Arguing with DH over whether to vaccinate or not

[LetsGoToTheHills]

This is causing a lot of conflict and we are both really upset about it. He is for, I am against (never had them myself). Both equally passionate. This is my first time on MN and I have found a lot of useful information and interesting viewpoints, but was wondering if anyone has been in a similar situation? How did you manage to resolve it?

Farlo, I'm just going to have to answer you quickly and in bits I'm afraid - this week isn't looking any less busy!

As I said, there is no way to identify which children are more at risk and doctors don't go out of their way to find it of there are any potential risk factors (eg. a family history so there really is no way to determine which children have a 'valid medical reason' for not vaccinating. Even when children DO have reactions parents struggle to get a doctor to admit that it was vaccine related so rather than being able to perhaps compile an accurate list of potential risk factors it all just gets swept under the 'coincidence' carpet.

You are talking a lot about herd immunity but unfortunately there are still outbreaks even when vaccination rate is up around 100%. The 'weak links' may be children too young to be vaccinated, children who can't be vaccinated, children whose vaccine didn't work, adults whose immunity didn't last as well as people who have chosen not to vaccinate. In relation to the other groups, people who have chosen not to vaccinate are very small percentage.why allocate them more blame than an adult who hasn't tested their immunity or had a booster in years? Also, these outbreaks are more likely to spread in the unvaccinated (although many vaccinated people are also affected) - the very group herd immunity is supposed to protect. Based on this, I think it would be a but irresponsible to base your decision not to vaccinate on relying on other people for protection. It isn't reliable.

I know you mentioned some methods of transmission more common to children eg sharing toys but there are ones more common to adults eg kissing. There are also a huge number of adults out there who cough/sneeze into their hand (if you're lucky!) and then touch trolleys/door handles/shake your hand and a large percentage of adults don't wash their hands after going to the toilet. (yuck)

You made a point about chickenpox being particularly dangerous For immunocompromised children yet that is something that we don't vaccinate for in the UK. If the vaccine was available here would you expect people to vaccinate their children against it purely to protect immune compromised children even though we consider it to be a usually mild childhood illness? I know that there are many MN who can't vaccinate their children who have said several times that they do not expect anyone to vaccinate for their benefit. Maybe because some of them have vaccine damaged children they are more aware of what the consequences of an unknown risk can actually be.

I used the Russian roulette analogy and you commented that it is also a gamble with the disease. With the diseases, we have more knowledge of what the risk factors are eg for measles - Complications are more likely in children who are deficient in vitamin A. Or we know how likely it is that our children will contract the disease eg for polio it is pretty much zero in the UK.With the vaccines, we don't know what the risks are for each individual child (obviously some are at greater risk than others) so it is like playing Russian roulette when you don't know how many bullets are in the gun - it could be 1 (probably for most children) but it could be 6 for others. It's a big gamble when you don't have any idea what the odds are for your child.

You also mentioned the whole 'vaccines happen at the same time of development changes' argument. There are other people here who will take great offense that because you are effectively saying that they don't know their children and are just looking for something to blame. Not nice! In any case, the MMR vaccine has been given at a few different ages so which age exactly do you think symptoms start to show? 18 months? 15 months? 13 months? 12 months?

Vaccination can be (if you don't follow the standard schedule) a real minefield.

People have different reasons fro delaying or not giving various vaccines. I think the first step is to try to work out if there are vaccines you definitely object to (whether down to unease over triple/quadruple/quintuple components, or because you feel that you would rather your child 'meets' that disease wild and has a chance at lifelong immunity, or whatever the reason) and ones that you maybe don't feel so strongly about.

Some vaccines are available as singles, others aren't (or at least not for children, or not in this country).

And the OP's dh shoudl do the same - are there ones he feels are absolutely non-negotiable?

ultimately it is not easy to compromise over vaccination - it is something that is done or not done, there is no half way step (talking about individual jabs now).

non-vaccination need not be an absolute, though - it can be revisited and opinions revised. we certainly talk regularly about dd2's vaccination status, and what we now feel shoudl be done (or not), and will do so for the next baby too.

vaccine damage can and does occur, but it is rare. long lasting effects from illness can and does occur, and again it is rare. there is no right answer for everyone - jsut answers that each family are comfortable with, for them, at that point in time.

