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Are Vaccines My Choice — or Yours?


Baby Ike, in the land of no germs. hide caption

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Today we're heading to our doctor for Ike's "one month" checkup.
So far, the office visits have been fun, as we chart Isaac's growth and our terrific pediatrician answers all our new-parent questions.

But there is one big question on the horizon, as I was reminded this weekend by a letter to "The Ethicist" columnist Randy Cohen in Sunday's New York Times. The reader asked whether it was ethical for the moms in her playgroup to force out a child because he hadn't been vaccinated.

Cohen's decided that by skipping vaccines, the mom is putting only her own child — and other unvaccinated ones — at risk. But the question remains: Are vaccinations a public health concern or a private decision?

Every state has a law requiring certain vaccines before kids can go to school, and the CDC and the American Academy of Pediatrics recommends the shots as a crucial part of a health plan. But what about parents who believe the potential damage outweighs the benefits?

I have my own thoughts on this, but it's yours I'm wondering about. So I'm asking.



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Here in San Diego, we went through a measles epidemic because one girl whose family decided not to have her vaccinated for measles, contracted measles while in Vienna, brought it back home, spread it to everyone in her day care & pediatrician's office, got onto a plane to Hawai'i (giving it to everyone on the plane), and then spread the virus throughout Oahu. Now, someone who can afford to fly back & forth to Europe, then fly to Hawai'i, can't use the excuse that their insurance wouldn't cover the cost. It was so bad here in San Diego (and, no doubt, in Oahu, too) that, when my son had a rash (which turned out to be no more than prickly heat), we had to go to a different waiting room that seemed to border Outer Mongolia.

I don't see what potential damage outweighs this kind of public health risk. One court decision aside --a decision where the court conceded that the victim had a genetic predisposition-- there is no scientific link between autism and vaccination. This supposed link between autism and vaccination is little more than the left-wing version of the Salem witch hunt. We're seeking after denoms that aren't there.

On the hand, science, thankfully, has improved our country's infant survival rate a thousand fold because of vaccinations. It wasn't that long ago that a fifth of all children would die before their fifth birthday. Do we want to go back to those days just because there might be, maybe, could be, on the outside possibility, the chance that this vaccinations, along with some genetic predisposition, causing autism? God, I hope not.

But, if you do decide that you don't want the benefits of science out of fear of autism, here are two words you should know: home schooling. Two more words: house calls. Two more words: private jet (the last two may be only for my neighbors here, but I hope you get the idea).

Sent by Matthew Scallon | 1:09 PM | 6-3-2008

Vaccines work by reducing the number of people in the population who are susceptible to a disease. No vaccine is 100% effective. This is from memory, but I believe the polio vaccine is only about 70% effective. The susceptible percentage of a population that is required to keep a disease actively spreading depends on the disease vectors and how virulent it is. People who don't vaccinate are not only putting their children at risk, but they are also putting children at risk who got the vaccine, but were not made immune. You won't know where the tipping point for the next epidemic is until it is too late.

There are some provable risks for vaccines, on the order of 1 in a million, and some widely reported but utterly bogus non-risks. Any doctor will tell you that the risk versus reward for vaccines is a no-brainer.

Poor, Ike. It only stings for a few seconds though.

Sent by Dave Wiley | 2:01 PM | 6-3-2008

As the mother of two small children, I can tell you this issue is top-of-mind. But as your other commenters mentioned, the benefits of vaccination far outweigh the risks. And if you ever want to send your child to daycare or school, you'll have no choice: most, if not all, require children to receive all standard immunizations.

Best of luck. I understand you don't want to put your child at risk; no parent does. Vaccines, however, reduce the risk that your child will contract and/or spread a dangerous illness.

Sent by MichelleBB | 2:12 PM | 6-3-2008

@Alison, if you're worried about Ike's shots, here's what we do. My wife hides behind me (because she's scared), and I hold my son Roy's hand while he's getting the shot. That way, when he gets the shot, he looks at me and blames me for the pain and not his Mom. After the shots, my wife breastfeeds him. Within twenty minutes, he's his normal smiling self. So, make sure your husband's there for the shots so he takes the fall. It only fair after all that labor.

Sent by Matthew Scallon | 2:17 PM | 6-3-2008

Most states require a vaccination be made available to every child by law. I know that, at least in my state, none are required by law despite what doctors, nurses etc. will tell you.

And most epidemics come from poor sanitary conditions and often are spread through animals, not by lack of vaccinated people. The biggest threat now-a-days is from drug resistant microbes, which comes from half-medicated people.

