I just heard a public health ad on my car radio informing me that as of July 1st, all children who attend daycare or school will be required to have a chicken pox vaccination. My immediate reaction was disappointment, mainly because my terrible bout with chicken pox was a transformative and wonderful few weeks in my young life. But then I started thinking about larger issues.

According to the sites I just looked up on Yahoo, chicken pox only kills 50-100 people every year. I don't want those people to die, but I'm not totally comfortable vaccinating an entire population because it's an "inconvenient" disease. In general, I support vaccinations; I know there are groups of parents who are against all of them, and I can't help but think that might be a little foolish. At the same time, however, I wonder at what level we will stop. At what point does a medical problem cross the line from inconvenience to legislated danger? Also, I've heard several times on various media lately that children are actually getting sick from NOT getting sick--too much handwashing and clean play never builds up their immune systems. One guy is even working on a "dirt shot"--a vaccine made up of the critters in the soil that children are being overprotected against.

What do you think? Are we overprotecting kids from cooties? Are we overvaccinating the little ones?

-- Anonymous, June 21, 2001

Answers

Well, Myself, good question. I just realized that if I had a kid, regardless of my questioning of this new law or desire for that poor little bugger to get the pox, I would be required by law to shot the child or it wouldn't be able to participate socially in most things. That irks me a little bit.

I would like to add that I am taking bets on which usual suspects could have a rollicking good time arguing this topic.

-- Anonymous, June 21, 2001

Vaccinating kids doesn't shield them from exposure to germs, so your argument about "overprotecting" kids doesn't apply to vaccination. Actually, vaccination does the exact opposite--it exposes kids to more microbes and builds up their immune systems, thus counteracting the effects of too much handwashing, etc.

As for the issue of vaccination in general and how much is too much, I think it's warranted for any disease which is common and disabling and if a safe, effective vaccine exists. I haven't read all the literature, but from what I understand, the chicken pox vaccine is pretty uncontroversial in medical circles, as it seems to work well on an extremely common disease, and has few side effects. A disease doesn't have to be widely deadly in order to have a negative impact on society.

-- Anonymous, June 21, 2001

Well, that makes sense. As I said, I don't oppose vaccinations as a rule. I'm just beginning to wonder at what point we will substitute a shot for the experience. And I wonder about the legal part of it all. Does anyone know how the no-vacc parents do it? I know that even in dogs, the no-vacc people have to act like fugitives sometimes (to get into obedience classes, to travel, etc).

So the chicken pox vaccine is low risk? I know that there have been several studies showing that there isn't any connection between autism and vaccinations, but I do know that a lot of people are wary about simultaneous injections (it's recommended to inject against pox at the same time as the measles series).

I'm scattershot on this one, but I find this all interesting.

-- Anonymous, June 21, 2001

To my non-medical knowledge, a pandemic disease like chicken pox can be mild when almost everyone gets it and it kills "only" 50-100 people a year. If it's introduced into a population without resistance, it's much more deadly. Maybe chicken pox and measles killed only 50 to 100 people in a population that's used to it and in a society with penicillin or whatever, but introduce measles into a clean human population like oh say American Indians and it kills them in huge percentages, and huger percentages die with a more serious pandemic disease like smallpox. That's documented history. The same could happen with chicken pox.

I assume that chicken pox has been the last disease to be prevented with vaccines because it was the least bad. Smallpox killed the highest percentage of its victims; polio left the most disability; measles, mumps, and rubella were again a degree less severe; and chicken pox, in the U.S. at least, would leave you with a scar or two where your parents couldn't stop you scratching or maybe with Rye's syndrome (?) if they fed you aspirin, but overall it was the least serious and thus the last to be tackled.

-- Anonymous, June 21, 2001

Were any of the rest of you sad when you read The Great Brain and realized you'd never get the mumps? I was. It seemed like such a romantic disease, much more interesting than strep throat. Chicken pox was the only thing that came to close to mumps or measles or any of those cool old fashioned diseases.

Raise your hand if you have a chicken pox scar next to your eye or on your temple ... everyone seems to have those.

-- Anonymous, June 21, 2001

I think that legally mandated vaccination is a good thing, because many people simply won't bother to get their kids vaccinated unless it is required. Having a large proportion of the population immunized is the only way to completely wipe out epidemic diseases like smallpox, which has been completely eradicated in humans due to aggressive vaccination efforts.

Obviously smallpox is a much more serious disease than chicken pox, but the impact of chicken pox is greater than you might think. As it now stands, practically every kid in America who is not vaccinated gets the disease. Most will not become seriously ill, but they will still fill up doctors' offices and hospitals (this article estimates that one out of every 200 kids who gets the disease requires hospitalization) and require parents to stay home with their sick kids or else hire caretakers. The cost per child may be small, but when you consider how many kids get the disease every year, it adds up.

As for the vaccine's health risks and benefits, from what I've read, the vaccine provides good protection against the disease (85% effective against mild cases of the disease and 100% effective against severe cases according to that same cnn.com article I linked above) and the side effects are mild (the most common ones are soreness at the injection site and fever, and no deaths have been associated with the vaccine).

-- Anonymous, June 21, 2001

As the father of two small children, I'm constantly exposed to arguments against vaccines. _Parenting_ magazine promotes the fear that there's mercury in them, that there are potentially unknown side effects (_Vaccines: Do They Cause Autism?_). People who rely on sources like that can easly forget what the child mortality rate was in 1900. As the son of a polio survivor, I have never had any doubts. I get kind of irritated with _Parenting_ -- it never offers any hard facts. They act like vaccination is a matter of opinion, like whether or not to spank or whether or not to take the kids to church. It's all presented in the tone of _Hard Copy_, and there's never any acknowledgment of the hard fact that if you don't vaccinate and your kid somehow catches one of the serious diseases, he or she could die.

-- Anonymous, June 21, 2001

if you don't vaccinate and your kid somehow catches one of the serious diseases, he or she could die.

Or he or she could pass it on to some other kid who might die!

-- Anonymous, June 21, 2001

See, there's the non-logical part of my argument: the chicken pox WAS an inconvenience and a bother, and that was a really good thing. I got some one on one attention, a little break from school (a break that taught me a lot and removed me from a nasty situation), a great story, and some friends. There was a girl whose parents made her come to school while she was still scabby, and I was the only one who would talk to her. We became great friends. My grandparents took me to the snow by myself, no sister or parents. I still remember the pox parties the parents on our block would throw: toss the kids in a room with the contagious kid during the summer break or pre-kindergarten. Maybe it was the braces of my youth, the medical thing that one simply had to get.

So I'm biased. And yes, mumps sounded lovely. On another note: are flu shots required? Because the flu does kill people and is highly contagious. Just wondering. Oh, and if the kids are vaccinated, they can't catch the disease, right? So how would a NON-vaccinated kid pass the disease to them? That argument doesn't sound right to me. Dr. Jen?

-- Anonymous, June 21, 2001

Mumps? Lovely? Uh, no, they weren't, they weren't fun and they are potentially dangerous. (They vaccinate for mumps now? Wow. I had 'em and both my kids did, too. And we did all the regular vaccinations. I'm confused.) (This is normal, not to worry.)

