A word or two about vaccinations
A few weeks ago I taped some footage for a Momversation about vaccinations, and yesterday it went live:
Here I willingly admit to not understanding parents who choose not to vaccinate their children, an opinion that is now as controversial as refusing vaccinations used to be, and I will admit that this is a bit of a misleading and unfair statement, something I will further explain in a minute.
Thing is, I didn't always feel this way. In fact, my opinion about the choice to vaccinate your child used to look much like my opinion about most other parenting decisions (breastfeeding, co-sleeping, homeschooling, etc) in that I think you have to figure out what works best for you and your children and ignore all the people who are screaming at you that you're doing it wrong.
But let me back up a second... when Leta was born five years ago I had very few friends who were mothers and wasn't participating in any sort of parenting communities online. All of the mothers I did know had vaccinated their children with no lasting side-effects, and my pediatrician, a man who had vaccinated all eight of his children, talked me through what it all meant and assured me it was in Leta's best interest to have her vaccinated. I had heard stories about certain parents refusing vaccinations, but at the time their concerns were not about autism or side-effects but about fears of a government conspiracy, something I did not take seriously.
Things have dramatically changed in the last five years, and there is now so much more information available to parents about vaccinations, information and warnings and horror stories. And in these years I have listened to many women talk convincingly about how their children developed symptoms of autism in close proximity to the time they were administered certain vaccinations. And then there were the women whose children suffered terrible fevers and rashes and sometimes seizures. This naturally raised some questions for me, and for a time I could totally see why someone would choose not to vaccinate her chid.
I can still identify with these concerns.
However, the issue totally changed for me when news broke last year of a measles outbreak in Southern California that occurred because a seven-year-old boy who had not been vaccinated brought the disease back to the states from Switzerland:
The boy's measles immunoglobulin M (IgM) positive laboratory test result was reported to the county health department on February 1, 2008. During January 31--February 19, a total of 11 additional measles cases in unvaccinated infants and children aged 10 months--9 years were identified. These 11 cases included both of the index patient's siblings, five children in his school, and four additional children who had been in the pediatrician's office on January 25 at the same time as the index patient. Among these latter four patients, three were infants aged <12 months. One of the three infants was hospitalized for 2 days for dehydration; another infant traveled by airplane to Hawaii on February 9 while infectious...
... Overall, approximately 70 children exposed to children with measles in the school, a day care center, the pediatrician's office, and other community settings were placed under voluntary home quarantine because their parents either declined measles vaccination or they were too young to be vaccinated.
And I put myself in the position of the mother of that ten-month-old baby who caught the disease because they happened to be at the doctor's office at the same time as the infected boy. A ten-month-old baby whose immune system is such that there is a possibility of death. And I realized, I do not think that I would ever be able to forgive the parents of that infected boy. That is my raw, honest emotion toward that scenario.
That our children do not have to fear death from diseases like measles or polio or whooping cough is a miracle made possible by modern technology and science. And I guess the crux of this really complex problem for me is that as the number of parents who choose not to vaccinate their children increases so does the likelihood that these diseases will become a problem again. If you've decided that the risks are too great to vaccinate your child then you are counting on the rest of us who are willing to take those risks to decrease the chances that your child will be exposed to these diseases. You are counting on us. Maybe what I don't understand (in reference to my statement in the video) is the act of and willingness to give up that control. The choice to refuse vaccinations just seems to me to be a first world luxury.
In some of the footage that got cut from the final video I talk about how the standard vaccination schedule can seem very aggressive, and I totally understand and support families who want to work with their doctors to modify that schedule (you can read one mother's level-headed and articulate experience with that here). And I know of and support mothers who have had to change pediatricians who were unwilling to take their concerns about the schedule seriously. I understand that some children are allergic to certain ingredients in some vaccinations and this prevents them from receiving them. Which is why I think it's crucial to maintain what I've heard referred to as herd immunity so that those who really have no choice, who cannot receive vaccinations, are protected by those of us who can.