And as a sidepoint, this country has one of the highest infant mortality rates of any developed country. This also happens to be the country with the most medical intervention...

Sent by WDH | 2:26 PM | 6-3-2008

@Dave Wiley, you make good points. What helped the epidemic spread here was that, though the girl was old enough to get the vaccine, many of the children she came in contact with were not old enough.

Not only is there no 100% vaccine for anything --or a 100% anything in science-- there is also age appropriateness for certain vaccines. My son can't get the flu vaccine for another 4 months, and, even there, we're not sure if he inherited my wife's egg allergy (they grow the vaccine on egg shells).

It's challenging being a parent, but like the vaccines, the benefits certainly outway the risks.

Sent by Matthew Scallon | 2:39 PM | 6-3-2008

I actually was so incensed by Randy Cohen's response that I sent him the following email:
Dear Randy,
I disagree with your answer to J.G. in Pasadena. The issue isn't about a direct danger to the vaccinated children in the playgroup. It is about taking a stand against an antisocial behavior that should not be tolerated. If this woman can blithely choose to not vaccinate her child, it is only because she is counting on there being a sufficient mass of vaccinated people to prevent epidemics of killer diseases. In her logic, it is right that hundreds of children risk autism (stupid) so that her child can be free of the risk of polio. She is a free rider, a bum, putting her inane fears for her child's health above the real danger of insufficient levels of vaccination.

The other mothers in the play group did not spit on her, they did not call her names, they did not burn down her house, they did not lynch her. They chose, as is their right, not to associate with a selfish, ignorant woman. They gave a message about what behavior they accept in society, and that is their right, and I would say, their duty.

Sent by Marc Naimark | 3:33 PM | 6-3-2008

@WDH, I was with you until you said, "This also happens to be the country with the most medical intervention." I'd have to see your citation on that one, because I know of a couple countries from personal experience (Japan, Italy, Spain) where nedicine intervenes far more than in this country.

I'd also point out that vaccinations have rendered those other diseases' rates lower than animal-borne diseases and drug-resistant bacteria. I don't know if you had intended to suggest that diseases for which children are innoculated aren't as critical as other diseases, but I got that impression.

Sent by Matthew Scallon | 4:21 PM | 6-3-2008

Vaccinate. There are plenty of hard decisions that come with parenting, but this isn't one of them. Save your energy for the other ones.

Sent by Sandy, Honolulu, HI | 4:35 PM | 6-3-2008

Where is the middle ground in the decision to, or not to, vaccinate? Are there other parents that are neither pro, nor anti, vaccine? I think that benefits of the vaccines for polio and meningitis are worth the risk, but do not think the same about the vaccines for chickenpox and HPV. Child care providers and schools abide by state recommendations. States take an all or nothing stance. Children either comply with state guidelines by getting the full list of shots or the parents file a religious exemption. Must I falsely claim to oppose vaccines, based on religious values, to avoid subjecting my child to the entire schedule of required shots, yet provide my child with the vaccines that I think are worth the risk?

This is the course that my spouse and I are trying to navigate. We firmly believe that it is our responsibility to do what is right for our child, even if our beliefs differ from the general public, government, or pharmaceutical companies.

Sent by A Sharp | 5:03 PM | 6-3-2008

First, thanks for pleasant discussion instead of normal online arguing.

I erred in my wording, I was trying to avoid sweeping possibly incorrect terms. "Most medical intervention" is not something easily proven, I retract that statement. But the C-Section rate is very high, around 30%. Very few of the technology advanced countries have that kind of number. Japan is around 8%. And every country in front of the United States in mortality rate still uses Midwifery principally instead of medical doctor primary care.

Then once the baby is born the laundry list of tests, shots, etc.. that is presented is staggering. I recently had my first child and me and the wife had to turn down countless pointless "procedures". Unfortunately, a big part of this is the sue-happy culture we live in, the hospitals want to cover their butts. They wanted to treat our child for Jaundice because it "might" have a higher possibility of getting it, not that he had it. Sigh.

Gotta go, I will try to complete some more of my thoughts later...

Sent by WDH | 5:07 PM | 6-3-2008

I vaccinated my child, but I didn't like the aggressive schedule that is generally recommended. We opted to get only two vaccines at one time, and made a couple of extra visits to the clinic to keep on schedule.
The nurse at the clinic praised us, saying that she thought 4-5 vaccinations at one time is a lot for a little one to handle.
I do believe that some children suffer long term negative effects from vaccinations, but the public health issue is pretty compelling. I wouldn't get my child vaccinated if he was sick or taking medication. The vaccines are a stress on the system; if your kid is already struggling, the added stress of the vaccine might be enough to trigger a serious condition.

