Health and Science News for Parents
Jun
3

An important study from New York leads to my own “vaccine story” about my son

written by Tara Haelle

Today’s post is a little different. After I describe a recent study in Pediatrics, I’m going to tell another personal story — what happened when I vaccinated my son. Stories from parents about what happened when their children received their vaccines populate all corners of the internet, and I felt it was important to add mine to the mix, especially following this study, for reasons that will become clear.

The study looked at the rates of religious exemptions for immunizations in New York state and then looked at pertussis (whooping cough) rates across the state. Pertussis, or whooping cough, is the bacterial respiratory infection that causes severe coughing for weeks or months and can kill vulnerable individuals, primarily young babies. Religious exemptions are available in 48 states (Mississippi and West Virginia don’t have them), with varying strictness and requirements, for parents who state that vaccinating their children would violate their religion. It’s worth noting that only one major, recognized religion teaches beliefs that may be contradictory to vaccination — Christian Science, which has only 900 to 1,100 churches throughout the entire U.S.. Yet even Christian Science church leaders often encourage adherence to vaccination laws, and outbreaks have started in Christian Science communities. (Contrary to some people’s beliefs, the Amish do vaccinate their children.)

The researchers found that the use of religious exemptions has increased over the past decade in New York, from 0.23% in 2000 to 0.45% in 2011. These are admittedly small percentages, but the percentage of religious exemptions more than doubled in 34 counties (out of 62) over that decade. While the lowest county rate was 0.06%, the highest was a significant 5.6%. In addition, as pertussis rates have increased throughout the U.S. over the past decade, they’ve increased at a higher rate in the New York counties where religious exemptions increased as well. Counties with more than 1% of residents using religious exemptions had 33 pertussis cases per 100,000 individuals, compared to 20 pertussis cases per 100,000 people in counties with religious exemption rates below 1%.

I felt much better after my son's 2-month well-baby visit, when he was protected from pertussis and other vaccine-preventable diseases.

Unsurprisingly, unvaccinated children in New York were at higher risk for pertussis than vaccinated children — 14 times greater risk with 302 cases per 100,000 unvaccinated children, the authors found. But here’s the part of the study that concerned me the most: “High exemption rates in the community increased pertussis risk for both vaccinated and exempted children and especially among vaccinated and exempted children living in counties with high exemption rates (P = .008). In counties with overall low exemption rates, the incidence of pertussis in vaccinated children was not significantly influenced by pertussis infections among exempted children.” (The p value means there is only a 0.8% chance these findings are due to chance.)

I’ve often heard (or read online) parents of unvaccinated parents say something to the effect of, “What difference does it make to you whether I vaccinate? If you vaccinate, my child’s vaccination status doesn’t affect yours.” That’s dead wrong. Especially with a disease as contagious and prevalent as pertussis, and especially given the limited long-term effectiveness of the current pertussis shot, other parents’ decisions not to vaccinate their children absolutely affects my children. It affects my vaccinated child, who is at greater risk for pertussis if herd immunity is reduced, and it puts any babies under 2 months old (when kids get their first DTaP shot) at very high risk for a disease that can kill them — 18 babies died of pertussis in 2012.

While this study does not discuss why religious immunization rates have increased, other studies have shown that parents use medical exemptions to skip public school or daycare vaccine requirements because they have unfounded fears about vaccine safety. Religious exemptions are also frequently (mis)used by parents to avoid vaccinating their children even if immunization would not actually be against the family’s religion. Sometimes, a family seeking an exemption does not even belong to a church; the Internet is full of stories of parents lying to get religious exemptions. They believe vaccines are unsafe or unnecessary, so they seek a religious exemption to avoid school immunizations requirements. Their fears lead to more exemptions, which leads to higher rates of disease, which leads to more death. Pertussis is the only vaccine-preventable disease with an increasing rate of deaths in the U.S. While the increase in pertussis rates is largely due to the long-term waning effectiveness of the current vaccine, this study demonstrates how vaccine fears and exemptions are contributing as well.

And that’s what brings me to my story about vaccinating my son. As I mentioned, the internet is full of parents’ vaccination stories. These stories are earnest, most filled with sadness, tragedy and tears. Unfortunately, nearly all of them inadvertently contain a damaging element of untruth which feeds the fears I described above. That’s why I’m telling my story.

