The Vaccination Conundrum



It is proof of MMR immunity season again.  Students entering school this fall are being asked to prove they have been fully vaccinated against Mump, Measles (rubeola) and Rubella infection as well as other routine immunizations in order to be allowed to enroll.  A small but significant and vehement minority insist they should be allowed a personal exemption from the requirement that the majority willingly comply with.

Concerned, caring parents make the decision every day to forego life-saving immunity by refusing to vaccinate their children, truly believing they are doing the right thing. They do not perceive an imminent risk to their child from the older contagious diseases despite their resurgence in developed countries like the U.S., focusing instead on the low—or often non-existent but ballyhooed—risks of vaccinations.

These are parents—most of them well-educated and on both ends of the political spectrum—who refuse to vaccinate their children, thereby denying a consensus of scientific evidence and increasing the risk for further outbreaks. “Oh my God. Wealthy, white, liberal enclaves are at risk!” declares Daily Show correspondent Samantha Bee, mocking the anti-vaccine bloggers and activists. So too at risk are some conservative Christian church communities where vaccination rates are low.

As clever the satire may be, I can’t bring myself to laugh or crack a smile. Now in my 60s, I remember the illnesses brought on by these diseases before vaccines. As a physician, I’ve seen cases of them coming back with fatal consequences.

Maybe some of us have forgotten or are too young to realize the severity of these conditions. Healthcare providers who haven’t had firsthand experience with these contagious diseases don’t always think of them when confronted with classic signs and symptoms. But it’s only been a little over 50 years since vaccinations became routine for childhood killers like tetanus, diphtheria, polio, measles, mumps, and pertussis, or whooping cough. Americans growing up before then had no choice but to suffer through childhood infectious diseases as they quickly spread through a community.

Most of us survived our illnesses, rewarded for our affliction with permanent natural immunity. Others suffered lifelong consequences: paralysis from polio, deafness from rubella, sterility from mumps. Some did not survive at all. My father nearly died at age 41 from a case of the mumps I brought home from school. As an infant, my sister-in-law almost didn’t pull through when she turned blue from pertussis infection.

Today, I’ve seen healthy people develop encephalitis and pneumonia from chicken pox. A fit college student in my practice died of influenza within a week of the start of his symptoms. Our university clinic just diagnosed a case of mumps during a local outbreak.  Our herd-immunity for many vaccine-preventable conditions has been waning, as reports of pertussis, measles, mumps, and chicken pox reemerge, in affluent countries with robust health care systems.

Parents who opt to leave their children unvaccinated contribute to the recent outbreaks. Well-meaning American parents are convinced they are doing the best thing by protecting their children from potentially rare and often unproven vaccine side effects. Some Christian parents claim vaccine risks are unwarranted, since God will provide the needed immunity if their children gets sick.

Most cases originate overseas, so it’s especially critical that Americans be vaccinated when traveling outside the U.S., even to Europe. (Those who serve in mission fields are particularly vulnerable, and I’ve found it interesting that previously unvaccinated Christians are more than willing to accept immunizations when they know for certain they will be exposed.)

As a physician of faith, I tell parents God indeed provides immunity. But as we’ve seen over millennia, it comes by very real suffering through a potentially fatal disease. In our modern society, God grants us everyday miracles, both pharmacologic and surgical, including the potential of long-lasting immunity in the form of a vial of vaccine. I don’t think these parents would deny insulin for their child newly diagnosed with diabetes, nor would they fail to strap their child into a car seat before starting the ignition. Vaccines are instruments of prevention, too, given to our healthy youngsters in order to keep them (and others) healthy.

“I’m concerned that so many people seem willing to let others carry the supposed burden of vaccination so that they don’t have to,” wrote Rachel Marie Stone in a Her.meneutics post several years ago. “To me, that’s a failure of the commandment to love our neighbors: our infant neighbors, our elderly neighbors, and our immune-compromised neighbors.”

When I was vaccinated for diphtheria, pertussis, and tetanus (DPT) at the age of 4 months in 1954, my mother wrote in my baby book: Up most of the night with fever 104.5 degrees, a good “take” for the vaccine. She was relieved that it had made me sick, as it meant that my stimulated immune system would keep me safe if exposed to those killer diseases that were so common in the 1950s. Our society doesn’t think about immunizations as we did back then and thankfully a febrile reaction like that would be unusual due to significant changes in how today’s more effective vaccines are formulated.

