AskDrSears - The Vaccine Book: Dr. Bob Sears Offers Advice in March 21st New York Times Health Section on Vaccine Choices Parents Make

Dr. Bob Sears Offers Advice in March 21st New York Times Health Section on Vaccine Choices Parents Make

Thursday, March 27, 2008

The recent measles outbreak (if you can call it that) in San Diego last month, in which twelve children came down with the illness after an unvaccinated family brought the disease back with them from Switzerland, raises awareness of a growing trend among families to decline certain vaccines.

This article raises the question, should parents have the right to decline vaccines when doing so may put the health and safety of other children at risk? In twenty states of our free nation, parents are allowed to decline vaccine for personal reasons. But in 28 states they must have a religious reason, and two states (West Virginia and Mississippi) don’t allow parents to decline them for any reason.

I believe our nation can tolerate a certain percentage of unvaccinated children without risking the overall public health in any significant way. Since most children are vaccinated, our nation has enough “herd immunity” to contain outbreaks like this one. However, in the San Diego case, some infants caught measles before they were old enough to even be vaccinated. Fortunately, all cases passed without complications, as is usually the case with measles.

So the question is, are unvaccinated parents putting the rest of our children at risk? Maybe a little. But in my opinion parents SHOULD have the right to make health care choices for their children. They should not be forced into vaccinating if they feel strongly against it.

Click here to read the whole New York Times story.

Dr. Bob

Labels: Vaccine News

20 Comments:

At April 2, 2008 9:11 PM , Anonymous said...

The recent measles cases in San Diego certainly were an 'outbreak', and without adequate herd immunity, could have caused many children to experience brain damage and death.

Yes, in many states, parents have the right to decline vaccines, and yes, when doing so they are putting the health and safety of thier own child and other children at risk. I feel your public promotion of your 'alternative vaccination schedule' adds to the risk for all children.
Our nation has been forced to tolerate a certain percentage of un-vaccinated children, primarily through the shameful underfunding of children's health care and inadequate public health responses to needs of vulnerable sub-populations of children. My search of your AskDrSears.com does not bring me to your comments advocating SCHIP or other important efforts to expand access to health care for children. Re: your statement, "all cases passed without complications, as is usually the case with measles" the last serious US breakout in 1989-91caused 55,622 measles illnesses, 45% in children less than 5 years old; 20% of the infected individuals were hospitalized and 123 died. Your definition of 'usually' is quite different from mine.
So I answer your question, "Are parents of un-vaccinated children putting the rest of our children at risk?", YES! Parents have the right to make health care choices for their children and typically are not forced into vaccinating. On the other hand, if you believe, as you state, (on the AAP vaccination and autism public statement) "I must admit that I agree with almost everything in this statement", then raise your well-projected voice on behalf of the proven benefits of early and full vaccines, until such time as you or others prove (through study, and not just opinion,or the too limited view of a single multi-doctor practice) that the risk/benefit ratios reveal currently unknown problems that would deserve modification of current US vaccine schedules.

Intersted parties may choose to review my posting on autism and vaccines in the prior comment section. Marc Lerner, Pediatrician
At April 15, 2008 12:59 PM , Anonymous said...

Dr Sears, you say, "I believe our nation can tolerate a certain percentage of unvaccinated children without risking the overall public health in any significant way. Since most children are vaccinated, our nation has enough “herd immunity” to contain outbreaks like this one."

This statement puzzles me. It seems to assume that it is ok for some parents to decline because most other parents are vaccinating their kids.

So, my neighbor who doesn't want to vaccinate gets the luxury of choosing to rely on me to vaccinate. What kind of reasoning is that?

And what is your tipping point? At what point are too many kids unvaccinated so that there is no "herd" to rely on? And what does that do to your reasoning about vaccinating, or your "alternative vaccine schedule?"

I'm betting that more parents are going to decline or delay vaccines just based on how vocal and well known you are. And there is no question in my mind you will cause doubts in parents just by the negative comments you've made about the research. So what is that going to do to the herd? Will there be enough of a herd if EVERY parent follows your schedule?

And what if every parent declines? Does your alternative schedule need a protective herd to make sense? Or can you be comfortable without a herd of vaccinated children protecting your apparently unvaccinated/delayed vaccinated patients?

While I do appreciate some of your thoughts on this subject, I think that statement quoted above does a disservice to the debate.

The "herd" is irrelevant. Either the vaccines are safe for all, or for none. Yes, other kids might be lucky there is a herd, but you are not serving them well by equivocating.

Sincerely yours,
A Parent who vaccinates, but does not usually blog
At April 15, 2008 3:24 PM , Anonymous said...