I did not give my son the hepatitis B shot when he was born. I was still uncertain and had not done enough research to feel comfortable with the shot. (Today, however, if/when I have another child, I will have them get the hep B shot at birth.) Yet for the next two months, I lived with a bit of anxiety until his 2-month well-child visit. I lived in Austin, where we have a substantial population of “crunchy” mamas who don’t believe in or fear vaccination and where pertussis rates were accordingly substantial. I had done my research on vaccines with credible (and, for curiosity’s sake, non-credible) sources, and I was confident regarding the overwhelming evidence about their safety and effectiveness. But I was uneasy about the many families in my community who did not believe in vaccines’ safety or effectiveness; they increased the risk of a local outbreak. I was careful about where I took my son and who we visited or who visited us because I was legitimately concerned about the risk my son could contract whooping cough, and die from it.

At his 2-month visit, my son got all the recommended immunizations, plus his first hep B shot. He got the first round of rotavirus, DTaP, Hib, pneumococcal and inactivated polio vaccines. The nurse was impressively fast with sticking those needles in his little legs, and I was unsure how he would react. His face scrunched up, and he cried a little. I nursed him immediately afterward. We left about 15 minutes later. That day, my son ate, slept, cooed and cried like he had the day before. The next day, he ate, slept, cooed and cried as he always had. Over the next several weeks, I noticed nothing unusual. Before long, it was time for his 4-month well-baby. Again, he got all the recommended vaccines. Again, he scrunched his face and cried but only briefly. Again, I nursed him. He slept a little extra that day, but otherwise, nothing unusual occurred. If he had a fever, it was small enough not to be memorable. The days and weeks following his 6-month visit, when he again received all his recommended shots, were similar.

Then his 1-year visit approached. This was the one where he would get his first dose of the MMR, the vaccine that protects against measles, mumps and rubella that so many still worry about because of a long-debunked, scientifically invalid, non-replicated study of 12 children by a fraudulent researcher who lost his medical license. My son would also get the varicella (chickenpox) and hepatitis A vaccines. He received them all. He barely flinched and didn’t even cry this time. I was a little surprised but glad. And that was it. Weeks and months later, my son continued developing as he always had with no noticeable changes, delays or concerns.

It’s not a very exciting story, is it? Honestly, the most “exciting” part was my anxiety: the stab of uncertainty I had before each round of shots, despite my knowledge of vaccine safety (after all, I’m human, and my amygdala is just as powerful as anyone else’s), and the worries I had about him actually contracting pertussis before his 2-month shots or measles before his 1-year shots. The latter was far less likely, but it was not impossible. Despite the lack of drama in my story, however, mine is the more common story.

What about those other stories I mentioned? Most of them are “vaccine injury” stories, describing a disease or injury or disorder that reportedly resulted from a vaccine (I’ll get to that in a moment). If you added up all the stories you read on the Internet in two columns — the “vaccine injury” ones and the “I got my kid’s shot and nothing happened” ones — the former would outweigh the latter by several hundred. Yet this lopsided proportion does not reflect reality. The reality is that millions of children get their recommended shots every year and nothing special happens. Many cry. Many suffer a fever. Many sleep for longer. Many have soreness and redness at the injection sites. Some experience a high fever or sleep heavier than usual for a few days. And nearly all are a heck of a lot more protected from the diseases that ravaged past generations.

Those diseases still ravage some families, all across the world and even in the U.S. Sadly, though, if you search for the stories of families where a child suffered from a vaccine-preventable illness, even these would not (yet) outweigh the misleading “vaccine injury” ones, yet more children become sick and even die of vaccine-preventable illnesses, even in the U.S., than suffer a serious side effect from a vaccine. That’s just not the story Google tells in the new “information” age where everyone, for better and for worse, has a voice and a story to tell. The problem with these “vaccine injury” stories is that they perpetuate beliefs about the safety of vaccines that are inaccurate and dangerous. The “damaging element of untruth” I referred to is the fact that the injury being described, in 99.9% of them, had nothing to do with a vaccine. Whatever injury, disease or disorder the parents are describing is almost certainly real. It also certainly causes the child and the parents pain and difficulty, and the suffering for the child and the parents is undeniable and tragic. And the injury and suffering have nothing to do with the fact that the child got their vaccines around the same time the condition’s symptoms showed up.

There are real risks to vaccines and real injuries that can result from them. I’ve written about them in this blog, and most of the serious ones (things other than fevers, soreness, sleepiness, etc.) occur to about fewer than 1 in a million children, or even 1 in 10 or 100 million, depending on the vaccine and the side effect. But those facts are not part of the reality portrayed in these many unfortunate stories online. Humans often have a hard time accepting coincidences as… coincidences. Parents want an answer and then make the mistake of presuming that vaccines caused whatever disorder, disease or other health problem the parents have described.