Boulevard I read that studies have actually shown that the more educated a parent is, the less likely they are to vaccinate.

I haven't read the studies myself so don't know what higher level studying the parents have completed, whether it's in the medical or scientific field, but I would presume that parents educated to such a level were able to read the various pro and anti arguments, decide how valid those arguments are based on who has written the document, and then make a very informed decision.

There is a mistaken belief that anti-vaccers haven't read beyond the Daily Mail headlines.

Well these things are all complicated aren't they?

And there are about a hundred factors a parent has to take into account - most of them unknown quantities, making it virtually impossible to give true informed consent but equally making it extremely difficult to know if withholding consent is the correct route.

And that is why the 'greater good' argument is actually hugely unethical.

It is unethical to require a person to take an unknown risk, of unknown risk/benefit ratio, to themselves, for the good of wider public health.

Of course we do it and there are arguments in favour of doing it. I would feel better about those particular arguments if people would call a spade a spade and admit that such actions do not comply with the basic medical ethics, which apply to, and are designed to respect, the individual's right to bodily integrity.

Which of course brings us round to safety. The foundation of the 'greater good' argument, is that vaccines are very very safe. So it doesn't matter terribly if certain individuals do not want them or need them, because any element of risk is negligible, so the individual 'might as well' in order to do their bit. It is 99% sure that they will come to no harm, they will be protected from some potentially nasty diseases and bonus! they get to participate in protecting wider public health. Surely it would be terribly selfish, if not irresponsible and indeed unreasonable, not to cooperate?

Which sounds reasonable enough and quite altruistic so it appears to justify overriding basic principles of medical ethics that would normally apply.

So far so good.

But there are a couple of significant, although not immediately obvious, hitches to this argument.

The main one being that the actual current real safety data is inadequate and incomplete. We know that adverse reactions happen to vaccines but we don't know at what rate. We have not identified many of the at risk groups, and we aren't very good at recognising the signs and health consequences of vaccine damage when it does happen (in part because that area of research is very understudied and also exceeding unpopular). We are also not very accepting of cases of vaccine injury - something I find extremely inconsistent with the previously alluded to altruism of the 'greater good' public health argument.

Then we have another issue which is that science and the gathering and disseminating of scientific data, does not exist in a social, political and financial vacuum. And that is another whole can of worms, which I don't have time to go into right now.

Must watch out for those classic errors....

Sorry. Inner nerd popping out.

I mostly agree with silverfrog's post above. (And I never thought I'd say that on a vaccination thread!)

So I agree with silverfrog and others on this thread who suggest that you discuss each vaccine as an individual drug and try to decide which ones are right for your family.

There are doctors who will be willing to help you with this and who will respect your concerns.

As silverfrog says, decisions to not use certain vaccines or to avoid multiple vaccines can fit in with the use of other vaccines. And these decisions can be revisited. The sex of your child and family history are factors that a doctor should be willing to consider.

WRT to sources of information, I agree with Boulevard that there are a lot of dodgy sites out there - for everything really! When I'm looking for information about the diseases and how many cases there are I use the NHS/HPA/WHO websites.

world gone crazy - you suggested I might like to read 'the other side of Jenner'. I had a look at this link - sorry but who is Barbara Flynn MBA? Who peer reviewed this article? Do you really give credence to this sort of unscientific ranting? Her last question is telling: What price do we pay as a society for the gross human rights violations we casually accept as mandatory vaccination laws?
The answer of course is the eradication of killer diseases, such as smallpox and (soon) polio.
You also say that "I read that studies have actually shown that the more educated a parent is, the less likely they are to vaccinate". I find that very surprising and have never seen a respected study which comes to that conclusion. Do you have any references? I would also wonder about what sort of education those studies refer to. I would hazard a guess that it does not include medical or scientific education...

Bumbley, I'm recommending you read Nemesis, about polio, because you have no idea what it is like to live in the middle of a polio epidemic. Because vaccinations have been so successful, this generation in the West has no experience of killer childhood diseases. You are now making decisions not to vaccinate because you have experienced only the safety of herd immunity, and therefore you do not perceive the risks associated with childhood diseases - you see only the risks associated with adverse reactions to vaccinations (and I am the first to admit that they do occur). You may think I am patronising - I do not intend to be, but I am older than you and I remember how things used to be.

