Ask Before They Play To Keep Chickenpox, Pertussis and Measles Away
Jul 15, 2014

Part One: Why Ask at All?


By Dr. Lara Zibners

 “Oh, you know, we never had baby gates, because, you know, of the controversy.”

This was the response I got from a mom at a playgroup after some random conversation about safety. Our house had a flight of stairs just off the living room that was 16 wooden steps ending directly onto a slab of stone. So we had baby gates at either end. The story was likely the one about me installing these gates and then calling the company to find out how to open them. They were that good. Anyway, it made perfect sense to me that small children + long staircase + stone floor = potential significant injury. Until that exact moment, I was unaware there was a “controversy.”

Yet, apparently this other mother had read something about boundaries and teaching children to respect the staircase from behind imaginary walls. Which would then in turn help them develop self-control. Whatever. To my mind, having your frontal lobe all bruised up after a flight down a staircase would also create long-lasting issues, so I went for the option with an immediate safety return.

If you look between the lines of this exchange, you can see that it’s not so different from finding out that this mother was a vaccine-refusing parent. Her philosophy about parenting was so incredibly different that mine, and her ideas seemed so far out there, that I had no answer for her. Just a smile and a nod. (And a snarky comment about traumatic brain injury—I couldn’t help myself.)

Is that really so different from mentioning your child’s flu shot appointment and being met with a response that implies (or flat out says) that the flu is not dangerous and actually good for building their natural immunity? Those of you who are convinced that immunization is the most effective way of protecting your children from a variety of preventable and life-threatening illnesses have already made peace with this decision. If, on the other hand, you’ve chosen to vaccinate but still have questions than I suggest you continue to hang around sites like this. The more you learn about the scientific evidence that supports immunizations, the more certain you will be in your decision.

FosterKidImageBut what do you do when you find out about parents who have made other decisions?  What do you do when you discover your child’s best friend is unvaccinated? Should you care? After all, is it any of your business?

To answer the last point first, of course you should care. When rates of vaccination drop, rates of vaccine-preventable illnesses go up. That is fact. It might be tempting to think that this is simply the cost to individuals who choose not to vaccinate: the very real risk of a life-threatening illness. But it’s not that simple. Firstly, those at risk of contracting an illness such as measles, mumps or whooping cough are both the unvaccinated and the vaccinated. No vaccine is 100% effective in preventing illness. Most vaccines therefore rely on herd immunity. That’s a whole post in and of itself, but trust me, the more people who are vaccinated, the fewer cases of illness; the infection just can’t spread as easily.

Now you may be thinking, if vaccines don’t give 100% protection, why bother? But the reality is that vaccinating can prevent many of the complications, even sometimes make an illness no longer contagious, so it’s not a game of all or nothing. For example, wild-type chickenpox is pretty darn catching. As in a non-immune person has an 80-90% chance of becoming infected after exposure. A little kid who has had the varicella vaccine can still get chickenpox. But the risk is decreased by 98% after the second dose.  And yes, it’s true that a child can actually catch chickenpox after the shot. But only about 1% do and then it’s a mild case that is virtually free of complication and is rarely contagious. And by rarely contagious, I mean there are 5 reported cases of chickenpox transmitted from a recently vaccinated person to a non-vaccinated person over 55 million doses. So, technically, vaccine-related chickenpox is contagious. But my real hair color is technically mouse brown and good luck finding a single strand of it on my head, you know what I’m saying? So back to the point. Even if vaccines aren’t 100% effective, they are still mighty protective.

Secondly, what about children who are unvaccinated because they are either too young or have a medical contraindication? You may be putting them at risk as well. For instance, babies under 6 months who haven’t had 3 primary doses are at significant risk for an overwhelming pneumococcal infection. The first series of shots (giving minimal protection) to pertussis aren’t allowed before 6 to 8 weeks. And measles and chickenpox vaccination doesn’t begin until one year. What about a child who has cancer? This kid is at risk from the most benign of infectious diseases. Not to mention the fact that cancer treatment can erase all the protection a child may have had from prior immunizations. Some kids either have no protection or are medically not eligible for certain vaccines. That is fact. Which means these kids rely heavily on the rest of us to stay safe. Babies and sick kids. Our most vulnerable populations at risk from those who have willingly not vaccinated.

But beyond that, we may want to consider the parenting philosophy behind that decision to not vaccinate.

