I had the opportunity to speak with three ladies today. One is going to be married, one is a single mom with two kids. One is just single. All three of them have apparently become convinced that vaccinating children is somewhere between mere child abuse and sacrificing the rugrat on an altar to Baal after reading naturopathic websites on the internet.
None of them have the level of understanding of how biology works that even 32 hours of premed science would bring them - and yet they consider themselves to be experts on the topic. One even said "I’ve done all the research, I’m not changing my mind."
I never thought I’d have to deal with such medievalism in people’s thinking. Unbelievable.
I’m going to stick my neck out here… I think we’ve been in this discussion before…
Each person has their own reasons for being “against” vaccination…some do so because somebody somewhere says it’s wrong… others have what they believe to be REAL evidence to disagree with vaccination as a whole or in part.
I happen to be one of the latter… and I don’t imagine that medical school will change that.
I see the merits of vaccination… my kids are partially vaccinated… I don’t disagree with the ideas of vaccination… we want to prevent insult/injury/death to children/adults by vaccinating… I understand (as much as I could at this point - not being fully schooled) the mechanisms of the immune system.
HOWEVER, there are principles that I fully disagree with that are being implemented in the vaccine programs.
1. multiple vaccine combinations - yes, it’s not quite as bad if billy gets one stick versus 3, however…for maximum immune benefits, it’s best to charge the system with one substance at a time. It IS possible to overtax the immune system… why chance it?
2. additives - despite the debate that thimerasol causes Autism (believe me I’ve read studies on BOTH sides), the additives/preservatives are NOT necessary. They are done so multiple vaccines can be packaged together (ie MMR as measles, mumps, and rubella individually DO NOT contain preservatives as is the case for many other single vaccines). Thimerasol or more appropriately mercery is a neurotoxin. You don’t have to read “naturopathic” literature to know this… read an MSDS sheet - it will say the same thing.
3. culture ingredients - this only applies to a chosen few - but it happens to be a concern of mine. using egg albumen or calf liver or lactose or some other type of bovine serum is DANGEROUS for those with allergies. the way that the current vaccine regimen is set up now and the supposed penalties for healthcare providers (although I really have YET to read anything conclusive - it’s all suspect) it is STRONGLY discouraged that people test vaccines on potentially allergic individuals… that is people with allergies to one component or more of the vaccines… REACTIONS TO VACCINES DO OCCUR… I can’t stress that enough… and I mean allergic reactions… NOT just fever or rash or whatever… but anaphylaxis, bronchial spasms, etc…There needs to be MORE education on this topic… far more… patients should have the RIGHT to expand their vaccination schedules or alter them in some way in order to accommodate testing and evaluation.
SO, there are legitimate concerns for people… as I alluded, there’s quite a bit of controversy surrounding the MMR and Autism… I WILL NOT go into that here…but I will say, as I mentioned above, that there are legitimate concerns that people may have, based on REAL SCIENCE that makes them wary of the current vaccine schedules.
As physicians, I would HOPE that we would be MORE THAN WILLING to listen to our patients - including evaluating their information sources WITH THEM, rather than immediately passing judgement on them. This goes for ALL of their health concerns, not just this one.
Andrea
stepping down off of her soapbox
Request thimerasol free vaccines…
The MMR/autism link seems to be weaker than a piece of wet toilet paper…
http://www.quackwatch.org/03HealthPromotion/immu/autism.html
I believe we originally discussed this in the Ethical discussion area… we might want to move this there if we revive the topic fully…
It seems to me like the more I’ve learned about science, the more this general situation has come up–where people present their views on a health topic and then try to justify it with reasoning that I would say quite often does not sound like it is based much on science. (BTW, I am responding to Boeing’s original post here, not any of the subsequent information).
