Vaccine risks pale next to illness risks


In the modern age of medicine, one fact is difficult to dispute: Using vaccines to prevent disease is hugely successful.

And as parents prepare to send their children back to school, this time of year serves an important reminder of how the highly effective vaccines we have today can protect students and their classmates from the horrible diseases suffered by kids I treated in my medical practice years ago.

Medicine continues to push forward to identify ways to isolate genetic and immune properties of infectious germs in order to protect us -- the germs' hosts. In the absence of protection, the bugs will find us.

Witness the recent outbreak of whooping cough in Northern Idaho, the 12 outbreaks of measles across our nation or, in 2010, the largest outbreak of pertussis in California in 65 years. Consider recent outbreaks here in Washington that have put the health of our children and their peers at risk.

Despite these risks, some still ask, "Why can't I just be 'careful,' wash my hands, eat right and stay healthy? Why do I need vaccines?"

Consider risk in a different realm for a moment. You are a safe driver and have never had an accident. Your car has eight airbags, a reinforced steel frame and shoulder/lap belts. So why would you put your child in a car seat when, not so long ago, parents thought it barbaric to "restrain" their children? For most parents, this decision would be the logical one.

Most of us can incorporate the concepts of risk, and respond when protection requires a reasonable investment of time, money and effort. Even then, not everyone uses car seats. In this example, as with bicycle helmets or toys with small parts, a parent's perception of the risk of injury can sometimes be at odds with the actual risk.

The same can be true with vaccines. It certainly seems like this is true with parents that are choosing not to vaccinate.

Here in Washington, our state is No. 1 in the nation for families opting out of vaccines for their children. About 6 percent of our kindergartners were missing one or more immunizations last year. Many of our families are worrying less about the actual risk of vaccine-preventable diseases and worrying more about the perceived risks of vaccination.

As a general rule, these risks are actually the opposite. The higher the perceived risk, the lower people would consider the actual risk. In plain language, once fear enters the mind, it's extremely hard to make it disappear.

A new Washington state law now makes it more difficult for parents to simply sign a vaccination exemption form and submit it to their child's school. The new law requires parents who choose not to immunize their children to have the exemption form signed by a physician, nurse practitioner, physician's assistant or naturopath after being provided benefit-and-risk information associated with infectious diseases and vaccinations.

People like me who are health care providers have a responsibility to do our best to present vaccine information in a meaningful and personal way. The information we share with parents must be based on sound science and a painstakingly honest representation of current medical research. Additionally, we must communicate that medical decisions always acknowledge a benefit-and-risk equation.

On a personal note, those of us who can still remember diagnosing and treating the horrific infectious diseases that have been eradicated by vaccinations should continue to emphasize to those choosing not to vaccinate that health can be fleeting.

Parents want and deserve the best of health and happiness for their children. The mission of pediatricians is to be their partners with that goal in mind. Health care providers can help provide information to you and your family to make those decisions and participate in one of the greatest, ongoing success stories of modern medicine.

Dr. Don Shifrin, a clinical professor of pediatrics at the University of Washington, has been a Seattle-area physician for more than 30 years.


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