02Jul2011

Should I Vaccinate My Child For Travel?

200490829-002

The single most surprising question I get asked by readers of this blog is this: “should I vaccinate my child for travel?”

I say “surprising” because, to be honest, the travel jab question was a no-brainer for me.

As, I think, it is for most child-free adults contemplating travel to the developing world.

Y’know. You’re going somewhere where there are tropical diseases, dangerous diseases, ones that are almost eradicated in the developed world, but kill millions elsewhere in the world.

So you see a specialist doctor, get your recommended shots, and vastly reduce your chances of contracting said diseases.

End of story…

One would think this approach would be the norm for people travelling with their kids.

You don’t want to put your child through a month-long course of agonizing injections if he or she gets bitten by an animal that might be rabid.

You don’t want your child paralysed by polio. You don’t want your kid getting measles complications in a third world hospital.

Ergo, one would think, you’d vaccinate.

But this doesn’t seem to be the norm.

Especially not online, where scaremongerers shout loudest of all and the voodoo voices dominate dialogue.


Online, I’ve seen advice from homeopaths seriously recommended as an alternative to doctors, citronella presented as a better insect repellent than DEET, not to mention a bunch of utter (and dangerous) garbage about “natural immunity” or (worse) “inherited natural immunity”.

Let’s start with rabies. This is 100% fatal when contracted. NO ONE has EVER had any natural immunity to rabies. You get it, you die.

Around 55,000 people died of it last year – it kills tens of people a year in well-touristed Bali.

You can acquire immunity via surviving an infection (“natural immunity”) or being vaccinated.

I can honestly not see why anyone would risk their child’s life by giving them whooping cough (pertussis), which kills 300,000 people every year, worldwide, rather than give them the jab.

As to “inherited natural immunity”. Mothers do hand on antibodies to their newborns, resulting in increased immunity for a short period.

But, as should be obvious from the numbers of families where, for example, grandmother, mother and grandchild have all had chickenpox, or, more simply, the fact that a myriad forms of flu and common cold still exist, it’s not an effective protectant.

Edward Jenner developed vaccinations precisely because so few people have natural immunity to serious diseases. His invention has saved an incalculable number of lives over the last couple of centuries – hundreds of millions, if not billions — and vastly increased the quality of life for everyone.


Sadly, it’s precisely because childhood vaccination programmes work –- polio cases in the UK have dropped from 4000 a year when vaccination was introduced to a handful of cases, almost all among adults to old to have been vaccinated –- that some parents are now opting out.

There is a tiny risk of polio in the UK and the US. Why?

Not because unvaccinated children have “natural immunity”. Not because polio’s not an infectious disease. But because everybody else vaccinates their kids, so the disease is (currently) not out there.

This enables parents to focus not on the diseases, which can and do return (measles is soaring in the UK), but on perceived and largely anecdotal risks of vaccination.

In countries where polio-crippled adults beg on street corners, you won’t see many people opting out of the polio jab from a concern for “side-effects” –- because they’ve seen what the disease can and does do.

Worldwide, over a million under-5s die every year from diseases that could have been prevented by vaccination (more than one-third of them from measles).

That’s a lot of grieving parents. Very, very many more, I would venture to suggest, than those who even claim – let alone can demonstrate – any damage to their children from vaccination.


Online forums, however, are full of people who have traveled with their kids without vaccinating them proselytizing others to do the same.

One assiduous online self-promoter, whose blog and social media feeds cover her own and her family’s various health complaints in quite mesmerizing detail, posts all over the internet as an advocate of homeopathy and travel without vaccinations – presenting her own avowedly excellent health as an example.

Now.

Of course you can travel non-vaccinated and not get sick. You can drink drive and not have an accident. You can smoke crack and not become addicted. You can smoke cigarettes and not get lung cancer.

But your risk of health problems is higher when you do not vaccinate. End of story.


Why are people so scared of vaccinations? And why does this fear only kick in when they’re parents?

Firstly, there’s the bewildering belief that what is sold as “natural” is somehow safer and more effective.

Now, I’m not anti-natural: I’d rather get my vitamins from fresh fruit and vegetables than from supplements (“natural” or otherwise), and would rather ride out a bug than mess with antibiotics.

In the case of serious illness or accident, however, I’m rushing straight to a hospital with evidence-based medicine, into the warm and statistically proven embrace of Big Pharma.

Homeopathy is not ineffective. It works as well as a placebo, because people believe in it. (For a fascinating article on the placebo effect and homeopathy, click here.)

Mind you, if anyone would take a dangerously ill child to a homeopath or alternative therapist over a Western hospital – let’s say they’re comatose, fitting or running a fever of 104+ — I’d be really interested to hear from you.

If you wouldn’t leave a dangerously sick child in the hands of a homeopath, don’t base your vaccination decisions on their advice.

While I’m on this soapbox, it’s worth knowing that many medicines marketed as “natural” contain chemical ingredients (including antibiotics), while others can be toxic (the preeminent “natural” anti-malarial is banned in India). (See this pathologist’s report for more on this. )

The “natural” healthcare industry, often presented as a series of backyard mom and pop organisations, is often at least as greedy as and always infinitely less regulated than Big Pharma.


Then there’s the vaccination scare thing.

Bizarrely, these vary from country to country. In the UK, our big one was about the MMR injection, a combination jab against measles, mumps and rubella.

(Why vaccinate against these often trivial illnesses? Rubella can cause birth defects and miscarriage; measles can kill and cause brain damage; mumps can cause sterility in men.)

The MMR scare in the UK was started by a now-discredited doctor who claimed, on the basis of a sample size of 12, that the MMR jab could cause autism. (For a chilling analysis of the scare and the role of media in it, check this piece by Ben Goldacre.)

It was a psychologically compelling idea. The jab is administered around the time when autism spectrum conditions tend to present in children.

Many parents, whose children presented with autism around the time of the MMR jab, still hold that it was the jab that caused their children’s illness.

Of course they do! It’s only natural, when a heartbreaking condition strikes, to look everywhere for an answer, a reason why…

Christ! It struck a chord with me. My brother lives with Aspergers syndrome, an autism spectrum condition that makes many aspects of life very challenging for him.

Taking my child to the doctors for his jab with screaming bold-face headlines in the newsagents about how it would give him autism was…

Well, difficult, honestly…

Even though he’d had the full programme of jabs, beginning at a few weeks old (as in most of the developed world, our government gives them out free), I was afraid my son would present with my brother’s condition. And then I’d forever be blaming myself, and the immunisation, for his condition.

He had it. He was fine.

The only noticeable side effect he’s had from any of his myriad injections is a sore arm (this is, along with mild fever, among the side effects you’ll find listed in painstaking detail in the literature).


So… Should you vaccinate your child for travel?

If you’re anti-vaccination, or, as happens in well under 0.001% of cases, your child has had a reaction to vaccines severe enough for doctors to recommend that they are not vaccinated further, and you’re starting in the developed world, you’re going to run about the same risk wherever you go.

Y’know. Madrid, London, Tokyo, New York, Melbourne, Auckland – your child can get sick there, and infect other children there (babies too young to be vaccinated routinely die in the West via infections contracted from unvaccinated children). But their chances of contracting, say, polio or typhoid are minimal.

If you’re headed to Rwanda, East Indonesia, Mongolia, Suriname, rural Brazil, Mali, India, Pakistan or Nigeria, for example -– your risks are very, very different.

And I think the question you should ask, when planning to travel with an unvaccinated child to regions where dangerous diseases are prevalent is: “Could I live with myself if my child died of these diseases or was permanently damaged by them?”

For most of us, the answer will be no. And most of us, therefore, will want to change either our travel plans or our approach to vaccinations…

I’m interested to hear where you stand on this — what jabs did you have? Where did you go? Whose advice did you take?

67 Comments

  1. As soon to parents for the first time (that love to travel) – I found this pots helpful. Aahhhhh, so many things to think about!!

    • Theodora says:

      Congratulations, Cam! I think, don’t over-complicate it — you’re Canadian, right? The other thing is that once you have a child (well, after the first couple of weeks of shellshock — where you suddenly can’t leave the house without providing for someone to take care of your child) they fit in really easily — whatever your lifestyle is. When are you due?

  2. Amy says:

    Theodora you have landed yourself on a controversial topic! When Mike and I first set out overseas we had all the jabs we could get. My extended medical paid for 80% of everything so we got the travel Doctor to load us up no questions asked.

    Now that we have children I do consider vaccinations more carefully. I guess it is just the thought of putting something so foreign into the arms of my babes, especially with all the controversy surrounding them. That said, they have still had all of their childhood vaccinations and we have started on the travel ones. I do, however, question the advise of the travel Doctor who is paid by how many jabs they push. We took the advise and are now researching ourselves to decide which travel vaccines to give our children.

    I think this is a really important topic for traveling families, and one many families have a hard time with. Thank you for addressing it.