I think you have to have vaccinations mandated because while there are a lot of parents who are on top of what their kids need, there are quite a lot of parents who are lazy or negligent, and having it become a necessity for the child to have it in order to attend school might be the only way to get some parents to get their kid the vaccinations s/he needs. Now, if these parents were bucking the vaccination because they objected to them on medical grounds, they should have some input (assuming the evidence they're citing is accurate). But a lot of what I've seen as a parent are other parents simply not bothering and not having a clue. Those kids need the mandate to have access to the vaccinations. (I'm not absolutely certain, but I think it also needs to be some sort of mandate before the public health system can offer them free to lower income families or through the schools themselves.)

-- Anonymous, June 21, 2001

At what point, though, is a disease sufficiently serious to warrant mandatory vaccinations? I mean, that's a pretty serious intrusion on personal liberty, taking it at its most basic level. I can see overriding the personal liberty interest for very serious diseases like smallpox and polio. But isn't there a point where the disease, although dangerous to some people, isn't serious enough to warrant mandatory vaccines?

If you can protect your own children against a relatively minor illness like chicken pox by vaccinating them, then maybe it's none of your business whether other parents vaccinate *their* kids ... since it's chicken pox, not smallpox or polio. Some parents also don't make their kids drink their milk or take their vitamins, but we don't make those things mandatory, either.

(I think the issue with flu shots has more to do with the relative scarcity of the vaccine.)

-- Anonymous, June 21, 2001

On another note: are flu shots required? Because the flu does kill people and is highly contagious.

Flu shots aren't required, although they are strongly recommended for those who are likely to die from flu (mostly old people). But the flu is fundamentally different from chicken pox, measles, mumps, etc. in that there are millions of strains of flu, and flu shots only protect you against the ones epidemiologists predict are likely to be prevalent that year (some years the guesses are better than others). This is also why you have to get a new flu shot every year.

With chicken pox vaccine, you only have to get it once and then you're protected throughout your childhood (and perhaps beyond), and if all kids got chicken pox shots, the disease would probably eventually become exceedingly rare or die out altogether. Flu shots, on the other hand, won't eliminate the flu virus, because with the present technology there's no way to kill all the possible flu strains.

It would be a lot of work to mandate that every kid got a flu shot every year, and even if they did, flu shots are a lot less effective than most other vaccinations.

Oh, and if the kids are vaccinated, they can't catch the disease, right? So how would a NON-vaccinated kid pass the disease to them?

I'm not sure whose argument you're referring to here...

But, like I said in my post above, chicken pox vaccine (like all other common vaccines) is highly effective, but not 100%. So, it is possible for a kid who is vaccinated to still get the disease, but it's less likely than if he or she were not vaccinated.

-- Anonymous, June 21, 2001

Sorry--I may have combined two posts with that question. I was responding to the possibility of your child passing the disease to another child. If the other parent hasn't vaccinated their kid, they know that infection is a possibility. Then I don't feel bad for them. Pffpt.

Those are logical reasons for no flu shots. I am pressured every fucking year to get one by my relatives and co-workers and the occasional doctor. Sometimes I get the flu and get sick, sometimes I don't. I'm not in a high-risk group, I handle sickness pretty well physically, I have a serious problem with needles, and the vaccine is usually in short demand. You can chalk this up to one more non-logical reason I have against mandated (let alone faintly recommended) shots. I think Beth has a good point about basic freedoms as well.

-- Anonymous, June 21, 2001

One good reason to vaccinate against chicken pox is that although you can only get the disease once, the virus stays with you for the rest of your life... and in some cases turns into shingles... which is quite painful (ask my Dad), and can continue cause pain for long after the rash has healed.

http://www.niaid.nih.gov/shingles/cq.htm

Also, if you aren't vaccinated, but don't contract it as a child, you run a chance of getting chicken pox as a teen or adult... making your risk of complications much higher.

Still not a disease threatening to eradicate large portions of the population, so the mandated vaccinations make me a little nervous (where do we draw that line?), but vaccinations seem like a good idea.

-- Anonymous, June 21, 2001

Mumps are dreadful. The MMR (Measles/Mumps/Rubella) inoculation wasn't mandatory when I was in elementary school, and it isn't the fun and romantic disease the books make it seem it is. Of course, I always wanted TB after reading Little Women.

The Chickenpox innoculation, as I read from the chart at the doctors, getting all my shots to move to America, isn't really to protect the children, it is to protect the adult men and pregnant women those children grow up to be, or be near. Chicken pox in adult men causes terrible things - sterility was about the least scary thing on the list and the most common, but I can't remember the others. In kids, chicken pox is a dreadful annoyance, but in adults, it is brutal.

So the idea is, to protect pregnant women and adult men, we innoculate them as kids, so that they can avoid getting the disease when it is annoying, or being part of a pandemic in schools, where all it takes is one sick kid to infect them all, and to keep them from bringing it home to their own parents. The bonus is that they are still protected as adults themselves.

-- Anonymous, June 21, 2001

I guess I would be more supportive of the "basic freedoms" argument if someone could give me an argument against vaccination which sounded even vaguely like it overrode the concerns of public health.

Also, this is not just an individual issue. If you choose not to vaccinate your child, it risks not just your child's health, but the health of every other person your child comes in contact with. As I mentioned before, vaccines are not 100% effective, which is why high compliance is such an important factor in using them to contain epidemics. Measles, mumps, polio etc. are almost unheard of in America today, not just because you and I are vaccinated, but because all the people who might have otherwise given us those diseases are also vaccinated.

And finally, I want to point out that these vaccinations are being required to attend public schools, which already have many requirements of their students which compromise their individual freedoms such as dress codes and restrictions on religious speech. If parents don't approve of those conditions, they can home-school their kids or send them to private school. The same applies to people who don't want to protect their kids against potentially serious diseases for whatever crazy reason.

-- Anonymous, June 21, 2001

Easy, easy. I don't think anyone here has argued against vaccinations. Just a little questioning. I was kinda hoping that one of the no-vacc people or a representative thereof would poke their head up because I am very curious about how they do it. Regardless of how much sense full vaccinations and public policy make, there are a huge boatload of people who have problems with the current shot requirements. I had no idea that it had gone as mainstream as Parenting mag. So nobody here is in that camp? No parents with doubts or questions or protests?

Anyway, just clarifying, as I don't understand how this is getting heated--no one really seems to be disagreeing. Oh, and fun fact: I had chicken pox more than once. Just wasn't severe enough until the last one. I wonder what the shot would have done for me...

-- Anonymous, June 21, 2001

I guess I would be more supportive of the "basic freedoms" argument if someone could give me an argument against vaccination which sounded even vaguely like it overrode the concerns of public health.

Um, but that's not the way things work in this country. We start off with the presumption of basic freedoms, and then the burden is on those who want to take those freedoms away to prove that the public health concerns are sufficiently serious to warrant that.

I'm not saying that burden isn't met in the case of chicken pox or other childhood diseases. I don't know enough about chicken pox to have an opinion on that. But it does seem to me that mandatory vaccines aren't something to take lightly.

What if they came up with a vaccine for the common cold? Should that be mandatory? What about a vaccine against something less communicable, like herpes? Mono? Do we make any available and effective vaccine mandatory for school children just because we can?

-- Anonymous, June 21, 2001

Also, if you aren't vaccinated, but don't contract it as a child, you run a chance of getting chicken pox as a teen or adult... making your risk of complications much higher.

