Vaccination is a subject that provokes heated debate regarding efficacy, necessity, societal obligation, safety and reliability. The debate over vaccination tends to be steeped in rhetoric, dogma and exaggeration. It is undeniable that vaccination can help prevent potentially life threatening illnesses. On the other hand, many serious side-effects have been linked to the process of vaccination.

Objective of Childhood Vaccination

Vaccines are designed to artificially stimulate the immune system to produce antibodies against specific bacteria and viruses. Antibodies are small proteins that aid in the destruction of invading organisms. Ideally the process would prevent some serious diseases of childhood, provide lifetime immunity from these diseases, and produce no side effects. Clearly vaccines can prevent some childhood illnesses. Unfortunately, no vaccine can provide 100% lifetime immunity, and no vaccine is entirely safe. Adequate research to assess the long term hazards of injecting foreign proteins into the bodies of young children does not currently exist. The question then becomes, how well do vaccines accomplish the intended long range objectives and at what cost to the recipient?

Public Health vs. The Right of the Individual

Those promoting compulsory childhood vaccination cite the concept of herd immunity as the overriding benefit. When high levels of immunity to a specific disease exist within a population, that disease cannot spread uncontrollably throughout the members of a population. If everyone in society receives the recommended vaccinations, a critical mass of individuals may become immune and the population acquires herd immunity to the disease in question.

According to public health philosophy, the moral obligation of receiving vaccinations is implicit within the social contract of living in a society. The risks associated with vaccination are deemed acceptable in light of this greater good. However, when pressed many people in the field of public health acknowledge that the safest scenario is an unimmunized person in a fully immunized society.

In regard to immunization, the perspective of the individual is in opposition to that of society. As a parent in the middle of the immunization decision, your main concern is what’s best for your child. An inherent conflict exists between any implied social contract of those living within a society and the individual’s right to refuse medical treatment based upon informed consent.

Naturopathic Perspective

It is obvious that germs contribute to the development of disease, and that vaccines can generate protective levels of immunity to certain diseases. However, the infectious agents are not the only factors to consider. The individual’s health and constitution as well as his/her social and physical environment are also crucial determinants. In other words, a strong and healthy body is not fertile ground for the spread of infection and disease. The naturopathic community does not have one unified position on the topic of vaccination. The final decision rests with responsible parents. We recognize the complexity of the decision, and encourage parents to carefully consider many factors in the light of existing knowledge.

 All doctors should obtain from parents signed informed consent by providing printed information describing the risks of the infectious disease, the risks and benefits of childhood vaccinations, and other options. Consent forms describing such information should be provided in a form and manner which would allow responsible parents to make informed decisions regarding the vaccination of their children. All doctors should respect that the parents or guardians have both the responsibility and freedom to decide within the range of options provided for by state law whether or not their children should receive vaccinations.

There are several criteria to assess prior to making any decision.

1. What is the risk (or probability) of this child contacting the causative agent of the disease in question? It makes little sense to vaccinate an infant against an agent he/she will not likely contact. For example, children who receive care primarily in the home incur less exposure than children in day care. A child who is not crawling or walking is unlikely to have exposure to tetanus.

2. What are the consequences of the natural infection? Illness in childhood plays an important role in the development of the child’s immune system. Giving children time to be ill and to recover is an important part of their growth and can promote a healthy adulthood. “An increasing number of reports describe how chronic illnesses such as eczema, asthma, or multiple sclerosis, have been cured through a serious childhood illness suffered in later life.”¹

Study the material that follows, and do your own research in this area. The potential consequences of infection are also considered in light of the individual. A healthy child, in a healthy environment, who receives good medical care during an illness is much less likely to develop serious complications. Your naturopathic doctor can help you create a lifestyle that supports health in a balanced way. However, there are no guarantees that any child will not acquire a disease or develop significant complications from disease. Children of excellent health can get sick.

¹ Thompson, John. Natural Childhood. Simon & Schuster, 1994: New York, NY. Page 276.

3. Is there a safe vaccine available? Because we have no adequate methods of investigation, the opinions on both sides of the safety issue are largely speculative. Pro-immunization advocates will acknowlege occasional side effects to vaccination, but they consider this to be a rare and mostly benign event. No one knows if any of the currently available vaccines are entirely safe. Some side effects are well documented in the current research literature. Immediate side effects such as anaphylaxis and encephalitis are obvious, but even these are vastly under-reported. For instance, the risk of aseptic meningitis after the MMR vaccination was found to be 62.5 times higher than previously reported after a new and better reporting system was developed.

