With winter’s departure, the long-dormant mud in the meadow of the K-8 Waldorf school my youngest sons attend is back. So, too, is whooping cough. Six years ago when there was an outbreak at the school, my son Jules, who was then in the second grade, caught it. A dreamy, lithe child with large eyes, I watched for three months as his body convulsed while he coughed for minutes at a time, leaving his ribs aching and his eyes floating in tears from the exertion. Unlike his two older brothers, I had not vaccinated my son for pertussis, commonly known as whooping cough.
Lately, after several outbreaks of measles in the United States, there has been renewed media attention given to the anti-vaccination movement, much of which would leave any reader thinking that anti-vaxxers are either ignorant of basic science or sociologically indulgent, willing to coast on the high vaccination rates of others. I am neither.
When my first child was born in January of 1994, many societal constructs were being questioned with some Americans opting out of what had seemed inviolate institutions just a generation earlier. While not all practiced equally by the same groups of people, things such as co-habitation before marriage, homeschooling, homebirth, organic and local agriculture were no longer unheard of and, at least in the case of premarital co-habitation, were well on the way to becoming a new norm. It was in this milieu that I gave birth, at home, to my first child. I had medically appropriate prenatal care throughout my pregnancy and after my son was born, the midwives administered a PKU test, pricking his heel and filling dots on a card with his blood to be sent to the local health department to screen for about 40 possible disorders. I also received a Rhogam shot to prevent my negative blood type from creating antibodies lest any future fetus have positive-typed blood. Circumcision is not religiously significant to me but was another previously accepted protocol for all infant boys with many hospitals often performing the procedure as a matter of course. I read all I could on circumcision and found no compelling reason to cut off my infant son’s foreskin.
Choosing whether and when to vaccinate, as well as what vaccines to give my child, was not so simple for me as choosing homebirth or foregoing circumcision. After reading everything I could find, I decided to follow a middle path of my own. Japan, hardly a backwards country, was at the time initiating vaccines for children not at birth, but at the age of two. With the exception of Haemophilus influenza Type b, or Hib (which is most harmful to children under the age of five, but especially babies), I decided I would begin vaccinating my son at the age of one, when his immune system had developed. I believed, with good reason, that as an exclusively breast-fed baby for nearly nine months, he was benefitting from my immunity.
In the 1990s, I was hardly alone in struggling with concerns about vaccinating my child. At the time, many educated parents questioned several important things about vaccines. The vaccine for DPT (diphtheria/pertussis/tetanus), for instance, was often cited as being mixed in dirty solutions. This was confirmed for me when I met with my son’s pediatrician to begin vaccinating him in the winter of 1995. We were living in Boston at the time and she told me that Massachusetts had created its own batch of DPT, available only in that state, to avoid using the tainted batches found in the rest of the country. However, that same pediatrician was incredulous when I insisted upon strictly giving my son the killed polio vaccine because it was possible, albeit a very small risk, to contract polio from the live vaccine. “You have to give the live vaccine in the first dose because it has to go through the gut, which is how the disease enters the body,” she told me. When I mentioned that diphtheria was also contracted through the gut but the vaccine for that disease was not given through the gut, she had no response. I stuck to my guns and four years later, in 1999, the United States abandoned the use of live polio vaccines.
There were also issues with other vaccines in the 1990s. In 1998, the rotavirus vaccine was introduced and recommended by the American Academy of Pediatricians for all infants. It was pulled the next year when several children required surgery for intestinal blockages directly linked to the rotavirus vaccine. It was eventually reintroduced in 2006, which means it took seven years of research to resolve the issues with a vaccine that for one year had been recommended for all infants in the United States.
And then there is the thimerosal controversy. A derivative of mercury, which is highly toxic in certain formulations (but not in elemental liquid mercury), thimerosal was still abundantly used to preserve vaccines in the 1990s. At the same time, autism diagnoses exploded to what felt like epidemic proportions. A diagnosis that was rare, though not unheard of, in my childhood became so common in my early years as a mother that it felt like an inevitably with each pregnancy. So significant was the increase of autism and Asperger’s (which is now seen as part of the spectrum of autism) it seemed implausible to think the increase was simply due to improved methods of diagnosis. Thus, it is not surprising to me as someone who lived and bore children in the 1990s and early 2000s that parents were susceptible to claims that thimerosal in vaccines caused autism. Eventually, in 2011, an article in the British Journal of Medicine thoroughly discredited any connection between thimerosal and autism. But by then my firstborn was seventeen years old and my third son, Jules, had long recovered from his pertussis.
Neither out of stupidity, nor out of entitled indulgence did I vaccinate my children differently. I struggled to find the best way to protect my children from disease and from the risks in vaccinating. Sure, the chances of contracting polio from the live vaccine were very slim, but if it is your child who is the one in a million, the results are no less devastating because 999,999 other children did not contract the disease.
My third son was born in the summer of 2000 and like his brothers I had him immediately vaccinated for Hib. When he was a year old, I began his regular vaccinations. But then we moved and I did not complete the cycle. Today, I struggle to recall why that was and I do not believe I simply had forgotten to complete the booster schedule; there was an element of choice. A choice made in part due to continued distrust of less significant vaccines. I read several articles in non-mainstream publications that cited the inefficacy of the annual flu shot. Then, in November of 2009, The Atlantic published a comprehensive article on the flu vaccine that pretty much agreed, across the board, with the non-mainstream publications.
My oldest son is now twenty-one years old and many of the issues I had with vaccines when he was an infant have been resolved, which may be due in part to the fact that a small percentage of the population began opting out, thereby putting governmental light on their concerns whether real, as in the case of polio and rotavirus, or not, as in the case of thimerosal and autism. But when I watched pertussis debilitate my son Jules for three months in 2009, I had what I call a “Coming to Jesus Meeting” with myself in which recognized the following:
- None of today’s vaccines come with the risk of developing the disease for which the vaccine is being given such as it was with live polio.
- Not only has the thimerosal/autism theory been thoroughly debunked, since 2001 thimerosal has been removed or greatly reduced in nearly all vaccines.
- Furthermore, with cleaner, safer vaccines it is important to consider the collective benefit of herd immunity. I worry about infants who are exposed to the pertussis that is now roaming the halls and playgrounds of my children’s school.
I reviewed my three sons’ vaccination records and had them all brought up-to-date and inoculated for things I had chosen to forego in the past, such as Hepatitis A and B. I went on to have two more children in my forties, both of whom have been fully vaccinated on schedule in part due to the approach of my pediatrician. An M.D. PhD, our pediatrician is never condescending when she talks candidly with me about the latest research on vaccines. My fifth and final child, who is also my only daughter, has Down syndrome. People with Down syndrome can have suppressed immune systems and my pediatrician told me that studies of children with Down syndrome have shown that vaccination not only protects these children from the specific diseases, it also improves their immune systems overall.
Where there is a need, vaccines should be improved and gone are the days when physicians can talk to most patients or the parents of patients in a patriarchal, top-down manner and expect unquestioned obedience. Medical personnel owe it to their patients to give them accurate, up-to-date information without any trace of condescension. For the history of vaccination, inarguably one of the greatest scientific advances in human history, is not uncomplicated. But today, more than ever, the benefits far and away outweigh any risks and I hope that one day soon pertussis, measles and mumps can go the way of small pox, which has been eradicated through vaccination. (The same would be true of polio but extremists in parts of the Middle East have gone so far as to murder health workers in order to prevent the administration of the polio vaccine in their regions.) Because no child should unnecessarily suffer, as my son did, from a disease that is entirely preventable.