Every parent today has questions about child vaccinations. Are vaccines safe? Is there still mercury in some? What are the potential side effects? Can I delay some shots? Are all the diseases still common? Do vaccines cause autism? You want to know the answers before your baby’s first checkup and shots, but you have nowhere to turn for unbiased advice. Your doctor tells you that all vaccines are perfectly safe, that the diseases could kill your child, and that you have to vaccinate or else you are putting your child, and everyone else in the country, at risk. On the other hand, the anti-vaccine books, websites, and some of your friends tell you that vaccines are dangerous, the diseases are harmless, and that you are crazy to vaccinate. All these uncertainties boil down to the one all-consuming question of the decade that every parent agonizes over – Should I vaccinate my child?

Answering this question begins with a discussion of the various diseases we are trying to prevent by vaccinating. Read on for a brief overview of each vaccine-preventable disease and its vaccine.

Vaccine Overview

HIB. This very serious bacteria causes meningitis and bloodstream infections. It is now a fairly rare disease (thanks to vaccination), and occurs mainly in infants and the elderly.

We give a HIB vaccine at 2, 4, 6, and 15 months to protect babies and toddlers.

Pneumococcal Disease. This very common bacteria causes anything from mild cold, cough and ear infection, to serious pneumonia, bloodstream infection and meningitis. Like HIB, most serious cases and fatalities occur in infants and the elderly.

We give a Pc vaccine at 2, 4, 6, and 15 months to protect babies and toddlers.

Diphtheria. This is a very severe throat and upper lung infection with a high fatality rate. It is virtually eradicated from the U.S.

We vaccinate against this disease using the DTaP vaccine at 2, 4, 6, and 18 months, with boosters at 5 and 12 years of age. Although Diphtheria is eradicated from the U.S., we still vaccinate to keep it that way.

Tetanus. This germ festers in deep dirty wounds and causes weakness and temporary paralysis. It is rare, and virtually all cases in the U.S. occur in adults.

We vaccinate against this disease using the DTaP vaccine at 2, 4, 6, and 18 months, with boosters at 5 and 12 years of age. This keeps infants and children immune to tetanus in case of injury.

Pertussis (whooping cough). This is a very common and severe coughing disease that affects all ages. Virtually all fatalities occur in infants 6 months and younger.

We vaccinate against this disease using the DTaP vaccine at 2, 4, 6, and 18 months, with boosters at 5 and 12 years of age. Pertussis is big threat to infants, so the early vaccines are used to cover them during the riskiest first year or two. We vaccinate the older kids in order to decrease the risk of exposure to infants.

Hepatitis B. This sexually-transmitted disease (or other modes of blood exposure) causes liver damage. It is most serious when contracted during infancy or childhood, but virtually all cases occur in adults.

The Hep B vaccine is given at birth, 1 month, and 6 months. Alternatively it can be given at 2, 4 and 9 months of age. Even though infants and young children aren’t at risk of catching this sexually-transmitted disease, it is given during infancy to make sure they have protection long before the teenage years.

Rotavirus. This virus causes severe diarrhea, vomiting and dehydration and can be fatal during infancy. It is less troublesome after age 1 and most children catch it at least once.

The Rotavirus vaccine is given by mouth at 2, 4, and 6 months to protect infants during the most vulnerable first year.

Polio. This virus causes weakness and paralysis and is potentially fatal. Fortunately we haven’t had a U.S. case in over 20 years. It has been eradicated from the entire western hemisphere and only occurs in parts of Africa and Asia.

The polio vaccine is given at 2, 4, and 18 months, with a booster at 5 years. We continue to give this vaccine in order to keep polio out of our country.

Measles. This fever and rash disease is now very rare in the U.S. Fatalities are almost unheard of, but occasional organ damage can occur.

This vaccine is given as part of the MMR vaccine at 1 and 5 years of age. It’s not given earlier in infancy because, as a live virus vaccine, it doesn’t work well until the immune system is more mature.

Mumps. This virus is usually harmless in children, but in teens and adults can cause some organ damage and complications. It was fairly rare until a recent outbreak spread through the Midwest.

This vaccine is given as part of the MMR vaccine at 1 and 5 years of age.

Rubella. This is a fairly harmless fever and rash illness, and it is now extremely rare in the U.S. It can cause birth defects if a pregnant mom catches it.

This vaccine is given as part of the MMR vaccine at 1 and 5 years of age so young kids don’t spread it around and infect their pregnant moms and teachers.