I have never had chicken pox. My twin sister got it when we were four, but I had been hospitalized for a broken elbow. She was not allowed in the hospital to visit me, and for a long time, she blamed me for stealing her limelight, by having a more glamorous (and non- contagious) injury.

Please innoculate your kids. I'm 28 years-old, never getting younger, and I'm scared to friggin' death of getting chickenpox.

-- Anonymous, June 21, 2001

h--I'm not heated. I guess I just sound that way!

But to address Beth's point:

We start off with the presumption of basic freedoms, and then the burden is on those who want to take those freedoms away to prove that the public health concerns are sufficiently serious to warrant that.

Well, it's been well established that chicken pox is an extremely common, highly communicable disease which at its worst can kill, and at its very mildest requires many missed days of school and/or work and at least one doctor's visit. I think that constitutes a public health concern. And there's a vaccine which could probably eradicate that disease if it were given widely.

The only counter-arguments I've ever heard against that vaccine are people who don't believe in medical intervention for religious reasons and those who are suspicious of vaccines in general (despite the fact that it's been around for something like 30 years now, and nobody has ever died or been seriously ill from getting it). To me, these arguments don't even come close to overriding the obvious public health benefit of a widespread vaccination program.

-- Anonymous, June 21, 2001

Well, I guess you could put me in the questioning camp at this point in time. When I had my older son (3 years now), he went through the whole schedule save for the new Prevnar vaccine and Chickenpox. I was very ignorant at the time and followed my doc's advice pretty blindly. However, my mindset, in regard to the medical community, has changed alot since I had my younger son (7 months) who has yet to get one shot as I want to do selective vaxing with him after I finish doing my research.

Most of my concerns with the vaccinations come with what is in the vaccines [fetal bovine serum, formaldehyde, thimerosal (which is being phased out) etc.] and how we bombard infants who are just barely building up their immune systems from day one. As it is, from birth to age 2, the CDC recommends 20 different shots for 11 different vaccines. That's alot for a small, growing child.

The current recommended vaccination schedule for infants starts with Hep B right after birth. This is primarily a sexually/drug use transmitted disease - why does an infant in the United States need to be vaxed against that. They certainly won't be indulging in such risks until they are at least 12 years older (sad to have it be such a low number), so I'd rather wait for my son to get it when he's a teenager if he chooses, too, like I did. I have it, despite not engaging in the risk factors, since as a midwife I will come into contact with more than your average amount of bodily fluids.

As far as the other vaccines, I honestly will probably have them given to my son after he turns two. By then the suspected risk for developing autism from MMR (the jury is still out on that, of course) will be over and he'll have had 2 full years of breastfeeding and gentle immunity built up to base the vaccines on. I plan on doing the MMR. The concerns of loss of fertility (mumps) and the potential for birth defects in pregnant women who contract Rubella, make sense for me to want to vax him. Tetanus is also a given as we are outside alot and hope to have a small farm in the future which raises the risk. What I find interesting about polio is that the only cases in the US today have been contracted from the vaccine itself even though it is a very small number. I will still probably have Caedan vaxed for that at some point as I don't wish for it to come back any time soon. Pertussis/whooping cough is probably the least effective vaccine from what I've read (I've read numbers as low as 50% effective) and what gets me is the difference in diagnoses that many doctors give children who contract it based on their vaccination status. If a child hasn't been vaxed it's labelled pertussis, if they have it's just whooping cough or a virus.

Chickenpox to me is something I want my sons to have "wild", not from vaccine. Someone mentioned shingles earlier - some people have still developed shingles from the vaccine, so it certainly isn't a cure-all there either. If worse comes to worse and I have yet to get my sons exposed to CP by the time they are teenagers, I will consider the vaccine because of the complication it causes in adults. At least they'll be older and not need a possible booster (it's unknown how long the CP vaccine truly lasts) until they are much older rather than possibly needing one in their 20's.

As far as dealing with the school systems and state law requirements, parents do have a choice even if it may not seem like it. Every state offers some kind of waiver (philosophical, religious, etc.) for parents to avoid the requirements because if they didn't they'd be opening themselves up to lawsuits over the cases where a child or adult has reacted to a vaccine and became ill or, worse, died. In our case, we plan on homeschooling our boys so we will not have to deal with the requirements. In the case that we do choose to enter private or public schooling we'll use a philosophical waiver.

Anyhow, I guess in my roundabout way, I'm saying I don't have so much of a problem with most vaccines as I do see the public good when it comes to some of the more serious ones, but rather the pervasive way they are forced upon our kids at such a very young age.

-- Anonymous, June 21, 2001

To bring up another possibility. Many of us are convinced that the rise in autism in children---much higher than those of other mental deficiencies---in the last two decades---is not a "phantom" statistic, caused by better reporting (in which case we would think other mental deficiencies would seem to rise at the same rate---which it doesn't.)---but something real, an alarming epidemic among the young. Twenty years ago, an autistic child was one in ten thousand. These days, it's one in five hundred. A twentyfold increase. Even if only part of it was real rather than apparent, that's a frightening statistic.

Many suspect the MMR shot---measles-mumps-rubella threefold shot---as being TOO shocking to many young kids' systems, and many who might have a genetic weakness in that area become autistic. That seperating the shots might be better for the children.

I personally do not think the evidence justifies the idea of the MMR shot being the cause of some autism, and several studies seem to agree with me. But perhaps we should look into seperating those shots, just in case.

Al of NOVA NOTES.

-- Anonymous, June 21, 2001

Okay ... so accepting that you're correct about chicken pox, we'll accept that the vaccine is a good idea in that instance, and that perhaps we even have enough to warrant mandatory vaccines. But you still haven't answered my question about where the line is drawn, and you got right back to saying that the public health concern wins out because there aren't any arguments against it. The biggest argument, of course, is that people have a right not to undergo medical procedures without their informed consent, without compelling state interests to the contrary. Again, we'll accept that you've established that compelling state interest for chicken pox. What about other diseases? What criteria do we use to decide?

Arguing that vaccines are only mandatory for children attending public schools is a little disingenuous, since we have compulsory school attendance, many people can't afford private school, and not all communities permit home schooling. By that same logic we could require all women in government jobs to have yearly mammograms, and all men to have prostate exams as a condition of renewing their driver's licenses. Fortunately we do take medical freedom a bit more seriously than that.

-- Anonymous, June 21, 2001

Errghh ... Greenspun took forever to let me post that, and the last two replies came in in the meantime. That was a reply to Jen.

-- Anonymous, June 21, 2001

Please innoculate your kids. I'm 28 years-old, never getting younger, and I'm scared to friggin' death of getting chickenpox.

If that's the case, Nita, you need to go and get yourself vaxed. The vaccine is not just for kids.

Varicella virus vaccine is approved for use among healthy 
adolescents and adults. 
      • Persons 13 years of age or older should be administered two 
0.5-ml doses of vaccine, subcutaneously, 4-8 weeks apart. If more than 
8 weeks elapse following the first dose, the second dose can be 
administered without restarting the schedule.
      • Vaccination is recommended for susceptible adolescents, 
adults, and health-care workers and family contacts of 
immunocompromised persons.
      • Vaccination should be considered for susceptible persons: 
teachers of young children, day-care employees, residents and staff of 
institutional settings, inmates and staff of correctional settings, 
military personnel, and women who are not pregnant but who may become 
pregnant in the future.
      • Vaccination should be considered for international travelers 
who are not immune to VZV infection. 

