Vaccine: The Debate in Modern America

6. Getting to the Source of Anxiety

Getting to the Source of Anxiety The public controversy about a possible link between vaccines and autism— which I want to again state exists in the face of powerful scientific evidence to the contrary—concerns me. Over the last two decades we have seen a rapid escalation in both the number of vaccines administered to the average U.S. child and the intensity of the standoff between the U.S. medical community and opponents of mandatory vaccination. Parents are caught in the middle of this increasingly passionate debate. Issues involving individual liberties and public health require a subtle balance of competing goals. In this controversy subtlety has been lost, and the battle of harsh words will likely escalate. Peter Hotez, president of the Sabin Vaccine Institute, has said, “If the surgeon general or the secretary of health or the head of the CDC [Centers for Disease Control and Prevention] would come out and make a really strong statement on this, I think the whole thing would go away.” In my view, as I hope this book has shown, a “really strong statement” is hardly what is needed, and it certainly would not make the problem disappear. Public health officials, researchers , and physicians must look beyond the vaccines-cause-autism debates to confront the foundational issues causing so many parents such great concerns. What are these issues? Problems with the modern vaccine schedule have been oversimplified and bundled into the claim that vaccines cause autism as parents’ fears have been supported by the views and efforts of anti-vaccinators. Unfortunately, the scientific and medical authorities have been content to wage their battle in support of universal vaccination within the confines of the vaccines-causeautism claim. It is certainly reasonable for them to do so. The assertion that vaccines do not cause autism (or, we do not see evidence in our studies that vaccines do cause autism) is much more limited, and it allows them to engage in the debate on the basis of their authority in the realm of science and to use their impressive capacity to analyze the problem scientifically. The result is a very public battle that avoids addressing the essential problems with our vaccine regime. Here, then, are some of the underlying problems. 6 158 Vaccine Vaccine Schedules In Washington, DC, in 2008, Jenny McCarthy led 7,000 demonstrators all chanting “Too many, too soon.” By the start of the twenty-first century, a fully vaccinated six-year-old U.S. child received almost three dozen inoculations containing about fifty vaccines against fourteen communicable diseases . This number grows far higher when influenza vaccines are included, because each year’s flu vaccine contains at least three different influenza vaccines , and sometimes additional influenza vaccines are recommended, as happened in the 2009–10 influenza season. Over half of these vaccines are given in a child’s first eighteen months of life. Again and again throughout their babies’ first years of life, many parents watch carefully in the days and weeks that follow each vaccination for adverse effects. Childbirth and child rearing have become medicalized in the United States. Parents are expected to bring their children into their pediatricians’ offices for a series of appointments that are called “well-child visits.” These visits happen at regular intervals, typically within the baby’s first week and then at one, two, four, six, nine, twelve, fifteen, and eighteen months, and every year after that up to age six. They typically involve a general physical exam, discussions about development and nutrition with the parents, and vaccinations. Most insurance companies fully cover the scheduled well-child visits, and many uninsured children have access to some sort of statesponsored health care to allow for them. Well-child visits are essential to the modern U.S. immunization schedule because pediatricians’ offices have become the location for almost all routine childhood immunizations, and a sick child cannot be vaccinated. To insure that babies receive all of the required and recommended vaccines in the first years of their lives, parents have to be compelled to bring them into the doctor’s office when they are healthy enough to be vaccinated. Unfortunately, the large number of vaccines given in a child’s first year, combined with the relative infrequency of well-child visits, means that many children receive multiple vaccinations at key office visits. At the six-month visit, for example, the CDC recommends children be vaccinated against rotavirus , seasonal influenza, diphtheria, tetanus, pertussis, Hib, pneumococcus, and polio. Parents may...