Formerly permissive pediatrician urging an MMR for 12-month-old

[DaisyO]

Hello all,

I have a 12-month-old girl, whose pediatrician has, up until this point, been very understanding about delaying vaccinations.  In fact, she doesn't like to see babies get any shots at all until at least four months, and then spaces them out in a way that is even gentler than the Sears schedule.  She never gives more than one new shot at a time (that is, shots of things the child hasn't had a shot for yet), she lets you space them far apart, and she won't administer one if a child seems even a little sniffly.  Some children in her practice (I know, because a friend sees her and refuses to vaccinate) skip the shots altogether. 

Anyway, I wrote her to ask about what was coming up for my baby's 12 month appointment, and she said she would like to do an MMR this time, because measles is out there, people are getting sick, and she herself had even received notice of having been exposed on a train ride.  There isn't an outbreak in this state, but there was at least one infected and contagious tourist near here who was reported this summer.  I guess the pediatrician used to wait until the babies were two years old, but is no longer into humoring parents now that the risk of measles seems more threatening.  Which I totally get...but...

I feel confused.  I know I should trust this doctor--she is very experienced, and is very confidant about the safety of the MMR at the same time as she practices complementary medicine, pediatric hypnosis, etc.  I have endless respect for her abilities and intelligence.  But we chose her in large part because she allowed delayed and selective vaccinations (even though she's pretty expensive and doesn't take insurance), and despite the evidence I'm worried about the MMR.  In fact, it is the primary vaccine I wanted to delay, so this is quite a disappointment.  I am pretty sure that if we refuse it she will go along with our wishes, but I know she won't be happy...and I can't help feeling like she really knows best.  I'm just terrified, that's all.

Anybody have any perspective on this?

thanks,

Daisy

[LisaSedai]

The following link is to a morbidity and mortality weekly report, where you can find information about cases of disease that occur in the US.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6035md.htm?s_cid=mm6035md_w#tab3

For the week ending Sept 3rd, there were 3 cases of measles reported in the US - in MN. There were 181 cases reported so far this year.

week ending Aug 27, there was 1 case in CA

week ending Aug 23, 0 cases

week ending Aug 13 1 case in WA

and so forth.

I'm not sure why the weeks don't seem to start or end where 7 days would be- maybe someone out there knows.

The following information is about the cases of measles reported in the US from Jan-May 2011

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6020a7.htm?s_cid=mm6020a7_w

Of the 118 cases, 47 (40%) resulted in hospitalization. Nine patients had pneumonia, but none had encephalitis and none died. All but one hospitalized patient were unvaccinated. The vaccinated patient reported having received 1 dose of measles-containing vaccine and was hospitalized for observation only. Hospitalization rates were highest among infants and children aged <5 years (52%), but rates also were high among children and adults aged ≥5 years (33%).

Yes, there is a possibility that you ( how is your measles titer? is your vaccination up to date?) or your child can contract measles from someone who has traveled to a country with an outbreak, got sick, and brought it back home. Just because there were only 181 cases reported this year so far (which seems like a small number to me considering the number of the people in the US) doesn't mean that there won't be a huge outbreak in your state next week. Just because none of the people who caught measles (in the report above) died or got encephalitis doesn't mean there won't be a death from measles in the US. I'm thinking that the odds are on the side of me not getting measles and not dieing from it though.

Your doctor is doing what the CDC is advising, trying to get her patients vaccinated. She sounds like a reasonable person. If you discuss with her your reasons why you really want to wait on the MMR she probably is not going to fire you, she might even convince you to go ahead and get the shot. Why are you especially wanting to delay it?

[DaisyO]

Thanks for the response.  The info is very interesting.  I am up-to-date on the MMR because I went to grad school a few years ago and needed a shot (at least I think it was that, maybe it was just a TDaP) I wanted to say, I am worried about the MMR in particular because I can't shake the Dr Wakefield-autism connection stuff, as discredited as it all is.  I know in my head that it isn't true, but it's hard to get rid of this particular fear.  I guess I shouldn't look at "Age of Autism" any more, I can't help it though!  It's almost like I want to scare myself.  I just don't want my dear girl to change.  I love her so much.  But then, I don't want her to get measles, with all the possible complications, either. 

Anyway, my main qualm here is that 12 months seems awfully young.  I wanted to wait until 24 months.  Does anybody have experience vaccinating such a young baby with the MMR?  She is very healthy now, but was three weeks early at birth.

