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The danger of refusing immunizations

By Stacy Beller Stryer, M.D.

Just last week three parents in my practice either refused or asked to alter the recommended vaccine schedule for their infants, and so far this week there have been another two. None of them have had good reasons, and none had truly researched the pros and cons of having their child receive each vaccine. The other day there was a memo on my desk, from the American Academy of Pediatrics, which discussed 5 children under age 3 years who had developed haemophilus influenza (Hib) in Minnesota last year, one of whom died. Three of the children who became ill, one of whom died, were unimmunized because of parent refusal.  Another had a recently diagnosed problem with the immune system, and the last hadn’t finished the Hib series at the time of illness.

It is difficult to hear these parents refuse the vaccine, and, although asked by parents, I cannot choose which vaccines they should get now and which they should get later because all are potentially deadly. If only parents could see what I saw as a medical student and resident, before there was the widespread use of the Hib vaccine, and before the development of the pneumococcus vaccine. If only they could see the infants and toddlers admitted with terrible infections, such as meningitis, where some developed permanent brain damage or total hearing loss, and others were not so lucky. Or the children who developed epiglottitis and could barely breathe, where even asking them to open their mouths or agitate them by examining them was risky and could cause respiratory collapse. Or those who developed arthritis in their hip or bones and received antibiotics for weeks, hoping that they would not need surgery or develop permanent damage. And, of course the many children who were admitted to the general ward or intensive care unit with pneumonia and significant respiratory distress. These are just some of the things I saw before the development of these two vaccines, most of which I just do not see anymore.

According to the Centers for Disease Control, before the widespread use of the vaccine about 15 years ago, Hib occurred in over 20,000 children per year, and about one in 200 children under age 5 years developed meningitis, with 25% of those affected developing permanent brain damage. Since the use of the vaccine, the number has dropped dramatically but is now beginning to increase again because parents are not immunizing their children adequately. The Hib vaccine prevents against infections such as meningitis, epiglottitis, septic joints, bone infections, soft tissue infections and pneumonia. There are no known serious side effects to this vaccine. The pneumococcal vaccine prevents against pneumonia, sinusitis, ear infections, meningitis, and soft tissue infections, among others.

Not only do parents harm their own children refusing a vaccine, but they also harm others. If parents don’t immunize their children, they are at greater risk of becoming ill with serious illnesses, are more likely to infect others with these infections, decrease the general “herd” immunity in the community, and may need to be excluded from school or other activities during outbreaks with vaccine-preventable illnesses. I am asking you to read about these vaccines, look at the research on their association with autism, ask your physician questions (we did spend seven years in medical school and residency learning about this), and make an informed decision. I am confident that, if you educate yourself, your decision will be the right one.


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One Response to “The danger of refusing immunizations”

  1. IndianCowboy says:

    I originally sent this comment to Dr. Val in an email with a link to a post I had written on this subject, but the more I read it the more I feel the need to comment more vocally.

    I am a fourth year medical student and eagerly awaiting the day when I take the oath and am able to call myself ‘Doctor’.

    But I am also a trained scientist, which is not part of our training as doctors. And ‘vaccine safety’ studies are fraught with methodologic and theoretical errors.

    There is absolutely no doubt that vaccinations have had a very positive effect on public and personal health. I unfortunately did have the experience of seeing a child with HIb epiglottitis last year, as well as a case of pertussis. Both were scary, and very sobering.

    But we actually have very little knowledge of how safe vaccines are or aren’t.

    Pre-marketing safety studies usually last just days, or at best a couple of weeks. How can you monitor for the possibility of vaccine-induced autoimmune disease if it takes 3-6 weeks to mount a full immune response in the first place? And may take even longer for autoimmune damage to show up?

    Post-marketing surveillance is notoriously poor, capturing, by the FDA’s own estimates, only 1-10% of all vaccine ADRs. And then, disingenuously, we use uncorrected figures from VAERS to show that certain diseases appear no more frequently than they do in unvaccinated populations.

    And there are hardly any retrospective case-control trials that have been done to exonerate vaccines have taken a comprehensive look, singling out diseases one by one, rather than casting a wider net, which would be necessary given the wide range of side effects that have been linked to certain disease (e.g. the case was made that HBV may be linked to neurologic sequelae ranging from peripheral to CNS deficitis–case-control studies ‘disproving’ this point focuses solely on MS)

    There is little doubt that a large component of the anti-vaccination movement is hysteria. But there is also little doubt that many of the claims of the more erudite among them are valid, and remain largely unaddressed.

    If my (future) patients were to ask me specifically, scientifically, what the risks of vaccines are, I would be forced to shrug my shoulders and say I actually have no idea. It has been beaten through the current generation of medical students’ heads that this is the era of ‘evidence-based medicine’. Let’s put our money where our mouth is and demand that we develop the evidence about vaccine safety in a convincing manner.

    It is not enough to speak from a position of authority. We must speak from a position of scientific integrity. Which we currently can’t.

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Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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