Vaccine Jitters

They are painful rites of passage for American children, from infancy through elementary school. Kids dread them, their parents reluctantly accept them, and the government mandates them. And, until recently, few really questioned the need for--or the safety of--vaccinations.

Now, alarmed by reports of severe reactions, a series of unsettling announcements by health authorities and contentious congressional hearings, not to mention fear-mongering on the Internet, a small but growing number of parents are contesting national vaccination policy.

They suspect that the fusillade of 22 injections imposed on children by age six may, alone or in combination, pose significant dangers. Although the evidence is largely anecdotal, some parents charge that inoculations have brought on such disorders as multiple sclerosis, rheumatoid arthritis, chronic fatigue syndrome, diabetes and even autism.

Doctors and medical associations are disturbed by the antivaccine sentiment in some communities. They fear that it could erode public confidence in the nation's largely successful vaccination policies and lead to outbreaks of many infectious diseases now held in check by inoculations.

The value of vaccinations is most obvious to those who remember row upon row of iron lungs occupied by victims of polio epidemics and the quarantine signs posted on the homes of people stricken by diphtheria, whooping cough, smallpox and measles. Of these scourges, smallpox has been wiped out and the others have become rare and largely preventable through the use of vaccines. Says Duke University pediatrics professor Samuel Katz, a leading authority on vaccines: "Immunization is the single intervention that has most dramatically reduced childhood morbidity and mortality."

Vaccines, of course, aren't without risk. A slight possibility always exists that those containing live but weakened viruses--oral polio, measles and mumps vaccines, for example--could trigger the disease they're intended to prevent. And a few vaccines originally thought to be safe have caused side effects so severe in a small percentage of inoculated children that they've had to be modified or temporarily withdrawn.

Though the last naturally caused case of polio in the U.S. was in 1979, recent announcements and recalls by government agencies have drawn public attention to the real if very small risks of inoculation. Each year an average of eight children are infected with polio by the otherwise highly effective Sabin oral vaccine, which is made from live but attenuated polio viruses. This danger was highlighted in June, when the Food and Drug Administration recommended the Salk killed-virus vaccine, which is safe but somewhat less effective, instead of the Sabin variety, for the first two of the four required polio inoculations given children. The two additional Sabin vaccinations would be deferred until the kids are out of infancy.