    • Theodora says:

      Thanks for your thoughtful response, Amy — as British citizens, most jabs are free and the travel specific ones are a fraction of the price in the US, so cost has never been a very significant factor (no insurance, but much lower prices).

      One interesting thing with the travel docs I’ve always used — they’re at the Hospital for Tropical Diseases in London, UK (it’s the research and treatment centre, and has a ?commercial? arm that does the travel clinic) — is that they advised us *against* Japanese Encephalitis B, which I thought we should get, on the grounds that the risk of side-effects was higher than the risk of exposure given we weren’t going to be living/working in specific rural regions where it’s prevalent. I’ve also had them advise against the Yellow Fever jab.

      I wonder what response we’d have had if we’d gone to a pure-commercial “Travel Clinic”, where I would guess you are correct and docs are paid by the jabs they deliver? It would be worth doing a “compare and contrast” study, just to find out…

      So I think it’s well worth picking the right place to get the injections done, but it’s probably easier in countries where free health care exists and the framework is different.

      • Amy says:

        We are in Canada. All of our routine vacs are free but the travel ones are ridiculously expensive and are privatized. The travel doc we saw did recommend us getting the Japanese Encephalitis and said “It is a routine vaccination in Thailand so I really think you should get this one.” Interesting that yours advised against it. The other ones that were stressed were Hep A (of course we are getting that one) and Rabies. We are on the fence about rabies. I know there are lots of feral dogs in Asia and that children run at greater risk of being bitten but we are very cautious with dogs even in Canada as one of my sons had a bad experience as a toddler. I feel like if one of us ever was bitten we would not be far away from a medical centre. I know the post-bite jabs are much more intensive than if you had gotten vaccinated, but for us I feel like the best thing is to just be extremely cautious. We do plan on going to a travel clinic in Bangkok to get their opinion as well and if we get more vaccines they will come at a third of the price we would pay here.

        • Theodora says:

          That’s interesting they recommended Japanese Encephalitis. I thought we’d need it for Papua, but they said it’s only recommended if you’re going to be spending months living in close contact with rural communities in certain specific regions of Asia — it’s certainly never been recommended for other places we’ve travelled. Some districts will do travel shots for free, but most don’t, in the UK.

          My impression is that British guidance is more specifically nuanced than that in North America — I get the impression US docs recommend anti-malarials for anywhere in Thailand, where British docs will say “Where are you going in Thailand?” and only prescribe if you’re going to the northern border regions, which are the only places considered significantly risky.

          We’ve not been bitten by anything in over 18 months (though we have had one scary run-in with a gang of strays), but my main rationale for getting it done was that we were going to remote regions where we could be (and have been) 3 days travel from a clinic. One thing to bear in mind, though, is that your travel insurance often won’t cover the course of shots post-exposure if you haven’t been vaccinated: so I’d check your insurance status before you make the decision (the post-exposure treatment runs $1500 or more in Asia)…

        • Amy, dogs are different in Asia, so rabies has to be considered differently.
          First of all, the traffic is insane, so only the smartest stay-on-the-pavement dogs survive.
          Second of all, the locals are not stupid. There are kids everywhere and if there is a dog that bites they’re going to deal with it.
          Third of all, people still love dogs in Asia. They are family pets, they are loved and looked after. It’s not like you’re walking through the jungle with hungry tigers trying to take a bite out of you.
          I’m vaccinated for rabies because that was advised before I moved to Asia. But my daughter isn’t and, unless we are swamped by rabid dogs in some remote region, I don’t see the need to vaccinate her.

          • Theodora says:

            I think it depends on which bit of Asia, Barbara. There’s been over 100 rabies deaths in Bali over the last 18 months — at night you see a lot of very mangy and frightening stray dogs that missed the cull… We had a run in with some very scary dogs on Palawan, in the Philippines. But, yes, it does depend where in Asia you are.

  3. Ana says:

    Thanks for writing this, Theodora! I totally agree with getting all the vaccinations needed when you travel. We were fortunate to get all our travel shots in Spain, where we only paid 30 euros per person for all the vaccinations they recommended at a travel clinic. Yet, had we gotten them in the US (we did a bit of research before our round-the-world trip), it would have cost about $US 2,000 EACH to be vaccinated. It’s an insane amount to pay, and it makes no sense to me.

  4. Emiel says:

    Great post. We also vaccinated our children before our travels to Morocco, Thailand and Bali. Here in Holland children already get a basic set of vaccinations, but when we travel to other continents we definitely need some additional ones. And so we did, no question about it. Costs are in between 80 and 150 euro per person. One shot protects you for 10, 20 years or sometimes even a lifetime.

    We don’t travel with our kids to malaria areas, just because I don’t want them to get these daily malaria pills. That’s our choice.

    • Theodora says:

      That makes sense, Emiel. We also use anti-malarials in malarial areas (which are, obviously, fewer than many people think) — but I can understand the desire not to hop kids up on antibiotics or Malarone against malaria.

  5. I found myself screaming “AMEN!” over and over while reading this!!! You make SUCH a good point when you said, “In countries where polio-crippled adults beg on street corners, you won’t see many people opting out of the polio jab from a concern for “side-effects” –- because they’ve seen what the disease can and does do.” We in the first world are SPOILED because we take for granted that these diseases don’t affect us.

    “Of course you can travel non-vaccinated and not get sick. You can drink drive and not have an accident. You can smoke crack and not become addicted. You can smoke cigarettes and not get lung cancer.

    But your risk of health problems is higher when you do not vaccinate. End of story.” – Yes, yes, YES!!! Exactly! And worse, you’re putting at risk those too young to be vaccinated and those whose immune systems don’t work as well.

    “Natural” sounds wonderful, and sometimes it is. We eat organic fruit and veggies when possible, and largely eat natural foods. But lets not forget that arsenic, botulism and tapeworms are all natural!

    We don’t vaccinate my children because they are sickly. I do it because I want them to remain healthy. Vaccines work by teaching your immune system to recognize the disease so that it can protect you. They STRENGTHEN your immune system, not weaken it. We are grateful that with a simple prick of a needle, we and our children are spared the often devastating consequences of these horrible diseases.

    Thank you for this well thought-out post!!!

    • Theodora says:

      Thanks, guys! I’ve been expecting a lot more negative comments. I’m glad, also, you make the point of putting other children at risk, and others with compromised immune systems — some of the saddest deaths happening in Australia and the UK are those of babies too young to be vaccinated, who contracted diseases from the children of anti-vax parents.

  6. Alyssa says:

    An interesting post. I think most people get scared of listening stories that are the exception and don’t really think well the odds. When I was seven and went up to the rainforest for the first time, our truck was stopped by a man pointing towards some huts were we should get the yellow fever shot. Having travelled all his life in the jungle, my dad said no thank you, but the man said: if you want to risk the lives of your children, go ahead! We all got the shot. I’ve been vaccines against yellow fever three times now, twice in those huts, once in a lab when I needed the certificate. Nothing happened
    However, when there was a campaign against scarlet fever at school and all o us got vaccined, my sister got scarlet fever immediately after. She was fine but now I’m a little more distrustful of government handed vaccines. Then again, I live in Lima, in a third world country with polio and tb and dengue, even malaria, so at least here parents don’t have much of a choice.
    Thanks for the post, and great blog!

    • Theodora says:

      Thanks for your kind words, Alyssa. We don’t vaccinate for scarlet fever in the UK, which is interesting — even in high risk children, with weakened immune systems — this is what’s said on the government website http://www.nhs.uk/Conditions/Scarlet-fever/Pages/Introduction.aspx. But, yes, even though one knows in theory that vaccinations can give you a mild dose of the disease, to actually see someone get it would shake your faith by transforming the theory into the practical…

  7. Tracy says:

    Well I think you’re going to get a few comments on this one! It’s a very important travel topic but the opinions are very divided!

    I completely admit to being one of those parents that never though anything of getting themselves vaccinated … and then I had kids. Suddenly the word ‘MMR’ became one of the scariest things I’d ever heard. Well meaning friends started mentioning ‘oh didn’t you know they put mercury in immunisation X and nasty chemical in immunisation Y’ … and suddenly I was questioning every shot. I’m still not sure where I sit honestly on these issues, and if we were in Australia I probably would never have looked outside the standard immunisation schedule because of the fear that surrounds immunisations … but when we decided to travel with the kids, immunisations seemed like a no brainer to us!

    We looked around to find a good travel doctor. Our experience was similar to yours not Amy’s – ours actually recommended against a huge number of vaccines and was very upfront discussing all the side effects (rumoured and proven) for each vaccination contrasted against the long term consequences of the disease itself.

    Some we chose not to get because the risk of contracting them was minor, as was the seriousness of the disease. But we did vaccinate against most problems in the areas we intend to travel – for us it was either change our travel plans or vaccinate. I wouldn’t visit a city in the middle of a riot with our kids, get on an overcrowded leaking boat in the Philippines or take an airline with serious safety concerns … so I definitely wouldn’t be taking my kids into rural Cambodia or Laos without vaccinating them first.

