As vaccinations increase, some parents ask: Are immunizations a shot in the dark?

[heidi1439]

Melanie Plunkett didn't think twice about the shots when her son, Isaiah, was born.
"I just went along with the vaccination schedule," she said.

Not anymore.

Plunkett has decided to space out her 4-year-old son's vaccines from now on.

"I just think that we give kids too many vaccines at once," she said. "It's too much, too soon for their immune systems."

Now, Isaiah is going to receive one -- two, tops -- at a time.

"I just wish I would have done that from birth," she added.

Vaccines. It's become a hot topic with mothers around the country and Muncie is no exception.

"Moms are doing their homework," said local pediatrician Michael Burt of CHS Pediatrics Center. "There are definitely more mothers these days with questions; they have read information and have concerns about immunizations."

Questions about the possible link between vaccines and autism. Questions about whether or not certain vaccines are still necessary. And, like Melanie Plunkett, questions about the number of vaccines given.

But while the number of questions regarding immunizations has risen, the number of children receiving them hasn't.

"Our numbers are up this year," said Sue Goebel, who has been a nurse with the Delaware County Health Department for 17 years. The numbers she referred to are the children who have come in for free shots during the Shots for Tots clinic at the downtown YWCA.

And according to the Indiana Department of Health, 94 percent of public schools and 68 percent of private schools reported complete immunization data for the 2006-07 school year, an increase from the previous year. Only two Muncie Community Schools students filed exemptions from vaccinations last year.

In fact, according to a report released in September by the Centers for Disease Control, the majority of the nation's parents are having their children get the recommended vaccinations. The CDC reported that more than 77 percent of children were fully vaccinated and that less than 1 percent of children had received no vaccines by age 19 to 35 months.
Benefits outweigh the risks

Morgan Kerr is one of those children. At age four months, she was nearly up-to-date on all of her vaccines.

She smiled as she sat on her mother's lap with a nurse on either side, needles at the ready.

The nurses counted down. "One, two, three." The needles, carrying a combination of vaccines, went into her thighs.

The baby paused for a second, taking in what just happened, then wailed.

Her mother stood up and cradled the baby in her arms. "It's OK," she whispered into her daughter's ear.

The tears, Mom said later, are worth it. In fact, she admitted shedding a few the first time her daughter received the shots.

"You feel horrible about it," she said. "But we all want our kids to be healthy, right?"

MacKenzie said she discussed vaccines with her family doctor before consenting to shots.

"I decided that the benefits of getting the shots outweighed the risks," she said.

And there was something else, she said.

"I trusted my doctor."
48 doses by age 6

Doctors are recommending more vaccines than ever before.

In the 1970s, the Centers for Disease Control (CDC) and American Academy of Pediatrics (AAP) were recommending that children get 23 doses of seven vaccines by the age of 6. The first vaccinations were given at two months old.

Today, the CDC and AAP advise doctors to give children up to 48 doses of 14 vaccines by the age of 6, according to the National Vaccine Information Center. The first vaccination is given 12 hours after birth. At age two months, a baby can receive up to eight vaccines on a single day. At age 15 to 18 months, he or she can receive as many as 12 vaccines at one visit.

Nationally-known pediatrician William Sears (as well as his pediatrician son Bob) is among a growing group of doctors who recommend an alternative vaccine schedule, which includes holding off on the Hepatitis B vaccine until age two months and splitting up the combination shots (only giving two at a time).

While Burt will work with parents to space out vaccinations, he said it's not necessary.

"Their immune system is capable of dealing with multiple times the number of immunizations they are given," he said. "There is more of a immunological challenge when they fall and scrape their knee."

Even so, nurse Goebel said more parents are choosing to space out the vaccines. "It gives moms a little more control," she said.
Peet and the 'parasites'

Kathy Munroe, who is expecting her first child in March, was already searching the Web regularly for immunization information when the "fight broke out."

The fight between actresses Amanda Peet and Jenny McCarthy, that is.

McCarthy, who has a son with autism, is leading a charge to "green vaccines" and decrease the number of vaccinations given to kids under the age of 2. Peet, a mother and spokeswoman for Every Child By Two (a campaign designed to make sure all kids are up-to-date on their vaccines by age 2), responded to McCarthy's efforts by saying that parents who don't vaccinate their children are "parasites."

She went on to make appearances trying to dispel the "myths" of McCarthy's campaign.

But it's hard to ignore medical records, court cases, "Wakefield studies," personal testimonies and even YouTube videos of parents who believe the link is legitimate.

