Advice about Vaccinations

See also: Friends & Family Who Don't Vaccinate ... Vaccination Requirements for Childcare and School ... Immunizations for Travel

Archived Q&A and Reviews

Questions

Public health aspect of not vaccinating
UC Childcare & Immunizations
How do I exempt out of school vaccination requirement?
Homeopathic Alternatives to vaccinations
Where Can I get Balanced Info about Vaccinations?
Worried about Vaccinations
Vaccination Exemption for Green Card?

Public health aspect of not vaccinating

June 2004

okay-here i go dredging up the old vaccination debate again...my child is three now and i plan on finishing the series of DP that she has already started. i'm trying to figure out which of the other vaccines to do with her. i'm really confused about the public health aspect of choosing to or not to vaccinate. in the archives i read a post about an ''irresponsible mom'' who let her unvaccinated child play with kids who had measles and then took her to a party two weeks later where she created a massive measles outbreak. wouldn't only the unvaccinated get the disease? or do the vaccines not work that well. and then is the logic that i should vaccinate my child because they don't always work?

there was another post from a mom making an impassioned plea for folks to vaccinate their kids because she couldn't vaccinate her immune-challenged child. it really affected me but then i couldn't figure out how vaccinating my child would really help her. if vaccinated kids can get the measles wouldn't they be just as risky to her child as unvaccinated kids would be? or is it that only unvaccinated children can spread the disease and vaccinated kids just get it? does anyone know how this really works? Is it really true that if everyone vaccinated that these diseases would disappear? what about natural immunity-would that disappear too?

my plan was to wait until she was past 2 years old and she is so now i'm just trying to figure out what to do. the public health part is really hard for me to debate in my head and with others because i just dont get it. thanks in advance for your non -judgemental input. on the fence

You asked whether vaccinated kids can catch the illnesses against which they were vaccinated. Yes. My daughter caught Whooping Cough (Pertussis) at age 18 months. She had already had two of her three Pertussis vaccinations. Most likely, she picked this up from an unvaccinated child in a public playground. Our pediatrician, the recently highly-recommended Annemary Franks, said that illnesses that were almost extinct like Pertussis are back because the whole population is no longer immunized.

My daughter was sick for over a month, and coughed so hard at night that she would vomit. She had broken blood vessels around her eyes from coughing so hard. We had to keep her largely isolated for most of a month, despite it being the middle of sunmmer. It was heartbreaking to watch her go through such a horrible illness and not be able to help her. Despite how sick she was, Annemary told us she actually had a much lighter case than she would have had without the two shots she received.

I'm trying hard not to be judgmental in my response and report just the facts to you, but I think it's obvious how this experience has shaped my opinion. it should be mandatory

I've been reading not-so-few articles about this controversy, and I will try to summarize (and quote) an article from May 2004 issue of Parenting magazine (that was my last article I read and the one that I still have available). Try to get a hold of that article would give you more complete reading and you then can decide yourself.

1. Yes, there is risk in vaccination, namely a allergic reaction to the vaccine. BUT, the risks are tiny, for example, the MMR vaccine has been linked to 1 death per 2,000,000 doses.

So, if you're rather uneasy about the potential risk to your child, you can ask the doctor, if that particular vaccine has been out in the market in a while and what the fatal/severe allergic reaction rate is. Brand new type of vaccine might have unknown side effect, for example, DTP has been replaced by DTaP, which causes far fewer reactions.

2. There is only 1 vaccine required at birth, that is Hep B vaccine. Since a high fever (most common severe reaction) is much more dangerous for newborn, one might want to wait until the infant is 2 MO-old. However, it's best that the rest of the family members are screened for their potential to be carriers (the test is not foolproof, though). Of course, if the baby goes to any child care (albeit part-time), it's better to get the vaccination (remember that the risk of reactions is such a small percentage).

3. Now, of course the questions are: Is it worth risking the potential allergic reactions, albeit small, on your child? Are the benefits outweigh the risks? Are the benefits only for my child or for the greater good of the overall public health?

Most studies have shown that vaccines can prevent unnecessary illness and tragedies. Smallpox is gone from the entire planet (aside from what few labs might still keep), and who can argue for the horror smallpox gave to human being. Polio is almost gone from the entire earth (well, beside current outbreaks in Africa due to wars). [USA: Before the polio vaccine in the 1950s, 1000 people dies and 20,000 more were paralyzed from the disease each year; around 1980, zero]. Tetanus is also completely useless thing to get and so easy to prevent. And so on, so forth.

So, yes, I think the benefits of vaccination are greater than the risks.

Now, that you have taken the risk for your child, is there any benefit for the overall public health. Or is my child 100% immune from the disease, thus I do not have to worry about the unvaccinated children?

The answer for the later is NO. Your child might not 100% immune because about 5% of cases -- up to 20% for pertussis -- a vaccine does not fully ''take''. So, in event of exposure or outbreak, there's no way to know in advance which vaccinated child might get ill.

