Monday, August 27, 2012

Moms Who Vax: "Slow-Vax" to Pro-Vax

By Melissa Clark

As parents, we are faced with making many decisions. It can seem overwhelming. We are bombarded with information and advice from other parents, friends, the media, doctors—the list goes on. When I was pregnant with my first child three years ago, I knew I wanted the way I parented to fall somewhere on the attachment theory continuum. I hoped for a natural childbirth, planned to breastfeed, to use cloth diapers, to wear my baby, to co-sleep—you get the idea.

I thought one of the decisions I needed to make was whether or not to vaccinate my child. As a nurse, I understood the importance of vaccination, but as a soon-to-be new parent, I fell prey to the “toxins” argument. So I did what any well-intentioned parent would; I began to research vaccines. I turned to Dr. Sears’ Vaccine Book and decided that I would follow his delayed vaccination schedule. I knew that vaccines were important, but I thought there was a “safer” way to administer them to my child that would minimize her risk of exposure to toxins.

Fast forward a couple of years, and I am pregnant with my second child. One morning I saw a post on Facebook in regards to the flu vaccine. It claimed that the vaccine contained aborted fetal tissue. In my head I knew that didn’t sound right, and a simple internet search revealed that I was correct, vaccines do not contain aborted fetal cells.

It was at that moment I realized that if that article was false, what other beliefs about vaccines that I held to be true were actually false? My thinking started to shift. I began digging deeper into the issue of vaccines and found that, in fact, I had been duped by fear. I had bought into the scare tactics. I trusted the opinion of one man, instead of the scientific evidence proven by many.

I felt like a selfish jerk because I realized that not only was my decision to delay vaccinating my daughter arrogant, but even worse, that decision could have had deadly consequences for my daughter as well as other children. Never had I been told that my decision to alter the CDC vaccination schedule myself could cause harm to someone else’s child.  
I also felt guilty for spewing the scare tactics and biased information to other parents, thus potentially influencing their decision to vaccinate. After that lightbulb moment, I knew that I would vaccinate future children on time, according to the CDC schedule; I also began getting my daughter caught up on the vaccines that she was missing.

As my attitude toward vaccines changed, the question came to mind “when did vaccines become a choice?” When did it become okay to purposely expose our children to vaccine-preventable diseases, like chickenpox? Why is the loud voice of the anti-vaccine movement often the only one parents hear when they turn to various media and social outlets for information?

I wish I had the answers. What I can tell you is that I know how easy it is for an educated, well-intentioned parent to be swayed by fear and misinformation. I can tell you how easy it is to see the fear- mongering for what it is once you are presented with scientific truth. Yes, as parents we are tasked with making many difficult decisions on behalf of our children; however, vaccinating is not one of those difficult decisions. The ramifications of not vaccinating your child are not contained within your family; they threaten the safety of public health. So, once you are confronted with the truth of science, what will you do?

Melissa Clark is wife to an amazing husband, and mom to two awesome kids. Her educational background is in nursing, and she is a doula and Lamaze childbirth educator. She enjoys coffee, the Internet, and a sparkling kitchen sink.

Friday, August 24, 2012

Will Pro-Vax Blogs Infect Your Computer? Anti-Vax Activists Want You to Think So

Apparently, some anti-vaccine folks are trying to scare parents way from blogs with a pro-vaccine bent by claiming the blogs will infect computers or that they contain some kind of malware. They've even been reporting such sites as malware to malware reporters, creating headaches for the blog owners and wasting everyone's time. When challenged and asked for specifics, they, of course, can provide no evidence of malware or infection.

This is patently false, in case it needed to be said. It wouldn't, however, be the first time such a claim was made (and in this case he is dealing with it yet again).

In some ways I take this level of mendacity to be a good sign--you would never catch a pro-vaccine activist or parent resorting to such tactics, and I like to think you'd only find an otherwise rational human being making up such nonsense because he or she feels the evidence is against her.

That being said, I still find this very sad. Because we're all parents and we all want the best for our children, no matter what our stand on vaccinations. At the same time, as a parent wanting to know more about vaccine safety, it might be good to put this kind of retributive and frankly downright irrational behavior on the scale when you begin making decisions about which parties you find to be reliable sources of information.

