The “vaccine discussion” is always challenging. Here's how I respond to the common vaccine-related concerns that I hear from my patients' parents.
In a previous blog of June 2013, I discussed our practice policy of 100 percent vaccination. My worst fear has become true with the current measles outbreak due to parental reluctance and refusal to get recommended vaccination.
It seems that the social attitude is changing based on many recent news articles and Facebook posts attacking the “non-vaxers” as irresponsible and even dangerous to the general public. Until the ridiculous fears about vaccines recede into historical anecdote, I would like to share how I handle parents reluctant to proceed with vaccination.
First, we let parents know up front that our practice expects full vaccination according to CDC and AAP recommendations. The front desk informs new patients that we need vaccination records sent to us before becoming patients of the practice and that if they don’t vaccinate, they should consider not selecting us as their primary physicians.
Even with that, we still get a few patients that have incomplete vaccines and of course some newborns with hesitant and questioning parents once the routine vaccinations start at two months old.
Rather than take a defensive posture and attitude, I find it more effective to start the conversation by asking what about vaccines is frightening the parents. That way I can counter any misgivings and misinformation they may have. This does require knowledge of the diseases in question including all risks and morbidities these infectious illnesses possess. I also must know the same profile about the vaccines, including ingredients and potential side effects.
The argument that these diseases don’t exist anymore or have gone away is answered by recent headlines about cases of measles and mumps. Also very young children do not have the ability to fight off certain bacterial infections. Modern technology has created a way to induce immunity for these deadly infections. In my lifetime I have seen two very dangerous causes of meningitis completely wiped out because of the Haemophilus and Pneumococcal vaccine. But they can occur in unvaccinated infants because adults can carry these dangerous bacteria without becoming sick.
Some parents have concerns about the safety of the vaccines themselves. I counter with a short history of recent vaccines being pulled from the market. We no longer give the more effective oral polio vaccine which is live and instead only use the killed injectable polio vaccine. In the United States, the risk of the live vaccine outweighs the possibility of coming in contact with wild type polio, which prompted this change in the late 1990s. There are several other examples of vaccines that have been removed from the market by the CDC and FDA. I feel very confident that no harmful vaccine is allowed to remain in production or use.
The only vaccination that has completely eradicated a serious infectious disease is smallpox. Unfortunately, this virus is still maintained in government labs in the U.S. and Russia. Hopefully it will stay secure but due to potential terrorist threats, the U.S. has enough smallpox vaccination for every person in this country. So why are we not simply vaccinating everyone? Because this vaccine has a high rate of potentially lethal side effects. The risk of the vaccine is higher than the possibility of encountering real infection; until the threat is real, it is better to not have mass vaccination.
Parents also need counseling about the claim that too many vaccines overwhelm a child’s immune system. This is not based on medical science. A newborn infant does have his immune system collapse when exposed to multiple antigens (protein molecules) such as being sneezed on by older sister! Babies have very capable abilities to form immunity to the antigens contained in vaccines. Again, this rumor is promoted by the fear mongers that clearly do not understand the way immunity works.
Lastly, parents will be concerned that there are so many more vaccines now than when they were kids. What they don’t know is that the amount of foreign protein antigens in the old vaccines was far more than in the multiple vaccines children receive today. Modern vaccines are much cleaner and “smarter” than previous versions. So in reality, children today are given far fewer protein antigens through vaccines than their parents.
The “vaccine discussion” is always challenging. However, most of the time when I explain vaccination and immunity as I understand it to hesitant parents, they agree to my recommendations. Perhaps with this looming measles epidemic, the “anti-vaxers” will be more willing to listen to my pleas about getting immunized.