First off, there is no such thing as a SAFE vaccine so whether parents decide to inoculate their babies or not is out of the question. All the statistics claiming that vaccines had eradicated "nasty" diseases are but a bunch of lies and misinformation. Secondly, I encourage every parent to get educated regarding the nature of each childhood diseases and the natural process of their course. Don't let fear conquer our motivation to investigate before subjecting our precious children to inoculations.
At April 16, 2008 10:29 AM , Amber said...

4 of the 12 children who contracted the disease in San Diego WERE VACCINATED...which tells me, why harm my childs immune system when they are obviously NOT immune anyways!
At April 16, 2008 1:19 PM , Anonymous said...

Most vaccines are not going to be 100% effective in preventing disease. In an outbreak, it is possible that some immunized children are still going to develop disease. However, the RATE of infection is likely to be much, much less in the immunized population. So, consider an outbreak where 6 people catch a disease, and 3 of them were immunized, 3 not. If you consider, as an example, 85% of the population was immunized, the rate of protection is much greater in the immunized population. So, the fact that some immunized children get the disease does not mean the vaccine is bad. Another thing to consider is disease severity. When chicken pox vaccine first came out, for example, (succesful) the intent of the vaccine was not to eliminate chicken pox, but to significantly reduce complications (though now the bar has been raised with an eye towards elimination). Kids who are vaccinated sometimes get chicken pox, but it tends to be milder disease than typical, with a low rate of complications. hgollup
At April 17, 2008 7:33 PM , Anonymous said...

This is funny. The way vaccine manufacturers develop these dreadful vaccines is through animal experimentation. And now, their are "herding" the people? Aren't this for cattles and sheeps? Well this will make the population the real experimental guinea pigs. Terrible.
At April 17, 2008 10:51 PM , Anonymous said...

Someone has to vaccinate their kids or the whole luxury of choosing not to vaccinate wont work. Those choosing not to vaccinate are assuming there is a low risk for disease because most of the population is accepting a risk to vaccinate in the interest of improving community health. Sit down with someone from the 1940s and ask about polio. And ask how many parents chose not to vaccinate when the vaccine became available. This luxury of not vaccinating will not work if we all make that same choice. And that is the part of this conflict that makes me angry. But I am also adamant that we owe it to our kids to make vaccines as safe as possible.
At April 18, 2008 8:58 AM , Anonymous said...

FYI, there were no deaths that have been reported in the United States since 1979 due to wild-type poliovirus and there were no cases of wild-type poliovirus infection either. Until 1998, an average of 8-10 CASES associated with the VACCINE VIRUS were reported every year. Will this make you more angry? You wouldn't just sit and ask someone for information re: polio, would you? Even doctors will not tell you this. Get educated because knowledge is power.
At April 29, 2008 1:31 PM , Jenna said...

I think the main thing is to consider the risks of disease with the risk and benefit of the vaccine. I am choosing to selectively vaccinate my child. For the serious/debilitating/deadly diseases, we are vaccinating. The ones borne more out of convenience we are skipping. One of which is chicken pox.

This also brings me to my question for Dr Sears - Chicken Pox is going around a friend's neighborhood right now. I would like my daughter to be exposed, but am not sure when is the ideal time for exposure. She is one year old now. Is she too young?
At May 3, 2008 6:28 AM , Anonymous said...

In my family, the risks of vaccinating are greater then the risks of not vaccinating, even without so called herd immunity. My children react very badly to vaccines, and I do believe that the autism regression I saw in two of my children was due to the vaccinations. My youngest was very ill for two months after each series of vaccinations, so after her third series I refused the vaccines. To the poster who said "Just sit down with someone from the forties and discuss polio" My mom and my uncle both got polio BECAUSE of vaccination. They suffer irreparable damage. How do we know that children aren't still being injured today from the vaccines? I for one am glad that I am not required to vaccinate my children because to do so would be to seriously harm them.
Sarah, mom to four girls
At May 18, 2008 3:41 PM , Anonymous said...

Re: April 2: "then raise your well-projected voice on behalf of the proven benefits of early and full vaccines, until such time as you or others prove (through study, and not just opinion,or the too limited view of a single multi-doctor practice) that the risk/benefit ratios reveal currently unknown problems that would deserve modification of current US vaccine schedules."

I think Dr. Sears's point is that nothing HAS been proven. Where's the research that vaccines work? So many of them do not provide the immunity they claim (are there studies that follow patients who have been vaccinated?) Why should we have to blindly follow whatever the vaccine industry tells us? Anyone who recommends all NEWBORNS receive a toxic shot to provide immunity against something that only a small fraction of them are at risk for is not to be trusted, IMO. Show me the research!!!
At May 29, 2008 2:52 PM , Anonymous said...

