Ask Amma

Vaccines – how to decide?

In How on 10 April 2011 at 6:37 am

How to take decisions on vaccination? Have read a bit on its politics… but is there anything such as an immunization that “must be given?”

– new mom from Palampur

One immunization that must be given from the beginning of baby’s life is mother’s milk.

As Jack Newman writes in “How Breastmilk Protects Newborns,” breastmilk “supplies infants with far more than nutrition. It protects them against infection until they can protect themselves.” In mother’s milk, “the collection of antibodies transmitted to an infant is highly targeted against pathogens in that child’s immediate surroundings. The mother synthesizes antibodies when she ingests, inhales or otherwise comes in contact with a disease-causing agent.” This means these antibodies are custom-made by the mother who comes in contact with the same disease-causing agents as her baby does.

Regarding specific vaccines such as Polio, DTaP, etc, the Indian Medical Association recommends this schedule.  American Medical Association schedules are listed here.  Centers for Disease Control lists schedules as well as information sheets on each vaccine.

Data from the Centers for Disease Control, as well as sources listed below, are useful for those who are prepared to study each vaccine and form an individual schedule of vaccines, rather than accept without question whatever is offered whenever it is offered.  It may seem daunting to develop your own schedule of vaccines but you don’t have to do it alone.  You can discuss the vaccine schedule with your doctor.  I also don’t think one is obligated to develop an individual schedule, nor should one be.  One should advocate for rigorous testing and development in the public interest and not for private profit.  When people trust the agencies that develop and approve vaccines to act in the public interest and not for private profits, they will not fall prey to manufactured skepticism.

While those who question vaccines are often stereotyped as being superstitious or anti-science, people can ask scientific questions about a vaccine’s risks and benefits.  You may find a local doctor who supports or at least respects his or her patient’s decision to delay, separate, or opt out of selected vaccines, when backed by guidance from sources such as the Center for Disease Control.  In fact, Dr. Jay Gordon says, “A doc who won’t hold these discussions [about vaccines] is too busy and you may need to move on to another.”  I was pleasantly surprised when I talked with my daughter’s pediatrician in Chembur and she acknowledged that some vaccines are given too often and too early.  The reason for this seemed to be “better too early than too late” and by the same token, “better too many than too few.”  When I appreciated her patience with my questions, she told me that she had never discussed this with any other parent.  So, I guess there is always a first time, and we as patients can help raise expectations for rational use of medicines as well as right to informed consent.  Again, this is best done in a climate where public health policy is made in the public interest.

In addition to the sites listed above, some works that have helped me develop a perspective of health, immunity, the role of disease and of vaccines are:

Aviva Jill Romm, Vaccinations: A Thoughtful Parent’s Guide: How to Make Safe, Sensible Decisions about the Risks, Benefits, and Alternatives.
Robert Mendelsohn, How To Raise a Healthy Child In Spite of Your Doctor.

  1. Aravinda, I can borrow a copy of these books? Do you own any?


  2. […] Apart from the vaccine-preventable diseases, there are also a number of factors that are reducing longevity in the present, such as pollution, increasing rates of hunger/homelessness (for the poor) and obesity (for the rich).  And if you believe Malcom Gladwell and his sources, there is also the role of close-knit community in promoting longevity – that is certainly declining globally.  And in some populations, decreased breast-feeding is also weakening the immune system, but due to increased use of medicine, those populations may not experience decreased longevity. A vaccine stimulates the immune system so that it is better prepared to attack a pathogen and thus make you far less likely to get a disease.   If that disease is fatal then you can say that the vaccine lowered your risk of from dying of that particular disease and thus increased your life expectancy.  Germs in the environment can also stimulate the immune system – sometimes but not always resulting in disease.  Which form of stimulation is “better” for you — that depends on many factors including nutrition and environment.  It is also different for different diseases and also different vaccines and different people.I would look at each vaccine and judge its risks and benefits and also look at each disease and judge its risks and benefits.  The key book that helped me was Aviva Jill Romm: VaccinationA Thoughtful Parent’s Guide.  See also Vaccines: How to Decide. […]


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