The advent of combination vaccines has provided parents with yet another worry—namely, that their newborns are being bombarded with high-powered chemical cocktails. Kathi J. Kemper, a professor of pediatrics at Wake Forest University School of Medicine, in Winston-Salem, North Carolina, believes there's no cause for alarm. "It's no fun to get four shots at once," she says. "So, for example, in the last few years, varicella has been combined with measles-mumps-rubella. Manufacturers are working on combining, but it has to be done in a way that's safe, doesn't increase the risk of side effects, and still allows for an optimal immune response."
Even with the combination shots, children today face twice as many immunizations as they did 10 years ago. But Kemper says that's not a problem: "Kids are getting more shots now because we're covering more diseases, but they're actually receiving fewer antigens, the proteins the body reacts to that can cause side effects like fever. The newer shots are more targeted."
Arguments like that don't wash with parents in the anti-vaccine camp, many of whom question whether their kids might not be better off without some or all shots. Although several vaccinations are required for public-school entry, it's possible to circumvent those laws by obtaining official philosophical, religious, or medical exemptions. Which isn't to say that going the exemption route is easy. Some doctors won't keep children who don't get vaccines as patients, and many schools, public health departments, and public officials pressure abstaining parents to change their minds. "There is no limit to the bullying in this country," says Randall Neustaedter, a Bay Area doctor of oriental medicine, education director of the Holistic Pediatric Association, and author of The Vaccine Guide: Risks and Benefits for Children and Adults (North Atlantic Books). "In most countries in Europe, vaccines are voluntary. They don't have this totalitarian view. The medical establishment there may advocate vaccines, but they don't pass laws that coerce people."
Michael T. Brady, a professor of pediatrics at Ohio State University, in Columbus, and a member of the American Academy of Pediatrics' Committee on Infectious Diseases, acknowledges that there are side-effect risks attached to vaccinations, including pain, fever, and allergic reaction. But when you weigh those against the benefits conferred by vaccinations, he says, there's no contest. "When I was a young child, getting people to take a polio vaccine was easy, because everyone knew someone who had the disease," he says. "In 2006, nobody in North America knows somebody with polio, just like nobody knows anyone with tetanus. But people don't realize that the bacteria responsible for tetanus are just as prevalent in the soil as they were before the vaccine became available—it's just that now, we're protected against them."
In addition, as the CDC's Allen points out, many diseases that are no longer a threat in the U.S. are still circulating throughout the world. "They're only a plane ride away," he says, "and they could easily be imported back here."
In the end, it's easy to see why some parents would choose to forgo the preemptive strike of vaccination, at least until incidents like the April 2006 mumps outbreak in Iowa become more commonplace. In making that choice, however, those parents are banking on their more conventional counterparts to follow the standard schedule of vaccinations. Simply put, unvaccinated kids are afforded some measure of protection by the "herd" of immunized children they interact with on a daily basis.
"With herd immunity, diseases aren't as common," says Brady. "But it would be better if everyone were immunized."