Perhaps by phrasing my opinion as, "I don't understand parents who don't vaccinate their children," I am misrepresenting my stance, and I will blame that on the fact that I had to film footage in the five minutes I could wedge into a packed SXSW schedule on a Monday afternoon a few weeks ago. Because what I'm really feeling is an unease, one that is directly proportional to the unease that causes certain parents to refuse vaccinations, an unease at what might logically happen if more and more parents refuse vaccinations, even if that refusal is well researched.
I know many of you disagree with me and that I risk some of you feeling alienated by even bringing up this topic. And I'd love to hear from you because I don't think that any of the unease on either side can be addressed or alleviated until we start communicating with each other in a tone that suggests we really want the same thing: health and safety for all of our children.
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Fe said:
I have not immunised my children.... and have strong opinions about live virus vaccinations which precluded me from doing so. They are now 10 and 12 and have had measles, chicken pox and even whooping cough after being exposed to immunised children who became ill. I took the responsibility of my choices seriously and quarantined them for their entire illnesses.
I do, however, not judge anyone who chooses to immunise their own. I agree that it is a first world luxury to choose. And I'm grateful for that luxury.
What I wanted to say to you, however, was that I appreciate how wonderfully worded your post was. I read no judgement and if more people were willing to have open discussions about controversial topics WITHOUT flaming, the world would be a better place!
04.07.09 - 04:25 PM / 1Jen said:
I think you did well at elaborating. And you're right about the information that is out there and how it can be hard to distinguish. I think sometimes there are trends that happen and unfortunately those trends can be dangerous.
04.07.09 - 04:26 PM / 2Michelle said:
On this I agree with you completly! One of my daughters came down with Rubella at 8 weeks old from another child who's mother decided not to vaccinate.
This disease has an incubation rate before it manifests and I unwittingly exposed my pregnant sister in law to the infection which could have seriously harmed her unborn baby. As well, my daughter was so very sick for over a week.
I could not and never will forgive this mother for the risk she willingly exposed my family to for what I considered supersitious ignorance.
04.07.09 - 04:29 PM / 3Anonymous said:
I don't have children, but I do have dogs and work at an animal hospital. I know it'll piss some people off to compare their children to dogs, but Dooce's arguments are applicable to animal vaccines, too. Diseases like rabies, distemper and parvo could be entirely eliminated if everyone vaccinated their animals. And while some pets do have reactions, even fatal ones, to these vaccines, it is such a small percentage that if everyone ELSE had the vaccines done, it would prevent the spread of disease among other animals. The point is, you're vaccinating your pet or your child not only to protect him or her, but to protect others that he or she will come in contact with, as well.
04.07.09 - 04:30 PM / 4Katherine said:
I live in an area that has recently had mass outbreaks of whooping cough. As a child when I got the vaccination I got really sick when I got the DPT shot. Since then, I haven’t been vaccinated with the “P” or pertussis part of the vaccine for fear that I will again have the same reaction. Every time I hear about another outbreak here in Minnesota, I fear that I will get sick. I wonder if the parents of children who haven’t had their children vaccinated fear the same thing?
BTW, I completely agree with your thoughts on this one...
Kate
04.07.09 - 04:30 PM / 5J. Bo said:
Thank you, Heather, for so clearly, intelligently, and sensibly explaining the logic and ethics of what has become a gigantically emotional subject in recent years.
04.07.09 - 04:30 PM / 6Glyn said:
Heather, I am firmly with you on this. I think it is really important to be vaccinated and to prevent the old childhood diseases emerging again.
I think I come from an interesting background, in that I was not vaccinated as a child (my mother was one of the "conspiracy" types I suppose) and I got ill with pretty much all of the childhood ilnesses - measles, mumps, rubella, chickenpox, whooping cough. Luckily I got over them with no long-term ill effects that I know of, but I would not want to go through them again.
My brother wasn't born when I had mumps, and has therefore never had them, leading to worries that if he gets them now he might become infertile.
My mother has changed her mind nowadays and says she would vaccinate if she had to go through it again. When I have children they will be getting the standard schedule. When I travelled overseas I made sure I had all the vaccinations needed before I travelled.
A good reference for information is neurodiversity.com, also some of the bloggers at sciencebasemedicine.org.
Best wishes for the rest of the book tour and the birth of your second daughter!
