Observations on the Immunization Controversy

Anyone involved in the healthcare of children knows there is a growing number of parents who are selectively immunizing or not immunizing their children at all.  The medical establishment is becoming quite alarmed about this trend and becoming rather unpleasant towards parents who are questioning the benefits of immunizations.

It has become an increasingly frequent experience for parents, who have concerns about the safety of vaccines, to have very negative encounters when interacting with the medical system.  These interactions range from being treated as ignorant weirdos who need to be properly educated, to the outright refusal of care.  We are, sadly, now at the point where a majority of pediatric practices refuse to care for children who are not immunized according to the official recommendations.  Here is a typical vaccine policy from a pediatric practice (http://milestonepediatrics.com/vaccine_policy.html)

My practice has the philosophy that parents, not the medical establishment, should be the ones choosing how or if they will immunize their children.  It is a matter of freedom, which to me, takes precedence over the science of immunizing.  I am personally in favor of vaccines and all of my children have been immunized according to the standard schedule.  However, I believe it is wrong for a physician to coerce a parent into vaccinating, when they are uncomfortable with it.  I believe each of us has the right to make our own decision and then we have to live with the consequences of that decision.  It grieves me, when I see the guarded or fearful look come into the eyes of a parent when I start asking questions about a child’s immunization history, because they are afraid of what will happen when I discover they are not immunizing according to the established rules.

This philosophy of freedom first, has certainly led to a boom in our pediatric practice as parents have sought a place where they can get medical care for their children, without having to endure an unpleasant doctor-parent interaction.   I now have had a significant amount of experience with selective and non-immunizers and I have some observations I would like to pass on to providers of health care to children:

  1. These parents are NOT ignorant.  In fact, many of them are far more educated about vaccines than most pediatricians.  Most physicians would argue they have misinformation and one can discuss the accuracy of the data on either side of this issue, but the issue is not a lack of education.  It is ridiculous and insulting when providers browbeat these parents over and over about the issue of immunizations.
  2. These parents are NOT weirdos.  These are very engaged, critically thinking parents, who are trying to protect their children from unnecessary risk.  The fact that a majority of the medical establishment does not agree with their conclusions does not make them weirdos or troublemakers.
  3. These parents are NOT unconcerned about their children’s well being.  They are every bit as committed to their children’s health as the parents who willingly go along with the standard immunization schedule.  They have simply come to the conclusion that the risk to their child from immunizations, especially at such a young age is greater than the risk from the rare diseases that we are immunizing against.  Again, one can disagree with their conclusion, but it does not make their motives wrong.
  4. I do not understand the reasoning, when a doctor says he/she will not take care of an unimmunized child because he/she is concerned about the child having proper medical care.  They claim that immunizations are absolutely critical to the well being of children, but then if a parent refuses to immunize, they tell the parent it is better for the child to have No care than to not have care the way they deem appropriate.  How is no care better for the child, than unimmunized care?  There are all kinds of areas where patients do not comply with our recommendations.  Why are immunizations treated differently than any other area of “non-compliance” where we take care of patients to the best of our ability within the context of that individual’s environment?  (I have my theories, but that is for another posting.)
  5. Informed consent should apply to vaccines, the same as any other medical procedure.  A major tenet of contemporary medical practice is “informed consent”  The theory is that a patient is given the risks and benefits of any intervention and the patient then chooses whether they want to undergo the procedure or not.  How is it “informed consent” when one does not have the right to say “No”?  No intervention, including immunizations, is risk free and yet parents are only ever given the positives of vaccines, never any potential risks.  That is not informed consent.
  6. There is a tremendous sense of disproportion on both sides of this controversy.   Every time a parent  puts their child in a car, they accept without hesitation, the risk that the child could be injured or killed during that trip.  At the same time,  those same parents agonize over the potential risk that a vaccine poses to the child, even though that risk is only a fraction of the risk we assume by putting our child in a car.  I am not arguing that a parent should not consider risk and benefit when it comes to vaccines, but I do not think vaccines are as dangerous as some would have us believe and parents need to keep things in perspective.  Pro vaccine advocates are just as guilty of overstatement.  To listen to the rhetoric, one would think that if a child is not immunized, they WILL get sick with one of these illnesses which we immunize against.  This is just not true.  Thankfully, these disease are all very uncommon and very few children, immunized or not, will develop them.  One can argue, that they are rare as a result of successful immunization programs and for some this is undoubtedly true.  At the same time, regardless of the reason, the low incidence of these illnesses does impact the risk-benefit calculations.
  7. Unimmunized children are NOT sicker than immunized children.  There are no studies comparing outcomes of immunized vs unimmunizing children and unfortunately this kind of study will never be done.  However, as I mentioned earlier, I have lots of partially or unimmunized children in my practice.  I can say, unequivocally, that these children are not sicker than the immunized ones.  In fact, they are in the doctor’s office far less than their immunized counterparts.  I do think they are at a slightly increased risk from vaccine preventable illnesses, such as pertussis, but that is a risk these families have chosen to take, over the risk from the vaccines.  For every other illness, they are not sicker and for a few reasons may be healthier.
  8. Unimmunized children are not a danger to immunized children.  Some argue that forcing children to be immunized or ostracizing those who are not, is for the purpose of protecting all of those children who are immunized.  Again, I question the logic.  In the first place, immunizations protect against very specific, but uncommon illnesses.  Since these diseases are so uncommon, it is highly unlikely that an unimmunized child will contract these illnesses and transmit them to immunized children.  Then if the vaccines are such successful sources of protection against disease, then even if an immunized child was exposed to a vaccine preventable disease through an unimmunized child they should be protected from getting the illness.  The reality is that these outbreaks that one hears about is mostly among immunized individuals and has little to do with a child.  This is not an argument against vaccines as vaccines do protect a majority of their recipients and even when an immunized person gets one of these illnesses it tends to be milder.  However, it is an argument against the emotional response of treating unimmunized children like lepers.
  9. You catch more flies with honey, than with vinegar.  The vast majority of parents who come in opposed to immunizing their children do eventually at least partially immunize their children.  They are mostly looking for a physician who will listen to their concerns and allow them the time and freedom to move forward with immunizations when they feel comfortable and not be forced into a one size fits all mold.  They are very put off with the condescending, even hostile treatment they get at many physicians offices.  If the real goal here is to keep children as healthy as possible, treating these parents respectfully will get much more accomplished.  By badgering unsure parents into immunizing, you will get some more children immunized, but you will also build walls and resentment with those parents.  For those parents who are sure they do not want immunizations at this time, they will just disappear from health care all together and that is not improving the health of the children.
  10. Physicians should be scientific about vaccines.  It astounds me how unscientific many physicians are about immunizations.  A scientist is always questioning and testing assumptions.  A true scientist looks at all possible explanations.  Very few physicians, who take adamant stands about the value of vaccines, have actually studied the subject.  They just quote what they were taught in medical school and accept the recommendations of the professional organizations as gospel.  If evidence arises that contradicts the assumptions, they just toss it away as irrelevant.  Obviously, we cannot independently study every topic with which we deal.  What I am asking is to keep an open mind, as we should with all subjects.

