm doing the math right, the mercury levels in the most toxic fish are around 0.5 parts per million, and the mercury level in the flu vaccine is 50 parts per million. Huh-wha?
The next incisive moment was researching the first vaccine they give a newborn: hepatitis B, spread by bodily fluids. Well, I don't know about you, but I know very few drug-using, promiscuous newborns. By the age they could be dope-dealing hookers, the vaccination's effects have usually worn off. So I really couldn't see what the point of baby hep B vaccines was.
As I read more, I kept a cheat sheet, writing down pertinent facts and my still unanswered questions. I starred the illnesses that scared me more than the vaccine, and I tried to crystallize a position: Was I for or against vaccines? Was I more afraid of the vaccines or more afraid of the illnesses? (Because, no matter which, everyone's position seemed to come down to fear.) Every well-baby visit, our pediatrician would once again ask where we stood and if we wanted vaccines now, and every time I would just keep putting it off. If nothing else, we were following a delayed vaccination schedule, delayed only by my inability to decide what to do.
I found out interesting information as I researched.
• First of all, the theory that vaccination is what has caused all the harmful diseases to diminish is flawed. The data show that many of the vaccine-preventable diseases were decreasing before widespread vaccine use, and that's probably has much to do with increases in sanitation and clean drinking water.
• I found out that most recent cases of polio in the U.S. have been from the vaccine (the discontinued, live version).
• By vaccinating for childhood illnesses like the life-threatening, terrifying chicken pox...wait, chicken pox? Seriously? I had that when I was four and was itchy for a few days and lived to tell the tale. As I was saying...by vaccinating young children against such generally benign illnesses, the onset is being delayed. Because vaccinations are not the same as immunity, and because vaccinations vary widely in how effective they are, we're now going to see outbreaks of chicken pox in adolescence and early adulthood, when the consequences can be much more severe, particularly if pregnant women no longer have immunity. I'd say that all we're doing here is trying to keep mommies at work instead of home with their sick preschoolers, but that might be my jaded sensibilities talking.
• The ingredients in vaccines will make you blink. Mercury (you've heard the stink about that, presumably), yes, also aluminum, formaldehyde, chicken embryo (when we're cautioned against feeding eggs to our infants), gelatin, MSG, aspartame, aborted fetal tissue — none of them things I relish injecting into my baby's body.
• Vaccines have outright killed children. Vaccines have given children the diseases they're being immunized against. Vaccinated populations have higher rates of chronic immune conditions.
• Friends of ours have dutifully gone for their babies' vaccinations and had those babies react acutely. One baby had a high fever and a month-long bout of diarrhea. The kicker: The parents keep going back for the next round! That's how entrenched the value of vaccines has become in the public mind.
• Perhaps most disturbing to me personally, there have been (disputed) links between vaccines and multiple sclerosis, a degenerative autoimmune disorder that unfortunately runs in my family. No one knows yet what causes MS, but one theory is that there's a genetic element that requires a trigger to start causing symptoms of the disease; that trigger might be immunizations. I would hate to protect my baby from mumps, which in almost all cases is a harmless childhood illness like chicken pox (ask your parents or grandparents), only to have him later develop a debilitating neurological disorder.
As you can see, those were kind of the anti-vaccine rationales. So I'll try to give some "on the other hand" information here:
• There have been increasing outbreaks of pertussis, also known as whooping cough. It's unclear whether these are natural, periodic outbreaks, or whether it's an argument for or against the herd immunity theory. It is true that pertussis is being diagnosed more often in areas with lower vaccination rates. However, it's unclear whether pertussis is being diagnosed there because doctors are aware of it, as opposed to diagnosing it elsewhere as a cold. Plus, the pertussis vaccine is one of the least effective.
• Mikko has one testicle, after surgery to remove a damaged one. I have never experienced mumps firsthand but had heard something about potential infertility from mumps. It turns out that mumps can cause glandular swelling, and sometimes one testicle (rarely both) can become swollen and then, rarely also, become sterile. It's usually not an issue, because most guys pack them in pairs, but our little guy doesn't have a backup. The math looks something like this, though: Mumps is rare; swelling is rarer; swelling of testicles is even rarer; sterility as a result of swollen testicles is almost infinitesimally likely. Besides, if he's sterile, he won't have to reproduce and make all these tough vaccination decisions. (Ha ha, little joke — I thought things were getting all stuffy in here. He could always adopt...)