So you will think: ''After taking the risk of vaccination, my child is still carrying 5% risk of getting the disease? So why should I take the risk to begin with?''

This bring us to the topic of the overall public health. Here what the article says:

''Vaccines are made from weakened or killed viruses (or bacteria) that stimulate the antibody formation without the illness. Once nearly everyone is immunized, it's difficult for the viruses to keep the disease cycle going, a phenomenon known as 'herd immunity'. That's why even unvaccinated kids in the US are far less likely to contract a serious illness that they were just a generation ago, when vaccination rates were much lower. Ironically, herd immunity is also what makes it easier for individuals to opt out. People don's see the disease that vaccines prevent anymore, so they don't think there are compelling reasons to be immunized.''

''But herd immunity can disappear. Last Sept and Oct, in adjoining Westchester and Putnam counties in New York, 33 children and 6 adult caregivers got whooping cough; by Feb, another 34 cases were reported. Health officials traced the outbreak's origin to 4 children in 2 families whose parents chose not to have them vaccinated.''

''Two years earlier, in a county in Germany where the immunization rate for measles was only 76%, a measles epidemic sickened nearly 1000 children. The rest of the country, where the rate averaged 90%, was unaffected''

The article concludes by saying:

''So all kids - those who get their shots; those who can't get their shots due to medical conditions that affect the immune system; and those whose parents refuse shots - rely on our society's near-universal immunization. When children around them don't get sick, the won't get sick, either''.

The last paragraph can be rewording as (I'm sorry if it's too strong to some members of the BPN): Those who chose to opt-out are free-riders of the society since they can afford to opt-out and most of time their kids are OK, because majority of parents chose to take the risk of vaccinations.

Those who can not get the shots due to their medical conditions are in the total mercy of the rest of the population. More parents opt-out, the more dangerous situation their kids are in. Having taking the risk

I don't know a lot about this subject but I do know when I was trying to decide how to give my Daughter the MMR this website was very helpful http://messageboards.ivillage.com/iv-ppvaccinedb It is a vaccine debate page. there are lots of people there who have done lots of research on the subjects. try them to get your answers. Good luck. melinda

You raise some really important questions and I think you may find it helpful to speak with the immunization nurse for the City - she has years of experience in this community and can respectfully address your concerns. She understands well the public health imlications of under-immunized communities, and can tell you what has been seen in Berkeley over the years. Her name is Vera Labat and she can be reached at 981-5300. lyn

Hi, It can be confusing. Vaccinations are about 90% effective. It is the high percentage of the population that gets vaccinated that limits the spread of the disease. Unvaccinated children can spread the disease to vaccinated and unvaccinated friends. If you are thinking about the best for public health your daughter would be less likely to catch and pass on measles, mumps or rubella if she is vaccinated. The MMR vaccination protects against measles, mumps and rubella. If you are thinking about the potential benefits to your daughter - Measles can have fatal complications, Rubella can cause birth defects in the fetus of a pregnant woman (if she were to get infected while pregnant), mumps can cause sterility. This said, there are reactions to the vaccine which I'm sure you know about. I hope this helps. Good luck with your decision. Lori

I dread responding to this issue, as it is so close to my heart. I ask anyone worried about the small risk vaccines may pose to their own child to PLEASE consider as well the vast benefits they provide to his or her child and ALL children.

One of my children had a liver transplant as a baby, and so is not able to be vaccinated against chicken pox or MMR. He is now a thriving 5 year old, but these diseases could be serious and even deadly to him. As you can see, we are literally at the mercy of the community and can only hope that all parents choose to immunize.

Our pediatrician has told us that no medical intervention, Eastern OR Western, has improved health on the scale that immunizations have. It is difficult for some parents, who have never seen the impact of such diseases, to imagine and they worry more about the possible reactions.

Another doctor told us that she saw a child with whooping cough, a very rare disease, in the Children's Hospital ICU because a significant number of the population in this area is choosing not to immunize their kids.

By all means, find answers to your questions and concerns from your child's pediatrician, but PLEASE immunize! julie

this was a tough one for us. my husband works in public health in alameda county and has some VERY strong opions. i did some research and my mom's group discussed this concept quite a bit. my husband and i had huge fights, sleepless nights, tears in the pediatricians office, etc.....

Here is the bottom line of our family discussions: all of these diseases that the CDC recommends vaccinations for have been seen somewhat recently in Alameda county. They exist here. Period. Unless your child lives in an isolation bubble (think of that 70's TV movie The Boy in the Bubble), they are at risk of exposure. This is what got me: the standard of care in the emergency department for an infant under 6 mo. with a fever of 102+ and not current on immunizations - is a spinal tap/lumbar puncture. A parent CAN NOT refuse this.

