Every parent today has questions about vaccines. Are they safe? Is there still mercury in some? What are the potential side effects? Can I delay some shots? Are all the diseases still common? Do vaccines cause autism? You want to know the answers before your baby’s first checkup and shots, but you have nowhere to turn for unbiased advice. Your doctor tells you that all vaccines are perfectly safe, that the diseases could kill your child, and that you have to vaccinate or else you are putting your child, and everyone else in the country, at risk. On the other hand, the anti-vaccine books, websites, and some of your friends tell you that vaccines are dangerous, the diseases are harmless, and that you are crazy to vaccinate. All these uncertainties boil down to the one all-consuming question of the decade that every parent agonizes over – Should I vaccinate my child?
I’m going to share with you some of the questions I asked myself as an author, doctor and parent, the answers that I found, and what I’ve learned from parents, medical research, and colleagues over the years. I hope at the end of these few pages you’ll feel more equipped to make an educated decision for your child.
What diseases are the most common and serious for infants?
Some diseases are very common, and some are rare. Some are very serious, even life-threatening, and others are fairly mild. Obviously, a disease that is both common and potentially severe would be very important to vaccinate against. A disease that is mild and rare would be less so. In addition, some diseases are only serious during infancy, but not later on. Knowing at what age each disease poses the greatest risk is important as you decide when to do each vaccine. The diseases that are mainly serious during infancy, but not beyond age 2 or 3, are HIB, pneumococcal disease, pertussis, rotavirus, and the flu. All these diseases, except for HIB, are still very common, so vaccinating against these during infancy is fairly important.
What diseases are more serious and common for teens and adults?
The diseases that are fairly mild if contracted during young childhood, but become more serious for teens and adults, include chickenpox, measles, mumps, rubella, and hepatitis A. Diseases that virtually never occur in kids, but do occur in teens and adults and are potentially serious, include hepatitis B, HPV, and tetanus.
What about diseases that are fairly mild or extremely rare? Are those worth vaccinating against?
The main reason we keep vaccinating against mild or rare diseases is to keep them that way. If we stop vaccinating against polio, for example, before it is eradicated from the world, the disease could begin spreading around the world again. Plus, even diseases that are usually mild will cause an occasional complication or fatality. If some of these rare or mild diseases run rampant though our country, more complications would occur.
How common are vaccine side effects? Are they worse than the diseases themselves?
We know that all vaccines can cause some standard side effects, such as fever, fussiness, pain and swelling, and various body aches. Such reactions are expected, and I consider them to be harmless in the long run, as long as they aren’t too severe. But it’s the more serious, life-threatening reactions that have most parents worried. How common are such events?
According to my research, the likelihood of a severe vaccine reaction that results in a sudden, life-threatening event, a prolonged hospitalization, a permanent disability, or death, is about 1 in 100,000 doses. Kids get about 39 vaccine doses over their childhood, so the risk of a severe reaction over the entire vaccine series is about 1 in 2600.
What about the risk of catching a severe or life-threatening case of a vaccine-preventable disease if you are unvaccinated? This risk varies greatly among the various diseases. For some it is as rare as 1 in a million. For others it is a very high 1 in 100 risk. Grouping all vaccine-preventable diseases together, the risk of a severe case during the first 12 years of life is about 1 in 600.
It seems that statistically the diseases pose more risk than the vaccines. But if long-term problems, such as ADD, autism, and other chronic diseases, are ever proven to be associated with vaccines, then it’s a whole different story. In The Vaccine Book I help parents understand the risks of each disease compared to the risk of its vaccine so you can make an educated decision about each shot.
What are some of the legitimate worries of our current vaccine schedule?
My first worry about vaccines is that babies can get as many as 6 simultaneous injections at each checkup at 2, 4, and 6 months of age. Although there’s no definite proof that this is harmful, I acknowledge that theoretically the simultaneous exposure of the various chemical ingredients and germ components may not be ideal for such small babies.
One particular vaccine chemical that I am most concerned about is aluminum. While this metal is harmless if ingested into the gastrointestinal system, when injected directly into the body it is toxic and damaging to the brain and bones. The FDA carefully regulates the amount of aluminum that is allowed to be injected each day into hospitalized patients through IV solutions and medications to avoid toxicity. But vaccines are exempt from this limit. Aluminum is present in 6 of the childhood vaccines, 4 of which are given simultaneously at 2, 4 and 6 months. Depending on which brand of vaccines are used, a baby could get as much as 60 times the FDA’s known safety limit of aluminum at each of these visits. Why is this allowed to happen? Well, it’s the same thing that occurred with mercury. As more and more vaccines were added to the schedule, no one realized what was happening. I hope to change that.
