Choosing Vaccination For Your Child Is An Informed Decision
Jan 27, 2012

When it comes to issues regarding disease prevention, our choices impact our children now and throughout their adult life.  Whether we choose to vaccinate our children or not, or delay certain vaccines or not, we are making decisions that have consequences.
A child who falls ill with a vaccine preventable disease may end up just fine.  However, others will have to endure permanent health problems.  And still others will suffer and die, like the many whose stories appear on sites like Vaccinate Your Baby and Shot by Shot.
Earlier this week a comment on the Vaccinate Your Baby Facebook page that made me think about the challenges parents face.  A concerned mother, seeking guidance states:

“I have a 28 month old son and have been delaying and selectively vaccinating. I am looking for a neutral page where I can find information to help me make decisions about what vaccines to get. This page appears to be a page that will deliver only one side of the story. Where can I go to get information both positive and negative about vaccinating? I am faced with some decisions very soon and wish to make an informed decision. I have read some information about vaccines, but not enough to be comfortable just yet.”

I have heard these sentiments echoed time and time again.  When faced with uncertainty, parents often delay or selectively vaccinate until they can feel more comfortable with the idea.  While I understand this rationale on an emotional level, I believe that parents must begin by understanding the importance of research, science and statistics in order to make an informed decision.  In other words, it’s not that parents should look for a “neutral page”, as this mother suggests, but more importantly, an accurate one that uses scientific evidence to support their recommendations.
First, we must have confidence in our resources. 
I believe one of the best things a parent can do is to learn how to properly evaluate medical information on the internet and identify credible resources.  There are plenty of documents, such as this, to help parents discern facts from the myths.
In regards to vaccination concerns from a parental point of view, I suggest reading Dr. Rachel Dunlop’s piece entitled 9 Vaccination Myths Busted. With Science and Alice Callahan’s recent article in MamaMia, On Parenting, Science and Trust – and Choosing To Vaccinate.  While blog posts such as these can often present a great deal of personal perspective, both these authors do a fantastic job of linking to the scientific evidence so that readers can see the research that supports their beliefs.
While Vaccinate Your Baby and other public health sources appear to only present “one side of the story”, it’s important to recognize that they present information that represents the side of expert evaluation – not speculation, misinformation, conspiracy theories or anecdotes.
Second, parents should consider that what they are trying to do has already been done by the experts.
What we parents are hoping to understand is what immunologists (the people who study the way in which the immune system works in the body) and epidemiologists (the people who study the cause and transmission of disease) have studied for decades.  The good news is that there are countless experts all over the world that have done the research and agree on the importance of vaccination.
Parents should be reassured that the specific safety profiles for each vaccine are shared with the general public through the Vaccine Information Statements.  If there were something to hide there certainly wouldn’t be laws to ensure parents receive these statements.  They provide critical information regarding the risk of adverse effects – the risks that have been determined in scientific studies.  Parents who weigh these risks against the risks of complications, hospitalizations and deaths related to these diseases can easily determine what the experts have;  that the benefits of vaccination far outweigh the risks.  Certainly, if this weren’t true, the vaccine would never be added to the recommended schedule.
Third, parents need to understand the methods of monitoring vaccine safety.
Like other pharmaceutical products, vaccines undergo extensive safety and efficacy evaluations in the lab, in animals and in sequentially phased human clinical trials all prior to licensure. However, because vaccines are administered to healthy individuals, their safety standards are more stringent and they undergo more testing than the average pharmaceutical product.  They undergo lot testing for purity and potency and only obtain FDA licensure after the vaccine has met rigorous standards of efficacy and safety.
Once the vaccine is licensed, extensive monitoring continues through the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink, which ensures that safety continues to be of primary importance even after a vaccine is recommended for public use. Parents should feel confident in knowing that these kinds of reporting systems have helped to identify problems in the past, and will continue to do so in the future.  Yet they also need to understand that while the reporting systems and data collection are critical to the process, these reports undergo diligent medical review before it can be determined whether the adverse event was coincidental or causally related to a specific vaccination.
Small risks of adverse reactions shouldn’t give us reason to turn away from the value of vaccines.  Most reactions are minor, like pain and swelling at the injection site that can sometime occur with inactivated vaccines.  Others may be systemic and cause more generalized events such as fever, muscle pain and headache following live attenuated vaccines that must replicate in order to produce immunity. And yes, while there may be a small possibility of allergic reactions to vaccines these are extremely rare.  According to the course book for Epidemiology and Prevention of Vaccine-Preventable Diseases, known as The Pink Book, they only occur at a rate of less than one in half a billion doses.
These are just some of the statistics that experts use to evaluate the risks versus the benefits of vaccines.  They conclude that it’s better to accept a small risk of an adverse reaction than to leave your child exposed to a disease that presents a much greater risk of complications, hospitalizations or death.
Nothing is 100% certain.
I understand that parents want to be educated about vaccines enough to be comfortable with their decisions.  After all, they’re ultimately responsible for their child and only want what’s best.  However, parents must accept that nothing is 100% certain, 100% of the time.
A child can be vaccinated and still get the disease the vaccine was designed to prevent (because, for example, science has proven that there are cases when certain people don’t elicit an appropriate immune response to every vaccine).  On the flip side, a child can remain unvaccinated and yet be lucky enough to avoid vaccine preventable diseases because they either haven’t been exposed to that disease (as a benefit of herd immunity), or their body has effectively fought off the infection. However, that doesn’t mean that a healthy child will always be able to fight off infection.  Nor does it mean that a vaccinated child is never provided protection.  The way I see it, vaccination is like an insurance policy; helping to provide assistance and protection when the unanticipated, unforeseeable happens and our children are exposed to dangerous diseases.
If we abandon vaccination out of fear or complacency, it’s possible that we will begin to witness more widespread disease.  Scientists are continually working to improve our immunization practices and reduce the impact of disease across the globe.  What good evidence do we have to abandon that?
It’s my hope that parents trust and respect the extensive science that supports vaccines as a safe and effective way to protect our children from preventable disease and therefore feel confident in their decision to vaccinate.
For more information on vaccine safety, I recommend parents explore resources like the Children’s Hospital of Philadelphia’s Vaccine Education Center, and view their wonderful video series that helps to separate facts from fear.  There are also a host of other responses to frequently asked questions on the Vaccinate Your Baby website as well.

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