    • Theodora says:

      Thanks, Tracy. I’m so with you on the MMR thing. It was terrifying. I’ve never done anything beyond what the NHS provides, apart from specifically required travel injections: interesting that Australia and Britain seem to go for the lighter option. And, as per Alyssa’s point about Scarlet Fever, we’ve probably had fewer jabs than might be recommended in other countries. I suppose, personally, having seen my cousin almost die of whooping cough during the 1970s vaccine scare over that one, I’m pretty pro — and also, I guess, if polio could go the way of smallpox, that would just be amazing.

      But the big thing, as Stuart also points out, is to see a good travel doctor, who’s got good data, and who will give you the right information to make decisions. Must go and pop an anti-malarial, now…

  8. Stuart says:

    There’s actually been over 100 deaths from rabies in the last 18 months or so.

    What’s that saying about not being able to pick your parents? Unfortunately the kids who end up being the vector for these diseases have been forced, unwittingly, onto the frontline by their lunatic parents.

    When we had our second child here on Bali, one of the prebirth classes covered vaccinations and included a video of children here, on Bali, now, in 2011, fighting polio, whopping cough and so on. It was heart-breaking. I’d really love to see that ST3 loon sit down with those parents and explain how really, they are far better off for having an unvaccinated child.

    • Theodora says:

      I should have checked the Bali Times stats on that! The last piece I saw was *claimed* that it was declining and cited something like 37 deaths this year… I didn’t realise there was still significant polio in Bali, I have to say. (Obviously, we were both vaxed soon after birth.) My cousin almost died from whooping cough during a mercury-in-vaccines scare in the 1970s, so I’ve seen what that one can do. But, yes, I’d love to see any anti-vaccine campaigner face to face with a family where the child has polio, bollocking on about “natural immunity”, “inherited immunity” and how they should have gone with homeopathy.

  9. Stuart says:

    Sorry, I should add, that which vaccinations you actually get should be decided on after consultation with a travel doctor. Am not suggesting kids get vaccinated for everything available.

  10. Ainlay says:

    Bravo Thoedora and I totally agree it is a no brainer – we have kids, they got the shots. The end result of Rabies and Japanese Encephalitis is death, the prevention a couple of jabs, what is there to think about? Nothing makes me more annoyed than parents who ensure their own baby’s heath by relying on all the parents around them getting their own kids vaccinated so their own unvaccinated child is never exposed to the disease. I shudder to think what would happen to that child if he should one day decide to visit India or Cambodia…

    • Theodora says:

      We had a vogue in the UK for infection parties at the height of the MMR scare. So, get this: rather than get your child vaccinated against a disease, you encourage them to contract it from an infected child (and, no doubt, spread it elsewhere in the community). It really does rile me, sometimes, the selfishness of it.

  11. Jade says:

    We don’t have kids, yet, but we definitely vaccinated ourselves and I honestly can’t see why I wouldn’t do it with my kids too. Many schools are making it mandatory in California for whooping cough and I know I had to get certain ones before heading off to college.

    • Theodora says:

      Ah, the beauty of free medical care! Vaccines aren’t compulsory in the UK, but they are highly recommended, and free, so for most parents it’s a routine part of life (take baby to checkup; get that week’s shots; rinse and repeat) — if you’re a non-vaccinated adult, you can get all the non-travel ones (whooping cough, polio, diptheria, tetanus &c) free too. Don’t go changing!

  12. I think my favorite part of this piece was this: “Mind you, if anyone would take a dangerously ill child to a homeopath or alternative therapist over a Western hospital – let’s say they’re comatose, fitting or running a fever of 104+ — I’d be really interested to hear from you. If you wouldn’t leave a dangerously sick child in the hands of a homeopath, don’t base your vaccination decisions on their advice.”

    That’s the key for me. It’s easy to sit at home and decide what you would do, but when presented with a life-changing scenario, you might feel differently. Would I rather have my child get an IV drip in a 3rd world country or a vaccine needle in a developed nation? We ran into Mumps while traveling in Madrid — not exactly the middle of nowhere — but just living in a flat in the city. My husband went to the hospital and got meds, but it was scary navigating a medical system in a foreign language and they wouldn’t let me, his wife, into the examining room with him.

    I’ve heard some people say, “I’ve traveled to X countries and I’ve never been sick, my kids have never been sick, we’re all super healthy.” Well that’s not convincing for me. I want to hear from the parents who DID get sick. Who didn’t vax and their kid got whopping cough in India and they got through it and STILL didn’t want to vaccinate. I think your resolve is untested until your child catches something you could have prevented. Because that’s what we’re talking about here. We’re not talking about playing Russian Roulette and getting lucky, we need to make decisions based on the realities of what happens if you’re unlucky.

    • Theodora says:

      I’d like to hear from those parents, too. I don’t know how many of them are out there. I guess you get many fewer parents saying “Do you know, we only used ginger homeopathy tablets against malaria, and whaddayaknow, the kids got it?” than “We travelled for six months using only homeopathic ginger tablets and we were fine”… And, ditto, on vaccinations.

  13. Natalia says:

    Thanks for a brilliant post. Another one who has had all the vaccinations, and had my kid have all the vaccinations, no questions asked. Which still surprises some people ‘but you’re a vegan atheist home educating socialist left-leaner: surely you are anti-Big Pharma?’ My answer – don’t assume people!

    Also, I like that this is coming from a ‘big’ travel blogger like yourself. So often in the ‘travel community’ everyone is assumed to be a bit hippy, a bit ‘natural’, a bit self-conciously ‘I’m different to the norm’ and I find for some people, that means they automatically reject anything ‘normal’ and go for the ‘natural’ no questions asked. As someone who has had malaria (long story), who has seen how polio and TB blights people’s lives, all I can say is: do you really want to put your child’s life at risk for the sake of being ‘different’?

    Sorry, a bit ranty there :(

    • Theodora says:

      Hell, Natalia, it’s a ranty topic!

      Most of the queries I get assume — as people do with you — that I’m going to be anti-vax (my set of descriptors are different from yours, but a lot of overlap: single parent, atheist, long-term traveller, home schooler, left-wing…). And, to be honest, until I started blogging and delved into the blogosphere I had no idea how many people felt so strongly differently.

      And how much crap information was out there on the subject… Thanks!

  14. Snaps says:

    Somehow I didn’t expect such a polarizing and cheap post by you, Theodora.
    Hate and controversy undoubtedly sells, but is it really worth it.

    • Theodora says:

      Why “cheap”, Geri? There’s a lot of bona fide scientific data in here. There’s also far too much under-researched stuff on the internet — which is why I find it bizarre that you should consider siding with the WHO and 99.9% of doctors out there on a health issue controversial. Missing the hate, also.

      • Snaps says:

        Cheap, because there are dime a dozen posts exactly like this one out there.

        • Snaps says:

          (Sorry, it sent the comment by itself for some reason.)

          Hate, because of the loaded language you have used.

        • Theodora says:

          Oh really? There’s a million more on the other side, believe you me. Most of them not researched, which this one is, which is, since I guess you’re on the other side of this debate, why you’re not putting up any factual data to oppose the case I’m making. Where’s the loaded language?

  15. Crystal says:

    The anti-vaccine crowd make me MENTAL.

    We vax. Period.

    When moving to SE Asia, I asked what we’d need for Singapore, where we live (which was pretty much nothing…hep A, if I recall correctly…and I’m currently too lazy to grab her vax records from the other room) and added those into E’s regular schedule.

    However, as I want to travel more outside Singapore in this region, we need to talk to our travel clinic and see what we can/should add in. As a pregnant mum, I’m also in need of a nice long chat with the travel clinic as to when will it be safe to travel with the baby (and to where at what age–Hong Kong is obviously safer than Cambodia, and so forth).

    With E, we’ve done various parts of the US, the UK, Singapore, and Thailand. Beyond that, my husband and I have also done France, Switzerland, Canada, Hong Kong, and India (and don’t I wish now that I’d done the follow up jabs after India to ensure longer term protection–instead I have to start over again).

    • Theodora says:

      Yep, I think Singapore’s pretty much the same as anywhere in the Western world. So with you on getting the follow ups…

  16. Anne-Marie says:

    A brilliant post with masses of research, and it ought to be out there on every travel website in the universe. Pleasantly surprised to see that the anti-vax brigade are keeping very quiet – but then, when you’ve gone to the trouble of looking up the evidence, and providing links to it, only flat earthers and their like will contradict you.

    • Theodora says:

      Thanks. I don’t know that it will be, but I’m surprised I’ve had so few antivax comments so far, to be honest — they are by far the loudest voice on the topic online, at least.

  17. Excellent post! I, too, had no idea this was even a hot topic – vaccines were a given and we never considered not giving our children every advantage we could.

    Your point about considering what you would do in the event of a serious illness is exactly right – we can all carry on about how helpful homeopaths and such are, but who will we turn to when we are seriously ill?