So here is what we negotiated: delay hep B until 1 yr or plans to travel out of the country (I believe we are the only country that screens blood for hep B) and test our caregiver. No more than two immunizations at a time and space them at 6 weeks to try and stay in 'recommended' timeline. We started with Hib and Prevnar. Always do thimerosal free vaccines if available. I have tried to find a separated MMR but it no longer exists in this country, so I am contacting friends abroad. We put off the flu vaccine last winter because by the time our daughter was old enough (my husband wanted it twice and kept arguing with the ped's office about our daughter's weight vs. age) the flu had already peaked. But we will be getting the flu vaccine the first week it is available in the fall. (this is hard for me because I work with teenagers, never get the vacccine, and never get the flu)

I wish you and your baby all the best. found a middle ground that works

A discussion came up recently at a bday party re vaccination for chicken pox. A parent arbitrarily thought they would get their child immunized as a teen, if they did not become infected earlier. A doctor made the excellent point that even if you are willing to allow your child to have a very uncomfortable disease as a child, they run the risk of getting shingles, a herpes-like disease characterized by painful nerves in the spinal area (sometimes debilitating). You can't get shingles from the vaccine, only from live infection. From my own point of view, I worry about the new moms that bring their infants without full immunization to the preschool or playgroup and are putting them at risk by being in contact with an unvaccinated older child, even if their peer child is immunized. I think this is something that anti-vaccinators are not aware of -the risk to younger children they may be in contact with. Anon

UC Childcare & Immunizations

October 2003

Does anyone know the official and practiced immunization policy of UC Childcare? Does anyone have a non-immunized child that attends, and if so, what was the process of getting them in once you were offered a slot?

Our daughter has had most of her immunizations but we've chosen not to do the varicella (chicken pox)until she's five. UC Childcare required a note from our pediatrician and all it said was ''the parents can choose not to immunize.'' I don't know if the same goes for MMR, diptheria, etc. but that was all we had to do.

You can still get UC childcare, even though you are choosing not to immunize. All you need to do is sign a waiver form when you register your child. Tell Judy Cayot that your child is not being immunized for X, Y, or Z, and that you will sign the waiver form. It is a form saying that you recognize that your child can and will be excluded from childcare if there is an outbreak of a disease for which your child has not been vaccinated. It really is not a big deal to them, though the director of my child's school once tried to scare us when a student's brother contracted the chicken pox by saying my kid MIGHT be excluded from school because he was not protected (turns out the boy had actually been vaccinated and contracted the pox anyway!). -Son Not Vaccinated

We have had all the required immunizations for our son, who is in UC childcare, with the exception of the varicella vaccine. When it was time to fill out the UC paper work (they require a vaccination report from the doctor), I simply told them that we ''objected'' to the chicken pox vaccine, and signed some form and there was no problem. If there is a chicken pox outbreak at the school, however, I will have to keep my son at home (although I'd rather expose him!). I don't know if they take the same accepting approach with other, perhaps more important, vaccines. rachel

How do I exempt out of vaccinations for preschool?

August 2006

I realize that vaccinations are a hot topic and I'd like to clarify that this question concerns a child who is not able to be fully vaccinated for medical reasons. My question is concerning vaccines and preschools, not the pros and cons of vaccinations. I heard that the Director at a preschool said it is a licensing requirement that if a child is not vaccinated and there is an outbreak of chicken pox, etc., he/she will not be able to return to preschool until they either get and recover from the disease, or wait approximately four weeks until the incubation period has passed. Does anyone on this list know the licensing rules for preschools re: outbreaks and children who are not vaccinated? Concerned.

I am a preschool teacher and a parent who chose to delay vaccinations. Private preschools probably have the option to insist that you vacccinate your child, but it is not a licensing requirement. There are waivers that you will need to sign. In California, you can opt out of vaccinations simply for philisophical reasons as well as for medical and religious reasons. On the waiver, it does say that the school may exclude your child for some period of time. The key word here is ''may''. Some schools will exclude your child if you don't vaccinate him or her; other schools will not. When my son attended preschool, there was a chicken pox outbreak. I was informed by the school of the outbreak and then given the choice to do as I pleased. A few years later, at my son's elementary school, there was a chicken pox outbreak. I was told that I could either have him vaccinated immediately or keep him out of school for two full weeks. What all of this comes down to is that you will have to ask the rules at the particular schools you are applying to Anonymous

March 2003

My 2.5 yr old is going to preschool in the summer and they want the medical forms filled out and turned in. We've decided not to vaccinate her for MMR or Varicella. I understand that legally we're allowed to do this, but how do we get the forms for this? Will a preschool allow us in if we don't do the vaccinations but have the proper forms? Any advice welcome, thanks.