I wish vaccines were perfect in their protection and potential side effects, but they aren’t. I wish medications developed for treatment of some of these illnesses were perfectly effective, but we can’t depend on a guarantee of cure once sickened. I wish our immune systems were perfect in their response to exposure to pathogens, but they too fail and people do die. Even though there will never be perfect prevention or treatment, parents in third world countries who have watched their children suffer and die from completely preventable disease will walk miles, for days, to get their children vaccinated when they learn of a mobile health clinic setting up an immunization center. Undeterred by that harsh reality, some in our highly educated society choose to run, not walk, in the opposite direction from much more easily accessible free state-supplied vaccine.

There will always be a new plague to worry about. Even as we eradicated illnesses through vaccine, we watched HIV, SARS, avian flu, multidrug-resistant tuberculosis, and MERS infect us. Some countries have seen the return of polio, and we remain concerned over smallpox somehow finding its way out of its lockbox in laboratories.

Given these threats and the new pathogens on the horizon, it remains unwise to refuse safe and effective vaccination. By doing so, we invite the old plagues, these killers of yesteryear, back into our homes, our churches and schools, and inevitably, onto our death certificates.

We can and must do better for our next generation.


(an earlier version of this essay was published online three years ago with a significant negative reaction from Christian readers.  It bears repetition because anti-vaccination beliefs continue to be an issue in the midst of current rubeola measles and mumps outbreaks in the U.S.)


9 thoughts on “The Vaccination Conundrum

  1. I’m sure you’ve heard it a million times, but I think the problem is that we’ve all been lied to, even if by omission, and no doubt even suspect we’ve been part of a guinea pig drug test without our knowledge or consent. There is no proof to the contrary, or at least not convincing.

    The ancient vaccines for the known previous killer diseases seem okay, I’d agree with that, but as for all the newer ones — where’s the ten years of testing, and what are the results?

    The biggest hesitancy around here is the sudden “herd” of autism diagnoses, since its onset occurs after childhood innoculations (or at least, that is the biggest common denominator discernible to date, to my knowledge). Do I recall the numbers correctly as being 1 in 10 (or less) children in America acquire an autism diagnosis? I honestly can blame no mother or father for their hesitancy on serious drugs being injected into their children. How terrifying to think you’re only saving a child’s physical life at the cost of his or her mental and/or emotional safety for the rest of his or her life. What was the point? We don’t owe that loss to anyone!

    I think only disproving autism’s link to immunizations will turn this tide. It’s just too scary a gamble anymore. And I am 100% glad I am no longer a mom of little ones, and am not a doctor who has to face people like myself!!


  2. The autism/vaccine link has been disproven many times over as well as discredited as a public relations ploy by a British physician who no longer has his license yet people perpetuate the myth.

    The U.S. tends to be the last to get official approval for vaccine use (from the FDA and recommendations/guidelines from the CDC and ACIP) – most vaccines have been in use in other countries first.


  3. Wholeheartedly agree with you. I find it disturbing the Christian community had such a negative reaction to this article. I know you are right. It was never a question in my mind not to immunize my children. It saddens me that people make the decision to not be protected for everyone. I’m a Christian & have a grad degree & very at peace with my decision for my kids & thankful my mom felt the same way.


  4. I work with a hygienist whose daughter is so terrified of needles, that she refuses to be vaccinated. Can you suggest anything, besides her reading your compelling post, that might help her?


  5. As a physician, you have seen both sides of the vaccination conundrum. I don’t know how many total vaccines children are given any more as my children are in their early 40s, putting me in the grandma role. Do parents have the option to spread out the vaccinations so the child isn’t getting them all together? I know that’s what I do with my Scharly(haflinger horse) as she reacts if I give her shots all on the same day.
    Thanks for your daily blog.


  6. We have the same problem over here in UK, and I find this alarming as a staunch Christian. Why do Christians think God will do all the work for them? He expects us to do our part, and that includes safeguarding our children from diseases, if at all possible. He gave us this world to enjoy and to protect, but we don’t seem to be making a very good job of it. Having been born just after WW2 when antibiotics were in their infancy and vaccines only then being developed, I appreciate just how lucky we are to be able to ward off illnesses and diseases, even childhood ones, any of which can kill at any moment or leave behind devastating disabilities. Please listen to Emily, and protect your own children, and thus other children, too.


  7. I’m with you on this, and remember when we adopted my son. We had a wise physician, we asked about not getting the immunizations because of the horror stories we’d heard, he said if the diseases were contracted it would be even more horrendous and the odds were astronomical that he would not have a bad reaction. My kids have done great, and I can rest knowing we did the best thing.♥


  8. Hear Hear! As a retired health professional I so agree. TX for the succinct words; would love to re-post on Facebook.


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