    That’s not to say natural medicine doesn’t have it’s place – but I would never turn only to alternative medicine without seeking out established health care as well. There needs to be a balance – and vacs.

    • Theodora says:

      Thanks for your comment, Nancy. I think of myself as not a big fan of natural medicine, but there’s a lot of very simple stuff that I do use (honey and lemon for sore throats; ginger for nausea; orange juice if run down; and I will try out clove oil if I get a stomach bug): and it’s good to have a perspective from someone who combines natural and evidence-based (and vacs)

  18. Justin says:

    If I spend a year planning and saving for a huge trip to some off-beat destination and one of my family members goes and gets rabies – well that puts a serious damper on the trip! Who needs that drama! Doesn’t travel come with enough headaches and interruptions. Who wants to throw in the possibility of getting paralysis via japanese encephalitis! Seriously, what are we talking about here. There should be no debate on the issue.

    Is someone is fearful of the effects of a vaccine, DON’T GET IT! And you know what else, DON’T GO ON THE TRIP! No one says you have to travel into the jungles of who knows where.

    Look, if there was a magic little dart that I could stick in my arm to prevent a plane crash I would do it, even if it was developed in some lab. Everyone would, even though the odds of crashing are slim. If I could give my kids a pill that ensures their safety and allows us to travel and experiences life with less worry, GREAT! Sign me up! That is what vaccines ARE – Insurance, a magic pill. I bet you all the people living in those “rural” areas wish they had the vaccines. I bet they have seen enough to jab themselves 1,000 times with anything that will prevent them from getting THAT! I think I am SOOOO Fortunate to have vaccines!

    Vaccines cost me a bundle as an American and I will always get them or we just won’t go. Travel Insurance and vaccines are a pain in the ass, but they make life for travelers easier and safer and more comfortable. I worry enough as a parent, I am happy to take rabies and other causes of DEATH off my list if someone can offer up a way to keep my kids and I safe.

    Thanks for the GREAT article Theodora and for conquering a tough topic! I hope you finally set the record straight.

    • Theodora says:

      Thanks, Justin. I am absolutely sure there are a myriad parents absolutely desperate for vaccines, and it does seem a little spoilt for Westerners to reject them…

  19. Elissa Joy says:

    One of the trickiest things is to be a parent and make the best decisions you can based on having as many facts as you can.

    My kids have not been great travellers.. so hence we did not go very far beyond the camping trip 2 hours away. we did move across Canada to the West Coast from Ontario though. :)

    I have to say that it does not always mean that your kids being vaccinated is going to 100% STOP your child from getting the disease/virus.

    9 years ago, 3 of my kids got Whooping Cough ( we were living in Toronto Ont. At the time) 2 of them were vaccinated against Whooping cough, the youngest, not.

    Whooping cough is 9 weeks of coughing. And ALL at night. We used homeopathy to help us. And yes.. it helped. It did not Take the whooping cough away.. but the remedies did help. ( And to be honest.. there were times when sometimes the did not work.. but not because they were like placebos .. the remedies worked when they were the right potency and timing.. )

    Amazing that you use the ” Placebo’ concept for homeopathy, but not for allopathic medicine.. Big Pharma has a staggering Placebo effect.. IT was even found out that some Heart surgery, performed for 50 years, was found to be not effective as they thought it was when some dr’s did tests of creating a scar in the patient but not performing the surgery and saying they did. The results? the patients without the ACTUAL heart surgery did fine.. ( don’t remember if it was better or the same.. ) as the ones with the surgery.. but they stopped this risky procedure.

    The point is.. homoeopathy works. AND there are times where we need Allopathic medicine too. Far less than they make us believe we do, but it can be useful. ( Like with broken bones, etc).

    Vaccinating our children is a PERSONAL choice. One which any parent who asks you is wanting to do so out of CONCERN and willingness to weigh all the options before making a choice.

    Travelling with kids is also a personal choice, and one that the parents have taken much into consideration of where, when, and why they want to go.. and the expenses etc.

    Here, you offer your own opinion on what is best. Trashing others for their decisions that they make won’t help them. Offering as best you can why you think their kids would be better off with the vaccinations is a much more motivating way to reach them… Your rant only creates more animosity. I don’t see many parents who responded on your comments who said they chose NOT to vaccinate their kids. Hmm….

    Like I said.. I have done both. Mostly the vaccinations came BEFORE I was aware of the dangers. Another issue you left out was the fact that the syrums ( sp) are for mmr are made in an egg base ( or they used to be.. good to check this out as they are always changing things) and any kids with egg allergies are specifically told NOT to get the vaccine.

    Make INFORMED decisions. That is what your readers were asking you for.. to help them make their decision informed. They ARE taking the responsibility. And asking you.. sheesh.

    • Theodora says:

      Hiya. I only cite the placebo effect in the context of homeopathy — though you are right that the placebo effect is also present in evidence-based medicine — because the only surveys done on it with statistically significant numbers have proved that it is *only* the placebo effect that works, given the active ingredients are diluted by billions of parts. Did you read the link? It explains in much greater detail than I could.

      There’s actually some debate in Germany on whether to prescribe placebos, precisely because the placebo effect works so well on certain conditions (notably mild depression).

      I find it bizarre that you state that homeopathy works immediately after describing how “it didn’t take the whooping cough away… sometimes they didn’t work…”

      But I’m glad you use evidence-based medicine for broken bones. Would you turn to a homeopath or an evidence-based hospital if your children were in a coma?

      If you could provide a link to your case that faking heart surgery provides a better effect than heart surgery, that would really be helpful. Ideally one to a scientific source, with data and references, like the ones I’ve cited. You can read all sorts of stuff online. It doesn’t mean it’s true, or accurate. If you want to make an informed case for not vaccinating, why not cite some actual literature that’s been peer-reviewed?

      That’s why I cite the WHO, the NHS and Ben Goldacre, a trained doctor who has published in serious peer review journals, is precisely to provide information — data, not anecdotes, reviewed by peers.

      As regards eggs and MMR, for the UK the NHS FAQs say here: “My child is allergic to eggs. Can she have the MMR vaccination?

      Yes, the MMR vaccine can be safely given to children who have a severe allergy to egg. This is because MMR vaccine is grown on chick cells, not the egg white or yolk. If you have any concerns, talk to your health visitor, practice nurse or doctor.”

      The vaccines used in Canada appear to be produced the same way. So I would suggest that the “egg white serum in MMR vaccine” is another scare story generated on the internet through a misunderstanding of relatively basic science and presented, all over the shop, as a basis for “informed” decisions.

      Now, I do agree that vaccination is not 100% effective against getting the disease — it’s a risk reduction (I also don’t think I claimed anywhere that it was 100% effective). Nor, of course, is getting the disease proof against getting the disease: I had rubella as an infant, got the jab, got rubella again (for most people, either a prior infection or the jab will produce immunity).

      The point about vaccines is that a) the vast majority of people who get the vaccine are immune b) in countries where most people are vaccinated, herd immunity means that people do not get the diseases: that’s how vaccination eliminated, for example, smallpox. It’s a risk-reduction strategy.

      I’d also observe that the risks of choosing not to vax when moving within a developed first world country like Canada with high vaccination rates are significantly lower than when visiting, say, Rwanda, Tanzania, rural Cambodia, Nigeria – places where kids routinely are paralysed by polio, and where health care standards are atrocious.

      And the reason, I think, I’m not currently getting many comments from people who’ve chosen not to vax their kids for travel is because I cite INFORMATION and they, like you, don’t actually have anything but anecdote to provide.

  20. The Bradley's says:

    We chose not to vaccinate Kaya, after a friend of ours had her daughter die at 3 months, post being vaccinated. Then, I ran into a neighbor and her son had become severely ill and not the same ( mentally) after a round of vaccines; she was a nurse as well, and she swore she would never give him another vaccine again after the drastic change in him.
    The thing to watch out for is not the vaccine itself, it is the additives such as squaline and thimerisol. Now, the good thing is that many countries do not allow said additives, although the US does for some. These pass through to a babies brain and can cause serious neurological problems. The vaccines I got pre 95 are very different then the ones being administered now, and thus the distress some of us have regarding vaccinations. I know Ky is almost never ill, no matter where we have been, and I attribute it to the fact I am still nursing her.
    You are right no one should bring an ill child to a homeopath; Western medicine excels in the ER and with trauma. But if there is a signifigant amount of money being paid from vaccine makers to med schools and associations, and if there are changes to additives, AND if kids who are vaccinated may be at risk to other illnesses or disorders ( watch Vaccine Nation) then it is worth all of us at least reading the additives in the vaccines, and questioning which ones we choose.
    Will we vaccinate Ky in the future? That depends. For now we won’t, not because we are bad parents but because of what we have observed and researched, with regards to thimerisol and other additives.