Do you feel comfortable expempting yourself from vaccines because all the other kids are doing it so therefore your child is pretty safe? From the point of view of families who do vaccinate their children, this seems like a selfish motive. If you want to exempt your child from vaccines maybe you should accept the consequences that your child may not be allowed to be part of a society that has decided that vaccines are best for the greater society. i recommend you consider moving out of a major urban area where your chances of getting a deadly disease or passing it on will be less. concerned parent

I also delayed MMR and Varicella for my daughter, and yes, you are legally allowed to do this. There is a place on the back of the blue state vaccination form (which schools keep on file for licensing requirements) for you to sign a waiver. My daughter attended a preschool in Oakland and is now at one in Orinda and at both schools she was not the only child who did not have all her vaccines. jchartman

Before you opt out of vaccines consider that you can only do so because most other people do not opt out. When large numbers of people decide to make the choice you are making we will return to a time when, during outbreaks of rubella, 20,000 children are born deaf and blind. If you are particularly concerned about the measles part of the vaccine, then why not get rubella and mumps in a separate vaccines? Refusal of parents to vaccinate their children has led to outbreaks of polio in India. If we do not vaccinate our children we will see a return of deadly childhood illness, and young men made sterile from mumps, and deaf and blind children who need not have been. The CDC has said that measles is not longer endemic in the U.S. ''The fact that measles is not a commonly found illness in America is welcome news. Recently measles outbreaks have killed hundreds in Asia and Africa. The illness kills almost one million children worldwide each year. CDC officials noted that measles could again become endemic if the rate of vaccinations decreased. They also noted that global immunization is necessary to protect Americans from measles.''

YOu can read the full text of the Immunization Safety Review by the CDC: http://www.iom.edu/IOM/IOMHome.nsf/Pages/MMR+Autism+Summary http://www.cdc.gov/nip/news/iom-04-24.htm

http://www.msnbc.com/news/793320.asp?cp1=1 NEW DELHI, India (AP) Polio cases in India have nearly tripled in the first half of this year compared with the same period a year ago, a jump that could set back the world's drive to wipe out the crippling virus by 2005. The new figures were dismaying for India, which only two decades ago saw tens of thousands afflicted with polio every year, but was now thought to be on the last lap in the race to wipe out the disease after an ambitious immunization campaign.

In some rural areas, Muslim clerics tell their brethren to shun the vaccine, calling it evil and part of a conspiracy by the Hindu-dominated government to limit the birth rate of Muslims, India's largest minority. Most of the new cases were in Uttar Pradesh and Bihar states, according to the Indian government.

Rubella (German measles) is a mild childhood illness that poses a serious threat to the fetus, if the mother contracts the illness during pregnancy. More than 20,000 babies were born with birth defects during an outbreak of rubella in 1964-65. The same outbreak also resulted in at least 10,000 miscarriages and stillbirths.

Fortunately, major outbreaks of rubella no longer occur in this country. Since 1969, when a vaccine for rubella became available, children have been routinely vaccinated, helping to prevent the spread of the illness to susceptible pregnant women. Most women of childbearing age are immune to rubella because they either were vaccinated or had the illness during childhood. Because of widespread use of the vaccine, birth defects caused by rubella have become rare.

However, since small outbreaks of rubella continue to occur, the potential for susceptible pregnant women to become infected continues to exist. As many as 2 in 10 women of childbearing age are susceptible to rubella. Women can protect their future children from the effects of rubella by getting tested for immunity prior to pregnancy and being vaccinated if they are not immune.

Mumps in young adult males (and older) may result in the development of orchitis, an inflammation of the testicles - a condition that ultimately can lead to a decreased sperm count. Usually one testicle becomes swollen and painful about 7 to 10 days after the parotids swell. There is a high fever (often to 106 degrees Fahrenheit or 41.1 degrees Celsius), with shaking chills, headache, nausea and vomiting. After 3 to 7 days, testicular pain and swelling subside, usually about the same time as the fever passes. In some cases, both testicles are involved.

Mumps may also lead to encephalitis or meningitis (inflammation of the brain or the lining of the central nervous system). Symptoms appear 3 to 7 days after parotid swelling begins and may include: high fever, stiff neck, headache, nausea and vomiting, drowsiness, convulsions, loss of consciousness and other signs of brain involvement.

http://www.nytimes.com/2003/02/20/health/20VACC.html

http://www.centerforhealthstudies.org/news/010312.html

http://www.helioshealth.com/cgi-bin/news/news.cgi?212

http://news.bbc.co.uk/1/hi/health/1170424.stm

susan

A good way to exempt out of vaccinations is to attend a vaccine free preschool! That way, the risk is fairly distributed throughout the student population, as is the burden of prevention. These schools are hard to find however, you may have to look over seas. anon

In regard to vaccinations it IS legal to choose not to go ahead. All you need to do is give your pre school a letter from yourself stating that you have decided for personal reasons not to go ahead. Nothing else is needed. I know this because I am repsonsible for all health forms for my pre school and some parents at our school have taken this option. There is no need for anyone at the school except the pre school Director(and person administering your paperwork) to know. It's legal to say no to vaccinations

I am not an expert, but I believe that although you can opt out of shots when you register for public school in California, private schools/preschools can set their own policies about this. In other words, they are not obligated to let your child attend if you forgo immunizations. However, I think that most schools around here are flexible. You should speak to the person in charge (at the preschool) about your decision, and find out what they say. You may find them totally flexible. When it comes time to register for public school, you simply sign a waiver, which should be provided on request wherever you enroll. R.K.