Thank you! 

[tarasuetx]

Hello, I'm relatively new at these forums, but I've done a LOT of research into vaccines.  I don't mean just "Google University." I've actually read multiple scientific and epidemiological studies and skimmed the Institute of Medicine reports. I'm a health reporter, so I've also interviewed the Executive Secretary of the CDC's committee that recommends the schedule, interviewed Dr. Sears in person, and interviewed multiple people on all sides of the debate (including the founder of the largest vaccine safety/anti-vax organization in the U.S.).  I say all of this to let you know - I have done my homework :) 

I also have a 15-month old son, and I did have him receive the MMR vaccine at 12 months. He did not experience any adverse reactions or even a fever. Measles is among the most contagious of all VPDs (90% transmission rate in unvaccinated persons) and the mortality rate is approx 1 in 1000. That may not sound high, but it is. Approx 2-3 of 1000 will experience severe encephalitis leading to brain damage. I know how powerful fear can be - I actually live in the same city as Dr. Wakefield. (I've also spoken briefly with the British investigative reporter who uncovered his fraud.) I'm currently taking an epidemiology college course to help me understand the science and studies even more. I can tell you this with as much certainty as I have love for my child: there is absolutely, positively no risk of your child developing autism as a result of the MMR vaccine. The most likely adverse event from the MMR is a high fever, and it's a somewhat common immune response that typically occurs 7-10 days after the vaccination. (Some doctors recommend not giving Tylenol so that the child develops more antibodies, but that's a personal decision, and it will not damage the overall efficacy of the vaccine.) There is an extremely low risk of encephalitis from the MMR - so low that, statistically speaking, your child has a better chance of being struck by lightning twice while you're buying a winning lottery ticket.

It sounds as though you have a compassionate, reasonable and cautious doctor who truly has your child's best wishes at heart. Given that those 181 cases are the highest outbreak since the 1980s, I would err on the side of scientific caution and get the MMR when your doctor recommends it. No vaccine is 100% safe or 100% effective, and it's not possible to calculate the exact odds of your child being exposed to measles. Given recent trends, however, I will unscientifically guess that odds are greater that tour child would contract measles than experience a life-threatening adverse reaction.

[DaisyO]

Well, your reply makes me feel better about the situation (as did the first reply).  I thank you.

How interesting that somebody with a direct Dr Wakefield connection could write in!  Anything else you have to say would be interesting...why did he want to hoax us, anyway?

thanks again

D O

[caityjane]

We are absolutely not getting MMR, it's the shot that my pead advises against. I'm an RN and about to sit my step 3's for Doctor of Medicine and there's no way I'll be giving this vaccine to my LO (only adding that part in to let you know I've researchedc this vax to within an inch of it's life and I'm still not comfortable with it). I wouldn't try to change your mind or your Doctors mind though, chances are, your LO will be fine if he gets the vax.

I'm very open to all forms of discussion on the MMR vax, it's one of my favourite. I think we have massively blown out of proportion, the risk measles poses to a typical healthy child. The CDC has even admitted to using figures pertained from a poverty stricken area of Africa for mortality stats early on - this is where the 1 in 250 stat we see in the media comes from.

WHAT IS MEASLES?
A contagious disease that produces a pink rash over the body. The first symtpoms appear 10d ays after becoming infected. Fever may reach 105 and a cough and runny nose may develop. Beginning at the head, once the rash reaches the feet (in two or three days) the fever generally drops, the rash begins to fade and the person feels better. Antibiotics and drugs do not work to shorts or alleviate the symptoms. Treatment mainly consists of allowing the disease to run its course and making the patient comfortable with lotion and hydration. The disease creates permanent immunity, the person will not contract it again.

IS IT DANGEROUS?
In the 1960's most children in the US and Canada caught measles. Complications were unlikely and previously healthy children usually recover without incident. Meales can be dangerous is malnourished children and populations newly exposed to the virus. Ear infections, Pneumonia and death are some of the possibilities. Complications are more likely when the disease strikes infants, adults and anyone with a compromised immune system.

There are strong links between Vitamin A deficiency and complications with Measles.

Also several interesting studies about the dangers of giving fever reducers for the fever...In one study done in Africa, "children with the most violent, febrile form of the disease actually had the best prognosis". Fever reducers greatly increased the instance of complications.
 

