Vaccine and Vitamin K Refusal

I just read this article from Scientific American.  While I have great respect for the magazine, I find the author somewhat lacking.  In fact, I have found a great deal lacking in nearly every author promoting the medical industry and attacking skeptics of modern medicine.  Now, I am not saying that the medical industry is wrong, but it is at fault in a large degree for the various movements opposing vaccination and other things like vitamin K shots or eye drops for newborns.

The primary problem is not the media and movements encouraging parents to avoid potentially life saving treatments for their children.  The problem is general mistrust of doctors, which has been caused by their own poor behavior.  My wife is a doula (a professional labor coach and educator).  We have chosen to forgo both the vitamin K shots and the eye drops that hospitals typically give all newborns.  Our first child was born in a birthing center, where we were educated on all of the risks involved with both sides.  Further, we did some research of our own.  We found that the risk of complications is extremely low without the treatments.  Contrary to the article, both treatments do indeed carry risks, however they are also extremely low.  Based on our knowledge, we chose not to allow the midwives to administer either of the treatments.  Similarly, we have been very selective about vaccinations.  Now, let me first assure you that we do not believe the claims (which have been proven false) that vaccines cause autism.  This is a bunch of crock spread by celebrities that have no medical education.  Our first reason to limit vaccination is that many vaccines contain small amounts of latex, and my wife and at least one of our children has shown a sensitivity to latex.  Latex allergies can quickly become life threatening with repeated exposure, so we chose to limit vaccinations to limit latex exposure.  We have had our children vaccinated for a few things.  These are diseases that either have a high probability of fatality or permanent injury or that cannot be cured once contracted.  While I have seen no empirical data on this, I have observed that people who get every single vaccine and thus rarely get sick tend to fare less well when they do get sick, while people who avoid common vaccines that are mostly just for convenience (the flu vaccine for most people) tend to get over nearly anything fairly quickly.  So, why would anyone choose to forgo even vaccines for higher risk diseases?

As a doula, by wife is present when her patients give birth.  This typically occurs in a hospital.  Additionally, we have had several of our children born in hospitals.  My wife has had multiple experiences where doctors or nurses administer treatments without informing or consulting the patient.  In many cases, these treatments have not been strictly necessary and were administered either for the convenience of the patient or for the convenience of the medical professional.  I am also aware of instances where a doctor has recommended an unnecessary, high risk treatment to a patient for personal convenience.  In one case, the doctor used scare tactics to convince the patient to agree to a cesearan section because the birth was taking too long and was going to cut into a birthday party the doctor wanted to attend.  In one case where my wife was present, the doctor and nurses completely ignored a list of documented requests from the patient without any medical reason for doing so.  In this last case, the patient is now showing symptoms of post traumatic stress disorder related to pregnancy and hospitals.  This is why people refuse vaccinations and other treatments for their children.  After an experience where your human rights are blatantly violated by medical professionals, it becomes very natural to distrust the medical industry in general.

The problem is not those who spread lies about potential side effects of vaccinations or other treatments.  The problem is the doctors that mistreat patients and breed mistrust.  Sadly, the most common place this occurs is in hospitals.  Private practices and family doctors tend to be much better at informing patients about treatments, with one small exception (I'll get to this).  In hospitals, it is very common for nurses and doctors to treat patients without ever discussing the treatment with the patient.  With births, doctors will frequently tell the patient a treatment will be administered without any concern for the desires of the patient (unnecessary C-sections and inductions are a very major problem in the US, and typically the mother is never even offered a choice).  This is wrong, and to most people it is clearly a violation of human rights.  It really should come as no surprise that many parents are willing to trust unknowns over the people who have violated them and lied to them.

Now I want to look at the one exception.  Vaccinations always carry risks.  In fact, any time the skin is pierced with something, there is a risk of infection.  Modern sanitation practices have reduced this risk to almost nothing, but it does exist.  There is also a risk that any given patient is allergic to something in a vaccine.  Again, this is typically very small.  Most pre-drawn vaccines contain latex, and the rubber stopper on vaccine containers that are not pre-drawn frequently contain latex.  For those with a threshold allergy to latex (this is the kind of allergy that becomes more severe with each exposure), even this small exposure to latex can be life threatening.  Even if it is not, it can cause the next reaction to be more severe.  Overall though, for most people the risk of complications from vaccination is extremely small.  In fact, the risks are so small that beyond asking about allergies first, I do not see any reason why doctors should be forced to discuss them in detail.

On the other hand though, there is the risk of serious complications from catching the disease that the vaccination would have prevented.  For instance, the flu almost never kills.  When it does, it is almost exclusively very young children and extremely old people.  On occasion, it kills someone else who has a severely compromised immune system.  Outside of these easily identifiable groups, the flu is merely a brief and slightly painful inconvenience.  Chicken pox is even less severe than the flu (though it does carry the risk of getting shingles later in life, which rarely kills but is extremely painful).  Getting these trivial diseases does little more than cause inconvenience, but they can ultimately strengthen the immune system (something like exercise strengthens muscles).  Now, these two diseases are trivial, but fairly common.  That is not true of the rest of the diseases that we typically vaccinate against.  Most vaccines provide immunity for diseases that less than a percent of a percent of the population will ever be exposed to.  Further, many of these diseases, while they can be severe, are no longer as deadly as they were when we did not know how to treat them.  The chance of serious complications, when combined with the extremely low chance of exposure, may even start to approach the potential risk caused just by getting the vaccine in the first place.  This is what doctors do not tell you.  Most vaccinations will never even matter and may even increase the overall risk of harm.