There is no question it takes significantly more time and energy to openly deal with this issue, but if our role as physicians is to be advisors and healers to our patients, it is right that we do so, regardless of the decision they ultimately make.

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64 Comments

  1. What an amazing post, Dr. Stafford. It’s sad that parents (myself included) are so amazed and bowled over at your approach of respect and informed consent; most importantly, we appreciate your keeping the mind of a scientist and continuing to learn and not simply be stuck in ways of controlling practice that are solely for reasons not truly related to the best possible care of kids.

    Reply
  2. Kelley C.

     /  December 18, 2011

    The practice you linked to is actually who we use. Although they have that statement on their site I have never encountered any issues with delaying vaccinations for either of my children and I have many friends who also use a delayed schedule at that practice. Use of this particular schedule (Dr. Sears) is so common there that they actually have the schedule posted in the office. When I have asked the Drs. opinion on a vaccine they always tell me they believe it is safe (and I truly believe they do), but they do defer to my judgement as the parent. Whether I have chose to delay or decline a vax (MMR for example) I never experienced any problems. I’m glad parents have you to turn to when they encounter a practice that won’t work with them…I’m just saying Parkside isn’t one of those.

    Reply
    • My link to Parkside Pediatrics was not for the purpose of criticizing Parkside. I used it, because their published statement is the way most practices are approaching this issue. I am glad to hear their approach has softened from their official position.

      I think each practice has the right to approach this issue in the way they think best. My purpose in writing this was to put into words an alternative way of looking at this issue from what many families experience.

      The subject itself is very complex and I can see valid arguments for all viewpoints. I simply believe that parents should be the one’s making the final decision.

      Reply
    • I did not have an understanding experience from them before I had my second baby. I wanted to sit down and go over more in depth each vaccine and learn more WITH our doctor but was told, “well we can do that but you know we don’t just make this stuff up. It’s based on a lot of research.”. That statement told me two things: our doctor at Parkside wasn’t truly interested in sitting down with me to come up with a different plan and they’d obviously done no research for themselves. So we switched to Dr Stafford and I’ve been very happy (especially, even off topic, hearing “do you have any concerns?” instead of “are you starting solids yet?” “are you putting her to sleep on her back?”, etc….made me feel like a child that didn’t know what to do with my own baby. Theres never just one right way.

      Reply
  3. As a parent who 100% agrees with Dr. Stafford’s opinions on vaccination and informed consent. I have experienced all of these negative behaviors from our prior pediatrician (Ahem… Parkside Peds).
    Having a daughter who suffered a severe reaction to her 2 month vaccines (on Sears schedule) and still being pushed to vaccinate and never given any sound medical advice besides “this is what is recommended” and “I believe it best” and finally “if you cannot follow my recommendations on vaccination you may need to find a different doctor.”
    I would leave the pediatrician in tears with the only thing on my side being a deep rooted instinct that this was not what was best for MY child. The anxiety and fear I harbored prior to visits I will never forget.
    To this day I still question my options related to vaccination, but that is okay. I know that whatever my husband and I decide is our decision and we can make that on our own terms (Thank you Dr. Stafford). And as an RN I can feel the pressure related to this issue, but I too respect the right to make and exercise an informed decision. How would I feel if I pressured someone to make a decision that they weren’t comfortable with and something happened to go wrong?
    This is the core of parenting, finding that balance and making decisions based on what you feel is right, not what you are told is right.
    I am so thankful to Dr. Stafford and not just for his acceptance and tolerance on this issue, but for the kind and knowledgeable care that he provides regarding ALL issues. This is care that puts the patient first and I am so grateful.

