Monday, January 01, 2007

Childhood Immunization

Reasonable, rational people of my acquaintance have made a choice I believe is ill-considered and based on sloppy science at best, but possibly on outright fraud. They are choosing not to give their children any immunizations. None.

I understand those who choose to reject the chickenpox vaccine. Few healthy children ever died from complications of chickenpox and I am very concerned that my immunized youngest son will actually face greater danger as an adult if his immunity from the vaccine wanes. He is immunized, but I worry.

I can understand religious objections to immunizations made with cell lines from aborted fetuses. My church has stated that those cell lines are so far removed from the original abortion that the immunizations are morally acceptable, but I understand those who choose to avoid those immunizations. There are so-called ethical immunizations made without aborted fetal tissue in any part of the development, but these people reject them as well. I do not understand that choice.

I fear that they simply do not understand the risks to which they are subjecting their children. I have seen Hemophilus influenzae meningitis. They are too young to have any memory of that virtually eliminated disease. I have seen an infant with Pertussis (whooping cough). They have not. I survived measles and mumps with minimal damage, but I am well aware of the potentially lethal complications of both.

I was fortunate to have had Rubella at an early enough age that it did not risk damage to my children -- my mother was pregnant with my youngest sister at the time. Fortunately, she suspected the pregnancy and her doctor gave her gamma globulin to ward off the danger. The danger was very real. Mom caught rubella a few years later when my younger siblings did.

I have never seen polio, but I know people who limp and those who lost siblings to that once dread disease. It was easy for me to choose to immunize my children, because I know the risks and the benefits.

Sadly, many people are declining to immunize their children out of fear of Thimerosal -- even though Thimerosal has been eliminated as a preservative in virtually all children's immunizations. It was eliminated even though there is no evidence linking it to autism. Many of the "links" were made by people like this physician who was well-paid by a lawyer's group for his services. He was part of their unsuccessful suit against vaccine manufacturers and the children in his study were parties to the suit. Conflict of interest, anyone?

Dr. Flea is writing a series of posts on childhood immunizations. The links follow. I'll be adding links as he adds posts. Thanks, Shinga, for the suggestion.

Just so you know. I have comment moderation turned on. I won't be publishing any anti-vaccine comments to this post. Feel free to put them on your own blog.

Dr. Flea's Immunization Posts (unfortunately not currently available - I'll re-link if he reposts)

* A Very Great Fright (smallpox)
* On My Left Shoulder (smallpox)
* The Can From Hell (polio)
* Go Home and Die (Haemophilus influenzae type b)
* Strangling Angel (diphtheria)
* Risus Sardonicus (tetanus)
* The Cough of One Hundred Days (pertussis or whooping cough)
* Dew Drops on Rose Petals (chickenpox)
* Yellow Alert (Hepatitis B virus)
* Rota-gate (The facts on RotoTeq and intussusception)
* The Chicken Pox Vaccine Sucks (One he doesn't like)


Stephanie said...

I've found all of Flea's posts just reinforce what I've believed, even as an 'uneducated' lay-person. We have good friends that have chosen not to immunize their two children. We've taken a good deal of heat from them for doing ours. I pointed out that we respect their decision and they need to respect ours but they kept on with the 'aren't you in the least concerned that you're putting your daughter at risk...' ad nauseum. I think the thing that shut them down was when I finally responded that I immunize MY child so that they have the option of not having to immunize their own. Quick retreat that... ;o) I've very much enjoyed everyone's posts along this subject line. Thank you for reinforcing for me what I felt with my mother's intuition...

Judy said...

Thanks for your comment. Yes, they do have the option due to herd immunity. People tend not to challenge me, since I'm a nurse. If they did, I think I'd be inclined to answer honestly that I am concerned, but I've considered the risks and the benefits and feel very strongly that the risks of not immunizing are far greater.

That isn't likely to stop your anti-vaccine friends as they are likely to believe that you simply need to be educated whereas I am not often challenged because I am beyond hope since I'm part of the medical establishment.

Anonymous said...

I do not respect the decision some make to not immunize their children. I recognize that that is their choice to make, but I don't respect the decision. It increases the risks for everyone when some children do not get their immunizations.

I agree 100% with what you're saying.

