As parents, we tend to be dramatically polarized on a number of topics. But one of the hottest these days is the subject of vaccination. So, inspired by the current measles outbreak in Minnesota, here I go into the fray to provide you all with my two cents.
As a parent who has been extremely conscientious of my vaccination decisions (we've gotten Ren most of the AAP-recommended vaccines, but delayed or declined a few), I've often mentally lumped myself in with the anti-vax crowd. This position has gotten me in some trouble with the pro-vax folks, who seem to think that any opposition or hint of opposition to the AAP vaccination schedule indicates superstitious ignorance at best and borderline child neglect at worst. I find that to be simplistic and insulting. For one, I'm not interested in a conversation about dangerous vs. safe. The research I've done indicates that vaccines are about as safe as any medication can be. So that issue is put to bed for me.
No, one of the things I'm most concerned about with regards to vaccines is the long-term consequences. (I'm also concerned about case-by-case necessity, but I'm not going to get into the necessity argument right now, other than to say that I don't care how safe the Hep-B vaccine is, it was not necessary to give my newborn medication to prevent that particular disease). And measles is the perfect disease to illustrate my point about long-term consequences.
With the current epidemic, most of the reports imply or state outright that measles is a very serious disease. They stress that people can die from measles. The truth is it can be a serious disease for some people, particularly the very old or very young, just like the flu or chickenpox/shingles. But, like those other diseases, it is generally not a serious illness in otherwise healthy people. So what we're really concerned about with a measles epidemic is protecting infants and the elderly.
The reports also suggest that vaccination is the answer. Well, actually, what they really suggest is that non-compliance with the AAP vaccination schedule (by wing-nuts like me) is the problem. The thing is, if we were to allow children to get measles naturally instead of vaccinating them, infants and the elderly would arguably be better protected:
"Recovery from natural measles infection confers lifelong immunity and a woman who has recovered from measles as a child passes maternal antibodies to her fetus, which often protects her newborn from measles for the first year of life. Young mothers today, who were vaccinated as children and never had measles do not have natural maternal measles antibodies to pass on to their babies and, so, most American babies born today are vulnerable to measles from the moment of birth." - http://www.nvic.org/Vaccines-and-Diseases/MMR.aspx (emphasis mine)
That is why I am concerned about the measles vaccine, not because of any claims about autism (thoroughly, utterly debunked, by the way). Currently, most older people had measles naturally as children, so they are protected. There will soon come a day, however, when they are not protected because they all got the vaccine as kids instead of the disease and their immune systems may be too compromised for a booster. At that point, those people most likely to suffer complications from the disease will be completely vulnerable should an outbreak occur; today's babies are already completely vulnerable.
By using this vaccine we've put ourselves in a position where:
A) parents no longer recognize the disease
B) doctors no longer know how to treat it
and
C) the most vulnerable people (the very young and very old) don't have a natural immunity.
By vaccinating, we've done a good job of drastically reducing the number of measles cases, but in exchange the disease is that much more dangerous when there is an outbreak. And I'm afraid the same thing is happening with the chickenpox vaccine. I'm not saying there's an easy answer, I'm just trying to demonstrate that there are consequences to any decision.
All that being said, I chose to get Ren the MMR when she started going to day care because, whatever my personal qualms, I felt a duty to our community to protect all its vulnerable members. I'm just not 100% happy with that choice; it'd be nice if Ren could have natural immunity as an adult, and her babies could have protection as infants. It seems like a Catch-22 either way...
I know this is a hot-button issue for many people, and I hope I haven't offended anyone. What do you think?
As a parent who has been extremely conscientious of my vaccination decisions (we've gotten Ren most of the AAP-recommended vaccines, but delayed or declined a few), I've often mentally lumped myself in with the anti-vax crowd. This position has gotten me in some trouble with the pro-vax folks, who seem to think that any opposition or hint of opposition to the AAP vaccination schedule indicates superstitious ignorance at best and borderline child neglect at worst. I find that to be simplistic and insulting. For one, I'm not interested in a conversation about dangerous vs. safe. The research I've done indicates that vaccines are about as safe as any medication can be. So that issue is put to bed for me.
