Wasserman: A pediatrician’s case for mandatory vaccinations

Editor’s note: This op-ed is by Dr. R. “Mort” Wasserman, an attending pediatrician at Vermont Children’s Hospital at Fletcher Allen Health Care and a professor of pediatrics at the University of Vermont College of Medicine.

I am a UVM College of Medicine faculty general pediatrician, over age 60, with a degree in public health. Although I am primarily a researcher now, in my years of active practice I cared for many children whose parents were reluctant or refused to immunize them and am sensitive to parents’ concerns about immunizations. I regularly engaged those parents in discussions on the issue and some changed their minds. I appreciate the chance to change others’ minds.

Knowledge can be gained from personal experience and/or from examining the data. As far as experience goes, my vaccine-related experiences began with a kindergarten classmate dying of polio. Two other ex-schoolmates suffered lifelong disability from that disease. Also in the experience department, I have provided care to children who died of pertussis (whooping cough) and bacterial meningitis and to others who survived meningitis but have severe lifelong disabilities. Pertussis, bacterial meningitis, and many other vaccine-preventable diseases are much less frequent or quite rare because of vaccines.

Most Vermont parents who are concerned about vaccines lack personal experience with these diseases. They have not stayed up, night after night, with a child coughing from pertussis or sat next to the hospital bed of a child with bacterial pneumonia. They take the absence of vaccine-preventable disease for granted. A few are also angry about the greedy pharmaceutical companies. They value personal choice. I also am no fan of the pharmaceutical companies and I also value personal choice.

I have provided care to children who died of pertussis (whooping cough) and bacterial meningitis and to others who survived meningitis but have severe lifelong disabilities. Pertussis, bacterial meningitis, and many other vaccine-preventable diseases are much less frequent or quite rare because of vaccines.

However, I also have a public health perspective driven not only by personal experience, but by data. The laws about vaccines are directed at protecting the public’s health, and the data are quite clear. Children get very sick from, hospitalized because of, and (sadly) occasionally die from vaccine-preventable diseases. The impressions of every Vermont pediatrician over the age of 50 who has seen multiple child deaths and permanently disabilities resulting from these diseases are supported by substantial research. As to vaccine complications, the data also are very clear. Children very rarely get sick from, hospitalized because of, or die because they received a vaccine. The supposed autism-measles vaccine connection has now been thoroughly discredited by multiple groups.

Are vaccines completely effective? No. Is vaccine policy based only partly on science, and partly on convenience of administration? Yes. But do vaccines drive up Vermont health care costs? Absolutely not – every cost-benefit analysis shows substantial cost savings. Do Vermont doctors profit mightily from administering vaccines? No. They typically obtain vaccines from the Vermont Department of Health and charge only a modest administration fee.

This public policy debate is about the protection of our children. When parents don’t immunize their children, they place other people’s children at risk, including: (1) children too young to be immunized against some of the diseases in question (generally infants younger than 6 months of age); (2) those whose immunization series has begun but who have had too few doses to establish immunity or who have not had the needed booster doses; (3) those who have been completely immunized but for whom the immunization series does not afford complete protection (varies from vaccine to vaccine, but approximately 10 percent for most vaccines); and, of course (4) those whose parents have chosen not to have them immunized. That risk persists because insufficient immunization levels in the general population fail to confer the “herd immunity” that prevents the overall spread of disease.

In Vermont, many thousands of children are being placed at risk of serious illness so that adults can make a personal choice. As a pediatrician and a child advocate who wishes to prevent needless suffering, I have no choice but to stand up for Vermont’s children and to support laws mandating vaccines for children attending school and child care.

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32 Comments on "Wasserman: A pediatrician’s case for mandatory vaccinations"

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2 years 11 months ago

Thank you, Mort.

I had pertussis when I was 13 and the thought of the same happening to either of my children makes my heart pound.

