The Vaccination Decision

The decision to vaccinate a child can be stressful and difficult.  For some parents this is an easy decision and for other it is complex and fear-provoking. Whether you decide yes or no there are some facts a parent needs to know.

Vaccines prepare children to fight off an infection. Vaccines activate white blood cells to make antibodies. These antibodies are disease-specific and fight off an infection. Vaccinating your child allows your child to make antibodies ahead of time and prepares your child to produce more antibodies as soon as an infection or exposure occurs. Vaccines allow your body to have a standing army ready and waiting to fight off an attack by a bacterial or viral invader. If your child is not vaccinated a volunteer army would need to be recruited at the time of an infection. This takes time and your child may become seriously ill waiting for white blood cells to recognize the infection and produce antibodies.

Vaccines are composed of either live attenuated viruses or dead viruses. Bacterial vaccines often are composed of part of the bacteria which allows the body to be tricked into thinking it is under assault. Booster doses are needed for most vaccines and some vaccines cannot be given until your child reaches a certain age. Some strains of viruses like influenza mutate from year to year and that is why a new vaccine is needed every year.

Vaccines are quite safe. Almost all reactions to immunizations are mild and short lived. Common side effects include redness, mild localized pain or swelling, irritability and a low grade fever.  Most of the often heard risks of vaccines are based on misinformation or bad science and are not fact-based. Vaccines do not cause autism, seizures, multiple sclerosis or brain damage. There is about a 1 in one million chance of a serious reaction from a vaccine. The real risks to your child come from not being immunized.

The most common reasons for not immunizing a child include fear of adverse reactions, a lack of awareness that these viral and bacterial infections still are common, and philosophical or religious reasons. If over 90% of children in a community are immunized the risk of a child being exposed to an infection is low enough that the unvaccinated children are at a lower risk for contracting an illness. This type of immunity is called herd immunity and the higher the number of unvaccinated children the lower the herd immunity.

When a doctor or medical professional takes the time to communicate with a parent who questions the need for an immunization a relationship can be fostered and concerns can be discussed and understood. Listening is the first step before the sharing of information and science.  The next step is to discuss the science and how it affects the child who needs the immunization. This allows an immunization schedule to be built without using guilt or fear and supports long term compliance and cooperation.

To Vaccinate or Not To Vaccinate

In recent years more and more parents are choosing not to vaccinate their children. In the years from 2003 to 2009 statistics have shown there has been a 4 fold increase in the decision not to administer vaccines. This is an increase from 2.5% to 10%.  The reasons given as to why parents decide on not receiving vaccines range from direct medical contraindications including a direct allergy to an immunization component such as gelatin that is used in chickenpox and nasal spray influenza vaccine to philosophical and religious reasons. If your child has an identified allergy to the vaccine or a component of the vaccine then that vaccine should be avoided unless a decision is made under the direction of a pediatric allergist. The other common reasons for not receiving vaccines are based primarily on fear and personal preferences and not on scientific evidence.

All vaccines are associated with potential risks but the risk of not receiving childhood vaccines is much higher than the risk of receiving vaccines. The rates of serious childhood illness have been dramatically reduced as have the serious potential life-threatening complications that often accompanied these illnesses. Dramatic decreases in common life-damaging illness such as H flu meningitis also support the use of vaccines. There have been tens of thousands of studies that have reviewed the risk benefit ratios concerning vaccine administration risk and efficacy. These studies strongly support the reasons to choose vaccine administration when you are asked whether you want your child to be vaccinated.

Although all states but West Virginia and Mississippi allow religious exemptions it is important to note that freedom of religion is not an adequate explanation if a life-saving transfusion or surgery is required for your child. In those situations the Equal Protection Clause of the 14th Amendment of the Constitution supports that everyone, including children, is equally protected under the law and this protection is independent of a parent’s belief system, whether it be a personal or religious belief.

Receiving vaccines is a very difficult decision for some parents and an easy decision for others. If you are a parent who is hesitant to pursue vaccination and are anxious or fearful of potential side-effects you must remember you are not alone. Many parents have similar concerns. As your pediatrician our job is to communicate with you and explain all the pros and cons of vaccines. As a parent you are never alone. We want to listen to you and encourage you to explore what is best for your child. We promise to be honest and non-judgmental. We will make our explanations simple and direct and throughout the entire decision making process be empathetic to the difficult decisions you as a parent need to make. We want you to know there is no need to rush this decision. By providing you the information and knowledge in an unhurried fashion and by recognizing your emotions we want to be present with you during these difficult decisions.  Through a therapeutic alliance with you and your child we seek communication and the avoidance of misunderstandings that will allow you to make a decision you will trust for many years to come.