Photo by Greg Westfall

Photo credit: Greg Westfall

Is this an issue that is so big, so important, that I’m not going to allow my children to play in that home? Many of you are familiar with the push to ask about loaded weapons in the home before allowing your child to play there. Is the refusal to vaccinate the equivalent to a loaded shotgun sitting on the kitchen table? Does this family have an approach to child-rearing that is so diametrically opposed to your own that you want to limit your child’s exposure or have difficulty trusting the other parents to support your parenting decisions and rules?

And while there are lots of other reasons why immunization programs are essential for both individual and societal reasons, as my last point I want to emphasize that we have a duty to try and protect families who are willingly unvaccinated. I would never consider illness something to be deserved. That means I don’t say “I told you so” when I meet a parent whose unvaccinated child has whooping cough, and I certainly don’t walk away from a child who needs my help. Vaccination is a social obligation, one that stretches beyond our own children and becomes a moral responsibility. It is our duty to stand up for our beliefs and extend a hand to those families who are uncertain about vaccination.  In doing so we may help others make positive decisions that can ensure the safety of as many others as possible.

While there are societal considerations, if you allow unvaccinated children to play with your own you’re increasing the risk of your fully vaccinated child catching one of these diseases you’ve worked so hard to protect her from. So, yes, you should care.

Great. That’s settled. So now what do you actually say?

Check back later this week for the second part of this blog series when I will explore some specific suggestions on how you can open the conversational door on immunization. In the meantime, feel free to comment below on why you feel it’s important to know the immunization status of your child’s playmates. 

Dr. Lara Zibners is board certified in both general pediatrics and pediatric emergency medicine.  As the author of the award-winning book “If Your Kid Eats This Book, Everything Will Still Be Okay,” and a hilarious blog, Dr. Zibners has been an avid and very public supporter of vaccination.

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39 responses to “Ask Before They Play To Keep Chickenpox, Pertussis and Measles Away”

  1. Austin says:

    Dr Lara Zibners,

    Should we go into all of the stupid things that my vaccine loving friends do? Because they do stupid things, it means that vaccinating is stupid too – right? I can easily lump those individual decisions and for that matter all people who vaccinate together in one big generalization huh? I love the way you make those who choose not to vaccinate out as nut jobs.

  2. Lawrence says:

    @Austin – well, given the track record of the typical anti-vaxer, I’d say “nutjob” isn’t too far from the truth in the majority of cases… minimum, they do put other people and children at risk & should be avoided if at all possible.

  3. Chris says:

    Austin, my son had a medical reason for getting just the DT vaccine, and not the DPT. This was at a time when our county had a pertussis outbreak (thanks Lea Thompson and Barbara Loe Fisher!).

    So I always asked if a child he came into contact was vaccinated. I had only one person who “No”, also she was so self-righteous and nasty about it that I decided it was for the best. I really did not need my child around hers, and it was not just because she did not vaccinate.

  4. reissd says:

    I’d say, Austin, that if your vaccine loving friends refuse to put your child in a car seat, you should not let them drive. When their choices put your child at risk, it becomes very, very relevant.

    Same here.

    Furthermore: the article argues for helping families learn the right facts about vaccination. Because children deserve to be protected from preventable diseases, and letting the parents cling to misinformation is problematic.

  5. I cannot wait to hear what advice you have for broaching the subject. I have recently been asked this very question and have wondered myself ( I have two unvaccinated nephews that have never met my kids). I wonder which is the more “offensive” question: Do you have guns in the home” or “Are your kids unvaccinated?” I’d be willing to guess the latter.

  6. everychildbytwo says:

    thanks Dr. Zibner! I can’t wait to hear how to broach the subject either. As a vaccine advocate for the past 18 years, I still have trouble knowing how to broach and how to reply. I try science, I try personal anecdote (my son was hospitalized for flu before vax for young children was approved)…it’s always awkward and somewhat confrontational.
    Amy Pisani, Every Child By Two

  7. […] You all know what a big fan of vaccines I am. So much so that I pestered those kind folk over at Shot of Prevention and they have given me a 3-part series on asking about immunization before allowing your child to […]

  8. Jen says:

    What is your opinion Of HPV?

  9. Chris says:

    Jen, not typically an issue with children who cannot organize their own play dates. Though perhaps an equivalent would be requiring a screen of every young man your daughter dates.

    Though if it had been around forty years ago, I am sure my stepmother would have added HPV status to the twenty question drill she did for every single male friend I ever mentioned. Needless to say, I rarely mentioned conversations I had at the science club, the Explorer’s Post (a high school co-ed activity run the Boy Scouts of America), high school hallways and elsewhere.