    Reply
  4. Jessica

     /  December 18, 2011

    Thank you!

    Reply
  5. Shanda Miller

     /  December 18, 2011

    I was actually asking about this in your office the other day to one of the nurses. Do you know what the school system in our area requires as far as vacination to enroll children? And do you have a website that i could look at that shows the possible side effects of all the shots on a normal schedule? 🙂

    Reply
    • DrBill

       /  December 22, 2011

      All states have exemptions, all but I think two states have philosophical as well as religious and medical.
      If you look up exemptions for the department of health for your state, there should be a link to information and in some cases a form you can download.

      Reply
  6. Thank you so much for this post – I find myself wishing there were more doctors out there like you! Very much appreciate your words and hope they are spread far and wide (particularly that one about catching more flies with honey!). I find myself not wanting to go to the doctor at all when I think about her very obvious perception of my ‘ignorance’ and ‘weirdness’ – I find it very difficult to ask for and/or trust advice from a person who obviously has so little respect for me. It’s always heartwarming to see a perspective like yours among the medical community – kudos to you Doctor!

    Reply
    • colleenBeautiful! thanks for sh&#nnga#8230;&r8230;aid reminding me of the miracles of Haiti! Praying blessings over you….praying that God will multiply your love and provisions! When all we have is God and each other…..we have all we need…..so easy for me to say that – so touching to see you LIVING that!!! Know you are being prayed for!

      Reply
  7. Thank you for your stance on this issue!! It is so wonderful to hear a doctor with your approach. This is one of the many reason I refer people to you on a regular basis : )

    Reply
  8. Thank you for such a well balanced article on the issue, As an RN and a mother who has chosen to follow an altered vaccination schedule, I can attest to the fact that most parents who choose not to vaccinate or to delay have spent hours of heartfelt research and thoughtful consideration to the matter. I respect all parents right to choose what is best for their children despite not always agreeing, it’s lovely to see that there are other medical personal who do the same.

    Reply
  9. I completely agree with your article. It is not limited to children. The physicians of seniors view flu shots and pneumonia shots with the same attitude. We as adults and parents should have the right to make our own decisions. Pat. Gregory

    Reply
  10. This is one of the best treatments of this issue I have ever read. Thank you!

    Reply
  11. Ursula Torbett

     /  December 20, 2011

    Thank you Dr. Stafford. A very well written article, I appreciate your care, concern and open-mindedness. We often forget that this country was founded on the priciples of freedom, not to endanger but to at least have a say in how we live our lives. Will be contacting you soon.

    Reply
  12. This is a great article and I hope that perhaps some other doctors will read it and think about their own approach towards vaccinations. As a parent of 5 I have pretty much steered clear of doctors after some bad vaccine encounters at a pediatricians office and I think long and hard about going to the doctors with them for any reason because of the way we have been treated in the past. It is good to know that there are doctors who respect patients choices even when it is not the same as their own personal choice.

    Reply
  13. The flies with honey bit is absolutely right. Thanks for this excellent post. And I’m very much looking forward to the “other post” you promise in point 4.

    Thanks for all your great care!

    Reply
  14. Michelle Mixell

     /  December 21, 2011

    Dr. Stafford,

    Thank you so much for the well-thoughtout article. You were the best doctor we ever had. I really appreciated your attitude when I told you that we wouldn’t be vaccinating our son. You treated me with respect and not disdain. Chase is still a very healthy boy and our daughter is as well. Our pediatricians here in Arizona have been rude and condescending. I wish I could have packed you up in a suitcase and brought you with us when we moved here. Have a Merry Christmas!

    Reply
    • Nagyon jó írás. Nagyobb körben kellene ismerni, legalább a következtetéseit. (Egy pici megjegyzés: az elején olyan érzésem van, mintha Ön elhinné, hogy a NATO-nak érdeke a béke. Míg a közepén-végén &qoel;luleptezi" a béketerveket. A NATO-t sem tartom jobbnak legalábbis én. Nem tudom, hogy igazam van-e – érdekelne a véleménye.

      Reply
  15. Kevin Cottle APRN

     /  December 21, 2011

    I agree with Dr. Stafford approach to this topic. I too have used this approach in my own practice and have found it yo be the best method. I know my medival director does as well, because he agreed with my wife on a delayed schedule for my youngest child.dd

    Reply
  16. Val

     /  December 21, 2011

    Thank you so much for standing for the rights of parents to decide about these issues. Your comments are very wise, balanced, and greatly appreciated. God bless you!

    Reply
  17. Julie Rupe

     /  December 21, 2011

    I am so grateful for this post. We chose to immunize our daughter and have not regretted that decision. Thankfully, her doctor goes to our church with us, as does Dr. Stafford, so we were well informed from the onset. Thank you for writing and posting this for parents…very practical and honest!

    Reply
  18. I still remember the pure dread of taking my firstborn to the pediatrician. Fleeing in a blaze of glory and postpartum tears when the nurse wouldn’t let me breastfeed my baby during her vaccination. And later with a family doctor hearing belittling parenting advice with an undertone of “you’re doing it all wrong”. I left crying or shamed so often.