    • Theodora says:

      I’m sorry to hear about your friends’ experiences: I think it’s highly understandable that when a child gets sick after vaccination (as with the parents of autistic children in the UK who attribute it to the MMR jab), you blame the vaccination (and many will continue to do so despite the vast studies, covering tens of millions of children, which have found no linkage). And I really do feel for people who have those experiences. (One family member of mine, however, got a cerebral inflammation with chickenpox — of all things — so from personal experience, as well as from the medical literature, I’m well aware of the complications that can ensue.)

      It’s very interesting to have a US perspective on this. Rules on pharmaceutical marketing are very different in the UK (for example: we can’t advertise drugs to consumers). Also, most of our vaccines are provided through the NHS (free) framework, which takes out the profit motive (I’ve only ever had vaccines within NHS-operated clinics).

      Now, I find it intuitively hard to understand why vaccines that produce immunity to certain conditions should reduce immunity to others: if there’s any data on this, I’d like to see it. I can certainly understand that extended nursing brings benefits (we stopped at 6 months, because he was being bottle-fed expressed milk while I worked, and realised the bottle delivery system was quicker…)

      Still, Z, fully vaccinated and only briefly breast-fed, is also a healthy kid. In 18 months of travel he’s had 3 half-day bouts of the runs (his immune system doing its job), one eye infection, one 1-day fever and one cold.

      As regards your specific concerns on squalene and thiomersal, which seem to be used mainly in the swine flu jab, which is not part of vaccination programmes within the UK: http://www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/documents/digitalasset/dg_182310.pdf. And professionals guidance with more data: http://www.checktheevidence.co.uk/pdf/NHS-Clinical%20Professionals%20Brief%20on%20Swine%20Flu%20Vaccination.pdf (dodgy site, but the download looks real).

      They say that, as regards squalene, it’s been used in 25 million different cases, with “no associated severe adverse events thought to have been caused by the vaccine”. On thiomersal, it says that both the WHO’s vaccine safety committee (GACVS) and a UK body have issued statements saying no evidence of neurodevelopmental adverse effects.

      The (GACVS) WHO’s site on vaccine safety looks like a really useful research, also http://www.who.int/vaccine_safety/en/. It’s got tools to assess the credibility of websites where information is delivered, which i think are pretty vital for anyone aiming to research this topic.

      Here’s their statement on thiomersal: http://www.who.int/vaccine_safety/topics/thiomersal/en/index.html.

      And here’s one statement on squalene: http://www.who.int/vaccine_safety/topics/adjuvants/squalene/Jun_2006/en/index.html.

      There’s a lot more on the site. I would seriously check it out, because, as I put in the post, Ky will be exposed to more, and more serious diseases, as you travel.

  21. Kate Maindonald says:

    Thank you for such a well put argument. I will go on till I am blue in the face about (as other people have said) how complacent people in the west have become about polio, measles etc. As you know! Hope you’re having fun out there, will try and skype soon…

    • Theodora says:

      It’s Laouena’s birthday today, isn’t it? Say happy birthday to her from me. He’s hit her with a Happy Birthday pillow on FB… Let’s Skype soon. We have reasonable internet today and tomorrow, though it’s shared…

  22. Kristy says:

    We have lived and traveled all over most of SE Asia. My Children were born in Taiwan. We thought long and hard about Vaccines. In part because we had heard the horror stories about autism. But then, my parenting instinct kicked in. I remembered my gradeschool principal who had to walk with crutches after surviving polio as a child. I remembered stories my father told of the neighbor kid who had to be placed in an iron lung to breath during his polio attack.

    I then read about the huge increase in communicable teburculosis spreading around the world, in third world countries as well as the inner cities of the United States. I know my parents suffered the loss of a child to the FLU, yes the flu. I chose, for me and my children to vaccinate. But, I did choose wisely. The vaccine that was on the market in Taiwan at the time was not proving effective for Chicken Pox, so we skipped it. But, we did vaccinate them later in Singapore.

    We did not, and had not vaccinated for much of our travels around Thailand, but then again we stayed in more frequented areas. But did we vaccinate for our trip to India? you bet we did. I got very sick on one trip to India and surely didn’t want to put my kids through it.

    Vaccinations are a personal choice and I appriciate that, but I believe that it you do your research you will find (as you have well pointed out Theodora) that in all most all of the cases (save the freak .01%) that the benefits of not losing a child to a disease that could have been prevented was worth it. I think of it as putting on your seat belt in the car. Would you drive down the block without your seat belt? Sure, probably? Would you let your 2 year old be in the car, even for a block without being belted in? Probably… but you never know if that car is going to fly out of nowhere and t-bone you. I would rather err on the side of caution.

    • Theodora says:

      Thanks for this, Kristy. The reason we vaccinate for many diseases is, of course, that they can kill — the flu epidemic of 1919 killed tens of millions…

      The parallel you make with seatbelts is very exact. Damn you! I wish I’d thought of it! Almost all the time, it won’t actually matter if you’re not wearing one, because nothing hits you. On the vast majority of other occasions, it will save your life. And for one tiny fraction of people, the seatbelt will leave them trapped in the burning vehicle…

  23. Abby says:

    The anti-vaccination crowd seem to be harping on about how it is a ‘personal decision’. It is by no means a personal decision – you are deliberately exposing your child to infections which can kill a person, and if your child is unfortunate enough to catch one of these, they can easily pass it on to others who are not vaccinated. So this ‘personal’ decision can have consequences for others who have not been factored into your ‘personal’ decision. It is a social responsibility.
    I know I am going to be hated on now but I think that anyone who does not get their children properly vaccinated is unfit to parent. You may have made an ‘informed’ decision, but you have clearly been terribly, terribly informed.

    • Theodora says:

      I’ll back you if you get hated on. It is a social responsibility. But, I think, it is also a personal choice.

  24. Rachel says:

    Thank GOD Theodora – the voice of reason!! Having seen my child only seriously ill once (and at the time thanking my lucky stars that it couldn’t be x,y,z as she’d had the jab) I cannot imagine nursing her and thinking ‘I could have stopped this, I could have alleviated all this suffering, possible lifelong side-affects and yes even DEATH by sticking a needle in her arm for 10 secs.’

    The seatbelt anaolgy is off – the comparison you are making is with a functional lifesaving seatbelt next to you and you choose not to put it on. We have travelled in non seatbelted vehicles because it was the only option – if they’re there we use them, just like vaccines.

    We live in Spain and to go to state school here you have to have a medical certificate signed by a state paediatrician who will only do it with an up to date vaccination card – they have to have all the normal childhood jabs plus chicken pox and Hep B by the time they reach the legal school age of 6.

    P.S. Theodora – my brother also has Asperger’s – random!

    • Theodora says:

      Wow! I didn’t know Spain was that focused on jabs — but chickenpox does seem to be the coming thing. Z had it, as a toddler, with minimal impact, but my brother had it as a child and had a neural reaction to it (on top of Asperger’s — talk about a double whammy).

  25. I think its a good thing to vaccinate you never know whats out there when you travel to foreign lands

  26. Elizabeth says:

    Hey Theodora! Sorry for the delayed response! I am actually a Brit myself, but half American; we lived in LA for 9 years, which is where Ky was born. You are right regarding how in the US drugs are directly advertised to people! I haven’t been back to the UK for some time, but greatly prefer getting medical treatment there, as I couldn’t afford to get it in the states, and our insurance never covered doctor’s visits.
    You are right regarding the squaline in swine flu. But regarding other vaccines, for example Japan halted vaccines from Pfizer and other vaccine companies ( http://www.naturalnews.com/031616_vaccines_Japan.html) after 4 kids died. I spend a lot of time reading mainly indie medical studies on vaccine safety, not mainstream ones. CDC vaccine scientist and researcher Poul Thorsen ( who headed up the Denmark Study) was indicted after I guess being accused of money laundering and fraud, altering the report in favor of vaccines being safe. A few new indie studies out this year and last, including one published in the Human and Experimental Toxicology showed a connection between vaccines and SIDS, and A study published in the American Journal of Epidemiology found infant death to be eight times greater within 72 hours post vaccination. A study published in Virchows Archiv and International Journal of Pathology exposed the oversight of many autopsies on suspected SIDS deaths( it is a pretty disturbing study).
    Another incident was reported by CNN, where more then 1000 kids got mumps. 77 percent were vaccinated against it. The spokeswoman said ‘Anyone fully vaccinated from mumps receives two doses of the vaccine, according to the CDC. Of the New Jersey cases, 77 percent were vaccinated’.

    Japan and Sweden require the lowest number of infant vaccines prior to one year of age and have the lowest infant mortality rates in the developed world, where the US ranks relatively high, despite its economic standards and health care. The UK seems more aware of studies published in medical journals. But the vast majority of public worldwide do not know of the frequency with which these studies ( which do not have links to vaccine makers, which most of the mainstream CDC and WHO approved ones do, as has been even reported on mainstream news such as ‘Follow The Money’). Therefore, when any of us who chose not to vaccinate mention we did it because of say adverse reactions or thimerisol, we get told we are wrong and hurting our children. Not here have I been told this obviously, but on forums. Normally when I show these types of studies done by universities and researches people don’t read them, so I rarely quote them unless I was asked or feel someone may benefit.
    If anyone wants any links to newer studies published in medical journals, let me know.