Beachcomber says "The main (hitch) being that the actual current real safety data is inadequate and incomplete". Sorry Beachcomber, that is just not true. Millions of vaccinations have been given over the years, and the data on adverse reactions is all available. Yes, there are adverse reactions. They may be few and far between, but of course if they affect your child that is scant comfort. I understand that parents do not want to take risks with their children's health - who would? - particularly because there is no perceived benefit, as childhood diseases have largely disappeared (as a result of vaccination). But of course when you stop vaccinating, the diseases reappear (except those which have been eradicated...) Look at the measles statistics in France, and look at the increase in cases in and around London following on Wakefield's MMR/autism scare.

Funny that this topic arouses such incredibly strong feelings...

Of course it is more educated people who CHOSE not to vaccinate. Most of those who choose not to vaccinate live in the west. Who on here left school at 10? Who never went to school and also never had any home education?

In Afghanistan one problem with recruiting police officers is that they have to be taught to read, as part of their training. Less then half the men and only 12% of women can read and write.

So anyone in the west who refuses a polio vaccine for the child is more educated than an Afghan who doesn't.

Interestingly the Taliban allow vaccination teams to travel and vaccinaate in the areas they control.

Beachcomber

Your ethics / greater good argument is flawed.

I used to be a healthcare worker, I also have both psoriasis and eczema and a laytex allergy.

I knew that sometimes after uning hibiscrub my skin would react, sometimes it didn't. I still washed my hands before medical procedures because the unknown risk, would my skin react, was not going to kill me, but could have a devastating effect on a patient. I would also use laytex gloves if the supply of polyurethane ran out - i that case I knew I would have red itchy hands and need piriton - but again I believed (and still do) it was for the greater good.

WE don't know there are adverse reactions, we do know how many serious ones there are, but not the ones where the reaction is mild because these are not recorded.

The main (hitch) being that the actual current real safety data is inadequate and incomplete"

The IOM safety review, which I linked to above,looked at 12000 peer reviewed article, it is hardly under investigated.

happymumoffour

These are the journals/research mentioned on this page which talks about more educated parents being less likely to vaccinate.

American Journal of Public Health, 10.2105/AJPH.2005.076661.

Sexually Transmitted Infections 2008;84:318-323, British Medical Journal Publishing Group. (regarding HPV vaccination)

BMJ 2008;336(7647):754-7

BMJ 2006;332:1312-1313 (3 June), doi:10.1136/bmj.332.7553.1312

Nursing Times, 9 February 2010

US News Health, 3rd November 2010

sashh the research has been around parents in the Western world, so does not include the large numbers of uneducated people in the third/second world who are unvaccinated.

Sorry Beachcomber, that is just not true. Millions of vaccinations have been given over the years, and the data on adverse reactions is all available.

Happymum, I'm afraid that is quite simply not the case. We just don't have all the data. The DoH is aware the the majority of adverse reactions do not get reported. The reporting system is a passive one - there is no follow up. The information just isn't there. Anyway a report of a suspected bad reaction is just that, a report. It does not mean that the event is actually recorded as a vaccine reaction (which is fair enough in one way because there may well not be an association with the vaccine). It does not necessarily mean that an event is actually investigated.

You are right that millions of vaccines have been given and it seems that in the majority of cases everything has been fine. But 'majority' is a terribly vague term. I'm of the opinion that the data gathering on post marketing vaccine safety is inadequate and clumsy.The DoH agree with me as the estimation is that only about 1 in 10 reactions are ever reported (I do not know how they come up with this figure - you would need to ask the DoH).

The data is very incomplete. That is indisputable I'm afraid. (Of course that doesn't mean to say that complete data would point to anything terrible - it just means we would have adequate safety information, something that seems worth working towards to me!)

I agree with you that most people do not want to see the return of measles, etc, but that want does not make up for the significant lack of precise safety data on the vaccine schedule. Well not in my opinion anyway.

Beachcomber

Your ethics / greater good argument is flawed.