It is also well known that live virus vaccines depress some parameters of immune function and can remain latent (dormant) within the body. Also, vaccines may contain chemicals such as formaldehyde and phenol that are known toxins and carcinogens. They may also contain potential contaminants such as bacterial endotoxins, non-filterable viral particles of the immunizing agent, unintended viruses or viral particles, and possibly even non-human tissues and viruses.

On a more speculative level, we can never know what the individual’s total lifetime response will be to vaccination. We have no way of knowning what long range effects vaccines will have on immune function. We don’t know how vaccination will effect the health and longevity of the individual. Many potential side effects are delayed and may not seem connected to the vaccination. Some of these under scrutiny include recurrent otitis media, asthma, allergy, eczema, inflammatory bowel disease, minimal brain damage, autism, learning disabilities, arthritis, chronic fatigue syndrome, auto-immune disease, cancer and almost any chronic degenerative disease.

4. Is the immunity conferred by the vaccine solid and long-lasting? In contrast to the natural infection, most vaccines do not confer life-long immunity. Receiving a vaccine during infancy places an individual at potential risk later in life. Many minor childhood diseases have serious consequences when contracted as an adult. In addition, maternal passive immunity suffers when vaccines fail to provide life-long protection from infection. A pregnant mother passes antibodies through the placenta to her fetus. A baby born of a mother fully immune to a specific disease has protection from contracting that disease for several months post-partum. A woman who was vaccinated as a child may not have the life-long immunity provided by the natural infection. It is unlikely she will have an adequate level of immunity to pass protective antibodies to her developing fetus.

5. Is the route of vaccine administration compatible with the route of natural infection, and are the appropriate elements of the immune system stimulated? The natural immunity of a healthy person is based upon a series of bodily defense layers which include the skin, nose, throat, digestive system and finally the bood. In contrast, vaccinations inject large amounts of antigens directly into the blood stream, thereby bypassing several important layers of the immune system. If a vaccine is to be used at all, it would be ideally administered via the same route as the natural infection. Only the trivalent Sabin oral polio and the tetanus toxoid vaccines are congruent with this criterion.

6. What is the particular child’s health history? Was the child breast fed for at least six months? Was the mother healthy and properly nourished during the nursing period? Was the child infection-free during the nursing period? If the answer to any of these is no, the child has a greater chance of sustaining infection from an exposure to a disease.

7. What is the child’s current health status? Does the child seem to have a competent immune system? Does the child catch every cold and flu that comes his way? Does it seem likely the child’s immune system is prepared to deal with childhood illness?

8. Are alternatives available, and if so, are they safe and effective? A healthy child with a history of being breast fed by a vigorous mother is in itself a natural alternative to vaccination. Vaccines deprive a child’s immune system from experiencing natural infection. It is believed by many experts in the field of immunology that the immune system needs the experience of challenge by natural wild viruses in order to properly mature. Minor childhood illnesses could actually be friends in disguise — compelling the immune system to become strong and better able to defend the body. Some parents deliberately expose their children to measles, mumps and other minor childhood diseases. General supportive care, with the support of a doctor, during the typically mild course of the natural disease provides the child with life-long immunity.

Some Potential Options

Some possible options include:

1. Immunize fully according to the schedule and guidelines recommended by the American Academy of Pediatrics and the U.S. Centers for Disease Control and Prevention.

2. Immunize fully, but modify the schedule. Wait until the child could potentially come into contact with the pathogen. For example, don’t give tetanus until the child is at least crawling or walking. The infant’s immune system may not be mature enough to handle the insult of an immunizing agent injected directly into his/her blood stream. By delaying the inoculation as long as possible, you increase the likelihood that your child’s immune system will effectively deal with the vaccination. Immunity is more likely to be life-long if the vaccine is delayed until age four. The timing of inoculations suggested by the American Academy of Pediatrics is designed to establish immunity in a child before he/she has the chance of exposure to the natural infection. Some infections, such as pertussis, are much more serious for infants than for older children. Your decision to delay immunizations must be weighed against all other factors.

3. Immunize partially—either according to the recommended or a modified schedule.

4. Defer all immunizations at this time. Remember, this decision is never permanent or final. You can always choose a different option at a later date.

Summary

 There is no doubt that the most currently used vaccines do confer varying degrees of immunity with little known risk. It is the risk that cannot be assessed which causes concern for doctors who are committed to the first principle of healing, “Do No Harm.”

