Ask The Doctor

Dear Caring Mother
In comparing the risk of giving the vaccine to the risk of a child contracting a disease, every situation is different. In medicine, this is referred to as the risk-benefit ratio. What is the risk of getting the vaccine vs the benefit of avoiding the disease? If a child is vaccinated, what are the risks (side effects)? If a child is not vaccinated, there are many factors involved in whether or not the child will actually be exposed to the disease, will contract the disease, and will suffer from having the disease.

Therefore, in any given vaccine, the question is whether or not the risk of vaccination outweighs the risk of getting the disease.

The number of vaccines added to the list of recommended or required vaccines for children has increased tremendously in the past 10 years. The 1995 list included DPT (diptheria and pertussis and tetanus), polio, and hepatitis b. Now added to the 2007 list is pneumococcal, influenza, varicella, hepatitis a, rotavirus, meningococcal, and human papilloma virus (HPV). Infants receive 4, 5 or even 6 shots at a single visit, encompassing up to 9 diseases.

For the most part, immunization is based on the concept of “herd immunity”, a type of immunity that occurs when the vaccination of the a portion of the population (or herd) provides protection to un-vaccinated individuals. The theory behind the development of “herd immunity” is: in diseases that can be passed from person to person, it is more difficult to pass that disease easily when there are those who are immune to it. The more immune individuals there are, the less likely it is that a susceptible person will come into contact with someone who has the disease.

Even if valid, the concept of herd immunity does not apply to some vaccines such as the tetanus vaccine, which protects only vaccinated persons from pathogens, and does not generate herd immunity within the population.

Since 1991, Hep B is a vaccine given to all newborns. Yet it is virtually impossible for a baby to get hepatitis B unless the mother is infected. Unlike diseases that are transmitted via air and casual contact, hepatitis B is transmitted by direct contact with blood and other body fluids. Those at risk include intravenous drug users, sexually active individuals, blood transfusion recipients, and health care workers.

Yet hepatitis B vaccination is mandatory for attending day care and 42 states added the vaccine to their lists of immunizations required for attending school. This is because, in failing to reach the high-risk populations, public health officials are making hepatitis B vaccination compulsory for all children, even infants who clearly are not at risk. Infants are simply the easiest targets to immunize.

The question to ask with each and every vaccine is whether or not the disease is highly contagious and/or likely to be contacted. Balance this against whether the disease can be prevented by abstaining from exposure. A final note is the concept of passive immunity. Immunity is transmitted from mother to baby via breast milk, so a mother who has antibodies against any of the diseases in question, whether by having had the disease of by having had the vaccination, will pass on the immunity during the period of time that the baby is being breastfed. This is another reason to breastfeed your baby well into the second year, and beyond.

A general discussion about alternatives to vaccines can be found on my website here: http://www.attachmentparentingdoctor.com/vaccinations.html

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Dr. Susan Markel, MD, is a Board Certified Pediatrician, and Attachment Parenting Advisor. She is also the author of, "Ask The Doctor," in partnership with ERGObaby. If you have additional questions, please feel free to visit her website at http://www.AttachmentParentingDoctor.com and request a private consultation.