Chickenpox. This well-known virus causes a week of miserably itching spots. Fatalities are rare, but complications are more common for teens and adults.

This live-virus vaccine is given at 1 and 5 years of age to protect kids well into their teen years.

Hepatitis A. This viral intestinal infection usually passes unnoticed in young kids. Teens and adults will suffer through a week or two of severe intestinal flu symptoms. It is fairly common.

The Hep A vaccine is given at 1 year, with a second dose between 18 months and 2 years, in order to try to eradicate this disease from the U.S.

Flu. This most common vaccine-preventable disease is mainly serious in the elderly, and occasionally for infants. Fatalities do occur, but are far less common than the media hype would have you believe.

The flu shot is given every year at the start of flu season to all kids ages 6 months through 5 years. It is also given to older kids with chronic illnesses and any adults who work with children.

Meningococcal Disease. This bacteria causes a very severe bloodstream infection and meningitis and has a high fatality rate in all age groups. Fortunately, it isn’t very common.

This new vaccine is given as a single dose at 12 years of age or older to protect against this form of meningitis. It may become approved for use in younger children in the near future.

Human Papillomavirus (HPV). This sexually-transmitted virus causes genital warts and cervical cancer. It is extremely common, infecting most people who have had numerous sexual partners.

This new vaccine is given as a 3-dose series beginning around age 12, before sexual activity begins.

Alternative ideas and approaches to vaccinating

Many parents follow the advice of their doctor and go with the standard vaccine schedule. Some, however, like to take a more cautious approach. They worry about giving so many vaccines simultaneously. They worry about overloading their little baby with so many chemicals. They worry about creating more side effects by over-vaccinating. While there isn’t a lot of evidence to suggest that such worries are valid, some parents nonetheless are going to be more cautious anyway.

These parents will often choose to give their babies only the most important vaccines first; this insures that their babies are protected from the most common and most severe infant diseases like HIB and Pc meningitis, pertussis, and rotavirus. Delaying the less important vaccines limits the amount of chemical vaccine ingredients a baby gets while small.

Once a child is a little older, the parents then may continue vaccinating for the less common diseases, like polio, Hep B, measles, mumps and rubella.  They may then move on to vaccinating for illnesses that are fairly common, but are usually not severe like chickenpox, the flu, and Hep A.

As for the two new teenage vaccines, Meningococcus and HPV, most teens are getting the shots. But some cautious parents worry about brand new vaccines and may put these off for a few more years.

How to approach your pediatrician with vaccine questions without getting kicked out of the office.

As a pediatrician, I see all kinds of parents with different ideas about vaccinating. Parents used to just do whatever the doctor ordered, no questions asked. But now, with worries over autism, mercury, and vaccine side effects, some parents are a little more leery. What do I do when parents tell me they want to vaccinate differently, or even not at all? I feel that parents have the right to make an informed decision, so I’ve never been hard-line about vaccines. But some doctors will dismiss patients from their practice just for questioning vaccines.

Well, there’s good news. The American Academy of Pediatrics has become increasingly sensitive to parents concerns when it comes to vaccines, and they published new guidelines for us pediatricians to follow when parents question vaccines. These guidelines are in the 2006 Red Book of Infectious Diseases that every pediatrician views as “The Bible” on disease information and policy. The Book clearly states:

• A non-judgmental approach is best. Listen carefully and respectfully to the parent’s concerns.
• Inform the parents of the risks and benefits of each vaccine as well as the risks of each disease.
• For parents who are concerned about multiple vaccines at one visit, develop a schedule that spreads the vaccines out.
• Continued refusal to vaccinate after adequate discussion should be respected (unless the child is at significant risk of serious harm during an epidemic).
• In general, pediatricians should avoid dismissing patients from their practice solely because of refusal to vaccinate.

But if you have a lot of questions, don’t surprise your doctor at the end of your baby’s checkup with a whole laundry list. Your doctor won’t have another half hour to spend with you to go over every aspect of vaccines. Make a separate appointment on a different day. This gives your doctor the time he or she needs to address all your concerns.

How common are severe vaccine side effects?

We know that all vaccines can cause some standard side effects, such as fever, fussiness, pain and swelling, and various body aches. Such reactions are expected, and I consider them to be harmless in the long run, as long as they aren’t too severe.  But it’s the more serious, life-threatening reactions that have parents worried.

