The Pros & Cons of Vaccinating Children

Although most parents choose to follow the American Academy of Pediatrics' recommended vaccination schedule for their children, vaccines are a controversial aspect of pediatrics. The recommended schedule has grown to include more and more vaccinations. Some parents worry about short- and long-term effects. There are important benefits to vaccinations, but there are also dangers and concerns that have not always been adequately studied.

History

• The first vaccination for human use was the smallpox vaccine, developed by Edward Jenner in 1798. Jenner discovered that exposing someone to cowpox could protect them from the related illness smallpox. Nearly 100 years later the strategy was put to use against other diseases, beginning with rabies in 1885. Since then, many vaccines have been developed. In 1964, the Advisory Committee on Immunization Practices was formed to advise Centers for Disease Control on vaccines. However, as more vaccines were recommended to the public, side effects were reported. Concern over safety grew. In 1986 the National Childhood Vaccine Injury Act was passed, requiring health providers to report problems to the Vaccine Adverse Effects Reporting System.

Function

• Vaccines are meant to prevent an individual from contracting disease. For most people, vaccines have been effective, to the extent that the last smallpox case in the world occurred in 1977, and the last case of wild polio (contracted naturally, not from a live vaccine) in the U.S. was in 1979. However, no vaccine works in all cases. For example, pertussis and tuberculosis continue to be relatively common diseases in the U.S., though their vaccines have been in use since the 1920s. According to the CDC, there were mote than 10,000 cases of pertussis and more than 13,000 cases of tuberculosis in the U.S. in 2007.

Considerations

• Most parents follow recommended guidelines for vaccinating their children. However, some pediatricians, such as Dr. William Sears, recommend alternative schedules. Sears advises delaying some vaccinations and modifying others so they're given one at a time instead of combining multiple vaccinations in a single dose. This allows babies to more fully develop their immune systems before vaccines are given. It also allows parents to easily pinpoint which vaccine caused a reaction. Sears also recommends avoiding the newest vaccines, suggesting that parents wait until a vaccine has been in use for a few years before administering it to young children.

  Vaccines are required for day care and school attendance, but this is not a consideration in choosing a vaccine schedule. According to the National Vaccine Information Center, all states allow medical exemptions from vaccines. Many allow philosophical or religious exemptions as well.

  If a child's relatives have a history of reactions to a particular vaccine, the CDC recommends avoiding that vaccine for the child.

  When modifying a vaccine schedule, consider the risk for the disease it's meant to prevent. For example, a mother certain of her negative Hepatitis B status may choose to avoid giving her newborn that vaccine at birth. In the U.S., some diseases, such as polio, are rare enough that parents may choose not to give the related vaccine, though CDC continues to recommend it.

Misconceptions

• Although there is literature claiming that the MMR (mumps, measles and rubella) vaccine causes autism, studies have failed to find a direct link. However, some U.S. courts have ruled that an indirect connection exists. For example, in 2008, the U.S. Court of Federal Claims ruled that the MMR vaccine aggravated one child's preexisting genetic disorder, leading her to develop symptoms of autism.

  Another misconception in anti-vaccine literature is the belief that vaccines do not prevent diseases. According to CDC records, the rates of vaccine-preventable diseases have decreased since the introduction of their vaccines.

Benefits

• Vaccines are effective at preventing disease. However, there has never been a controlled study comparing vaccinated and unvaccinated populations of children to examine long-term effects of vaccinations. Such a study would be difficult and possibly unethical, because most doctors believe it is wrong not to vaccinate children. The current method of studying the safety of new vaccines -- comparing populations vaccinated with an older vaccine to those receiving the new one -- is not a truly scientific practice, because it lacks a control group. Controversy over vaccines could benefit children if it prompts more controlled studies.