Immunizations: Why Parents Should Freely Participate in the Decision

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By: Christian Wessling, M.D.
Missouri Physician Investigates Immunizations

As a family physician I am often asked, "Doctor, should I have my child vaccinated?" This question became more frequent after Missouri's 1992 immuni­zation law removed the parents' freedom of choice to exempt their child from vac­cination. Children could only be ex­empted for "medical contraindications" or "religious belief." Following this, the Department of Health promptly followed by unilaterally adding a rule which lim­ited religious exemption to members of specific organized religions. This created a situation where vacci­nations were no longer voluntary in Missouri (20 states are volun­tary). Parents who chose not to vaccinate found themselves out­side the law.

Fortunately, a group of con­cerned citizens made its voice known at the Legislature. As a result, the Department of Health retracted its restrictive rule. Since April 1994 Missouri parents can now claim exemption by simply stating that vaccination violates their religious beliefs. Through­out of all this I was troubled by many questions which made me research the issue further. What I learned during this process made me ponder the future of health care, the decisions my wife and myself will make as parents of three young children and, most of all, my role as a physician and healer.

Firmly believing in the ancient maxim of medical ethics: "First do no harm," I discovered that in 1986 Con­gress was alarmed enough about serious reactions to common childhood vaccines to enact the National Childhood Vaccina­tion Injury Act, establishing the Vaccine Injury Compensation Program. This fed­eral program has thus far paid over $400 million to vaccine-injured children and their families. The federal government receives about 1,000 reports of vaccine-associated injuries or deaths every month!

Other countries do not share the same enthusiasm for vaccines as our U. S. health authorities. The governments of Sweden, Great Britain, and Taiwan have withdrawn DPT (diphtheria-pertussis-­tetanus) from general usage because of concerns about its safety; Japan restricts its use to children over two years of age. Another well-recognized concern is that measles immunization has altered the epidemiological pattern; since the artifi­cial immunity acquired through vaccina­tion is inferior to the lifelong 100% im­munity conferred by having gone through the illness. More cases are now seen in older children and young adults as well as infants who are no longer protected by their mothers' antibodies. In both these groups, complication rates are much higher than they were when measles was a naturally occurring illness. Nationwide, about half the cases of whooping cough and measles have occurred in vaccinated individuals. I also found the efficacy of commonly used childhood vaccines is far less than the public realizes. Of the 120 cases of pertussis (whooping cough), which occurred in Missouri in 1992, 48% of the victims were fully vaccinated. It concerns me that public debate does not give the whole picture. We are told the drop in death rates from polio, lockjaw, measles and other dreaded epidemics is due to immunization programs when, in fact, most of this drop had already occurred prior to their implementation, mainly as a result of improved sanitation and other factors. A rosy, optimistic picture is painted of humanity, soon, forever-freed from these "old scourges." But even the World Health Organization has conceded its "war on measles" is not about to be won. Even the term "vaccine-prevent­able illnesses" is a misnomer because it ignores the high percentage of illnesses occurring in vaccinated persons. This is not to imply vaccines should not be given. Vaccines occupy an important place in our nation's health care system. But should vaccines be forced on people against their will?

The concept of publicly enforced vaccination campaigns stems from a time when smallpox epidemics were threaten­ing and at times wiping out large popula­tions. Things have changed since then. In 1994, what are the real threats to the health of our children - measles or poor dietary habits, whooping cough or lack of exercise and childhood obesity, chicken pox or domestic violence? Government child advocacy, which focuses on the 2% of Missouri children not immunized by first grade, aims to restrict the parent's rights to determine their children's medical treatment and does little to improve the more serious threats to the children health.

"Should children be vacci­nated?" My answer is, "Let the physician advise, but let the par­ents make the ultimate decision. Let us have true informed con­sent, after considering the risks and the benefits as we do for other medical procedures." We now have a schizophrenic situa­tion where federal law requires parents to sign that they under­stand these risks and benefits before any vaccination may be given, yet state law makes it "unlawful" for any child not to he vaccinated. More vaccines are on the horizon, some already in use, though not yet required by law. Two new vaccines were recently licensed - one for hepatitis A, the other for varicella (chickenpox) which latter, as we all know, is very rarely a serious health threat. Quite likely we will soon see pressure to include them in routine vaccination schedules. There is a motion at the Federal level to soon require states to track each child's immunizations from birth in a govern­ment computer. using the child's social security number. This represents an Orwellian vision of "Big Brother" invad­ing children's private medical records.

Democracy assumes that individuals are competent to make their own deci­sions, including those regarding health care. It is totalitarian to assume that citi­zens are incompetent and the government must make their decisions for them. Be­hind the zeal to "get every child vacci­nated," there is a worrisome trend away from basic democratic values.

The physician Benjamin Rush, signer of the Declaration of Independence, once warned: "Unless we put Medical Free­dom into the Constitution, the time will come when medicine will organize itself into an undercover dictatorship." The time has come to think about this once again.

Christian Wessling, M.D. is a family physician in Webster Groves, Missouri.

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