>death : vaccines : maria

Date: Sun, 5 Apr 1998 03:45:53 -0400
To: maria
From: justin
Subject: thesis/vaccine questions

maria -

thank you so much for your time; i appreciate that you're busy. at least you will end up in mexico soon hereafter! i hope your cold clears up before you have to leave.

in order to graduate this june, i am preparing a thesis: "technology and citizen choice: priorities and responsibility for tool selection." how do people evaluate and implement technologies? who is responsible?

the most current draft of the thesis is online at
http://www.sccs.swarthmore.edu/~jahall/thesis/

vaccination illustrates this path of inquiry as it becomes increasingly mandatory. one girl here whose family refused to have her vaccinated was obliged by swarthmore to receive a measles shot before she could get her grades. so in that case, regardless of her (parents)'s conscientious objection, she was forced to accept vaccines, a technology with a less than perfect track record. why did she have to participate? why did her parents refuse? who should be responsible for the vaccine decision?

in part from our debate about children and the internet, i know you maria to be a concerned parent who questions the level of interaction between her children and technologies. accordingly, you popped in my head as someone to ask about vaccines.

here are the questions, please feel free to write between the lines, skipping lines, or any which way you please. if you will need until after mexico to finish them, please let me know. i just found out thursday that my thesis is due in early, not late, may, so my personal thesis production timetable has been shifted to a rather excited level!

From: Maria
Date: Tue, 21 Apr 1998 05:39:42 EDT
To: (justin)
Subject: vaccination thesis questions

Dear Justin,

Here are my thoughts on vaccines. I'm sorry I couldn't have gotten it to you sooner. Please call me if it is gobbledy-guk--I'll try to figure out what I was talking about. Good luck with your thesis--feel free to call me or e-mail me with any further questions. --

Maria


> Did you know that you had a choice to vaccinate? If so, how?
Although no one told me that I had a choice in whether or not to vaccinate my children, I always assumed that I did. (My mother says that this confidence is an arrogance that is a product of being too young to remember what it was like before Roe v. Wade.)


> Did you feel any pressure to vaccinate?
I never felt any pressure from friends, family or our family doctors to vaccinate, but then again, I came to the conclusion that it was a pretty good idea. I may have felt pressure had I gone against the "norm," deciding against vaccinating.

I only had one doctor (a well meaning fool who was neither our regular pediatrician nor in our pediatrician's practice) pressure me into revaccinating my daughter with the Pertussis vaccination, to which she is allergic. He explained to me that her allergic reaction had been a mild one (which luckily it had been) and that "from a public health point of view" all children should be fully vaccinated. He said this after acknowledging that statistically, the chances of a stronger allergic reaction would be higher since there was a reaction on the first exposure. I told him that I would not even consider for a minute putting my daughter's health at risk for the sake of "public health" and that his suggestion was irresponsible and inappropriate. My pediatrician strongly agreed with me and had a talk with the doctor personally.


> Did you find your doctors helpful when/if you asked questions concerning vaccination? Did they offer you information or advise specific to your children?
My doctor is very giving with information about vaccinations. She provided, in writing, a discussion all of the side effects of each of the vaccinations, following up with a face to face discussion of the pros and cons. She also told me about various resources that were available to me if I wanted more information. As a doctor, her belief is that vaccinations in general are important to the health of the child. But as a parent, she hates the idea of putting a virus, albeit weakened, into the arm of a healthy, vibrant child. She confessed that she can't stand it when he own children get their vaccinations.

She was also helpful in suggesting which vaccinations might be appropriate for each of my children--as a result, my kids do not have identical vaccination histories.


> Have your two children been vaccinated? The same vaccinations for each? Were there different concerns for each child?
My two children are vaccinated, but because of different medical histories and needs, they do not have identical vaccination histories. My pediatrician and our other family doctors were very helpful in helping us find the correct vaccination plan for each child.

My daughter, "Anne", was born strong and healthy. She has had the usual round of vaccinations- MMR, DPT/DT, Polio. On her first DPT she had a mild allergic reaction to the Pertussis vaccine--a high fever and lots of crying--and our pediatrician took it very seriously. As a result, Anne was never revaccinated for Pertussis, only receiving DT for the remainder of the series. I declined the Hepatitis vaccination because I feel there is only the tiniest chance of her ever getting hepatitis in our present situation, and she is strong and healthy and her body should be able to work through the disease as well as anybody else's. As we begin to travel more (as we are only starting to do now) or when she reaches her teen years, her chances of exposure will be greater, at which time it will be more appropriate for her to be vaccinated against Hepatitis.

My son, "John", was born with some medical problems and spent a good deal of time in the hospital. There was an outbreak of measles in his ward at the hospital so he was vaccinated immediately for measles. We followed up with the usual MMR, DPT (he's not allergic like his sister), and Polio. He was very fragile his first few years and got several bouts of pneumonia. Because illness escalated so severely and so remarkably quickly for him, he received regular flu shots for his first three years. Additionally, the rest of the family, Anne, my husband and myself, got annual flu shots for his first two years in an attempt to keep the "household" healthy, thus limiting the likelihood that John would get sick and wind up in the hospital again. (Although in theory I do not believe in annual flu shots for strong healthy people, those were the healthiest winters that this household has ever been through!) I decided to vaccinate John against Hepatitis. This was an intuitive decision. Although he is strong and healthy now and has been for several years, I am hesitant in his body's ability to fight off a strong, lingering illness like hepatitis if he were unlucky enough to get it.