I've also opted not to vaccinate for chicken pox. I'm inclined to expose my kid to the disease, especially after hearing the recent NPR piece on shingles.

Sent by Denise Dennis | 5:19 PM | 6-3-2008

A Sharp: "I think that benefits of the vaccines for polio and meningitis are worth the risk, but do not think the same about the vaccines for chickenpox and HPV."

This is a good point. Vaccines are not an all or nothing proposition. It is not a bad bet, however, that if a vaccine exists it exists for a reason. Speaking as someone who still has scars from a childhood case of shingles I think the chickenpox (same virus) vaccine is a boffo idea. Doctors are now on the edge of recommending this vaccine for older folks as well. Childhood immunity wears off and shingles is a disease that hits harder the older you are when you get it.

HPV vaccine is a pretty good idea as well. The phrase "the cure for cancer" is bandied about a lot. This vaccine is not the cure for cancer, but it is very effective at preventing one type of cancer. If I had a child this too would be an easy decision.

Sent by Dave Wiley | 5:35 PM | 6-3-2008

@Dave Wiley, first of all, I had chickenpox myself, along with every other primary student at St. Theresa's in Palatine,IL, and it was not fun. I don't know what scars shingles leave, but I have freckles where no one should. I know, TMI.

While I agree with you about the HPV vaccine, because of how HPV is contracted, there needs to be more clinical sociology attached to how to counsel parents and children about this vaccine than other vaccines. I've heard legislators who, when trying to mandate this vaccine, have said words to the effect of, "Since they're going to have sex in high school anyway, you better give them the vaccine." I do hope none of those legislators are MD's. Mind you, I agree with the same outcome, but that's the wrong intent. As a parent, much less the child, I would greet that kind of attitude with an equal mixture of anger and embarrassment, which is the worst thing to happen to such a great vaccine.

Two parishioners in my parish were featured in the local newspaper regarding the HPV vaccine, and I think their attitude about the vaccine is a great example of the way the HPV vaccine should be counseled. Their father died of cancer, and they didn't want their mother to hurt again because they got cancer. One of them said, "I'm not going to need it until I'm married, but, since it'll help me then, I should take it now." From the mouths of babes.

Every family is different. If the child is already sexually active, there should be a different tactic than one who isn't, for example, which is why we have to be sensitive to sociology involved with this particular vaccine.

Sent by Matthew Scallon | 6:18 PM | 6-3-2008

@Alison: That feeling of being a new mother is coming back to me through your experiences. I remember questioning all of this stuff, too. We held off on the Hepatitis B vaccine for my daughter because of the controversy surrounding it at them time. Eventually she got it and she is fine. Then we tried waiting out ear infections instead of getting tubes. That didn't work. It just delayed the inevitable. Of course, there will always be questions and challenges, that's parenting. My daughter is 9 now and puberty is our next challenge. I wish there really was a Mother's How-to Handbook.

Sent by lc | 6:39 PM | 6-3-2008

@WDH, yeah, it is kind of nice when we all can play in the sandbox with no one getting sand in their eyes. We should do this more often. And, thank you for the clarification. I agree with you about C-sections. My wife only agreed to one after 30 hours of induced labor with our boy not budging.

I don't remember much testing from the hospital for our son, just a genetic test and maybe one oral vitamin. As you said, maybe this hospital's administration feared becoming a lawsuit magnet.

As far as the jaundice goes, I think that might just be standard issue. I know my son had the whitest of whites of his eyes (whiter than mine). But, it's San Diego, and our room faces south toward the sun, and it's only 5 minutes a day, so why not, we thought. Also, since my son is biracial, I was afraid that he would be as pale as I am (irrational, I know; but I was sleep deprived). Since then (Roy's almost 8 months), my wife and I, when taking our son for a walk, call the walk "giving him his jaundice treatment" or just "jaundice." I know childhood diseases are scary, but it's good we've able to keep our humor about us.

Sent by Matthew Scallon | 6:52 PM | 6-3-2008

@Denise Dennis, by long term negative effects, do you mean something other than autism? I'm not sure I follow. Do you mean psychological scarring from the pain? If it's that, I can tell you that the moment a woman smiles at my son, he flashes his toothless grin, and all is forgotten.

