If persusis isn't controlled by the "herd" vaccination process, and those without vaccination are at an increased risk of contracting it even in a fully vaccinated environment, then I'm not sure how its all that relevant that another child in the day care doesn't have vaccinations.

I think not getting your child vaccinated is about as dumb a thing as you can do, and I think there is 0 science behind it, but I'm certainly not going to tell/force people to do it. Yes, it sucks for this woman's child, and I feel for her and her child. But the reason we have freedom is so that you aren't forced to do something that could be against your interests.

Its possible, highly unlikely, but possible, that the nonvaccinators are correct. Do you really want to take the chance to harm or kill even say 100 children so that your one child can have that "magical experience." Of course you do. Should that mean that everyone has to do what you want them too so that your child can have that experience? No.

It sucks, but the world and the people on it aren't here to give your child a magical experience. Plus, there are 100s of other magical experiences for this child. Nearly everything is a magical experience for a child in one way or another. We as adults and parents sometimes allow our experience with the world to shade and cloud a simple fact... that we've experienced it and are bored with it doesn't mean that a child encountering it for the first time will be.

Celebrate that whatever experience your child ends up with will probably be a magical one for the child that he/she will remember and best of luck fighting the disease!

Because sufficient vaccination is necessary to prevent a pertussis outbreak from taking hold and spreading.

I think that vaccination is a social duty. It protects you, but it also protects others. If you refuse to vaccinate your kid based on your own ignorance or junk science, you put other people's kids at risk, especially kids that are too young for vaccinations or with compromised immune systems, like the author's son. (You also put your own at risk, but presumably you've already decided that's acceptable.) And if enough people make the same decision you do, there will be more outbreaks of previously suppressed childhood diseases, because herd immunity will have been lost.

It's so easy for people to minimize the importance of vaccinations in the United States, because we don't remember what it was like before important vaccines were developed--my grandmother still speaks with horror of polio, a disease that was basically wiped out in this country by vaccination.

Thanks for the platitudes. Let's see: you trotted out "freedom" and told the author that whatever happens will be magical--I can just see it now: Cancer is magical!. And I bet she was glad to hear that you think cancer sucks or not being able to attend the daycare of her choice or whatever point you were trying to make. Maybe, if she just had a better attitude and considered...oh nevermind. Why bother.

We delayed vaccinating our daughter because I'd had adverse reactions to some vaccines in the past and I was staying home with her so she wouldn't be in close contact with other children on a daily basis. We started vaccinating at her first birthday and slowly got back on schedule so she could join our co-op preschool at age 2. Being a hippie school, there were several kids who were behind on their vaccines or not vaccinated at all, though no one was actually adamantly opposed to vaccination altogether. I was amazed at how many people continued to use the religious exemption (Oregon doesn't allow "philosophical exemptions") to keep their kids from getting vaccinated despite just being behind the schedule. How someone could have a religious problem with the polio vaccine but not the pertussis one boggles the mind, but apparently it's a-okay with the state. The following year, at another preschool, our daughter was threatened with exclusion until she caught up on her vaccine schedule (she was missing a single dose of one vaccine) and yet again, many of our friends got away from the requirement by simply stating a religious exemption. Now she's in public school and I don't haven't met many of her classmates parents, but I wonder how many of them are still claiming the exemption to get around having to shell out the money for vaccines right now when times are tight.

Working with older people is an eye opener. I see people who live daily with the consequences of life before vaccines were standard. The patient who had polio and who now has a common polio type syndrome, which is a degenerative type disease which means his ability to walk, drive, etc. is severely compromised. His life expectancy is also shortened. All of my patients want flu shots. They remember pre-vaccine days. This is not something to play with. Diseases that were all but eradicated have made comebacks in recent years. There is so much bad information out there it makes you doubt. But when the school sent home the permission sheets for the flue vaccines, both "regular" flu and H1N1, I did sign the forms. My older child has a good immune system, good health, but my younger is not as healthy.

"If persusis isn't controlled by the "herd" vaccination process, and those without vaccination are at an increased risk of contracting it even in a fully vaccinated environment, then I'm not sure how its all that relevant that another child in the day care doesn't have vaccinations."

The portion of the article that you refer to is poorly written and should be refined by the author for clarity. Short answer is that herd immunity is less protective of unvaccinated people against pertussis (a bacteria present in the environment) compared to other viral diseases (e.g., measles) because humans are not the only reservior for the bacteria (while they are typcially the only reservior for most viruses). However, herd immunity does still play a role because an unimmunized person infected with the bacteria that causes pertussis is going to be harboring a ton of bacteria. There bodily secretions will then be seeding their environment with that bacteria that can be picked up by other individuals who can be carriers or diseased individuals, thereby perpetuating the cycle. If the levels of exposure of batceria are high enough, even immunized people are at risk.

You wrote:

"Its possible, highly unlikely, but possible, that the nonvaccinators are correct. Do you really want to take the chance to harm or kill even say 100 children so that your one child can have that 'magical experience.'"

Even if the non-vaccinators are correct, the vaccinations cause could not possibly "harm or kill" 100 children in one day-care center. If the most dire concerns of the anti-vaccination claims are true you would be harming ~0.000001 child by insisting that all the kids in one day care center or one school be vaccinated for the sake of the child with cancer. In other words, you would be exposing children to an extremely low risk in order to benefit this one child. It is probably at the level of crossing the street in front of the school a few times. Suppose the child with cancer was weak, and having trouble carrying a bookbag, and your child wanted to cross back over the street to help, would you tell your child: "Don't do that. There is a slight chance that a car will come and kill you. Never do anything for anyone that might subject you to any risk, even a one-in-a-million risk."