From the CDC themselves: http://www.cdc.gov/ncidod/srp/varicella.htm#vaccine

-- Anonymous, June 21, 2001

Side question--is the only way to get the measles/mumps/rubella shot in the three-in-one? That would be kind of silly if by splitting them up the medical establishment could get more kids vaccinated. Hey, I even had the shots for my puppy split up. The vet said it was a reasonable choice, since in a small percentage of pups, immune system crashes happen after the multiple vaccinations. Why take the risk? Can't help but think there MIGHT be a similar situation in kids...

If you requested to split the shot up for your child, could you do it? I think that the 3-in-1 is great for parents who are fine with the system or who are less responsible, but for those who have unanswered (and researched) questions, splitting might calm some anxiety.

Thanks to everyone who is poking their head in from the unpopular side--I knew you were out there!

-- Anonymous, June 21, 2001

Beth, I see your point about personal freedoms, and yet, I think we have to recognize that we do have safeguards against negligent parenting. It certainly doesn't include not giving them their vitamins or making them drink milk (or exercising and not doing a host of other harmful things), but if someone failed to feed their child or give them basic care, there are laws which would allow the state / social services to step in for the child's benefit. While personal freedoms are critical, it's such a fine balance when the child may not have a voice (or the knowledge one way or the other) to help themselves.

Where do you draw the line? I doubt we'll ever really know that. I don't think it's a finite thing which can be drawn, since we're always going to be learning more about health and welfare and repurcussions of medical choices. (There are too many examples of a medicine which was deemed perfectly safe by many studies and the FDA which then later had to be pulled because of a side effect which ended up being far worse than foreseen -- or was never foreseen.) If we err, I'd rather err on the side of making available / mandatory a healthy benefit to children. I think if we were talking about an elective type of thing, something superficial (like being able to make the child taller or something), then the infringement on personal liberty would be obvious. But when you're talking about children who may not have any other access to health care except that which is mandated by the school system, and when you have many parents who are either negligent or uninformed or just plain means-well-but-is-clueless, then having some sort of mandatory process in place is a plus. Besides, I suspect we'll always have good attorneys who are looking out for those personal freedoms and child welfare to keep the lines in question -- which is the best we can do. While the mandate is in place, the personal right to question it and challenge it is also in place. As long as some parents remain uninvolved, something needs to be in place to assist their children.

I know we could get into a whole "it's the parent's responsbility" argument and argue against whether or not the state evern should be involved, but I doubt we'd get anywhere there, either. I would love it if every parent were involved and made informed choices (or at least, asked questions), but until that happens, the children need health care.

I'm glad to hear there are waivers for those who do not consent and I'm certain that if someone felt strongly enough about the subject and didn't want their child vaccinated, they would either find a way to have it waived or they'd go to bat against it, either through legal means or educational means / public outcries. Should they have to do this to cling to their personal freedoms in that sort of case? Who knows. I think it's part of the process which both educates us and helps us define and re-define freedoms.

-- Anonymous, June 22, 2001

You know, I'm actually in favor of mandatory vaccinations for serious communicable diseases, but I'm finding this discussion rather disheartening. It concerns me that we're so willing to say that the burden is on those who value personal choice to go to court, fight the system, etc., instead of making personal choice our default and requiring the government to affirmatively show a good reason to override that choice.

-- Anonymous, June 22, 2001

Beth asked:

What about other diseases? What criteria do we use to decide?

Well, developing a vaccine takes a lot of time and money, so vaccines are only developed for diseases that can cause serious illness or death and which are relatively common. It's not like there are millions of vaccines sitting around being considered for mandatory immunization.

But if there were a plethora of vaccines out there for all kinds of diseases, I think the criteria would be pretty straightforward--I would ask the following questions:

-Is the disease common?

-Is it easily communicable?

-Is the disease significantly disabling? Is it serious or even deadly?

-Could it be eradicated from the population with a vaccination program?

-Is the available vaccine safe and effective? Does it have serious side effects?

Obviously, you'd then have to weigh the answers to each of those questions and make a judgement as to whether the vaccine constitutes a significant boon to public health. But I think the case of chicken pox, the arguments are overwhelmingly in favor of requiring vaccination.

And are there really communities which don't allow home schooling, even for religious reasons? Even if so, I think you have to make a distinction between saying that immunization is "mandatory" and that it is required for enrollment in public schools.

By that same logic we could require all women in government jobs to have yearly mammograms, and all men to have prostate exams as a condition of renewing their driver's licenses. Fortunately we do take medical freedom a bit more seriously than that.

Actually, I have had several jobs where certain medical exams and vaccinations were required. The examples you cite are not really relevant to the subject at hand, as cancer is not a communicable disease, but pretty much anyone who works at any sort of health care center in the U.S. is required to take regular TB tests, and most require vaccinations against Hepatitis B, and yes, chicken pox. This is because hospitals, like schools, are breeding grounds for these infections. So yes, in the case of hospital employees, it is the same logic, and I think it's a perfectly legitimate requirement.

-- Anonymous, June 22, 2001

Home schooling is illegal in many places, if it's just a question of parents teaching their kids at home without any affiliation to a private or public school. Parents have been prosecuted under truancy laws if they could not meet the state requirements for a private school. That can include testing, licensing, minimum educational requirements for instructors, etc. I don't think any state bans home schooling outright, but some states make it much more difficult than most people assume.

-- Anonymous, June 22, 2001

You can give individuals (or families) the right to choose how to react to the more murky public health issues, but if the end result of that decision is causing other people increased health risks, then the question doesn't really just deal with their personal freedom but all of us and our rights.

That would be the question I would ask, as to how flexible to be in mandating vaccines or not.

-- Anonymous, June 22, 2001

That must of been some really good writing, to make mumps seem romantic! In third grade, I was out of school for nearly half a year, because I got measles, then mumps, then chicken pox, then mumps AGAIN (more than one gland can get them, and not always at the same time). None of it was fun but by far the mumps were the worst - imagine a horrible toothache sensation sitting back in the glands near your throat. Big fat cheeks, and it hurts like hell to cry because it all tightens up worse.

As far as chicken pox vaccinations go - great! Only my youngest has had it (with zero side effects) since the other three got their vaccination the old fashioned way - by exposure and dealing with the discomfort and potential scarring of the disease itself. Chicken pox is not normally life threatening, but like many childhood diseases it get more dangerous the older you are when you get it. So parents traditionally try to expose their children to it early. Sometimes, the kids don't get them enough and are still at risk from a second bout, sometimes they have a very severe case and wind up with a lot of scarring (in the case of one of mine, chicken pox brought on her first problems with excema that she still deals with, and has a lot of scarring). My husband never had chicken pox and had to avoid exposure to the kids - their run with chicken pox lasted nearly 2 months altogether, and thank goodness I wasn't working at the time.

Obviously, if there is a safer and more controlled method available that won't be infectious to other people, it should be preferred. Look at it this way - you're not vaccinating the child, you're vaccinating the adult they'll be someday.

-- Anonymous, June 22, 2001

Nita, I'll second the suggestion to go get the vaccine now.