Glyn
04.07.09 - 04:30 PM / 7Andi said:
I was also one of those people who believed that the choice to not vaccinate your children was really none of my business, much in the same way that I would never judge a mother for choosing to bottle feed vs. breastfeed. But as a pediatric oncology nurse, I have seen children go through a bone marrow transplant (which replaces your immune system, requiring vaccinations to be repeated) and before they are healthy enough to undergo their vaccinations again, they contract something that should have been eradicated decades ago, like measles or chickenpox. In many cases, those "simple childhood illnesses" have caused death to these children. I believe that it is ethically irresponsible to put other children at risk because you are afraid of autism or other "potential" side effects.
Very well written post. I admire that you were willing to open this can of worms! ;-)
04.07.09 - 04:31 PM / 8Allison said:
Thank you. I think this was well put. And I agree.
04.07.09 - 04:32 PM / 9Amanda said:
I am unsure why really no one has (as of yet) posted any comments... I imagine hundreds of people would have leapt at the opportunity to talk about this. As of yet, my opinion may not be considered valid by some because I don't have any children. However, I plan on having a child in the next year or two, and because I am almost a graduated nurse, I read a lot of research. I have been particularly interested in the vaccination "dilemma" and keep up with current peer-reviewed research. As of now, all of the current, valid, peer-reviewed research (including meta analyses) has shown that vaccines are SAFE - even the old MMR vaccines with thimerisol showed no statistically significant results indicating causality or even correlation with autism or autism spectrum disorders. That's my two cents... so in essence, I complete agree with you. It is absolutely unfair to the innocent kids who are too young or too ill to receive vaccines to get hit with a deadly disease because of someone else's misinformed decision.
04.07.09 - 04:32 PM / 10Mari said:
I vaccinated all 3 of my kids with no problems but that was years ago. Today I would ask for a less aggressive schedule of treatment because I suspect that may be a large part of the side effect issue. But I would always vaccinate. It is a calculated risk. But so is driving, flying in a plane or eating sushi. Sometimes we do those things that serve the whole even if our personal druthers would have us living happily free of any risk in a yurt in the middle of Montana.
04.07.09 - 04:32 PM / 11Jacquie said:
I have immunized both of my children on a careful schedule. I am leery of new vaccines and sometimes opt out until I have all of the information I need to make an informed decision. I wish that unbiased information would be offered by our healthcare providers without pressure to comply. Too often I think parents feel bullied and rushed into doing what they are told and are made to feel stupid if they ask too many questions or express doubt. In many people this brings up an automatic defense mechanism that might lead to an emotional decision one way or the other.
04.07.09 - 04:32 PM / 12Mary@Holy Mackerel said:
Well thought out and written. Thank you for clarifying what the real issue is. I too have vaccinated both my children, and agree with you wholeheartedly.
04.07.09 - 04:32 PM / 13Brittany said:
Agree, agree, agree. I don't understand why people don't vaccinate at all. And the schedule IS aggressive. I also spaced the out CDC's schedule so my daughter received only one at a time (which can still really be three at a time, ie MMR, DTaP, ect).
I think it is difficult to make education decisions with the slew of information regarding vaccinations and especially when that information can come off so hot-headed. Your post was lovely!
04.07.09 - 04:33 PM / 14Lex said:
I'm right there with you, Heather, without the empathy or understanding you display. I have never understood mothers who don't vaccinate their kids.
After dozens of elegant scientific studies with large sample sizes, there has been NO LINK shown between vaccines and autism.
Over and over again, the scientific community tell us vaccines don't cause autism! And if we don't trust science - and let's face it, even mothers who don't vaccinate fly in planes, drive cars, use the internet and go to the ER when their kids are sick - ALL provided to us through scientific research - we've only got people's gut feelings and empirical evidence to hold onto.
The signs of autism often first become obvious around 12 and 18 months, when vaccines are administered. These are sad and terrible coicidences, unfortunately.
04.07.09 - 04:33 PM / 15mmc said:
I completely agree with your stance, Heather. I don't understand why some parents would be willing to expose their children to diseases that are, for lack of a better word, archaic. If we are able to stop them from getting a disease, why on earth wouldn't you take that option? I understand modifying the schedule, but to refuse the vaccinations altogether seems reckless.