So, I guess I want to know what other long-term effects do you mean?

BTW, as one who survived the Battle of Chicken Pox Ridge, give peace a chance.

Sent by Matthew Scallon | 6:59 PM | 6-3-2008

@A Sharp, is your state mandating all or nothing? That's odd.

One of the shots that was recommended for my son was the hepatitis-B vaccine. When I heard it, I said to the doctor, "I don't remember getting that one." He told us that they don't require it but it's recommended if, as my devout Catholic doctor put it, "he's doing things he shouldn't be doing." Since I don't see him in that kind of scenario at least until puberty, we opted out of that vaccine. And, no I didn't have to sign a religious waver on that either.

Either someone's giving you false information about your state's vaccination laws, your doctor doesn't know the state's laws (that's scary), or your state's vaccination laws are fubar. Any one of these things are bad. Which state do you live in? I'll try to research your state's laws.

Sent by Matthew Scallon | 7:14 PM | 6-3-2008

@Matthew Scallon: "While I agree with you about the HPV vaccine, because of how HPV is contracted, there needs to be more clinical sociology attached to how to counsel parents and children about this vaccine than other vaccines."

I agree with your sentiment as well. These choices should be left up to the individual. Here's the way I boil it down. Most people will have sex with at least one other person in their life. That person may have HPV. Why not be safe? As to when I would think as early as is reasonable. If one grants the premise that the vaccine is useful then I can't think of a good argument to postpone getting it.

Sent by Dave Wiley | 12:16 AM | 6-4-2008

@ guys are great. Thank you for all the thoughtful responses.

Sent by Alison Stewart-NPR | 6:16 AM | 6-4-2008

I find it interesting that there are no anti-vaccination comments on this blog. I appreciate the comments I have read, and their mostly reasoned tone. I would, however, like to respectfully make a few points.

While it can not be argued that childhood vaccinations have not been a incredibly effective boon to public health, it is close minded to dismiss off-hand the mounting evidence that in some cases vaccination can have a negative effect on your child's health (beyond the admitted risks). Though the recent court decision concerning vaccines contributing to preexisting genetic conditions stopped far short of making a direct connection between vaccination and autism, it should give a parent pause.

Does your child have this predisposition? What percentage of the larger population has this predisposition or others? What factors, other than vaccination, could account for Amish and other religious communities having effectively no cases of autism? What other factors have caused the autism rate to jump from one in 10,000 in the early 20th century to one in 150 today? These questions just barely scratch the surface of the debate.

By no means am I suggesting that parents do not get their child vaccinated. But do not dismiss reasoned concerns. In any state, no matter the law about school attendance, a parent has the right to request an exemption from a their school board for their child to not get vaccinated. New York is now moving to make vaccinations mandatory, but currently no law can force this medical procedure on you or your child.

Finally, do not give in to aggressive vaccination schedules forced on your child by an HMO or insurance company. One vaccine, and the mercury it contains, is the equivalent of ten vaccinations in an adult. To give your child four vaccinations in one day is an unnecessary risk. Would you submit to forty vaccinations at a time? On the face of it, clearly a ridiculous proposition.

This is an important topic, and I look forward to seeing a lot more discussion in the public sphere.

As a bit of a post script, also keep in mind the massive amount of money that Big Pharm rakes in from vaccinations, and the massive amount of money spent not only to lobby Government, but also to sway public opinion.

Sent by Ryall Hyatt | 1:36 PM | 6-4-2008

Wow Alison. You got people going didn't you :). Well we have a 2 1/2 year old and we went through the same questions. Autism is a horrible thing. I understand parents concern. Would the pharmaceutical companies tell us if their products caused Autism? Can you say "class action"?

On the other hand, it is human nature to blame something for autism. We all want to know "why me". Is it vaccines? Hard to say, it could be plastic for all we know.

We gave our child most of her vaccinations, but on an altered schedule.

Ike should be just fine!

Sent by Jim Trenton | 4:30 PM | 6-4-2008

@Ryall Hyatt, if I may, I don't believe those concerns are being dismissed here. I think one thing some of us have said, including myself, is that the rewards of most vaccinations outway the remote risks.

In regard to "mounting evidence," I respectfully dispute that term. There are anecdotes, repeated a thousand times and then believed to have occured a thousand because of said repetition. There are post hoc fallacies of a mercury perservatives in vaccines coupled with increased diagnosis of autism.

My son had genetic testing which included a lot of the standard (e.g. spina difida (sp?)), but I don't believe the predisposition from the one court case had so much as a name let alone a pre-diagnosis test. Hopefully, one will be forthcoming --modern medicine is good like that.