But consider this scenario: If a parent took their child to the 6-month well-baby visit and got their shots, and then visited a friend’s house a week later, where the baby got nipped by an overprotective dog, chances are pretty slim that the parent would draw a connection between the dog bite and the vaccines. The parent likely would not even think about the pediatrician visit. If someone else brought it up, just about any reasonable, rationally thinking parent would consider it a coincidence that the dog bite happened within a week of the vaccinations.

Not so when it comes to countless illnesses or disorders that have been inaccurately and inappropriately linked to vaccines, such as autism, ADHD, asthma, brain damage, eczema… the list goes on. Yet dozens and dozens of studies have found, using appropriate scientific methods with millions of children from all sorts of populations, that vaccines do not cause these and other health issues. Most often, there is not even a biological mechanism that makes it possible for the vaccine to cause the condition in question. The disorder or injury the child is suffering is no less a coincidence than a dog bite, a car accident or any other unfortunate incident that might happen in the weeks following vaccination. The tiny handful of serious risks that can be caused by a vaccine, usually to an already immune-compromised child, are so rare that a child has a greater risk of contracting a vaccine-preventable illness, whether it’s an endemic one like pertussis or one brought over from an outbreak like the huge measles one in the UK right now (or the smaller one currently in Brooklyn).

Again, people have a hard time with coincidences. They want to believe they are something more than a mathematical reality, and their personal experience feels like it trumps the mountains of scientific information showing that a vaccine didn’t and cannot cause what they think it did. So they share their “vaccine injury” story, feeding unfounded fears that ultimately put my vaccinated child, and millions like him, at risk.

23 Responses to “An important study from New York leads to my own “vaccine story” about my son”

  1. You might be interested in Jennifer Byde Myers’ story of “the day her baby cried louder than science” http://www.thinkingautismguide.com/2011/08/my-baby-cried-louder-than-science.html

    Not dissimilar to your story….

  2. Marie

    so well-written. thanks for your personal (boring!) immunization story. We should get Tshirts made that say, “my kid is vaccinated and you’re welcome” (just kidding. kinda)

  3. Thank you for writing this! My son’s vaccine story is similarly unremarkable, but I guess it doesn’t sell papers. Hmmm actually he started walking soon after his MMR, maybe the MMR causes walking?

  4. Tara Haelle

    Marie and N Read, thanks! I hope that more parents start sharing these stories. I know Momma PhD shared hers today as well: http://mommacommaphd.wordpress.com/2013/06/03/another-unremarkable-reaction-to-vaccinations/

  5. KATHY

    I must say this is a very welcome story – if not rather boring! Thank you for sharing. My precious baby girl’s immunisation journey has been similarly unremarkable, aside from some vomiting and restlessness after her shots at 6 months, which were probably from the rotavirus vax. All this did was make us realise how good it is that this was only a minor reaction – and allowed us to imagine what a full-blown rotavirus illness would have been like. ‘Imagine’ being the operative word.

  6. Tara Haelle

    Thanks, Kathy! And I should mention for anyone commenting here who is not familiar with the organization that Voices for Vaccines is always looking for more parents to promote the value and importance of vaccines. If you haven’t checked out their website or joined, please do! http://www.voicesforvaccines.org/

    • KATHY

      I will definitely check it out. I’m on the pro-vaccine bandwagon at the moment… there is lots going on in Australia (where I live) about vaccines at the moment, as we are heading into a winter where there are likely to be outbreaks of preventable diseases. I don’t know if you’re following the situation here, but a couple of our state governments are passing legislation to try to increase declining vaccination rates, by making it legal for childcare centres to ban unvaccinated children. There has been a huge outcry from the prominent anti-vaccination lobby group, the Australian Vaccination Network. This legislation is on the back of a media-led campaign to do something about the rising rates of vaccine-refusers in Australia and the tragic deaths of little babies from pertussis in recent years. Anyway, I could go on and on, but should also mention that I have felt compelled to ‘do something’, as a concerned mother and citizen and have started a Facebook page ‘Vaccine Information’, which tries to provide science- and evidence-based information for parents who are unsure about the safety and efficacy of vaccines. Unlike some other pro-vaccination Facebook pages, I intend to keep ‘debates’ to a minimum, name-calling and derogatory comments about people who don’t vaccinate are banned, and I won’t be posting emotional images of babies/children suffering from vaccine-preventable diseases (too upsetting!). I think these types of things have their place, but I wanted to (try) to offer something a little different. I’m akso thinking of starting a blog or website. I feel like there are lots of well-meaning parents out there who have been scared by anti-vaccination campaigners into making the wrong decision for their precious babies. I’m hoping this might go a small way to providing information to some people. Woah, sorry for HUGE POST. PS your son is super gorgeous!