    Incredibly thankful for Dr. Stafford who truly believes I call the shots for my kids. Pun intended. 🙂

    Reply
  19. Mary Ann Hall

     /  December 21, 2011

    I think Julie Rupe also hits the nail on the head. She was INFORMED. It has been my experience that physicians do not always wish for us to be informed. Most of my grandchildren are in the same family practice. The ‘old’ doctor (and father to the other two doctors) is wonderful, respectful about their choices and never condescending. His first son, the ‘middle’ doctor, is condescending and adamant about vaccines, although he doesn’t refuse care, just makes you feel like an idiot. The ‘young’ doctor has a child who plays baseball with my three youngest grandchildren (one from each of my girls). He comes to the ballgames (of course) and is very available socially. In fact, my youngest daughter’s son and his son have frequent play dates. This doctor seems to have come from a totally different background but it would not surprise me if he did not hear a LOT more in medical school that people were choosing not to immunize. I have no idea whether he immunizes or not, and respect his right to choose, but I get the feeling that he respects the parents’ rights as well. I can’t help but think that at least part of this is knowing the parents socially and seeing how caring they are for their children.
    I, too, look forward to seeing the further article from Point number 4. I am printing this article and encouraging my children to do so also. I will spread the information as needed.
    Thank you, Dr. Stafford!

    Reply
  20. thank you so much! as a maternity nurse, i am exposed to the lack of informed consent a lot and so, am so happy with your attitude. that is how i wish my own medical care to be, we discuss it and i get to many an informed decision.

    Reply
  21. Sonja Watson

     /  December 22, 2011

    Dr Stafford,

    You are a blessing.

    Here is my 10 cents. I was given 10 shots as a child and now there are almost 40. We can look at childhood mortality rates in the USA versus the rest of the world and it is mind boggling…that the USA ranks at the top! Where are the benefits from vaccinating almost 3x more than any other country? I believe there is corruption in the system and I believe it is bigger than most people are willing to accept at this time. But I do believe that truth is on the horizon. And I believe that you are the answer to many prayers. I have many Dr friends that believe there is corruption ..including one that cured his son of autism using IV chelation. I think there are many issues that need to be resolved….and we deserve to have vaccines that are toxin free and are given responsibly. Currently we have a program that started out with good intentions but has been abused/used to profit a small group that would have us believe that we need 40 shots in order to live disease free. I think people are getting smarter, and we appreciate your support more than you can ever imagine.

    I had a Dr tell me I would not be able to send my child to school … Boy was he surprised when I said what I said. I think lying to patients and using fear and some letter that the AAP sent out that they just factually repeat to parents is irresponsible. Many Drs are told what to say…so then they become repeaters…they are just repeating. This is not the kind of Dr I would respect to look after our most precious developing children.

    You are to know that you are so appreciated!

    Reply
  22. Nicolette

     /  December 22, 2011

    As a parent who does not vaccinate my children, I thank you. You must know the resistance we face, and the hatred. It is heartbreaking, scary, isolating and unnecessary. I am so grateful for this article.
    If only everyone could think logically as you do.

    Nicolette

    Reply
  23. Sarah Wilbur

     /  December 22, 2011

    Love, love, love!!! This is why we chose you as our primary doctor for our children while we lived in Greenville!! I miss you and your wonderful office so much! What a blessing to enter a dr.’s office and not feel nervous or tense about having to deal with the vaccine topic and have to defend/have to spew out our reasons behind our vaccine choice. You explained your view, once I asked, and yet never argued or tried to guilt me into vaccinating my children once I shared my informed decision. Thank you for that! I, too, wish I could pack you up and have you moved into NE PA!! Isn’t that where you or Tara were from originally? lol COME BACK!;)

    Reply
  24. mark petty

     /  December 22, 2011

    I was very open to vaccines but after reading about it I became concerned about the apparent lack of valid studies on vaccines (most seem to be epidemiological in nature) and also with the use of Aluminum in so many. The claim is that the body does not take up aluminum but this is only if taken orally and, of course, vaccines are not taken orally (except polio I guess). The vaccine I find most strange is Hep B–given to newborns irregardless of the status of their mother. Are we assuming these infants are going to be having intercourse or using IV drugs?? So odd.

    My understanding via Dr. Sears is that West VA and Mississippi allow NO exemptions. And I found this study of unvaccinated vs vaccinated but it appears on a website that seems a bit militant so I don’t know it veracity.

    thanks
    m petty, Surrey BC

    Reply
    • I love to read here. I wish this was a WordPress type blog that sends noifttcaiions when you post something new. I guess I just have to try to remember to come here every once in a while.In the meanwhile, my fans should definitely enjoy this. It’s going on the AfroSays So Facebook fan page.

      Reply
  25. MMS

     /  December 22, 2011

    What an amazing and insightful post. Most of the pediatric community needs to learn from you and listen to what you are saying. Thank You.

