Risking deadly diseases

"Risking deadly diseases" Continued...

Issue: "Between Hell and Hope," Feb. 12, 2011

So does Gainesville, Fla., pediatrician Tom Benton, a longtime member of the Christian Medical & Dental Associations (CMDA), which officially endorses vaccination. During Benton's residency program at a Houston children's hospital in the 1980s, he saw children suffering the effects of meningitis (induced by the Hib bacterium) on a weekly basis: "Their mental health would be damaged. Their hearing would be damaged. And some of them didn't make it."

Since the 1987 introduction of the Hib vaccine, such infections have virtually disappeared. Benton acknowledges that there are risks to taking vaccines-but he doesn't think they warrant forgoing shots altogether: "I accept that not every parent agrees with that. But it doesn't sway me."

(Benton also noted some Christians object to certain vaccines that were originally developed using tissue from aborted fetuses. CMDA lists them on its website, cmda.org.)

It's true that some diseases are rare in the United States today, but they're often kept at bay by the largely immunized population. Remaining unvaccinated increases risk for all: A 2009 Pediatrics study found that the children of parents who decline vaccinations were 23 times more likely to catch pertussis. Outbreaks sometimes target groups of unvaccinated people as well, as in 2005 when an Indiana teenager returned from a Romanian mission trip carrying measles and passed the virus to three dozen church members. Most were young, homeschooled, and hadn't been vaccinated for the disease.

Although no deaths occurred, outbreaks prompt some disease experts to push for government intervention. A 2007 article in the Journal of Law, Medicine & Ethics argued state governments should enforce vaccination among homeschoolers just as they do public- and private-school students. North Carolina has already taken that approach, requiring parents to keep immunization records for their children at home. West Virginia and Mississippi don't allow public- or private-school kids to opt out of vaccines unless they have a medical reason to do so.

"I would be against vaccine mandates even if occasionally it did result in an outbreak," said Jane Orient, an internist and executive director of the 5,000-member Association of American Physicians and Surgeons based in Tucson, Ariz. "It's a basic freedom issue." Orient views parental resistance to vaccines as positive because it helps guard against "sloppy testing" for safety.

In spite of the whooping cough outbreak in California, Sears takes parents' concern in stride. He guessed roughly one-fifth of his patients choose not to vaccinate, and another 10 percent use a delayed schedule, spacing the shots out over a child's first years. "Most doctors actually kick such patients out of their office. I don't think that's a very open-minded policy."

The real blame for whooping cough outbreaks, Sears said, lies less with apprehensive parents and more with the fallibility of the DTaP vaccine, which provides actual immunity in about 85 percent of cases. In addition, whooping cough regularly increases and decreases in the United States about once every five years. The last peak was in 2005, so the 2010 outbreaks are "actually no surprise," said Sears. (Some also speculate that new strains of pertussis are resisting the vaccine.) Still, the vast majority of whooping cough cases he has seen, said Sears, have been among unvaccinated patients.

Whooping cough is generally only dangerous for infants, but newborns like Callie Grace are too young to receive a pertussis vaccine themselves. To provide a cocoon of protection around a baby, doctors recommend family members get vaccinated. The whooping cough shot for teens and adults, called "Tdap," isn't foolproof-and its effectiveness wears off over time-but it reduces the chance of transmission.

Katie Van Tornhout said she and her husband weren't aware of the adult pertussis vaccine when Callie was born. Today, they aren't taking any chances: With another baby in the house (Chesney Rose, born in December), they've put a "do not enter" sign on the front door for anyone who hasn't had a Tdap booster: "People think we're crazy, but if it's going to protect somebody's life, then I'm all about it."

Lost linkage

Mystery over the apparent increase in children with autism over the last several decades has led many to speculate that the developmental disability can be triggered by vaccination. Although controlled studies looking for a link between vaccines and autism have failed to find one, a survey last year showed 1 in 4 parents still suspects a connection.

The vaccine-autism hypothesis faced two major setbacks in 2010: In February, the British journal The Lancet retracted an influential 1998 paper linking autism and childhood vaccinations and said the lead author, Dr. Andrew Wakefield, had falsified his data. In May British medical authorities barred Wakefield from practicing medicine in the UK. Wakefield responded saying his work had been "grossly distorted."


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