  7. Stephanie Christine Carlson

    The only reaction my daughter has had to any vaccines she’s had is the fact that she can be an epic boob for a day or two after.:-)Thank you for sharing your story.

  8. The State of New Mexico eliminated philosophical exemptions to vaccinations, and required that the parents provide evidence that they belong to a religion with a dogma opposed to vaccines. It won’t eliminate all of the abuse, but it makes the parents who want exemptions to work at it. Of course, maybe they’ll worship at the Church of Wakefield or something.

    • KATHY

      Michael, I don’t know if you read my comment above, about the new legislation in New South Wales in Australia – and possibly other states. There is much debate about a ‘loophole’ in the legislation that allows parents to claim religious exemption to refuse to vaccinate. The Australian Vaccination Network (an anti-vaccination group at the centre of lots of controversy at the moment), have been encouraging its members to join the ‘Church of Conscious Living’ in order to take advantage of this loophole.

    • Tara Haelle

      That’s great news, Michael! Let’s hope the concept spreads!

    • Joanna

      I just came across your site, and I’m very pro-vax. HOWEVER, if we’re going to allow a religious exemption, I don’t want any government agency in the position of deciding if my religion is “valid”. I actually thing that violates the 1st Amendment. That said, I’m totally for not allowing children in the public school system (and allowing private schools to ban) those who chose to take that religious exemption. I’m approaching the mindset that the only thing allowable should be a medical exemption, because humans are just bad at evaluating risk.

      • Tara Haelle

        I wholeheartedly agree with you on both points. It does not make sense for any government institution to determine if this or that religion is “acceptable,” the best solution is therefore not to allow religious exemptions at all for public schools. I’ve never understood why a religious exemption is acceptable for a public school because, to me, that also violates the First Amendment.

  9. Rach B

    Great post. I live in country where vaccination is optional. My inlaws aren’t fans of vaccinations and as my husband was uncertain about it, it took us a long time to decide to vaccinate our first child., but we did for both children. I wish I had done it earlier. Two months ago my husband got diagnosed with cancer. He is having treatment and is likely to recover well. However, he cannot risk being around whooping cough. There are heaps of immuno compromised people in our communities and we have to look after them. I’m off to do my bit and book my booster shot.

    • Tara Haelle

      I actually just got my own Tdap last week, which I’ll be blogging about shortly because of the circumstances. Thanks for sharing your story, and I’m glad you eventually made the decision you did!

  10. supermouse

    Great post, thank you. Every rational voice must speak out to maintain herd immunity and protect those too young to be immunized or those who can’t be (immunocompromised, etc).

    My children’s stories are like yours—uneventful. They were a bit premature and born in January in New England, so we were very concerned with keeping them healthy at the beginning, but they were fine. People who persist in believing thoroughly debunked fairy tales about vaccines drive me up the wall. I am a scientist, doing immunology research no less (not vaccines though) and fear/hatred of science breaks my heart and makes me angry. Science curricula in this country need an overhaul, that’s for sure.

    • Tara Haelle

      I agree that science literacy is disturbingly lacking, and I think a better understanding of “risk” is probably at the heart of this situation as well.