    Some links to recent studies:
    http://aje.oxfordjournals.org/content/136/2/121.short

    http://www.ncbi.nlm.nih.gov/pubmed/16231176

    http://www.whale.to/v/sandler9.html

    http://edition.cnn.com/2010/HEALTH/02/08/mumps.outbreak.northeast/index.html?hpt=T2

    http://journals.lww.com/mecpsychiatry/Fulltext/2011/01000/Study_of_some_biomarkers_in_hair_of_children_with.2.aspx?WT.mc_id=HPxADx20100319xMP

    • Theodora says:

      OK. The WHO vaccine safety site gives a guide on how to assess the authority of site here: http://www.who.int/vaccine_safety/good_vs_sites/en/. I’m reviewing your links on a step by step basis.

      I’m discounting Natural News: http://naturalnews.com. The tone is hysterical, external citations are missing, and there’s no indication that the writer has any medical qualifications whatsoever. It fails at every basic credibility test.

      More importantly, following the halt and the investigation, Japan is now again using those vaccines, which almost all the mainstream and none of the “indy” media covered: http://www.forbes.com/2011/03/09/japan-says-pfizer-sanofi-vaccines-did-not-cause-pediatric-deaths-marketnewsvideo.html

      http://aje.oxfordjournals.org/content/136/2/121.short The article abstract here doesn’t suggest that vaccines are harmful. It reports that studies have found that *fewer* vaccinated children suffer SIDS, and suggests that this finding might be because children who are vulnerable are not vaccinated and that further controls may be required: it’s not suggesting that vaccinated children are *more* likely to suffer SIDS, just suggesting that the results that vaccinated children are *less* likely to get SIDS may be skewed because vulnerable children are less likely to be vaccinated, and recommending this be investigated further.

      http://www.ncbi.nlm.nih.gov/pubmed/16231176 This abstract article is on one child. Tragic for the parents, but not statistically significant. It says “it offers a *unique* insight into the *possible* role in *vulnerable* children” and its focus is on recommending thorough autopsies as this child might have had a bad reaction.

      http://www.whale.to/v/sandler9.html This isn’t an academic study, and I’m at loss to see either its credibility or its relevance. Polio is almost unknown in the US since vaccination began and I fail to see why anyone would trust this site.

      http://edition.cnn.com/2010/HEALTH/02/08/mumps.outbreak.northeast/index.html?hpt=T2 We all know vaccinations aren’t 100% effective: they work by creating herd immunity, which is why we don’t have smallpox any more. Here’s a credible source on this. http://www.aapnj.org/showcontent.aspx?MenuID=1037 It appears to suggest that this highly unusual mass resistance to vaccination occurs largely among Orthodox Jewish populations in Israel and NY/NJ and there might be hereditary factors. It’s also worth noticing that, unless vaccination rates in the population are below 77.3%, unvaccinated kids were *still* more likely to get the disease, despite what appears to be a case of community resistance.

      http://journals.lww.com/mecpsychiatry/Fulltext/2011/01000/Study_of_some_biomarkers_in_hair_of_children_with.2.aspx?WT.mc_id=HPxADx20100319xMP This article abstract says that a study of 32 children with autism, not a statistically significant number, shows some mercury content in their hair. It recommends further investigation. That’s all it says.

      As regards Poul Thorsen — he was one of multiple authors on a single one of the many studies that have refuted the claims on the MMR vaccine (not a lead author). And he stole his research budget. Didn’t receive money from big pharma. Just a doctor turned fraudster, a bad guy. Unless everyone else on his team was also done for fraud (they weren’t), I fail to see the relevance of this. Link here: http://www.reuters.com/article/2011/04/13/us-crime-research-funds-idUSTRE73C8JJ20110413.

      I would recommend you read the links you’ve submitted. Because, with the exception of the hysterical piece from Natural News — now irrelevant since Japan has restarted vaccination with those precise vaccines — not a single one of them has anything to say that vaccines are unsafe. So your researches are giving you some very, very bad info.

      • eliza says:

        What a disappointing post- finger-pointing and blinker-donning was not what I would have expected from someone I who took to be an incredibly switched on and open minded woman.

        Some interesting food for thought:

        I currently live in a small town in the south west of Australia. It is the end of winter here and we are in the midst of a whooping cough epidemic of all things! I am a primary school teacher and last week, 9 out of 24 of the children in my class were away with whooping cough. 8 OF THESE CHILDREN WERE IMMUNISED AND FULLY UP TO DATE WITH BOOSTERS etc. The case is the same with many people in the community- PEOPLE WHO HAVE BEEN FULLY IMMUNISED YET ARE STILL CONTRACTING WHOOPING COUGH. Improved living conditions and standards of hygiene have more to do with the eradication of nasties like polio etc. Obviously some are determined to have us believe otherwise but there happens to be a growing body of research on this.

        Theodora, you also talk a lot about research, evidence etc but you need to question who is behind the research and what they stand to gain…Not all is as it appears- too many people fall for fear monging tactics the pharmaceutical companies and medical fraternity pump out without objectively investigation both sides of the story for themselves…

        • Theodora says:

          I don’t just talk about research and evidence, Eliza. I cite research and evidence. I’ve also looked at every piece of “research” and “evidence” that’s been cited in the comments from folk who are anti-vax: I’ve yet to find one that’s remotely convincing, let alone objective, and quite a few of the ones I’ve read mean something different from what the person who cites them thinks they mean.

          If you could cite some of the “growing body of research” on your claim that the eradication of polio has little to do with vaccination rates, that would be good. Smallpox no longer exists in the wild. That’s not better nutrition and hygiene — though, I agree, that helps. That’s a global vaccination campaign.

          Research published by the “medical fraternity” has to subscribe to scientific standards. Numbers are published. Control groups are published. Data is published. Research is peer assessed and open to question and further development. I’ve yet to see anything coming out from the other side that comes remotely close to objectivity.

          The other advantage of medical data is that it also tend to deal in very large numbers — large studies, and then meta-studies, which are studies of studies. WHO statistics are good statistics because they’re gathered from millions of people in hundreds of countries over decades. Not one class in a primary school.

          I think another point to ponder is that if medical and pharmaceutical data is so unobjective, why do they identify the possible negative reactions? If it was all about shilling for big pharma, wouldn’t they all say that there were no negative reactions? Every big pharma data sheet, for consumers, not medical professionals, contains info on possible side-effects and their frequency.

          I find this talk of vested interests comprehensible on some levels — big pharma — and mystifying on others. The British and Australian vaccination programmes are government-funded. Governments want to cut costs. Why on earth would either be interested in spending money on vaccines if they didn’t ultimately save them money by improving public health? They track and choose which vaccines to use.

          Further, I don’t claim that vaccination makes it impossible for anyone to contract any illness: just that it reduces the general risk of contracting it and the risk within the general population of the germ being wild in the first place.

          As regards your immediate point — there were 15 children in the class who did not contract whooping cough. How many of them were vaccinated? How many weren’t? What about the school population as a whole? How many kids in school? How many vaccinated? How many not? Which out of which group got sick?

          Why this is important is that it’s a common claim that “children who are vaccinated are more likely to contract XYZ illness”. What it usually means is that: there were (eg) 300 people in the school. 5 weren’t vaccinated. 4 got the illness. 295 were vaccinated. 15 of them got the illness. So, yes, more vaccinated children got sick in numerical terms — because there were almost 295 of them and only 5 non-vaxed. But only 6% of those who were vaccinated got sick, whereas 80% of those not vaccinated got sick — so in real terms, vaccination protects. Further, with higher vax levels, the chance of exposure to the germ reduces. As per smallpox…

          This is also where the big medical studies come in, is that they can look at millions, tens of millions of people, and break them down into percentages, control for other variables — such as the ones you mention, improved living conditions, etc. And the bigger the numbers get, the more obvious it becomes that vaccination, in general, protects individuals and populations.

          And, yes, I am open-minded. So share your research. And I’ll look at it.

  27. […] Theodora, from the wonderfully written and always entertaining blog Travels with a Nine Year Old, makes a compelling case for getting your child vaccinated. […]

  28. […] in the rarefied world of family travel bloggers, which is why I found myself writing a post insisting on the value of vaccinations — that the first step is to get your shots. See a specialist doctor, ideally one affiliated […]

  29. […] the homeschooling community, vaccines are one of those huge, controversial issues and man, there is some heated debate. But, suffice to say that, though I understand both sides, she’s 11 years old and I feel like […]

  30. eliza says:

    Perhaps I didn’t explain myself clearly regarding the whooping cough in my class. I was not making aby arguments that the unvaccinated children are by nay means healthier. I know you have admitted that immunisation is not 100% effective. I am simply stating that IN THIS CASE it is not even 70 % effective (24 children in total , 19 vaccinated, 5 unvaccinated. 1 unvaccinated child got whooping cough, 8 vaccinated children got whooping cough).I believe total numbers were published in the school letter. Obviously I am reluctant to name my school and link to the newsletter but if you were to do a goggle search on the whooping cough outbreak in the southwest of WA, I’m sure you could get some further info.