I wish I had known about it before I got the chicken pox at age 25. It was terrible. No idea how I caught it, as I was not in daily contact with any children -- probably from some random person on the subway.

-- Anonymous, June 22, 2001

(Addressing an earlier question:) I understand that the triple MMR is given all at once because of the difficulty of getting patients to return for subsequent visits. Poor people in general have a more difficult time with time off from work and transportation to get their kids to a doctor once, let alone thrice; plus separating the shots means paying for three office visits. If the AMA recommends splitting up the shots against the chance of autism or overloading baby immune systems, it'll be another health advantage that the children of better-off parents have over the not-so-well-off.

Comment: Ah yes, shingles! I had shingles in the spring of 1998. Very itchy, very painful, but for me, luckily, neither scarring nor disfiguring. One of my first college acquaintances had already had shingles at age 18. Because the virus resides at a nerve ending, it affects half your body at a time. I had it around my right hip and itched for three weeks without scarring; the right side of his face was affected, permanently. The entire right half of his forehead was scarred as if by fire, as was his right eye to the degree the iris did not react as it ought to light. Chicken pox isn't a mild disease.

My own questions: did Beth (March, not Xeney) have TB (as someone wrote above)? She never coughed or spat up blood. I always thought that she had some conveniently vague and unspecified, romantic wasting disease.
Also, did anyone else try that toasted new bread with butter and sugar that J.D. ate to taunt his two older brothers when *they* still had mumps? I did; it's what got me liking the heels of loaves of bread. It's best with brown sugar.
And Beth (Xeney, not March), was it smallpox the Nolan kids got the shot for in their dirty arms? I figure that's the only disease that might have been vaccinated against in 1910--or could it have been tetanus? I always thought smallpox, because tetanus isn't contagious. Either I don't remember, or it's Smith's point that the family were too ill-informed to know.

-- Anonymous, June 22, 2001

Actually, I've been vaccinated for chickenpox, but I'm still scared silly of chickenpox.

-- Anonymous, June 22, 2001

Just for the record, the AMA does not recommend splitting up the MMR shots, nor does any other major medical association, nor do they plan to do so. There is now quite a bit of research on this subject, and there is no scientific evidence that MMR vaccination causes autism. For more info on this see the info on MMR from the websites of these major medical associations: The AMA
Centers for Disease Control
National Institutes of Health
American Academy of Pediatrics

-- Anonymous, June 22, 2001

I got chickenpox when I was 15. I was sick for a month, almost hospitalized. It was horrible. Huge blisters all over my body. On the bottoms of my feet. In my mouth. On my fingers. In my ears. EVERYWHERE. I was sick as a dog and miserable.

And scarred like a sonofabitch.

Hey, just what every teenage girl needs - big pox marks all over her face.

When the chickenpox vaccine came out I was first in line - sign my kid up, don't make her go through what I did.

Of course I checked into it first - found out the risks and all that, but if there was a way that I could prevent her having to go through that horror then it sounded like a good deal to me.

And when my son is old enough he'll get it as well.

I don't know if it is mandatory here or not - it is sorta moot since I already had her vaccinated, but I am all for it being mandatory. Yeah, you think it's some sort of infringement on your civil rights or something, well, wait till you have kids in the public school system and have them in class with other kids who are sent to school sick. Just because I keep my kids home when they are sick doesn't mean other parents do, and there is nothing like that feeling to go to school to pick her up and see a notice on the door about what the latest ailment is going around the classroom. "Wonderful, here is what I have to look forward to" I think and then hope that my kid doesn't come down with whatever it is.

Chickenpox is a nasty and unpleasant disease and if we can prevent kids from getting it then by all means, give them the shot.

- t

-- Anonymous, June 22, 2001

Thanks, but I am 100 percent certain that even if I had kids in the school system, I would not believe that my convenience overrode the right of other parents to make decisions for their children in matters that weren't life-threatening.

Notice the caveat -- life-threatening diseases, hey, I'm all for mandatory vaccinations. But otherwise, you all are scaring the living shit out of me. No wonder we have no privacy in this country.

-- Anonymous, June 22, 2001

Whoa, wait a minute. I don't want to have the default shot split up. I support the promotion of the 3-in-1 and the requirement for each vaccination included. I'm also not convinced by the autism argument (as I stated above). What I'm wondering is if, since the three vaccinations are required in any case, concerned parents could split them up if they wanted. To use my puppy, yet again: the vast and overwhelming majority of pups get their shots in big combos. This is good because otherwise a whole bunch of people wouldn't return for separated shots and the risk of distemper or rabies is way worse than that of an immune system crash.

BUT, I do have concerns about the combo shot, and when I asked (the vet didn't offer up the info), I had the option of splitting it up. I'll still need to get all the shots to license my dog or take obedience classes--the requirement stands. I just had the option (if I did the research and specifically asked) to break them up.

Again: yay 3-in-1, yay requirement. Does one have the OPTION of splitting up the shot? That one little choice seems to be what is frustrating a lot of the concerned parents. And I should think that those are the parents who would return. Besides, they have to get all of the shots anyway to participate publicly.

-- Anonymous, June 22, 2001

Notice the caveat -- life-threatening diseases, hey, I'm all for mandatory vaccinations.

The only problem with that argument is that I can't think of a single disease which isn't sometimes life-threatening. Kids and old people are especially susceptible to weird complications from typically benign illnesses, as well as people who are immunocompromised due to HIV, chemotherapy, steroid treatments for asthma or other problems...

Also, death is not the only serious potential outcome of illness. Common communicable diseases can leave you blind, deaf, paralyzed, disfigured, brain damaged, infertile, etc. I think preventing my (hypothetical) kids from being exposed to diseases with such potential outcomes constitutes much more than mere "convenience."

As for the MMR being split up, I'm sure you can do it, but it seems a bit cruel, given the lack of any medical support for doing so. Splitting up the shots means exposing your kids or pets to three times as many painful needle sticks.

-- Anonymous, June 22, 2001

Vaccinating your own children against rare complications certainly is within the range of choices it's reasonable for a parent to make. I would in all likelihood make that choice if I were a parent. But at some point it is a question of convenience. Illness is a part of life; it's certainly part of childhood. Deciding not to vaccinate children against diseases that don't pose a serious threat of complications is also within the range of reasonable choices a parent might make.

What really troubles me about the discussion here is the unquestioning acceptance of government control over our decision- making. I don't know about you, but I want the government to have a damn good and compelling reason before they make anything I do or do not mandatory. That limitation on government control, to me, is an inherently good thing. It's depressing as fuck to see so little concern for that here.

(Depressing enough to make me turn off moderator notification for this board, because I don't want to read any more of this. You all are bumming me out and making me feel a little hopeless about this country. Have a nice day; I'm turning off my end of this board until Monday.)

-- Anonymous, June 22, 2001

With the puppy shots, the three pinches are worth the tradeoff for a possible crash and the resultant lifelong care that dog will need. Granted, the vet establishment recognizes and acknowledges that such a crash is possible (vs. the autism thing). It just seems to me that those parents who are into the autism thing don't object to the vaccinations themselves but to the combination. Hell, make those parents dance a little jig, bring it up on their own, fill out a few forms, and if it will get a few more kids vaccinated (instead of pulled out of the system entirely), split up the shots. It sounds like mumps are more painful than a shot. The pain argument doesn't work if the alternative is those three diseases. Just to clarify (since I'm still not quite sure what the answer is): so you can't split the shots up, period? And again: I support 3-in-1. I just want to know if the paranoid parents have an argument here.