Anyway, rest assured, Moms Who Vax is safe, as are the other blogs you'll find under our Links. In case you'd heard otherwise.

Wednesday, August 22, 2012

Survey Says...

One of the reasons the anti-vaccine movement was able to get such a foothold in the parenting culture of the last ten years or so is because the public health and medical establishments were, by their own admission, slow to respond. I understandy why. It is, on paper, hard to grasp the reasons why people find information from shadowy websites and Hollywood celebrities more credible than peer-reviewed science and information fromt ehir own pediatricians. The turh is that, as parents, we tend to put a lot of stock in the experiences of our peers, and rightly so. We’re the ones on the ground dealing with everything for the first time, armed with nothing but questions. Parents don’t want to take anyone’s word for it—they want information. Because the Internet has become our go-to source for information, without any attendant filter that might red-flag a site that offers nothing but misinformation, parents have been doing their “research” there.

I mention this because pediatricians and public health officials are starting to respond effectively to anti-vax messaging by turning to parents, and by reaching out to new parents, including the vaccine hesistant (a different crowd from the anti-vaxxers). Heck, I was a vaccine-hesitant parent. It’s okay to be hesitant. It is, however, critically important that we understand where the information we base our decisions on, and whether science factors in to your decision. One place you’ll find some much-needed outreach is at the Minnesota Department of Health’s Immunization website. This website is scheduled for a redesign, and the folks behind it are looking for responses from parents and members of the public at large about what changes might be useful, through an online survey. They are looking for feedback from anyone, whether the parent has been to their site before or not. The goal of the site is to become a place where parents and providers want to go for information—or wants to refer others to.

It’s rare that parents get a chance to tell public health officials how to best communicate with them, though I see it happening more often. So please consider taking a look at the website, then taking the short survey. Be candid. This is a great chance for your voice to make a difference.

Monday, August 20, 2012

Moms Who Vax: There's an Anti-Vaccine Movement?

By Katie Ellis

It's no secret that I have always been science-minded.  My entire life, I wanted to become a doctor.  I took AP science courses in high school, entered college majoring in biology/pre-medicine, and enjoy reading scientific journal articles "for fun." It was no surprise, therefore, that, as a microbiologist whose work focuses on vaccines, I never questioned vaccinating my children.  I knew how great of an achievement vaccines were for the history of science, and the profound enhancements they have made to public health.

Katie Ellis, mother of two
My son was born in 2009, and he was vaccinated per the CDC and AAP recommended schedule.  I knew I was making an informed, intelligent choice to protect him from deadly childhood diseases. I had heard all of the hype with the Andrew Wakefield fraud incident, but knew that it was nonsense, and never doubted my vaccination choices. At this point, I was obviously pro-vaccine, but had never given a thought to advocating for the use of such vaccines.

Soon after this, Dr. Paul Offit spoke at my place of employment.  The topic of his talk was the anti-vaccine movement, which intrigued me – I didn't know there was a big enough group of people against vaccines to form a movement.  After hearing Dr. Offit speak, I felt a multitude of emotions. I felt fascination, for Dr. Offit was such a dynamic speaker who clearly had vast amounts of knowledge about vaccines and infectious diseases.  I felt anger, that parents in this country had access to life-saving technology and were not utilizing it.  More than that, parents were not vaccinating due to fear, uncertainty and doubt spread by Playboy models, geologists and other parents who have graduated from the "University of Google."  Mostly, though, I felt a spark of passion to become an advocate for the safety and efficacy of vaccines.

This spark was further stoked when I became pregnant with my daughter. I began to read about outbreaks of whooping cough that occurred in California, in which ten babies (not yet old enough to be fully vaccinated) perished. I read about the anti-vaccine movement, and how it grew by scaring new parents with absolute lies.  I started to peruse pro-vaccine blogs, such as Shot of Prevention, and Facebook pages, such as Vaccinate Your Baby and Nurses Who Vaccinate.  Amazed by the depth of knowledge of the active pro-vaccine advocates on those pages, I was deeply inspired – and my passion grew.