Everybody likes to talk about polio without even knowing the whole story. Here's a very good article about vaccines. Think people.

http://www.chirotips.com/immunization.htm

Proponents of vaccines are quick to cite the polio vaccine and the eradication of smallpox as being the two great benchmarks of vaccination. Those that oppose vaccination, however, argue that infectious disease mortality rates in the U.S. and England declined steadily before the advent of vaccinations due to improved sanitation, hygiene and diet. If these two vaccines were responsible for the decline of polio and the eradication of smallpox, how did these epidemics end at the same time in European countries who refused to vaccinate against the diseases?

Even the WHO (World Health Organization) admits, disease and mortality in Third World countries have no direct correlation with immunization procedures or medical treatment, but are closely related to the standard of hygiene and diet.

A Scientific American article in 1973 revealed similar findings: “over 90% of all contagious diseases were eliminated by vastly improved water systems, sanitation, living conditions, and transportation of food.” Mass vaccination did not appear on the scene until a century after the decline in infectious diseases started (1850-1940), but inoculations were, and still are given full credit.
At May 29, 2008 7:55 PM , Anonymous said...

Everybody needs vaccinations and adults need to get the updates as well. The end.

So all the religious people don't want to be told what to do by the "gov't". People with no scientific knowledge pretending to know something based on nothing.Religion is mental masturbation. Religion is just an excuse to do whatever you want to do. The end.

Dr. Sears says it's okay for a small % of the population to not vaccinate. Yeah, the small, rich percentage in So. California that pay his bills. What about the Hippocratic oath? Such weak arguments go nowhere. The end.
At June 4, 2008 1:21 PM , Anonymous said...

Dr Lerner-
123 deaths out of 55,622 cases?! That is a very small percentage of deaths. I'm going to need something a little more convincing than that.

Did any of those children (many probably babies who were too young for the MMR shot anyway) have compromised immune systems?? I bet they did. You didn't look into that though, did you. Nope, you just come on here touting that you're a "pediatrician" and expect us to take your word as gospel.

Times are changing folks. Big Pharma, the CDC & doctors better start doing something about this because people are no longer going to sit idly by while you all line your pockets at the expense of our guinea pigs...oops, I mean children.

Signed,
An angry parent
At June 4, 2008 1:39 PM , Anonymous said...

Shame on the person talking bad about religion! Jesus is Lord THE END!
At June 10, 2008 1:38 PM , Carole said...

To Dr. Sears… I usually like your common sense oriented view of child rearing and medicine, but on the subject of vaccinations, I have to disagree with you on your “herd immunity” mentality. For one thing, this “herd immunity” doesn’t exist until 8 weeks of age with the first set of immunizations. Until 10 weeks of age (adding 2 weeks for significant immune system priming), babies really have very little defense against viruses and bacterial infections. Bacterial infections are easier to deal with (unless a systemic septic infection is involved) because of antibiotics, but these antibiotics DO NOT have an impact on viral infections because of how our immune systems are designed and work. So this “herd immunity” of which you speak doesn’t exist unless everyone in the “herd” is immunized.

Next… to those individuals touting the “lies and misinformation” associated with “dreadful vaccines” being perpetrated by “big pharmaceuticals, the CDC, and doctors:” PLEASE get your facts straight. I will agree that the pharmaceutical companies need to be held to a higher standard now more than ever, but the CDC, FDA and most doctors are working to ensure that the vaccines and medications that make it into use are actually working and worth taking. But drug trials do become necessary after a certain point in research and development – so to those people that have a problem with responsible animal (and human) testing (and no – I DO NOT mean cosmetic testing – I’m talking about cancer treatments, antivenoms and other medically relevant testing), I suggest that you do a little more research into the subject before burning it in effigy.

