(This is is the fifth in a series of guest posts by Dr. Mark McColl answering reader questions about vaccinations.  Please read my vaccine history and introduction of Dr. McColl before reading this post.  You might also like to read his earlier posts on his vaccination choices for his kids, ethics and parental rights, delaying vaccinations, and kids that need special consideration.)

Why are there so many more vaccinations today than 30 years ago?

The number of vaccines has increased over the years as the science and technology has advanced to allow for further and better protection.  Just car and airplane safety has increased with emerging technology, the science of building a vaccine against a deadly organism has advanced.  When certain specific markers on these organisms are identified the process of replicating those markers in such a way that our immune system can and will recognize them begins.  Many of the tried and true methods that are already in place are used but each vaccine is unique in what protection it provides.

It is very clear from the domestic and international data that as the number of organisms against which we are able to vaccinate increases the childhood morbidity and mortality rates decrease.

Why do our kids need to be vaccinated against chicken pox when we weren’t?

Childhood occurance of chicken pox (varicella zoster) infection used to be common place.  Many of us remember the “chicken pox parties” our parents organized to allow for the spread of the virus.  As a disease spread by respiratory particles merely being in the same room with an infected child is sufficient to cause infection.

Childhood infection itself is fairly miserable.  Common complications of primary varicella infection are things such as skin infection from invasive group A streptococcus bacteria (the same bug that causes strep throat can infect the skin), scarring of the pox marks, encephalitis (infection and inflammation of the brain), Reye syndrome (a form of liver failure often associated with aspirin use while infected), and pneumonia.

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This is a series of guest posts by Dr. Mark McColl on vaccination issues.  Please read my vaccine history and introduction of Dr. McColl before continuing.  You can also read his previous posts on his vaccination choices for his kids, ethics and parental rights, and delaying vaccinations.  These questions were all submitted by blog readers.  Enjoy!

Is the current whooping cough outbreak related to parents choosing not to vaccinate?

Yes.  For example, in 2011 in California, ten infants died after contracting whooping cough from their parents.  There were probably more children who contracted the disease from their parents but in these ten cases it was documented that their parents were encouraged and counseled to receive the whooping cough vaccination for themselves prior to the infant’s birth.  If their parents had chosen to vaccinate themselves it is very unlikely their children would have contracted the illness nor died from it.  Imagine the pain of these mothers when they look back on their decision and wanting to choose differently?

Benjamin Franklin had a similar experience with small pox killing his son, Franky.  He wrote “In 1736 I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way.  I long regretted bitterly, and still regret that I had not given it to him by inoculuation [sic].  This I mention for the sake of parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it, my example showing that the regret may be the same either way and that, therefore, the safer should be chosen.”

For children born very prematurely, is there wisdom in delaying some vaccinations to compensate for their adjusted age? Are vaccination risks greater for preemies?

For premature children the risk of remaining unprotected against preventable diseases is actually greater than for children born at term.  They lack much of the natural immunity delivered in the last month of pregnancy.  They certainly lack much of the nutrition given to them during that last month.  Most vaccinations do however have a weight limit for which it has been adequately studied.  In general, vaccinations are delayed until the child is at least 2 kilograms (4.4 lbs).  Practically this only applies to the Hepatitis B vaccine and is the data from which we established the weight limit.  There is no increased risk of adverse reactions to vaccinations in children born premature compared to full term children. Continue Reading →

This is part 1 of a series of guest posts on vaccination.  Please read the post on my vaccine history and the post introducing Dr. McColl before continuing.  And know that whatever your opinions on this topic, we’d probably get along great in real life so try not to let this become a dividing issue between us.  If you’re looking for information, this is good information from a man of integrity.  If your mind is made up, I’m not intent on changing it.  This will not be a format for debate, so feel free to write responses wherever it is you do your writing, but we won’t have a big dialogue in the comments section here.

Dr. McColl is going to be very straightforward with you—much more so than I would be.  His words are not my words, but I also haven’t cared for kids who are suffering from a vaccine preventable illness.  I might be a little more direct after that experience, too.

Guest post by Dr. Mark McColl

So Maralee has asked me to write a few posts concerning vaccines and specifically to respond to some questions generated by you, her audience.  I’m really pretty excited to get to do this.  I got to know her and her husband when they gave me the opportunity to care for their little boy after his adoption many years ago.  Since then we have struggled through some hard questions (both about vaccines and others) while they were here and we’ve had the chance to stay in touch after they moved.  I wish I had had the chance to care for all their kids but apparently we don’t need any insurance salesmen in Tennessee.

Vaccines and children’s vaccination schedules certainly are a hot topic in our modern culture.  Many people are diligently trying to make a wise decision about how to care for their children but are concerned about certain aspects of vaccinations.  Most parents I run into aren’t set against vaccines per se, as one might be set against communism or cocaine use, but rather are worried that in light of their children’s health and apparent lack of exposure to these diseases they are increasing the risk of injury in their children rather than preventing it.  Most parents tend to believe that their children start out at a rather low risk of death or disability from infections and therefore don’t need much protection.  We know this is true from surveys and polls about many different topics from cancer risk to car accidents.  We have a bias towards optimism, perhaps not for others, but certainly toward ourselves.

What I try to contend for my patients is an understanding of the truth.  I don’t want to paint a grim and dreary picture if that isn’t the truth nor do I want to whitewash a problem that really needs to be addressed.  I want to strike the appropriate course of reality.  We stand at a crossroads.  If we choose path A we have a certain set of risks and benefits and if we choose path B we have a different set of risks and benefits.  There is not an option to stand still and not pick a path.  By doing nothing we have chosen already.

So the first question I’ll address it the most personal.  Have I vaccinated my own children?  Yes, I have.  Completely.  I have two school age children.  I have a beautiful blonde haired, quick witted daughter who has more musical talent when she snores than I ever had my whole life.  I also have a bright and creative poet for a son with a bazooka as a right arm to whom I am forced to apologize regularly for the genetically defected hair line I’m sure he is going to get.  Every fall I bring home the FluMist and administer it to them myself at our kitchen table.  I also plan on vaccinating my daughter against Human Papillomavirus (HPV) when she is old enough.

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