As Summer Estall approached her first birthday, her mom, Lisa, had more on her mind than party plans. Summer was about to receive not only cake and presents, but also -- surprise! -- her fourth round of shots in ten months. "Her last vaccinations had been tough," says Estall, of Grand Forks, North Dakota. "She was her usual happy self after being examined by the doctor, but then we were called into a room where two nurses were both holding long needles. They told me to lay Summer on the table, pull her pants down, and pin down her arms. Of course, she started to scream, and it felt like I was preparing her for torture. By the time the nurses got the Band-Aids on, Summer seemed to be okay -- but I was a wreck."
However, it wasn't just the painful pricks that worried Estall about her daughter's 12-month shots. "Everywhere I go, someone's talking about the danger of vaccines," she says. "There are moms posting about their kids' side effects on just about every online parenting forum. The other day I had coffee with two friends, and one of them said she wasn't vaccinating her kids. I can't help but wonder: Should I really be injecting a healthy child with these things?"
The answer from the vast majority of medical experts is a resounding "yes." The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) recommend that healthy children get vaccinated against 14 diseases by age 2 (with boosters later for some), along with an annual inoculation against the flu. In fact, the government supports vaccines so strongly that any uninsured child can walk into a clinic and get his or her shots for free. "Immunizations are simply one of the greatest public-health achievements," says Mary Glodé, M.D., professor of pediatrics at the University of Colorado in Denver.
And yet, despite doctors' reassurances and mounting evidence that underscores the safety and value of vaccination, many educated, dedicated parents are still wary of vaccines -- or passionately opposed to them. Although the national immunization rate has remained stable over the past decade (76 percent of children ages 19 to 35 months were up-to-date on all of their shots in 2008), that's still short of the government's goal of 80 percent. In some pockets of the country, a rising number of parents are delaying shots for their kids or skipping certain ones altogether, citing religious or philosophical exemptions from state laws that require kids to be vaccinated in order to attend school. As a result, there have been recent outbreaks of serious diseases that vaccines had virtually wiped out in the U.S., including measles, mumps, pertussis (whooping cough), and haemophilus influenzae type b (Hib), which was once the most common cause of bacterial meningitis in kids under 5.
Infectious-disease specialists say these cases are due to a breakdown of what's known as "herd immunity." In order for a community to be fully protected against a disease, 80 to 90 percent of its population needs to have been vaccinated, says pediatrician Lance Rodewald, M.D., director of the Immunization Services Division of the CDC. Whenever coverage drops significantly below that level, a school, a church, or a neighborhood becomes susceptible to the disease. Babies who aren't old enough to get the shot yet are at the greatest risk of becoming sick.
Most of the recent measles outbreaks have been traced to individuals who visited a country where vaccine-preventable diseases still flourish. "The fact is, all of these diseases still exist -- some circulate in this country and others are only a plane ride away," says Dr. Rodewald. "They could easily become widespread again if more people refuse vaccines."