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In December 1997, the National Advisory Committee on Immunization (NACI) released their Guidelines for Childhood Immunization Practices. Following an extensive consultative process, the guidelines were developed to establish national goals and targets for vaccine-preventable diseases of infants and children. The 17 guidelines can be found at the Health Canada Web Site <www.hc-sc./gc.ca/hpb/lcdc/>. Parents searching the internet for information surrounding childhood immunizations will find not only the NACI guidelines but also a variety of other points of view and agendas.
The NACI guidelines emphasize the importance of the vaccines being available, that there be no barriers to receiving immunizations and that the costs of such programs should be publicly funded. Guidelines 5 through 7 specifically deal with informing caregivers about immunization. Guideline 5 provides a general description of the need for immunization followed by specific risks and benefits associated with vaccines, and Guideline 7 emphasizes that withholding or deferring vaccines should only be done for true contraindications. The NACI guidelines, in keeping with the mainstream medical literature, focus on serious medical situations such as immunodeficiency, history of anaphylaxis and presence of a severe illness. The list of noncontraindications is much more extensive and is based on the best knowledge available.
Parents searching the internet will also discover general sites that provide a variety of links to other sites <vaccines.com/forparentshealth.htm>. Included on such sites is usually a hot link for the Centers for Disease Control and Prevention’s fact sheet on recommended vaccinations and their risks and benefits <www.cdc.gov/nip>. Parents might also encounter health department web sites such as that produced by Tacoma Pierce County in Washington State. Such sites give indications for immunizations, information on when to immunize and contraindications to vaccination. As well, parents are provided with the recommended schedules for the immunizations and where they can obtain them <www.healthdept.co.pierce.wa.us/general/srvc/immun/immun.html>. Parents’ questions about differences between Canadian and American immunization schedules should be addressed by their child’s doctor or local public health department.
Finally, some paediatric groups have even produced their own web pages for their patients and provide information on the risks and benefits of immunization versus acquiring the ‘natural’ infection <www.parentsoup.com/experts/greene.html>. These sites, which are based on epidemiological evaluation of the medical literature and use evidence-based decision-making, are generally supportive of immunizations.
However, a parent performing a general search on a subject will encounter many more sites developed by individuals who believe in vaccination. While seemingly supportive of vaccination, such sites are largely supportive of parents who choose not to immunize their child. A good example of such a web page is the Vaccine Information and Awareness (VIA) web site <www.access1.net/via/>. Such a site emphasizes the importance of individual decision-making and does not mandate any vaccination. This page does provide a few links to sources that favour vaccination. However, the overwhelming majority of link sites focus on anecdotal reports of complications attributed to immunization, alternative interpretations of the medical literature and the promotion of a variety of branches of alternative medicine ranging from chiropractic to naturopathy and homeopathy.
Examples of the tragedies that individuals attribute to vaccines can be found at <www.909shot.com/richie.htm>. The litany of putative problems with vaccinations are expounded upon at <www.i-wayco.com/niin/vaccinationupdate/basics.html> and at <www.unc.edu/~aphillip/www/vaccine/dvm1.htm>. According to these sites, vaccines are highly toxic and contain poisonous substances. Moreover, the sites state that vaccines are grown on and contain foreign tissue and altered genetic material of human and animal origin as well as being produced from substances such as rotten horse blood for diphtheria and puss from sores of diseased cows for small pox <www.pcslink.com/~klove/immunize.htm>. Further, the sites assert that such information is being suppressed by physicians. Vaccination is said to depress and disable brain and immune function. These web sites indicate that “honest, scientific investigation” has linked vaccination to the cause of many illnesses including sudden infant death syndrome, autism, seizures, mental retardation, hyperactivity, dyslexia, immune deficiencies including AIDS and Epstein-Barr syndrome, and degenerative diseases including muscular dystrophy, multiple sclerosis, arthritis, cancer and leukemia). Moreover, physicians seem incapable of diagnosing these diseases and fail to report this plethora of illness precipitated by immunizations adequately.
A particularly effective site of the prochoice vaccination groups <home.issprynet.com/sprynet/gyrene/Home.htm>. Superimposed on a picture of a cute baby with a horrified look on his face, with a syringe and a needle in the foreground, is the message “Impending Doom”. The web site then provides 12 pages of single spaced medical references that seem to chronicle all of the problems associated with immunizations. Some titles are augmented by ‘selected’ quotations from the papers, while others have editorial comments made by the list’s compiler. Without further investigation by the web page visitor, it would appear that there is a medical conspiracy surrounding the true safety of vaccines. However, a critical epidemiological review of the material, as well as the inclusion of articles refuting some of the observations of the articles included in this list, would still result in physicians and public health authorities supporting the NACI Guidelines. Nevertheless, this is a very effective strategy to heighten concerns about immunizations and seemingly support the assertions of the prochoice vaccination groups. These sites also maintain not only that are physicians involved in suppressing information about immunizations, but also that the media ignore the evidence surrounding the dangers of immunization <www.pnc.com.au/~cafmr/newsl/media.html>.
Furthermore, any celebrities who support immunization campaigns are subject to criticism. They are purportedly supporting products that have “killed and disabled recipients, adults and children alike”. Individuals targeted include Paul Simon, Michael Jackson, Bill Cosby, Audrey Hepburn, Whitney Houston, Jimmy Smits, Robin Williams and Whoopie Goldberg. Unfortunately, the prochoice vaccination groups will have to add the Cat in the Hat to the list. The United States Health and Human Services Department has launched a national immunization campaign in the United States using this character. The initiative includes six posters supporting immunizations bu using popular children’s characters from Dr Seuss books <www.dhhs.gov/news/press/1997pres/971030b.html>.
The most nefarious aspect of vaccines is their role as part of a government conspiracy to increase social control through production of mass behavioural and neurological problems <www.trufax.org/m3v2/vacc2.html>.
Organizations such as the International Chiropractic Pediatric Association <www.4icpa.org/research/vaccinat.htm> have responded to the issue by indicating that their organization does not “advise against immunizations”. However, the association does highlight the risk of immunization, emphasizing the importance of parents becoming educated to allow them to make the best choice for their children. The Association states that the life of no child is expendable and then suggests that parents visit a specific prochoice vaccination site, which conveniently happens to promote alternatives to immunization such as chiropractic.
The vaccination positions on risk of immunization do not go unchallenged. Good examples of immunization forces being called to task include the claims that immunizations cause cot deaths being challenged by Lon Morgan <www.pnc.com.au/~cafmr/coulter/vacc-deb.html>, and the response by the Ministry of Health in New Zealand <www.moh.govt.nz/phg/phillips.htm> which dispels ‘vaccination myths’ <www.livelinks.com/sumen/health/myth-2.html>. Finally, even the graphics used by the prochoice vaccination group are being called into question, ie, the picture of the baby and needle entitled “Impending Doom” <www.ozemail.com.au/~glum/vaccdanger.html>.
The issue of the dangers of vaccination would not be complete without at least one legal firm offering its services to ensure adequate compensation for persons with vaccine injuries <www.ccandh.com/vaccine.htm>.
In summary, the prochoice vaccination forces are organized and articulate. Their desires to have no-risk vaccine programs are appealing, and no one would ever wish to see a child or adult injured by vaccine. However, the implication that only alternative medicine offers such an opportunity and that the ‘natural’ disease-acquired immunity is better for the population underscores the challenges ahead. Perhaps, provinces should consider making the NACI Guidelines provincial standards to ensure that there is consistency and quality in both the agents given and the communication surrounding immunization.