Another worry that I have about so many simultaneous shots is that this may trigger more adverse reactions than would happen with only 1 or 2 shots. Many babies react to each round of 6 shots with days of fussing and fever, signs that the vaccines are irritating the immune and nervous systems. When a baby does suffer a severe adverse reaction, it would be prudent not to repeat that vaccine again. But if 6 shots were given together, there’s no way to know which one was the culprit. And most doctors would likely just continue all the shots and hope for the best, instead of stopping all 6 suspected vaccines. With my schedule on only 2 shots at a time, it’s easier to sort out which vaccines are causing severe reactions. Fortunately, such reactions are rare.
My Alternative Vaccine Schedule circumvents these potential problems and allows babies to become fully vaccinated in a more gradual manner that may decrease risk.
Are there some differences between the various brands of vaccines that parents should be aware of, so they can request safer brands from their doctor?
It’s important that parents understand how each vaccine is made, what the ingredients are, how the various brands of each vaccine compare, and what ingredients may be risky. Some brands of vaccines have mercury, while others don’t. The aluminum content of certain vaccines various between brands. There are many other variations in ingredients that parents should be aware of so they can choose the safest brands. In The Vaccine Book I discuss each vaccine in such detail that you can fully understand exactly what is in each shot you are choosing for your child.
What about delaying vaccines. Is that an option?
Anything is an option when it comes to vaccines. But parents need to make sure what they choose to do makes sense. A common recommendation among vaccine critics is to delay vaccines until a child is two years old. Theoretically this allows time for a child’s immune and nervous systems to mature and handle the vaccines better. I haven’t found enough research to prove or disprove this claim, so I can’t say whether or not delaying vaccines is the right choice. But I would like to point out that some of the diseases we vaccinate against are only serious or mainly occur during the first year or two. So, if you wait until age 2 to vaccinate, there are some vaccines your child wouldn’t need anymore. The way I see it is that infancy is when the diseases are the most risky and severe. So, parents should either vaccinate their babies during that time when the shots are most needed, or skip some of those vaccines altogether and move on to choosing only the vaccines that are needed to protect against any common or serious diseases that may occur during the rest of childhood.
Talking to your doctor about vaccines
Some doctors, unfortunately, are so pro-vaccine that they will kick you out of their office for even asking questions. However, new guidelines from the American Academy of Pediatrics were published in the 2006 Redbook of Infectious Diseases which discourages this practice. The AAP suggests doctors take a non-judgmental, approach, inform parents of the risks and benefits of each vaccine and disease, and develop a schedule that spreads out the vaccines if parents are uncomfortable with so many at once. If the parents still decline vaccines, this decision should be respected (unless there is a current epidemic that puts the child’s life at significant risk) and doctors should avoid dismissing parents from their practice solely on this basis. Since these guidelines are new, most doctors may not know about them yet.
More importantly, don’t ask your doctor about vaccines at your baby’s checkup. There simply isn’t enough time. If you have several complicated questions, or you want an in-depth discussion, schedule a separate vaccine consultation appointment. This gives the doctor and you the time you need to have a complete discussion.
Do breastfeeding and choosing a stay-at-home lifestyle for your baby decrease the risk of diseases?
Parents should assess their own baby’s risk of diseases as they consider vaccines. A formula-fed baby is much more likely to become ill when he inhales or ingests an infectious germ. A baby who is in a group daycare or frequents nurseries (such as church, synagogue, or health clubs) is more likely to be exposed to infectious diseases far more than a stay-with-mom baby.
When parents of a stay-at-home breastfed baby tell me they want to delay or decline vaccines, I worry a bit, but not too much, since I know this baby’s risk is low. I also tell them they better plan to breastfeed for at least a year, and two is better. On the other hand, if a mom tells me she just weaned her two-month-old, is planning to put him into daycare next week, and she’s thinking about skipping the vaccines, I cringe. This baby is virtually guaranteed to come across at least one serious vaccine-preventable disease.
Should you vaccinate your baby?
This is not a question I can answer for you in just one magazine article. I’ve tried to wet your appetite and give you some interesting ideas to ponder as you consider vaccines. I do feel vaccines are important, and as a pediatrician I vaccinate most of my patients. But I do so using a safer schedule than the standard one most doctors follow (see The Vaccine Book for my Alternative Vaccine Schedule). I also have patients that delay or decline shots. I have written The Vaccine Book to give you everything you need to know to make an educated decision for your children. I have also created TheVaccineBook.com as an interactive, blog-based website where you can ask questions, discuss issues with other parents, and find a doctor near you who feels comfortable with parents who want to vaccinate differently.
Dr. Bob Sears is a father of three, pediatrician, and author of The Vaccine Book: Making the Right Decision for your Children. He received his medical degree from Georgetown University and trained in pediatrics at Childrens Hospital Los Angeles. He practices in Dana Point, CA. For more information, visit www.TheVaccineBook.com