Healthy Kids    

Let's do shots!

Local doctors weigh in on vaccinations

In 1975, Japan stopped vaccinating against pertussis (whooping cough). Just five years later, they went from having 373 cases of pertussis to 13,000 cases and 41 deaths.

The vaccination issue became a hot debate after a controversial study appeared in the British Journal of Medicine in the late 1990's linking the measles vaccine to autism.

HVP revisits vaccination debate

However, as Dr. Barbara Gannon, Vice Chair of Pediatrics at Orange Regional Medical Center and a pediatrician at Washingtonville Pediatrics explains, "that study has been thrown out," and the physician who conducted the studies has since lost his license. Dr. Gannon says that the twelve children in the study who were diagnosed with autism were already showing signs of abnormality even before the study began.

Who is to blame?
"Between birth and two years is when children begin showing signs of abnormal development and it's also when most of the vaccines are given, so it's easy to point
the finger." Dr. Gannon has seen firsthand the effects of measles and pertussis on unvaccinated children. "I was trained in the Bronx and saw children die from preventable diseases," and she adds that because we don't see these diseases, "we've become complacent. These vaccines have been around a long time and have multiple studies on their effectiveness." She cites she HIB vaccine which helps prevent meningitis, and since its introduction, she has not seen any cases of the disease.

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“Before the introduction of the vaccine, not a week went by during the winter months when we did not see a case of HIB meningitis. According to the Centers for Disease Control and Prevention website, due to routine use of the HIB vaccine in the United States from 1980 to 1990, the number of invasive HIB disease has decreased from 40 in 100 per 100,000 children to 1.3 per 100,000.

The Herd Immunity
When one person chooses not to get the vaccine, it will affect those who, for some reason, cannot get the vaccine. For example, Dr. Gannon explains the time when a child with measles came to her waiting room. Along with that child there were two to three other infants in the room who were not able to get the vaccine yet.

"Children under one year of age still have immunities from their mothers, so they don't get the vaccine yet," says Dr. Gannon, "but that doesn't mean they can't contract the measles."

Vaccination Exemptions
That was the case this past fall, in a school in Ulster County, when a child who had not been vaccinated allegedly brought back the disease from a trip overseas.
That child, who had to be quarantined, could have given the disease to over 80 unvaccinated children. Why had they not been vaccinated? In this case, the child and many in the school had received religious exemptions.
"For religious exemptions, parents can provide documentation and sign off on a request," said New York State Department of Health Spokesperson Peter Constantakes. "The school will then determine if they believe the exemption should be granted." The only other exemption is for medical issues, and for that
"a healthcare provider generally documents the need for the exemption and it goes to the school nurse to approve or deny,” said Constantakes.

Is your child exempt from vaccinations?

“If there are questions concerning the exemptions, the request may go to the Department of Health’s regional office for review and we would determine whether it is valid." A medical exemption, says Constantakes, "that may (or may not) be valid would include things such as allergies or severe reactions in the past."

The Herd Immunity comes into play when the majority of the population is vaccinated, which then protects those that for some reason cannot be vaccinated either because they are too young or for religious or medical reasons.

Doctors debate

So, if a parent comes into Washingtonville Pediatrics and requests that their child not be vaccinated, what happens? "We will ask them to find another pediatrician's office," says Dr. Gannon. "If we allow unvaccinated patients in to our office, we're putting our other patients at risk, especially our infants."

It also comes down to a matter of trust. "If the parents do not trust me on the vaccination issue, then what will make them trust me if an emergency with their child comes up?" she says.

Dr. Howard L. Barenfeld of Pediatric Arts of Monroe has a different philosophy. "We won't ban a child because of the beliefs of the parents," he says. "We like to work with parents on a partnership basis, with a give and take. If a parent chooses not to vaccinate their child, we will still ask them on every visit if they'd changed their minds or I will give them new data on the vaccine.” In the end he says, "most decide to get some vaccinations."

When infants come in for routine check ups, they are immediately escorted into an exam room. "The chances of catching one of these communicable diseases in a waiting room are rare," Dr. Barenfeld says.“It's when they're in day care or a classroom that the risks are greater."

MJ Hanley-Goff is a freelance writer who lives in Monroe.