-- Anonymous, June 22, 2001

Deciding not to vaccinate children against diseases that don't pose a serious threat of complications is also within the range of reasonable choices a parent might make.

Yes, but by making that choice for their own child, a parent is also making that choice for all the other people the child will be exposed to. Vaccines do not convey 100% protection (and they are especially ineffective in people who have weak immune systems to start with, who would be the most susceptible to those illnesses).

Immunization programs against epidemic diseases fight those diseases in two ways: they decrease risk both at the level of the individual (by decreasing one's susceptibility if they are exposed to the disease) and at the level of the population (by exponentially decreasing the risk that people will be exposed in the first place due to a smaller number of carriers). Saying that this is a matter of individual choice disregards the latter objective of a vaccination program, which is ultimately the more important of the two.

-- Anonymous, June 22, 2001

Sigh. And minor illnesses are a part of life, and it's not the rest of the world's responsibility to protect your children against any and all risks.

Honestly, never mind. This isn't going anywhere. You said that the chicken pox vaccine was 100% effective against more serious complications of the disease, so even if it's only 85% effective against minor infections, then we're supposed to make it mandatory to protect people against a 15% chance of a minor illness? You think that's okay? If you do, then we have nothing else to talk about, because to me, that's fascism, and to you, it's just science.

-- Anonymous, June 22, 2001

Trust me Beth, there are still lots and lots of minor illnesses around that kids can and do get and can and do give each other (and each other's parents, parent's co-workers, etc, etc) - being able to eliminate the problems of *some* of them won't take that fact of life away.

But just saying 'it's a part of life' isn't really compelling for me - smallpox was once a fact of life. Disfigurement from polio was once a fact of life.

Compulsory shots seem actually less intrusive now than they were when I was a kid - no only did I HAVE to have a polio shot to stay in school, but we had the shot (and annual TB tests) IN school.

You mention that it's not fair to make certain health procedures mandatory to be in public school because school itself is mandatory - but if that's the argument, then shouldn't that be where the fight is, too? Make school not mandatory (or make alternatives more readily available). Because as long as it's mandatory for MY kids to be there, I expect there to be reasonable precautions taken to ensure it's not a requirement that my child be exposed to all manner of contagious disease from OTHER children whose parents are making 'reasonable choices' that has major effect on me and mine - and a disease that leaves scarring isn't 'minor' to the kid whose going to have a horrible adolescence being teased about it, not when the solution is available.

Frankly, I don't think the schools do nearly enough disease control - not when I hear of there being half the teachers AND students out sick, coming in still sick and contagious with lord knows what - and it just gets passed around and around for months, and no one ever seems to decide at a certain level of sickness that maybe it's time to shut down for a week and let the bug die out. They don't give excused absenses if you want to take your own out to keep them from getting sick.

All that said, I don't have much of an opinion on the vaccine being made mandatory, I'm just thrilled it exists at all. But what will happen to the kids who don't get it is that they're going to have an increased likelihood of contracting it as an adult, as there will be fewer opportunities for them to contract it 'wild' in childhood (since most kids will stop getting it). So, uh... best of luck to 'em.

-- Anonymous, June 22, 2001

And minor illnesses are a part of life

Sure, and so are drunk drivers. That doesn't mean we shouldn't take steps to protect ourselves and our kids even if it means restricting the rights of a few in order to protect the health of many others.

You said that the chicken pox vaccine was 100% effective against more serious complications of the disease, so even if it's only 85% effective against minor infections, then we're supposed to make it mandatory to protect people against a 15% chance of a minor illness?

The article I linked said that it was "almost 100 percent effective" in controlled trials which was definitely some sloppy paraphrasing on my part. Sorry. So some very small, but non-zero, number of people who are vaccinated will still be susceptible to severe disease. But also, a child who is vaccinated and contracts a mild form of the disease is still going to be a carrier, and can pass that disease along to a non- vaccinated person, or a vaccinated person with a weak immune system.

Even if the vaccine did confer complete protection against severe illness, I still think governments should have the right to take steps to ensure that kids, teachers and their families are reasonably protected from epidemic disease in the public schools when a safe, effective vaccine is available. People who don't want their kids to be vaccinated have many options for doing so, as has already been articulated.

-- Anonymous, June 22, 2001

I don't know. Do you think it is possible to use the same reasoning as an extension to justify implanting microchips in everyone's kids or some other alarming invasive act?

I'm just curious, if the logic of vaccinations is rather specific, or can it be expanded for more ominous reasons?

-- Anonymous, June 22, 2001

the vet establishment recognizes and acknowledges that such a crash is possible (vs. the autism thing).

h, are you sure about this? I hadn't heard of immune crash as a possible side effect of MMR until this discussion, and wasn't able to find anything about it online except on a few private anti-vaccination websites which didn't have any actual scientific data. Do you know of any data out there?

-- Anonymous, June 22, 2001

That's because she wasn't talking about MMR. She was talking about shots for dogs, which is why she said "vets" and not "doctors."

-- Anonymous, June 22, 2001

governments should have the right to take steps to ensure that kids, teachers and their families are reasonably protected

Actually, governments don't have "rights." They have privileges and responsibilities. A crucial distinction that unfortunately seems to be lost on too many people.

-- Anonymous, June 22, 2001

I think I'm in agreement with you, Beth.

I'm generally in favor of vaccinations and had the usual ones when I was growing up in the 50s. But I think requiring the chicken pox vaccination is going too far.

I do think our culture has gotten to a point where we are overemphasizing killing germs and trying to eliminate all risks.

-- Anonymous, June 22, 2001

I am reading this whole thread, and the thing that sort of bothers me is that the discussion seems to be 'do we have to be mandating innoculation for minor or inconvenient disease'. But chickenpox, which is the example that keeps popping up, isn't a minor or inconvenient disease - it takes kids out of school for weeks at a time, is incredibly easy to transmit, causes adult men to be sterile, causes gross deformity in fetuses, and is considered a major cause of heart problems in young adults.

From the CDC records, until immunization came about, 4 million people a year in the United States had chicken pox. That is a tremendous amount of class and work time, lost. 11 000 people a year were hospitalized. That seems like a tremendous strain on resources, especially when you consider that Polio, which no one seems to have a problem with immunizing for, was only reporting 13 000 to 20 000 cases a year. And while Polio, it can be argued, causes long term effects, so does Chicken pox. Childhood Chicken Pox is being linked to heart disease in young adults.

So it isn't just the dreadful itching and scars that you have to worry about - it is also about keeping it suppressed in the population, to protect men's reproductive health, pregnant women, and to protect children's future heart health, a topic near and dear to me, childhood chicken pox sufferer and young adult with heart disease.

Measles? Kills an estimated one in a thousand who contract it. Hep-B? One third of the people in America with Hep-B contracted it as children. Mumps was the leading cause of deafness in children before immunization.

I know I sound all soap box-y about this, and I really am not, I swear it. But I know that I would sure as hell have rather had the chicken pox vaccine at the age of 5 over the heart attack at 17, and I would be willing to bet that women who gave birth to mentally retarded children as a result of their own childhood exposure to Rubella would be wishing they had had the MMR. If you can suppress a disease, why not suppress it?