We did not vax at all. you can legally do this. you have to fill out forms but i think preschools don't have to let you in. you may have to go with home type coop preschool. Legally only public schoools k-12 cannot refuse you because you opt out. check out www.909shot.com Julie

You can exempt out of vaccinations ''legally'' for schools; not for private pre-schools, which can make their own rules. I wouldn't want you with My child if you exempt out of MMR; it is bad enough that my children may have to go to school with yours. I hope you reconsider. also anon

Cynthia Cournoyer's book WHAT ABOUT IMMUNIZATIONS and the following web site can give you the legal information about each state. All states allow medical exemption: http://www.homeovax.com/vaccinat.htm.

Exemptions: There are three exemptions to the general rule.

1) Any person 18 years or older, or those seeking admission to a community college. Health and Safety 3384.

2) If the parent or guardian files with the governing board of the respective school district ''a letter or affidavit stating that such immunization is contrary to his or her beliefs.'' ''However, whenever there is good cause to believe that such person has been exposed'' to a communicable diseases ''that person may be temporarily excluded from'' school. Health & Safety 3385.

3) If the parent or guardian files with the governing board a statement by a licensed physician who believes that the immunization wouldn't be safe for the person, along with the nature, duration and contraindications of the medical condition. Health & Safety 3386.

Designated Diseases: Diphtheria, pertussis, tetanus, poliomyelitis, measles and mumps. Additionally, any other disease consistent with recommendations by the US Public Health Service, will require immunizations. Health & Safety 3380(a). (Immunization from Rubella was effectively eliminated. Health & Safety 3381.) Tuberculosis is added under Health & Safety 3400. A ''contrary to his or her beliefs'' exemption is allowed under Health & Safety 3406.

Philosophical Exemption: The following 17 states allow exemption to vaccination based on philosophical beliefs: Arizona, California, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, New Mexico, North Dakota, Ohio, Oklahoma, Rhode Island, Utah, Vermont, Washington and Wisconsin.

In many of these states, individuals must object to all vaccines, not just a particular vaccine in order to use the philosophical objection or personal conviction exemption. Many state legislators are being urged by federal health officials and medical organizations, to revoke this exemption to vaccination. If you are objecting to vaccination based on philosophical or personal conviction, keep an eye on your state legislature as public health officials seek to amend state laws to eliminate this exemption.

Medical Exemptions: All 50 states allow medical exemption to vaccination. Proof of medical exemption must take the form of a signed statement by a Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.) that the administering of one or more vaccines would be detrimental to the health of an individual.

Most doctors follow the AAP and CDC guidelines. Most states do not allow Doctors of Chiropractic (D.C.) to write medical exemptions to vaccination. Some states will accept a private physician's written exemption without question. Other states allow the state health department to review the doctor's exemption and revoke it if health department officials don't think the exemption is justified. [In California, DCs can] Anon

Hi, we teach vaccination seminars each year and this is where most parent trip up if they don't want their children vaccinated. When you get to the school that you want your child to attend and they don't know how to handle the issue of your right to refuse to vaccinate, you can always write your own document, have it signed by a notery, make a copy for your child's health folder and give the original to the school. Otherwise, simply take the form that they have on file for vaccinations, turn it over and if it is the complete form, there should be a choice for exemption on that back side. Sign it, make a copy and give it back to them.

Now if this is a Private school, they may have made it manditory that you must vaccinate to attend their school . If you are not going to comply, simply let them know that you are not going to attend this school because of their ruling on this matter and hope that they bend the rules for you. If not, you have no legal rights to push the issue with a private school. Please, if you are still stuck with this one, give us a call, we will help you. Anything to support your choice. Good luck. Dr. Eileen

There is an official form that schools use that list vaccinations, and on the back of that (blue?) form is a nice space that allows you to say you choose not to vaccinate for personal reasons. And you sign it. Perhaps some pre-schools have their own policies, so find one that matches your values. As an RN who has witnessed damage from vaccinations (and the lack of science behind all of this as well as denial of serious side effects is astonishing) I urge you to continue to follow your convictions. lfraley

I appreciate your willingness to consider any advice. Here's mine: As an epidemiologist, I believe your decision not to have your daughter vaccinated against vaccine-preventable diseases is an unwise one, and that you are choosing to put your child, as well as those she associates with, at preventable risk. Perhaps something in the following brief information will encourage you to reconsider.

We, living in the US, so rarely encounter vaccine-preventable diseases, our society has largely forgotten that unvaccinated people are sometimes left with mental and/or physical disabilities, disfigurement, and some die due to vaccine- preventable diseases such as measles, mumps, rubella, and chicken pox. These and other results of vaccine-preventable diseases occur in children as well as adults, and in developed countries as well as developing countries.

