Commentary

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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