In most cases, it comes down to mercury. Thimerosal was an often-used preservative in vaccines until recently. Now all but some flu vaccines are Thimerosal-free.

And as far as all of the children who were exposed to it in the past?

The American Academy of Pediatrics and the CDC have rejected the link between Thimerosal and autism.

But the Georgia Supreme Court ruled this month that a family's lawsuit against the manufacturer of a vaccine with a mercury-based preservative can go forward to trial on claims that the vaccine caused their child to develop autism.

Which leaves Kathy Munroe with one, big question. "Who am I supposed to believe?"

Most physicians and experts agree there is no clear-cut answer on whether or not vaccines cause autism. All will most likely say that more research needs to be done.

Burt gets personal.

"My daughter is going to have a baby in the next several weeks and I will advise her that the immunizations recommended are, by every means I have to judge by, safe and effective," he said. "I would never propose something for my granddaughter that would in any way put her at risk."

Still, there are some who will opt out. "There are a number of parents who just don't feel comfortable with immunizations," he said. "All of the evidence in the world coming from my perspective isn't going to be enough."
What happens if we opt out?

So, what happens if we say no to vaccines?

"If we are talking about 1 or 2 percent of babies, that does not represent a problem," Burt said. "The other immunized babies around them will give them protection. But if 10 to 20 percent of the population is unvaccinated, that is enough to cause these illnesses to occur, and with serious consequences. Measles, as I remember it, was just something everyone got in kindergarten. Now it can cause serious brain damage, even death."

A measles outbreak in July was the biggest this country has seen in more than a decade. It infected more than 130 people in 15 states. Most of them, 112, were not vaccinated, according to the CDC. Of the 95 who were eligible for vaccination (by age and medical status), 63 had chosen not to get shots because of religious or philosophical beliefs.

In Indiana, you can opt out of vaccines for religious or medical reasons.

The outbreaks and concern that more parents will opt out has medical groups scrambling. Chicago-based American Medical Association, the American Academy of Pediatrics and 20 more of the nation's most influential health-related groups have formed a coalition to get the word out about vaccine safety.

"The ongoing measles outbreaks in several states are testimony that those who forgo vaccinations are vulnerable to infection from imported disease, and can pose a significant health risk for their communities," said AMA board member Dr. Ardis Hoven, an infectious disease specialist.

"We do not want to become a nation of people who are vulnerable to diseases that are deadly or that can have serious complications, especially if those diseases can be prevented," added Dr. Renee Jenkins, the American Academy of Pediatrics' president, in a statement.

But what if the complications come after the vaccine is given?
Reporting every high fever, rash

Laura Powers said she "freaked out" after her then six-month-old daughter experienced side effects from a vaccination.

"It was the DTaP shot," she recalled. "She had a high fever, she was vomiting. She was very lethargic."

And Mom remembers vividly the way the her daughter's arm looked. "It was so swollen and red, I thought it would never go down," she said.

It did. But Powers decided that she would hold off on shots for a while. In fact, her daughter hasn't received one since.

"I'm not ready to try again yet," Powers said. "I'm not sure I will ever be ready."

The most common side effects -- in one out of four kids -- from vaccines, according to the CDC, include tenderness, redness and swelling where the shot is given and a mild fever. But there are others. Side effects that can occur after receiving the DTaP vaccine -- which is a combo vaccine for diphtheria, tetanus and pertussis -- can include seizures and high fevers. Many can, in extreme cases, cause death.

All side effects are supposed to be documented.

"There is a reporting agency that keeps track of any adverse reactions -- VAERS," said Joyce Mitchell, a registered nurse with the Delaware County Health Department. The Vaccine Adverse Event Reporting System from the FDA and the CDC collects information about all adverse effects to be analyzed and perhaps, more importantly, viewed by the public.

Anyone can report to VAERS. The majority of the reports come from vaccine manufacturers (42 percent) and health care providers (30 percent). The rest come from state immunization programs (12 percent), vaccine recipients (or their parent/guardians, 7 percent) and other sources (9 percent).
Go ahead, ask questions

It's a lot to consider when you're making the decision about whether or not to vaccinate your child.

"It can be tough," Burt agreed. "But parents are doing the right thing -- they are staying informed."

"We welcome questions," nurse Sue Goebel said as 8-year-old Leslie Navarro made her way into the room at the Shots for Tots clinic. "We understand that you want the best for your children. We do, too."

"One, two, three."

Navarro sat perfectly still as the needles went into her arms.

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