THE MEASLES VACCINE;
The live virus vaccine is usually given as MMR.

Attenuvax - "Propogated in chicken embryo cell culture" Each dose contains soldium choloride, sodium phosphate, sucrose, sorbitol, hydrolyzed gelatin , human albumin and fetal bovine (pig) serum. Produced by Merck and given in 2 doses.

The meales vaccine is one of the most reactive and has a long history of causing serious adverse reactions. The pharma company that makes the vaccine publishes an extensive list of ailments known to have occured following the shot. These affect nearly every body system - encephalitis, SSPE, GBS, convulsions, seizures, ataxia, ocular palsies, anaphylaxis, angioneurotic edema, bronchial spasms, panniculitis, vasculitis, leukocytosis, pneumonitis, deafness, otitis media, rash, fever, dizziness, headache and death.

VERY interesting study done of the effects of measles vax on the immune system in particular....re: the process of the virus bypassing all the bodies natural defences and being injected straight into the blood stream.....
 

HOW EFFICIENT IS THE VACCINE:
This is a hard one. Merck lists the vaccine as 97% effective after extensive clinical trials and a series of double-blind controlled field trials, However, nearly all of these trials are unavailable for review because data is 'unpublished' (sealed by the manufacturer) or the available data refers to the studies conducted in the 1960's , long before the current vaccine became available.....It does not confer permanent immunity. Dr. Atkinson, a epidemoligist with the CDC conferred "measles transmission has been clearly documented among vaccinated persons. In some larger outbreaks over 95% of cases have a vaccine history" (makes you question the efficacy released my Merck).

According to WHO, the odds that measles will strike those vaccinated are about 15 times greater than those left alone. In 2003 in Pennsylvania, there was an outbreak of measles in a school with 99% "herd immunity".

WHAT ABOUT HERD IMMUNITY?
Authorities released a figure of 70-80% of people needing to be vaccinated to eradicate the disease. It has since been shown that outbreaks can occur in 97% vaxed populations and 98% vaxed populations. Examining 320 works from around the world, 180 european medical doctors conculed that 'the eradication of measles would appear to be an unrealistic goal'. John Hopkins University in the US released a study that showed, with current mass imunizations, and supression of the immune system, by 2050 there may be a great deal more deaths by measles due to the newer strains emerging. The vaccine does not create permanant immunity.

OTHER THOUGHTS:
The CDC recently admitted that the vaccine may have changed the disease by altering distribution to high risk groups. For eg. Before the vaccine it was very rare for an infant to get measles due to the fact that most mothers had aquired natural immunity to the disease and passed these antibodies onto their child. With fewer mothers aquiring natural immunity from the disease, the number of infants suseptible to it has increased.By the 1990's 25% of all measles cases were seen in infants. It is believed this will be the case for a number of wild-type viruses. 

This was emailed to me by another GP who graduated a year before me to have a look over, which I have not done yet, but thought I would post here and see what others thought. I'm obviously against the vaccine, I don't believe we fully understand what injecting it into the bloodstream can do to the 'immune system' as such. But I love to hear what others think. GL OP :)

[ma2two]

tarasuetx, perhaps you could send DaisyO your contact information. You have guaranteed that her child will absolutely not develop autism from the MMR. So are you willing to back up your guarantee by agreeing to pay lifetime medical and care expenses for her child if she does, in fact develop autism from the MMR?

[TCMoulton]

Originally Posted by ma2two 

tarasuetx, perhaps you could send DaisyO your contact information. You have guaranteed that her child will absolutely not develop autism from the MMR. So are you willing to back up your guarantee by agreeing to pay lifetime medical and care expenses for her child if she does, in fact develop autism from the MMR?

What exactly is the point of this reply except to stir up trouble on a thread where members are having a polite discussion.

[emmy526]

Originally Posted by ma2two 

tarasuetx, perhaps you could send DaisyO your contact information. You have guaranteed that her child will absolutely not develop autism from the MMR. So are you willing to back up your guarantee by agreeing to pay lifetime medical and care expenses for her child if she does, in fact develop autism from the MMR?

unfortunately, if her child does show signs of autism after the vax, the connection between the two will be denied by the dr anyway.  even if her child is the "one in a million" who experiences a adverse reaction, she'll have to go to vaccine damage court to prove it.