No it isn't. It is very very basic medical ethics. I guess I wasn't precise enough in my language because I'm not talking about taking an individual choosing a risk such as wearing gloves they may react to. Gloves are not drugs and they have not been administered to you by a third party. You have an accurate idea of the risk benefit ratio to you and to others, and you have therefore given informed consent.

I'm talking about a health care professional giving a drug, that is not for the benefit of the patient and is of unknown risk benefit for the patient, and whose primary motivation is to benefit people other than that individual. Matters are confounded if the HCP coerces the patient by misleading the patient as to the clinical need for them to have the treatment.

The rubella vaccine for boys springs to mind as an example. But you could say this about any vaccine that the individual would have chosen not to bother with for their own benefit.

Another example - I would prefer my daughters to have German measles just like I did as a child. I don't see how it benefits my children to be vaccinated against what is a very mild disease in healthy children. And neither does my doctor - he wants then to have this vaccine in order to protect other people. This is a very dodgy argument - you want a child to be given a drug which will alter their immune system and status, and which carries an unknown risk for that individual child, for someone else's benefit?!

Serious vaccine damage may be rare but let's not pretend that we have solid data - we simply don't. Human biology is complex, establishing whether a health outcome is due to a vaccine is difficult (and as I said before, not a popular area of science!!). I think the MMR controversy is proof of this.

It can take a family years of struggle to have a serious vaccine injury recognised. www.bbc.co.uk/news/uk-england-merseyside-11125343

Sorry OP this is not very relevant to your actual question - please say if you would like those of us who are discussing this point to start our own thread . As you can see and as Happymum said, feelings run high. No doubt you and your DH both have strong feelings and of course you both want what is best for your child. Good luck with your decisions.

Bruffin have you read the IOM report? I believe it is 800 pages long!!

They do clearly say themselves that safety information is not complete. I have read the summary and I quote from it;

Although the committee is optimistic that more can and will be known about vaccine safety in the future, the limitations of the currently available peer-reviewed data meant that, more often not, we did not have sufficient scientific information to conclude whether a particular vaccine caused a specific rare adverse event. Where the data was inadequate to reach a scientifically defensible conclusion about causation, the committee specifically chose not to say which way the evidence ?leaned,? reasoning that such indications would violate our analytic framework. Some readers doubtless will be disappointed by this level of rigor. The committee particularly counsels readers not to interpret a conclusion of inadequate data to accept or reject causation as evidence either that causation is either present or absent. Inadequate data to accept or reject causation means just that?inadequate. It is also important to recognize what our task was not. We were not charged with assessing the benefits of vaccines, with weighing benefits and costs, or with deciding how, when, and to whom vaccines should be administered. The committee was not charged with making vaccine policy. We did receive calls to stride into this contentious debate, but others, such as the Food and Drug Administration and the CDC, are tasked with formulating recommendations for use that balance the risk of vaccines with the benefits, with studying the safety of the vaccines during pre-release trials, and monitoring them closely once the vaccine is in use in the population.

The IOM report tells us that the data is incomplete in the area of study. That area being stated in the title of the report "Adverse Effects of Vaccines: Evidence and Causality".

Which seems logical given; the enormity of the task of gathering that data, the number of vaccines given, the number of possible variations to the vaccine schedule, the complexity of human biology and individual variations and predispositions therein, the holes in our knowledge about how the immune system works (particularly in children).

It would be an herculean task to compile complete data. I don't know if it is realisable.

So let's not pretend that the data in this incredibly complex area, involving millions of people, is complete. It can't be given the enormity of the task and the limitations of human scientific knowledge and study in the field.

I'm not saying that we don't have a lot of data - we quite clearly do. I'm arguing against the notion that we have adequate data to justify the dodgy ethics of the 'greater good' argument.

Beachcomber

You have daughters but don't want them to have the rubella vaccine? When the primary "other person" being protected is your own unborn grandchild. I think that says it all.

My mother was exposed to a child with rubella when she was pregnant - fortunately it was a relative who could inform her, if it had been a child sitting next to her on a bus she would not have known. She was given gamma globulin, 40+ years later that is the same treatment. The stats for deformities in babies exposed to rubella before the mother is 9 weeks pregnant are the same - 85% will suffer a deformity / disabiity. Before the vaccine it was the major cause of birth defects.

Rubella vaccine is a live but weakened strain - so you want your children to be exposed to a live 'wild' vaccine, but not to the same virus in a weakened form?

