September 2006

The Debate Over How Much to Vaccinate

By Linda Thomas

A Seattle mother wasn’t sure who was more upset during her daughter’s 2-month-old doctor visit. The baby screamed after receiving four immunizations and tears rolled down her red face. Mom cried too.

“It was so hard to watch Sara get jabbed,” says Anne Ingham, “and it’ll be difficult every time she’s vaccinated. But the diseases would be much worse than a few minutes of pain.”

Before Sara turns 16, she will have almost 30 vaccinations and booster shots if Ingham follows the recommended childhood immunization schedule.

Most health experts and physicians believe vaccinations are the best way to protect children from serious diseases. But some doctors and parents believe the immunizations are given too early in a baby’s life, and they question whether some of the vaccines are safe.

Value of Vaccines

“Vaccines are one of the past century’s medical miracles,” says Michele Perrin with the Washington State Department of Health. She manages the state’s health promotion and immunization program called CHILD Profile (Children’s Health Immunizations Linkages and Development).

Smallpox, which affected two million people worldwide as recently as 1967, has been eradicated, she notes. Before vaccines were introduced in the United States, thousands of children became permanently disabled or died each year from these diseases:

· Polio paralyzed 10,000 children.

· Rubella caused birth defects and mental retardation in 20,000 newborns.

· Measles infected four million people, killing as many as 3,000 children.

· Diphtheria was the most common cause of death in school-age children.

“We have a luxury in this country that parents can even think of not vaccinating their children,” says Perrin. “They’re depending on others in the community to vaccinate their children against diseases that are rare, but still exist in the world.”

Last year there were four cases of polio in the United States from foreign travelers, and a couple of cases of diphtheria were also reported. Mumps outbreaks have occurred in the Midwest, and this summer three mumps cases were reported in Vancouver, Wash.

“As world travel increases, we need to keep immunization rates high in our country to protect the health of children and adults also,” Perrin added.

Washington’s vaccination rate is below the national average, according to the latest National Immunization Survey. Nationwide about 81 percent of children are fully immunized, while 78 percent in Washington have had all their shots.

Perrin attributes the lower rate in Washington to parents who forget to follow through with vaccinations that are recommended after 2 years of age.

Some parents choose not to get the shots because they’re concerned about the safety of vaccines. While vaccines are continually monitored, Perrin says “a lot of misinformation can be easily found on the Internet and that scares parents from immunizing their children.”

A Mother’s Worry

Some parents are not so quick to dismiss a possible link between vaccines and neurological impairments.

Auburn resident Tami Giles, for example, knew there was something wrong with her son after his first vaccination.

While it’s not unusual for kids to become attached to a soft, cuddly blanket or favorite stuffed animal, Daniel was obsessed with a jar of peanut butter. On a trip to Disneyland, he carried the jar around the park and put it down for only a few moments to go on rides. He insisted on sleeping with the peanut butter at night.

Daniel, who’s now 8, was diagnosed with autism five years ago. Autism is a brain function disorder that generally appears before the age of 3. Autistic children have problems with social interaction, communication and behavior.

“I am absolutely positive vaccines caused his autism,” says Giles.

Giles’ son had bad reactions to vaccines beginning with the shot for diphtheria when he was 4 months old. After receiving the vaccine, Daniel had respiratory problems and began gagging on food. Later – after receiving the vaccine for measles, mumps and rubella at 15 months of age – Daniel stopped talking and making eye contact.

“All the signs for autism became clear after that,” Giles says. “He had no interest in people and would stare off at an object, hum constantly and slap his hands together.”

Disappointed by the lack of information from her doctors, Giles started a group called ARROW – Autism Recovery Resources of Washington. She has 200 local people on her mailing list with similar stories.

“Every parent has the same kind of horror story as mine. Their child was normal until they had their vaccines,” Giles says.

Doctors Disagree

Is there a link between autism and vaccines?

