By Dr. Carolyn Roy-Bornstein
We’ve never met. You just had a baby named Angelese with my cousin’s son George. I guess that makes us family. You had your baby at home. I am glad things went well for you with no complications. She’s beautiful. I’ve seen pictures of her on my cousin Christina’s Facebook page. Christina says you’re going all organic for the baby. That’s the way to go. She doesn’t need all those antibiotics and hormones in commercial meat and milk.
She also says you’re not planning on vaccinating your baby. Ever. Against anything.
And that’s where we have a problem. Or at least I have a problem. You see, I’m a pediatrician. I vaccinate for a living. I’ve been around a while and have seen children die of diseases that have largely been eradicated due to vaccines. Vaccines I believe in.
The truth is Angelese will probably be just fine. She is afforded a certain amount of protection — called herd immunity — because most parents do vaccinate their children. That may not always be true. In fact if enough parents en masse refuse all vaccinations, herd immunity will evaporate and we will all be at risk, not just Angelese.
And that’s the thing. You have only your daughter to take care of. I have to keep all the other children in mind. If Angelese gets chicken pox, besides a few pox scars, she will likely do just fine. She’s strong with a healthy immune system. She can fight viruses just fine. But some children are not strong or fine and do not have healthy immune systems. My niece Emma just underwent chemotherapy and a stem cell transplant for neuroblastoma. For her, varicella could be deadly. Those are the children I need to think about. For me, this is the ethical reason to vaccinate.
In my community there are some pediatricians who won’t accept you into the practice if you don’t go along with the immunization schedule as recommended by the American Academy of Pediatrics. In my practice, you’re welcome. (In fact, one solo practitioner’s, to me, over-the-top response is to threaten you with a call to DCF. He believes with-holding vaccines from your child amounts to child abuse.) I don’t believe that. I do believe deep in my heart, that all parents loves their children and no matter what decision they make, they are making the decision that they truly believe is in the best interest of their kids. I don’t believe in cutting those parents off from health care just because they disagree with me. But I do believe it’s my job to continue to defend and recommend vaccines.
We have parents in our practice who, for whatever reason, want to space out their children’s vaccinations, give just one at a time, delay some and defer others altogether. I take care of all of them.
When pregnant women come to the office to interview me as a possible pediatrician for their babies, the most frequently asked questions involve the vaccine schedule. I make it clear that they should not interpret my willingness to give them their shots on an alternative schedule to mean that I agree with them that it isn’t safe to give three shots at once. I don’t agree with them. And it is. One of the most compelling pieces of evidence for this was a June 2010 study in the medical journal Pediatrics that found no adverse neuropsychological outcomes in children who received on-time vaccines in their first year of life.
These parents also need to understand that their children are at risk for whatever disease they’ve not vaccinated them against for as long as they’ve put off that vaccine. I also tell them up front that I’ll be hawking them at every visit to pony up and get vaccinated. I even email my patients news stories about disease outbreaks and clinical studies on vaccine safety and efficacy.
It was easier to convince parents about the efficacy of vaccination when their biggest worry was autism. The relationships between the MMR vaccine, thimerisol and autism have been roundly debunked for some time now.
Parents’ concerns nowadays seem more to have to do with the necessity of vaccines at all. The vaccine program is in some ways a victim of its own success. Parents who have never seen encephalitis from measles, amputations after meningococcal infection or a seizure during a case of pertussis may not fully appreciate how aggressive some vaccine-preventable diseases can be.
No decision is easy when it comes to our children. There is always something to worry about. (My 28-year-old son announced recently that he is taking up sky-diving. Believe me. There will always be things to worry about.) You’d feel terrible if something happened to Angelese because you vaccinated her. You’d never forgive yourself if something happened because you didn’t. As parents, we all just do the best we can with the information we have. I hope you’ll consider listening to the information regarding vaccines.