How can we deal with this? First, I think that doctors should be required by law to discuss both potential negative and positive consequences of any treatment with the patient or guardian before administering any treatment (except in serious emergency cases where there is not time, in which case the discussion should take place after the emergency situation is over).  Until this happens though, parents and patients will have to figure out how to deal with these things on their own.  I would suggest asking you doctor a lot of questions.  You can legally refuse any treatment (the doctor may ask you to sign a wavier though).  This means that you can tell the doctor that you will not permit treatment until you are fully informed of all potential risks involved.  You can also search the internet, but make sure you find sources from both sides of any debate, otherwise you will only get half of the knowledge you need to make an informed decision (also, learn to distinguish reputable sources from random people running their mouths; in medicine, celebrities are not reputable sources).  Look for numbers.  If you find something saying that some treatment increases the chances of some horrible outcome by 50%, try to find what it is 50% of.  If the chances are 1 in 1 million, that means they are only 1.5 in one million with the treatment.  Relatively, that 50% increase seems large, but the actual probability is still extremely low.

There is one other thing doctors will rarely tell you.  Most vaccinations now are given to improve "herd immunity."  What this means is, the chance that your child will get the measles, even without the vaccination, is almost non-existent.  Your child will probably not benefit at all from it, in fact.  Many vaccines target diseases that are almost extinct (at least in the 1st world).  The goal of the vaccinations is to keep the disease isolated or even to eliminate it, not to benefit the individual getting the vaccine.  This is called herd immunity, because it benefits the group (or "herd") as a whole, but it almost never benefits the individual.  In other words, there is almost no individual risk of getting the disease to balance the negative risks associated with getting the vaccine.  Now, in case you are feeling disgust that doctors would value the well being of the abstract herd over the well being of your child, you should know that this herd immunity gained from widespread vaccination is what eliminated small pox.  It was so effective that we no longer vaccinate for small pox because the risk is almost literally zero.  Now, with that in mind, feel free to form your own opinions.

Here is our solution to the problem.  My wife and I avoid vaccinations for trivial diseases like chicken pox or the flu.  If there was an extremely severe strain of the flu going around (and a vaccine was made available quickly enough; for the flu, they usually are not), then we might consider getting our children vaccinated.  Otherwise, we do not consider the risk, though small, worth the minor convenience.  We also opted out of many of the vaccinations for extremely uncommon diseases with very low risk of permanent harm.  We did, however, get our children vaccinated for one of the hepatitis versions that is difficult or impossible to cure once contracted.  One reason is that we are occasionally exposed to people who have recently come from a country where that disease is more common; the other is that a serious disease that cannot be cured is probably worth getting vaccinated for, even if it is pretty rare in the US.  The hepatitis vaccination happens to be commonly administered in combination with a few other vaccinations, so we decided to get the combo, because the difference in risk between the single and the combo is negligible (if existent at all).

Our solution to the vitamin K and eye drops was to opt out.  Our reasoning is this: Most complications requiring vitamin K occur in the hospital.  Other complications are extremely rare (and at least one is genetic, and neither of us has any family history of it).  The eye drops are designed to more or less sanitize the eyes after birth, in case some dangerous bacteria got into the eyes.  This is also extremely rare.  At the time, the eye drops were made of some silver compound that happens to be toxic to humans as well.  There has been no research showing the silver drops to be safe for humans, so we decided the risk was higher than the benefits and opted out.  (Note that most hospitals are now using a different compound for this.  I do not know anything about the safety record of the new compound.)  Anyhow, we have opted out of these two things with all four of our children, without any issues.

Now, all of this is personal choice.  I do not want to convince you to vaccinate or to avoid vaccination.  Similarly, I am not trying to encourage or discourage trusting doctors.  Not all doctors are as negligent as those you frequently hear about.  I want two things to come out of this article.  First, I want regular people to know that they do not have to let doctors bully them.  You never have to accept treatment you do not want.  You can ask about the risks of a treatment, and you can refuse it if you are not willing to take the risk (this is even true of "mandatory" things, like the IV our local hospital requires for birthing mothers).  You also have the ability to learn for yourself and to keep yourself well informed (most hospitals offer free WiFi; bring your tablet, smart phone, or laptop, but make sure you find reputable sources of information).  Second, I really would like to see doctors be held more accountable.  An honest mistake or impossible situation can happen where the doctor may not be entirely responsible, but cases where the doctor makes a judgment call without any concern for the desire or well being of the patient should never be permitted.  No person should be practicing medicine who is willing to subject a patient to unnecessary surgery to get to a party on time, and a patient who comes away from the hospital with post traumatic stress disorder due to poor treatment from the nurses and doctors should be compensated very well for the suffering (not to mention be compensated for treatment for the PTSD).  If accountability were higher, fewer doctors would mistreat patients, people would trust doctors more, and scare tactics and lies designed to trick people into avoiding beneficial treatments would be far less effective.