No, one of the things I'm most concerned about with regards to vaccines is the long-term consequences. (I'm also concerned about case-by-case necessity, but I'm not going to get into the necessity argument right now, other than to say that I don't care how safe the Hep-B vaccine is, it was not necessary to give my newborn medication to prevent that particular disease). And measles is the perfect disease to illustrate my point about long-term consequences.
With the current epidemic, most of the reports imply or state outright that measles is a very serious disease. They stress that people can die from measles. The truth is it can be a serious disease for some people, particularly the very old or very young, just like the flu or chickenpox/shingles. But, like those other diseases, it is generally not a serious illness in otherwise healthy people. So what we're really concerned about with a measles epidemic is protecting infants and the elderly.
The reports also suggest that vaccination is the answer. Well, actually, what they really suggest is that non-compliance with the AAP vaccination schedule (by wing-nuts like me) is the problem. The thing is, if we were to allow children to get measles naturally instead of vaccinating them, infants and the elderly would arguably be better protected:
"Recovery from natural measles infection confers lifelong immunity and a woman who has recovered from measles as a child passes maternal antibodies to her fetus, which often protects her newborn from measles for the first year of life. Young mothers today, who were vaccinated as children and never had measles do not have natural maternal measles antibodies to pass on to their babies and, so, most American babies born today are vulnerable to measles from the moment of birth." - http://www.nvic.org/Vaccines-and-Diseases/MMR.aspx (emphasis mine)
That is why I am concerned about the measles vaccine, not because of any claims about autism (thoroughly, utterly debunked, by the way). Currently, most older people had measles naturally as children, so they are protected. There will soon come a day, however, when they are not protected because they all got the vaccine as kids instead of the disease and their immune systems may be too compromised for a booster. At that point, those people most likely to suffer complications from the disease will be completely vulnerable should an outbreak occur; today's babies are already completely vulnerable.
By using this vaccine we've put ourselves in a position where:
A) parents no longer recognize the disease
B) doctors no longer know how to treat it
and
C) the most vulnerable people (the very young and very old) don't have a natural immunity.
By vaccinating, we've done a good job of drastically reducing the number of measles cases, but in exchange the disease is that much more dangerous when there is an outbreak. And I'm afraid the same thing is happening with the chickenpox vaccine. I'm not saying there's an easy answer, I'm just trying to demonstrate that there are consequences to any decision.
All that being said, I chose to get Ren the MMR when she started going to day care because, whatever my personal qualms, I felt a duty to our community to protect all its vulnerable members. I'm just not 100% happy with that choice; it'd be nice if Ren could have natural immunity as an adult, and her babies could have protection as infants. It seems like a Catch-22 either way...
I know this is a hot-button issue for many people, and I hope I haven't offended anyone. What do you think?
The CDC schedule is designed to be conservative for "average" families. There are plenty of good reasons to adjust the schedule for your family (and some bad reasons).
ReplyDeleteHep-B, for example, is important at birth if the mother's Hep-B status is positive or unknown. It is often unknown, so it makes good sense to recommend the vaccine to all neonates. However, if you know that the mother is negative, there's no reason to vaccinate until the age of biting other children.
We delayed the chickenpox until weaning for exactly the reasons you talk about delaying the MMR. I would have far preferred that Lea get mild chickenpox for lifetime immunity while nursing than a vaccine which wears off (and they have revised how often it needs to be administered several times). It was extremely difficult to find someone who would share pox with her, though, and she weaned without exposure.
After weaning, it was simpler (and perhaps smarter, as she was approaching the age where a case is much more likely to be serious) to vaccinate her.
As for the MMR, the other M and the R are more serious, especially for pregnant women. Given that mothers of small children are at risk for being around small children and getting pregnant (again), it makes good sense to work hard for herd immunity in these populations.
You're a smart woman and a conscientious mom and I'm glad to hear your two cents on this tricky issue. We are having to tackle it again as Jasper nears two, and I really appreciate hearing thoughtful input on the matter. What bothers me most about this debate is the extremism on both sides, all the fear mongering and name-calling. We all want our kids to be healthy. We want our immune systems to work. We want our communities to be safe from dread diseases.
ReplyDeleteWestern medicine IS amazing but it ISN'T always right. We can't let others make our decisions for us, especially when we don't really know who those others are... unfortunately you always have to ask "who is making money off of this?"