Needled by my critics

Posted: Feb 25, 2006 12:05 AM
Sometimes the best letters come from doctors.

“Medical science often does not make ‘sense’ to people that don’t know the full picture,” writes a family physician from Kansas. He was responding to a recent column in which I opined that it doesn’t make sense to give children four or five vaccinations all at once. In fact, he wrote, “When the immune system is required to build antibodies to multiple diseases at once, a greater amount and duration of immunity is achieved.”

For the sake of argument, let’s stretch this to its logical conclusion. If five vaccines at a time are good, why not all 20 at once? Why should doctors make parents come back again and again and again? Think of the immunity we’d build then.

This is actually similar to the debate over the minimum wage. It’s self evident that raising the minimum wage will make employers less likely to hire people, but liberals refuse to accept that. They insist it can be raised with no effect. Well, then, let’s make the minimum wage $10,000 an hour. We can all work one day and take the rest of the year off.

Oh, wait. That’s absurd. Of course raising the minimum wage that much will increase unemployment. Well, then the debate isn’t over whether or not raising the minimum wage causes unemployment, it’s over how much it could possibly be raised before we cause harm.

The same theory holds for vaccinations. How many shots at a time are too many? Dr. Paul Offit, a vaccination proponent at Children’s Hospital of Philadelphia, wrote in 2002, “Our analysis shows that infants have the theoretical capacity to respond to about 10,000 vaccines at once.”

10,000 shots at once? He may be correct, and he does indeed have a study suggesting he is. But let’s remember that, every once in a while, medical science is wrong.

For instance, doctors have long recommend people eat a low-fat diet because doing so would supposedly reduce the risk of cancer and heart disease. Well, a major study released recently by the National Institutes of Health shows that low-fat diets don’t, in fact, lower a person’s risk of heart disease.

This doesn’t mean doctors were lying when they said a low-fat diet was good. It simply means that medical science can be wrong. If Offit’s report turns out to be wrong (common sense suggests 10,000 shots at a time would be dangerous) parents would learn (too late) they’d been putting their children in danger for no reason.

Parents want to trust their doctors, but we also need doctors to become more involved in the vaccination process -- a process that, unfortunately, is dominated by the government.

Today the Centers for Disease Control issues a vaccination schedule explaining that all children should get the same shots at the same time. That should alarm doctors. They’re supposed to give their patients individual care tailored to their needs. Our children deserve that.

But by taking medical decisions away from doctors, the government has made doctors less responsive to parents. As Michelle Cottle wrote in TIME on Feb. 27, her pediatrician “treated me and my husband with the sort of arrogance and unresponsiveness that, upon consulting with other moms, I’m discovering is not uncommon in parent-ped relationships.”

What is all too common is scare tactics. “Just remember that pertussis, polio, rubella, diphtheria and their friends have caused a lot more disease and suffering than autism,” my correspondent wrote. Maybe, maybe not. At its height in the ’40s and ’50s, one out of every 5,000 people contracted polio. Today the CDC says as many as one in 166 children have an autism spectrum disorder.

Sadly, we’re getting closer to Dr. Offit’s 10,000 shots at once. The government’s Advisory Committee on Immunization Practices declared on Feb. 21 that every child should be vaccinated against rotavirus, a disease so rare that many people haven’t even heard of it. Rotavirus does kill about 50 children each year, but more than twice that many die while simply walking or riding bikes on roads.

The CDC’s Umesh Parashar says the vaccine seems safe, but “it’s something we’ll continue to look at and hopefully confirm absence of risk.” Talk about putting the cart before the horse. Shouldn’t the vaccine be safe before we give it to newborns?

The government says children should get rotavirus doses at 2 months, 4 months and 6 months (along with the 4 or 5 vaccines they’re already getting at those times), and unfortunately pediatricians are likely to fall into lockstep with that schedule. Oh, and apropos of nothing, Dr. Paul Offit holds a patent for this rotavirus vaccine and stands to make money off its use.

The answer isn’t “let’s not vaccinate,” it’s “let’s not vaccinate against every disease all at once.” We can still give shots, but let’s give only the shots that are really needed, spread them out over time and tailor the vaccination schedule to the patient. That, doctor, is simply common sense.