If you're like most parents, you don't think twice before having your children vaccinated. You want your kids to be healthy, so you make sure they get their shots. In fact, nearly 90 percent of kids in the United States are fully immunized against ailments that once killed thousands of children every year.
Yet despite the fact that vaccines can prevent many serious diseases, a small but growing number of parents are questioning the need for, and benefits of, immunization. Groups like the National Vaccine Information Center, a grassroots parents' organization that has publicized the possible risks of vaccines, are a source of increasing concern to public-health experts, since unimmunized kids can endanger a whole community.
"Some people don't believe that illnesses like measles and pertussis are still out there," says Benjamin Schwartz, M.D., of the Centers for Disease Control and Prevention (CDC), in Atlanta. "So instead of focusing on the very significant risks of the disease, they focus on the very uncommon risks of the vaccine." It's easy to lose sight of the benefits of vaccination, especially when you hear rumors that it can cause everything from SIDS to brain damage. The conflicting information may have you wondering whether vaccines are really safe. To clear up some common myths, we asked the experts.
Vaccines often cause serious reactions and may even cause the disease they are supposed to protect against.
Vaccination by definition means exposing a healthy child to a weakened or dead virus -- a fact that understandably makes some parents nervous. Although no vaccine is 100 percent risk-free, the chances of major side effects from a shot are minuscule compared with the potential damage to your child's health if she contracted the disease itself.
One vaccine that is commonly associated with developing the actual disease is the oral polio vaccine, which contains live, weakened polio virus. Although vaccine-associated polio is incredibly rare (one in every 2.4 million doses), public-health officials were sufficiently concerned that they recently recommended a reformulated vaccine. The new, injectable polio vaccine contains an inactivated, or killed, virus and has not been associated with any cases of the disease.
Some antivaccination groups are concerned that DTP (diphtheria/ tetanus/pertussis) can cause brain damage and SIDS. But there is no convincing evidence to support these allegations, says Mark H. Sawyer, M.D., an associate professor of pediatrics at UC San Diego School of Medicine. However, since the vaccine on rare occasions causes such serious side effects as high fever and convulsions, a new, safer vaccine has been used since 1997. Research does not support the DTP/SIDS link. SIDS happens to strike most often at the precise age when the DTP vaccine is administered, and chance alone predicts that 50 cases of SIDS each year will occur within 24 hours of vaccination. "The best way to prevent SIDS is to be sure your child sleeps on his or her back," says Dr. Schwartz.
Since most children are already vaccinated, it's no big deal if a few kids aren't.
Immunization doesn't protect just individual children; it protects the entire community. Unvaccinated children and adults serve as a reservoir for infection, which they can then pass on to other susceptible individuals, including the small percentage of immunized kids who don't respond to a specific vaccination, children who are behind on their vaccination schedules, and those who can't be vaccinated because of medical problems. Pregnant women and babies are also at risk. "Children under 1 year old who are exposed to measles, mumps, and other vaccine-preventable diseases before they have been immunized are much less likely to survive the infection," says I. Celine Hanson, M.D., of Texas Children's Hospital, in Houston.
Diseases such as diphtheria and polio have been wiped out in this country, so there's no point in vaccinating a child against a disease she's unlikely to get.
Just because a disease is lying low doesn't mean it won't return. History has shown that when vaccination rates drop, disease rates rise, no matter how rare the illness may have seemed. With the rise in international adoption and travel, serious illnesses are only a plane ride away. "Until a disease is eliminated from the planet, we will have to continue immunizing against it," says Dr. Sawyer.
Chicken pox is a mild disease, so my child doesn't need the vaccine.
"Chicken pox is actually responsible for the death of one child every week in this country," says Dr. Sawyer. "It causes more deaths than any other vaccine-preventable childhood disease because complications like strep infection are so common." Chicken pox can also reemerge in adults as shingles, an extremely painful nerve and skin disease. Although the vaccine doesn't offer complete protection from shingles, experts believe the risk is greatly reduced. Parents who prefer to have their children acquire immunity against chicken pox naturally also face another hurdle: It's becoming harder and harder to find a sick child who can infect yours. In fact, the CDC recently recommended that all states require the vaccine for children entering day care or preschool. That dramatically lowers the chance that your child would catch chicken pox from a schoolmate or sibling during early childhood, explains Dr. Sawyer. "And the older your child is when he or she becomes infected, the more severe the illness is likely to be."
Good nutrition and natural remedies offer enough protection against disease, so vaccines aren't necessary.
"Natural stimulants of the immune system may help your child's overall health, but they don't provide the disease-specific protection you get from vaccination," says Dr. Hanson. For that, you have to challenge the child's immune system with the specific virus so that it can produce the appropriate antibodies. And it's much safer to do that with a vaccine than to let your child become ill from natural disease exposure.
Vaccine immunity wears off.
Vaccination usually provides lifetime protection against infection -- but it's not perfect. We need tetanus boosters every decade or so throughout life. And researchers recently discovered that immunity to pertussis may also wane with time. Vaccine failure sometimes occurs with the chicken-pox vaccine as well, but if an immunized person does develop breakthrough illness, it's usually very mild, says Dr. Schwartz.
Kids with certain health problems may need to avoid specific vaccines. The best way to tell whether your child is in a high-risk group is to talk to your doctor. He should carefully review your child's health history, explain all the potential risks of each vaccine, brief you on possible side effects, and give you the comprehensive Vaccine Information Statements, put out by the CDC. In general, children with immune deficiencies, seizure disorders, or neurological problems need to be carefully evaluated -- some vaccines may be appropriate and safe; others may not. Since vaccines can prompt severe allergic reactions in people who are hypersensitive to one or more of their components (e.g., eggs or yeast), parents of children with certain food allergies or drug sensitivities should consult their doctors before receiving some vaccines.