Speaking of research/ history - the smallpox vaccine was originally developed when a scientist (Edward Jenner, 1796) noticed that milkmaids exposed to Cowpox developed a mild reaction and did not contract Smallpox. The Vaccinia vaccine does not claim to provide complete immunity to chickenpox… only to decrease/ shorten the reaction when children do come in contact with the virus. Considering that an exposure and reaction to the chickenpox virus causes SEVERE reactions (can we say SHINGLES?) in adults – I’d rather my children were inoculated and exposed as children. Also, since the advent of the Poliovirus vaccine in 1951 by Jonas Salk, countless numbers of children have been spared this illness. To those that state that the vaccine actually gave polio to their family members – please do some research – there were actually 2 vaccines developed by Brodie and Kollmer in 1936 that were complete shams. These “vaccines” provided no immunity whatsoever – in the case of Brodie’s, which included “formaldehyde-fixed monkey spinal cords,” caused severe allergic reactions in children inoculated – and Kollmer’s vaccine caused similar adverse reactions, some of which were lethal. Sensitivities to vaccines occur commonly throughout our population; for instance: I haven’t had an influenza vaccination since I was in grade school because I’m sensitive enough to the virus that I will develop a reaction. However, I’m not in the “at risk” populations (the very young and the very old) and I didn’t bat an eye or lose any sleep when I asked for the influenza vaccinations for my daughter this winter. I am also aware that there are contradicting reports being published about the connection between autism and immunizations. Most of these reports deal with a preservative used in some vaccines (thimerosol) that has either been removed completely or diluted to negligible levels. Again, I ask that you do your research before blindly accepting anyone’s opinion (doctor or otherwise) as the truth. It literally took me five minutes to look up information about vaccines and viruses on Wikipedia, and then follow the references for this information back to a more credible source (NCBI – PubMed http://www.ncbi.nlm.nih.gov/). And yes – this includes the Measles outbreaks in 1989 – 1991, in which the 123 deaths quoted were from BOTH immune compromised children AND adults.

Just a few more points and I’ll step down from this rant.
Vaccine research and follow-up studies ARE prevalent and ARE accessible to the public. Please follow the PubMed link above or go to your local library.
Immunizations and inoculations are NOT actually meant to provide complete immunity. These vaccinations ARE meant to prime the immune system with a non- or less-virulent form of a virus so that your body will produce antibodies and/or other immune complexes that will later recognize and destroy the more virulent form of virus if you are exposed to it at a later time. If all vaccines provided complete immunity, then pregnant women (and other immune compromised individuals) would not be cautioned to avoid any exposure to measles, mumps, rubella, Fifth’s disease, cytomegalovirus, influenza, etc.
Hygiene and diet do have a significant impact on a population’s immunity, in that healthy habits and diet promote a healthy immune system. This will not provide significant immunity alone, however, and should not be relied upon above and beyond all other vaccinations.

And lastly – to those individuals that took the cheap shots (either for or against) religion – could you PLEASE stay on topic next time?

Signed,
Immunologist from Mississippi
At June 16, 2008 9:42 AM , Anonymous said...

You have a concern about aluminum in vaccines. Are there other sources of aluminum that need to concern us?

One obvious source is the aluminum in anti-perspirants. Should pregnant women or nursing mothers avoid the use of anti-perspirants? How much aluminum does a fetus or newborn receive from a mother using anti-perspirants?
At July 10, 2008 9:26 AM , Anonymous said...

if you are giving your children vacinations i would assume that you beleive they are safe from the disease that you have vaccinated them against. If any one is at risk it would be my child that does not have the vaccination.

If you did the research instead of having blind faith in your doctor, you would realize that the vaccination causes more problems that just keep on rising.
At November 11, 2008 8:04 PM , Anonymous said...

I feel that the choice of what medical care a child gets should be between the child's parents and doctor. how can an unvaccinated child harm another if they are vaccinated? Either the vaccine works or it doesn't. Either way, the parent who decides not to vaccinate his child should not be censored by the government.
At November 14, 2008 12:11 PM , Anonymous said...

I wonder if the story would have hit the news if the family that contracted measles in Switzerland HAD been vaccinated?

Let's admit it: nobody REALLY knows how safe vaccines are and we really don't have any business badmouthing those who choose (or not) to vaccinate their children until we have good, solid evidence to support our claims. Evidence does not have to come by way of "scientific" study alone. As a scientist myself, I know that research is and has to be limited in order to make the connection between cause and effect. In limiting variables, we also limit our ability to make broad claims, such as that of vaccines being completely safe (or not). We can only describe what we see. That's why it's also important to pay close attention to anecdotal evidence from parents and children. Hopefully, most of us make the best decision possible for our children, based on the available information, and I think that is what Dr. Sears is trying to assist us with.

What would be shameful is if those who have had the opportunity to witness benefit or harm associated with vaccination have withheld that information in order to influence the decisions of others (e.g. a pharmaceutical company trying to avoid lawsuits and profit loss, or someone against vaccination who does not want to look like an idiot for falsely labeling a vaccine as unsafe when the evidence indicates otherwise).

Let's all, including lawmakers, doctors and scientists, just do our best and stop acting like we know everything, because WE DON'T. And, as long as we're not absolutely SURE that our way is the ONLY way, let's respect the choices of others, shall we?