Typically, the M.M.R. shot is given to infants at about 12 months and again at age 5 or 6. This doctor, Andrew Wakefield, wrote that his study of 12 children showed that the three vaccines taken together could alter immune systems, causing intestinal woes that then reach, and damage, the brain. In fairly short order, his findings were widely rejected as — not to put too fine a point on it — bunk. Dozens of epidemiological studies found no merit to his work, which was based on a tiny sample. The British Medical Journal went so far as to call his research “fraudulent.” The British journal Lancet, which originally published Dr. Wakefield’s paper, retracted it. The British medical authorities stripped him of his license.
Nonetheless, despite his being held in disgrace, the vaccine-autism link has continued to be accepted on faith by some. Among the more prominently outspoken is Jenny McCarthy, a former television host and Playboy Playmate, who has linked her son’s autism to his vaccination: He got the shot, and then he was not O.K. Post hoc, etc.
Steadily, as time passed, clusters of resistance to inoculation bubbled up. While the nationwide rate of vaccination against childhood diseases has stayed at 90 percent or higher, the percentage in some parts of the country has fallen well below that mark. Often enough, these are places whose residents tend to be well off and well educated, with parents seeking exemptions from vaccinations for religious or other personal reasons.
At the heart of the matter is a concept known as herd immunity. It means that the overall national rate of vaccination is not the only significant gauge. The rate in each community must also be kept high to ensure that pretty much everyone will be protected against sudden disease, including those who have not been immunized. A solid display of herd immunity reduces the likelihood in a given city or town that an infected person will even brush up against, let alone endanger, someone who could be vulnerable, like a 9-year-old whose parents rejected inoculations, or a baby too young for the M.M.R. shot. Health professionals say that a vaccination rate of about 95 percent is needed to effectively protect a community. Fall much below that level and trouble can begin.
Mass vaccinations have been described by the C.D.C. as among the “10 great public health achievements” of the 20th century, one that had prevented tens of thousands of deaths in the United States. Yet diseases once presumed to have been kept reasonably in check are bouncing back. Whooping cough is one example. Measles draws especially close attention because it is highly infectious. Someone who has it can sneeze in a room, and the virus will linger in the air for two hours. Any unvaccinated person who enters that room risks becoming infected and, of course, can then spread it further. Disneyland proved a case in point. The measles outbreak there showed that it is indeed a small world, after all.
What motivates vaccine-averse parents? One factor may be the very success of the vaccines. Several generations of Americans lack their parents’ and grandparents’ visceral fear of polio, for example. For those people, “you might as well be protecting against aliens — these are things they’ve never seen,” said Seth Mnookin, who teaches science writing at the Massachusetts Institute of Technology and is the author of “The Panic Virus,” a 2011 book on vaccinations and their opponents.
Mr. Mnookin, interviewed by Retro Report, said skepticism about inoculations is “one of those issues that seem to grab people across the political spectrum.” It goes arm in arm with a pervasive mistrust of many national institutions: the government that says vaccinations are essential, news organizations that echo the point, pharmaceutical companies that make money on vaccines, scientists who have hardly been shown to be error-free.
Then, too, Mr. Mnookin said, scientists don’t always do themselves favors in their choice of language. They tend to shun absolutes, and lean more toward constructions on the order of: There is no vaccine-autism link “to the best of our knowledge” or “as far as we know.” Those sorts of qualifiers leave room for doubters to question how much the lab guys do, in fact, know.
Thus far, the Disneyland measles outbreak has failed to deter the more fervent anti-vaccine skeptics. “Hype.” That is how the flurry of concern in California and elsewhere was described by Barbara Loe Fisher, president of the National Vaccine Information Center, an organization that takes a dim view of vaccinations. The hype, Ms. Fisher said in a Jan. 28 post on her group’s website, “has more to do with covering up vaccine failures and propping up the dissolving myth of vaccine acquired herd immunity than it does about protecting the public health.” Clearly, she remained untroubled that most health professionals regard her views as belonging somewhere in Fantasyland.Continue reading the main story
I didn't think I was going to vaccinate my children. I've always been earthy, crunchy, whatever. Fair trade? Artisanal? Free range? I love it all. I care about what I put into my body, and when I got pregnant, I became acutely aware that my decisions affected someone else. Someone who I had a duty to protect.