2 years 11 months ago

“Are vaccines completely effective? No. Is vaccine policy based only partly on science, and partly on convenience of administration? Yes. But do vaccines drive up Vermont health care costs? Absolutely not – every cost-benefit analysis shows substantial cost savings. Do Vermont doctors profit mightily from administering vaccines? No.” An important paragraph. Thank you for that. While I am not a supporter of mandatory vaccination (or mandatory anything else, really) I am also not a supporter of dishonest and hysterical “debates” and you did a great job summarizing the messy facts of the matter concisely. My own distrust of pharma multinationals… Read more »

Pat Jones
2 years 11 months ago

“Do Vermont doctors profit mightily from administering vaccines? No.”

This is to bad. The vaccine administration business is estimated to bring in over $50 billion dollars this year. This is from a report on CVS pharmacy published in Forbes magazine. Pediatricians serve one purpose and one purpose only, sell vaccines. All 71 doses. No negotiating. I won’t let my children get within 10 feet of a pediatrician. All they care about is their paycheck. What has Dr. Wasserstein done to help one single family devastated by vaccine injury? I’m sure he abandons them just like every other pediatrician does.

Kathryn Kinzel
2 years 11 months ago

What an absurd statement, that pediatricians only work to “sell vaccines”. Way to insult an entire profession that works very hard to keep kids healthy.

Kudos to Dr. Wasserman for articulating the continued need for vaccination so well.

2 years 11 months ago

For a living, I work with pediatricians on practice management issues.

The statement that, “Pediatricians serve one purpose and one purpose only, sell vaccines…” is absurd and offensive and clearly not based in any objective reality or facts. I have personally reviewed the costs and revenue from the vaccines administered in 100s of practices around the country and it’s generally a break even endeavor for most pediatricians. In fact, for many, it’s a significant financial LOSS. They provide the vaccines because they believe in the science.

Boris Ogon
2 years 11 months ago

“The vaccine administration business is estimated to bring in over $50 billion dollars this year.”

This, of course, is the happy (and commonplace) antivax conflation of revenue with profit.

David O'Leary
2 years 11 months ago

To Pat Jones: You ask, What has Dr. Wasserstein done to help one single family devastated by vaccine injury? He used several up-close experiences both as a child and adult to inform his decision to become a healer of children and a researcher of childhood diseases. He also put himself out there to give his expert opinion on why vaccination have worked in the past and will continue to work. Secondly, you say that pediatricians only care about their paycheck? If all they cared about was their paycheck, they would not pick one of the lowest paid specialties in medicine.… Read more »

2 years 11 months ago

I’m puzzled how you come up with such a misty mirage on reality, Dr Wasserman. You have three years on me, however, your assessment doesn’t match with ground zero. Surely, you READ the medical literature? I have a suggestion for you. Revise every article on whooping cough, by your USA expert James D Cherry, including his 2012 NEJM “resurgence” article, and then come back and commit to some decent dialogue. Anyone reading Cherry’s articles talking about how the whooping cough vaccines creates original antigenic sin, and CL Weigart’s articles pre-dating those, which obliquely expand on that explaining explain WHY the… Read more »

Suzanne Michels
2 years 11 months ago

Bravo. My unvaccinated 5th child (my first 4 were fully vaccinated) is my healthiest child. She is 5 years old and has never had an ear infection, croup, or a stomach virus. My other children suffered from chronic ear infections, chronic croup, etc. When my 5th child catches a cold, she basically has a little clear nasal drainage…and keeps on playing. Last month, when the flu hit our household, my 5th child ran a fever for one day..and then she felt better. Everyone else who caught it (including me) was sick for 3 days, with a 4th day for recovery.… Read more »

Laura Condon
2 years 11 months ago

I wish I could believe Dr. Wasserman’s claim to be willing to listen to parents and others who have concerns about vaccines but his condescending tone leads me to believe otherwise. Still I suspect he is a bright enough man and I hope he will read and consider my comments. My concern about vaccines was raised some 33 years ago when I began work with vaccine injured children and their families. Oh yes, there are vaccine injured children out there…thousands and thousands and thousands of them. Dr. Wasserman’s denial and claim that they are rare, neither makes them non-existent nor… Read more »

