Where to start?
Parenthood is tough! Decisions, decisions, decisions. And here in “The Information Age”, many parents feel that there is no room for poorly informed choices for The Big Decisions. For many parents, the issue of vaccines was at one time a “no brainer”. Children were “completely” vaccinated. Everyone believed that vaccines were necessary to save your baby’s life. For the majority, vaccines were completely beyond debate. Today, many parents are questioning the safety and necessity of the large numbers of vaccines on the schedule, particularly for obscure or milder diseases. Vaccine necessity, which used to be taken for granted, has suddenly become an uncertain, debatable matter that has to be researched in depth.
What are the issues which require consideration as one steps outside the “Just do whatever your doctor tells you to do!” mindset?
- 1) the ethics of vaccine decisions in light of herd immunity
- 2) the immediate risk to the baby or child from both the diseases and the vaccines
- 3) the social stigma of possibly going against the flow and not following the recommended schedule
- 4) and the confusing, often conflicting ocean of scientific literature on the topic.
So where should a parent start?
Many parents find it helpful to look at individual diseases first.
Here is the US recommended vaccine schedule. It begins with a dose of the Hepatitis B vaccine at birth, followed by rotavirus, DTaP (diphtheria, tetanus, pertussis), IPV (polio), PCV (pneumococcal), Hib, and additional HepB at 2, 4, and 6 months.
An excellent place to familiarise yourself with the diseases is the CDC’s Pink Book chapters.
After coming up with a list of the diseases you’re interested in possibly vaccinating against, there are a few useful pages you can check out.
- a ) The MMWR, selected cities, notifiable diseases page will help you figure out what the immediate disease risk is.
- b ) The “Reported Cases and Deaths“, from vaccine preventable diseases from 1950 to 2005″page, along with the “Vaccine Coverage Levels” page are also useful for double checking conflicting accounts of possible disease severity and incidence, and the impact mass vaccination has or hasn’t had.
For example: Look at pertussis and h influenzae on both the “Reported Cases and Deaths” and ”Vaccine Coverage Levels” pages over the last 10 or 15 years. Surprising, isn’t it?
Researching problems with vaccines is a more complicated matter than understanding the basics of the diseases.
If you don’t know where to start looking, internet searches can easily lead you astray. Vaccines are controversial, controversy can attract passion, and passion on occasion, can lead to misinformation and strongly defended extremism. While personal stories can be interesting, they aren’t science, on either side of the debate.
Always check out the facts. Look at how trials are done at clinicaltrials.gov. Check the CDC, check the FDA website where vaccine documents are held, check the articles published in peer reviewed medical journals.
As you read and cross check information, you’ll become more confident. Each new scientific principle you understand will add another building block helping to clarify the bigger picture when it comes to disease, epidemiology, risks, benefits, and how they relate to your specific child’s immune system and your family’s medical history. Any intelligent human being is capable of understanding scientific research, although it takes time and effort.
Checking the manufacturer’s package inserts is useful for information on possible reactions to vaccines. Keep in mind that there are reactions listed under the “rare” category that might or might not be actual side-effects of the vaccine. Causation is difficult to determine in the case of rare events.
Merriam-Webster Online now has a medical dictionary to help. Just click the “medical” box before you search.
A useful tool for finding accurate information is Google Scholar. Here’s a quick tutorial on how to use it:
- The “all X versions” function on the right (after you do a search) will take you to fulltext versions a lot of the time.
- The “recent articles” function at the top (after you do a search) will take you to the newest research on the subject.
- If you find something interesting, use the “cited by X” button under the the title to see what newer research might have confirmed or conflicted with what you just read.
PubMed is another good site. If the fulltext of the abstract you’re reading isn’t available through Pubmed (sometimes it will say “free fulltext at…” in the upper righthand corner) try putting the title of the abstract into Google Scholar, and looking through the “all of X versions” function to see if any of them are fulltexts.
To find a collection of the information that supports a vaccine’s recommendation by the CDC, try using Google with the keywords :
[disease name] vaccine recommendations MMWR.
For example: to find the ACIP’s MMWR recommendation for chickenpox, this search will take you there. Reading official information is important so that you know you have not missed any important information (even if it is sometimes “cherry-picked” or inaccurate) as you make your vaccine decision.
Okay, now you’ve got the tools to do basic research on diseases and vaccines.
More advanced sources and techniques can be found here.
Ready to start work? Make a list of questions or topics you’d like to research. Start a page (either paper or computer) and put down the first topic from your list. Start building a list of search terms. Once you’ve got some possibilities, start searching. Make notes of what you find and save useful links with notes on what they link to and why they are useful. You’ll find yourself refining your search terms as you go along, dropping some terms and adding new ones.
Final advice? Don’t spend your entire life on the computer!