04.07.09 - 04:34 PM / 16Jennie said:
"If you've decided that the risks are too great to vaccinate your child then you are counting on the rest of us who are willing to take those risks to decrease the chances that your child will be exposed to these diseases. You are counting on us."
This is where I do have judgment about people who choose not to vaccinate. They are not weighing the risk of vaccinatng their children against the risk of their child catching whatever disease the vaccination is supposed to prevent. They are expecting other parents to bear that burden.
I also have issues with parents who refuse to acknowledge the results of scientific studies on the subject. On the one hand, I realize that there are examples from history that make it difficult to trust the scientific community when they assure us that x is safe or that there is no connection between y and z. OTOH, people who choose to believe anecdotal "common sense" evidence over cold, hard, empirical facts make me nuts.
04.07.09 - 04:34 PM / 17Martha said:
As the mother of a chronically sick child (long-term effects of RSV), I believe that vaccinations are absolutely necessary. My daughter's immune system can barely tolerate a simple cold, let alone something more drastic. There was a mumps outbreak at my daughter's daycare about two years ago, and most of the parents were absolutely furious, for the reason that you pointed out--some of the little ones couldn't be vaccinated yet, and they were at the mercy of another parent's decision not to have his/her child vaccinated and bring it into the daycare.
04.07.09 - 04:34 PM / 18Tricia said:
I do think the number of vaccinations that children get these days does seem excessive and some of the things that they vaccinate for aren't horribly dangerous to most kids (i.e. chicken pox) but that the big ones absolutely should be vaccinated for. Can these kids without immunizations go to school? Most of the people I know who refuse to immunize home school their kids or plan to.
I know I had to get a new MMR to go to college because there was some question about the effectiveness of the vaccine I had in the early 70's.
04.07.09 - 04:35 PM / 19Katherine said:
I understand the passion and intellect of parents on both sides of this decision. As I have no plans to be a parent myself, I do not envy those of you who have to make this decision. I don't know what I would choose.
04.07.09 - 04:35 PM / 20Vanessa said:
I wish that the conversation among parents didn't always have to be as black and white as Pro-Vaccination and Anti-Vaccination. I believe we can still be for vaccinating our children while ALSO being critical of an overly aggressive One Size Fits All vaccination schedule, of some ridiculously unnecessary vaccines that will probably hurt our children in the long run more than they will help (I'm talking the chicken pox vaccine mostly), of some of the sketchy cocktail ingredients and poor independent testing (or lack thereof) done, and of pharmaceutical power and intentions. We can still protect our children from some of history's worst diseases while demanding improvement in the way it's all done.
And yes, the herd mentality to vaccination is part of the point, even if you know the chances of your kid contracting Hep B is minimal or you're not afraid of what the measles looks like on your (non-immune compromised) child. I wish every parent the best of luck in sorting through all of the (mis)information and making the best decision not only for their child but for others as well...
A helpful read for me was Dr. Sears' The Vaccine Book, by the way.
04.07.09 - 04:35 PM / 21Mary@Holy Mackerel said:
Oh, and I forgot to add that my son had cancer, and like Andi (#8) said, contracting chicken pox or measles, etc. when immune-depressed would have been a possible death sentence for him.
And thank you for opening this up for discussion. It's about time.
04.07.09 - 04:35 PM / 22Sarah said:
Thanks Heather. It's one of those areas where I've felt like I'm damned if I do, damned if I don't. I chose to vaccinate our daughter schedule though, and thankfully no regrets so far.
04.07.09 - 04:36 PM / 23Lori Cleghon said:
My mother had polio as a small child in the late 20s, an event that affected her health for her entire life. She made sure that my sister and I were 'first in line' for the polio vaccine in the early 50s. My own children received the recommended vaccinations in the 70s with no ill effects. I have great sympathy for parents whose children develop autism. But I wonder if it might be a coincidence that this condition close to the age that vaccines are normally administered.
04.07.09 - 04:37 PM / 24Kate said:
I don't think I've ever heard it put so well. I cannot imagine the heartbreak of having a child develop autism. Nor can I fathom the pain of having a child die, much less of a preventable illness.
