Taking Back "Informed Consent"

Pediatrician Richard Pan also happens to be the California state legislator responsible for introducing AB 2109, which will make getting a vaccine exemption for philosophical reasons a touch more difficult (the bill will require a parent to get a sign-off from a health provider indicating that the health provider outlined the risks of not vaccinating).

The uproar among California’s vociferous but small anti-vaccine community has been predictable, but one thing Dr. Pan mentioned in a wonderful conference call Every Child By Two set up last week has stuck with me. He said it’s time for the pro-vaccine community to “take back the term ‘informed consent.’” I was thunderstruck by his comment.

Yes, I thought to myself, of course! Anti-vaxxers tell new parents that immunization laws trample on their rights as parents to make medical decisions, without mentioning that their choice not to vaccinate their children tramples on the rights of everyone around them to a healthy life. The code word for their opposition to vaccines is often “informed consent.” So what is informed consent? A simple Google search will bring up articles and web pages from a number of very official-sounding websites, which are actually anti-vaccine organizations (National Vaccine Information Center, Vaccine Information Center, etc), and there you will learn that doctors like to jab kids full of toxins at every well-child check and they like to keep the contents of those shots super secret. Therefore, the parents are not informed.

This claim is, of course, without merit. Vaccine ingredients are publically available, and the Vaccine Information Sheets (VIS) provided at well-child checks, along with supplemental sheets each provider may choose to give parents, contain transparent information about what is contained in each shot. The same cannot be said of other injections regularly given during doctor’s appointments, like antibiotics for children suffering from illness, for example. Of course the anti-vaccine activists don’t make mention of this fact.

The truth is that the raising the flag of “informed consent” with regard to vaccines is like American women marching in the streets in 2012 demanding the right to vote. We already got it. Only the anti-vaccine activists have misapplied the term to their desire to not vaccinate their children and put the community at risk.

But there is one scenario in which “informed consent” has not been fully implemented, and it has nothing to do with the ingredients of a vaccine. It has to do with informing parents of what can happen if they choose not to vaccinate. And telling them in clear, transparent language. Informing parents that not vaccinating their children can lead to serious illness, disability, and even death. As a new parent, I was not informed of this. I did not hear the words “risk” from my pediatrician except in describing the “risks” of the vaccine itself—fever and soreness. What if I had been “informed” that not vaccinating my child could put my child at risk of developing a potentially fatal illness, or even a long hospital stay? What if I had been told that not vaccinating my child would put the kid down the street with leukemia at serious risk? Or the one in my playgroup with a gelatin allergy? Maybe I would not have delayed my son's MMR vaccine for three months. Maybe, after each well-child check, I would have run to my social network and reminded my fellow parents why vaccination was so crucial.

In fact, the failure of informed consent is not that doctors and vaccine manufacturers do not inform parents about what is in vaccines and the risks of the immunizations. The failure is that parents have not been adequately informed of the risks of not vaccinating. And so Dr. Pan is right. It’s time to take back the term informed consent and apply it to something real: the risks of not vaccinating.

Moms Who Vax: Kristen's Story

By Kristen Robinson

Kristen and her children

When my daughter was born three years ago I never questioned her having to be vaccinated. I read through the book What to Expect the First Year a million times and would always just sort of skim past that whole chapter. I didn't question her need for them, I was pro-vax, and I knew she needed the vaccines to stay healthy—although back then I would not have called myself pro-vax. I didn't even know there was such a thing as being pro or anti-vax! I just thought everyone vaccinated their children. I had no clue how heated of a topic vaccinations could be or how strongly people’s opinions on the subject could be.

When I was pregnant with my son, who is now eight months old, I knew I would vaccinate him as well. Or so I thought.

I did not have a great pregnancy. I did not enjoy being pregnant and just wanted it over with. So I can only equate my feelings of guilt over the way I felt about my pregnancy as to why I suddenly was having doubts about vaccinating. I was suddenly terrified something would happen to him.

I am "friends'” with a woman who is against vaccinating, so I reached out to her and she seized on my hesitation. She began sending me all types of emails and articles begging me to at least think of spacing the vaccines. When she saw that tactic wasn't working very well she started mentioning how a friend of hers has a little boy who had a reaction to the MMR at thirteen months, a reaction I happened to know was a 1 in 10 million doses kind of adverse reaction. Still, the thought that something could possibly happen had been planted in my head. I was starting to cave, and she knew it.

The final anti-vax article she sent to me was over the top, but I will admit that I read it and got scared, which the whole intent of the article and the woman who sent it. She knew what my weakness was and she preyed on it. I knew as I read it that it was fear mongering at its best, but I couldn’t stop reading. Then, after sitting there digesting it, I read it again and I started to see the flaws. There was nothing scientific or factual backing up any of the claims in this article. Nothing. In fact, it was purposely written to scare moms just like myself who are on the fence. It made me sick.

I turned completely in the opposite direction and I picked up the phone and made the appointment for my son to get his two-month shots. He has had all of his shots since. I now have this enormous feeling of gratitude towards this "friend" every time my son gets his vaccines because if she had not sent me that final article I would have in all likelihood joined her on the dark side and decided not to vax. Now, the thought of NOT vaccinating scares me much more than anything that could ever be written about adverse reactions or any of the other fear-inducing thoughts anti-vaxxers try to put into our heads as parents. 

I know that there are many, many other mothers out there just like myself who have a fear of vaccines. I hope by writing this that I have helped them know that they are not alone. My hope for every parent is for them to be informed by reliable information, to be presented with facts not fiction, and to feel confident and supported, not made fearful by claims that have nothing to back them up.

Kristen Robinson is a stay-at-home mom to a little girl, Presley, who is three, and her little man, Kadena, who is eight months.