My daughter developed an immune system disorder. Some people once suggested to me that maybe it was the immunizations. No proof whatsoever, of course. Speculation in ignorance isn't helpful.

But let's say she hadn't been immunized and still developed the disease. Once she became ill she would have been less protected than before, and more susceptible to diseases which now would have a much greater chance of killing her.

But even with the immunizations she got, non-immunized children were now a greater threat to my disease-susceptible daughter.

I take this sort of thing very seriously.

Judy said...

Rather like the people who insisted that chemo and radiation would reduce my chances of surviving cancer several years ago. Or those who insisted that I wouldn't have gotten cancer "if only...." pretty much shut them up when I informed them I was doing all that and got cancer anyway.

It must be hard to be civil to people who disregard well-designed studies to inform you that your child's illness is your fault.

I think the main reason people feel entitled to share their "wisdom" on such subjects is the imaginary thinking principle that if you did something wrong to cause your (or your child's) illness, then they are safe because they've made a different choice.

Life just doesn't work that way. At least not all the time.

NurseWilliam said...

Excellent thread. We've had nurses exposed to pertussis many times in my ER because the parents would not vaccinate their children for other than cultural reasons. Most of the time, these parents are into complementary/alternative medicine and only visited the ER because someone twisted their arms to the breaking point. They are openly resentful and hostile towards us and when we tell them that young Forrest (or Dylan, or whatever) has to be admitted, they get really upset.

Silly, silly people.

Judy said...

I believe that people are trying to make the best choices for their children -- even those people with whom I violently disagree. I have found that approaching people with this attitude is helpful in negotiating care for their kids. One talking point I have found consistently useful is to ask people the DATE of the information they are using to make their decisions.

I had a baby in the NICU whose parents were using mid-1990's information to make a decision about human milk fortifier. When I listened to their concerns and shared more recent data with them, they were able to make a better decision. Most of my co-workers thought we should insist on using it over their objections. No need going that route if negotiation will get you to a more satisfactory resolution. Sometimes it's even faster.

For myself, I worry more about Pertussis than the other preventable diseases. Since I haven't had a Pertussis immunization in many years, my immunity has waned. Probably to nothing. I have asthma -- and a life-threatening allergy to the drug of choice for Pertussis. Fortunately I don't work in the ER ever and only occasionally on the pediatrics floor. I have the right to refuse patients with pertussis or even RSV if there are other patients available for me to take on the peds floor, since I could be recalled to the NICU if we get slammed there. Gotta know the kid has pertussis, though. At least there is an adult vaccine now, which I intend to get as soon as my employer can get in a supply.

Shinga said...

That must be very trying for you, Judy. I think that is interesting that people picked up medical information that is perhaps years or even decades out of date but nothing prompts them to review it. I was thinking of this during the week when there was a survey that reported that more than 50% of smokers believe that smoking-related cancer is a matter of fate, rather than something that one can influence (by say, not smoking).

Regards - Shinga

Judy said...

I don't mind educating families and helping them develop better research skills. I believe that they will take what they learn back to their circles and share it with people I will never meet.

I hate having to battle with co-workers who want to use an authoritarian style of patient care. I know what does and does not get me to change my behavior. Authoritarian styles don't work well for me and likely not for many other people.

As for pertussis, I need to find out more about the incident, but several staff members on our pediatric unit were exposed last week before the patient was diagnosed. The child was of an age that s/he should have been at least partially immunized and I don't know whether or not s/he was. One of the nurses also works in the NICU and won't be until she is cleared by employee health. I hope this inspires them to seek alternative sources for the adult pertussis vaccine they've promised us.

Nathan said...

I've had the odd (for this day and age) fortune to see a pertussis outbreak as a medical student. And I think it is borderline criminal not to immunize children, despite never having seen any of the really bad diseases like smallpox or even H. influenza.

Thanks for your comment on my blog, by the way.

Anonymous said...

I know that everyone has the right to choose. But they also have the right to being informed before they make the choice. Choosing not to immunize their children (where they - the parents - immunized as children? And what bad things came as a result of that?) puts so many other people at risk - family, friends, the community in general. Look at the outbreaks of anything that can to attributed to a child/children who were not immunized. I think this decision takes more informed thinking than to choose what type of diaper to buy - and yet, as many state, the information they choose to inform themselves with (the downside of the internet) is often so out of date as to be worthless...