Associations that have been made between childhood vaccinations and chronic diseases or conditions (such as autism) have been dispelled through solid epidemiologic investigations, and results have been published by the Centers for Disease Control and Prevention (CDC), and peer-reviewed pediatric journals.

I encourage you to review CDC's website at www.cdc.gov for more information about vaccine-preventable diseases, vaccinations, and investigations into associations between vaccines and other illnesses. Amy

I have never used a form. I type or handwrite a letter explaining that I have a philosophical objection to vaccinations. A letter is what the preschools always ask for and we have never experienced any problems with having exempted out. anon

I found that a note from my doctor to the preschool was sufficient for documentation purposes. He supplied the reason we chose to exempt. We weren't excluded in any way from particiating in the program. By the way, we exempted out of the same two vaccines as you have and had all the proof that our daughter has had the other ones. Heather

I had to respond to this one- not that I am a shrinking violet on this issue - but because I had a good example of the problem of unvaccinated infants/toddlers. In Sacramento, there was an outbreak of whooping cough among the elementary school children in a Catholic school last week where my sister's kids attend that may have been due to the vaccine wearing out at that point. The problem, however, is that those children should never have been exposed to the virus if their younger siblings were vaccinated as recommended. I also find it incredible that parent's can opt out of vaccinating and enter private preschools and that vaccinating parents would not know about this. I will be certain to check this out with my preschool and possibly boycott the school for the fall. anonymous

I feel compelled to respond after reading all the replies about exempting out of vaccinations. First, with all due respect, you were NOT asking our opinions about your decision not to do a full spectrum of vaccinations, but rather how to communicate your decision to school administration. Folks--vaccination is ultimately a personal decision, just like other forms of healthcare and personal wellness: diet, exercise, attitude, circumcision, family dynamics, etc. I think the shrill and righteous tone of many replies was really uncalled for and I am sorry that we all have to revisit this hard-line every time the word vaccination is uttered. People can make intellegent decisions about vaccination WITHOUT doing full spectrum ''by-the-book'' vaccinating, despite opinions to the contrary. As for communicating your decision to schools. We did very selective vaccinations on our son, and only started these after 8 months. He has not had several at all (Hep, HiB and varicella). We simply write a letter to school administation(s) (1 daycare, 1 preschool, and 1 BUSD school, so far) stating exactly what we have done. We also state that if our child is exposed to any of these illnesses, and if any of these illnesses surface at school in other children, he will not attend until there is no risk of illness. This type of signed statement is the legal requirement. Some people use the blue form for the signed statement; we write our own, more complete, version. Claire D.

I was deeply offended by some people who replied to this posting by stating that the poster might be selfish. If you think about it, most people who vaccinate their children don't do it for the good of society, they do it for the good of their children! Conversely, a person who thoroughly studies an issue, concludes that it's a bad idea, and then does the opposite of what everyone else is doing, is not necessarily bad for society. For example, Hepatitis B is not normally carried by babies and children. For most of us, the medical establishment just decided that it was easier to vaccinate babies for it while they were getting their other vaccinations. Fran

I was really surprised by all the answers lecturing the poster for her decision not to vaccinate. Since she didn't ask what people thought about the vaccination issue, those responses seemed really rude to me. What if the kid had HIV, cancer, or were allergic to vaccine materials? Public health professional who vaccinates

To those who responded to the parent who asked about vaccination waivers and such: I found it really upsetting to read so many borderline-hostile replies. I myself am reading as much as I can about vaccines and am still deciding whether or not to expose my child to any of these supposedly benign vaccines. I see many sides to the issue, and though I understand the public health argument, I also see very strong arguments against vaccinating: suppression of the immune system being just one. I think a balance can be struck, and it's not an all-or-nothing decision. Still, respect a parent's choice. Those of us who choose not to vaccinate do not do so lightly or because we don't care. In fact, I'd venture to say that, for the most part, those who opt out have done a lot of their own research, and many people just decide to do them all without even thinking about it because their doctors tell them to.

If you do have your child vaccinated, know all the ins and outs of that vaccine, and know the potential side effects of giving them, especially when giving more than one at once. Has anyone wondered why a Rider was added to the Homeland Security Bill that basically protects vaccine manufacturers from major lawsuits (I think class-action ones)? And why they do not properly fund longitudinal studies of side effects, while claiming that they are totally safe? Anyhow, obviously the issue is complex. But respect those of us who question vaccinations. We care about kids just as much as anybody else, and want all kids to be as healthy as they can be. Allisong

I cannot believe the scathing responses to this request for advice! So, what I understand, is that many of you would like to see myself and my children go away, and not be a part of society for not vaccinating my children?

Do you realize, that while vaccines are safe for most children they are not safe for me, or my kids. We are allergic to a component in several major vaccines. Because we aren't sure what that is, it's safer not to vaccinate. At least not with the normal guidelines. After my daughter almost died from the allergic reaction, we've worked with her doctors to selectively vaccinate. Her brother will not be vaccinated until he is 2 years old, even then, it will be a case by case basis. It would be really nice to see more people take personal medical history into consideration before judging others. Rachel

I would like to express my frustration with some of the responses to the request \x93How do I exempt out of vaccinations?\x94 While the author asked for advice, the request was specifically about vaccination exemptions and preschools; not on the pros and cons of vaccinations.

