Wi: Missed shots stick with docs

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Missed shots stick with docs

Concerns arise as more parents opt out of child's vaccines

By Peerenboom

<jpeerenb@...>

January 9, 2006

http://www.greenbaypressgazette.com/apps/pbcs.dll/article?AID=/20060109/GPG0101/\

601090505/1206/GPGnews

Pamela Hencke of Green Bay was concerned about the reported link between

the mumps/measles/rubella (MMR) vaccination and autism cases. As a parent,

she struggles with whether to have her children continue with

immunizations, she said.

" When my daughter was 3 months old, she had her shots, " Hencke said. " When

she turned 12 months, I had a co-worker whose son was diagnosed with

autism. It was a scary ordeal for them and it brought to the forefront

that concern that autism was linked with immunizations. "

Hencke discussed the situation with her daughter's pediatrician and felt

more comfortable waiting until her daughter was 18 months before getting

the MMR vaccination shot. " I went with the other shots because my daughter

was in day care. "

With her second child, Hencke knew another co-worker whose child was

diagnosed with autism. " That brought it to the forefront again. I talked

with my co-worker and had an open discussion with the doctor about MMR. I

said I was afraid of not knowing the cause of this. When you talk with

friends and family, as a lay person, it's hard to know what to do. I opted

to wait with the MMR for our son " who is 14 months old now.

Doctors say they are seeing more parents opt out of having their children

get one or more of the immunizations. As this happens, there's growing

concern that diseases once thought eradicated will re-emerge, local

pediatricians say. There's also concern among elementary school

administrators and day-care center operators.

" My husband and I talk about it and talk with other parents, " Hencke said.

" Because they can't link what's causing the increased rate of autism, I'm

concerned. There isn't a handbook for parents to tell us about this. I've

heard so much about that shot, we've held off on it. But we go with the

other shots because the kids are in day care. You think you're doing the

right thing as parents, but you don't know. The best thing is to talk to

the pediatrician and discuss your concerns. "

Opting out seems " to be becoming a bigger issue the longer I practice, "

said Dr. Beno, a pediatrician with Aurora BayCare Medical Center.

" The common reasons include feeling that the vaccine will overload the

immune system, the child has a cold or infection, the reported connection

with autism or that the child will develop a disability. "

Doctors try to combine the vaccines to cut down on the number of pokes or

shots that children receive, Beno said. There is discomfort involved, " so

we give them as quickly as possible. Yes, there are side effects, but they

are much less than the effects of the disease. "

" More people are opting out than were doing so 10 years ago, " added Dr.

Ellen Neuhaus, a pediatrician with Prevea Clinic, " but it's still a small

number. There is what we call herd immunity. The more kids who are

vaccinated, the more likely it is that those who aren't won't get sick.

But as more opt out, there's more chance over time that these diseases

will come back. "

In Indonesia, for example, there is a cultural bias against the polio

vaccine; 200 cases have been reported there in the past year, Neuhaus

said.Polio is on the increase in several countries, the United Nations'

World Health Organization reported. There were 1,185 cases in 2004

compared with 784 in 2003.

" If more people opt out, it puts all kids at more risk, " Neuhaus said. " We

spend a lot of time talking about this in our clinic. There is a lot of

bad press out there on the Internet. For millions of kids who aren't

getting sick, their parents aren't talking about it. You don't hear about

the successes. "

Beno said more people travel worldwide today so they come in contact with

more diseases.

Neuhaus said some state legislatures are looking at standards that say

children who aren't immunized because of nonmedical reasons cannot use the

public schools.

Wisconsin law says children have to be immunized to be in schools or day

care, but there are opt-out options.

" We're not seeming to have a problem. People opting out are few and far

between, " said Eleanor Dockry, director of programming for Encompass Day

Care. " We keep up with the immunizations. We watch their schedule for

vaccinations and we keep a record for each child. "

The YWCA's policy requires immunizations unless there is a health issue or

religious conviction, said Tammie Walkowski, director. " We definitely

prefer that they be immunized " she said. " The concern is if someone gets

sick, it could spread. We have very little problem with this at this

time. "

Beno said one of the concerns raised by parents is the use of thimerosal

as an additive in vaccines. Some think this is the link to the increase in

autism cases. Thimerosal is a preservative that contains a form of

mercury, he said. It is effective in preventing bacterial and fungal

contamination. The amount has been drastically reduced, he said, and there

is no evidence of harm caused by the small amounts of thimerosal in

vaccines, except for minor effects like swelling and redness at the

injection site.

There also was a study done in Great Britain " that looked at all the kids

with autism and looking at which ones had the MMR shot and which had not.

There was no difference, " he said.

" Measles were really frequent in the United States. If we stop immunizing,

we'll all be at an increased risk, " Beno said. " There were 3 to 4 million

cases of measles a year before the MMR vaccine. In 1996, there were 47

cases; in 1998-99, there was one. And, mumps is a large cause of sterility

in males. Rubella, or German measles, has been linked to birth defects.

" If people opt out of immunizing, they are depending on everyone else

having the vaccine. That's really not protection at all, " Beno said. " The

diseases we are trying to vaccinate against are still around. That's why

we vaccinate. "

Babies and shots

The recommended schedule for vaccines for infants is:

# three at 2 months

# three at 4 months

# two at 6 months

# none at 9 months

# three at 1 year

# two at 15 or 18 months.

Most of these vaccines are combined into one shot. Also, boosters are

recommended at different times. Most recently, there has been a call for a

booster for whooping cough at age 12.

The vaccines fight against measles, mumps, rubella, hepatitis B,

diphtheria, tetanus, pertussis or whooping cough and polio.

Source: Dr. Beno, Aurora BayCare Medical Center

Wisconsin law

State law says children have to be immunized to be in schools or day care,

although there are other options.

" There are some opt-out options on the form: health reasons with a

physician's signature; for religious or personal reasons, " said Eleanor

Dockry, director of programming for Encompass Day Care.

*

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