February 19, 2011

Treacherous Territory: When a Mother Questions a Vaccination

It's never a good idea to stand between two warring parties, you're likely to get a grenade dropped on you.  That's precisely what's happening to me in my decision to delay the application of one currently recommended vaccine for infants.  On one side are the alarmists who believe all vaccines are unfounded for a variety of reasons, and on the other are the conformists who claim that anything with documented history and a scientific/medical association stamp on it must not be questioned.  Approach either side with a questioning mind and you're likely to get figuratively flogged.

I should start out by saying I am not opposed to vaccines in general.  I myself have received the full palette as a child and more than the typical ones as an adult, for having traveled to Venezuela and for wanting to practice preventative health care measures. I should also say that I have a good relationship with my daughter's pediatrician, one in which we discuss all options and I submit to most of her recommendations while she supports mine.  Perhaps most importantly, I take good care of myself during lactation and my daughter is a happy, healthy child- from conception to present- normal size, height, weight, not been sick, etc.  So I think I'm doing something right.

With that said, I am not afraid to go against certain mainstream recommendations.  I always do plenty of research, talk to my husband, family/friends, and pediatrician first.  I've mostly ended up accepting vaccines, but I have questioned one single vaccine's timing- .  After some thought, research, and discussion, I decided to delay its application until my baby is older.  I underestimated what a hubbub this would provoke.

The vaccine in question for me is Hepatitis B.  Honestly, while I was still pregnant and saw it on my daughter's "at birth" vaxn recommendations and recoiled, I hadn't even looked into the dangers of the vaccine.  It just didn't make sense to me why it was now being recommended for infants on the day of their birth, if it was a sexually transmitted disease, and when she was already getting so many other injections.  When my pediatrician explained that the concern was for mothers' ability to infect their infants or for babies in populated day-care situations, and I responded that I'd previously had the vaccination series and would not be putting my baby in day-care, she supported my decision to delay its application.

When she was first born, I was concerned that by attending a state/federal vaxn program, I might run into problems trying to get an extended/selective vaxn schedule applied to my daughter.   I talked to my pediatrician about getting them with her and she replied that whereas she supported my concerns, the advantages of going with the govt. vaxn program is that it's free and fresher vaccines.  I also read that some pediatricians advocate an extended vaccination schedule meant to lighten the load on immature immune systems and pacify worried mothers, such as that found at http://www.askdrsears.com/thevaccinebook/

It gave me hope that with luck we'd be able to get our wishes respected in our own process. So we decided to go for it,  The first time we went, at one month of age in October, we were able to selectively receive only the BCG (tuberculosis) vaccine (which, by the way, is not even considered a high incidence country, with only 11/100,000 case incidence- although its virulence is increasing because of individuals who begin treatment regimes but do not follow through with them due to a migratory lifestyle) and weren't forced to accept the Hep. B vaccine.

The second time we went, in November, we also were let off the hook with Hep B, and received only the first round of the pentavalent combo of Tetanus, Diptheria, Whooping Cough, Influenza B, and Polio at the recommended two months of age.  Unfortunately, they didn't have enough stock of the Pneumococcus vaccine which was also recommended at that time. So we had to wait a month and take her in December- causing the cycles to be staggered for the following months.

The January 4 month round of pentavalent went fine, except for the fact that our original clinic where we were assigned for free general medical services under the new Seguro Popular had become quite crowded and chaotic because they eliminated the turns procedure they had once had.  But since the govt. vaxn program advertises that you can receive vaxns at any clinic for free, we tried to go to another closer to our mother-in-law's house.  This was when more confusion began.  First, they wanted to know why we had gone there.  Next, they were concerned that the Hep B series had not been started, but ultimately relented when I reminded them that vaccines were voluntary, not obligatory.  Finally, they told us to go to yet another clinic in February, when she'd get her Pneumococcus booster.  So we did so.

That was yesterday.  Unfortunately we arrived at 9:15 am and were told all the turns for vaxns were finished- to come back Saturday am at 8:00 am.  So we got up at 6:00 am to be able to be in line early.  When we got there at 5 to eight, they were still readying the premises, dusting off desks and placing out vials of deparasitization antibiotics, which they also offered us after giving us a short talk about their benefits, which we politely declined.  There was only one woman in front of us, but it wasn't until 8:35 that they finally sat us down to register us.  There was a complaint that we were at the wrong clinic, and a complaint that we hadn't received the Hep B schedule. I repeated what I always do at the other clinics, but the head nurse was not having it this time.  Pardon me, but vaccines are obligatory, she said. OK, if that's really true, I thought, then why are folks not being fined for not bringing their kids in for vaccines?  In the end, they only applied the single Pneumococcus vaccine after she spoke to the head doctor and I promised I'd bring a letter to absolve them of any responsibility for us having skipped the vaccine.  She withheld our new vaccine card that they'd issued the baby for that new clinic, and told me we couldn't have it until we brought the letter.  Then told us we needed to go to the original clinic for all services.  Why, why, why?

Margo was angry that she withheld the card and sent us back to the original clinic.  I suspected it had to do with them not wanting to deal with my special requests.  Every clinic feels so uncomfortable (except, ironically, the original one downtown that first saw us but now has the unreasonably long lines) with my attitude.  I get treated condescendingly although I am very polite and firm.  I resist my sarcastic and arrogant urges, and remember this is just about my basic rights.  I am simply practicing my right as a mother (also educated as a biologist) to inform myself and choose intuitive, practical preventative care, like other mothers who question blanket vaccination like in http://mothering.com/jennifermargulis/tag/monkey-study.

However, on the way home, my usual rock of support, my husband, showed signs of wearing down under the constant pressures to conform to the government system.  After a brief shared bout of complaining where we agreed that the clinics aren't really as concerned with protecting babies as they are with covering their backs, his tactic suddenly turned.  Well, the real problem is that you don't want them to give her that vaccine, he said, essentially blaming me for this issue.  I got upset but then remembered a discussion about hospital procedures we had with our midwife after the birth itself.  Basically, because of a perceived hierarchy among the practitioners in the room (that diverged from how I'd hired them to act), and the fact that my husband and doula had not stood up for my requests about a position I wanted to be in, I had ended up being my strongest advocate while I was busy pushing out my baby, and that had upset me.  That's when they both confessed that here folks don't really feel comfortable standing up to authority. 

At first I reacted badly to his comment about my issues with this vaccine, but instead I decided to back myself up.  So I went online and found out that there is more to the issue than just my instincts that it's just a little too early to get the Hep B series applied.  Others share my concern that the implied necessity of the vaccine at birth is overblown, such as those shared at http://articles.mercola.com/sites/articles/archive/2002/01/23/hepatitis-vaccine-part-three.aspx.   Even so, there are still those who feel, quite vitriolically, that any attempt to question mainstream recommendations is unscientific (isn't that paradoxical?). Even though the issue will probably continue to resurface in various guises throughout my daughter's childhood, this has given me a little more resolve to try and not fall into either category- neither exceedingly alarmist nor conformist.   At least my headache has subsided somewhat for the time being.

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