Ok, I'll respond because I enjoy pain.
I'm a MD. I don't work with kids most of the time, and I don't do primary care. This means that I almost never deal directly with vaccinations. The only time I do is when working with immune compromised people, and this is a very different situation than with most kids in peds offices.
First, there's a few misconceptions I've seen over and over on this thread. Some of these deal with med school. My med textbooks and the reference books I use today are not written, sponsored, or paid for by drug companies. There's plenty of drug company-sponsored literature out there, especially stuff aimed at patients, but reputable text books are not. Second, most med students have little to no experience with drug reps in their first two years of med school. These are the lecture-based years in which students learn about normal (physiology, anatomy, histology), abnormal (pathophysiology), and pharmacology. In my pharm class, we were taught the generic names of drugs, not the trade names (the names of individual drug company products). This was also required in the clinical years, especially when writing prescriptions. So we learned "ibuprofen" and not "Advil". None of the material in Pharm class was from drug companies. To ensure that, my profs wrote their own class material (this is a common practice in my med school).
While in med school, we were taught to evaluate articles critically again and again. This continued for all 4 years. We had lecture-based classes and multiple writing assignments about this. Evidence-based medicine is a fairly new development in med education, and this is a huge part of it. In every paper centered around a study, in addition to other things, I had to write something about the limitations or flaws of the study. [FTR, the standard published study must include a section about its limitations.]
As for education about vaccines, mine was very limited. I put some of the blame on med schools, but I put part of the blame on the CDC and FDA. I think the CDC and FDA fail completely in the completeness of the information provided to parents and physicians and in the studies required for vax approval. I think it would be easy for the CDC to go through its files and provide a full picture of a VPD incidence, from pre-licensure of the vax to present day that also includes in the same discussion rates of vax coverage. What they give instead is fairly useless. Sure, reports are spotty pre-reporting requirements for reportable diseases. But they could do much, much more in making meaningful reports.
In terms of reactions from vaxes, this is where I probably differ from many here. I think VAERS is useless. Completely useless. It is not much more than anecdotes of bad things that happened some time after a vax was given. Again, part of the blame is on the CDC. Thanks to their system, it is impossible to put together a scientifically rigorous study of vax reactions from VAERS. I also am skeptical of some of the things many perceive as vax reactions. But there is no good system in place to evaluate these. Ideally, peds would be highly trained in spotting and reporting childhood vax reactions, but I don't think that is the case.
Then there are the VPDs. Some are not worrisome. Sure, a few people with Hep A will have a rocky course, but I don't see the need for vax in most young children. I could see recommending the vax for those will liver disease to avoid the risk of fulminant liver failure, men who have sex with men, people being treated for some clotting disorders, people who use IV drugs, and folks who work with or around people with HAV. I also wouldn't think it would be a bad idea to test older people for immunity to HAV and offer the vax if their are not immune as it can be more serious in this population. I blame the CDC for having at its apparent goal "eradication of disease", which makes any disease a possible target for a vax.
Some are worrisome. Of course, many people with polio will not get the paralytic form, but the risk is not worth it in my mind as there's very little that can be done for those who do. Measles can be mild or it can kill, and you can't always predict the course in any one given patient. Rubella may not be all that bad in kids - although it certainly can be - but I'm glad there's a vax in order to cut down on congenital rubella syndrome.
In terms of docs seeing deaths from VPDs, that is a fact. I have seen more than one. People ask, "was that person breast fed" or "were they previously sick". In terms of being breastfed, that certainly helps but it does not confer magical protection. As for being previously healthy, some were and some were not. I've seen some previously healthy college-age students die from meningitis. One was a college athlete home for spring break. He thought he had the flu around dinner time, his parents brought him to the ER at 9 pm because his neck hurt and he was confused. He died at 7 am the next morning. He was unvaxed. Would the vax had saved him? No one knows, but if there was any chance of that happening you can bet his parents would give their own lives to go back and do it.
Statistics are weird things. Maybe only 1 in 100,000 get some terrible complication of VPD X. But it doesn't matter if that one person - or that one patient - is YOUR child or your responsibility. I tell people that stats give you an idea of risk, but that for an individual all risk stats are really binary: Either it happens to you or it doesn't. Use the real stats to develop a basic comfort level regarding the chances of something bad happening, but realize that it still could happen, or not.
I would not say I"m "pro-vax". I would say that I think most vaxes are mostly good. I also think vaxes have helped contain a number of previously prevalent VPDs. I do wish the CDC would snap out its fog and truly address the problem of a lack of meaningful information on the possible harms from vaxes and full story of VPD incidence. But I do think if all vaxes were ended today, eventually we would see some heartbreaking rises deaths and complications from some VPDs.
I am pro-vax education, despite the challenges the CDC's presents in doing this well. I have no problem with parents to make an educated or religious-based decision not to vax their children. I just wish there were better information out there, less misconceptions on both sides, and more respectful and open-minded - and open-hearted - debate on the subject.
Sorry this is so long.
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: Seriously, I was not only extremely disappointed, but scared into action. I knew then that I was going to have to be the one to obtain information and be in control of my children's medical decisions. So, yeah, I agree w/ previous posters who say it is due to ignorance.
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