-- Anonymous, June 22, 2001

You're right...shoddy speech there. *I* the the right to have my family's health reasonably protected while in government sponsored facilities.

Again, the issue is that public school itself is mandated - if that's the case, then I think the rights of the parents who wish NOT to have disease run over their family as a result of obeying the mandate to attend school gets higher concern than those who wish not to vaccinate. Those who wish not to shouldn't have to - but they may need to consider an alternative educational arrangement, and the government has a responsiblity to ensure that alternatives (such as homeschooling) aren't so burdensome to apply that the alternative doesn't really exist.

And yea, my opinion is that that is going to lead to some uneducated people likely to get some major diseases after their grown, and that those kids had THAT mandated on them without their input, too. But, I guess that's a fact of life.

-- Anonymous, June 22, 2001

That's because she wasn't talking about MMR. She was talking about shots for dogs, which is why she said "vets" and not "doctors."

Sorry, yes, I accidentally wrote MMR instead of dog combo vaccines. But my question still stands. I did a web search and wasn't able to find anything scientific regarding an immune crash, but maybe something's out there and I just wasn't able to find it.

-- Anonymous, June 22, 2001

Totally off-topic now:

Jen--not being research girl (damn English major), I can't provide you with any sites or the name of the syndrome I am referring to shadily as "immune crash." I have no idea if it has a formal name. It is real, however. Certain breeds are more prone to it (Cavalier King Charles Spaniels, for example), but it can hit any breed. My vet knew about it (and seemed pleased that I was informed), my breeder warned us, and if you ever watch Animal Planet's show, Emergency Vets, they have a case come through every now and then. I am also on a mailing list with people whose dogs crashed (4 dogs out of perhaps 600 people on the list). It doesn't happen often, but it does happen. It probably wouldn't have happened to my dog, but now I know for sure it won't. I don't know if this is at all applicable to the topic at hand, but I did appreciate the opportunity to split the shots.

-- Anonymous, June 22, 2001

I think this book is the primary resource, although it looks like their studies are ongoing. I found references to complications arising from multiple vaccines on every vet info site I looked at (see here), although the only peer-reviewed article I found on the subject was just an abstract from a journal in South Africa.

I suspect that safety testing for animal vaccines is far less rigorous than it is for humans. Cats, for instance, are susceptible to injection-site sarcomas. Presumably if our kids were getting cancer at the site of their vaccinations, we'd stop vaccinating them, right?

-- Anonymous, June 22, 2001

Still off-topic:
Jen--I did some surface poking around in my mailing list, and most of the immune system crash cases mentioned one Dr. Jean Dodds, DVM, as being the current torch-bearer for research and speaking. I have no idea if she is a nut, but there were a bunch of results on yahoo when I typed her name in. Most of them were in medical blabber-jabber, but I hear that you can read that stuff. Even if she is (a nut), I still believe there is something going on: my vet is very conservative medically, but she knew immediately what I was talking about and discussed it with me for a little while.

-- Anonymous, June 22, 2001

It sounds to me like the combination vaccine risk theory is pretty controversial, and is mostly based on anecdotal or questionable evidence (the research in the book Beth cites is based on self-reported questionnaire data, which is not a very accurate method of data collection). This page seems to be more in line with what most of the major veterinary sites are saying, although admittedly, I only looked at a few.

Attempting to steer us back on topic, though, I do think it's interesting that a theory with apparently so little evidence to support it has gotten such widespread attention, and it's an interesting parallel to suspicions about the dangers of vaccines used in humans.

-- Anonymous, June 22, 2001

Canismajor.com is a terribly unreliable site. Just so you know. For instance, they once came to the astonishing conclusion that deliberate dog breeding has no impact on pet overpopulation. That site is partially maintained by a dog breeder who is, as far as I can tell, a nut. I'm not sure what their bias could really be in a case like this one, but I certainly wouldn't take that site's word as gospel on anything, especially when they don't cite any sources.

Most of the veterinary sites I found said that a certain percentage of dogs do run the risk of problems with the combined shots, but that it was a small risk. I'm not going to rerun my search, but it was the major vet resources that come up in Yahoo. Canismajor is an advocacy site, not a veterinary resource.

-- Anonymous, June 22, 2001

on topic: I can understand where the parents are coming from--their healthy kid suddenly goes autistic, and I imagine they are scrambling about for any answers they can find. I suspect that there are other suspicions, but the vaccination one garners all of the attention because it is contraversial and kids are required to get the shots. That doesn't mean that I think that is what happening, but I can see how the panic has spread.

off topic: I guess I'm just going to be bitchy about this, but really, Jen, my vet has diagnosed and treated a few dogs (2 or 3) after crashes, the vets on the tv show didn't seem like they were seeing an unheard of syndrome, there seems to be an acknowledged treatment for such crashs and a schedule that avoids the possibility, and the vaccine manufacturers even admit to a slim chance of such a thing happening. It seems very reasonable to me that certain breeds have a higher risk for whatever genetic reason, and they might not have been covered in the manufacturer's trials. I would love to see a trial that included all breeds...good luck. Lest it get all mucked up again, however, I do NOT equate this to the combo vaccines with kids. I was just paralleling the ability to divide shots.

-- Anonymous, June 22, 2001

While I honor and sometimes embrace philosophic absolutes, pragmatic concerns erupt here. Let me explain: Teaching children places me in the company of children for long continuous hours, in sickness and in health. Sickness often being more evident than health in public school, I catch what they catch--and carry. As a consequence I endure many viruses and infections. This spring, by means of the Typhoid Mary effect, I was given the measles by a child whose younger brother had them, as I did when a child. While immunity is not necessarily perpetual, whether come by naturally or through inoculation, it can help. Like others, I love teaching, don't mind the poor pay, but am approaching my limit. Poor is one thing, sick is another.

-- Anonymous, June 22, 2001

h, just because a dog gets sick after being vaccinated doesn't mean that the vaccination caused the illness, just like a kid becoming autistic after being vaccinated doesn't mean that the vaccination caused the autism. I just haven't seen any substantive non-anecotal evidence to support the immune failure theory, and all the sites I've found which tout this theory either provide no references at all or cite references which have dramatic flaws.

-- Anonymous, June 22, 2001

Jen--I'm done arguing the dog vaccine question: my highly respected and *conservative* vet, as well as most veterinary sources I ran across earlier, recognize this is a risk (albeit, once again, a very slim and probably genetically influenced one) and know how to treat the problem if it does occur. In either vaccination case (all at once or broken up), the dog ends up fully vaccinated within the proper timeframe.

Again, and I don't know why I have to say this again, I'm NOT equating this to the autism thing. I AGREE WITH YOU about the autism thing--no proof that it is caused by vaccinations. The dog shots came up only to illustrate a point about flexibility in the process. When the shots get split up, the dog (or hypothetical kid) would still end up getting their vaccinations. I just wondered about that component. Otherwise, the two situations are not alike--kids don't come in breeds, the vaccines we use for children are presumably much more researched, and people are very slightly less crazy about their dogs' health.

