http://www.ama-assn.org/sci-pubs/amnews/amn_99/edit0906.htm

American Medical News
Editorial for Sept. 6, 1999

                 Vaccine anxiety


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

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

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

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

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

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

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

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