  10. Amy Smith says:

    Thank you. I have been asking these very questions about exposing my kids to anti-vaxxers and their children. I homeschool and want to find homeschooling families that vaccinate.

  11. […] the first part of this series, Ask Before They Play to Keep Chickenpox, Pertussis and Measles Away, Dr. Zibners explores why a parent might be concerned if their vaccinated child […]

  12. So what does one do if the vulnerable person is not a child but an older adult with a major immune compromise? My husband has ALS – aka Lou Gehrig’s Disease (we are in Canada). He is already up against a very hard and high wall. We have a three-year-old grandson. He’s fully vaccinated but ultimately, we will encounter his friends whose vaccination status is unknown. Last week, said grandson gave us all a scare as he appeared to have chicken pox (husband has never had varicella, nor been immunized as a child in England). Luckily for our grandson and also for us, it turned out to be an allergic reaction to a plant or insect bite. But it felt like a close call at the time. Imagine trying to survive ALS and also chicken pox!

    Risk management is hard at any age. It goes beyond children into the adult world and nobody should be placed in danger because someone chooses not to protect his or her child (and the rest of us as well).

    Thanks you so much for this post. I wish it weren’t necessary – but it is.

  13. Elisabeth says:

    ” …if you allow unvaccinated children to play with your own you’re increasing the risk of your fully vaccinated child catching one of these diseases you’ve worked so hard to protect her from.”

    Worked so hard? You drove her to the doctor’s office, waited for your turn, and let the nurse vaccinate her, then paid the bill or let the insurance pay for it.

    How DO you work hard to protect your child from common childhood illnesses? You:
    – feed them immune-building foods that cultures have been eating for this purpose for centuries: fermented cod liver oil, raw milk, grassfed meat, pastured eggs, lard from pastured pigs, fresh vegetables and fruit, bone broth, fermented foods, properly prepared grains, natural sugars, organ meats, wild seafood, and coconut oil (google WestonA Price if you’re curious).
    – let them play in the dirt
    – let them go out in the sun WITHOUT sunscreen
    – keep chemicals, dyes, preservatives, additives, and all other toxic substances out of their diet to the best of your ability
    – keep white sugar out of their diet
    – encourage a lot of exercise
    – trust in the amazing handiwork of God that He has created our bodies to resist illness if properly nourished and cared for

    The results are not immediate – vaccination satisfies the “want it NOW” mentality – but will build a child’s health for life as opposed to putting it in a downward spiral in exchange for parent’s peace of mind and shirking of the responsibility to properly nourish his or her child.

  14. Chris says:

    Elisabeth: “You:…”

    Citations needed for all of it. Provide the Pubmed indexed studies by reputable qualified researchers that feeding your prescribed diet will prevent measles. I did not say “allow to recover”, I said “prevent.” As in not even getting a fever nor a rash.

    Roald Dahl lived on a little farm where they grew most of their food. Sometimes it is open to visitors, and then you can see the little garden he planted in memory of his daughter Olivia. Do you know why?

  15. […] the first part of this series, Ask Before They Play to Keep Chickenpox, Pertussis and Measles Away, Dr. Zibners explores why a parent might be concerned if their vaccinated child […]

  16. […] of the unvaccinated. From Dr. Lara Zibners, (sister and cheerleader to attorney Amanda Naprawa):… Quote: Those of you who are convinced that immunization is the most effective way of protecting […]

  17. Lindsay Allen says:

    Elizabeth’s recommendations are good ones. There is no method which will guarantee a positive outcome for every individual, and people just have to research it and decide on their own what they think the safer route is. And not many people are going to do something they think stands a good chance of hurting their own child in order to possibly benefit other people’s chldren.

  18. Chris says:

    Then Ms. Allen, you will be quite willing to provide the missing citations. Otherwise we will just believe you both just made up out of thin air.

  19. Lindsay says:

    You’re saying that you think there’s a study out there somewhere which definitively provides a solution that will help all and harm no one? If there are any parents out there willing to do something they believe will hurt their child because it may protect other children, fine. I’m not one of them. Are you? We have to have a study proving any such parents exist? And if we did, then what? I would still not join them.

  20. novalox says:


    No, you are just putting words in Chris’ mouth, as well as falling for the Nirvana fallacy.

    First of all, are you willing to show citations that supports elizabeth’s assertions, since you support them?

