Informed Consent:
How and Why to Research Vaccinations
By Turquoise D. Heine

You are your child’s first nurse. Whenever she is ill, you are the first to decide if she can be treated at home or if she requires medical attention. If you understand vaccinations and the illnesses that they are intended to prevent, you can make an educated decision for your child’s treatment. By understanding the process and its purpose, you will be a valuable, active partner with your health care professional.

Informed consent -- what does it mean?
When you give informed consent, you are agreeing that you have a clear understanding of what the procedure is and what it does: its risks, its benefits and everything in between. Basically, you agree that the procedure is necessary, you request it to be done and you accept the risks involved.

Why should you research vaccinations?
Every medical procedure (including vaccination) has risks along with benefits. If your doctor wanted to perform any other procedure that would alter your otherwise healthy child, you would research that procedure first.

Vaccines are no different. They are intended to alter your child’s healthy immune system for the purpose of preventing illnesses your child does not yet have. This is a permanent alteration and cannot be undone. Understandably, you will want to know as much about the process as possible before it is done.

What to ask
To be fully informed in the case of vaccinations, you will need to know about the vaccine.

How is it created?
What is in it?
What are the possible side effects?
What precautions should be taken?
What are the contraindications?

You should also know about the illnesses for which the vaccine provides protection.

How is it transmitted?
How can it be prevented?
What are the symptoms, treatments, and possible complications?

This is good information to have, regardless of whether you ultimately choose to vaccinate or not. Unfortunately, vaccinations are not 100 percent effective. If you take the time to learn about both the vaccine and the illness, you will be prepared in case your child gets that illness.

Research the vaccine

Be prepared. Know what vaccinations your child will receive and at what age he will receive them. Your child is scheduled to receive approximately 21 shots for 12 different illnesses before reaching 18 months of age. For the complete schedule, please visit your local health department web site or the Center for Disease Control web site.

Know what the vaccine is made of. Some vaccines contain ingredients (human blood products, animal tissue, aborted human fetal tissue) that are morally objectionable to people of some religions or that are common allergens which can cause a life-threatening reaction (eggs, gelatin, antibiotics).

Therefore, the CDC recommends that parents read each vaccine’s Vaccine Information Statement (VIS) before they consent to the injection. For further information, request a copy of the package insert that comes with each dose of the vaccine and discuss any questions with your health care provider.

Know what reactions to look for and how often they occur. Some reactions are as mild as fever and swelling; others are as serious as seizures, coma, brain damage and death. Discuss with your health care provider how to treat the mild reactions, and ask when it is necessary to seek medical assistance.

Many will suggest that you call them as soon as you notice any reaction so that they can help you to evaluate the situation, ensure that it gets reported to the Vaccine Adverse Event Report System (VAERS) and assist you if you are eligible for compensation under the National Vaccine Injury Compensation Program (VICP).

Know the contraindications. Most vaccines should not be given to a person who is currently ill. Some vaccines should not be given to children who are allergic to eggs, gelatin, the antibiotic neomycin or other ingredients. Other vaccines should not be given to children who have certain underlying medical conditions, who have had a reaction to a previous vaccine or who have a family history of certain conditions. Complete information on vaccine contraindications is available in the manufacturer’s package inserts. (See table below.)

Know your options. In the United States, there are three options for exemption from mandatory vaccination: medical, religious and philosophical. All states offer medical exemptions, most provide for religious exemptions and many offer philosophical exemptions. Check with your state health department to see which exemptions are available to you, should you require one, and what procedures must be followed for each.

Research the Illness

Know the symptoms of the actual illness. In some cases, your child may get a particular illness even if she is fully vaccinated against it or if she comes in contact with the illness before being vaccinated. Some illnesses may be so mild that you may not even notice that your child has the illness. Knowing the symptoms will help you treat the illness early and appropriately, reducing the risk of complications.

Know how the illness is spread and who is likely to get the illness. Most vaccine-preventable illnesses are transmitted one of three ways: blood contact, ingestion (contact with stool or saliva) and inhalation. Babies are generally safe from blood-borne illnesses, which can only be contracted through intercourse, IV drug use, blood transfusion and during childbirth if the mother is infected.