The fact is, scientific evidence is overwhelming AGAINST vaccines causing autism. The fact that some children develop autism symptoms around the time of their vaccinations seems a matter of the fallacy of causation. Maybe that particular vaccine is given around the age symptoms commonly develop or become noticeable. It is even possible that after all the controversy surrounding vaccinations, parents and doctors come to note behaviors that were already present.
What we know is that measles, polio, etc, can cause debilitating and sometimes deadly illnesses. Some people cannot be vaccinated, and it seems to me that allowing these illnesses to gain a foothold in the population again invites the risk of "new and improved" diseases developing for which we do NOT have adequate vaccines. Asking everyone to join a non-vaccinating family in assuming that risk is...shocking.
04.07.09 - 04:38 PM / 25Erin said:
I feel like you, Heather, and try to stay out of other parents' decisions or choices because what's best for one is not always best for all. But vaccinations are different. I worry that my 1st grade son talks to much in school and makes it hard for other kids in his class to learn. Imagine how I'd feel if he was responsible for getting an entire class sick, especially a child with an otherwise compromised immune system.
I worked on a terrific PBS program a few years back called Rx for Survival (narrated by Brad Pitt). The Web site lives on is a great resource on this and other global health subjects.
pbs.org/rxforsurvival
p.s. you were great on Oprah yesterday!
04.07.09 - 04:38 PM / 26Daddy Scratches said:
One lesson about parenting that I learned during my wife's pregnancy is that, like it or not, you have to play the odds. At one point, we were advised that we could have an amniocentesis conducted to check for a certain chromosomal disorder ... but, based on the figures provided to us, the odds of the amnio causing some kind of problem were greater than the odds of our unborn child being afflicted with the chromosomal disorder in question. Thus, we passed on getting the amnio.
With regard to vaccination: we felt that the odds of our children developing a life-threatening illness if not vaccinated posed a greater risk than the odds of our children developing autism in the wake of their vaccinations. Thus, we got them vaccinated.
Now, if they *had* developed symptoms of autism, I'm sure I'd be singing a much different tune, and therefore I have no quarrel with parents who, after being put in that unfortunate position, advocate not getting your child vaccinated.
Short of any irrefutable evidence that vaccinations cause autism, however, I agree that the ability to vaccinate your child against illnesses that once killed people in large numbers is a medical advance worth taking advantage of.
(FWIW: My wife has a master's degree in social work and works as the clinical coordinator for a program that provides services to adolescents on the autism spectrum, so she is perhaps more tuned in than most people to the issues surrounding that community ... and she had no hesitation about getting our kids vaccinated.)
04.07.09 - 04:39 PM / 27Kris said:
This is an exceptionally well written post.
It made me think about my neighbor's daughter, too young to be vaccinated against meningitis (in Canada) and being exposed 1.5 weeks before she was eligible to receive the vaccine by an unvaccinated older child. She almost died. The extent to which her brain was damaged continues to unfold for her devastated family.
I will be linking this post tomorrow at my blog. You have eloquently expressed exactly what has been in my brain for a long time...something I have never myself been able to write down or express effectively. Thank you.
K.
04.07.09 - 04:39 PM / 28Rhonda said:
I think the pros outweigh the cons. I rather take my chances with the vaccine than the illness.
Thanks for the great read!
04.07.09 - 04:40 PM / 29ellebee said:
Hi Dooce,
LONG time reader, first time commenter. I just wanted to say thanks for your post. I am one of the few (it seems like) who agree with you. I am a person who is allergic to certain vaccines, and there is always a little part of me who is terrified to go out and about into the world for fear that someone is going to give me a horrible disease because they didn't get vaccinated. If I have a child who is also allergic to vaccines, and they get a deadly disease because they CAN'T have a vaccine, I'd never be able to forgive those parent either. I am a student physical therapist, and in our pediatrics class, we had a vaccination "debate" during the autism lecture, and I could not believe how many were against vaccines. Thanks for stating your opinion, and you're not the only one out there!
04.07.09 - 04:41 PM / 30