    Second, since you think that everything has to be 100% safe in order for you to use, it, we can apply reducio absurdio to your argument. That means you won’t eat any food since there is a small chance that you will choke and die, that you won’t drink any water since there is a chance that you will drown, that you don’t drive any sort of vehicle since there is a chance you will be in an accident and die, and that you shouldn’t be using a computer and typing here since there is a small chance that you will be electrocuted by your computer.

  21. Chris says:

    Ms.Allen, I am asking for a citation to prove Elizabeth’s suggestions will prevent measles.

    She made lots of suggestions, I just want to know if they are better than providing a child two MMR vaccine dpses. So if you agree with her, you would be able to provide the scientific proof in the form of PubMed indexed studies by reputable qualified researchers that complying with Elizabeth’s list would prevent a measles infection.

    So just provide the studies that show Elizabeth’s suggestions work. How hard is that?

    Well, it could be difficult if they did not exist. So prove us wrong. Explain how an airborne virus can be stopped in its track by providing the proper diet and exercise for a child, with verifiable evidence in the form of PubMed indexed studies by reputable qualified researcher working in an industrialized country.

  22. Chris says:

    Lindsey: “If there are any parents out there willing to do something they believe will hurt their child because it may protect other children, fine. I’m not one of them.”

    Please provide the PubMed indexed studies by reputable qualified researchers that the MMR vaccine causes more harm than measles.

    Also if you believe Wakefield showed autism was caused by the MMR vaccine with his fraudulent twelve child case study, then you must show that autism increased in the USA after their 1971 introduction of the MMR vaccine, which was the preferred version for the 1978 Measles Elimination Program. Just provide verifiable documentation dated before 1990 that autism increased in the USA during the 1970s and 1980s that correlates with the use of the MMR vaccine containing the Jeryl Lynn mumps component.

  23. Lindsay says:

    I don’t care if Elizabeth’s suggestions will prevent measles: her suggestions would improve the child’s health so that he or she could cope successfully with measles on his own. it is not a disease that should be prevented for the vast majority of children. I understand that Elizabeth’s recommendations woud not prevent measles, but I don’t care if they would or not. It is very very rarely a dangerous disease. Sometimes it can be, but not often. I do not ask for 100% effectiveness before choosing to do something: I consider and balance many things before I make my choice. I know the MMR is dangerous, knowing several people who were severely damaged by it. I do not believe that Dr. Wakefield’s study was fraudulent, but do believe that there are powerful interests who want people to believe it was fraudulent. My belief, my research, my choice.

  24. Gray Falcon says:

    Lindsay, if someone’s belief and research led to them believing that someone else put a curse on their children, would that make their choice to have the “witch” burned at the stake acceptable? Your choice affects the lives of innocent people. We have every right to disagree with you.

  25. Gray Falcon says:

    To put it to you another way, Lindsay: You beliefs mean nothing here. No amount of belief can make two and two add to five. Only the facts are important, and the fact is that the MMR vaccine has caused far less damage than measles ever has.

    By the way, do you know what Roald Dahl’s daughter died of? And at what age? Think about that.

  26. Chris says:

    Lindsay, Elizabeth made a claim. She needs to support her claim with evidence. You came to support her, so you must now support those claims.

    Also, since you seem to prefer letting children get sick and suffer from measles because “only” four hundred died from it before there were vaccines, you need to provide the PubMed indexed studies by reputable qualified researchers that the MMR causes more harm than measles.

    And since you are supporting Wakefield, you should come up with some undeniable evidence that would show he had actual reason for his “hypothesis” connecting the MMR vaccine to autism. The MMR vaccine was introduced in the USA in 1971, and was the preferred vaccine for the 1978 Measles Elimination Program. It was used much longer in and in a country much larger than the UK. If MMR did cause autism it would have been noticed in the USA during the 1970s and 1980s.

    Please provide the verifiable documentation dated before 1990 showing that autism increased in the USA coincidental to the MMR being used. This way you’d show that Wakefield had something other than the wad of cash from a lawyer as a reason to do his “research.”

  27. Lindsay says:

    Gray Falcon,
    Since vaccines can damage and even kill some who get them, it is not just a question of maybe protecting other people’s children, but whether you are willing to take the chance of damaging or killing your own child. You think the vaccines don’t damage or kill very often, but many others think that they do so much more often than you think. If I am just not willing to take the chance of vaccine damage, I have the right to refuse vaccines for myself or my children.
    I don’t have to think the way you do, or accept as accurate your Pubmed references. You do as you like, and let others do as we like. As far as Roald Dahl’s daughter who died of measles encephalitis fifty or sixty years ago, yes, some people die from the vaccine-preventable diseases. But even so, I still have a right to accept or refuse vaccines as I see fit.