It seems as if you are getting a lot of responses, as vaccinations can be quite a controversial topic. I agree that it is wonderful of you to state that you are open to all types of advice. I really believe in parents being informed and empowered to make decisions like this for their children, even if they go against the norm, as long as no harm is done. That being said, I want to add my voice in support of vaccinations. I do have a public health background, however, long before I had that training, I was at a gathering in Oregon of a few hundred people from the entire state. A friend of my housemates was there with her unvaccinated five year-old daughter as well. During the gathering, her daughter came down with a severe fever and became quite ill. Immediately afterward she came down with a rash and was diagnosed with having measles. She related that her daughter had played with some children who had the measles two weeks prior. Because she acted so irresponsibly, knowingly taking her exposed child to a gathering of people assembled from a large geographical area during the time she was most likely to develop the disease and be contagious, she started a measles epidemic around the state. The facility hosting the gathering was just about shut-down, almost causing them significant economic hardship, not to mention the impact healthwise and other on all the families affected by her negligence. Now, I am assuming that most parents who choose not to vaccinate their children would never act in such a grossly irresponsible manner. However, if you choose not to vaccinate your child, you cannot count on others who choose the same to be reliable. Also, the disease can be spread even among responsible people if someone is not aware they've been exposed. If you feel uncomfortable with the safety of vaccinations, you can always choose to give them when your children are a bit older as well as separately. Good luck deciding. Your children are lucky to have such a thoughtful concerned parent. anon

As a health care professional I shudder at the thought of not having children vaccinated. However, I also know that there are a certain percentage of children who have suffered ill side effects from the vaccinations. While my oldest child did have the oral polio vaccine and I did and so did many others - I am so glad that the protocol was changed to use only the injectable vaccine because the incidence of contracting and spreading polio after being given the oral vaccine was higher than we should be comfortable with. You have to remember though - that prior to these vaccines, many many people contracted polio and were disabled for life - some even confined to iron lung machines. So if the only choice were to possibly contract polio or take the oral vaccine - you'de have to weigh your chances heavily. I'd say with the injectable - given that there are a number of cases every year and that we live in an area which attracts people from all over the world - vaccinated or not - my advice would be not to forgo this vaccine. I won't go into the horror stories of diptheria,or pertussis as I have never personally known anyone who contracted these diseases, but I have known several people - adults and children - who have contracted polio in countries where it is still somewhat prelavent. As for tetanus - this is one vaccine that is worth the risk if you ever want your child to play outside in the dirt. As for measles, mumps, rubella, chicken pox, hemophilus, Hepatitis B, Hepatitis A - okay - well I had measles, mumps, rubella and chicken pox as a kid. None of them were pleasant and I was very sick from the measles. My brother was very sick from chicken pox and so was the kid down the street who wound up being hospitalized. I have a cousin who had the mumps who can't have children. I had scarlet fever as a child (no vaccination for that) and was lucky not to have gone blind. On the con side of vaccines though - when most of us were kids, there were only a couple of vaccinations - all I had was polio, dpt and of course smallpox. Now there are so many more vaccines that a baby can get - my concern might be the cumulative effects of the thimerosol (mercury based preservative) that is in some of them.

Anyway, it is no fun to acquire immunity to these diseases naturally and your child could die or suffer permanent disability by not being vaccinated. So you have to seriously consider those risks as well as the risks your child would pose to your own family and other children if they did come down with one of these preventable diseases. (I was also quarantined in our home for 2 weeks or when I was in kindergarten because of the scarlet fever - along with the other kids in my family). Please be careful about the information you read - there is a lot of misleading information circulating (on both sides of the story). anon

Homeopathic Alternatives to vaccinations

Feb. 2003

We are not doing any routine vaccinations on our 4.5 month old son for the time being. I am interested in an alternative, homeopathic nosodes. If anyone has done these in lieu of traditional immunizations or who knows of a reputable practioner, please let me know. Melissa

I am reminded of a post that appeared a couple of years ago from the mother of a child whose immune system is extremely damaged and for whom any contact with an unvaccinated child is an enormous danger. She asked us to consider the dangers to her child of diseases as common (and seemingly benign) as chicken pox: your decision not to vaccinate could result in her child's death. Yvette

Where Can I get Balanced Info about Vaccinations?

Oct 1999

My first baby is due shortly, and I am wrestling with the issue of whether or not to vaccinate (and if I do, which ones might I want and which not?) The fact that people are so polarized on this issue makes the decision(s) that much harder. I know where to find plenty of info at the extreme ends. Does anyone know where I could find a resource who discusses BOTH pros and cons?