The final decision on vaccination rests with responsible parents. No one knows for sure whether immunizations are worth the risk or not. There is no one right or wrong answer. There is only what is right for you and your child at any given point in time. Carefully consider the available literature, and trust your parental intuition. In any case, the decision is difficult. It will require a certain amount of faith in one’s philosophy of health and disease as well as faith in the safety and efficacy of the particular type of treatment chosen.

View the AMERICAN ASSOCIATION OF NATUROPATHIC DOCTORS Position Paper on Childhood Vaccinations

Selected Readings on Immunization

Vaccination, Viera Scheibner, Ph.D., New Atlantean Press, 1993. This book provides an excellent review of the scientific literature on immunization. It is compelling and extensively referenced.

Vaccinations: A Thoughtful Parent’s Guide: How to make Safe, Sensible Decisions about the Risks, Benefits, and Alternatives. Aviva Jill Romm. Healing Arts Press (September 1, 2001) This book is an excellent information resource for parents.

Vaccination and Immunization: Dangers, Delusions and Alternatives, Leon Chaitow, The S.W. Daniel Company Limited, 1987. This book covers the history of immunizations, explains immune function in relation to vaccines versus natural immunity, and how to enhance immune function naturally. It covers homeopathy, botanicals, osteopathy, acupuncture, and nutrition.

The Immunization Decision, A Guide for Parents, Randall Newstaedter, North Atlantic Books, 1990. Available from the Homeopathic Educational Services. This book gives information about infectious diseases in lay terms, the vaccines, and their side effects. It also gives support to parents who choose not to immunize according to the standard schedule and gives lists of resources, organizations, homeopathic information and books.

Dangers Of Compulsory Immunizations, How to Legally Avoid Them, Tom Finn, Family Fitness Press, 1988.

Vaccines: Are They Really Safe and Effective?, Neil Z. Miller, New Atlantean Press, 1992. Available from the New Atlantean Press. Endorsed by the National Vaccine Information Center. Covers current studies and graphs, heavily and thoroughly referenced, easy to read.

Resource for laws governing vaccination in different states

Vaccination, The Rest of the Story, A Selection of Articles, Letters and Resources, Peg O’Mara, Mothering Magazine, 1992. Available from Mothering, PO Box 2208, Albuquerque, NM 87103-2208

A Shot in the Dark, Why the P in the DPT vaccination may be hazardous to your child’s health, Harris L Coulter, Avery Publishing Group, 1991. Immunization Resource Guide, Available from Ohio parents for vaccine safety.

Excellent booklet that includes book reviews, resource listings for organizations and publishers, and general vaccine information. Vaccination, Social Violence And Criminality, Harris L. Coulter, North Atlantic Books, 1990. Maximum Immunity, Michael Weiner, Houghton Mifflin Co., Boston, 1986. Your Personal Guide to Immunization Exemptions, Grace Girdwain, Dorrance Publishing Co., Inc., Pittsburgh, 1992. Sutphen, Sussan MD, MEd: "Vaccine Preventable Illnesses: Are They Under Control?". MedScape CME. December 6, 2006 Cave and Mitchell: "What Your Doctor May Not Tell You About Children's Vaccinations" 2001; Grand Central Publishing. Sears, Robert MD: "The Vaccine Book" 2007; Little, Brown & Company Publishing James Keith Colgrove: "State of Immunity: The Politics of Vaccination in the Twentieth Century America". 2006; University of California Press Joanna Karpasea Jones: "Vaccination: Everything You Should Know About Your Child's Jabs and More" 2006; Meadow Books. Link, Kurt. "The Vaccine Controversy: The History, Use, and Safety of Vaccinations" 2005; The Greenwood Publishing Group, Inc. Buccholz U et al: "Varicella outbreaks after vaccine licensure: should they make you chicken?" Pediatrics. 1999;104:561-563. Arvin A. "Varicella zoster virus". Clin Microbiol Rev. 1996;9:361-381. Talan D et al: "Tetanus immunity and physician compliance with tetanus prophylaxis practices among emergency department patients presenting with wounds." Ann Emerg Med. 2004;43:305-314. World Health Organization: www.who.int United States Centers for Disease Control: www.cdc.gov Guris et al: "Changing epidemiology of pertussis: increased reported incidence among adolescents and adults 1990- 1996." Clin Infect Dis. 1999;28:1230-1237.