Vaccines: The Reality Behind the Debate

The Case for a "Middle Ground"

Not all parents are reassured by facts like these. After all, most have met a child with autism; probably few have seen one who has crippling polio. Moms want to eliminate even a remote chance that their child will experience side effects from a vaccine, and they may fear that multiple injections could overwhelm the immune system. In fact, a national survey of parents published in Pediatrics last month (although conducted in 2009, before the retraction of Dr. Wakefield's study), found that 54 percent of parents were concerned about the serious adverse effects of vaccines, and 25 percent believed that some vaccines cause autism.

Enter Robert Sears, M.D., author of The Vaccine Book: Making the Right Decision for Your Child. Published in 2007, it includes a different immunization schedule that delays or spaces out several vaccines so that children never receive more than two shots at a time -- and it has become a bible for many parents. Dr. Sears says that his main purpose is to make sure that children whose parents would otherwise opt out of immunizations get at least some protection. His top concern is aluminum, an ingredient that is added to half of all vaccines to boost their effectiveness. "Most experts believe the amount of aluminum contained in vaccines is safe, but studies in human infants haven't proven that," says Dr. Sears. "Spacing them out seems like the best way to limit overexposure."

Research has shown, however, that kids are exposed to more aluminum in breast milk or infant formula than through vaccines. And in 2004, The Cochrane Collaboration, an international not-for-profit health-care research organization, analyzed five studies on the effects of aluminum-containing vaccines and concluded that children who receive them are no more likely to experience any serious or long-lasting health problems than those who don't. For parents who are concerned about overburdening their child's immune system with multiple vaccines, Dr. Offit points out that young children are exposed to more antigens -- bacteria, viruses, toxins, and other substances that can stimulate disease-fighting antibodies -- in a single day of eating, playing, and breathing than they are through immunizations.

While popular with some parents, Dr. Sears's alternative schedule has been criticized by the AAP. "Vaccines protect babies' immature immune system," says Margaret Fisher, M.D., a pediatrician at The Children's Hospital at Monmouth Medical Center, in New Jersey, and chair of the AAP section on infectious diseases. "When you delay vaccines, you leave children unprotected against dangerous diseases at the time when they're most vulnerable." In 2008, for example, three of the five kids in Minnesota who developed invasive Hib disease (one of whom died) had parents who'd chosen to postpone vaccination. "People always ask me, 'Which shot can I skip?'?" says Dr. Fisher. "Honestly, I can't think of one I'd wait on."

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