-- Anonymous, June 22, 2001

What the hell, since we're totally off in left field anyway: I never thought that I would say it, but damn, Jen, I now know the addictive compulsion to argue with you, a tendency I have previously only witnessed from afar. I just can't stop, and since you are a last-word type of gal, I'm hopelessly stuck. It's a strange kind of allure to possess. Have you considered politics or rearing a teenager?

-- Anonymous, June 22, 2001

Well, you know, I wouldn't need to do it if everyone else weren't so damn wrong all the time...

That was a joke, btw.

-- Anonymous, June 22, 2001

Jen, I think it's only fair to warn you that I remember Dave saying that once.... Let us know if you need an intervention. We can take you to a group therapy session and force you to validate and respect everyone's sources. Erm, feelings.



-- Anonymous, June 22, 2001

I don't think the MMR vaccine is the culprit either; OTOH, although vaccines for children might be fairly well investigated (although the only way to guage long-term effects is to wait for them to happen) autism is minimally researched, and quite frankly, it's even worse under this administration. We haven't the faintest idea what causes it, and less how to prevent it, although obviously there's a genetic component, or why there is an apparent twentyfold increase of it in the last twenty years.

I think the MMR vaccine got a bad rap because it's close to the age when language starts forming, and the delayed or nonexistence of language developement is the main sign of autism. Before, there ARE no signs. On the other hand, if I knew of a family that had one autistic child or sibling to the parents, I would warn them of the suspicions about the MMR and perhaps suggest they talk with their doctor about getting the shots seperately. It certainly can't hurt...

Autism is a riddle which has no clear answers, no tests besides behaviorial ones, and no current hope of cure. If people understandably look for a cause for the rise of same (again, most suspect it would only happen to those children who had a predisposition to it) in the environment, it was a reasonable suspicion. It just doesn't seem to be borne out by the (very, very few) studies done with control groups and actual populations.

Al of NOVA NOTES.

-- Anonymous, June 22, 2001

Lynda B said: "All that said, I don't have much of an opinion on the vaccine being made mandatory, I'm just thrilled it exists at all. But what will happen to the kids who don't get it is that they're going to have an increased likelihood of contracting it as an adult, as there will be fewer opportunities for them to contract it 'wild' in childhood (since most kids will stop getting it). So, uh... best of luck to 'em."

I totally agree. Given how much worse it is to get it as an adult, I think it's a horrible idea to let them catch it "wild."

I have never had chicken pox. I don't remember anyone in school ever having chicken pox, yet somehow they had all had it by the end of elementary school and I never did. I spent many years freaked out that I was going to get it as an adult and it would fuck me up. I insisted on getting vaccinated for it when I was leaving for college- but oddly enough my blood test turned up that I'd already been exposed to it and never got it. No need for a vaccination. Phew.

-- Anonymous, June 25, 2001

Jennifer, my experience with not having chicken pos is much like yours. I didn't freak out about possibly being exposed, but never having had Chicken Pox (or Chicken Pops as I called them when little,it was of a bit of concern, especially when I was pregnant. (There was no vaccine at the time and I've still not been vaccinated.) Interestingly enough, my mother never had chicken pox either despite direct exposure many times. I wonder if there is some genetic thing that makes us carriers.

When my son was born nearly nine years ago, I did a lot of research into vaccines and the pros and cons. Living in Santa Cruz provided for a lot of friends and acquaintances being firmly in the no vaccination camp. That choice did not resonate with us, but our research at the time revealed some interesting information about the polio vaccinations.

We could opt to give Aidan the live virus via a liquid or the dead virus via an injection. Even though very small, the only way a person could become infected with polio from vaccinations was through the live virus liquid which was the most common method of giving the vaccination. We opted for, and quite frankly had to argue to get, the dead virus vaccination through an injection. (Both the dead and live virus vaccinations were equally effective as vaccinations.) It offered the zero possibility of obtaining polio, but the nurse thought I was the worst mother in the world for subjecting my son to an injection when he could have had a liquid. Regardless, I have never had an ounce of doubt or regret over that vaccination. Even though the chances of getting polio via the liquid were small, there were reported cases. When faced with the opportunity of small risk vs. no risk, I opted for the latter even though it put my son in a very temporary amount of pain.

As to my son having the chicken pox vaccine - I honestly don't know if he's had it or not. I know for his last round of vaccinations it was not mandatory. I know we did some research about the risk factors, but try as I might I can't recall whether or not he got the shot. I just know we had a choice. (I don't have a copy of his vaccination record here at home.)

Oh and Beth, I agree with you whole-heartedly. I share your concern about making such things mandatory for the very reasons you do. Us agreeing on a semi-political topic? Who'd have thought?

-- Anonymous, June 25, 2001

When it comes to chicken pox, what I'm worried about is how when those children grow up to be irresponsible college students/adults and let their vaccinations lapse (when did I last get a tetanus shot? ummm...), those of them that have contact with children might rather easily catch this contagious little disease. It's much more serious in adults than in children, isn't it?

(Pause for some research to alleviate ignorance on whether the shot requires boosters, etc.) Okay, from what I can see, the vaccine is only given once, but 'some doctors' believe it may wear off over time. That actually sounds rather more dangerous than the 'some people may let it lapse' argument, if it's true -- simply delaying the disease until adulthood would be an extremely bad idea. But I don't know if it's true.

If the vaccine were permanent, I see no reason not to vaccinate. There's nothing particularly character-building or noble about getting some crummy disease during childhood so your mom can take embarrassing pictures of you naked and covered in spots. The only benefit is that it's usually mild in childhood and confers permanent immunity. If the shot doesn't do that, I'd rather have my kid get the disease young.

-- Anonymous, June 25, 2001

Off-topic animal vaccine stuff:

I hadn't heard about immune system crashing due to multiple vaccines, but I have heard (in cats) that some vaccines (which I can't remember) may be (more) dangerous when given in the scruff of the neck rather than hind leg.

I got my indoor cat vaccinated when she needed a health certificate in order to accompany me on the plane for my cross-country move, but other than that I usually let them slide. She *never* goes outside or has any access to strange creatures; on a third-floor apartment, she isn't likely to anytime soon. I don't meet strange cats either, so I don't think I'm going to bring any viruses home. This vaccine side-effect stuff weirds me out a bit.

On topic: I think the benefit of mandating vaccines is to prevent laziness (see case in point above, though if this were my kid and not my cat, I might get it done, since my kid would be meeting other kids, one hopes) from being a major contributor to vaccine lapses and the resurgence of polio and smallpox and measles god knows what. I wouldn't have gotten that measles vaccine in high school if it weren't mandated. I don't get my tetanus shot because I don't have to. I do get flu shots, but that's because I had the flu (real flu, not 'I think I have the flu or something' flu) once and would leap out of a very high window if I got it again. If people have to do it, they do it. If they don't, even well-meaning people let it go. If their kid can't enter third grade without the shot, the kid gets the shot, and there's more incentive to have vaccine clinics easily accessible because a lot of parents are going to have to get their kids those shots.

I do think there ought to be some threshold of seriousness for a vaccine to be mandatory, and I really don't think chicken pox makes the cut, but I also don't think that in the name of free will it should be *that* easy for someone to say, "I don't feel like getting Jimmy a measles shot" or "He doesn't like needles, so we won't get it, nobody gets measles these days anyway" or "I forgot." Having certain age checkpoints for certain vaccines, I think, is a damned good idea.

-- Anonymous, June 25, 2001