Tuesday, July 31, 2012

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.

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