To vaccinate or not – making an informd decision

One’s philosophy is expressed in the choices one makes … and the choices we make are ultimately our responsibility.
Eleanor Roosevelt 

When I asked the mother of two sons, aged 17 and 21, her opinion on this hotly debated topic, her answer highlighted how times have indeed changed: “When my boys were young, it wasn’t an issue, it was simply something every parent did.” Today it may not be something every parent automatically does, but it is an issue that every parent should make an informed decision about. What are the benefits? Are there real risks?

If you are undecided as to where you stand with regards to vaccination, perhaps the first thing to ask is what exactly is a vaccine and how does it work? A vaccine is defined as ‘a substance given to stimulate the body’s production of antibodies and provide immunity against a disease, prepared from the agent that causes the disease, or a synthetic substitute.’ In other words, a vaccine is a small dose of the disease in question (or an engineered substitute); administered to the body, which in turn fights the disease by producing antibodies. Should the body then be exposed to the disease in future, it already has defenses against the disease and will therefore remain unaffected. This all sounds good in principle, so why then the debate?

The greatest fear amongst parents faced with this decision is whether the vaccine that is intended to protect the child from life-threatening diseases will cause immediate or long-term illness. The short answer is that no, vaccines are not totally safe. Although it is relatively uncommon, it is possible for a child to have a severe adverse reaction to the vaccine. In rare instances, it is also possible for a child to contract the disease against which he or she is being vaccinated. That said however, organisations such as the Centre for Disease Control and Prevention, the American Medical Association and the World Health Organisation (WHO) have found that the risks of vaccines are outweighed by the significant benefit they provide. WHO states that ‘vaccination is one of the most important public health interventions.’ This begs the question, perhaps especially for parents in developing countries – are we being irresponsible towards our communities if we do not vaccinate?

WHO has further established a Global Advisory Committee on Vaccine Safety in order to ‘respond promptly, efficiently and with scientific rigour to vaccine safety issues.’ They offer the following key points concerning adverse events following immunization:

• ‘There is no such thing as a “perfect” vaccine, which protects everyone who receives it AND is entirely safe for everyone.
• Effective vaccines (i.e. vaccines inducing protective immunity) may produce some undesirable side effects which are mostly mild and clear up quickly.
• The majority of events thought to be related to the administration of a vaccine are actually not due to the vaccine itself – many are simply coincidental events, others (particularly in developing countries) are due to human, or programme, error.
• It is not possible to predict every individual who might have a mild or serious reaction to a vaccine, although there are a few contraindications to some vaccines. By following contraindications, the risk of serious adverse effects can be minimized.’

Those who are vehemently pro-vaccination will argue that not vaccinating is akin to child abuse. While those who are strictly anti-vaccination will say the exact opposite is true. Then again, there are many parents who believe there is a middle ground: that certain vaccines should be administered and others not; that vaccine brands that are low in potentially harmful substances such as aluminium should be required; that vaccinations should be spaced further apart to relieve the immune system. The bottom line is that there are so many variable involved and it is every parent’s right to make decisions about issues that have an effect on their family. Read the multitude of literature available, consider the country and circumstances in which you live, ask the advice of a medical professional you trust, learn about each specific vaccine and make an informed choice.

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