I'm a fairly confident person, but I was filled with so much uncertainty when I became pregnant. I was thrust into a world of choices: home birth? Drug-free? Inducement? Caesarian? Eat my placenta? And when I shared my birth plan with other moms, I would often feel shame, like I wasn't willing to go as far as others. Every conversation felt like a million little tests that questioned my motherhood. The consensus seemed to be that anything short of a drug-free home birth in water was child abuse. It was a lot of pressure, but ultimately I felt like having a human pass between my legs was stressful enough. I didn't need the added trouble of something going wrong and screaming, "Why am I squatting on a silk pashmina surrounded by wind chimes; where are all the doctors!?"
The doubt and difficult decisions didn't dissipate after the birth. The responsibility of keeping another human being alive was often overwhelming. Each little choice felt like it had the power to irrevocably shape her entire future. The weight of that often brought out strong, emotional responses to even the most benign decisions. The important decisions felt almost paralyzing. What if I messed up and chose wrong?
At first, I leaned toward keeping our kids vaccine-free. I thought the concern about vaccination made sense. There are countless reasons to distrust the pharmaceutical industry, and I didn't want to put anything artificial or unnecessary in my child's body. Least of all something questionable that protects from diseases that don't even exist anywhere near us these days. Still, I felt a nagging responsibility to hear both sides of the argument (largely because I had my heart set on a "mother of the year" mug).
I decided facts were my friends. I couldn't rely on word-of-mouth, friend-of-a-friend information. It was going to require actual research from vetted sources; I wanted the truth.
It wasn"teasy sifting through all the false and deceptive studies to find them, but now that I have, I feel compelled to share them with any of you who may be struggling with this tough choice.
First, tell me why I need a vaccine.
Vaccines train your immune system. They give it a chance to build up resistance to dangerous diseases, so that if you are ever exposed to the real thing, your body is able to fend it off.
Vaccines DO contain disease particles, which is not only gross -- it's scary. However, the disease particles are dead or severely weakened, which renders them unable to cause the original disease. Even very young children can easily handle them.
The immune system is far more effective when it knows how to identify and fight off what doesn't belong. Vaccines are like a wanted poster hanging in the saloon. They train the bartender to spot the bad guys and kick them out.
Next, must you put chemicals into vaccines?
You may have heard that vaccines contain mercury. This was a major red flag for me. It turns out that 'mercury' is one of those buzzwords that frighten people (myself) without the right information, but shouldn't in this case. It turns out it's just a harmless preservative called thimerosal (which doesn't sound very harmless, I agree), and it is included in very few vaccines still on the market. Thimerosal doesn't contain the dangerous kind of mercury, and it's only got a tiny amount that is easy for the body to process and dispose of. There's less mercury in a vaccine than in a tuna sandwich.
But why are there preservatives in my vaccines at all?
Turns out they have a very good reason for showing up to this party: They're the bouncers. Preservatives prevent harmful bacteria from growing in a vaccine dose. Thimerosal makes it possible for vaccines to be stored in multi-dose vials -- as opposed to single-dose vials. This helps make sure vaccines can stay cost-effective and be provided to as many children as possible.
Still, I'm not into preservatives for my children, and I think a lot of parents feel the same way. I know I was pleased to hear that the United States had decided to remove thimerosal from almost all vaccines (with the exception of some flu vaccines) to reduce our fears as well as our children's exposure. By 2001 very few vaccines in the U.S. contained thimerosal, and now you can ask for thimerosal-free versions of those that still do.
You may also have heard that there is formaldehyde in vaccines... Someone hand me another red flag and watch me wave it! But then I learned that even infants naturally produce formaldehyde. An infant naturally contains and safely processes 50-70 times more than the maximum amount they would receive from a single vaccine dose. I'm not going to be adding it to my smoothies any time soon, but that really put my fear of formaldehyde in perspective.
Are vaccines sufficiently tested before they're administered?
The FDA is not doing a good enough job of protecting our food. Period. But the separate piece of the FDA that handles vaccines is meticulous, and its results are incredibly comprehensive. This branch is called the Center for Biologics Evaluation and Research (CBER), and it conducts extensive evaluation of all vaccines both before they are approved and long after they are in circulation. It can take as long as 10 years or more for a vaccine to be approved for use.
What's the deal with "herd immunity"?