    Reply
  26. Dr. Stafford,
    I greatly appreciate your approach to this matter. My family no longer seeks regular medical care, in part because of the attitudes we encountered when we stopped vaccinating our first child, who suffered a neurological reaction to her second set of infant shots. My daughter is now eight years old, and unfortunately is still recovering from that reaction. I do not believe vaccines promote health. I disagree with your assertion that vaccines are safer than a car ride, because the safety stats are not firm; they are based on very shaky science and a highly flawed, passive reporting system. With under-reporting being such a big problem (the CDC has stated that as much as 90% of vaccine reactions remain unreported), there is no way to accurately determine how many children are being hurt by vaccines. In addition, vaccination does not equal immunization. Since not all individuals will respond to a vaccine the same, and vaccine efficacy varies according to the specific vaccine given, there is no way to estimate who is protected from which disease. Vaccination status is not a reliable way to determine immunity; laboratory titers are the only accurate way to identify antibody presence, and even with that, there is some controversy as to how much protection that offers a person. Vaccine-free children can develop immunity to disease without vaccines, and unless there is an underlying disorder, enjoy the benefits of a fully functioning immune system. Pair that with sanitary water, adequate nutrition, sunlight, fresh air, and exercise, and you have the necessary elements for health. Let’s also not forget the negatives that vaccines have brought about. The early polio vaccine actually caused many cases of polio…still can, to this day, when the live version is given. Polio vaccines were also found to be contaminated with the SV-40 virus, which was found to cause cancer in animals. Bacterial vaccines have caused serotype replacement. Varicella vaccine use seemed to cause a spike in shingles in the population. Live vaccines can spread from the recently vaccinated to the vulnerable population. Some vaccines, such as pertussis, are not known to prevent transmission, but instead decrease symptoms in the vaccinated; this mechanism allows for “silent carriers” and potentially puts others at risk (certainly just as much risk as any non-vaccinated child presents).

    Thank you for your consideration of my points made, and I do hope that you will consider looking more carefully into this matter, as I’m sure you have already begun doing.

    Reply
    • cwalk

       /  December 22, 2011

      You have made a lot of claims and statements, however, you have not provided us with any scientific studies or evidence to support your claims. Evidence Please.

      Reply
  27. Michelle Knight

     /  December 22, 2011

    Because there are children and adults who cannot be immunized because their bodies do not make antibodies, others need to be immunized. I’m not saying that their rights need to be taken away, but I do believe more information and scientific studies and results need to be shared. I believe the public needs to be treated with respect and treated like they can understand basic scientific research and statistics.

    When people make personal choices for their children, they need to remember they are making those choices for those around them that cannot be immunized. “Herd immunity” is key in making immunizations work. Even if a healthy person is immunized, if they are exposed enough times to the disease, they can and some do get the disease. The higher the percentage of children that are not immunized, the less protection the whole community has. This makes those that are compromised in their immune systems especially vulnerable. There are parents who have to hire special care takers because they cannot allow their preschoolers to go to a child care facility that allows children that are not immunized to attend. Because their own children cannot be immunized, they depend on the rest of the community they are in to be immunized.

    Dr. Stafford, in areas of the country, where there is a higher population of unimmunized children, these rare diseases are making a rebound. The reason they have become rare in the past is because of immunizations. In 2009, nearly 17,000 cases of pertusis were reported in the US and those are the ones that were bad enough to be diagnosed as pertusis and not the milder cases that are often misdiagnosed as bronchitis. For infants especially, pertusis can be deadly. (just one of many references http://www.cdc.gov/media/subtopic/matte/pdf/2010/whoopingcough.pdf)

    When I looked into these issues with my children, I asked my mother why she immunized us as children and she said she lived in an era where she knew of family members and neighberhood children who died from meningitis and other now rare diseases because of immunizations. I am concerned that these educated parents that choose not to immunize are not getting all the facts because the amount of risk for immunizations is far less than what our everyday risks are for day to day activities. Because we are accustumed to living in an immunized community, we do not know nor understand the horrors that whooping cough, meningitis, and others that can and do happen in unimmunized communities. There is a reason these diseases had immunizations developed for them, because they were a real threat and they can be again if the “herd immunity” breaks down.

    I know my opinion will not be popular on this thread, however, I believe thinking intelligent parents should hear from a parent that once was a skeptic but now immunizes her children. Are there risks in immunizing? Yes, but there are real risks in not immunizing too.

    Reply
    • Is there not equal skepticism and questioning of the herd immunity theory (that does not hold any water at all to many statisticians)?

      Reply
  28. luckylass319

     /  December 22, 2011

    A real scientist and a truly caring doctor…such a rare thing today and I thank you for your wise and tempered stance! Our decision not to vaccinate was made after hours of deliberate research and I still have doubts from time to time because it is hard to know if your information source is valid (on both sides). I don’t judge other parents for their decisions; I just want to be allowed to make mine. Again, thank you!

    Reply
  29. Nina C

     /  December 22, 2011

    I don’t understand your conclusions that there are real risks in not immunizing. You admit that unvaccinated children are healthier and not coming to see you as much as their vaccinated counterparts. You also mention that the diseases we vaccinate against are rare.
    I don’t understand where the risks in not vaccinating are? Even if an unvaccinated child did catch measles or the flu, don’t you think a healthy child with a proper diet could fight it off the majority of the time?

    Reply
  30. Some comments on your post. First, the vast majority of anti-vaccinators are not critical thinkers at all. They do not have the ability to critically analyze data and weigh it to come to a conclusion based on *quality* of the evidence. They use anedcote and emotion, not science, to support their opinions. They may “know” a lot about vaccines, but if that information is false, then they in fact know nothing at all.

