Dr. Russ and I have discussed your anxiety and your reluctance about immunizing your newborn and I thought that I might forward some information to you in this regard. As pediatricians, our entire group recognizes your concern for your child’s welfare and we do respect your right to decide what is best. We hope that you will appreciate our education, training and our sincere desire to help you keep your child healthy and strong.

The first article that I’ve enclosed should specifically address many of the concerns you have regarding some of the adverse consequences that have been associated with vaccination in the popular media and in the scientific literature. I think you’ll have a better appreciation of the great benefits that vaccines have wrought and that many of us (including physicians) take for granted. This article was published in the newsletter of the National Alliance for Autism Research (NAAR) which is distributed to both professionals and parents interested in autism and autism research.

The article was written by Eric London, MD, who is one of this country’s leading authorities in autism. He is the cofounder and vice-president of medical affairs of NAAR, which is a leading private source of fund-ing for autism research. Dr. London is my brother-in-law and his autistic son, Zachary, is my nephew. I have attended NAAR’s Scientific Advisory Board meeting at Harvard University and if you review the credentials of this board on the NAAR web site, you’ll see that these are some of the leading scientists and researchers in their respective fields. This article closely reflects my position regarding the risks and benefits of vaccination.

The second enclosure is a “Refusal of Vaccination” form. Some pediatric practices use this form if parents absolutely refuse to have their children vaccinated. I’ve adapted this form for our practice, but the five of us feel so strongly about the need to vaccinate, that we only use this form for educational purposes—so that you’ll specifically see what complications may result from a failure to vaccinate for each of these vaccine-preventable diseases.

These diseases present more than a “theoretical” risk. During my pediatric training in the early 1980’s at New York Hospital-Cornell Medical Center, I commonly treated children hospitalized with meningitis, sepsis, and other invasive infections caused by the Hemophilus infuenzae type B (HiB) bacteria. This bacterium was one of the leading causes of such infections in early childhood and often led to serious lasting injury or even death. During my last year of pediatric residency a new vaccine was released to prevent this disease and within a few short years, HiB disease has become an uncommon cause of childhood disease.

Chickenpox, a very common childhood illness, is a disease that most parents and grandparents look upon as a benign “right” of childhood. Many pediatricians also have this same attitude about the disease and com-plications such as pneumonia, myelitis, encephalitis, etc. are rather uncommon but still a concern. Even so, chickenpox accounts for 50 to 100 deaths a year among healthy children.

During the past ten years, pediatricians began to see more and more serious skin infections following chickenpox. Perhaps you recall the reports on television of adults with “flesh-eating” strep infections that antibiotics were powerless to stop. We as pediatricians began to see the same serious infections in a few of our chickenpox patients. Drs. Gerba, Inguagiato, Russ and I have each separately diagnosed, hospitalized and treated children with these “flesh-eating” streptococcal infections. While the disease is more treatable in children than in adults, it still requires a prolonged hospitalization for long courses of intravenous antibi-otics and surgical treatment.

The chickenpox vaccine can prevent this very real and life-threatening complication.

Other diseases can appear in childhood in unexplained circumstances. Unfortunately, because of the fre-quency that we administer vaccines, some of these illnesses may appear to be related. However, under care-ful evaluation, the overwhelming majority of these illnesses are not a consequence of vaccination but merely a coincidence.

Of course, with every medical treatment, there are certain risks. But in the vast majority of children, these risks are far outweighed by the benefits. There are a few circumstances in which some vaccines are con-traindicated. We as pediatricians are aware of these risks and contraindications and will take these factors into account before we administer your child’s vaccines. 

For certain vaccines, we can accommodate your anxiety or reluctance to vaccinate and postpone their ad-ministration, such as the hepatitis B vaccine—assuming that your obstetrician has screened you during pregnancy for this disease. 

On the other hand, for most of these childhood vaccines, it is our individual and collective medical opinion that timely vaccination is a basic and necessary requirement for appropriate pediatric care. We do respect a choice not to vaccinate if you should make that decision. I hope that you can appreciate our concern that we may have failed in our medical duty to adequately inform you and to help you appreciate the potentially severe consequences of that choice.

We feel so strongly about this, that, as a group, it is our policy to dismiss a family from our practice if we are unable to appropriately vaccinate a child. 

The other reason that we dismiss a family from our practice is our fear that if we have failed in delivering this most basic pediatric care, a similar failure could occur under other serious circumstances. 

In the very few instances when we have had to dismiss a family from our practice, it is our sincere hope and desire that the next pediatrician will be able to do a better job of educating or reassuring the parents regarding the safety and the benefits of vaccination.

I know that I’ve been long-winded with this letter, but I hope that I’ve helped you to appreciate where we as pediatricians (and as parents) are “coming from.” If there are other concerns I have not addressed, I’ll be happy to discuss them at your next visit. You can also call or email me at dr.mirkin@MDs4kids.com. 

Sincerely yours, 
 
 

Gary S. Mirkin, MD