  11. Jim

    I think this is well written overall but for a few minor problems. Firstly, I wish you supported all of your claims with legitimate peer reviewed scientific studies. I say this because there are several instances where claims intended to support your position lack the necessary scientific support. It may exist, but it is not here and so portions of your piece go unsupported. I say this because as a new parent I spent a good deal of time researching the safety of vaccines. For every pro-vaccine study I was able to find other peer reviewed work that argued the opposite. I realize that I should be linking to these supposed works, especially given the fact that I am taking issue with your failure to do so, but in this case I am less concerned with proving one position over the other then I am with highlighting the bias in your work. You fail to address the legitimate scienctific research that is out there and instead suggest that people who question or forego vaccines do so because they exist in some kind of unsubstantiated fear based fantasy world which makes them prone to creating non-existent links. Your dog bite analogy is unfortunate and actually undermines your argument. Cause and effect is a pretty important scientific idea, by your reasoning a person who eats a peanut and goes in to anaphylactic shock does not do so because of the peanut. Parent’s whose children experience some kind of extreme reaction after having large doses of vaccines with adjuvants that are made up of potentially toxic substances are right to question the safety of vaccines. To dismiss it as coincidence in a field (scientific research) that does not believe in coincidence is a mistake. Cause and effect, we still use it today. There is actually no research that can substantiate your claim because no one has done it. The medical practice insists in the effectiveness of the vaccine but the fact of the matter is more research needs to be done. I’m glad that your child, as well as many others from what I see in the comments, appear to have had a positive/boring vaccine experience. But here is the rub, as they say. If you really believe that parents are wrong to create a link between vaccinations and a negative reaction because you believe it is actually coincidence, then doesn’t that also make your experience a coincidence making it wrong for you to think that vaccination and no reaction are at all related? If you vaccinate and the child has a fever we say those two things are linked, so how do you decide something is no longer linked to the vaccine when the research does not exist to support the claim? For the most part you make a fairly strong case, but my response highlights what I feel are some missteps that undermine your work. I appreciate your certainty, even more so because I felt that the decision to vaccinate or not to vaccinate was actually about picking the lesser of two evils.

    • Tara Haelle

      Jim, thank you for your thoughts here. I frequently link to peer-reviewed research in my posts and did so here as well, but given how much I wrote overall, I can see where you may wish to see more links. If there is any particular claim that I make which you would like to see links for, please let me know. I will add them here in the comments and in my post because I do feel it is very important to provide people with as much evidence-based information as possible on this issue.

      I remember being a new parent and embarking on a similar research project on vaccines. It can be challenging to find good information and make sense out of what’s out there, even when many claims appear to be substantiated by peer-reviewed evidence but are actually a misunderstanding of that research or are utilizing research that is not credible, even if it is peer-reviewed. I encourage you to seek out the excellent information provided at Children’s Hospital of Philadelphia (http://www.chop.edu/service/vaccine-education-center/home.html) and to ask any questions here about resources, particular questions, etc.

      You stated above, “You fail to address the legitimate scienctific research that is out there and instead suggest that people who question or forego vaccines do so because they exist in some kind of unsubstantiated fear.” If you can point to some of the research you are referring to, I would be happy to address it or point you toward discussions of it, if they exist. Most people who question vaccines do so because they lack sufficient credible information about vaccines or they have unsubstantiated fears. That’s the short of it, but I can provide links if you have specific questions.

      Regarding your statements on cause and effect, believe it or not, the vast majority of scientific literature does not deal with causation. It primarily deals with association. Only a randomized, controlled trial can provide results that point toward causation, and then these must be replicated many times under conditions that allow the results to be generalized to a broader population. My dog bite analogy actually illustrates the common misconception that a particular observed phenomenon (“effect”) is necessarily “caused” by an event that precedes it. Many, many, many times, this is not the case. A person who eats a peanut and then goes into anaphylactic shock is a different situation because a vast amount of scientific research has already established the existence of peanut allergies and the symptoms of the reaction. On the other hand, vast amounts of research have also established the *lack* of a connection between vaccines and many of the poor health conditions attributed to them. Therefore, the fact that a child may experience what is called an “adverse event” following a vaccine does not mean that the condition/disorder/adverse event was caused by the vaccine. It *should* be reported to VAERS (the Vaccine Adverse Event Reporting System) so that if it will be investigated and repeated instances will throw up red flags. But it does not mean it was caused by the vaccine and to assume as much is unscientific.

      When you state, “There is actually no research that can substantiate your claim because no one has done it,” I’m not sure what you are referring to. Plenty of research has established what is not linked to vaccines. No research has shown that dog bites are not linked to vaccines because it has not been studied because not enough people reported it as happening and there is no biological mechanism to make it plausible.

      Finally, you write, “If you really believe that parents are wrong to create a link between vaccinations and a negative reaction because you believe it is actually coincidence, then doesn’t that also make your experience a coincidence making it wrong for you to think that vaccination and no reaction are at all related?” Actually, you are not correct here. It is not a coincidence that nothing happened after a vaccine because that is the common expected outcome based on hundreds of research studies. What you are asking for here is to prove a negative, which is a scientific impossibility.

      Again, if you have specific questions about the post in which you would like to see additional research, please let me know.

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