I am absolutely positive that I will offend someone with this post. Great. Sometimes the wicked taketh the truth to be hard. Sorry, I just have to call 'em as I see 'em and this blog is about the truth (or at least how I view the truth - which is obviously the right way). Remember I am trained in the art of pediatric medicine and work for a company where preventative medicine is a keystone, and vaccines are an important part of preventative medicine, so add your grain of salt as needed. And remember we are talking about vaccinations not your mom or your religion, so CALM DOWN.
Let me let you into the mind of a pediatrician and what is going on behind that cheesy grin...
You, the parent, say: "I've been doing some research..." That's all you have to say, your pediatrician knows what's coming next.What the pediatrician hears: "My pride and/or insecurities and/or belief in misinformation is more important than my child's health." (whether this is fair or not, this is what they are thinking)
Then a discussion on vaccinations ensues. Usually it is either about how you want to avoid autism or how your read a book or website about how an 'alternative' vaccine schedule is more appropriate. Then your pediatrician says: "Well you are the parent, and you need to manage your child's health care according to your own conscience."
What your pediatrician is thinking: "You are an insane parent who has been manipulated or decieved by some outside influence and for some reason this information/influence is much more valuable than years and years and years of vaccine experience and vaccination of billions of children, and arguing with you is worthless since I have a waiting room full of patients and trying to convince you of your insanity would take more than the 15 minutes I have been allotted for you." I'm just being honest. That is really what they are thinking. All of them. Are they right? That is for you to decide.
Why do some parents want to avoid immunizations?
REASON 1: Scared of autism.
One study published about 10 years ago said there was a link between autism and the MMR. Since then study after study has shown this to be untrue. Some even show a protective benefit from autism by those who received vaccines. A HUGE study of the highest clinical power (a double blind placebo controlled trial) in Europe has shown no connection. Now the news has come out that the person who conducted the original study (that showed the connection) falsified information and is under investigation for misconduct (link). With all the evidence we have today, if you are not vaccinating your child for fear of autism you are putting your child at risk because you trust information that has been repeatedly found to be false and is now found to be one man's imagination from the start and no basis in reality.
REASON 2: Peer pressure
Unfortunately this is the most popular excuse these days, although there are few who are willing to admit it. **warning rascist comment follows**: I have never, ever, never had a mother decline vaccination who was not white. I've also never had a father (of any race) decline. These tend also to be part of the middle class. In my own experience, I've noticed as the family gets poorer and richer they are more open to vaccines. I have had a few mothers admit to me they had friends tell them, "I can't believe you are going to vaccinate your kids!" Then they go on to indoctrinate their friend with one of the other reasons listed. Just say no! I mean yes!
REASON 3: An 'alternative' schedule is better.
There are 101 theories on better ways to vaccinate your kids. Most of them are based upon the theory that an infant's immune system isn't ready to develop the maximal response at the age they are given. I may surprise you by my response to this one: this may be true. The one MAJOR problem with this thinking: several of the vaccinations protect infants (less than a year) from death. If you wait to vaccinate, the risk of death or severe illness has greatly declined. You are still preventing your child from an annoying illness, and the long term protection may be better, but I'd rather have slightly weaker protection from death than slightly stronger protection from an annoyance. Who needs vaccine protection more than an infant with an immature immune system? There are still MANY infants dying and getting serious illness each year due to illness that could have been prevented by vaccine (and the numbers are increasing due to decreasing immunization rates).
If you are choosing this reason for avoiding vaccines you are turning your child into one of these:
There are 101 theories on better ways to vaccinate your kids. Most of them are based upon the theory that an infant's immune system isn't ready to develop the maximal response at the age they are given. I may surprise you by my response to this one: this may be true. The one MAJOR problem with this thinking: several of the vaccinations protect infants (less than a year) from death. If you wait to vaccinate, the risk of death or severe illness has greatly declined. You are still preventing your child from an annoying illness, and the long term protection may be better, but I'd rather have slightly weaker protection from death than slightly stronger protection from an annoyance. Who needs vaccine protection more than an infant with an immature immune system? There are still MANY infants dying and getting serious illness each year due to illness that could have been prevented by vaccine (and the numbers are increasing due to decreasing immunization rates).
If you are choosing this reason for avoiding vaccines you are turning your child into one of these:
Calm down, Richard Gere, its a guinea pig, not a gerbal. The physicians/people who put forth these alternative schedules base their ideas on largely untested THEORIES. They all sound pretty good. They need to. They are trying to recruit unsuspecting parents (mothers, really - see above) to try their theories out for them without having to set up an actual study.
