Parents make decisions for their children every day, ranging in importance from what to bring for snack time (applesauce vs. banana) to what preschool they should attend (Montessori vs. Waldorf). But lately, no topic has been the focus of as much heated discussion—among parents, physicians and the media—as the debate over whether to immunize children, on what schedule and with what vaccines.
Although the federal government recommends one standard immunization schedule for all children, concerns over the safety of vaccines have more and more families questioning the national standard and instead opting either to vaccinate on their own schedules or avoid any inoculation at all. Physicians and parents alike are divided on this issue. Supporters of the government-approved Centers for Disease Control and Prevention (CDC) approach to vaccines call anything that diverges from that protocol irresponsible. But skeptics say there simply isn’t enough research to prove that vaccines are safe. Ultimately the decision falls on the parents, who may choose the standard path of immunization, follow a delayed vaccination schedule or opt out entirely.
Dr. Gary Freed, chair of the National Vaccine Advisory Committee, wholeheartedly supports the CDC’s recommended inoculation schedule. “Vaccines have prevented hundreds of thousands of cases of life-threatening diseases that parents simply do not have to worry about anymore,” Dr. Freed says. The irrefutable evidence that vaccination works is indeed hard to deny. Since the introduction of the pneumococcal vaccine in 2000, the U.S. meningitis rate has plummeted 78 percent in those under age five, saving an estimated 9,800 lives. Polio, a disease that struck fear in the hearts of our grandparents, now only appears in third-world countries.
Because the diseases that vaccines protect against are most dangerous in infancy and early childhood, Dr. Freed also disagrees with delaying a child’s shots. In regard to the argument that infants’ immune systems are too fragile to handle vaccination, he cites a lack of evidence that their bodies are overwhelmed. “It is worse for their immune systems if they contract polio or meningitis,” he says.
On the other hand, some parents fear that by agreeing to a vaccination, they are subsequently injuring their children. Dr. Jay Gordon, a pediatrician and a producer of the DVD Vaccinations: Assessing the Risks and Benefits, advises parents to wait until children are at least one or two years old before allowing them to be inoculated. According to him, only one shot—DTaP for diphtheria, tetanus and pertussis—is truly necessary at all, because pertussis, or whooping cough, can be devastating in infants and children.
The serious nature of many vaccines’ potential side effects is reason enough to delay or even avoid vaccination, Dr. Gordon says. The heavily researched link between autism and the MMR (measles, mumps and rubella) shot has received a lot of attention lately. Theories started flying in 1998, when a British researcher linked 12 cases of autism in children to intestinal inflammation that might have been triggered by the measles component of the MMR vaccine. Since then, some researchers and many vocal parents have theorized that something in the measles vaccine, likely when combined with some as-yet-unknown environmental or genetic factor, triggers intestinal inflammation which leads to the brain inflammation that may be the culprit in autism. The CDC, which has extensively studied this debate, states that no relationship has ever been found between the two. The American Academy of Pediatrics and the Institute of Medicine have also refuted any direct link.
In fact, the CDC believes that unnecessary concern about a link between MMR and autism is putting the population at risk. Earlier this year 64 people were sickened with measles, and 14 of them were hospitalized. Nearly all of them were unvaccinated, including 13 infants under age one who were too young to receive the vaccine. This outbreak highlights the concern presented by falling MMR vaccination rates: An unvaccinated public puts those most vulnerable to the disease’s ill effects at risk, namely infants and those with compromised immune systems.
Still, uncertainty about vaccination abounds in both parents and physicians. Until a definitive cause for autism is discovered, medical professionals like Dr. Gordon have decided to proceed with caution. “If there is a family history of autism, I don’t want to vaccinate,” he says. “The same goes for a history of diabetes or arthritis. When there is a genetic predisposition to autoimmune disease, leave the immune system alone at least for a while, and maybe leave it alone forever, to let it develop naturally.”
In addition to the autism/MMR debate, questions have recently arisen regarding the possible effects of additives such as aluminum and formaldehyde in vaccines. Many shots contain aluminum, including the vaccines against haemophilus influenzae type B (Hib) diphtheria, tetanus and pertussis (DTaP) and hepatitis A. Some argue these levels of aluminum could be toxic. Formaldehyde, which is a carcinogen in its inhaled form, is used as a preservative in the polio and hepatitis B shots, albeit in trace amounts.
In the vaccination debate, one thing on which parents and physicians do agree is the need for more research. Not only is the possible link between the MMR vaccine and autism still up in the air, but risks presented by vaccine additives have not undergone sufficient scrutiny. Longitudinal studies involving thousands of children, with control groups of unvaccinated children, have not taken place. Because of all this, researchers still know relatively little about vaccinations’ possible negative effects.
Here, we profile three families who have taken different courses of action: the government-recommended vaccination schedule, a modified vaccination schedule and no vaccinations at all.
Vaccinating as Recommended
Jessica Williams grew up the ultimate granola girl. Her food was organic, her remedies herbal, and nothing short of a broken bone would warrant a doctor’s visit. As a child, she received no vaccines until entering elementary school.