I had not planned on getting the children vaccinated against the Chicken Pox. This is not a life threatening disease, nor one that is generally known for having serious side effects--like loss of hearing, vision, paralysis, brain damage, etc. Although I do believe in vaccinations, I also believe that a natural immunity to the disease is probably better, stronger, and more permanent. I had planned to let my children get the Chicken Pox like everyone else in history. But then I helped out a friend by taking care of her two children, who were both sick with the Chicken Pox , while she visited her sick father. These were two of the most miserable children I had ever seen. They had Pox all over--on their eyes, in their rectums, on their genitals--they were going absolutely crazy. Anne was eight years old, John was five and neither one had gotten the Chicken Pox yet. I simply couldn't stand thinking about them suffering like this when there was a way in which I might be able to prevent it. I broke down--it was a purely emotional, maternally protective response. I had them vaccinate the next day. This is the only vaccination decision that I am not sure about. I did what I felt I had to do, but was it the right thing? Will the vaccine wear off and allow them to get Chicken Pox when they're adults and it is much more difficult? Time will tell.

> Did anyone in your family or community give you advice or criticism about your vaccination decisions?
No one who knows me and matters to me ever criticized my decisions. The only advise I was given was to look at the information carefully and to make the decisions that I thought were best. Strangers in conversations would make criticisms (Why didn't you give Anne a Hepatitis vaccination--don't you know what a devastating disease that is? How can you have vaccinated your children--you have ruined their natural immune systems!!), but I generally don't pay attention to those who know nothing about me.


> Have your feelings changed since you vaccinated your children?
No. I feel comfortable with my decisions.


> Do you think most people should be vaccinated with most vaccines?
I am not in a position to make a judgment about what most people should do with their health. I think that people, whether they vaccinate or not, should go through the active process of deciding. It is not something to be done, or not done, passively.

My stepmother who had polio as a girl wanted me to add her point of view. Her fear is that through the success of vaccination programs entire generations have never known the true severity of these illnesses, thus only see the terrible consequences for some people from the vaccinations. She fears that some people who choose not to vaccinate, may choose this because they do not understand and have not seen the horror of what the disease can do. As large groups of people chose not to vaccinate, are we going to see a resurgence of these diseases? And when the consequences of the diseases become more highly visible, are we going to then wish we had more successfully vaccinated?


> Who should be responsible for vaccine decisions?
Ultimately this needs to be in the control of the individual. Parents should decide for their children, but if a child of an appropriate age (14? 16?) wants to be vaccinated against the wishes of the parent, the child should be allowed to receive vaccinations.


> Do your schools agree? What's their policy on student vaccination?
My children's' schools "require" vaccinations, but no child may be excluded from school because they are lacking vaccinations. All a parent needs to do is tell the school that they have made the decision against vaccinations and the school has to accept them.


> Why did you decide to vaccinate your children?
(You didn't ask this question, but it seemed relevant)

I make decisions by making a "cost/benefit" analysis, calculating the risks against the benefits of a situation. In this case it is the risk of contracting the disease and the severity of the consequences of the illness, against the risk and severity of an adverse reaction to the vaccination.

The first thing I kept in mind is that the diseases for which children receive vaccinations (except for the new vaccine for Chicken Pox) often have very severe consequences including paralysis, blindness, loss of hearing, brain and nerve damage and at times are fatal. I balanced that with the knowledge that some of the vaccines can have equally treacherous consequences although generally at a statistically far lower rate.

To make these decisions I looked at how vaccinations and disease had affected my immediate family and friends. I looked first at my stepmother "Mary" who contracted polio as a child. She was in the hospital for months and being the oldest of a very large family, she spent much of those long scary months without visitors. She was one of the lucky ones who eventually returned home and learned how to walk again. Mary has worked very hard every day of her life since then. She is an active and reasonably athletic woman, a very strong swimmer, a fairly good runner, and an fine outdoors woman. She also does her long set of back exercises every day--she also has pain in her back every day. It usually is not too bad--just an annoyance. At times it gets very painful. The "cost" of her polio was not life threatening, but it has certainly decreased the quality of her life and her ability to enjoy life to its fullest. When I researched the statistical probability of my children contracting polio (we travel) and having some sort of long term effect from the illness I found it to be far higher than the statistical probability of them having a long term effect from the vaccine. I didn't feel comfortable withholding the vaccine.

Similarly, I have a friend, "Carlos," who contracted Mumps as a young man. He says he remembers being deathly ill, but made it through fine...except that one of his testicles shriveled up, "like an miniature, hard walnut." Being a non-intimate friend, I have never seen the testicle in question, but his wife admits it is shriveled up and pretty "creepy looking." He did go on to father three children, so his remaining testicle presumably is in good functioning order, but I would like for my children to get through life with everything intact if at all possible. Again, I looked at the numbers, and decided to vaccinate.

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