    Regarding some of your specific comments:

    “Pro vaccine advocates are just as guilty of overstatement. To listen to the rhetoric, one would think that if a child is not immunized, they WILL get sick with one of these illnesses which we immunize against. This is just not true.Thankfully, these disease are all very uncommon and very few children, immunized or not, will develop them. One can argue, that they are rare as a result of successful immunization programs and for some this is undoubtedly true. At the same time, regardless of the reason, the low incidence of these illnesses does impact the risk-benefit calculations.”

    Pro-vaccine advocates understand that the unvaccinated are at a far greater risk of contracting a VPD than the vaccinated. For proof of principle, see the current measles data from the CDC. Approximately 90% of the measles cases this year were unvaxxed. We have also have the most measles cases in 2011 than we have had in over a decade, and this is a direct result of the anti-vaccinators. As for your comments regarding the success of vaccination programs, well…yes. We have been protected by herd immunity. And as anti-vaccinators are enabled, the incidence of these diseases will increase, and in fact is already increasing.

    “Unimmunized children are NOT sicker than immunized children. There are no studies comparing outcomes of immunized vs unimmunizing children and unfortunately this kind of study will never be done. However, as I mentioned earlier, I have lots of partially or unimmunized children in my practice. I can say, unequivocally, that these children are not sicker than the immunized ones. In fact, they are in the doctors office far less than their immunized counterparts.”

    I have no doubt that your observations are correct and that unvaxxed children may visit your clinic less often. To imply that this is because they are healthier is ridiculous. Parents who do not vaccinate have a distrust of medicine in general and are less likely to see a family physician. See Dempsey’s 2011 paper in Pediatrics for more information.

    “I do think they are at a slightly increased risk from vaccine preventable illnesses, such as pertussis, but that is a risk these families have chosen to take, over the risk from the vaccines. For every other illness, they are not sicker and for a few reasons may be healthier.”

    If they are at “slightly” increased risk for VPDs, it’s because the rest of us vaccinate our children and protect theirs. I wouldn’t call a 22-fold risk of measles a “slight” increase, however. See Feiken et al. for more information. Further, this is not just a risk they have chosen to take for their family. It is a risk that they have chosen to pass on to their neighbors, families, and the infant out at Target as well.

    “Unimmunized children are not a danger to immunized children. Some argue that forcing children to be immunized or ostracizing those who are not, is for the purpose of protecting all of those children who are immunized. Again, I question the logic. In the first place, immunizations protect against very specific, but uncommon illnesses.”

    The premise of this entire argument is based on the fact that VPDs are, for now, UNCOMMON. If the anti-vaxxers keep it up, they won’t be rare any longer. Then I suppose all of the trendy anti-vaxxers will be hightailing it in for their vaccinations.

    Reply
    • I will never understand those whose wish is to tear down another’s opinion instead of simply writing their own elsewhere. Such is blogging. Needless to say, your comments about nonvaxers inability to think critically are offensive (the trendy statement just rude) when one considers there is serious doubt that you personally are aware of this specific people group and it’s resources, intelligence, and care.

      Herd immunity is the great joke to mathematicians and statisticians and epidemiologists who aren’t bought and sold.
      Promote your ideas without the guilt trip and ugly comments, please.

      Reply
      • Migs

         /  December 27, 2011

        Carey – What I like about Skew’s comment is that he shares with us, Dr. Stafford, where the information is from.. Cites specific papers as well as journals. It is a very good counterpoint(s) to the ones listed in the above list. What you respond with is just an opinion. I did not see any references to back up your post..

        I didn’t read any kind of guilt trip into what Skew had said.. To quote you – “..Needless to say, your comments about nonvaxers inability to think critically are offensive (the trendy statement just rude) when one considers there is serious doubt that you personally are aware of this specific people group and it’s resources, intelligence, and care…”

        Yes, Skew is an epidemiologist- This would make him/her very aware of your position.

        Another quote from your post, “Herd immunity is the great joke to mathematicians and statisticians and epidemiologists who aren’t bought and sold..” Please provide a citation of some kind.

  31. This is why I bring my little Vivian to your office! You are honest and to-the-point, yet you understand and respect the decision of the parent, and I’ve never felt judged for using a modified vaccine schedule. Thank you for writing this!

    Reply
  32. Ben

     /  December 22, 2011

    I most certainly will not be hightailing it in for vaccinations. I’d much rather just have the “life threatening” disease, which by the way I am “at risk” for since my childhood vaccinations likely worse off a long time ago. When you consider that “everyone” used to get measles, mumps, etc. and they were not considered a big deal in most cases (for “healthy” people) along with the fact that these things tend to be much worse as an adult, I can’t help but conclude (for other reasons as well) that perhaps there is a reason that children used to get these things. I’m not claiming to understand everything, but it may like working out in a gym… You work your muscles, and they get stronger. Research is beginning to validate the claim that temporary childhood illnesses prime and strengthen the immune system for later in life while vaccines (via original antigenic sin) alter the way the immune system responds to the same virus/bacteria upon second exposure. This is proving to be especially true with the flu shot. Not only are we preventing what used to be normal “milestones” in development, we’re pumping kids full of toxins in the process. If we stopped vaccinating, I don’t doubt that measles cases, as one example, would begin to rise, but I don’t think there would be very many deaths. This is apparent in the stats from before the measles vaccine. Most were still getting the measles, but very few were dying or having severe complications from it (due to better nutrition, sanitation, etc over the years). So if it’s the morbidity and not mortality we’re talking about… Again, I’m not willing to pump my child full of known neurotoxins for the sake of “preventing” something they might get, which even if they do get will likely be just fine. (I’m not however, saying that things like polio were something to be taken lightly. I’m just saying these things “in general.”) And I resent being called a “trendy anti-vaxxer.” Not vaccinating your child has nothing to do with being trendy. In fact, quite the opposite is true. Finally, if you feel that vaccinating your child is beneficial to his/her health, that’s your choice. But you don’t have the right to expect me to do the same. The school, Target, and the grocery store may be public, but my child is not.

