/ 5 August 2008

To vaccinate or …

Are dissenting parents putting other children -- and communities -- at risk? Nechama Brodie reports

Fresh controversy is brewing over the issue of childhood vaccinations, as opposing celebrity camps initiate a string of new public awareness campaigns in the United States.

In June actress and former Playmate Jenny McCarthy led a “Green Our Vaccines” rally through Washington DC (with her boyfriend Jim Carrey). McCarthy, whose five-year-old son is autistic, has been an outspoken critic of childhood immunisation schedules for some years now — saying vaccines contain a number of toxins and that the mandatory national health immunisation schedule forces infants to receive too many vaccines too soon.

In the past three weeks alone McCarthy has hosted a massive fundraiser for autism awareness charity Generation Rescue (an event that garnered even bigger headlines for drawing another celebrity mom — Britney Spears) and partnered wrestling federation WWE to spread the message of the “fight against autism” to capacity crowds during a Saturday “smackdown”.

On the other side of the ring is actress Amanda Peet who, last month, was forced to issue a cautious apology following an interview in parenting magazine Cookie, where she commented: “Frankly, I feel that parents who don’t vaccinate their children are parasites.”

While Peet acknowledged her choice of words was “mean and divisive”, she refused to retract her message, saying: “I still believe that the decision not to vaccinate our children bodes for a dangerous future. Vast reductions in immunisation will lead to a resurgence of deadly viruses. This is as indisputable as global warming. I know a lot of parents who secretly use as a justification, ‘Well, enough other people are vaccinating, so therefore, we don’t have to.'”

In the past year health agencies in the US and the European Union have reported a rise in the outbreak of measles. In the US (where in 2000 the Centres for Disease Control announced the virus had been “eliminated” from the US) almost all reported cases occurred in children whose parents decided not to have them vaccinated, or were too young to have received the vaccine.

In Ireland, where reported cases of mumps have increased 600% from last year, the Meningitis Research Foundation attributed the spike in both diseases to fewer people opting to get the combined MMR (measles, mumps, rubella) vaccine in recent years.

Ten years ago the MMR jab became the subject of intense medical and media speculation after a report was published in medical journal The Lancet linking the combined vaccine with an increased incidence of autism. The controversial study has been largely discredited (it was based on a study of just 12 children and a subsequent review revealed a number of these participants were already involved in legal claims against vaccine companies), to the extent that The Lancet issued a partial retraction in 2004 and 10 of the paper’s original 13 authors have retracted their conclusions. Since 1998 several subsequent studies have been published that dismiss any causal link between the MMR vaccine and autism — in one large-scale study conducted in Sweden, incidence of autism was actually found to be higher in the non-vaccinated group.

But the taint of scandal still lingers, resulting in thousands of parents choosing not to immunise. In the Middle East, Asia and Africa religious condemnation of vaccines, coupled with widespread distrust of what is often viewed as “Western” intervention, has seen a number of national immunisation programmes fall short of their targets. In December last year health officials in northern Pakistan admitted they had failed to immunise more than 160 000 children against polio; in an earlier case the suspension of Nigeria’s polio immunisation programme in 2003 saw the disease spread to 18 polio-free countries in Africa and Asia.

“It’s a big decision,” says Dr Vicki Compere, a homeopath and the mother of two small children. “Every parent wants what’s best for their child. We know that children will be exposed to diseases; but do I think my child is better off with the vaccine in their body? No.

“I feel that vaccines are immuno­suppressive over the long term and by vaccinating a child we don’t give the body’s natural defence system the opportunity to be activated. They’re called childhood illnesses because it’s better if you get them when you’re a kid — the symptoms are much worse for adults. I also believe childhood illnesses play a developmental role. If a child develops German measles, parents should all get together and have a party — then everyone gets it. The results of a vaccine wear off over time, but if you have the disease as a child you get immunity for life.”

Compere is not opposed to vaccines in the right circumstances — for example, in “communities where children are not being fed properly and don’t have easy access to medical information and treatment”. But, she says, in middle-class communities, better socio-economic standards (including better nutrition) and improved knowledge about illness means incidence of disease is naturally lower. In the event of infection, treatment is likely to occur at an earlier stage — before symptoms become life-threatening (measles, diphtheria and tetanus can all be fatal).

She does, however, caution that parents who choose not to vaccinate need to take responsibility for being educated on how to identify and treat such illnesses. “They need to take ownership of the decision,” she says.

For parents who are undecided, Compere advises that they delay making any decision until the child is at least six months old (standard immunisation programmes start from six weeks).

“No one can tell you 100%,” Compere says. “Either way you could be the one person who gets a bad reaction.”