pancake
Brilliant_Rock
- Joined
- Jan 7, 2010
- Messages
- 1,652
I am a paediatrician (in Australia) and when I see a thread title like this I often go "Oh! Relevant!" then after clicking on it, whilst waiting for the page to load I kind of wonder whether it is a good idea for me to read it.
Obviously I am not unbiased. I have a few thoughts to share though...
I think your husband's "better be safe than sorry" approach is best applied to the practice of immunisation, not the the practice of NON-immunisation. The original "research" linking MMR to autism spectrum disorders has been thoroughly discredited in repeated peer reviews and is widely known within the paediatric community to be BS. Unfortunately once something like that has been stated, on such an emotive and hot topic, it can't be "unsaid".
I agree that schools, kindergartens and childcare centres should reserve the right to refuse enrolment to an unimmunised child. Immunisation has two protective faces - one to the individual child, and one to the community (referred to in medical circles as "herd immunity"). As an example: in Australia in the last few years we have had large outbreaks of pertussis, and babies have died. In terms of immunisation, this is due to a) older children having not been immunised, and therefore contracting the infection and passing it on to young, vulnerable and non-immune babies (immunised or not - immunity to pertussis is only partial until completion of the primary series); b) parents not vaccinating their babies; c) older adults who have lost their immunity passing the infection on to babies (again, immunised or unimmunised). It is a scary, scary disease and there is nothing more frustrating as a health professional than looking after a critically ill child with pertussis, knowing that if community education and vaccine coverage were better, this kid would be healthy.
A side issue is multiplicity of vaccines in one injection, and the preservatives used in them. I can't speak for other places, but here vaccines no longer contain thiomersal (hence no mercury concerns), and more widely, there is no evidence of benefit/lessening of adverse effects by splitting combined vaccines or changing the spacing of the vaccines. All are carefully planned for maximal immune response and community benefit.
My experience is that society forgets that the infections covered by the immunisation schedule actually kill people. In the bad old days pre-immunisation, kids died - HEAPS of kids died - of measles, pertussis, diphtheria, epiglottitis, etc etc, the list goes on. It is the privilege of sustained good health - as a society - that leads people to believe that these infections just don't exist any more (so untrue) and that they are some kind of archaic relic from the deep dark past. Because the benefits of immunisation are often "invisible" to the community (ie. they don't see the infection...they don't "see" the benefit of immunisation), it is easy for misinformation to spread and for people to be mislead into thinking it is non-essential or non-useful - or even harmful, as I often encounter when talking to families at work.
I question the utility and/or wisdom of consulting parenting boards for advice on such a topic. I am not saying that doctors/health professionals are the be-all and end-all, but you are not going to be presented with empiric, rigorous evidence on a parenting board - it is going to be a mish-mash of opinions of varying substantiation and loads of emotion tossed in. Many tertiary paediatric centres have an immunisation clinic or service where professionals are available to discuss the pros and cons based on the international knowledge, without the obligation to go ahead. This would be a good starting point if you are looking to educate yourself.
My last word on this (for today!) is that there is no question I will immunise my kids according to the schedule. Heck - the more vaccines the better. Ditto for advice to my friends.
/soapbox
Obviously I am not unbiased. I have a few thoughts to share though...
I think your husband's "better be safe than sorry" approach is best applied to the practice of immunisation, not the the practice of NON-immunisation. The original "research" linking MMR to autism spectrum disorders has been thoroughly discredited in repeated peer reviews and is widely known within the paediatric community to be BS. Unfortunately once something like that has been stated, on such an emotive and hot topic, it can't be "unsaid".
I agree that schools, kindergartens and childcare centres should reserve the right to refuse enrolment to an unimmunised child. Immunisation has two protective faces - one to the individual child, and one to the community (referred to in medical circles as "herd immunity"). As an example: in Australia in the last few years we have had large outbreaks of pertussis, and babies have died. In terms of immunisation, this is due to a) older children having not been immunised, and therefore contracting the infection and passing it on to young, vulnerable and non-immune babies (immunised or not - immunity to pertussis is only partial until completion of the primary series); b) parents not vaccinating their babies; c) older adults who have lost their immunity passing the infection on to babies (again, immunised or unimmunised). It is a scary, scary disease and there is nothing more frustrating as a health professional than looking after a critically ill child with pertussis, knowing that if community education and vaccine coverage were better, this kid would be healthy.
A side issue is multiplicity of vaccines in one injection, and the preservatives used in them. I can't speak for other places, but here vaccines no longer contain thiomersal (hence no mercury concerns), and more widely, there is no evidence of benefit/lessening of adverse effects by splitting combined vaccines or changing the spacing of the vaccines. All are carefully planned for maximal immune response and community benefit.
My experience is that society forgets that the infections covered by the immunisation schedule actually kill people. In the bad old days pre-immunisation, kids died - HEAPS of kids died - of measles, pertussis, diphtheria, epiglottitis, etc etc, the list goes on. It is the privilege of sustained good health - as a society - that leads people to believe that these infections just don't exist any more (so untrue) and that they are some kind of archaic relic from the deep dark past. Because the benefits of immunisation are often "invisible" to the community (ie. they don't see the infection...they don't "see" the benefit of immunisation), it is easy for misinformation to spread and for people to be mislead into thinking it is non-essential or non-useful - or even harmful, as I often encounter when talking to families at work.
I question the utility and/or wisdom of consulting parenting boards for advice on such a topic. I am not saying that doctors/health professionals are the be-all and end-all, but you are not going to be presented with empiric, rigorous evidence on a parenting board - it is going to be a mish-mash of opinions of varying substantiation and loads of emotion tossed in. Many tertiary paediatric centres have an immunisation clinic or service where professionals are available to discuss the pros and cons based on the international knowledge, without the obligation to go ahead. This would be a good starting point if you are looking to educate yourself.
My last word on this (for today!) is that there is no question I will immunise my kids according to the schedule. Heck - the more vaccines the better. Ditto for advice to my friends.
/soapbox
I just wanted to add a point about my practice as a clinician in situations where parents are unsure, or have already decided not to vaccinate, as that was one of the questions asked by the OP.
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