I think the challenge here is really about communicating with people and having discussions with them about these things that don’t end in bitter disagreement. Of course it is also necessary to have a complete knowledge of all the relevant facts and controversies, but beyond that, as doctors we’ll want our patients to trust us–and to trust that we respect their opinions, even when we are trying to change them. I guess all I am saying is that vaccines are probably just the tip of the iceberg when it comes to health related issues that people feel strongly about. So we better be ready to deal with lots of these things.
Not that I’m trying to get in the way of a good argument! I’m not in the mood to debate this myself, but if people want to, I’m sure it will be interesting! 
Pediatric vaccines in the US now contain either no thimerosal or “trace” amounts of thimerosal.
http://www.fda.gov/cber/vaccine/thimerosal.htm
contains a helpful discussion of evidence around thimerosal.
NIAID also has a factsheet
http://www.niaid.nih.gov/factsheets/thimerosalqa.htm
which explains ongoing research on the topic.
j
This is true… Thanks for pointing this out Joe…
The only thing that I might add is that any old stocks that are out there that still contain preservatives are still being used…the supply is there until it runs out…
Thanks again for mentioning this Joe.
I’m going off to get the MPH half of my MD/MPH degree this fall, and hope to study this very issue - educated parents and their views/actions regarding childhood vaccines. My current goal is to develop a manuscript/decision structure that can be used by patients and pediatricians to make their vaccination decisions together.
Of course, all this is subject to change once I get there.
I, too, find these sorts of conversations very frustrating. There are lots more where that one came from.
Regards,
Susan
University of Minnesota Medical School - Twin Cities Campus
MS3 - Class of 2008
Johns Hopkins University Bloomberg School of Public Health
MPH Candidate
Quote:
I, too, find these sorts of conversations very frustrating. There are lots more where that one came from.
That’s for sure.
It’s also very interesting to hear that you’re starting an MPH. Please let us know how it goes! I’m really interested in doing that myself. I would love to hear what kind of stuff you’re learning.
I think it is important to recognize that people’s opinions are formed and shaped by a whole lot of influences. As health care providers we will be doing our patients a disservice, and missing an opportunity, if we simply dismiss differing viewpoints as “idiocy.” Even if we’re SURE we’re right, we need to be respectful of someone else’s opinion or we will have NO common ground for discussion.
I’m not saying this to be preachy. I’m thinking of the fact that I purposely had two of my children at home because I felt so strongly that the standard American hospital birth experience put me and my babies at risk of iatrogenic complications. Most physicians would disagree with me but I did enough reading and research to be confident that my decision was one I could live with. I would not have taken kindly to being labelled an ‘idiot’ or accused of following some primitive tribal custom. I was making a well-informed decision although some of my information sources were outside the mainstream of American medical experience.
Boeing, please don’t grow up to be an arrogant doctor! One of the things I really like about OPM doctors is that we tend to be a whole lot more open to the role of life experience in shaping people’s health care decisions. We’ve learned through our own life experiences that doctor doesn’t always know best. It’s humbling, and worth remembering. 
Mary
Mary makes some very good points.
My sisters chose home birth, extended breastfeeding, no circumcision, and no vaccinations for their children; because they can’t find doctors who treat them respectfully, they don’t go to the doctor ever, unless there is a life-threatening emergency. Their kids do not get regular checkups.
In my experience of seeing parents like this in clinic, they are noticeably relieved and pleased when I respect their decisions and treat them as the expert on their child. It gives us more of a foundation for a good relationship, a better connection with the health-care system for them, and I think that is better for their children in the long term.
Anyone watch House last night??
Interestingly enough, it kind of related to this discussion. First, House totally berates a mother who hasn’t immunized her baby and then the problem the main patient ends up having is related to the fact that his (real) mother wasn’t immunized and he contracted a virus prior to his vaccinations at six months that had remained dormant in his brain until now.
Farfetched, but interesting, none the less.
Nah, I was busy watching Stargate Atlantis where this one soldier’s life force is being fed on by a life sucking alien, but kills it in the middle of the feeding process and gets an overdose of some sort of alien hormone which causes him to develop a pupilless eye and superhuman abilities.