    Some links on how why vaccination has little to do with the eradication of nasties:

    http://childhealthsafety.wordpress.com/graphs/

    Check out a book by Dr. med. Gerhard Buchwald. ‘The Vaccination Nonsense’. (page 108)
    Also, http://epe.lac-bac.gc.ca/100/201/300/cdn_medical_association/cmaj/vol-163/issue-7/10-13.htm letter writtern by honourable research associate in the UK who specialises in the history of medicine.

    PLENTY of info out there if you are willing to search a little further beyond the user- fridenly WHO website.

    A cooped of comments have noted the absence of the ‘anti-vax’ brigade and attributing it to lack of hard data, etc. Sigh. I think you’ll find that what’s deterring them is being shot down in flames and accused of acting irresponsibly before even opening their mouths. Explaining yourself to people that just don’t wanna listen gets tiring after a while.

    There is much that have yet to fin out in regards to medicine and science- it is a learning curve , especially when it comes to the immune system and viruses. Even the most respected and experienced doctors and researchers in the medical industry will admit to this. Regarding Elizabeth’s links that you reviewed, I agree that the tone of ‘natural news’ is hysterical (although so is your post arguably). If you would like to read the same story from a more credible source, check out http://www.reuters.com/article/2011/03/07/us-japan-vaccine-idustre7260ly20110307. In reply to Elizabeth’s link on the NY mumps outbreak, you state that the link at ://www.aapnj.org/showcontent.aspx?MenuID=1037 appears to suggest that this highly unusual mass resistance to vaccination occurs largely among Orthodox Jewish populations in Israel and NY/NJ and there might be hereditary factors. It’s also worth noticing that, unless vaccination rates in the population are below 77.3%, unvaccinated kids were *still* more likely to get the disease, despite what appears to be a case of community resistance. Well maybe i am missing something but it suggests nothing of the sort. It DOES, however say that there were a number of reports of mumps in individuals with no links to the Orthodox Jewish community.

    Theodora, you claim several times in your post and comments that you *cite information*. After reading your post and scrolling through all the comments, I haven’t been able to find this veritable treasure trove of information you claim to be quoting from, unless I’ve mistakenly scanned past. All I can find are a few links to the official WHO website and a link or two to the use of thiomersal and squalene in vaccines. You make several sweeping statements (see *in countries where most people are vaccinated heard immunity means that people do not the diseases. That’s how vaccination eliminated smallpox*… I know this a common opinion, but, reference please? Obviously it hasn’t worgovernments community, where vaccination rates are at 82%). And if you think our governments and huge multinational organisations always have our best interests at heart, think again. Just look at the ‘Occupy’ phenomena. The WHO is also nobody’s angel. Have a look at this link ://www.youtube.com/watch?v=pCT1D-6rR4c . Pletny more info out there is you go looking for it.

    You also discount anecdotal evidence in favour of quantitative data, which is only natural. However, qualitative research is something that is lsregly missing frlom the vaccination deabte. Have a look at http://www.useit.com/alertbox/20040301.html for more info on the shortfalls of quantitavive research) Quantative studies boil a complex situation down to a single number that’s easy to grasp and discuss, whioch appeals to our human snese od logic, but when they are conducted on something as complex as vaccinations and the human immune system, all you are getting in the end is statements likke ‘… MAY be linked to… ’ ‘… is not THOUGHT to have caused….’ etc , frlom BOTH sides of the debate. The fact is there is NOT a lot of GENUINE hard and fast data as there are just too many variables (environment, diet, location, virus lifecycles, the lsit goes on) to many other variabkes to allow for a valid control group. For example, who is to say that small pox was elliminted by mass vaccination? Perhaps the disease was on the downturn anyway- think SARS, bird flu, swine flu. These were not (widely) vaccinated for but the epdidemic has passed (for now). Diseaeses and viruses come and go- has always has been and always will be the case.

    And saying that it is only natural that parents of autistic children are looking for someone to blame? Sheesh…. Mothers know their children- there are many stories of children changing overnight, in the blink of an eye, after having their shots. Now I am not saying that this is a common thing, nor am I saying that I believe autism/ aspergers is caused by vaccination. All I am saying is that this kind of ‘anecdotal’ evidence which you so blatantly snub is also valid and needs to be heard.

    You accuse the ‘anti-vax’ brigade people of being largely comprised of ‘voodoo voices’ or going against vaccines because they want be ‘different’, to pull off an image at the risk of their children. I do agree with this to a degree. My own town certainly has its share of ‘dippy hippies’ who are apt to shun anything ‘unnatural’ without critically thinking their decision through. However, not all anti-vaxxers fall into this category. A friend of mine is a qualified doctor and one of the most intelligent people I know- she has chosen NOT to vaccinate her three children (and has some interesting stories on the pressures she is under to push vaccinations, but that is off topic).

    Finally, I Find it deplorable that people are actually asking Theodora (awesome as she is and all) whether or not they should vaccinate their kids for travel. Folks, you and only you can make that decision. I am Read, research, question, READ BETWEEN THE LINES and trust your instincts. Your kids are depending on you fir it. As Goethe said, there is nothing more terrifying than ignorance in action.

    Apologies for the lengthy post, and if I fail to report back here it is NOT because I am backing off or lack evidence to further my claims but because I will be travelling without internet access- yay! Happy travels everyone :)

    • Theodora says:

      That’s an interesting link, thanks. On MMR and autism in general, go here for links to the Danish study &c, plus comprehensive debunking of Andrew Wakefield: http://www.vaccinesafety.edu/cc-mmr.htm. The Danish study’s the kicker, here (http://www.nejm.org/doi/full/10.1056/NEJMoa021134#t=articleResults). It shows a slightly higher (not statistically significant) percentage of autism spectrum disorders in non-vaccinated children.

      These parents too will have been grieving for the change in their children — because the appearance of the milder autism spectrum disorders is something that seems to come out of the blue (baby seems to be developing fine, toddler seems… well, different, changed, not the person that they were) but not attributing it to vaccination. Anecdotal evidence can be important. But it can’t outweigh big numbers (plus the endless smaller studies that have shown the same thing).

      As to the http://www.childhealthsafety.wordpress.com guy: I find the alternation between logarithmic scale and analog scale in his graphs INCREDIBLY dishonest. He picks and chooses not only his data but his timelines on the basis of what trends he wishes to extrapolate. When one doesn’t work he switches to the other mode. He does this both on smallpox — using the logarithmic to generate a trend of decline when he wants to prove that vaccination had no impact (and starting his trend AFTER the introduction of vaccination), and the analog when he wants to prove that STOPPING vaccination had an impact (pulling into a shorter scale for maximum value) — and on measles — when the vaccination impact bucks the logarithmic trend he’s lovingly created (even when he’s chosen the point at which he starts his curve), he switches to the analogue. He also decides that over-diagnosing of measles is a new phenomenon — i.e., that the figures which do not suit his case are junk, and that the previous figures, which he likes, were fine.

      His scurvy stuff is nonsense. It was naval doctors who developed the Vitamin C treatment. It’s medical awareness of the causes of the disease and effective treatment that reduced mortality — that and decline in long naval tours of duty (I would guess, judging by the wartime spikes). It’s nothing so woolly as better nutrition. The lime juice law was a government public health programme, specific to sailors. It’s medical intervention.

      Rubella vaccination has always been about the protection of unborn children. Why don’t we vaccinate against other birth defect-causing ailments? Because we, umm, can’t.

      You’ll notice he doesn’t have a trend line on his diphtheria graph? Why? Because any trend line you could draw on that data would not produce the eradication of diphtheria deaths that proceeds from the vaccination campaign which began in 1940 (UK).

      Tetanus? He ignores the introduction of post-exposure inoculation. I wasn’t vaccinated for tetanus as a child. But when i cut myself badly enough to need stitches, I got a shot, as my parents did too. I would bet my bottom dollar that this pre-vax treatment contributed to the reduction of death rates.

      Further, he deals in mortality rates (lower, because of better medical care — and nutrition and living standards too) rather than cases contracted: the after-effects of polio are hideous, and measles can cause lasting damage.

      And, umm, he fails to mention anywhere that Wakefield’s Lancet article was pulled, he’s been struck off the GMC and his research found to be “fraudulent”, or what happened to his case against the Sunday Times.