Put it that way and you see that your view is anti-social hysteria.

As it happens, the non-vaccinators have no case at all. Vaccinations do not cause autism. Of course they do occasionally cause other illnesses and side effects, but the risk that the child will get a serious disease from not vaccinating far outweighs the risk of harm from the vaccination.

This kind of debate, like many, panders to the extremes on either end. On one end is our author, whose child cannot participate in group daycare due to the risk of non-vaccinated children that could endanger his already compromised health. On the other is the grief-stricken parents whose children have sickened or died as the result of a rare complication/reaction from the vaccine. Whose pain is greater? The arguments on the pro-vaccine side have all been "sacrifice a few for the good of the many," and on the anti-vaccine side, the cry is "small risk does not equal no risk." When it comes to the health and well-being of our children, who is right?

So many laws and regulations have been mandated because a tiny fraction of our children have suffered accidents or criminal acts (Amber Alerts, consumer product recalls, etc), so why are the parents of those injured or killed by vaccines villified for publicly holding the medical community to the same standard?

dukebdc wrote:

". . . so why are the parents of those injured or killed by vaccines villified for publicly holding the medical community to the same standard?"

Because it is not the same standard. Holding the medical community responsible is like blaming pilots for airplane crashes. Pilots do cause most crashes, but not a single one of them wants to cause a crash, and they make every effort to avoid crashing.

The medical profession is not unmindful of the dangers of vaccination. They do not advocate vaccination callously, dismissing the pain and death vaccinations cause. They advocate vaccination because it prevents FAR MORE illness, misery and death than it causes. Millions of times more. What do you have in mind when you say you would like to "hold responsible" people who cause millions of times more good than harm, at a trivial dollar cost to society, and who make every effort to avoid causing harm? What exactly would you do to them? What are they culpable of?

Truly, no good deed goes unpunished.

Obviously, if there was any way to predict in advance which child might be adversely affected by a vaccination, doctors would take steps to do do this. No doubt vaccination safety will improve in the future. But science is never perfect and never will be, and there will always be a slight risk. People who refuse to vaccinate avoid a slight risk by running a much larger risk! This makes no sense.

JedRothwell , thanks for your reply. I am actually very pro-vaccine, and would not hesitate to vaccinate any future children both for their own good and the good of the community. I am merely curious about what seems to me a double-standard about the value of children's lives in this country. One baby strangles in an improperly set up crib, and the entire production line is shut down and recalled. An unsupervised toddler falls out the window of a high-rise and within months there are mandatory city-wide rules about how far windows can open, and how sturdy screens must be. However there is a known and unpredictable risk of vaccination, yet the parents of children sickened or killed are dismissed as exceptions and unforseen tragedies. I am not implying that doctors or manufacturers are being deliberately careless, but given the American culture of finding who is responsible when a child is hurt and making them "pay," I am surprised there is not more opposition than already exists.

dukebdc wrote:

"One baby strangles in an improperly set up crib, and the entire production line is shut down and recalled. An unsupervised toddler falls out the window of a high-rise and within months there are mandatory city-wide rules about how far windows can open, and how sturdy screens must be. However there is a known and unpredictable risk of vaccination, yet the parents of children sickened or killed are dismissed as exceptions and unforseen tragedies."

I believe you are still missing the point. If someone discovered that a vaccine has more risks than necessary, they would shut down the production line and recall the unused portions. However, once every reasonable precaution has been taken, and it can be shown that NOT using the vaccine is much more hazardous than using it, THEN we go ahead and use it despite the known dangers. At no point does anyone "dismiss" grieving parents. The price they pay is terrible -- unimaginable -- but they must pay it to ensure safety for the larger number of people. If they do not pay this price then far more parents will suffer.

To take another example, everyone knows that automobiles cause ~40,000 deaths per year. We make great efforts to reduce this toll (although we do not do enough, in my opinion). When a safety hazard is revealed they shut down the production line and recall the defective cars. However, we do not all stop driving cars just because they kill many people. We accept the risk because the benefits outweigh the cost. No one "dismisses" grieving relatives and friends of people killed by cars, but on the other hand we do not allow them to bankrupt auto manufacturers with lawsuits, or hammer the U.S. transportation system into paralysis. Celebrities are not going around telling us to abandon automobiles because they kill thousands of people.

In the case of vaccines the benefits far outweigh the costs, at a much higher ratio than for automobiles.

I'll accept that we are just talking past each other. Rationally, I completly understand your argument. That is the same argument I would use speaking to a non-vaccinator. My observation is more on the social, rather than medico-legal aspect of vaccination reactions. The crib and high-rise examples were to illustrate that even when the product in question (crib and window) was *not* defective (crib was not set up correctly, and toddler was unsupervised), the product is still held accountable for "causing" the death of the child. Because our society desperately wants each child to live to adulthood, and wants to eliminate every potential hazard. Many rare medical conditions have die-hard campaigners who would accept a huge increase in cost for everyone across the board to eliminate a tiny risk. [A former classmate's son died at 4 days old from a rare genetic defect and is bankrupting his family to advocate for mandatory (and expensive) testing at birth for this defect that afflicts fewer than 5 infants in the US each year]. It is just surprising to me that a prominent national foundation hasn't been started to fund further research into hazard mitigation for vaccines, given that individual children do still die from adverse reactions. I can only surmise that as you say, even those who lose children recognize the greater good served by mass vaccination.