If the theorist is wrong, and their schedule increases infant death, they say, "Oh well, dang, I guess my theory was wrong." I'd imagine the mother of the child who died as a result of this schedule might be a little more disappointed. I'm not judging. I enrolled my son in a pharmaceutical study when he was less than 6 months old. Made some good money when we really needed it. But you are volunteering your guinea pig for free.
Another alternative is the 'spread the wealth' theory of only doing one or two vaccines at a time. This is another one that has no basis in scientific realilty. In my own personal opinion, I find this schedule as tantamount to child abuse. Instead of getting all the shots over in a span of about 60 seconds, a parents decides to spread the pain out over many months, mutiplying the number of traumatic days by up to 3-4 times for absolutely no medical benefit. You are a meanie and maybe a commie.
REASON 4: Various conspiracy theories, including pharmaceutical companies benefitting from this schedule
Dr Gregory House said it best when he was talking to a parent with the same concern. He basically said you can choose which company you want to support: the pharmaceutical company or the 'teeny tiny coffin' company.
Conspiracy theories are always a little off, and if you believe in one, you probably are a little off, too. Sorry to offend you, but if you do believe in the conspiracy, this post isn't going to change your mind anyway (because I'm obviously a part of it).
Take home messages: Is the current vaccine schedule perfect? Not likely.
Does someone have an alternative schedule that will work better? Maybe.
Did you pick the right person's thoery that will revolutionize vaccines? Not likely.
If the theorist is wrong, and their schedule increases infant death, they say, "Oh well, dang, I guess my theory was wrong." I'd imagine the mother of the child who died as a result of this schedule might be a little more disappointed. I'm not judging. I enrolled my son in a pharmaceutical study when he was less than 6 months old. Made some good money when we really needed it. But you are volunteering your guinea pig for free.
Another alternative is the 'spread the wealth' theory of only doing one or two vaccines at a time. This is another one that has no basis in scientific realilty. In my own personal opinion, I find this schedule as tantamount to child abuse. Instead of getting all the shots over in a span of about 60 seconds, a parents decides to spread the pain out over many months, mutiplying the number of traumatic days by up to 3-4 times for absolutely no medical benefit. You are a meanie and maybe a commie.
REASON 4: Various conspiracy theories, including pharmaceutical companies benefitting from this schedule
Dr Gregory House said it best when he was talking to a parent with the same concern. He basically said you can choose which company you want to support: the pharmaceutical company or the 'teeny tiny coffin' company.
Conspiracy theories are always a little off, and if you believe in one, you probably are a little off, too. Sorry to offend you, but if you do believe in the conspiracy, this post isn't going to change your mind anyway (because I'm obviously a part of it).
Take home messages: Is the current vaccine schedule perfect? Not likely.
Does someone have an alternative schedule that will work better? Maybe.
Did you pick the right person's thoery that will revolutionize vaccines? Not likely.
As for me and my house, we will participate in the most tried and true schedule available that protects babies when they really need it (when they are babies) - the one currently recommended by the American Academy of Pediatrics and the Centers for Disease Control. It will likely be changed many times over the years. This is good and healthy sign that we are striving for the best schedule availabe. I would be worried if it wasn't true.
Addendum: Are vaccines completely safe?
No. Usually just pain at the site of injection and fussiness and occasional fever are the only bad effects. Rarely there have been reports of seizure afterwards. Whether it is connected with fever (and thus the very benign febrile seizures of childhood) or purely from the vaccine, that remains to be seen. If you have had a child who had a seizure after a vaccine, it can be scary. The truth of the matter is, however, that seizures are typically benign despite how scary they look and are not life threatening. You still made the right decision, because you may have saved your childs life by protecting them through vaccination, even though they had a seizure.
More severe reactions? Vaccines have been blamed for all kinds of illnesses all the way to sudden unexplained death. Anyone with kids will tell you, they get shots every few months for the first couple of years. If something serious happens, there's always a recent round of shots that can be conveniently blamed for it. Did the vaccine cause it? Probably not. In the unfortunate event that a child suffers a severe illness, every parent asks the question "Why?" repeatedly. Sometimes its nice to have something to blame it on. Unfortunatley vaccines frequently take the scapegoat role.
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11 comments:
Awww, Dr Jay you are very predictable. But I still like you. ;)
I like your blog. :-)
And my Dad would correct the famous "The customer is always right" phrase by professing "The customer is NOT always right, but the customer is still the customer."
