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To Save Some! (A Christian Physician's Brief Defense of Vaccines)

Below is the content of a letter I was asked to write, responding to a friend's hesitancy towards vaccination. I am posting it here, because I have had similar discussions on multiple occasions and hope these thoughts will be helpful to anyone confused by the vaccine debate.
"Greetings, friend!

I am writing because I care about you, the health of your kids, and the wellbeing of the general public. I know you are an excellent husband and father, and believe you only want what's best for your children. As a mother, I understand the shades of gray that often seem to settle over parenting decisions like discipline techniques, educational approaches, and medical care. As a physician, I have committed the last 15 years of my life (nearly half!) to the study of evidence-based medicine.

The field of medicine has evolved substantially over time, but the process by which therapeutic guidelines are created is more or less standard. Medical interventions (including vaccinations) are tested on a small scale for safety, then on a larger scale for safety and efficacy, then applied to the general public. The US is fortunate to have a federal body governing the safety of food and drugs (FDA). If an intervention proves to be unsafe after mass implementation, approval is revoked.


With that background, I will address briefly the main concerns/objections parents have regarding vaccines. Briefly, because they are better addressed elsewhere comprehensively... and because I will be unable to communicate in great detail in the 30 minutes my children are occupied in sleep/play.


First, safety. All reported adverse reactions to vaccines are recorded in VAERS (the Vaccine Adverse Event Reporting System; see here for a summary of this database's purpose and function). Serious reactions are quite rare. My husband (a Pediatrician) and I (Family Physician) have both seen cases of severe disability and death in unvaccinated children. We have never seen anyone who suffered long term harm from a vaccine. Of course, our experience is limited in scope and duration. For a more objective evaluation of safety, see the CDC site for vaccine safety monitoring or this insightful commentary.


Second, the supposed link to autism. Many large scale studies have disproven any potential link, which was found to be fabricated by a man who has lost his medical license (see here: http://edition.cnn.com/2011/HEALTH/01/05/autism.vaccines/). The myth of causation persists, in part, because a comprehensive explanation for increasing rates of autism has not been proposed. Certainly, changes in diagnostic criteria and understanding of the disorder play a role. Yet so many things have changed in the past thirty years (Media exposure! Cell phones! Social relativism!), it is difficult to develop a causal model that accurately assesses all variables.


Third, the belief that God will protect our children. While this is true, we don't cop out on our responsibilities to feed, clothe, and care for our children by saying God will do it. Medicine is a God-given means of caring for our children – both a privilege and responsibility for most families in the developed world.


Fourth, the preference for natural immunity or naturopathy. Claiming natural exposure to diseases like chicken pox, measles and Haemophilus influenzae will result in immunity for many children ignores the fact that many others will be seriously harmed or die in the process. Natural immunity is not a sufficient argument if vaccines have been shown to save lives (as addressed in the next paragraph). Additionally, many Christians have jumped on the natural medicine bandwagon, simultaneously rejecting known lifesaving treatments (including vaccines) for their children. Rejecting free, evidence based public practices for relatively expensive, unproven systems of homeopathic therapy is, at best, poor stewardship.


Fifth, the question of efficacy/need. Many who oppose vaccines note that communicable diseases were declining prior to widespread immunization. This is true, in large part to the efforts of public health campaigns by medical systems and governments that these same people now oppose. More importantly, greater declines were noted after vaccine implementation. Saving additional lives is a worthwhile goal, and so the medical community stands behind the need for vaccination. As noted in this rather blunt article, some diseases were still quite prevalent prior to the release of their vaccines.


Finally, distrust of the political and medical systems. As a parent, some skepticism is both reasonable and admirable. But continued distrust after provision of sound evidence of the overall benefit and minimal risk of a treatment is unwise. Distrust of authority is not a Biblical virtue. God puts governmental leadership in place to care for us (Romans 13).  Do we trust every authority? No. We trust God, who tells us to submit to authority -- even secular authority (I Peter 2:11-17, Romans 13:1-7).  Do physicians deserve respect for decades of study to best advise people on their health? Perhaps not. Most of us try to remain well-versed in literature on the most cost effective, evidence-based means of managing medical conditions.  Still, we are not all-knowing or perfect. We cannot insist that people follow our advice.  Indeed, we should not.  Being an informed patient does not equate to blind trust, but neither does it translate to a blanket rejection of medical community consensus.


As a final point, I would like to address our responsibility as parents of healthy children to protect those who are not so fortunate. Many cannot receive vaccines for reasons of immunosuppression (cancer, autoimmune disease), age, or access. As Christians, we can care for the "least of these" by helping keep communicable diseases (which may be a blip in the road for our kids, but a dead end for others') from spreading.


I will be praying for you and your family as you navigate this decision, which for many people around the world is a matter of life and death. I trust you will lead them well!"

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