    Reply
    • “Research is beginning to validate the claim that temporary childhood illnesses prime and strengthen the immune system for later in life while vaccines (via original antigenic sin) alter the way the immune system responds to the same virus/bacteria upon second exposure.”

      This is precisely why vaccines are so effective, Ben. They prime the immune system. To claim otherwise is absolute nonsense.

      “This is proving to be especially true with the flu shot. Not only are we preventing what used to be normal “milestones” in development, we’re pumping kids full of toxins in the process.”

      Infectious diseases may be a “normal milestone” for those who survive them with no serious adverse outcomes, but it’s obviously the terminal mile marker for those who do not. I suggest that you look up Natalie Norton if you’d like to see the potential, and very real, impact of a vaccine-preventable disease on a family. Regardless, death is not the only endpoint that counts, as anti-vaxxers like to point out. Further, there are no “toxins” in vaccines that are harmful to human beings at the doses found in the vaccines. The dose makes the poison. Even water is toxic at excessive doses…and I’m not talking about drowning here.

      “If we stopped vaccinating, I don’t doubt that measles cases, as one example, would begin to rise, but I don’t think there would be very many deaths. This is apparent in the stats from before the measles vaccine. Most were still getting the measles, but very few were dying or having severe complications from it (due to better nutrition, sanitation, etc over the years).”

      There are absolutely no data supporting this argument. I get that one person dying per day of measles isn’t a big deal to you. But I can assure you that it would be to the child’s parents. Further, there are several extremely serious and far more common sequelae to measles that you don’t want your child to develop, such as encephalitis.

      “So if it’s the morbidity and not mortality we’re talking about… Again, I’m not willing to pump my child full of known neurotoxins for the sake of “preventing” something they might get, which even if they do get will likely be just fine. (I’m not however, saying that things like polio were something to be taken lightly. I’m just saying these things “in general.”)”

      It’s super that in general you don’t take vaccine preventable diseases lightly. The medical and scientific community, with few exceptions, agrees. Again, your use of the word “neurotoxins” is highly misleading and frankly undermines your argument.

      “And I resent being called a “trendy anti-vaxxer.” Not vaccinating your child has nothing to do with being trendy. In fact, quite the opposite is true.”

      Actually, it has been established that it is currently trendy not to vaccinate. If this statement makes you resentful, you may want to consider more deeply why that is. You may find that the anti-vaccination movement, rather than being comprised of “alternative thinkers” who “did the research” is actually made up of people who understand dangerously little about vaccinations, or even biology, and make their decisions based on emotional anecdotes and incorrect information because they read about it on Facebook.

      “Finally, if you feel that vaccinating your child is beneficial to his/her health, that’s your choice. But you don’t have the right to expect me to do the same.”

      Yes, actually, I do have the right to expect you to do the same, as does your community. Your child puts my children at risk, and that is unacceptable.

      “The school, Target, and the grocery store may be public, but my child is not.”

      Then your child should be homeschooled. Period. No one else should be put at risk because you have a fundamental misunderstanding of vaccines.

      Reply
      • Christina

         /  July 21, 2013

        How does my choice to leave my child “unprotected” make your “protected” child less safe, if vaccines work? Since kids vaccinated with live-virus vaccines are contagious up to 4 weeks after their shots (live vaxes include measles/mumps/rubella, flumist & chicken pox), vaccinated kids ARE a risk to non-vaxed kids as far as disease transmission goes. Vaxed kids also are more likely to pass on “VPDs” if they do contract them.

        In some cases vaccinated kids are MORE at risk of contracting (and transmitting) variant forms of the disease they’ve been vaxed against- ex. http://m.rspb.royalsocietypublishing.org/content/early/2010/02/26/rspb.2010.0010.full

  33. cwalk

     /  December 22, 2011

    I find it very strange that a qualified medical practitioner would call childhood diseases ‘uncommon’ When I had measles as a child, all the kids in my street had it as well NOT ONE KID didn’t get it. Same with chicken pox, and the only reason these diseases are no longer as common as they were, is because of immunisation. I wouldn’t like to bring my children to sit in your waiting room

    Reply
    • Consider then, as a “qualified medical practitioner”, that maybe he has a point. Personal experiences in one life’s tiny neighborhood does not a scientific study make.

      Reply
      • Perhaps not. But there are a wealth of data proving beyond any reasonable doubt that immunization has, undeniably and substantially, reduced the risk of many infectious diseases.

  34. Carrie Gould

     /  December 23, 2011

    This is the most thoughtful article I have read on this topic. Thank you.

    Reply
  35. Robin

     /  December 24, 2011

    Thank you!