So there you go! You have some great points and have already figured this out.
Mom: Maybe you have ESP, too!!! . I'm glad you are getting a consistent messsage from your health care providers.
Andrea: Thanks for reading. Your father is a wise man. Healthcare these days is becoming more and more like other consumer industries. There's some good and some bad that results.
A couple of questions from an ignorant person who would really and sincerely like to know the answers:
1) How does the American Pediatric Association and Centers for Disease Control come up with the immunization schedule?
2) Explain what boosters really are in dumb-dumb language. Do you have them because your body only needs so much at a certain weight/age so then when you are bigger you need more? Or does the vaccine run out and then your body needs more? For example, if you miss a dose along the way, do you have to make up the dose or just pick up where you are? Is the theory the same for all the vaccines?
If you can take the time to answer these silly questions, I will be very appreciative. You see, our last pediatrician was so busy and underpaid, he couldn't/wouldn't take the time to explain such things to me. He just thought me argumentative when I asked these questions on my fourth baby. (I obediently had my first three immunized right on schedule.) Luckily, the student health center (& related health plan) we attend doesn't cover nor administer immunizations at all, so I get to go to the county health department where there are way less defensive about it.
Ooops, sorry for the bad grammar at the end..."where they are"
Oh and p.s. I'm really not one of those rabid anti-immunizations moms. I just wish I could talk about it with a professional that didn't assume I was one of "those" and would really inform me in an educated way.
Nancy,
Thanks for your honest questions, and I would feel happy to answer them. The vaccination schedules are revised yearly, and there are always changes being made. There sometimes are changes based on supply/outbreaks/new information, etc. There are committees designed to monitor all the latest research and incidence of diseases that decide what changes need to be made.
Boosters are necessary to "boost" your immune response in your body. When I was younger, I was under the impression that when you got an illness, you were immune from it for the rest of your life. This is basically how it works, but the immunity doesn't always last a lifetime. Immunizations are basically tricking your body into thinking you'd had the illness, thus developing immunity. Boosters I designed to 'remind' your immune system that it wants to be immune to the illness the vaccine is used for. Everyone's immune system is different, and booster schedules are designed to come when most people's immunity may be weakening.
This is actually why the infants need such frequent immunizations, and they are all the same ones they've had already. Since their immune system is still immature, they need more frequent boosts. Sure, if you wait until later they will typically need less boosters, but they need the most protection from these illnesses as infants.
Nancy, Remember that you most likely won't find a pediatrician who will tell you not to immunize. And they will tell you to give them ALL immunizations. Are they ALL necessary? I doubt it.
Do other reasearch too. But be careful because there are a lot of cooks out there AND you can find anything you want on the internet... pro and con so it's importamt to find reputable sources.
Sorry, Dr Jay, just a slightly different perspective. :-)
Mom: I appreciate your input. Again, I think it is healthy to have people disagree with the medical community, and it keeps us honest. I'm just not sure I would want to put my child at risk basing their immunizations on the untested theories that are out there.
You are right. There is an abundance of junk out there. Some of it is hysterical to read. There are also some educated ideas that can be very convincing, even to one who is medically trained.
I like that you say it is difficult to find a pediatrician who won't recommend against vaccination. Of all specialties, pediatrics is one of the most like an 'art', in that there are many different ways to practice it. This is due to the fact that there is much less research available on kids than adults. We just do the best we can with the evidence we have, which results in wide range of opinions on the practice of pediatric medicine. That is why it is remarkable that we all agree on something... vaccinations are good.
Link to a fun article about the fallout from the autism researcher 'beind called out.'
http://blogs.discovermagazine.com/badastronomy/2009/03/28/antivaxxers-and-their-trouble-with-truth/
Wow, I wish I could force all my friends to read this so I don't have to hear about their personal theories about how immunizations cause the 3 A's as they like to call it: asthma, allergies, and autism. I have a friend who tells me every time my kids get sick that I shouldn't have immunized!!! Ahhh! I just want to scream! Do they have M.D.'s by their names? Seriously people. I know I ask a lot of questions, but at least I ask my doctor (and you!) and don't google a word, read 1 of the 1000 articles that comes up on that topic, and then accept everything it says.
Immunizations are our friends.
Wow, Dr. Jay, since my kids are old enough that the decision has been very clearly made, LOL, I will say that I was able to read this with a free, open, unworried mind, and, quite frankly it had me cracking up!I realize it is a serious topic, and I love the way you presented it! Thanks!
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