School bells or jail cells?

Will it be school bells or jail cells for back-to-school this year? That
all depends on an important decision you’ll be making in the next few
weeks and whether some public-health official decides to yank your child
from school, stick them in a foster home and charge you with neglect if
you make the wrong one.

Your crime?

You refuse to subject your child to an unnecessary medical treatment.

It has happened in Hillary’s Village and will again if some officials
repeat previous threats. Last fall, a school superintendent in
Westfield, N.Y., threatened to take a 7th grader into state custody
because her mom refused to have her immunized against Hepatitis B – a disease usually spread by drug users and the sexually promiscuous. The
girl had a history of bad vaccine reactions, but the superintendent
refused to grant a waiver. The story was repeated with 77 middle school
children in Utica, N.Y. Television ads and school posters exhort us
to “Be wise – Immunize.” But some public health and school authorities
are behaving as if educating kids is less important than forcing
mandatory shots on students and their families.

Maybe the motivation is big bucks from a 1993 federal “Immunization
Initiative” that gives states more than $400 million in vaccine
incentives and a $100 bounty for each child vaccinated with the shots
the federal government decided are must-haves. So just how “wise” are
you to immunize? How do you decide and what do you do if you defy the
school rules?

Quackwatch warning: We’ll say up front, once again, as we did in
January in “Shots in the dark?” – vaccines can and do save lives. And we’ll have to say it again later because too many
have an “all or none” approach to the vaccine question. They seem to
think that all vaccines are created equal and equally effective and
therefore equally desirable.

As with all medicine, vaccines are not perfect. Some vaccinated people
still come down with chickenpox despite the vaccination, although not as
high a percentage as those who aren’t immunized. All vaccines cause
reactions, some good and some bad. The good and desired reaction results
in immunity from the disease. But there’s no absolute guarantee against
a bad reaction, such as an allergic reaction or even death. In other
words, there are always trade-offs.

Some vaccines are too risky for even the manufacturers. For example, the
rotavirus vaccine, originally recommended by federal government
officials, causes too many bowel obstructions and has been pulled from
the market.

More than $1.1 billion in claims, averaging almost a million dollars
each, has been paid out by the National Vaccine Injury Compensation
Program. All of these claims had to fit in the program’s tight
definitions and prove significant damage from one of the vaccines
covered by the program.

Again, vaccines do prevent illness and save lives. What we’re against is
requiring such medical treatment as a prerequisite for going to school.

Most parents will likely find that the benefits of some of the standard
vaccines, such as for diphtheria, whooping cough and tetanus, are worth
the time, effort and risk involved. But many parents find some of the
new vaccines, such as for Hepatitis B, to be too risky for their
children. Other vaccines, such as for chickenpox, measles, mumps and
rubella have enough benefits and risks to require thoughtful consideration
of the trade-offs, especially if your child isn’t perfectly healthy when
“shot day” arrives.

Your school may have sent you some forms about “free” vaccinations and
outlined some of the benefits and risks. But, at the same time, they
demand that children have their shots. Yet when challenged about the
requirement, school and government officials use the very fact that they
aren’t doctors to slither out of liability. They shouldn’t have it both
ways. In the end, physicians are legally and ethically responsible for
informing patients about the risks, and you as parents are the ultimate
decision makers.

As we said above and are saying for the third time, “Vaccines can and do
save lives.”

Some people are willing to have as many vaccinations as possible because
of the unpredictability and severity of possible disease. Others are
more comfortable having as few vaccinations as possible because of the
possible complications or because of religious objections.

So what’s a parent to do when faced with those official school
vaccination forms? First talk to your doctor to help you decide what is
right for your child. As with many other decisions in medicine or in
life, the value of each vaccine should be evaluated for that person. If
you need help asking your doctor the right questions, we recommend
National Vaccine Information Center’s common sense guidelines.

So what do you do if you decide that a vaccination, such as Hepatitis B,
isn’t right for your child but the school requires it?

Despite the federal bounty programs, not all states have mandatory shot
laws. Essentially all the other states have philosophical, medical or
religious exemptions. Each state has different wording that may be
required for an exemption or waiver request. Your state representative
should be able to provide you with the laws for your state. The laws are
also available online.

If a medical problem or medical history puts you or your child at
greater risk for a bad vaccine reaction, a written statement from a
medical professional may be required. If your application for waiver is
based on philosophical or religious grounds, a written request
describing your reasons in some detail should be sent to the officials
demanding the shots.

If the information on vaccines you received was incomplete and you
change your mind based on new information, the written consent you gave
on the basis of incomplete information is invalid. For example, if you
weren’t told that the likelihood of a severe reaction from the Hepatitis
B vaccine is three times greater than the likelihood that your child
will contract the disease, you might well change your mind about the
desirability of that vaccine.

Following your state’s procedures will usually work. But if they don’t,
notarized letters by certified mail to your doctor, the local health
department, and the vaccine manufacturer might be needed. You could
inform them that you would consent to the shots if they will accept full
responsibility for any bad reaction to the shots.

Yes, it takes a lot of work to get all the information you need to make a
truly informed decision. And if you want a waiver, it may take some
persistence. But don’t let school scare tactics intimidate you into a
vaccination decision that’s not right for your family. You’ll probably
take some heat, but isn’t your child worth it?