Even a casual stroll through Knoxville's cemeteries tells the tale; until about 50 years ago, many of the city's smallest residents died much too young, often before three years of age. Commonly, families lost several of their children at once. And the leading cause of death by a mile was communicable disease.
Measles, mumps, whooping cough, smallpox and polio—diseases which are rarely, if ever, seen in this area any longer—wreaked their own, particularly nasty hell on American children until the beginning of the immunization revolution in the 1950s. Because of this, the vast majority of parents and physicians support the government's various programs for encouraging a standard set of childhood vaccines. As the number of immunizations required for admission to Tennessee daycare centers or schools grows each year, however, some parents are questioning the safety of injecting their young children with so many types of vaccines in such a short period of time. Other parents, after learning of the potential side effects from vaccines, are choosing to selectively immunize their kids, or in some cases, avoid the recommended series of childhood shots completely.
Joe and Elizabeth Anderson (pseudonyms—this couple would like to remain anonymous because they claim to have been harassed for their views) are Knoxville parents who have chosen to forego having their children vaccinated. They came to this decision in 1997, after their oldest child experienced a series of seizures only hours after receiving one of his "routine" baby shots. Their son has been fine since that time, but their experience led them to do further research on childhood vaccines. Neither of their two children has received a single immunization since then.
"I never questioned having my baby fully vaccinated. It just seemed like the thing to do, like making sure he was in a safe carseat," explains Elizabeth. "But after he had seizures at nine months of age, I began to learn more and was very disturbed by what I found. "
According to the Andersons, their child's West Knoxville pediatrician refused to even consider the possibility that a vaccine had led to their son's epileptic episode. This was despite the fact that the literature provided by the Centers for Disease Control (CDC) and which all parents are required to read before signing off to have their child injected with a particular vaccine states clearly that seizures are a rare but possible side effect of many routine baby shots. The Andersons also discovered that a growing network of parents around the country believe that childhood vaccines and the ingredients used in them can in rare cases lead to autism, immune deficiencies, Sudden Infant Death Syndrome (SIDS), and other serious health problems.
According to Mark R. Geier, MD, PhD, a recognized expert on the biological effects of vaccine-induced infant death, 79 percent of all infant deaths under one year of age occur within 28 days of vaccination. Similarly, 71 percent of encephalopathy in infants under one occurs within 28 days of vaccination—as does 92 percent of reported febrile convulsions, 88 percent of nonfebrile convulsions, 66 percent of SIDS, and 99 percent of other neurological symptoms.
But for public health officials, the evidence linking individual doses of childhood vaccines with these health risks is inconclusive. Additionally, according to Dr. Stephanie Hall, former director of the Knox County Health Department and now the county's Public Health Officer, parents who focus on the possibility of individual children suffering from rare side effects are missing the big picture.
"In my personal view, we now have a generation of parents who grew up without having to see young children get sick and die from childhood diseases," explains Hall. "The decision not to vaccinate your child is a luxury that parents today have because they are riding on the backs of all the parents who have chosen to immunize their kids. The reason kids who are not immunized aren't at great risk is simply because everyone else in their immediate environment is vaccinated."
Hall notes that Knox County has an exceptionally strong program for promotion of childhood vaccinations, with the current immunization rate for children under 24 months of age standing at around 90 percent. She also acknowledges that in rare cases, serious side effects, including permanent neurological damage, can occur from a vaccination.
"No vaccine is 100 percent safe, that's true," says Hall. "But we cannot let our guard down. There are still measles outbreaks in this country and in England. And pertussis is back."
In newborns, pertussis, or whooping cough, is a very serious disease and can cause severe complications. About 72 percent of kids less than six months old who get whooping cough are hospitalized for it. One of the most widely publicized American pertussis outbreaks in recent years occurred in Knoxville in 1999, when several babies born at Fort Sanders hospital came down with the disease. It was determined that a non-immune staff member at Fort Sanders had exposed the newborns in the nursery and as a result, 200 previously-discharged babies who had been born at the hospital and who were determined to be at risk for the disease were given the antibiotic erythromycin as a preventive measure.
The Andersons say they do not oppose vaccinations for children whose parents are fully informed about the risks, but they are uncomfortable with the way immunizations for children are marketed and mandated.
"Most parents in this country don't question giving their kids every shot their pediatrician recommends. They probably don't even read the warnings that are handed out before their child is given the vaccine," says Elizabeth Anderson. "They have no idea that some children are brain-damaged or even killed by vaccines every year."
Vaccine mandates in the United States go into effect in a three-step procedure that, according to critics, evades accountability. First, the Food and Drug Administration (FDA) and its Vaccines and Related Biological Products Advisory Committee (VRBPAC) decide whether a vaccine can be licensed. After that, the CDC and its Advisory Committee on Immunization Practices (ACIP) decide whether to include the vaccine on the list of vaccines that are recommended to be given to all children. Third, individual state legislatures specify which vaccines and how many doses are required (or authorize a state health agency to put new vaccines on the compulsory list). State legislatures or agencies usually follow ACIP's recommendations. The CDC routinely grants conflict-of-interest waivers to members of its advisory committee, even if they have a financial stake in the vaccine being considered. In the event that a child is proven to have been injured by a vaccine, parents must seek compensation via a federally administered program that exists outside the usual civil liability system within the courts.
Many parents became aware of the risk of complications from childhood vaccines for the first time in 1999, when pharmaceutical giant Wyeth was forced to withdraw its heavily promoted vaccine Rota-Shield, after scores of young children developed a potentially lethal bowel condition requiring surgery after being injected with the vaccine (promoted as an antidote for rotavirus). While it's true that the disease rotavirus leads to hundreds of thousands of deaths of children in third world countries each year, the diarrheal illness is rarely life-threatening in American children.
Within months after government approval, 1.5 million doses of the new rotavirus vaccine had been administered to American infants. Despite the fact that several babies in clinical trials had developed serious bowel obstructions, the information sheet handed out to parents as their babies received the shot noted only that possible complications "included moderate fever, increased irritability, and decreased appetite and activity." Wyeth was forced to recall the vaccine within months of its initial release.
In recent years, the list of vaccines required for Tennessee children entering school or licensed childcare centers has risen to 13 doses of several different vaccines before age five. Included in the list for the first time this year is the chicken pox vaccine. Although supporters of the chicken pox vaccine point to the fact that in a handful of cases each year, children die of complications from the common disease, Hall—who supports the routine administration of chicken pox vaccine in Knox County—acknowledges that from a public health perspective, the reasons behind the new vaccine requirement are not so simple.
"There is an economic morbidity to varicella [chicken pox]," explains Hall. "When you look at the population as a whole, parents miss a lot of work when their children become ill with chicken pox."
Tennessee parents who do not wish to immunize their children in order to enroll them in school are eligible under state law to apply for a vaccination waiver on medical or religious grounds. In some other states, a waiver based on philosophical objections is also available.
The Anderson family has decided to homeschool their children rather than be forced to go through the waiver process at the beginning of each school year. They say, however, that they still face discrimination and harassment because of their decision to leave their children unvaccinated.
"We have been unable to find a pediatrician who will take our kids as regular patients when we tell the doctor of our concerns about vaccines. And on at least one occasion, a parent from our church who found out about the kids' status began a campaign to bar my children from the Sunday School," says Joe Anderson. "Now we pretty much don't ever mention it to anyone unless it becomes absolutely necessary. Very few of my kids' friends' parents know that our children aren't immunized. Their grandparents don't even know."