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The vaccination debate is ongoing one

Amid reports of illnesses caused by immunization, public health officials and regretful parents say the risk of the shots is far outweighed by the risk of devastating childhood diseases.

It used to be so simple.

You took your child to the pediatrician and she got her shots. Whatever vaccinations the doctor recommended were routinely administered. No questions asked.

Nowadays, with optional immunizations and debate about the safety of some vaccines, parents have to be smart consumers.

Last month, the U.S. Public Health Service and American Academy of Pediatrics asked vaccine manufacturers to reduce or eliminate the already small amounts of mercury used as a preservative in some common vaccines for childhood diseases. While consumer groups reacted with alarm, Surgeon General David Satcher urged calm.

"The risk of devastating childhood diseases from failure to vaccinate far outweighs the minimal, if any, risk of exposure to cumulative levels of mercury in vaccines," Satcher said.

Earlier this year, there was a scare over adverse reactions to the hepatitis B vaccine, which is now required for Florida children entering kindergarten and seventh grade. Congressional hearings were held in May, during which parents testified about children who had developed symptoms of arthritis, chronic fatigue syndrome and lupus, all immune system disorders, after being inoculated against hepatitis B.

As a result, the Association of American Physicians and Surgeons called for a moratorium on the vaccine for infants.

Another new vaccine, for the diarrhea-causing rotavirus, drew fire when some infants developed a bowel obstruction after receiving the inoculation. In July, the Centers for Disease Control and Prevention, along with the American Academy of Pediatrics, recommended that health care providers stop using the vaccine until at least November.

National policy also changed recently in regard to a childhood vaccine that has been common since the 1950s: polio. Since 1980, about 145 people in the United States have contracted polio after taking an oral dose of the vaccine, which contains live virus. (Children receive four doses of polio vaccine, two oral and two injected.) This summer a federal health panel recommended that physicians administer only the injected version, which contains a killed virus.

On the other side of the coin are parents such as Kathy Atchison of Palm Harbor, who trumpet the lifesaving value of vaccinations against common childhood diseases. Atchison's son Jonathon died in 1998 at age 6 from a severe case of chickenpox, for which a vaccine was introduced in 1995. (He had not received the vaccine.)

Thanks to Atchison's efforts, more parents now know about the availability of the chickenpox vaccine and Florida has changed its policy on immunizations. Starting in fall 2001, children entering preschool and kindergarten will be required to be vaccinated against chickenpox.

Other school requirements in Florida include: five doses of DPT (diphtheria, pertussis, tetanus); four doses of polio; two MMR (measles, mumps and rubella); and at least the first of three doses of hepatitis B (a series that must be spaced out over six months), which was a new requirement as of last year. All must be completed before a child enters kindergarten.

Students entering seventh grade must receive a second dose of measles (preferably MMR) vaccine and a tetanus-diphtheria booster, as well as the hepatitis B series if they did not get it earlier.

Horror stories such as children contracting polio or developing bowel obstructions shouldn't shake our faith in the overall value of vaccinations, health officials say. Even though incidences of vaccine-preventable diseases are at an all-time low, outbreaks do still occur. Between 1989 and 1991, an epidemic of measles in the United States affected 55,000 people and killed 130. In 1997, an outbreak of hepatitis A (for which a vaccine is available) affected thousands of elementary schoolchildren in Los Angeles.

Meanwhile, President Clinton's Childhood Immunization Initiative, begun in 1997, seems to have done its job. Vaccination rates for four infectious diseases _ diphtheria, tetanus, polio and measles _ are now higher than 90 percent among 2-year-olds, according to the CDC.

Information from Times files, USA Today and the Associated Press was used in this report.