I found the clearest explanation of herd immunity in a comic! Find it here, but essentially, epidemics are prevented when at least 80-90 percent of people are vaccinated. This means that the most important factor in promoting universal health is creating access to vaccination. Even those who are not vaccinated against a disease -- because they are too young, or have a weakened immune system due to chemotherapy, etc. -- are protected, because there are so many individuals with resistance that the disease doesn't spread very far. It takes a village, people. (Not the actual Village People, but like a village of people... anyway. Let's continue.)
Do doctors have a financial incentive to administer vaccines? What about the pharmaceutical industry?
Could doctors be recommending vaccines because they're so profitable? To make themselves more money? If that were true, believe me, I would be flipping cop cars in the streets with super-powered mom rage. But it's quite the contrary. Many pediatricians don"t make money on vaccines at all. In fact, some have to refer patients elsewhere because the costs are too high.
But I don't trust big pharma. Are they marketing vaccines like they're marketing Viagra? Well, if it was more of a moneymaker for them, I'm sure they would. Turns out, the pharmaceutical industry makes peanuts on vaccines -- they're only between 2 and 3 percent of the global market. The bottom line is, drug companies make more money when we all stay sicker. Vaccination actually keeps people from needing more of their products.
Why are vaccines given in clusters? Is this safe?
First of all, overwhelmingresearchshows that giving children multiple vaccinations at once is completely safe. They encounter many more germs every day simply by playing in the dirt than they get in the entire vaccination process.
And every parent I know is strapped for time. Vaccinations need to be quick and convenient, considering most parents have to take a day off work to get them done. Only when vaccination is easy can it create the vital herd immunity that protects all children from deadly diseases, especially newborn babies. Vaccinating in clusters isn"t sacrificing safety for schedule, so multitask away.
(For those parents who still have reservations, most pediatricians will work with you to develop a family plan that is right for you.)
What are the side effects?
Like all medicines, vaccines have some side effects. The common ones are mild -- redness, slight swelling right around the injection site, brief headache or fever. But these are actually GOOD to see -- these symptoms reflect that the body is responding to the treatment, and is learning how to deal with it. This is exactly what we want our bodies to do, so that we can react if we ever encounter the real thing. These common side effects are fire drills. Should the real thing happen, your child's body will know exactly where the nearest exit is.
There are rare cases of more severe side effects. Most often, these are essentially allergic reactions. These are serious, and scary, but occur almost immediately, and can be addressed by your doctor on the spot. This is why all patients receiving vaccinations are asked to be observed for a period of time before leaving the doctor's office. There's a point to making you flip through their back issues of Good Housekeeping magazine. They're keeping an eye on your little one.
Some side effects are so rare that it is impossible to tell if they are actually side effects of vaccines, or just coincidences. Interestingly, autism doesn't fall into that category. Autism occurs frequently enough that it can be studied, and it has been -- extensively. During my search for information I have found that the overwhelming majority of medical scientists agree that there isabsolutely no causal link between autism and vaccination. I know this can be a big one for many, though, so hereare a fewmorearticles to read if you are concerned about autism and vaccines.
Before I started my research, I had no idea what smallpox or polio looked like, and I bet you don't either. Most people aren't aware and therefore aren't afraid of diseases they've never seen -- or sometimes haven't even heard of. We owe that peace of mind to the scientists who pioneered vaccines. Maurice Hilleman, Edward Jenner, Louis Pasteur -- they aren't household names. They're not celebrities, they don't have PR people, and they don't have enviable Twitter followers. But their discoveries have improved our lives more than Steve Jobs' and Mark Zuckerberg's have. It is the safest time ever to have a child, and only one factor has been more life-saving than vaccines -- clean water.
What struck me most during my research was the sincerity of voices on both sides of this debate. Parents are just trying to keep their children safe. It is heartbreaking to me that the FDA and other government agencies have so eroded any trust that even when they are doing a good job it is overlooked or discredited. These agencies need reform so we can once again feel safe to take them at their word. I am confident that if our families can come together to demand transparency and separation between corporate interests and the safety of our children, we will be able to create the kind of trustworthy oversight we need.
As to the benefits of vaccinations, it has been proven; they work. That's enough for me to climb up on a soap box, make some ugly cardboard sign in my garage, and let other mothers know that it's safe, important, and bigger than emotion: It's the truth.
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