Vaccination: The best idea for your child?

Last week, I was asked to testify in front of congress in support of HB1555, an act creating a personal exemption to routine immunization. I had the opportunity to hear several people testify both in support and opposition to the bill including several infectious disease specialists. I also had the opportunity to share the naturopathic perspective. I thought some of you may like to hear my personal approach to immunization and opinion on the topic.

First of all, I think that this discussion needs to start at the beginning. Immunizations changed the health of Americans dramatically. At the time of their inception, infectious diseases were the number one cause of death in America. The average lifespan was in the 40s. Immunizations offered protection from many of the bacteria and viruses that were plaguing Americans. Some were extremely successful- the smallpox vaccine is no longer administered because the virus was effectively eradicated. They were lifesaving.

Today, many of these illnesses no longer present the same risks, in part to the success of the immunization program. In addition, hygeine, cleaner food and water, and several other factors have also reduced transmission of some of these infectious agents. And we have seen increases in rates of chronic diseases including neurological diseases in children as well as adults. Whether the increases of these devastating illnesses are linked to immunization? We can really have no idea- there are so many other things that have changed over time including changes in our food quality, exposure to pollutants, plastics, and numerous other factors whose sum likely contribute to the chronic diseases leading the race in causes of death for americans today.

In addition, proponants of vaccination who claim that vaccines are "totally safe" are either misinformed or misinforming. As a whole, perhaps they are mostly safe, but there are many instances of side effects ranging from common, mild effects such as redness at the injection site and mild fever or flu like symptoms through severe side effects like seizures, intusussception, and death. These side effects may be excedingly rare, but they are real risks. I also believe that although there is no sweeping connection between autism and vaccination, there are instances where a susceptible child can be pushed over the edge by a trigger such as immunization. There have been cases where causation has been proven although I would agree that data on a whole does not show that vaccination is the sole cause of autism.

When I speak with parents about immunization it is a conversation, not a one-way lecture. We begin by looking over the CDC's recommended schedule and we go through each vaccine one at a time. Different children have different risk factors, and some parents have legitimate medical or personal concerns surrounding immunization. This conversation is a lengthy one, and we revisit the topic at every well child visit.

What do my patients choose? It is a mix- Many patients are fully immunized, some on the CDC schedule and some on a delayed or spread out schedule. Others are completely unimmunized. Many are somewhere in between. I have personally diagnosed cases of mumps, rubella (german measles) and chicken pox. I have also seen a child be flown to Boston for emergency surgery following a serious complication following immunization. I see the risks and benefits to immunization. And I have seen parents wrestle with the consequences of their choices on both sides!

I recently did a well child checkup for a 2 week old new patient. I had treated his mother for years, and we had had a vaccination discussion in the past. I asked her if she had thought about immunization for her son. She replied, "I'd like to do whatever you did for your son". My reply? "So you'd like to get informed and make a decision that feels right to you? Great! I'll help you with that!" She laughed, but understood my point.

So what choice did I make for my own son (now 18 months)? You'll never know. And you don't have to. Because your decision should be the one that you are comfortable with.