Let me make clear up front that I'm glad our grandchildren are on schedule for most of the currently-recommended childhood vaccinations. I can be pleased with that because their parents have taken the time to research the issues, and decide which vaccines they think are worth the risk, and which are not, and are willing to pay the extra costs—in money and time—to spread the vaccinations out rather than subject their children to the assault on the immune system caused by receiving many vaccines on the same day. Moreover, the children are breastfed, which helps their immune systems deal with the vaccines.
Vaccines have prevented much suffering and death, and they do work; witness the frightening polio outbreaks in Africa when immunication efforts were hindered by Muslim clerics skeptical of both the vaccines and the good will of the vaccinators. But they are far from risk-free, and the government and the medical community are doing parents a disservice by pushing vaccinations as if they were entirely safe and absolutely essential for their children's health.
"Informed consent" does not mean handing your patient a long form, full of legal and medical terms, to sign on the day of vaccination, along with another sheet describing possible side effects. It means addressing the issue far in advance, with both pros and cons, admitting controversy and uncertainty, and pointing the parents to sources of further information.
Parents, too, have the responsibility of seeking out information on their own, to be better prepared to discuss the issue with their physicians. My doctor may have forgotten more about medicine than I'll ever know, but no doctor knows everything, and the best ones are always open to new information, carefully and respectfully presented.
Above all, avoid jumping on bandwagons. Don't vaccinate just because your doctor expects you to, and don't avoid vaccination just because that's what your friends are doing. Just as there are risks to vaccinating, and actions we can take to mitigate those risks, there are also risks to not vaccinating, and precautions that can help protect the unvaccinated child. One helpful, and reasonably balanced, resource is Aviva Jill Romm's Vaccinations: A Thoughtful Parent's Guide: How to Make Safe, Sensible Decisions about the Risks, Benefits, and Alternatives.
One of the hazards of being unvaccinated is catching a "childhood disease" later in life, when the body is often less able to handle it. One example made the news today, in this WebMD report on an outbreak of measles in 2005, the largest in the United States in a decade. A 17-year-old girl caught the disease in Romania and passed it to members of her church when she returned. Thirty-two of the 34 who caught the disease had never been vaccinated.
The story fails its readers by not reporting how the measles suffers fared. Do the parents regret their decision not to vaccinate? I had measles as a child, and it was a relatively minor affair, easier for me than chicken pox, which itched like crazy. There can be serious complications, however; were there any in this epidemic, or was it relatively mild? That's important information.
Because 20 of the cases were homeschooled children, Amy Parker of the Centers for Disease Control stresses the importance of promoting immunization among homeschoolers. If she means educating people about the risks and benefits of vaccination, I'm all for it. But buried in the article is this chilling statement:
Proof of measles vaccination is required for children entering school, but West Virginia is the only state in the U.S. with a similar requirement for homeschooled kids.
This should frighten every homeschooler in the country. Requiring immunizations for admission to public schools is understandable, as long as certain exemptions are allowed, because of problems inherent in the confining of large populations to small spaces for long periods of time. But what is the concern that causes the West Virginia government to want to impose immunization on homeschoolers as well? If it's the fear that a homeschooler taking a public school class might pass a disease on to fellow students, how can that occur if the rest of the students have been vaccinated?
It appears the source is actually worse than that, and should frighten everyone, not just homeschoolers. There are those in the West Virginia government (and elsewhere!) who believe the primary responsibilities and rights when it comes to raising children belong not to the parents, but to the state. If the state decides universal vaccination is desirable, parents should have no choice but to go along.
The Internet is a wonderful tool for finding information; it is less useful when it comes to updates to that information. In 2004 the West Virginia legislature attempted to pass a bill expanding the immuization requirements and exacting severe penalties for noncompliance. Whether the bill succeeded or not I was unable to determine. If it did, it was apparently weakened, because the requriements I found through the West Virginia Department of Health and Human Resources mandate fewer vaccines and impose smaller penalties. Nonetheless, it's chilling enough. State Code 16-3-4 deals with "compulsory immunization of school children" but apparently they mean all children of "school age," not just children in the public schools.
Any parent or guardian who refuses to permit his or her child to be immunized against diphtheria, polio, rubeola, rubella, tetanus and whooping cough, who cannot give satisfactory proof that the child or person has been immunized against diphtheria, polio, rubeola, rubella, tetanus and whooping cough previously, or a certificate from a reputable physician showing that immunization for any or all is impossible or improper, or sufficient reason why any or all immunizations should not be done, shall be guilty of a misdemeanor, and except as herein otherwise provided, shall, upon conviction, be punished by a fine of not less than ten nor more than fifty dollars for each offense.
Unlike every other state except Mississippi, West Virginia makes no provision for religious or philosophical exemptions to its immunization laws.
UPDATE: Please see the first comment, below.