  28. Chris says:

    “Since vaccines can damage and even kill some who get them, it is not just a question of maybe protecting other people’s children, but whether you are willing to take the chance of damaging or killing your own child.”

    Prove it. Of course you do not have to think like anyone else, but you need to support your statements. You are making a claim, therefore you need to provide verifiable evidence for that claim. The evidence must come from reliable and qualified sources. Until you do that, we will assume you are just making it up out of thin air.

    By the way, be sure to thank your responsible neighbors who vaccinate. They are protecting your children by helping to maintain your community’s immunity to measles.

  29. Scooter says:

    Lindsay, I agree with you 100%. These guys don’t understand because they don’t have a child that was injured by a vaccine. Once that happens it changes your view on vaccines for ever. Believe me, vaccines are way more dangerous then these guys would have you believe.

    • amandanaprawa says:

      Scooter, I am sorry you have had a bad experience with vaccines. Were you compensated under the NVICP? I ask because there are very few compensable injuries in relation to the number of vaccine doses. Many alleged injuries are anecdotal or parent-reported and not recognized on the Vaccine Injury Table. This is important to note because there is a difference between an evidence-based, medically recognized injury and an injury that is coincidental or correlated but not caused by vaccines.

  30. Chris says:

    Scooter: “These guys don’t understand because they don’t have a child that was injured by a vaccine.”

    My son was injured by an actual disease a few years before its vaccine was available. So what happens more often: injury from the vaccine or the actual disease? To support your answer please provide the PubMed indexed studies by reputable qualified researchers that a vaccine on the present American pediatric schedule causes more harm than the disease.

  31. Lindsay says:

    Are you saying that all vaccines are 100% safe and never damage anyone who gets them? If so, can you please provide the Pubmed study which proves that all those who think their children were permanently damaged or even killed by a vaccine reaction were mistaken?

  32. novalox says:


    You still putting words in Chris’ mouth? Please point to the post where she said so. Also, since you are a fan of the Nirvana fallacy, I assume that you don’t eat, drink, or drive since they post a greater risk of injury than a vaccine. Also, you shouldn’t be using any electrical devices at all, since they post a risk of electrocution.

    Also, since you keep on posting your assertions without any evidence, contrary to what the actual science states, we can assume that you are lying to us.

  33. Chris says:

    “Are you saying that all vaccines are 100% safe and never damage anyone who gets them?”

    No. Please post where I said that, with a direct quote.

    You will note than I am asking for your evidence that the MMR causes more damage than measles. That is a query into relative risk. Since measles causes encephalitis out of about a thousand cases, and recent outbreaks (like in Wales) have required about one in ten to get hospital care, I want to know if the MMR causes similar damage.

    You and Scooter are making claims like “Since vaccines can damage and even kill some who get them,” and ” vaccines are way more dangerous then these guys would have you believe”, you need to support those claims. So provide the studies that show the MMR is as great a danger as you claim.

    And as for claims, let me point you do this table of claims to NVICP since 2006. About 1300 claims have been compensated out of almost two illion vaccine doses. How big a percentage was that? So explain why you would rather take a more than a one in thousand chance of encephalitis (with about a one in five for pneumonia) over a one a million chance?

    Note more than half were not compensated, and of the 1300 that were, over a thousand were under the “settlement” column, which means: “A settlement therefore cannot be characterized as a decision by HHS or by the Court that the vaccine caused an injury.” So, really, for the third or fifth time, come up with the actual verifiable data that vaccines are as dangerous as you and your friends/socks claim.

    And remember, if your children have not had measles it is because they are being protected by the responsible families who know about the real risks who vaccinated their children. You really need to thank them.

  34. Chris says:

    Argh, bad html: two billion vaccine doses.

    Anyway, just tell what this equals: 1300 / 1,968,399,297

    Is it big or is it small?

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  36. […] Ask Before They Play To Keep Chickenpox, Pertussis and Measles Away […]

  37. […] Ask Before They Play To Keep Chickenpox, Pertussis and Measles Away […]

  38. […] Ask Before They Play To Keep Chickenpox, Pertussis and Measles Away […]

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