Immunization Debate Rolls On
By BETHENY HOLSTEIN
Source: The Intelligencer - May 08, 2004
While National Infant Immunization Week came to a close at the beginning of this month, the debate over the safety of vaccines and their status as mandatory continues to gather steam among parents, doctors and scholars around the world.
National Infant Immunization Week is an annual observance to promote the benefits of immunizations and to improve the health of children 2 years old or younger. This year the event's theme was "Vaccination: An Act of Love. Love Them, Protect Them, Immunize Them."
However, not all parents believe that vaccination is what they want for their children or that they should be forced to immunize their children for entry into school. One such parent is Wheeling's Linda Grindley.
"The anti-vaccination movement of today, to me, is like the anti-smoking movement of the 1970s and 80s," Grindley said, explaining that there is a group of people looking into the dangers of vaccinations and learning more about them in the face of a culture that believes in the safety of immunizations.
Grindley said she began her research into vaccinations about five years ago after she made the decision to not immunize her children. She, like many in the movement against mandatory vaccination, questions the safety of immunizations.
"When you find out something, you just have to pass it on," Grindley said. "We're just trying to warn people that this stuff may not be good. ... I really do believe that in the future, having mandatory vaccines is going to look like a barbaric act."
However, Dr. William Mercer, medical director of the Wheeling-Ohio County Health Department, said the point of vaccines is, in fact, to protect all members of society from disease, which would not happen unless the majority of the community was vaccinated.
"Nobody can argue that vaccines are not beneficial," Mercer said. "Medicine is not perfect, but we do know without a doubt that immunizations do prevent these diseases."
He said keeping high levels of immunized people is very important in keeping diseases under control, which is beneficial to all people, especially those who cannot be vaccinated for medical reasons. He added that if the levels of immunized persons dropped, the incidence of diseases such as polio, measles, diphtheria, tetanus and others could rise.
"A lot of these diseases we can't treat. We have seen great improvements in the treatment of bacterial diseases, but not to the point where prevention is not the best," Mercer said. "Treatment of viral disease is not far enough ahead for those diseases to be treated. Our only line of defense is vaccination."
Grindley said that because most people believe in the protection of vaccinations and because doctors recommend them, people would continue to be vaccinated, even if it was not compulsory.
"We're supposed to be the most free country in the world, but we have the most extensive amount of required vaccinations of any country in the world," Grindley said. She added that in Canada, the country's constitution states that vaccines cannot be made mandatory, but a high number of Canadians choose to be immunized.
She added that because of the high number of required vaccinations for young children, many children are given several shots at the same time, and she wonders at the impact that could have on a developing body.
"With every drug, there is a potential benefit and a potential risk, and if you add more and more drugs, there is more chance of an adverse reaction," said Grindley's husband, John. Linda Grindley also questioned the safety of vaccinating an infant before any allergies might be discovered.
She pointed to a report produced by the Institute of Medicine's Immunization Safety Review Committee Board on Healthy Promotion and Disease Prevention in which researchers studied what kinds of effects may occur from receiving multiple vaccines at one time. The 2002 report said:
"There is no study that compares an unvaccinated control group with children exposed to the complete immunization schedule, nor are there any studies that looked at health outcomes other than those classically defined."
Information from the Centers for Disease Control, though, suggests that a child's immune system is equipped to handle multiple antigens at the same time, and Mercer added that more problems would arise if the practice were unsafe.
"Studies do not show that (immunization) has caused any adverse reaction," Mercer said. "It is traumatic for everyone involved to give several shots at once, but we just know how important it is."
Mercer pointed to the Vaccine Adverse Event Reporting System, developed to track any problems potentially related to vaccines or caused by them. Doctors who suspect a problem associated with the administration of immunizations are requested to call and report the case, and the CDC tracks the reports to determine any problems with specific vaccines to ensure the public safety.
"If a patient believes there is a problem, then the doctors will look into them and report them," Mercer said, adding that while the system may not be perfect, it does work, as it did in the case of the RotaShield vaccine against rotavirus. Mercer said the results from the system's tracking information alerted the government to the problems the vaccine caused, namely a specific bowel obstruction called intussusception, and, as a result, the government suspended the use of the vaccine.
"Here was a problem, and they did something about it," Mercer said, adding that while some children may have adverse reactions, the number of people who are protected for the greater good outweighs the individual risk.
Grindley said she is not sure parents who believe their children were harmed by vaccines would agree that the government takes the reports seriously enough, adding that many times the reports are taken as an indication of an association but not a causal link to whatever problem develops.
She referred to the hundreds of reports of sudden infant death syndrome each year that occur in a short time frame following immunization, saying there may be a causal link with these deaths and the vaccines.
"Injure a baby, and it's easily written off as coincidental or as something else," Grindley said.
"Unfortunately, there are a lot of things in medicine we don't understand," Mercer said. "Sometimes we can only tell a person it's not from (the vaccine), but we don't know why it is."
Mercer said more studies need to be done on diseases like autism, which has been linked in the past to immunizations containing a mercury preservative called thimerosol. The CDC maintains autism is not caused by these vaccines, although vaccines containing thimerosol are no longer being produced.
"If these problems were from the vaccines, they would be more widespread," Mercer said. "People want these things to be in black and white, but sometimes there is no black and white in our time frame."
According to the CDC, the increase in the incidence of diagnosed autism has gone from an estimated four to six in 10,000 in the 1980s to an admittedly conservative estimate of one in 1,000 in recent years and possibly as many as two to five per 1,000. The rise is one that troubles parents and health care providers alike.
But Grindley said there are many questions surrounding the issue of immunizations that make it complicated, such as the use of animal tissue to make the vaccine cultures.
"Where's the science that says it's OK to do that - to put other animals' DNA in our blood stream?" Grindley said, adding there are issues surrounding other ingredients beyond thimerosol. She said more studies and test must be done on vaccines.
"Even though some of these ingredients are known carcinogens, these tests have not been done," she added.
Grindley said she is not against vaccines, nor does she want all immunizations to stop, but she said she does not believe that vaccines should be mandatory or that people should accept their safety without express proof.
"If you want to vaccinate your child, and you have faith that the vaccines work, then you use them and your child is protected," Grindley said. "If you want to use it, then it's your right. If I don't want to do it, then that should be my right as well."
She urges people to research the topic and become better informed before they choose to have the shots administered to their children.
"The great majority of parents don't even know what their children have been vaccinated for," Grindley said. "If you were to ask 10 parents, 'Which vaccines did your child receive?' I doubt even one would be able to tell you without guessing. I would encourage everyone to be better informed and educated before they make the decision to vaccinate or not."
Mercer agreed, saying anyone with questions about immunizations should do the research and ask doctors about the risks and effects of immunizations.