For some vvaccines, such as the old 1960s measels vaccine, I can understand the concern - there are, rare, reactions that cause major disability and are directly atributable to the vaccine. But rubella?

Yes the data is imcoplete because we don't report "baby was abit grizzly for 30 mins", or "child had a scab at injection site", we only collect data on serious reactions because most people consider a bit of a bruise or a grumpy baby for a few hours to be worth it for the vaccination protection.

Happymum, eradication of smallpox and (nearly) polio wasn't completely as a result of vaccination. You know that don't you? The surge in polio cases in the 1940s and 1950s has also been attributed to the frequency at which tonsillectomies were bring carried out at the time. Tonsillectomies put children at a greater risk of contracting polio.

Your 'I'm older so I'm wiser" comment doesn't make you seem any less patronising by the way. I'm old enough to have contracted measles, mumps, rubella and whooping cough myself as a child so I am well aware of what the diseases are like, thank you. I've already explained why I don't consider herd immunity to be a reliable source of protection so that didn't influence my vaccination decision.

Do you really think a fictional novel is a reliable source of information? Really?

You have daughters but don't want them to have the rubella vaccine? When the primary "other person" being protected is your own unborn grandchild. I think that says it all.

Are you intentionally misreading me or are you not managing to understand? "I think that says it all" is a rather silly judgy pants adversarial thing to post really isn't it? Are you purposely trying to imply that I don't care if my future grandchildren are damaged by congenital rubella syndrome?

My DDs are children, they are pre-pubescent. Are you implying that my young children are at risk for getting pregnant? What exactly are you trying to say about my family set up - that somebody is having a sexual relationship with my 6 and 8 year old children? How dare you.

I said I didn't want my DDs to have the rubella vaccine as children because I preferred them to have German measles the disease (in other words they would be immune to rubella. It is very odd and rather nasty to ignore that bit of what I said in order to pretend that my young children are having sex and I don't care about any future grandchildren).

I would prefer them to have German measles because it is a mild disease in healthy children and then my DDs will (normally, there are exceptions but they can apply to the vaccine too), be protected into their childbearing years without having to worry about being dependent on vaccine boosters. Seems sensible to me.

And it has worked out marvellously because they have both had German measles - bit snuffly with a rash for a couple of days. And now they are immune (we had their immunity tested).

Of course if they reached puberty without becoming immune we would talk to their doctor about them having the single rubella vaccine. In fact that was the public health policy for years in the UK - do you think 'that says it all' about the DoH?

Yes the data is imcoplete because we don't report "baby was abit grizzly for 30 mins", or "child had a scab at injection site", we only collect data on serious reactions because most people consider a bit of a bruise or a grumpy baby for a few hours to be worth it for the vaccination protection.

I'm afraid this is not true. It is simplistic wishful thinking.

I looked into the IOM's report a bit more and found out the following;

The report considered 158 potential adverse outcomes from vaccines.

Of these, 135 or 85% were found to have inadequate research to accept or reject a causal association.

Of the 23 outcomes where the research was deemed adequate, 18 or 78% were found supportive of harm.

There are lots of holes in our knowledge about vaccination. I'm of the opinion that it is better to be realistic and responsible about that. That way we have more of a chance of finding out who are the subgroups for whom alternative vaccine schedules are imperative.

A head in the sand attitude as to the extent of current knowledge is reckless and unethical.

so you want your children to be exposed to a live 'wild' vaccine

And what is this 'wild' vaccine of which you speak?

Or do you mean I want them to be exposed to the virus? A virus and a vaccine are not the same thing.

HTH.

Beachcomber - she may have used the wrong term but as a virus is worse than a vaccine best not get snotty about it.

And of course you don't 'want' your children exposed.

We are talking about rubella.

The rubella vaccine is given to children in order to protect women who are in early pregnancy, that children may come into contact with.

It is not given because rubella is considered a danger to healthy children.

And what does 'a virus is worse than a vaccine' mean?

Of course I want my children to be exposed to rubella - it is very important for them as they are girls. Do not tell me what I do or do not want, I know my own mind thank you.

