Decisions, Decisions, Decisions.

I am often surprised by the sheer number of choices I have to make every day as a parent. While most of these are as simple as what to feed my girls for dinner, others carry life-long implications. For my children’s healthcare, though, my plan was simple: listen to their doctor, and do what the doctor says. Well, that simple plan flew out of the window on day one when their first pediatrician insisted that my twins were identical just because they had the same blood type. I realized that I would have to be their advocate, actively making decisions instead of blindly trusting the experts. This led me to the issue of vaccines. Vaccination to me was standard healthcare and not something I had ever questioned. However, with all the buzz about the safety or otherwise of vaccines and vaccine schedules, this also became a decision I had to make. Would I get my children vaccinated?

To make this decision, I had to get informed. I found that the consensus among credible sources such as the World Health Organization (WHO)  and the Centers for Disease Control and Prevention (CDC) was that vaccines are a safe and very effective  way to prevent or reduce the severity of several infectious diseases. Why then did several sources claim that startling numbers of people were injured or killed every year by vaccines?  Was there a genuine risk associated with vaccination?

If one word could capture my search for facts about severe vaccine side effects, it would be “frustration”. I found that credible sources often provided a very one-sided view on the issue: A lot of talk about the benefits of vaccines but not much information on any potential problems. This may stem in part from genuine difficulties in determining exact numbers. For instance, in the US, suspected reactions to vaccinations are reported to the Vaccine Adverse Event Reporting System (VAERS). Since this system is based on self-reporting, anyone- parents, doctors, nurses, or vaccine manufacturing companies- can file a report. Consequently, a particular incident may get reported multiple times. Moreover, there is no requirement for proof of a link between a vaccination event and the supposed side effect.

The VAERS only collects information on possible vaccine side effects. Parents seeking compensation for serious side-effects suffered by their children are able to file a claim with the  US Office of Special Masters of the U.S. Court of Federal Claims (often called Vaccine Court). Here, alleged cases of severe vaccine side effects are reviewed, and compensation is given as the court finds appropriate. In this system, successful petitions are not considered an admission that an illness or a condition was caused by vaccines, but simply that it may have been. Last year, out of the 887 cases tried in this court, 696 were awarded some compensation. Since there are specific guidelines as to what can be reported as a vaccine-related injury deserving compensation by the government, this number gives a good idea of what experts consider possible vaccine-related effects.

Genuine limitations or not, this defensive stance taken by health organizations is problematic. The existence of a vaccine court and a compensation system points to the fact that there may indeed be some cases of severe reactions to vaccines. The absence of easily-accessible numbers then gives the impression that the authorities are hiding something. I also noticed that my kids’ pediatricians and nurse practitioners did not readily provide information on possible serious reactions to vaccines. I was told to expect mild reactions such as a low-grade fever or a rash.  Interestingly, I readily found a lot of information from propaganda-based anti-vaccination websites. If credible information is not easily available or readily given to balance out the argument, it handicaps a person’s ability to make decisions based on facts. Doctors and researchers may not have all the answers on whether, why or how frequently genuine severe side effects of vaccines happen, but even this is worth communicating to the public. There is much value in an honest “we don’t know yet”. Such openness would build trust between the scientific and healthcare communities and the public.

As a scientist, the evidence in support of vaccines is clear. As a parent, though, things are less straightforward.  The odds of an adverse reaction may be slim, but that means nothing if your child is affected. I realize, though, that I regularly expose my children to all kinds of risks. For example, my daredevil daughter climbs around the playground with the speed and agility of a circus acrobat. “Look, Mummy, I’m a ninja!” she shouts as I have another near-heart attack just watching her. In the US alone, there are 200,000 serious playground-related injuries every year. Even more astonishingly, 150 children are treated in emergency rooms every hour for car crash-related injuries, which are the leading cause of death by injury in children 5-19. Yet there is no talk of banning playgrounds or cars. We simply work to make them safer for our children.

The unfortunate irony seems to be that the efficacy of immunization may be the one factor inducing increased complacency, as most new parents have no personal experience with widespread outbreaks of preventable infectious diseases. Deadly outbreaks seem to have disappeared, along with our fear of them. However, if we stop vaccinating our children, these diseases will return.

I still cringe just a little bit when my kids get their shots, but I know that we have made the right decision for them. Whether or not I get my own booster shots on time is a different question! 

My little ninja