HEALTH A Shot in the Dark

AS I FACE THE DEADLINE FOR THIS story, also looming is my infant daughter’s first DPT (diphtheria-pertussis-tetanus) shot. Thus far, I’ve done all my parenting along the traditional route-annual checkups within twenty-four hours of birthdays and all available immunizations- but no parent can ignore the hard questions critics are raising: are vaccinations safe? Are they worth the risk?

With Dallas just emerging from a surprisingly severe measles epidemic, it seems crazy to be talking down vaccines, but many parents, including friends of mine, are choosing not to vaccinate their children. I may as well admit that I’m married to a rather mainstream M.D., and I’ve traditionally had little patience with people who talk about herbs and homeopathy. But there is no denying the passion I am seeing displayed toward the subject of immunization, in particular the DPT vaccine.

The friends whose children are not immunized are, without exception, well-educated, well-informed, devoted parents, and I know that they have endured all kinds of criticism and hardship for their choice to not expose their babies to what they term “foreign proteins.” They’ve been asked abruptly to leave pediatricians* offices for “putting other patients in jeopardy,” been publicly chastised at hospitals, and generally made to feel, says one North Dallas mother of four, “that we don’t have the best interests of our children at heart. It’s a difficult position,” she says. “I wish I didn’t believe the way I do.”

Dallas commercial real estate broker Art Kline is the father of two small children and an ardent proselytizer for a national organization called DPT (Dissatisfied Parents Together). Its stated purpose is to educate parents about vaccination deaths and injuries. DPT’s pamphlet includes five heart-rending photos of children who the group says either died or were left disabled by routine DPT vaccinations, which frequently cause fever, irritability, soreness, and swelling-and worse in some cases, according to the group.

“Most parents and many health care providers,” reads the organization’s brochure, “do not know that the pertussis (whooping cough) portion of the DPT shot can cause convulsions, shock, brain inflammation, and death.”

The organization also is trying to inform the public about the little-known National Childhood Vaccine Injury Act, established in 1986, which provides compensation for the families of children injured by immunization. Funded by excise taxes imposed on manufacturers of vaccines, it has paid more than $60 million for thousands of children injured or killed by routinely administered diphtheria, pertussis, tetanus, measles, mumps, rubella, and polio vaccines. (Parents must make application through an attorney for compensation through this fund by September 30, 1990, for injuries sustained prior to October 1,1988, and by 1992 for injuries sustained after 1988.)

Art Kline believes there exists a “conspiracy of silence and denial” among pediatricians who refuse to admit the risk of immunizing or to accept studies that show that routine vaccines can be dangerous.

Actually, it appears that no one denies vaccine injuries occur. Even proponents of vaccinations have called immunizations “unavoidably dangerous products”-socially useful but associated with a statistically small amount of risk.

Some critics question, however, whether the term “unavoidably” applies. Safer vaccines exist, they charge, and are already in use in other countries. The University of Rochester Medical Center in New York recently conducted a year-long study comparing a Japanese pertussis vaccine to its U.S. counterpart. The study found the Japanese vaccine to be safer and more effective, producing reactions in fewer than 5 percent of the children receiving the vaccine, compared to 80 percent receiving the American vaccine. Licensing of the vaccine in this country, however, may still be several years away.

Meanwhile, most physicians still recommend having children immunized. The benefits, they say, outweigh the risk. Dr. George H. McCracken Jr., chairman of the infectious disease division of pediatrics at the University of Texas Southwestern Medical Center, suggests parents compare vaccine complication rates to those of the disease. The American Academy of Pediatrics’ Red Book reports that a temperature of 105 degrees or more may occur in one out of 330 injections; convulsions or episodes of limpness and paleness in one out of every 1,750 injections. Permanent brain damage may occur about once in every 310,000 injections. By contrast, McCracken says, in an un-vaccinated infant population the risk of pneumonia due to pertussis is one in five; the risk of pertussis-related seizures is one in thirty-three. The chances of an infant’s having permanent brain damage following the disease are at least three thousand-fold greater than the chances of permanent brain damage as a side effect of the vaccine.



THE PERTUSSIS COMPONENT OF THE DPT VAC-cine is part of the traditionally recommended series of injections children receive beginning at two months of age and continuing through five years of age, but it is not legally required for school enrollment in Texas.

The number of students who have received approved medical exemption from DPT vaccinations in local public school districts is small; the most recent count of medical exemptions for vaccines was 183 among DISD students, forty-two for Richardson students.

Dr. Gordon Green, director of the Dallas County Health Department, says that he believes these few exemptions present no threat to the school population, as long as there are only a very few. “If a large number decline to be immunized, then the herd immunity is compromised. We saw that happen this year with the measles epidemic.”

Green believes it is “to the advantage of the child and society to be immunized.”

On this issue, which everyone believes can be a matter of life and death, one must come down on one side or the other. Groups like DPT and folks like Art Kline perform a public service by keeping tabs on vaccine risks and research to improve existing vaccines. But when informed parents are forced to consider the odds for vaccinated children vs. the unvaccinated, it’s an easy call:

Vaccinated children win by a long shot.