If Dr. Greg Poland has his way, his new study in the journal Human Immunology will serve as talking points for doctors besieged by “vaccine-concerned” parents whose viewpoint is so different from mainstream medicine that “they might as well be from a different galaxy.”
It’s National Infant Immunization Week, promoted by the U.S. Centers for Disease Control and Prevention (CDC) to encourage parents to protect their young children against 14 vaccine-preventable diseases. The CDC is honoring what it’s calling “childhood immunization champions,” doctors and advocates in nearly every state who are passionate about raising immunization rates in their communities. In Alaska — where nearly 9% of kindergartners aren’t vaccinated — Dr. Bruce Chandler distributes a weekly newsletter with updated vaccine information, punctuated with his slogan: Keep Vaccinating. In Arizona, Leslie Maier crusades for increased awareness of the meningococcal vaccine after her 17-year-old son, Chris, died less than 24 hours after showing symptoms of bacterial meningitis.
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And on Thursday, the United Nations Foundation’s Shot@Life campaign kicks off, drawing attention to the critical importance vaccines play in impoverished countries where access to medical care is iffy. BabyCenter’s Amy Graff, currently in Ghana with Bono’s ONE campaign to observe first-hand the importance of global immunization, wrote:
In these far-flung corners of the world, vaccines aren’t annoying — they are gifts from the heavens, shots of life-saving gold, hope for the next generation. But many countries don’t have sophisticated healthcare systems or funding to distribute them, and mothers are more familiar with the diseases than the vaccines. Globally, one in five children lack access to immunizations that help keep children in the U.S. healthy. Every 20 seconds a child in the developing world dies from a vaccine-preventable disease.
Statistics like those are exactly why Poland, a vaccinologist at the Mayo Clinic, can’t understand how U.S. parents can decide to not immunize their children. Some pediatricians have gone so far as to consider “firing” patients whose parents don’t vaccinate them: although children are required to be fully immunized before starting school, many states have “philosophical exemptions” for parents who are concerned about the safety of vaccines. Vermont, which has a 6% exemption rate, along with Washington — just under Colorado’s rate of 7% — is considering abolishing that provision. “It’s a balance between individual rights and our obligations to each other in society,” Vermont House Speaker Shap Smith told the Associated Press.
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Parents who choose not to vaccinate believe they are putting their children’s health first; experts strongly disagree. The numbers tend to back the latter: California, Oregon, Vermont and Washington have reported rising rates of whooping cough, which public health officials attribute in part to children not being vaccinated and adults shunning boosters. And measles cases tripled between 2001 and 2010 to 233 episodes in 31 states, largely due to children with vaccine exemptions, says the CDC.
“There are acts of omission and acts of commission,” says Poland. “I have had a mother come in and say, If I give this vaccine to my child and something happens, I could never live with myself. Right behind comes a mother who says if I don’t give this vaccine to my child and something happens, I could never live with myself. I wish both parents could hear each other.”
Here’s what Poland often tells worried parents: “Look, there are 2,000 physicians at the Mayo Clinic, and as best we can tell, all their kids have received vaccinations. Do you really think doctors would give their kids these vaccines if for a millisecond they believed there was more harm than benefit?”
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In response to parents such as Jennifer Stella, who voiced her suspicions about vaccines to the AP after her son suffered a seizure following immunizations and her daughter endured an eczema outbreak, Poland points out that chance alone dictates that some people will be coincidentally diagnosed with disease or suffer a loss soon after being immunized. “Say a woman has a miscarriage after being vaccinated,” says Poland. “There are 17,000 miscarriages a year. The vaccine did not cause the miscarriage. It would have happened anyway.”
But many parents remain dubious, particularly in communities where vaccine skepticism abounds. On Thursday in Seattle, where I live, two naturopaths are hosting a workshop for parents at the Center for Birth entitled “Childhood Vaccinations: Your Questions Answered” at which they’ll discuss the pros and cons of vaccination, the controversy surrounding vaccination and alternative vaccine schedules. Participants will receive, according to an email, “valuable information and resources that will help them to make informed decisions regarding their own child’s vaccinations.”
In Poland’s view, the only informed decision is one that adheres to the standard vaccination schedule endorsed by the American Academy of Pediatrics. His study, intended to help doctors persuade on-the-fence parents about the importance of immunization, is an acknowledgement that physicians need to step up their p.r. game.
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His research lists the top three “immunity-related misconceptions:”
- Babies’ systems aren’t ready for the number of vaccines given today.
- Vaccines can cause autoimmune diseases.
- Natural immunity is safer and better.
His suggested retorts:
- Babies’ immune systems are meant to be “immunologically educated.” Why worry about antigens being introduced when babies encounter no shortage of this foreign immunologic material while crawling around on the floor? In any case, the number of proteins kids are exposed to in vaccines has decreased from 3,000 a generation ago to 300 today. Contract one viral infection, and you’re potentially exposed to thousands of proteins, which are the building blocks of viral or bacterial organisms.
- With very rare exceptions associated with vaccines for rabies and smallpox, immunizations can’t trigger autoimmune diseases — or autism — because the bioimmunologic criteria for inducing disease against yourself aren’t present.
- Natural immunity is not better. Take chickenpox, for example. Each year, 100 U.S. kids die from complications. Plus, once you’re exposed, the virus lies dormant for decades, then reemerges as shingles in 50% of people who live to age 80.
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“Some people are militant about this,” he says, recalling the group that showed up at his home years ago to accuse “doctors like me of giving vaccines to cause autoimmune diseases in patients decades later so we would have a practice.”
“Choosing not to receive a vaccine does not absolve one of risks,” says Poland. “It’s different risks and greater risks. The most contagious disease we have is fear.”