I want my girls exposed to rubella too. the virus, not the vaccine (althugh dd1 has already had mmr, so could well be covered anyway)

would be happy (well, an odd way to put it, but hopefully I am not about to be jumped on with bizarre accusations about me being 'happy' if my children get ill) for them to have mumps too. especially since the mumps component of the mmr has proved to be none too successful over the years - leaving young adults exposed right when the virus can be more serious.

I had German measles as a child - as Beach said, a bit snuffly for a few days, and a rash. (I was kept isolated, before anyone starts).

I completely agree with Beach on this one - it is not any child's responsibility to protect other adutls around them - it is up to the adults in question to check their immune status before they get pregnant - this could be done at 12, 14, whenever really. but injecting infants, to spare adults a blood test is not my idea of ethical.

Well exactly silverfrog.

I am concerned that we may see a resurgence of German measles in the same population - something which has the potential for very serious consequences.

Both my boys had rubella when they were under a year old. We didn't even know DS2 was sick until the rash broke out because it was so mild. Tbh I wonder how many children have already had rubella before they have the MMR.

Most children didn't get it hence the huge numbers of congental rubella in epidemics, we are talking 10s of 1000s in the 60s epidemics. Epidemics only come round every 5-9 years so lots of people didn't get rubella as a child.
There is still a 1-5000 chance of encephylitis which in itself has a 20% risk of death, compared to the 1 in a 1000000 risk from the vaccine. Pretending it is a mild disease is burying your head in the sand.

Bubbleymummy - the only information on polio and tonsils I can find all lead back to whale so hardly likely to be very accurate.

Beach - have you actually read the conclusion of the IOM

Overall, the committee concludes that few health problems are caused by or clearly associated with vaccines

The dangers of vaccine are either very rare or mild ie a sore arm.

Also there is evidence that serious VAERs events can be over reported misuse of vaers for litigation

I'm not too sure what the litigation comment is meant to mean. Are you suggesting that people make up stories about their child's reaction to a vaccine because they fancy some litigation experience in their lives for the hell of it?

Attempting litigation against a vaccine is a gruelling and thoroughly unpleasant experience. I doubt many people do it for fun or because they think they will make some easy money out of their sick child. They won't get either, and it is a very rare parent who sees their child's health issues as a cash cow . Indeed it is a thoroughly offensive suggestion.

Also what you say here;

Also there is evidence that serious VAERs events can be over reported misuse of vaers for litigation

is not quite what they say in the article (have you read the whole thing?).

That article is rather odd actually and not a little bit concerning. They seem to have put the cart before the horse and set out to prove a highly subjective point. The interpretation of the data is very subjective.

Ok, here is my understanding of the paper.

The authors suggest that there are certain types of adverse events that are reported to VAERS where the majority of reporters are reporting for litigation purposes.

They give the following health problems being reported in this manner (for litigation); overdose, neuropathy, autism, mental retardation, arthralgia, and speech disorder.

They then count the number of reports for the above that are for the purpose of litigation and say 'yup in the majority of reports for this type of health issue, litigation is mentioned in the report'.

Then they conclude the following in their discussion;

The influence of the litigation process on longitudinal analyses is a serious matter and emphasizes the importance of interpreting VAERS data cautiously.

Now I read that with a face like this and then one like this .

There seems to be some sort of assumption that litigation reports are somehow false, that they don't really count - that they are nothing to do with vaccines given. There is no evidence given for this assumption.

What the authors fail to mention, is that if you think your child has developed autism, for example, as a result of vaccination, you will have to litigate to have that injury acknowledged as being a vaccine injury, and to have your child compensated. You don't have any other choice.

So surely the authors should be saying 'woah hold on a minute - there seem to be an awful lot of reports of this nature, maybe that should be checked out'.

They do note that reports came in following the 1998 Lancet paper. A case series report which brought the question of a potential association between gut issues, ASD and MMR/MCV to the public view for the first time.

Which doesn't seem surprising. If you were a parent who thought your child had become ill following a vaccine but you had no science to back up that claim, you would be unlikely to instigate litigation.

The conclusion of the article seems to be that litigation reports are 'skewing' the 'real' figures - a suggestion I find highly questionable.

I think a better question would be; why do so many parents think their child developed neuropathy, autism, mental retardation, arthralgia, and speech disorder following vaccination?