As to the Amish community, this comes back to my statement of increased diagnosis of autism. In earlier decades, autism wasn't so widely diagnosed: someone with autism might have been characterized as weird, anti-social, or solitudinal. As well, in those aforementioned religious communities, shunning is practiced on those individuals who do not conform to social norms, so it's difficult to conclude that there are no cases of autism among the Amish; just the lack in the Amish community as it's consistuted today.

Now, while it's fair to have a healthy fear of mercury, it's also important to know that most vaccines are not preserved in mercury. That said, in spite of the polemic originally cited, mercury isn't the second most poisonous substance on the planet. Human beings have lived side by side with mercury for millions of years. And, even if it were so dangerous, like all other poisons, it depends upon levels, concentration, and frequency. As an example, if my wife were to eat sushi (she doesn't, but work with me), there will be tiny amount of mercury in that fish, and an even tinier amount of that mercury will end up in her breast milk. Am I worried about my son? No, because the amount is so small, it will pass through him within days. Besides which, so long as she didn't eat sushi day in and day out, the amounts will stay low. Mercury is not like Kryptonite for Superman; it won't kill you with only one molecule.

I really have to ask where you got your values regarding one vaccine for a baby is equivalent to ten for an adult. While a baby has less body mass, they also have higher metabolism and more fat directly under the skin (the good kind of body fat). So, again, cite me your source or please refrain from referring to other propositions as "ridiculous."

BTW, Denise Dennis already said she spaced out the four shots over a couple of clinic visits, so, again, it's not an either-or.

Granted, on one side, there are large drug companies whose profits depend on the sale of the vaccines. However, as equally onerous, there are on the other side advocacy groups, professional victims, professional doomsday prophets, and their accompanying trial attorneys who look at the other side as the Golden Goose that laid their golden eggs. I hope that there are unattached scientists (and let's not pretend that scientists don't have their own respective political agenda) who can study this issue without interference from either side. So far, the scientific record shows no link between vaccinations and autism, in spite of --no doubt-- your well-intentioned claim of "mounting evidence." But, as a scientist, I know there's never a final chapter on any textbook, so, if you turn out to be right, I will humbly concede. I hope, if the opposite is true, you'll do the same.

Sent by Matthew Scallon | 5:12 PM | 6-4-2008

@Ryall Hyatt: "Though the recent court decision concerning vaccines contributing to preexisting genetic conditions stopped far short of making a direct connection between vaccination and autism, it should give a parent pause."

Court opinions are rarely based on a good understanding of science. Most commonly two or more experts with differing opinions pitch their case and a judge decides or a jury votes on which presentation they liked better. This is good at deciding court cases, but a lousy way to ascertain the truth.

It is right and good that parents are concerned for their children, but they should not be concerned about this subject for three reasons:

1) Thiomersal was dropped from infant vaccines in the United States years ago. Not only is this a reason to no longer fear vaccines, but since there was no drop in autism rates afterwards this strongly implies that thiomersal was never to blame.

2) There is no good science describing how thiomersal could cause autism.

3) There is no good science suggesting a correlation between thiomersal and autism. We American's make way too much of correlative studies anyway. Correlation is only a starting point for science -- never an ending point. For example: death rates due to infection dropped precipitously after the invention of the bikini. Even today, however, few doctors prescribe the bikini treatment. They are more inclined to prescribe the antibiotics that were perfected at about the same time.

There is a lively debate over the rise in autism rates that will probably rage for years to come. My favorite theory is that we are better at diagnosing autism or at least more likely to diagnose a behavior problem as autism than we were before. (This theory has the advantage of being nearly impossible to prove or disprove.)

As to why the Amish have lower autism rates, there are many possibilities. Their culture of intermarriage argues more strongly for a genetic basis for autism than their reluctance to vaccinate. Or perhaps their tendency to avoid western medicine in general could lead to a lower diagnosis rate but not an actual lower rate. Possibilities abound. Again, correlative studies should always be taken with due skepticism.

Sent by Dave Wiley | 5:58 PM | 6-4-2008

I have worked at an airport as an Immigration Officer, seen co-workers infected with TB, and was three feet from a client who had a "mystery illness" from Africa ( doctors thought at first it was Ebola and never did find a diagnosis), therefore I highly value the vaccination system that our two countries (Canada and USA) have put into place!!! While your precious snowflake has not left your respective state, he or she is being exposed to all kinds of viruses from Asia and Africa that you never even imagined existed. Eight years of on-the-job experience tells me that our globalized world means that an illness hosted by an individual in Nairobi could be in Kansas in less than a day and a half. It is naive to think that just because a given illness (TB, Malaria, Typhus) does not thrive in N. America at this point, that it could not do so five or ten years from now, because we did not take preventative measures when necessary.