[DaisyO]

Originally Posted by ma2two 
 

tarasuetx, perhaps you could send DaisyO your contact information. You have guaranteed that her child will absolutely not develop autism from the MMR. So are you willing to back up your guarantee by agreeing to pay lifetime medical and care expenses for her child if she does, in fact develop autism from the MMR?

Originally Posted by emmy526 

unfortunately, if her child does show signs of autism after the vax, the connection between the two will be denied by the dr anyway.  even if her child is the "one in a million" who experiences a adverse reaction, she'll have to go to vaccine damage court to prove it.

This is all too silly.  Please talk about real issues.  This is a serious thing for me, not an excuse for people to engage in frivolous snipping.

thanks

[ma2two]

Quote:

Originally Posted by DaisyO 

This is all too silly.  Please talk about real issues.  This is a serious thing for me, not an excuse for people to engage in frivolous snipping.

thanks

My and emmy526's posts are serious and based on real (tragic) issues. tarsuetx is not the first to give a false guarantee that a child will not develop autism from a vaccine. Doctors do it all the time, because they have nothing to lose, just as tarasuetx has nothing to lose, unless she follows my suggestion. The National Childhood Vaccine Injury Act of 1986 completely protects doctors from any liability, no matter what adverse outcome there is from vaccines. In light of this, it doesn't make sense that most doctors will refuse to acknowledge a vaccine injury once it occurs, although most do. Vaccine Court is extremely adversarial, and takes many, many years, sometimes over a decade, and it is the only way for parents to get compensation.

[emmy526]

think "Hannah Poling"...

http://www.nejm.org/doi/full/10.1056/NEJMp0802904

[DaisyO]

Quote:

Originally Posted by emmy526 

think "Hannah Poling"...

http://www.nejm.org/doi/full/10.1056/NEJMp0802904

Okay...frankly, I found that article reassuring.  Not sure you meant it to be, but it had certain information I found very interesting.  Such as the fact that the viral load of the recommended vaccines today, taken all together, is less than that of one smallpox inoculation a century ago.  Although the vaccine court itself seems frustrating enough, the other information made me feel better, not worse, about the MMR.  And believe me, I do have my concerns about it.

Anyway.  I don't want to hear just "yikes autism!" but to hear a discussion of if this vaccine has been used safely on anybody's one-year-old, and if it even makes a difference to wait until they are two.  If people are sick of this thread, that's cool, but I'm interested in a nuanced discussion, not just a "yikes!" scene.

thanks!

DO
 

[ma2two]

Quote:

Originally Posted by DaisyO 

if it even makes a difference to wait until they are two. 

It does. The measles portion of the MMR works better if given at 18 months or later.
http://www.jstor.org/pss/3864478

[emmy526]

One of my immediate thoughts about the Hannah Poling case is the fight in which her parents had to engage for years about her condition that was aggravated  by the vaccines. What they must have went thru! I wouldn't wish it on anyone!  And that poor girl...

[DaisyO]

okay, so she's letting us delay it after all.  In fact, it seems as though she forgot that she ever wanted us to get it at 12 months.  I'm still doing it...just later on.

D

[ma2two]

Quote:

Originally Posted by DaisyO 

okay, so she's letting us delay it after all.

I don't understand what you mean by "letting" you. The doctor has no power or authority over you.

[DaisyO]

I don't understand what you mean by "letting" you. The doctor has no power or authority over you.

I know...but I like to go with her recommendations because I trust her.  I would feel conflicted if she was still strongly recommending the shot at this point, but she isn't.  So it seems like things are easier for me now, with no conflict.

[emmy526]

I guess i wouldn't feel comfortable with any dr who "forgot " what they told me in regards to what my child needed. 

Quote:

 In fact, it seems as though she forgot that she ever wanted us to get it at 12 months. 

 

 

but I like to go with her recommendations because I trust her.  

[ma2two]

Originally Posted by DaisyO 

I know...but I like to go with her recommendations because I trust her.  I would feel conflicted if she was still strongly recommending the shot at this point, but she isn't.  So it seems like things are easier for me now, with no conflict.

But there are many thousands of doctors, and I'm sure you could find many whom you trust, who would recommend against the MMR vaccine. You have to do what makes sense and is comfortable to you. You mentioned in your first post that you were terrified, so I'm glad the doctor forgot that she recommended it.