Re Balanced Resources on Vaccinations, I doubt there are any. It is such a contentious issue. For a list of vaccine related links, try http://www.access1.net/via/ . This is the Vaccine Information Awareness and the links on this page are sorted pro-choice pro-vaccine so at least you have access to biased information from both sides.

There was a mothering magazine special issue on vaccines which is worth reading. They had a panel with 3 pro and 2 con interviewees. It's worth reading this as well as the letters to the editor which followed.

There was also a misc.kids faq on immuniztions a while back. I don't know if it's been updated. I found it quite interesting to read plus it had indivuals describing their own decisions and how they made them.

Good luck in your pursuit of info.

I would like to suggest you check out the MOTHERING issue Summer 1996 (No. 79). Also, a book written by a mother of 3 children researched the problem and wrote the book WHAT ABOUT IMMUNIZATIONS (by Cynthia Cournoyer). Another good resource is IMMUNIZATION Theory vs Reality, by Neil Z. Miller. Hope this helps!

Perhaps the person requesting information on immunizations saw the articles in the Sunday, October 10, 1999 issue of the Examiner/Chronicle. If not, they can be retrieved at: http://www.sfgate.com. There are several articles(Who Should Call the Shots, A Push to Return to Injectable Polio,A Gift of Health ); The following Sunday, the 17th, there are several letters to the editor.

These were some of the onlne resources listed at the end:
HAVE YOUR SAY --To reach us: Respond to THIS WEEK'S TOPIC at sunday AT sfgate.com, or join the discussion at sfgate.com/vent/ sunday. For other ways to reach us, see Page 5. See inside for feedback to recent sections. --To learn more about the medical arguments for vaccines, visit the web sites for the U.S. Centers for Disease Control at www.cdc.gov/nip/vacsafe or the World Health Organization at www.who.int/gpv-safety/index.html. --To read more about criticisms of vaccines, visit The Global Vaccine Awareness League at www.gval.com. --To read more about vaccine requirements for California students, visit the California Department of Health Services at http://www.rain.org/~medmall/specialties/immune/cdhs/ . Tim Vollmer is a medical anthropologist and writer based in the Bay Area.

My partner and I, after some reading and much agonizing, decided on a course of action that we're still feeling very good about 14 months later. I haven't seen anyone talk about it as an option, so here is the basic idea.

There are many problems with vaccinations, but even though we felt very concerned after reading a book about vaccinations from a homeopathic perspective, we agreed that we couldn't live with the possibility that our son would die from an illness we could have vaccinated him against. Once we decided to vaccinate, we focused on HOW to do it. One of the problems with vaccinations is that they are given so early -- earlier than (in some opinions) the baby's own immune system is ready to handle them. A second problem is that they are given in groups, which makes it hard to know what the baby reacts to if there is a reaction.

To address both these problems, we decided to start vaccinations a few months late, and stagger them so he only got one shot per visit. The decision when to start and in what order can be made based on: 1) discussion with your doctor, 2) information about the risk from the illness vs. the risk from the shot, 3) your own anxiety/gut feelings about how long you can wait, and which illness you're most afraid of. We factored all these in and decided to start at 4 months and add another shot every few weeks thereafter. A couple of the vaccinations our doctor agreed are unnecessary for infants altogether so we're skipping them.

The only thing I'd do differently is that I may start a little later. At the time, however, we got anxious about winter coming and potential illnesses.

As an unexpected side benefit, I found giving the baby one shot at a time much more humane than three shots. From friends' stories, I got the impression that it's the second and third shots that really get the babies scared, as opposed to the pain of one shot that does not induce the same fear reaction.

Lastly, make sure you have a flexible, knowledgeable doctor who can accept and support your decision even if he or she does not agree with it. One doctor's office told us on the phone that the doctor would not agree to us not vaccinating our baby -- needless to say, we chose another doctor. We wanted to make sure that whichever way we decided to go, we'd have the doctor's respectful support. Good luck to you, whatever you decide.

Mothering magazine has a 1997 publication entitled Vaccination: The Issue of our Times, A Selection of Articles, Letters, and Resources, 1979-1997. (phon: 888-984-8116). It includes the Experts Forum (of 3 pro and 2 con) which a previous reply referred to. I think it is a fairly balanced view, although I haven't read the entire book. Thought I wish we'd read it, before our child was born, it helped us to decide to continue to vaccinate, but to slow down the vaccination process, and omit some of the vaccinations. It's also good to keep up with current research findings as much as possible, and probably to hold off on newer vaccinations. (For example, had I known more about hep B, I would not have had it given to our newborn right away or perhaps at all, and when we asked our pediatrician to hold off on the hep B follow-ups, she said that there was research showing that waiting a long time, meaning even years, for the 3rd shot had more protection; had we not brought it up she wouldn't nave even told us that, as that is not the recommended schedule.) Support for LONG-TERM (longitudinal) research on vaccinations is essential for us to really know what is effective and what the risks truly are, so I would encourage all of us to find ways to support efforts to encourage this type of research, as well as wide dissemination of findings to the public.