Laura Condon
2 years 11 months ago

Interesting that Mr. Todd (last name witheld) has posted an awful lot of commentary here for someone who has no affiliation with any credible organization. Yes indeed I am a NH State Director of Advocacy for NVIC. This national non-profit has existed since 1982 and is a clearinghouse of valuable information and resources on diseases, vaccines and legal rights. The National Vaccine Information Center (NVIC) is dedicated to the prevention of vaccine injuries and deaths through public education and to defending the informed consent ethic in medicine. I hope all readers will visit the website http://www.nvic.org in their search for… Read more »

Kathryn Kinzel
2 years 11 months ago

I have seen cases of children who have died of chickenpox. Yes, it’s rare, but it happens more frequently than some of the alleged adverse reactions of the chickenpox vaccine. And we have had shingles ever since there has been chickenpox, and even if the current vaccine only decreases your changes of getting shingles by 50%, that’s something I would consider (since the vaccine also decreases the severity of shingles). Have you seen how people suffer from shingles? Wouldn’t you do whatever you could to keep that from happening to you? The National Vaccine Information Center is an organization designed… Read more »

Suzanne Michels
2 years 11 months ago

Thank you for this EXCELLENT post!

Joe Schwartz
2 years 11 months ago

Dr Wasserman, The scientific studies on the outcomes of childhood diseases are not older than you, so I wonder why you aren’t calling for mandatory employment and mandatory good diets since these factors impact the outcomes of these diseases more than vaccination status. Of course, it is well documented in peer reviewed literature that dietary training for medical doctors is woefully inadequate, so that might explain why you overlooked these key pieces of data. It’s amazing that people in public health want to take away the basic right to choose to forgo an unnecessary medical intervention which has a documented… Read more »

2 years 11 months ago

Any cursory review of the vaccination rates, exemption availability, infection rates and overall health outcomes in the United States quickly disproves the false allegation that exemptions harm health. The AAP conducts itself as if vaccination were a magic bullet, where the states with the highest vaccination rates have the best infant mortality rates and lowest infectious disease rates. This is absolutely false. Here are 2 slides comparing the Top 15 best states for Infant Mortality with the Top 15 states for Most Vaccinated for 2011. http://www.scribd.com/doc/85704894/U…cination-Rates Connecticut, the #1 most vaccinated state ranked 20th for infant mortality. Florida, the #3… Read more »

2 years 11 months ago
Ben Eastwood
2 years 11 months ago

It is interesting that Tod withheld that there are no states where the diseases we vaccinate for are major causes of infant mortality. Most of the diseases we vaccinate for have low mortality rates even if they occur in unvaccinated children. Perhaps in developing countries where there is little medical care available and poor sanitation and hygiene these diseases are a bigger problem, but in the US children are FAR more likely to die in an automobile related incident than they are from any disease. Cars cause far more health problems, from injuries to respiratory problems from pollution, to accidents… Read more »

Eileen Foster
2 years 11 months ago

Dr. Wasserman stated, “When parents don’t immunize their children, they place other people’s children at risk…” While Dr. Wasserman did not draw a relationship between the recent pertussis outbreaks and exemptors, I think it is important to the discussion to share the CDC’s position on this topic. The causal relationship between exemptors and pertussis outbreaks were addressed at a CDC Telebriefing in July 2012. Anne Schuchat, director of CDC’s National Center for Immunization and Respiratory Diseases, answered a question in regard to whether exemptors were the source of the Pertussis outbreaks. She responded: “Yes, thank you for that question. We… Read more »

David Rhodes
2 years 11 months ago

A very interesting debate from both sides of the argument! If (the many!) wish to vaccinate, then that is their choice … though I do believe that their children will suffer … later if not sooner. I began my own investigations following the removal of mercury amalgams, which I received 50-odd years ago as a child. I had been repeatedly told the fillings were perfectly safe, yet a few years ago I became very sick and run down for NO apparent reason … my symptoms TOTALLY disappearing after safe removal and a period of heavy metal detox. That began my… Read more »

Kathryn Kinzel
2 years 11 months ago

So science can show that Andrew Wakefield is a fraud, motivated by the profit of scaring concerned parents, but YOU listen to him and CLEARLY, the science is wrong because YOU believe him!