    Reply
  36. Zoey

     /  December 26, 2011

    Thank you, Dr. Stafford, for speaking out! You sound like a pediatrician I could work with. As you say, parents want very much to have a doctor who will listen and allow them time and freedom, in other words, work WITH them instead of against them (and maybe even learn something in the process). I am also delighted that you are correcting assumptions about the sort of parent I am. I graduated in 3 years with a degree in Physics from a most highly selective college. I 800s on the math and logic sections of the GRE. I do not need a pediatrician who swallows what they are told in medical school hook, line and sinker to tell me how to think.

    The next step in your evolution to being a GREAT pediatrician, would be to observe which children are among the vulnerable population — to vaccines I mean. The information is out there. The people with vaccine-damaged children have a number of factors in common — and living near a freeway and having older parents are way down the line. The single biggest thing they have in common is parents with autoimmune issues. Autoimmune issues ABOUND in the autistic community, and in the populations of those with high rates of asthma and allergies. Get a good health history of your children coming in. Those with parents who have asthma, allergies, rheumatoid arthritis, MS, fibromyalgia, Reynaud’s syndrome, Hashimoto’s thyroidits, lupus etc., etc. are NOT good candidates for vaccination, but especially not for vaccination “on schedule”. Find out if a child was born by IVF or other assisted reproduction techniques. Many of the mothers who go that route have autoimmune issues, and/or MTHFR gene defects which not only make it hard for them to get and stay pregnant, but give their children a genetic disadvantage when it comes to clearing toxins from their systems.

    Oh, and you might want to make a few corrections to your text. In number 5, the informed consent paragraph, the word should be “tenet” not “tenant”. In number 7, the phrase should be “doctor’s office”. In number 8, “contact” should be “contract”, and in the sentence starting with “Then”, the next phrase should also start with “then” rather than “than.”

    Reply
    • “Those with parents who have asthma, allergies, rheumatoid arthritis, MS, fibromyalgia, Reynaud’s syndrome, Hashimoto’s thyroidits, lupus etc., etc. are NOT good candidates for vaccination, but especially not for vaccination “on schedule””

      Zoey, can you please provide a reference to a scientific journal article that supports this claim? I’d specifically like to know which genes you are concerned about since you have made a broad statement regarding autoimmune diseases which have little genetic overlap with one another. And what specific MTHFR “gene defects” are you talking about here? Do you mean SNPs? Which ones are related to problems with “clearing toxins from their systems”? References would be super-helpful so I can read up on this.

      Reply
  37. Migs, thanks for your comment. Carey, I do, in fact, write on my own elsewhere. You are more than welcome to read my blog.

    Reply
  38. Sarah G

     /  January 29, 2012

    Thank you for your post! I really respect your approach with the issue! Now if I can just find a doctor out here in CA with the same approach I would be thrilled! The last doctor I took Reese to gave me the “bad parent” lecture…. needless to say we are using someone else now. Thanks again for the fair approach!

    Reply
  39. Sarah B.

     /  January 12, 2013

    Dr. Stafford, I had no idea you had a blog! 🙂 As you know, the reason we chose you as our family doctor has everything to do with this post. And, I too refer families to you on a regular basis. Those of us who share this same opinion appreciate SO much your understanding that this is a parents choice. Your patience on the issues means the world to families who have concerns or questions. Thank you for not being one of those doctors who gives the “bad parent” lecture. You are a blessing to so many.

    Reply
  40. Reblogged this on The Refurbished Rogue's Blog and commented:
    how nice to hear from a physician who believes in the vaccination schedule but still respects the fact that some parents are not comfortable with a one-sized-fits-all program. Mandatory vaccination represents a limitation on human rights. Any limitation of fundamental rights, such as the rights to liberty and security of person, is serious, regardless of the supposed public good involved. At the end of the day, vaccines are still “unavoidably unsafe” (see the 1986 National childhood vaccine injury act) and it is an undisputed, scientific fact that vaccines in their current state of development injure and cause death to certain people. The decision of when and whether we vaccinate ourselves and our children is a fundamental human right and I applaud this brave physician for speaking the truth and standing up for the parents in this country who have decided to go against the flow because it is what works best for their children.

    Reply
  41. Theresa

     /  June 6, 2013

    I’m so glad I read this. I have a 2 month old child that was 6 weeks premature. He had his 2 month check up today at a pediatric office in Spartanburg and I left feeling frustrated and filled with self-doubt about our decision to use the alternative schedule. During my appointment I was treated as an uneducated, first time mom. I didn’t think it was necessary to inform them that this is in fact my second child and that I am a family therapist that specializes in child development. I didn’t really think the information was relevant until I found myself having to defend my reason to delay vaccinations and express that I did my part in researching the topic. I spent 30 minutes completing all that new patient paper work which asked such questions… the least they can do is read it prior to our appointment. This topic is overwhelming and honestly exhausting. It is so refreshing to hear a doctor discuss this in a way where you can put your guard down and have a little trust… that is becoming more and more rare with doctors today. Though you are 30 minutes away, we will be transferring both our kids to your office. Thanks for your blog and your honesty =)

    Reply
  1. Observations on the Immunization Controversy – by W. Keith Stafford, MD | The Refusers
  2. Why Parents Delay Vaccines | CRUNCH.with.CHEW

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