When my godmother was diagnosed with whooping cough and sent to the hospital for two weeks, just months before my daughter was due, it was the final straw.  Right before her diagnosis, my family – including my godmother – had all been gathered at the hospital.  We were visiting my grandmother, who was sick with uterine cancer.  Not only was my grandmother at extreme risk, but so was my unborn child and I.  I was scared that I wouldn’t be able to fully protect my child when she was born and was too young to be vaccinated.  Thus, my passion grew to the point that I began posting comments on pro-vaccine blogs and pages.  As I posted more, the more I learned, the angrier I became, and the more passionate I became.  I now have confidence to post on anti-vaccine pages and blogs and new articles; I feel comfortable writing letters to members of Congress.  I am a greatly passionate vaccine advocate, and very proud of it.

Katie Ellis is a mother of two, who works full time as a microbiologist specializing in vaccines. She loves spending time with her family, running, baking, and being active.

Thursday, August 9, 2012

What Middle Ground?

By Karen Ernst

This morning OCWeekly published an article about self-declared vaccine expert and pediatrician to the stars, Dr. Bob Sears. The article, titled Dr. Robert Sears Takes on Both Sides of the Great Vaccination Divide: The author of 'The Vaccine Book' presents his own alternatives to the CDC-recommended schedules,” is mostly a discussion about reasons that Dr. Sears promotes his own vaccine schedule, available in his book. 

The problems with the article and with Dr. Sears reveal themselves in the headline.  We absolutely cannot allow the media to portray vaccination as something with a “divide” or “middle ground.”  While he-said, she-said journalism works for enticing readers and create buzz, it does an incredible disservice to public health.  So, while the article notes,
For years, the issue seemed to be black and white—moms and dads either gave kids all their shots or were ostracized by doctors and their communities. But now concerned parents are discovering what they see as refreshing middle ground,” this middle ground is, in fact, not refreshing.  This is ground that is risky and fraught with consequences, such as potential illness and additional procedures in the case of emergency. 

And Dr. Bob's waiting room is a prime example of the risks associated with delaying and skipping shots.  Dr. Bob's waiting room was ground zero during a measles outbreak, which originated with one of his unvaccinated patients who had brought measles from a vacation in Switzerland. (Click here for a photo of a child with measles, a disease whose seriousness anti-vax activists and fringe celebrity practitioners like Dr. Jay Gordon have consistently downplayed.Yet, half of Dr. Bob's patients remain in this risky middle ground, according to this OCWeekly article: “Roughly 25 percent of his patients do not vaccinate, and another 25 percent partially vaccinate.”

Clearly, Dr. Bob does as good of a job talking patients out of vaccinating as he does talking them into it.

Why does he continue to endanger the health of his patients?  “Sears sees his role as a bridge between the medical community and those skeptical of it, declaring that vaccinations don't have to be an all-or-nothing decision.”  However, how does one reconcile the idea that vaccines are bad, but I can do some of them?  Or that the CDC doesn't know what it is talking about, except with these vaccines that Sears, as someone with no background in immunology, likes? 

When asked about vaccines, Dr. Bob does not seem to describe them in a positive light: "There are chemicals such as formaldehyde. MSG is in some vaccines. There are chemicals that are very similar to antifreeze. Some flu shots actually have a spermicide used as a preservative. But they're all in tiny amounts, and I believe they're probably safe because they're in such tiny quantities."  He has an addendum at the end about the quantity of various ingredients, and most people with a basic understanding of chemistry know that the dose makes the poison.  
However, he equivocates this position, claiming they are “probably” safe.  This statement is utter falsehood.  The ingredients found in vaccines, as well as vaccines themselves, have been studied exhaustively and proven safe.  Thus, his suppositions about ingredients fall into the category of fear, uncertainty, and doubt.

The ingredients are not Dr. Bob's only issue, though. "He also had an issue with the way vaccines are approved by the government. When a medical manufacturer makes a vaccine, a panel of doctors at the
Food and Drug Administration must decide whether to approve it. Doctors on that panel might own stock in the vaccine manufacturers or even work for the vaccine manufacturers.”  This point may seem valid, if the FDA were the only check in place for vaccine safety.  However, the CDC and the ACIP also review vaccine data and studies, and they are the ones who make the schedule we all follow, which is supported by the AAP and the AAFP.  The system of nepotism that Dr. Bob alludes to is simply nonexistent, unless millions of doctors--uncompensated, by the way-- are in on it.