For illnesses spread through contact with stools and saliva and for airborne illnesses, simple common sense can go a long way towards protection. These illnesses are usually more of an issue for children in school or day care settings and can be prevented by frequent hand washing, especially after using the bathroom or diaper changes and before meals; ensuring that toys are thoroughly cleaned throughout the day; and encouraging sick children to cover their mouths and noses with a handkerchief when sneezing or coughing.

Another excellent way to help your baby or toddler avoid many illnesses (including some vaccine-preventable illnesses) is good nutrition and especially prolonged breastfeeding. Antibodies absorbed through breastfeeding may prevent Bordetella pertussis (whooping cough), Haemophilus influenzae type B (Hib), Streptococcus pneumoniae and Neisseria meningitidis and even polio.

Know the possible complications of the illness and what you can do to prevent those complications. Possible complications of measles, for example, include diarrhea, otitis media and pneumonia. These complications are more common among children under 5 years of age and in adults over 20 years of age. One way to prevent or reduce the severity of complications from measles is to ensure that the patient has an adequate supply of Vitamin A.

Where to start

Do your research in an organized manner. While it’s always best to begin your research before your baby is born, it’s still possible to make an educated decision without feeling overwhelmed. Research each vaccine in the order your baby will receive them. Just follow the recommended immunization schedule and research one illness at a time. (Most hospitals offer the hepatitis B vaccine within 24 hours of birth, so you may want to research this vaccine before you deliver your baby.)

Do a balanced search of the vaccine information. Check the manufacturer’s inserts for the vaccine and note its ingredients, warnings and contraindications. In addition to sources promoting the vaccination, also check independent sources that object to the vaccine. Why do they object? What studies do both sides have to support their claims? Who funds these sources and the studies they cite?

Most important, keep an open line of communication with your health care provider. Well baby visits are an excellent time to discuss any questions or concerns you may have about illnesses and vaccines. Just let your provider know when you schedule your appointment that you have questions you’d like to discuss during your visit so that they can schedule extra time to go over them with you. He or she can help you weigh the pros and cons and come to a solution that is both mutually agreeable and in the best interest of your child’s health. Your health care provider’s goal is to help you ensure your child’s good health. With your active participation, he or she will be able to help you meet your child’s unique needs.

For more information

Books
What Your Doctor May Not Tell You About Children's Vaccinations, Stephanie Cave, Warner Books, 2001

What Every Parent Should Know About Childhood Immunization, Jamie Murphy, Earth Healing Products, 2002

Vaccines Are They Really Safe & Effective, Neil Z. Miller, New Atlantean Press, 2003

List of manufacturers and where to find their inserts

Web Sites

Vaccine ingredients
National Vaccine Information Center
Disease trends
Detailed information on vaccine preventable illnesses
Contraindications
State and Local Health Departments

References
1. Hanson LA, Korotkova M, “The role of breastfeeding in prevention of neonatal infection,” JSemin Neonatol. 2002 Aug;7(4):275-81.
2. Choto RG, “Why mother's milk is best,” Afr Women Health. 1993 Apr-Jun;1:8-12.
3. Telemo E, Hanson LA, “Antibodies in milk,” J Mammary Gland Biol Neoplasia. 1996 Jul;1(3):243-9.
4. Wilczynski J, Torbicka E, Brzozowska-Binda A, Szymanska U., “Breast feeding for prevention of viral acute respiratory diseases in infants,” Med Dosw Mikrobiol. 1997;49(3-4):199-206.
5.Hahn-Zoric M, Carlsson B, Jeansson S, Ekre HP, Osterhaus AD, Roberton D, Hanson LA, “Anti-idiotypic antibodies to poliovirus antibodies in commercial immunoglobulin preparations, human serum, and milk,” Pediatr Res. 1993 May;33(5):475-80.
6. Kassim OO, Raphael DH, Ako-Nai AK, Taiwo O, Torimiro SE, Afolabi OO, “Class-specific antibodies to Bordetella pertussis, Haemophilus influenzae type b, Streptococcus pneumoniae and Neisseria meningitidis in human breast-milk and maternal-infant sera,” Ann Trop Paediatr. 1989 Dec;9(4):226-32.
7. Semba RD, Bloem MW, “Measles blindness,” Surv Ophthalmol. 2004 Mar-Apr;49(2):243-55.

© Turquoise D. Heine

Turquoise Heine is a health advocate and mother of two. She is the owner of BabyNMore.com, a company helping educate consumers about the benefits of natural, environmentally responsible products and how the choices we make today directly affect our future.