“The short answer is no,” says Dr. Bryan King, director of child and adolescent psychiatry at Children’s Hospital in Seattle. He also serves as a professor and vice chairman of the University of Washington’s Department of Psychiatry and Behavioral Sciences.

“The timing of the immunizations overlaps perfectly with when you’d expect to see the symptoms of autism,” Dr. King explains. “Even the most ardent proponent of a link between autism and vaccines has to realize we vaccinate millions of children, but autism is still a rare condition, thankfully.” (Estimates of the autism rates in the United States vary widely: Studies summarized by the Centers for Disease Control and Prevention peg rates at 3.4 to 5.7 per 1,000 children. Most researchers agree that rates have been rising rapidly in the last two decades.)

The latest study on the subject, published in the July 2006 medical journal Pediatrics, concluded that childhood immunizations do not cause autism.

Canadian researchers from the Montreal Children’s Hospital evaluated 28,000 children and found no link between thimerosal – a mercury-based preservative that has now been removed from all vaccines except some flu shots - and developmental disorders. The scientists also studied the vaccine for measles, mumps and rubella. Again, they found no association.

“In study after study, the link does not show up,” says Dr. King. “The risks from not being immunized against diseases greatly outweigh the potential risk of having an adverse reaction to the shots.”

Dr. Donald Miller Jr., a cardiac surgeon and professor of surgery at the University of Washington, has been interested the subject of vaccines for many years and has a grandchild who is autistic.

He has concerns about the “sheer number” of vaccines that are given to babies and supports a more conservative approach to immunizations. He states that the high concentrations of vaccines can overwhelm developing immune systems.

“Over the last 50 years there has been an explosion of immunological and neurological diseases in kids,” says Miller. “I think it’s a reasonable to investigate a possible connection between the disorders we’re seeing in children and vaccines kids are given.”

Miller believes families that have some history of autoimmune disorders, Alzheimer’s disease or Attention Deficit Disorder should be more conservative with shots.

They should vaccinate against the most serious of the diseases such as diphtheria, tetanus and polio, he suggests. After the age of 2, when a child’s brain and immune and digestive systems are more developed, then parents could get the other shots for their kids.

New Vaccines

Parents’ and some experts’ concerns over whether children receive too many vaccines rise with the increasing number of required or recommended immunizations.

The Food and Drug Administration recently approved a new vaccine that prevents cervical cancer. About 10,000 women get cervical cancer each year and almost 4,000 die from the disease. A federal panel of scientists recommended that all 11- and 12-year-old girls get a series of three shots to protect against human papillomavirus, which is a sexually transmitted disease that can lead to cervical cancer.

The discussion on whether to add the HPV vaccine to immunization recommendations will likely come up during the Washington legislature’s 2007 session. But a member of the State Board of Health said it will be two or three years before the vaccine is even considered for a school entry requirement.

Washington became the last state in the nation to require that school-age children be immunized for chicken pox. Starting this fall, parents of incoming kindergarteners and sixth graders will have to sign a card stating their children either had chicken pox or the varicella vaccine.

Parents who object to any of the vaccines can still get their children into a public or private school. “Provisions in the immunization law allow for medical or personal exemptions,” says Jill Lewis, the Seattle School District’s program manager for student health services. “The disadvantage to the students who haven’t had shots is that they’d have to stay out of school if there was an outbreak of a vaccine-preventable illness.”

Just What the Doctor Ordered

As an elementary school teacher, Eric Jones had a lot of experience with the germs and illnesses that quickly spread through a classroom. Now a naturopathic physician and clinical full professor at the Bastyr Center for Natural Health in Seattle, Jones advises parents to look at vaccines as one part of their child’s overall health.

“The ultimate goal for any parent is to raise a healthy child, and I’d encourage people to maximize all of the resources available for helping kids grow up,” says Jones. “Good nutrition and exercise are as important as vaccines for a child’s development and health.”

Linda Thomas is a Seattle freelance journalist and mother of two children. She writes a parenting blog for the Seattle Post-Intelligencer at EducatingMom.com.

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