You would suppose that Dr. Bob just wants to give parents information and let them decide for themselves what to do.  However, “he continues to be an advocate for parents who want choices, and at the moment, that includes fighting against Assembly Bill 2109, which would require parents to obtain a doctor's signature before they can enroll their child in public school if they wish to skip one or more vaccines.”  In other words, he would rather have parents self-educate than seek appropriate information about medicine from an expert in medicine.

Dr. Bob's advice, as always, is to hide in the herd. "Right now, enough people are vaccinating that the herd immunity of our nation is not being compromised yet," he claims. However, he may have missed that vaccine preventable diseases, like measles and pertussis, are coming back.  He may have forgotten the measles outbreak of 2011, but 222 people who contracted it, and the third of them hospitalized with measles, have not forgotten.  Highly contagious diseases like measles and pertussis are merely signs of what is to come if we do not raise our vaccine rates.

"You can argue with these parents that the decision they're making to not vaccinate is bad for public health, but most parents are trying to make a medical decision that's best for their baby," Sears says. "I think we're all selfish when making any decision for our own children. I can't fault parents for thinking that way."
  That true, Dr. Sears.  But I can blame you for supporting and promoting this way of thinking.

Karen Ernst is a mother, teacher, and vaccine advocate. She is the co-founder of Moms Who Vax.

Sunday, August 5, 2012

Note to Peds: They're Looking For You

The other day I did a search on "Moms Who Vax" to see how this blog was coming along in the fight to get pro-vax resources higher up on the virtual totem pole during a blanket search for "vaccines" and came across something interesting. Again and again my search results delivered forum posts from vaccine-hesitant parents who were querying their online communities for pediatricians who would accomodate delayed vaccinations. Below are just a few examples of what I found.

In Missouri:

In Texas:
(The questioner says she "thought she had a pediatrician but apparently she isn't taking new patients"--which made me smile--good on ya', doc!)

In Washington State (Seattle):

In Michigan (Grand Rapids):

And then this epic thread from Berkeley:

This is just a sample of the number I came across during a casual search. It reminded me of how I found my children's new pediatric clinic (I left my previous pediatric clinic after a child with measles exposed children in the waiting room, along with a pregnant pediatrician, to the virus). I had done a search looking for pediatricians in the Twin Cities area who were actively turning away anti-vax parents or parents who skipped a lot of vaccines for their children. Some pediatricians in Colorado and New England have begun doing this out of concern for their newborn patients. Alas, I had no luck finding such a practitioner in Minnesota, but I did locate a forum post in where a Twin Cities woman was looking for a practitioner who would be open to delayed vaccination. A couple women replied with the name of their pediatrician at a highly respected pediatric clinic.

I don't know why, but I felt moved to write the clinic a letter, along with a copy of this forum exchange, to let them know that this information was being spread on the internet and likely attracting anti-vaccine parents to their clinic, putting their patients at risk. Dropped it in the mail and did not include a return address for reasons I have no grasp on to this day! Anyway, I later found out that another of our fearless Moms Who Vax proudly claimed this clinic as hers--she drives her children all the way across town to see the pediatricians here. She was appalled by what I had found, and in true pro-vax mama style, printed off the pages of the forum exchange herself and showed them to her pediatrician, whose response was grim-faced silence. He was clearly very disheartened (he was not the pediatrician in question, by the way).

About three weeks later, I returned to the clinic's website to find it had put on its front page a clear, almost blunt statement about its policy on vaccines. While they were not turning anyone away, they were also making no bones about the fact that they encouraged and recommended vaccines, that a discussion about vaccines would be a part of every well child visit that would include immunizations, etc. I was so impressed by this that I scheduled an appointment with one of the doctors--and we are now patients of this clinic. Further conversations with the pediatricians have convinced me that they are 100% pro-vaccine; I am not sure what became of the pediatrician in question, however.