This is why we have the scientific method – anecdotal evidence appears strong because a person is telling the story, but one person could see things from a skewed perspective. Just because I watch a balloon rise into the sky doesn’t mean I can then discredit the theory of gravity.

2 years 11 months ago

Why have Todd’s comments been removed?

2 years 11 months ago

Dear Chip, It turns out that Todd was using a pseudonym for all of his posts. I contacted him and he is unwilling to use his real name. VTDigger requires that all commenters use their first and last names. This helps us keep the debate civil and transparent. We have never allowed avatars on the site. When they turn up, as Todd did, sometimes it takes us a while to figure out that they’re faking it, but eventually the ruse becomes apparent. In the spirit of fairness and transparency in which we endeavor to operate, we believe it’s important for… Read more »

Chip Hart
2 years 11 months ago

Thank you for the reply. I appreciate the situation you are in and encourage you to maintain your standards. What options do you have for someone who is afraid of retribution outside the context of this WWW site? I’ve been _very_ reluctant to post on this particular subject due to some serious harassment I have received in the past. I realize you may not have a solution, just wondering what your position is. I’ve run into 3 people locally who thanked me for my mild comments above (who knew this was so popular?) but don’t DARE add to the discussion… Read more »

2 years 11 months ago

Hi Chip,
We try to keep a handle on the anonymous commenters, though it isn’t always easy to tell. Yes, anyone’s name and ID can be questioned. It’s not so different from old-fashioned letters to the editor in which writers are asked to give their town of residence.
Anne

Boris Ogon
2 years 11 months ago

So, content itself is of less concern than a demonstrably futile etiquette policy?

Kathryn Kinzel
2 years 11 months ago

I’m not paid by pharma, nor are many of the pro-vaccine movement.

2 years 11 months ago

Of course not. Public health employees are taxpayer-funded civil servants.

However, “Conflict of Interests between Private Enterprise and Public Health” abound. This has enabled an outrageous amount of pharma influence over public health.

See: http://doctorsonly.co.il/wp-content/uploads/2011/12/2008_2_3.pdf

2 years 11 months ago

There is a new iPhone App called Vaccination Scheduler that is helping lots of parents by sending them reminders for every recommended vaccination appointment based on your child’s birth date. It also lets you track and record all of your children’s vaccination history and information. Based on the latest vaccination information from the Center for Disease Control and Prevention it come pre-installed with all the information parents need. Featured by Apple as the #1 New App in Medical Category and endorsed by medical practitioners, nurses, midwives and used by thousands of mothers around the world. You can learn more and… Read more »

Rebecca Shumsky
2 years 11 months ago

If anonymous comments don’t support your mission, how about commenters with fake names? Like Guillane Fox? You removed all of Todd W’s SCIENCE yet leave her vitriol. And she appears nowhere on the Internet except here on Vtdigger, making uncivil comments.

2 years 11 months ago

Her comments have been removed.

Chip Hart
2 years 11 months ago

I’m now concerned that comments that support one side of this debate have been removed while comments on the other side of the debate, from commenters with dubious identification and/or near-libelous and uncivil contribution, remain.

I can’t return to this site any more, not that it cares. I wonder if Dr. Wasserman knew of its bias when he wrote his piece.

2 years 10 months ago

Vaccines are pharmaceutical products delivered by syringe that have a wide range of potentially debilitating side effects. They are not seat belts. Certainly Dr. Wasserman in his many years of experience knows that there is nothing that should be more honored than the health choice of an individual or a parent. Regardless of their purported benefits, vaccines are inherently unsafe and the only person who can say yes or no is the individual or parent – not the doctor, and not the state. Read the fine print inside manufacturer package inserts and read the peer reviewed science before signing. Take… Read more »

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