Data from the Centers for Disease Control shows the likelihood of a severe vaccine reaction that results in a sudden, life-threatening event, a prolonged hospitalization, a permanent disability, or death, is about 1 in 100,000 doses. Such reactions include brain swelling and inflammation (encephalitis), brain dysfunction (encephalopathy), nerve dysfunction, organ damage, severe arthritis, auto-immune disorders, and other effects.

Are there some unusual ingredients in vaccines that are risky?

Vaccines are made in a variety of ways using many different techniques. Some contain live viruses, some have killed germs, and some only have fragments of the germs. Most contain various chemicals, from formaldehyde to MSG. Some vaccines use animal or human body tissues or blood products during manufacturing. Some vaccines have genetically altered germs in them. The list goes on. While most of these items are generally regarded as safe, they haven’t necessarily been researched in great detail. I worry that we don’t know enough about the safety of every single vaccine ingredient. However, I also can’t find many proven problems with vaccines and their ingredients.

It’s worthwhile for parents to understand how each vaccine is made, what the ingredients are, how the various brands of each vaccine compare, and what ingredients may be risky. This information helps parents make an educated decision.

Is mercury still being used in vaccines?

Mercury has now been officially taken out of all vaccines except for some brands of the flu shot and some plain tetanus and diphtheria-tetanus shots. All other shots on the standard schedule either have no mercury at all or have it filtered out to barely detectable amounts.

Although we don’t know for sure whether or not mercury is harmful in the amounts still used in some flu shots, prudence would dictate that parents try to make sure their baby’s flu shot is mercury-free. Fluzone is the only 100% mercury free brand for infants, but parents need to make sure it’s the single-dose version of the shot. The large 10-dose bottle of Fluzone brand still contains the full dose of mercury.

Vaccines and autism – is there a connection?

This has become the most controversial topic relating to vaccines today. With the continued rise of this heartbreaking disorder, now affecting 1 in 100 children, everyone is searching frantically for a cause and a cure. There’s no way to adequately cover this topic in just one paragraph, but I will summarize my own research. I believe there are many factors that all work together to trigger autism: genetic susceptibility to chemicals, exposure to such chemicals through pollution and diet, various intestinal infections and digestive problems, immune system abnormalities, allergic problems, and more. The suspected link to vaccines is described by some researchers as being due to mercury exposure (which is no longer much of a factor) combined with the live measles component of the MMR vaccine (which never even had mercury in it). The measles has been found to infect the intestines and brains of some autistic children, but it isn’t known for sure whether or not this actually contributes to autism. Ongoing research over the next few years will shed more light on this issue. The vast majority of medical research does NOT support a link between vaccines and autism.

What about delaying vaccines. Is that an option?

Anything is an option when it comes to vaccines. But parents need to make sure what they choose to do makes sense. A common recommendation among vaccine critics is to delay vaccines until a child is two years old. Theoretically this allows time for a child’s immune and nervous systems to mature and handle the vaccines better. I haven’t found enough research to prove or disprove this claim, so I can’t say whether or not delaying vaccines is the right choice. But I would like to point out that some of the diseases we vaccinate against are only serious or mainly occur during the first year or two, like HIB and Pc meningitis, Rotavirus and Pertussis. So, if you wait until age 2 to vaccinate, it doesn’t make sense to then get all the vaccines. The way I see it is that infancy is when these diseases are the most risky and severe. So, parents should either vaccinate their babies during that time when the shots are most needed, or skip some of those vaccines altogether and move on to choosing only the vaccines that are needed to protect against any common or serious diseases that may occur during the rest of childhood. Exactly which vaccines you should choose for your older child isn’t an easy answer, and explaining all the logic and details that go into such decisions is beyond the scope of this article. The bottom line is to get each vaccine at the age when its disease is most common and/or risky.

What’s the safest way to vaccinate your child?

There is one aspect of our current vaccine schedule that I have always been a little leery about, and that is the practice of giving as many as 6 vaccines simultaneously to babies at their 2, 4 and 6 month visits. Although this schedule has been shown to be safe, many parents worry that the overload of combined chemicals and exposure to so many vaccine ingredients all at once may not be the best thing for small babies. In my office I spread the vaccines out a bit. I give 2 shots at each of those checkups, and I have the baby come back at 3, 5, and 7 months for 2 more shots each time. I delay the Hep B and Polio series until after that. This allows my patients to get fully vaccinated, but at a more reasonable and logical pace. I call this my Alternative Vaccine Schedule, and I offer it to any of my patients who have concerns about vaccines.

Click here for more information on The Vaccine Book by Dr. Bob Sears.