• Haemophilus influenzae type b scares the pants off me. It's like one of those movie diseases that are being spread by ruthless aliens. Seriously, isn't it ominous sounding? Meningitis occurs in 50-65% of symptomatic cases, and the mortality rate is 2-5%. "In addition, 15%-30% of survivors suffer some permanent neurologic damage, including blindness, deafness, and mental retardation. Another 17% of invasive Hib cases include epiglottitis, an infection and swelling in the throat that can cause life-threatening airway blockage. Other forms of invasive Hib disease include: joint infection (8%), skin infection (6%), pneumonia (15%), and bone infection (2%). ... Even with antibiotic treatment, up to 5% of all children with Hib meningitis die from the disease." However, Hib is rarely life-threatening in children older than five years, in 2002 there were only 34 cases in children in the U.S., and most cases of Hib are seen in the vaccinated population.
• Rubella can cause severe complications (mental retardation, deafness, and just plain old death) for unborn babies if a pregnant woman is exposed to it. I envisioned a frightening picture of Mikko infecting any future siblings.
So, pros and cons, for and against, weighing our options and weighing them again but not really registering any numbers on the scale. Up till now, we've justified putting off the decision, both because we breastfeed and because Mikko hasn't been exposed much to other children. Now that he's in preschool twice a week, though, I need to reconsider. Bleh. I hate this whole conversation, to be frank.
So, it's back to my research standbys, which I herewith pass on to you:
Two books that helped me jot down basic information about each vaccine and each disease they're supposed to prevent are
Vaccinations: A Thoughtful Parent's Guide, by Aviva Jill Romm, and What Your Doctor May Not Tell You About Children's Vaccinations, by Dr. Stephanie Cave. The former is a little more anti-, and the latter a little more pro-, but they both give a balanced and informed look at the facts. For some reason, I never read The Vaccine Book: Making the Right Decision for Your Child, by Robert Sears, but I keep seeing it recommended as helpful so I'll include it here with a caveat. Because Bob Sears is a Dr. (of the famous attachment-parenting family), he tends to be more pro- as well, but it sounds like he presents the facts so that you can decide.
If you have questions about specific vaccines and diseases, or need support in your unorthodox vaccine-delaying ways, head over to Mothering.com's vaccine board and the knowledgeable minds who hang out there. There are specific subcategories for each vaccine/illness, as well as a place for selective and delayed vaccinators to talk freely.
Well, I was going to try to find some good ones to list here, but I'm researched out for the day. Post your favorite sites in the comments — for or against vaccination is fine.
If you do choose not to vaccinate, be active in championing your children's health in other ways. First and most importantly, breastfeeding will provide passive immunity. Be aware of the symptoms of the illnesses and their treatments so your child can get any needed medical help. Consider home- or unschooling. Serve your family whole foods, and get some exercise.
If you choose to vaccinate, do all of the above, plus prepare your child for the vaccines. Check your family for any history of adverse reactions, and never vaccinate when your child is even slightly ill, because the immune system needs to be fully functioning to process the vaccines. Read the inserts, set your own immunization agenda (do as few shots at a time as possible, and order the least contaminated versions of each shot), and think twice if your child shows a reaction to a vaccine.
If I were going to give Mikko any vaccines, these are the ones I would consider:
• pertussis — because of what seems like an unusual spread of whooping cough, and because I don't want to be the bad guy who spread it in the first place (that's not a good reason, I'm realizing as I write it — but isn't so much of vaccine propaganda about peer pressure?)
• mumps — because of the one-testicled wonder that is our son
• Hib — because that sucker sounds evil (interesting conversation from someone who thinks the same thing being answered by someone who disagrees)
• rubella — to protect the as-yet unborn
• tetanus — because I want Mikko to run around barefoot outside
• chicken pox — if he hasn't had the disease naturally by adolescence (chicken pox party, anyone?)
But I just don't know. I recoil from the thought of jabbing him with these viruses and toxins. I don't want his life to be in danger, though, from coming into contact with all those germy little babies at his preschool and in the church nursery. I think vaccines are much less effective than we'd like to pretend, and that they can be harmful. On the other hand, they often are innocuous (get the pun?), and the public pressure to vaccinate is great. We're trying to get away from the emotionalism of either side and look at the risks and benefits rationally. Hmm...
Can anyone decide what I think and tell me?
Vaccination photo courtesy of Nick Winchester