Vaccines: A (truly) balanced review

Greetings! It has been a very long time since I posted here, and I apologize for that. (I'm sure someone was waiting with bated breath. :) ) Ten years after I had my second child, I find I am pregnant again. (How did that happen?! Ok, yes, I know how that happened, but still...) This surprise has led me to research again all the decisions we made for the first two. This research has mostly been productive. Despite most parenting topics having been made unnecessarily contentious, there is *usually* at least one or two unbiased sources. Vaccines, sadly, are not in that category. I have dug and found the least biased, and then put them together, along with a conversation with a flexible (and pro-vaccine) pediatrician to come up with a plan for us. After all this research, I want to share with anyone who is inclined to read it what I can. As with all parenting choices, you have to do the best you can to make the right choices for your family; this post is absolutely against shame and name-calling (two things that happen ridiculously often on this topic.)

First, the good things about vaccines: There have been devastating and deadly diseases, many of which vaccines, at a population level, have managed to help decrease or nearly eradicate. It should be said that vaccines are not the only player in decreasing death-due-to-infection-diseases (as compared to death from all other causes); it may not even be the main player. However, with regard to several diseases, they have played an important role. This should not be understated. Our pediatrician practiced initially in India and has first-hand experience on just how devastating and deadly some of these diseases can be. (This is why he is pro-vaccine.)

Next, the not-good things: Vaccines are inherently an assault on the immune system. This is not controversial; it has been known at least since the 1940s. It is true that the immune system (like your muscles) needs challenges to be strong, but vaccines are a big challenge. If the immune system is already diminished (from being brand-new out of the womb, from a serious cold or flu, or from any other causes), this assault may cause long-term problems for an individual. This statement is controversial. The reason for the controversy is the difference between population-based research and individual medicine (epidemiology and clinical practice.) At the population level, the correlation between vaccines and serious, long-term injury or problems is hard to prove. That doesn't mean it doesn't exist. It doesn't mean it does (at the population level). It is just hard to prove. However, even when a correlation doesn't exist clearly across millions of people, an individual can experience a valid injury or problem. So, both the claims that vaccines are safe (long-term) and that they cause injury can be true. As far as I can see, that seems to be the case. (This is my conclusion from reading both parental first-hand-accounts of injuries and the statistics about safety, as well as looking at the safety records of countries where their vaccine practice is less aggressive at such a young age.)

Another issue is the safety of the ingredients. The most common concern is mercury, a heavy metal that accumulates and historically causes serious neurological issues. (Remember the Hatter in Alice in Wonderland?) However, mercury is mostly absent (at least officially) in most of the children's vaccines. (The multi-dose flu vaccine still contains a significant portion of mercury.) However, aluminum is another issue. It is possible (at least hypothetically, since this issue seems to not have been researched yet) to get a toxic load of aluminum. It is something the kidneys process out of the body, but they can only do so much at a time, especially in very small people. Because aluminum is still not playing a big role in the public discourse, there has been little to no push to remove it from vaccines. Therefore, several (those for hepatitis A and B, and the vaccines commonly known by their abbreviations PCV, and DTaP) still contain very high levels of it.

So, where does that leave a parent? Here are some questions to ask (both yourself and of the research) as you decide what you will do regarding vaccines:

• How likely is it that my child will get this disease? How prevalent is it?
• How severe is the disease should my child get it? AND how likely is that severity? Some are normally mild, and very rarely severe.
• How safe is the vaccine and/or its ingredients?
• How robust is my child's immune system? (You can improve this through breastfeeding, not vaccinating while the child is sick, reducing the number of vaccines at a visit, and/or some herbs can help boost the immune system.)
• Do vaccine reactions, immune problems, and/or neurological/sensory issues run in our family?
• In some cases, getting vaccinated is to decrease someone else's risks. How do you feel about that responsibility? Are you able and willing to do this for others? (This question was added at the suggestion of a reader. It is valid to not be able or willing, especially if you have reason to believe your child to be vulnerable. It is also a big reason for vaccination and a reason others feel strongly about doing so.)

One place to look up the diseases and vaccines is "The Vaccine Book" by Dr. Robert Sears. The author is definitely pro-vaccine, and recommends getting all vaccines. I found his research invaluable, and only slightly dated. He does provide a broken-out schedule of vaccination as an alternative to the standard AAP vaccine schedule (which starts at birth, and at two months nails babies with six separate shots, totally 10 diseases!) However, his schedule would have you at the pediatrician's office every month for a long time. (I found that a serious draw back.) There are other recommended alternative schedules. Drs. Stephanie Cave and Donald Miller also have each published a book on vaccines and suggested alternative schedules. Each has its benefits and limitations. One problem may be (depending on your health insurance situation) that they suggest getting vaccines at times when you would not normally have an appointment, and that they suggest getting single-dose vaccines, some of which are hard-to-impossible to get these days (and even harder to get insurance to pay for.)

I took the ideas and research that these people have provided and developed (yet another) schedule that I believe will work better for us. I delayed starting until four months (time to get breastfeeding solidly started, time for the baby's immune and elimination systems to get stronger and more capable), and then limited the shots to three or less (based on the suggested schedules from some less-aggressive European countries), and limited the visited to the normally-scheduled visits. I also did a little (not much) rearranging, based on the concerns for the baby's vulnerabilities, and skipped chicken pox (which, in my opinion has too low a likelihood of severe reactions, unless the child doesn't get it as a child), rotavirus (again, in this context, where we can rehydrate a baby with severe diarrhea, this did not seem to be worthwhile to me), and the flu vaccine (which I personally feel is a bad idea in most cases.) Here is my schedule for your enjoyment:

• 4 months: DTaP, IPV, Hib
• 6 months: DTaP, IPV, Hib
• 9 months: PCV, DTaP, IPV
• 12 months: PCV, MMR, Hib
• 15 (or 18) months: DTaP, PCV, Hib
• 24 months: PCV, IPV, Hep A
• 36 months: Hep A
• 48 months: Hep B, DTaP
• 60 months: Hep B, IPV, MMR
• 72 months: Hep B
• 12 years: Tdap, Meng, test for varicella immunity

I am not suggesting you should not get your baby vaccinated, or that you should, or that if you do, you should follow my schedule. My suggestion, my fervent hope, is that you will research what you can and balance the information with the good and bad of vaccines above; that you will ask yourself and the research to answer the questions I pose above, as well as any other questions you have.

Whatever choice you make, know you have made the best possible choice you can in a complicated situation with no perfect answers. Keeping that knowledge will not only help against those that are sure you did it wrong, but also help in all the other parenting choices there are to be made.