Vaccine anxiety

The individuals and organizations on a mission to sow the seeds of doubt about childhood immunizations may be weak on science but are savvy with technology. The Internet has given their contrariant movement what can be best described as a healthy shot in the arm.

Parents are among the millions who now turn to the Internet for health information. An Internet search to learn about the risks and benefits of vaccination for their children may well take those parents to a Web site that has well-reasoned, scientifically grounded information. Unfortunately, surfing the Internet -- a sea in which all assertions float equally -- may just as easily land those parents at anti-vaccination sites that grossly misinterpret or distort the facts, and even offer advice on how to dodge the mandatory immunization laws that play a vital role in protecting the public's health.

All physicians who count children among their patients should be prepared more than ever to counsel parents about the facts of childhood vaccination. With more and more people visiting the Web for health information -- one estimate is that that they will number 30 million by 2001 -- expect the confusion, questions and parental angst to continue to rise. Internet-literate physicians would do well to try their own search and visit some of those contrariant sites to see for themselves what medicine is up against.

Not that the Internet is the only factor muddying the waters on the issue of immunization risk. News media reports on the suspicions of parents who believe that vaccines are responsible for their children's illnesses would rattle any parent with an immunization-age child. The list of suspected reactions to vaccines includes autism, SIDS and juvenile diabetes. (Nor is the issue limited to children. News cameras are seldom far away when a member of the military is court-martialed for refusing an anthrax vaccination for fear of health problems.)

No one would deny the anguish of a distraught parent trying to rationalize a child's profound illness or disability. Any reasonable possibility of a connection to vaccinations should be scientifically examined. But as of yet, no scientifically sound link has been uncovered to the claims being made.

However, there is proven danger when fear or simply laxity causes immunizations to decline to unsafe levels. A recent example was a deadly outbreak of measles in the late 1980s and early '90s.

There is a small inherent risk in immunization -- which monitoring is designed to help uncover and reduce even as vaccines are in general use -- but it is vastly outweighed by the enormous, literally lifesaving, positive effects of this proven public health strategy. That's the message delivered last month to a House committee hearing on "Vaccines: Finding the Balance Between Public Safety and Personal Choice" -- itself a striking sign of the worry over vaccinations -- in testimony by U.S. Surgeon General David Satcher, MD, PhD, and others, including a representative of the American Academy of Pediatrics and the Infectious Disease Society of America. The AMA also strongly supported immunizations, in a written statement to the committee.

At the end of a century in which vaccines have more than proven their worth, it is hard to believe that they should require defending. Still, better an epidemic of questions than the return of one that could claim the lives of children.