I bring this story up because I happen to know that the pediatricians at this clinic were completely blindsided by this online discussion about their practice. They did not want to be known as a place where anti-vax parents could seek safe harbor, where parents who were delaying vaccines could find a sympathetic ear and a willingness to enable a parent to put a child, and other children, at risk. I wanted to highlight this online discussion because it's taking place all over the Internet, perhaps below the radar of medical professionals who probably have never considered doing a simple Google search with terms like "moms who vax" (which seems to turn up a lot of "No-Vax Moms?" and "Slow-Vax Moms" threads). But chances are they will be surprised to find that one of their pediatricians is being held aloft by anti-vax parents as a person in the mainstream medical community who will accomodate their unscientific beliefs about the dangers of vaccinations. The question now becomes how these pediatric clinics will fight back so they do not become gathering places for non-vaccinating parents, which could become a public health nightmare.

I think a good start, at least for this blog, will be to post, from time to time, the forum posts that mention such doctors by name. I choose to believe that the vast majority of them have no idea they have been identified by the non-vax community as their champions. My guess is that they accomodate these parents in the hopes of changing their minds; that is the reasoning behind most clinics accepting non-vaccinating parents. We have more of a chance of getting them vaccinated than we would if we kick them out and have them all gathering at the naturopath. But it's time to bring this underground discussion out into the light so non-vaccinating parents have fewer and fewer mainstream medical practitioners who will be warm and fuzzy in regards to their decision not to vaccinate; to help doctors get a better handle on how they and their practices are perceived when it comes to the vaccine question; and to help clinics and practices see how accomodation can often turn around and bite them in the rear end.

In the end, we'll have to face the fact that anti-vax and the so-called "slow-vax" parents utilize the kind of obfuscation and machination that would make members of the the Tudor court blush (this exchange on a forum post for example: "Here's an idea--when you go to your appts, just say no to more than 1 vaccine at a time. They cannot force them on you. Then you can just say that you'll do more next time you come in. Keep playing it that way.") But pediatricians can, with just a little casual Google research, at least get a handle on what's being said about their views on vaccination.

Thursday, August 2, 2012

Moms Who Vax: Nicholas's Mom

Editor's Note: Nicholas' Mom is a Catholic work-at-home mom who lives in the Northeast with her husband and their six children.  

"Are any of them twins?"

And there it is again.  It's not an unreasonable question with so many children so closely spaced together, but every time it comes up I have to pause and loosen the lump in my throat, smile and say that no, none of the children standing with me are twins.  One of them, my littlest girl with the pigtails and impish grey eyes, should have been a twin though.  And she was a twin until Fall of 2009 when I caught H1N1 influenza.

We hadn't even been trying to get pregnant, so when those two pink lines showed up we felt pretty stunned.  However, my husband and I quickly wrapped our hearts around the fact that we would be welcoming our 5th child and were so excited to see him or her on ultrasound.  In the darkness of the ultrasound room at first I didn't know what I was looking at and wondered why there was something else in my uterus next to "the baby" until the tech pointed out very clearly "so, there is baby A and there is baby B."  I asked if she was sure.  I had to stop driving a few times on the way home to collect myself, muttering under my breath "one baby... and another baby.  Two babies?!?!!"  I hadn't expected to be pregnant at all and here I was, extra pregnant with a couple of stowaway twins.  I called my husband who quickly started calculating how we were going to afford a full size van.  I called my midwife, and a nurse friend who had two year old twins and started figuring out how to try to have the healthiest multiple pregnancy that I could have.  I wasn't sure how all of the logistics were going to work out, but we are a Catholic family and decided to place our trust in God and to walk by faith.  

For weeks I took belly photos, counted grams of protein, devoured any book on multiple pregnancies that I could and consulted with my doctor and my midwife about how to plan for pregnancy, birth and life with twins.  I felt amazing and was so excited about my babies. I cherished listening to baby A and baby B's heart beats, so distinct from each other, one much faster than the other.  Living in a house that would barely have accommodated one more baby, we started looking at finding a bigger home in our area and price checked on eBay to see what kind of car that would fit our family we could afford with our tax return that year.  

When the first cases of H1N1 started popping up in Mexico I barely noticed.  I thought the idea of "pandemic flu" sounded so overblown.  When my friend told me that natural immunity was better than the vaccine and there were miscarriages associated with the flu vaccine, I took what she said seriously the same way I trusted her about what size shirts I was going to be in by the end of my pregnancy.  I was afraid to get the vaccine.  Ultimately I wasn't sure whether I was more scared of the disease or of the terrible things my friend told me could happen if I got the vaccine, but I decided to trust my health care providers and signed up for the very first vaccine clinic for pregnant women in my county.  Beyond that I went about my daily life and just waited for the vaccine to become available in my area since there was such a severe shortage in our area.  I never thought that anything bad could or would happen to me.  I was in my mid 20s, ate a healthy diet with lots of vitamins, tried to lead a more natural lifestyle and I worked too hard to have a healthy pregnancy for anything to possibly go wrong.  I worried about how I might get pneumonia if I caught H1N1, but beyond that it never occurred to me that my babies could be at risk.