When I was 20, I lost an adult friend to Chicken Pox which combined with pneumonia and killed her. Getting chicken pox as a child is somewhat luck of the draw- who knew that if she had had it as a child or been vaccinated it could have been her Blackjack to life?

With respect to HPV, you have a 30-50% chance of getting one of the 100 strains of it the first time you have sex. Whether you have sex for the first time at 15 or at 25, your possibility of infection remains the same. HPV does not care about your parental units' values and morals, and it is a nice concept to hope that your child will wait to finish college, find a job, pay off their student loans, get promoted, find true love, get married and then have sex (but only for the purposes of giving you grandchildren), but this is not always how the world works. When we think of our children's sex lives (shudder) we idealize it and like to picture it as only leading to the production of legitimate grandchildren, but for some children their future sexual experiences will be less than ideal. We cannot forsee that when they are less than 2 years old and we are deciding which needles to stick, but what we can do is acknowledge that someday they will be adults, and we can be proactive about their health.

Sent by Juli | 9:25 PM | 6-9-2008

Wow, I don't know where to start. I am amazed at the lack of informed commentary here. The plethora of blanket statements that "the benefits of vaccination outweigh the risks" speaks to a lack of awareness about the myriad risks posed by vaccination. Also, the only risk discussed here is the autism/thimerosal correlation, just one of many, but the one taking center stage in the media.

I also see some exaggeration in these comments. Matthew in San Diego, you claim that a girl gave measles to "everyone" in her daycare center and doctor's office and "everyone" aboard a plane to Hawaii. That would probably calculate to an excess of 100 cases of measles. The recent Measles outbreaks announced by the CDC have numberered in the one or two dozen range, not 100's. I haven't heard of the "epidemic" you're speaking of and I don't think the CDC has either. Could you please cite your sources? Also for your comments that "a fifth of all children would die before their fifth birthday" without vaccinations?

Here a just a few risks of vaccination:

1) Contamination from various sources. Are you aware that during the late 1950's and early 1960's millions of people were vaccinated with polio vaccine contaminated with simian virus "SV40"? This is widely acknowledged in the medical literature and there's an award winning book about it called "The Virus and the Vaccine". On the subject of contamination, are you aware that the FDA issued a warning letter to Merck's West Point, PA vaccine manufacturing plant in April of this year citing over 40 violations of "good manufacturing practices"? Read it yourself:

2) Are you aware that all vaccine manufacturer's package inserts (I have read 50 of them) contain the following disclosure: "This product has not been tested for carcinogenesis, mutagenesis or impairment to fertility." Read them for yourself:

I could cite more information, but don't want to monopolize this blog. Please inform yourself before you pass judgment on others for their decisions.

Sent by SD | 11:19 PM | 7-2-2008

After reading this blog again I feel compelled to make further comments. To the respondent claiming to be a scientist: I honestly intend no attack here, but your comments are replete with hyperbole. Scientists are generally a rather exacting breed not prone to exaggeration. I also note that you ask others to cite their sources, yet do not return the favor. My intent here is not to criticize, but to remind everyone to please stick to the facts (and preferably provide reference citations). This is a complex and very serious topic with risk inherent in all the options.

The topic of vaccination generates quite a bit of online opinion and posturing, from amateur bloggers to self-proclaimed "experts". Each parent owes it to their children to thoroughly research this subject and to come to their own conclusions. A decision that some people consider a "no-brainer" stimulates others to investigate and analyze the facts for themselves. Any physician reassuring me that consumption of any vaccine or pharmaceutical is a "no-brainer" is not being honest about risk factors and would not be my physician for long. Given that death from iatrogenic causes (death caused by medical treatment) is the third leading cause of death in the US (approximately 225,000 deaths annually, after deaths from heart disease and cancer) [Starfield B. Is US Health Really the Best in the World? JAMA, July 26, 2000--Vol 284, No. 4, 483-485] I don't intend to succumb to a "no-brainer" mentality (excuse the oxymoron) on this or any topic. There should be more tolerance for informed decision making rather than fear mongering and labeling.

Sent by SD | 1:59 AM | 7-3-2008