If you could decline just 3 vaccines, what would they be and why?
I'm curious to see where everyone agrees or disagrees and how many people are generally on the same page.
pertussis, it is becoming more and more common and i really don't want my kids to get it
polio, though it is rare, my uncle got it before the vaccine was available, and is still suffering from post-polio syndrome in his 60s
measles- complications are rare, but life-threatening
hep b, because it is not really needed in childhood
chicken pox,because i know how to manage it
rubella, i am immune, and there were only 7-80 cases of it in my country per year the last decade
The balances are between how serious the disease is, and how likely my kids will be to encounter it.
Measles and pertussis are relatively likely, considering the fact that people likely to be at a LLL meeting, a cloth diaper store, or a Waldorf or Montessori goods store are less likely to vaccinate. The vax rates at a local public kindergarten are nearly 100%, and at the local waldorf kindergarten, they are around 50%
-tetanus: I live in Australia and my kids are barefoot a lot of the time. Yeah, adequate wound care, sure. However, my kids are getting older and I'm not with them all the time anymore. They're out at the beach with friends. They're on school excursions to farms, the bush, whatever. They come home (more likely DS) with semi-scabbed over scrapes and I'll ask, "Um, when did you get that?" The school nurses clean what they're aware of, but with my DS, he's more likely to get a cut or scrape, cry a bit, and then go right back to playing in the dirt without telling anyone. Unfortunately, we cannot get the dT until age 10 here so it's a bit problematic that the kid who likely is at higher risk from dirty wounds is the one who has to wait another 4 years to get the vaccine.
-measles: complications are very rare; however, there have been 151 cases country-wide last year, the majority brought back from travellers to Asia. My kids have classmates who travel to Indonesia, Malaysia, and Thailand regularly.
-diphtheria: also very rare (as Mendelsohn writes, the chance of getting it is the same as getting bitten by a cobra). Also, the whole nutrition/sanitation/why haven't the millions of adults worldwide whose circulating antitoxin levels are below 0.1IU/mL gotten it, sure). That said, it is also endemic in Asia, can be present in vaccinated individuals who have been colonised by the bacteria, thus while my kids have as much chance clinical diphtheria as a cobra bite, their risk goes up a fraction more with a basket including said cobra possibly hanging out in their classroom. I can hope that nutrition is enough should any of their classmates bring back a souvenir from Asia or I can take one extra step to possibly help reduce risk.
(Polio also fits this rationale for us--the old individual immunity vs. transmission issues with IPV--but since we can only go with three, these are the ones we have elected to go with IRL already or in the nearer future. Polio will be more of an issue if they decide to go to Asia on school trips much further down the road).
-pertussis: one child has had it naturally already; the vaccine's effectiveness is just not there IMO to get it for the other child. The whole issue with antigenic drift is just too obvious here in Australia where the majority of cases analysed are not covered by the strains in the current vaccine.
-HPV: not convinced about relative safety vs. effectiveness; too new; there are other means to reduce the risk of developing cervical cancer. Other issues re: serotype replacement and ultimate overall effectiveness.
-Flu: no thanks. The evidence of effectiveness in children is just not there, IMO. Three of us actually came through suspected H1N1 when we were visiting family in Canada during an outbreak over Christmas. We didn't get it confirmed (who wants to sit in the ER and infect others), but we made it through okay.
There's a few more that I could put under decline: chicken pox, hep B, polio etc. but these are not absolute. If the kids get to the end of their teen years without demonstrated immunity to chicken pox, then it might be something for them to consider. By that point, they can decide for themselves if they want a varicella vax or a hep B if they feel they need it.
Well that depends on if you mean 3 vaxes for their lifetime or just their childhood:
I would get:
DTaP, MMR, and Polio - lots of international travel and it is still endemic in some areas, all can cause bad long term side effects.
There is nothing I can say we would never get because it depends on the situation.