I was the first in my family to show symptoms.  At first I felt slightly off and then I spiked a fever that evening. Through the night I slept fitfully, slipping in and out of hallucinations and for the first time in my life truly afraid that something worse could happen to me from a virus than just being miserable for a few days or weeks.  My doctor saw me first thing in the morning while my husband and then our kids started showing symptoms, and immediately prescribed Tamiflu.  I realized how serious my condition was when my doctor gave me the "if you start turning blue, don't try to get to the hospital.  Call 911 immediately" discussion.  Within even a few hours of getting the Tamiflu on board I started feeling not exactly better but like I wasn't getting worse.  I was still weak and took time to recover fully, but I was certain that the worst of it was over.

But what bothered me in the weeks that followed was that I only heard one range of heart tones.  Before there had been two, even as recently as the day before I was sick.  They were still in two different places and I measured ahead enough that my midwife had no concerns, but I couldn't shake the feeling that something was off.  I put it down to being the normal jitters of a mother who had had previous pregnancy losses and trusted that everything was ok even if it didn't feel ok.  After all, the worst was over, so I waited for my 18 week ultrasound to find out whether my babies were boys, girls or one of each.  We brought all of our kids with us to see the babies on ultrasound, the day after Thanksgiving that year.  It was clear as soon as the tech's face changed from excitement to concern that something was very wrong.  She kept looking but finally had to tell us "right now I'm only seeing one baby."   With those words my heart sank through the floor.  I had children in the waiting room waiting excitedly to find out whether they were having brothers or sisters.  I had no idea how I was going to tell them what had happened.  The radiologist came immediately and confirmed what the technician had found and life would never be the same again.

Through so many phone calls to be made, emails, Facebook updates I felt numb and wondered what I had done wrong.   I took all of my vitamins, I was healthy and working so hard for a healthy pregnancy.  As much as I looked for things I should have done differently or better, I kept coming to the bewildering conclusion that there was nothing.  I had done everything right and my baby, my daughter's twin, still died anyways.  There was no rhyme or reason.  There was no missing piece of the puzzle that if I had just done that one missing thing, everything would have been ok.   The only thing that would have made a difference was the vaccine, and no amount of wishing was going to change the fact that there was a shortage and that I got exposed during that delay.  I am so thankful to still have my daughter, that she was able to survive, but loving her doesn't change the knowledge there is someone who isn't here who should have been.  

No one looks at my family and sees that empty space where the lost child we named Nicholas should be.  No outside observer sees the missing fingerpaintings, hears the missing voice in the crowd, or notices the muddy footprints that aren't left alongside his brothers and sisters.  But I see them.  I see them in my daughter's eyes and wonder whether Nicholas' would have been blue, brown or grey like hers are.  I see them at Thanksgiving when my beautiful little girl sits so proudly at the table and I know exactly how old Nicholas should be this year.  These are the invisible losses, these are the hidden pains that I will always carry because of what H1N1 did in my life.  And I will spend the rest of my life wondering what would have happened if I had been able to get the flu vaccine.

The question still comes up every so often even now that we have our 6th child:  are of my children twins?  No, and yet yes.  My daughter will never know her twin and I will never have that baby, that precious child in my arms.  But I carry him in my heart and in my life just the same.  I remember him with every vaccine that my children get as soon as they are eligible to receive it.  I remember him with every stranger or friend I help to research vaccines so that they can feel comfortable in the safety of immunizing their children.  I remember him with every step of immunization advocacy that I take, every time I share his brief life with others.  This is his legacy.  This is his life, and how I honor it by remaining Nicholas' mom.

Editor's note: Flu vaccine is strongly recommended for all pregnant women. It is safe for both mom and baby, and will provide the newborn added immunity through its first few months of life.