Williams still subscribes to many of the values her mother instilled in her. But when the time came to decide whether or not to vaccinate her own children, Williams and her husband opted to follow the federal guidelines to the letter. “We did a hailstorm of research and put our pediatrician under the microscope,” Williams says. “We felt that the likelihood of something going wrong was slim and that it was an infinitesimally small risk to take for the protection we hope vaccination gives.”
Both five-year-old Joaquin and one-year-old Amaya have received all their scheduled vaccines but one. They skipped the hepatitis B shot, which they will receive closer to the teen years when they are more at risk. Williams and her husband believe this approach not only benefits their kids, but the public at large. “If all children are vaccinated, then it will help prevent the resurgence of things like polio,” she says.
To minimize the risk of vaccinations, Williams ensures her children only receive the bare minimum of shots at once. In addition, all the vaccines they do receive, including influenza, are thimerosol-free and therefore lack potentially toxic mercury preservatives.
Williams says both her children are healthy and she feels confident the decision she made was the best one for their overall well-being. “If there is anything I can do to try to protect my kids, I want to do it.”
Following a Delayed Schedule
When Megan Tietz first became a mother, she took a “doctor knows best” approach to her daughter Dacey’s vaccination. So up until her first birthday, Dacey received all vaccines as recommended by the CDC.
But when her pediatrician started talking about the MMR shot, Tietz got skittish. Her youngest sister has Asperger’s syndrome, a disorder on the autism spectrum, and in the 1980s her family was part of a successful class-action lawsuit blaming a bad batch of MMR for her sister’s disabilities. Tietz worried that the MMR vaccine could also negatively affect her daughter.
After researching and discussing the issue with her husband and her father, who has a master’s in public health and (despite his daughter’s Asperger’s) is a vaccine advocate, Tietz adopted a delayed vaccination schedule based on Stephanie Cave’s book, What Your Doctor May Not Tell You About Children’s Vaccinations. “I am highly suspicious and concerned about the schedules they put together,” says Tietz. “Your pediatrician won’t tell you there is another way to do vaccines—I had to decide for myself what was best.”
Dacey received the MMR shot at 15 months instead of 12. Tietz’s second child, Aliza Joy, never received the hepatitis B vaccine, and rather than having her first round of shots at two months, she was four months old for her first inoculations—Hib and polio. Because DTaP is a three-in-one vaccination for diphtheria, tetanus and pertussis, that shot is never given at the same time as any others to avoid taxing the child’s immune system. For the MMR shot, Tietz has found a manufacturer that offers it as three separate shots, and she plans to hold off on the measles portion until Aliza Joy turns three.
“I do believe that vaccines are an important issue in terms of public health,” Tietz says. “I just do not think we have to put all of this in these tiny babies at the same time.”
Dr. Nancy Massotto is a confessed research junkie. She has two master’s degrees and a Ph.D., plus she is the executive director of the Holistic Moms Network, a group for families devoted to healthy lifestyles. When she became pregnant with her first son seven years ago, she read every book she could find in order to make sure he arrived as healthy as possible.
As part of that research, Dr. Massotto studied up on childhood vaccination. Even before Michael was born, she and her husband decided to follow a delayed vaccination schedule. While many different delayed-vaccination options exist, for the Massottos this meant following their own schedule in order to avoid overloading Michael’s brand-new immune system with the large number of vaccines recommended for infants by the CDC.
So Michael passed his first birthday without receiving a single shot. Then, at 18 months, he showed signs of severe environmental and food allergies. Considering that the flu vaccine contains chicken eggs and that gelatin is found in certain brands of MMR, chicken pox and DTaP vaccines, the Massottos believe that by opting out of vaccines they saved their son from exposure to potentially dangerous allergens.
Since so much is still unknown about inoculation, the Massottos have decided against vaccinating both Michael and their two-year-old son, Dominic. Because they live in New Jersey, they were able to obtain a religious exemption for school-required immunization. Religious exemptions are provided in all states except Mississippi and Virginia. Every state allows for a medical exemption. Philosophical exemptions, the most lenient type, are available in 18 states: Arizona, Arkansas, California, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, New Mexico, North Dakota, Ohio, Oklahoma, Texas, Utah, Vermont, Washington and Wisconsin. To find the law in your state, visit the National Vaccine Information Center at www.nvic.org.
Massotto is glad such exemptions exist because it empowers parents to make the choice they think is best for their children. If vaccine manufacturers could guarantee their inoculations had no side effects, families could stop belaboring the issue, Dr. Massotto says. But until they know more, she believes parents should stay vigilant.
“You should not have to vaccinate out of fear, and you should not have to refuse out of fear,” Dr. Massotto says. “You should become educated, weigh the pros and cons for your family and make the decision that works for you.”
What Should You Do?
As it stands, parents must weigh the evidence themselves and make their own decisions. Do your research. Ask questions. And, as so many parents say, follow your instincts.