Whos Calling the Shots? By Walecia Konrad with Emily Harrison Ginsburg
When Brenda Anderson, a mother in Northern Cambria, Pennsylvania, took her daughter Brittany to the doctor at four months, shed already fallen behind in her immunizations. So the pediatricians nurse suggested a quick fix: Theyd give the baby girl both doses of her DTP shot (for diphtheria, tetanus and pertussis), which are routinely administered at two-month intervals.
Anderson balked. "Isnt there a reason they space them apart?" she asked. When Anderson offered instead to bring her daughter back one month later, the nurse called the doctor in. Despite her protests, the pediatrician gave her daughter the second shot anyway. Anderson stormed out of the office, vowing to find another doctor. When she didnt come back for her next scheduled visit two months later, she got a call from the pediatricians office. An apology? Hardly. The staffer warned Anderson that shed be reported to child services for neglect if she didnt get her daughter vaccinated properly. "The doctor is the one who should have been reported," fumes Anderson. "She didnt want to deal with anyone who asked any questions."
Threats? Harassment? Over childhood immunizations? There was a timenot so long ago, eitherwhen vaccinations were a simple, routine part of child care, as nonconfrontational as diaper changes. And theres no denying that vaccines have been one of the major medical triumphs of the last forty years: Smallpox has been eradicated, and both polio and diphtheria have been all but wiped out in the Western Hemisphere. Its estimated that before 1963 there were as many as 4 million cases of the measles and 500 deaths from that disease annually in the U.S.; in 1999 there were just 86 occurrences. The Hib vaccine has helped stem the number of cases of Haemophilus influenzae type bonce the leading cause of childhood bacterial meningitis and postnatal mental retardationfrom 20,000 a year in the early 80s to 54 in 1998.
But vaccines have become the subject of a fierce debate between a growing cadre of anti-vaccine activists and the medical establishment. The activists claim that vaccines can, in fact, hurt childrencausing brain damage, autism, even deathand they want to allow parents to opt out of the mandatory immunization schedule and to improve the safety of the shots children get. "Parents have a right to informed consentto get all the information and then make a decision," says Dawn Richardson, founder of Parents Requesting Open Vaccine Education (PROVE). Doctors and public health officials, by and large, have reacted with patronizing dismissal, characterizing advocates as a fringe element"misguided folks" peddling "misguided information," as one doctor says.
Then last summer there was a flurry of news that brought attention to the anti-vaccine case: Safer versions of two core vaccinesDTP and poliowere put on the Centers for Disease Control and Preventions schedule, a move that backhandedly acknowledged the activists claims. After that came the rotavirus debacle, in which the new vaccine, supposed to guard against a severe form of childhood diarrhea, was found to cause life-threatening bowel obstructions in infants. Just nine months after introducing the vaccine, the Federal Drug Administration recommended that it be pulled. As rotavirus made headlines, more and more parents began wondering what was going on. If the doctors had made a mistake this time, maybe they didnt really know that much after all. Maybe we should all be worrying about immunizations. Suddenly, the vaccine safety movement had gone mainstream.
Where does that leave you? Most likely in your pediatricians waiting room, wondering how seriously you should take the anti-vaccine claims and whether your doctor is (a) really up on this debate and (b) telling you all you need to know about the side effects of the twenty-four shots of vaccine your child will likely get over the next four years.
The vaccine whirlwind starts literally at birth, when many hospitals inoculate infants against hep-atitis B, an incurable disease that causes severe liver damage, but one that is usually transmitted sexually. By your babys two-month checkup, hes due for an onslaught of shots: a second dose of hep B and the first shots for diphtheria, tetanus and pertussis; polio; and Hib. Just watching the needles piercing your infants thigh is painful. Whatever happened to the polio vaccine we drank from a cup as kids? Thats the one the CDC took off its vaccination list last year, after vaccine safety advocates spent years publicizing what the government already knew: The tiny number of polio cases occurring annually in the U.S. were actually caused by the oral vaccine, which contained the live virus.
By the time of your childs four-month well-baby checkup, youre full of questions. Your son ran a slight fever after his last shotsa common minor reaction. But do you need to worry? Like many parents, you turn to the Internet for reassurance. Your search only raises your anxiety. At the National Vaccine Information Centers Web site (www.909shot.com), for example, you read about a Swedish study of 215,000 children who received the DTP shot. One in 17,000 either died from a reaction or ended up with permanent brain damage. The CDC site (www.cdc.gov/nip) says, "The risks of serious disease from not vaccinating are far greater than the risks of serious reaction to the vaccination," but how are you to judge the real danger to your child?
It doesnt help that all your Web surfing has landed your name on a couple of e-mail lists. Your inbox is full of dire messages with scary subject lines like "The Damning Evidence That the Medical Establishment Has Chosen to Ignore." One, headlined "Dirty Vaccines," implies that vaccines made with bovine material might be carrying mad cow disease. Every doctor visit is starting to feel like a game of Russian roulette. Meanwhile, your son, now one year old, is due for his first measles-mumps-rubella shot, and frankly, youre terrified. This is the vaccine that some activists claim is linked to the skyrocketing incidence of autism in the U.S. and Britain. Scientists dispute that theres any such connection, but what if . . . ?
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