      The two peer-reviewed studies he cites don’t dispute that vaccination helped eliminate smallpox. The first also observes that there appears to be a link between introduction of polio vaccination and decline in polio rates. It also admits that there’s a problem assessing medical measures against mortality rather than incidence. But, yes, sanitation and nutrition — also, importantly, medical understanding of transmission methods and effective medical treatment on transmission — have been central to the reduction in incidence and mortality of epidemic-type diseases. I think it’s interesting that they only measure medicine by specific drug treatments and availability rather than (say) hospital accessibility, general trends (hygiene post-Florence Nightingale, understanding of sepsis), and I think that in their missing mortality rate there will be more that is medical than they’re allowing for.

      Smallpox may have been on the decline in some countries. It was alive and kicking and killing in Africa: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2668906/. As regards efficacy of vaccination as a central part of the campaign of containment and surveillance that led to eradication: page 591 of this lengthy document has some tables as to how it prevented transition http://whqlibdoc.who.int/smallpox/9241561106_chp11.pdf. (There is some ABSOLUTELY excruciating detail on why these vaccines worked better than earlier ones.)

      As regards Leicester? That’s a fascinating little book. As regards the data — if it’s accurate, and it appears that both the author and his friends on the parish board would have been highly motivated neither to identify smallpox cases let alone write up deaths to smallpox — the population of Leicester is, and always has been, FAR, FAR smaller than London, Sheffield or Glasgow, so the infection rate per capita looks like it’s significantly higher. His data would suggest, though, that medical care in Leicester was better than that in the British Army in the UK (no big surprises there, given we’re talking only a few years after Florence Nightingale), and lightyears ahead of whatever the Japanese were doing. I’m curious, though, as to where he got his data on Japan. However, as data goes I’m going to take global eradication of smallpox over multiple countries over a 2% better survival rate than the British Army any day of the week.

      As regards Elizabeth’s link: the vaccines are back in use. There were concerns. These were investigated. The vaccine has been found safe. That’s what science does. Investigate something. Find it OK or not OK. React accordingly. And what’s irritating about it is that, more than two years after the vaccines came back in use, people are still saying “They don’t use them in Japan, because they kill.”

      The 77.3% figure came from her figures about those infected. I’m not sure WHY the scientists specified that the outbreak was among similar communities in Israel and the US, it’s true — my bad.

      Anyway, the public health stuff is interesting reading — particularly the one on where the improvements in health actually come from. It’s not a line of argument I like (because it’s the one used by AIDS-denialists in South Africa, that retrovirals don’t work but nutrition does — which is weird, because the people who were dying in the 80s and 90s in the West before retrovirals weren’t malnourished). But it is important and it’s something that (yes) the WHO focuses on too (cf their Breast is Best campaigns): big pharma does tend to medicalise the non-medical.

      Wow! Long comment, sorry. I don’t think governments have our best interests at heart (though I don’t think they’re automatically bad, either). What I actually said was that UK and Australian governments have their eye on their cash flow — our NHS is being cut to hell at the moment — and that if they could save money by cutting out vaccines, they would. I’ll stand by that one. (They probably are saving money already by not insisting on whooping cough boosters — it appears the vaccine’s only really effective for seven years…)

      And, yes, in the UK too doctors have vaccination targets that assist their funding. I asked my doctor about that on Z’s MMR, and she said, yes, they do. Ditto they have blood pressure reduction targets. Ditto targets in other sectors. But it’s the vaccine ones that draw the attention, for some reason.

      SARS and H1N1? Interestingly, crossing most Asian borders you are checked for symptoms, still. It’s an issue of containment, here, I think.

      I’m not setting myself up as a medical expert, here. But (perhaps I spend too much time on the internet), the loudest voices online — and particularly folk talking about travel with kids — are anti-vax and often quite staggeringly misinformed. And one of the reasons I wrote this post was because people assume that because we lead an alternative lifestyle and I am (I think) pretty open-minded that I wouldn’t jab or use antimalarials, whereas, in fact, I do both.

      Anywise. Have a nice trip. Happy travels. And feel free to pick up whenever.

  31. eliza says:

    sorry double post!

  32. D Murphy says:

    Yes, I agree, this really is a no brainer! I can’t believe that people would contemplate travelling to developing countries without vaccinations let alone not vaccinate their children, the dangers of disease far outweigh anything else..unthinkable!

  33. […] We had to take flew fever vaccine before coming to Costa Rica. I only did it because it was mandatory to leave Brazil with that in hand, but if you are about to travel and are thinking about vaccinations, you might want to check this post: Should I Vaccinate My Child For Travel? […]

  34. Dana says:

    I vaccinate my daughter, with one caveat: I’m aggravated beyond belief that people have gotten so hysterical about chickenpox. Fewer children die from that disease than die in automobile accidents but you better believe pediatricians are happy to send us home from our appointments with our children belted and seated securely in the backseat.

    If anyone ever gets a varicella vaccine that is not strong enough and their parents or the doctor don’t catch it, and it wears off when they’re twenty-five, they better pray for herd immunity because otherwise they are in very big trouble.

    And it doesn’t end there. Because we no longer have periodic exposure to the varicella virus, adults are now at greater risk of shingles on into old age. That is a tough disease to deal with even if it doesn’t kill you (and it usually doesn’t).

    But generally I am for the right of patients to consent to their care and, I know you don’t want to hear this, but parents are the stand-in for their children as far as medical consent is concerned. Sorry you don’t like the decisions that other people make for themselves, but if we’re to have a free society you will just have to learn to deal with it (multiplied, of course, by the number of people who are handwringing about this, not like you can take away everyone’s freedom all by yourself).

    Also, I’d just like to point out that vaccinated kids still catch diseases they are vaccinated against, and that diseases can change over time and the vaccine makers don’t always catch up. For instance, we had a pertussis outbreak here locally. That’s a bacterial infection. Apparently the bacterium has changed and nobody had bothered updating the vaccine yet.

    Then there’s the possibility of multiple vaccines in one shot being overwhelming to some children’s immune systems. Honestly, who catches diptheria and pertussis and tetanus ALL AT ONCE?

    And finally, it was known in the early 1900s that people who ate good, nourishing diets were much less susceptible to tuberculosis than people who ate a lot of junk, which was an issue even at that time. Now think about where all the really nasty scary diseases are happening. Most of the people in those regions ARE POOR AND STARVING. Of course they’re going to be vulnerable to the first nasty germ that comes along. Not that Americans going overseas are necessarily going to be much better off at this point, since we’re going around eating out of boxes and cans or boasting about going vegan (sorry, that’s not the best nutrition for people either). But we’ve got access to multivitamins that the poor in other countries don’t have. So we have a little bit of an edge, and we still have better nutrition here than people do who hardly get any *food* in, say, India–so I’d be surprised to see unvaxed American travelers get sick at as high a rate as the locals do elsewhere.

    I mean, there’s lots of room for argument and different opinions here. And yeah, again, I vaccinated my child. But you better bet I would have been on that federal hotline and on the phone to a lawyer if anything major had happened to her after any of her shots!

  35. […] With a Nine Year Old has the details about children’s vaccinations, those you need to worry about and those you […]

  36. Will R says:

    Bravo!!!

  37. Nic says:

    Thanks Theodora. I realise that I am about 2 years behind with this conversation. However, I am grateful for reading all of the above. I am a British citizen living in Australia and the health system here is so different, given that its mostly private, generally everything is recommended. I found it very difficult to get a straight answer as to which immunisations my 4 and 6 year daughters required for Thailand. At $60 a shot they appear to be advising a very long list of recommended shots. I guess that’s why I decided to seek advise from uk sites including the NHS, which lead me to your post. So thank you :)
    I have decided to add Hep A and Typhoid to my children’s vax records and will stick to my plan when I visit the travel clinic tomorrow.

5 Trackbacks

  1. […] Theodora, from the wonderfully written and always entertaining blog Travels with a Nine Year Old, makes a compelling case for getting your child vaccinated. […]

  2. By 32 Travel Health Tips from 32 Travel Bloggers on August 23, 2011 at 5:48 am

    […] in the rarefied world of family travel bloggers, which is why I found myself writing a post insisting on the value of vaccinations — that the first step is to get your shots. See a specialist doctor, ideally one affiliated […]

  3. By Child Travel Vaccines and Homeschooling on October 3, 2011 at 6:42 pm

    […] the homeschooling community, vaccines are one of those huge, controversial issues and man, there is some heated debate. But, suffice to say that, though I understand both sides, she’s 11 years old and I feel like […]

  4. By The best guide to traveling with kids on December 6, 2011 at 2:08 pm

    […] We had to take flew fever vaccine before coming to Costa Rica. I only did it because it was mandatory to leave Brazil with that in hand, but if you are about to travel and are thinking about vaccinations, you might want to check this post: Should I Vaccinate My Child For Travel? […]

  5. […] With a Nine Year Old has the details about children’s vaccinations, those you need to worry about and those you […]

Post a Comment

Your email is kept private. Required fields are marked *

*
*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>