by Mary Jessica Hammes
May 31, 2010

Let’s get something out of the way: I can’t stand the whole idea of a book series called The Complete Idiot’s Guide To… Whenever I see one of those titles, I imagine some disembodied voice thundering from above, “Ha, ha, we’ll make things really simple for you simpleminded folks.” And I shudder at the very thought of reading one.

That said, The Complete Idiot’s Guide to Vaccinations: A Balanced Look at the Pros and Cons by Michael Joseph Smith and Laurie Bouck, gave me pause. It’s straightforward intentions are well-written in a way that anyone can understand—hence the title. The book has one plain and simple mission: tell readers why they must vaccinate their children. The book, which advocates sticking to the American Academy of Pediatrics’ vaccination schedule, was published in late 2009 and remains relevant during a time when more and more parents are delaying or outright refusing vaccines for their children.

In fact, 39 percent of parents refused or delayed vaccines in 2008, up from 22 percent in 2003, according to a new study by the Centers of Disease Control and Prevention (CDC), the University of Rochester, and the National Opinion Research Center. The main reason? Fear. According to the study: fear of efficacy; fear of too many shots at once; fear of possible side effects including autism (despite the fact that the 1998 study that linked vaccination and autism has been fully retracted).

By reminding parents of the “pros” to immunizations, this book attempts to eliminate these fears; though it makes a misstep in its subtitle, which hints that it takes the “cons,” whether real or perceived, seriously. For example, the chapter called “Do Vaccines Cause Medical Problems?” could have been one word long: “No.” Readers who are unsure of vaccines may expect a certain transparency, one that gives credence to parents’ fears—maybe something along the lines of Robert Sears’ The Vaccine Book: Making the Right Decision For Your Child which allows for delaying or skipping vaccines altogether. But this book might as well be an official CDC guidebook. Any “cons” are quickly debunked as myth.

Because of this, readers who already have strong anti-vaccination views will bristle at the book, but still might enjoy reading at least the first (and possibly most interesting) part of the book, which tells the story of the very first inoculation—Edward Jenner’s smallpox vaccine, administered to a young boy in England in 1762. Jenner, a surgeon’s apprentice, noticed that the milkmaids who caught cowpox became immune to smallpox. Cowpox was a less severe disease than smallpox, so Jenner collected “biological material” from a cowpox-infected milkmaid and injected it into the young boy, thus making him immune to smallpox, too.

But, in the pages that follow, the book treads familiar territory: the difference between live and inactive vaccines; how vaccines are made; how they are delivered; and how they actually work. What sets it apart from other books on the subject is the authors’ ability to explain everything you need to know about vaccines clearly and without misinformation.

According to the authors—Smith, an assistant professor of pediatrics at the University of Louisville and an attending physician at Kosair Children’s Hospital; and Bouck, an established medical writer—concerns over vaccines are unfounded. One of the last sections of the book addresses common vaccine concerns and controversies.

Concerned about autism? Don’t be. Aluminum and formaldehyde? Don’t sweat it—your kid gets enough of it normally in the environment as it is, and at higher quantities, too. DTap does not cause SIDS. No link has been found connecting asthma rates to the number of vaccines children receive. There is no connection between hepatitis B vaccination and the onset of multiple sclerosis. Researchers have not found that vaccinations can cause diabetes. Multiple vaccinations? More vaccines than parents got when they were small? No worries. Today’s vaccines contain significantly less antigens than those of yore, so your kids are actually exposed to fewer antigens than you were, despite the increase in their number of shots.

That said, there is a chapter called “When Vaccines Harm or Fail.” It would be more aptly titled, “Vaccines Don’t Harm or Fail, Except for Extremely Rare Adverse Events Which Might Not Even be Related to the Vaccine in the First Place.”

As excerpted from the book: “On rare occasions, vaccines can cause problems. Vaccine-preventable illnesses have become much less common in the United States because so many people are vaccinated against them. Every vaccine, however, has some risk of causing a bad side effect.”

And that’s the crux of it all.

Choosing not to vaccinate is risky. But getting vaccinated isn’t without any risks, either—as baby gooroo has said before, “Few things in medicine work 100 percent of the time. Few things in medicine are risk-free. Researchers are working continually to improve the safety of immunizations.”

Apparently, more and more parents are simply unwilling to take those risks, however statistically small they may be.

Take the combination measles, mumps, rubella, and varicella vaccine (MMRV). The combined shot is meant to maximize vaccine coverage—getting one shot during one doctor’s visit is more convenient for a lot of parents, especially for low-income families, who are more likely to be delayed or lacking in vaccinations than higher-income families.

But there are problems with the MMRV, as illustrated in the CDC’s recent Morbidity and Mortality Weekly Report. The MMRV is no more effective than the plain old MMR, and no formal studies on the MMRV’s clinical efficacy have been performed. What is known is that the MMRV carries a higher risk of fever, rash, and febrile seizures—a kind of seizure the report says is common and not even particularly dangerous, but would no doubt be terrifying to witness. The CDC surveyed physicians in 2008 and parents in 2009, and found that neither group was terribly in favor of the MMRV: 67 percent of family physicians and 59 percent of pediatricians said they’d definitely or probably recommend the MMR and varicella vaccines separately; only 9 percent and 21 percent, respectively, would definitely or probably recommend the MMRV (24 and 20 percent, respectively, said they’d leave it up to the parents).

As for the parents, 41 percent said they’d accept the MMRV vaccine for the first-dose vaccination if the pediatrician recommended it; 31 percent said they’d refuse. According to the MMWR report: “Mothers who reported that they would refuse the MMRV vaccine said they were unwilling to accept any additional risk over that of MMR vaccine and varicella vaccine, regardless of how small.”

Well, of course they are unwilling to accept any additional risk. Does that surprise anyone?

Recently, a pediatrician wrote an article about how his approach to dealing with reluctant vaccinators has changed over the years. Instead of refusing to work with such parents, he now listens, commiserates, offers flexibility, inspires trust—and, maybe, eventually convinces the parent to vaccinate. Nearly all the comments for the article were written in favor of delaying or completely foregoing vaccinations.

It’s easy to understand why some parents’ faith in vaccine safety wavers. Consider the rotavirus vaccine. An earlier incarnation of it was taken off the market due to reports of intussusception (a sometimes life-threatening folding of the intestines), then replaced with another vaccine. That vaccine was temporarily suspended just last March, and now, this month, the Food and Drug Administration has reversed that decision, declaring Rotarix safe.

Regardless of the reasons behind those decisions, that’s a whole lot of back-and-forth for a parent already freaked out about vaccines.

The questions remain: Are you a negligent parent if you don’t vaccinate? Are you putting your community at risk if you don’t vaccinate? If you read this book, you’re likely to think so. Having known several parents who chose to delay or forgo vaccinations, I feel it’s simply a matter of deciding which risk—disease or side effects—a parent is more comfortable with. It doesn’t take a genius to see why parents are confused and conflicted about vaccinating their children; and it may take more than an easy-to-read book to convince them to do so.

Mary Jessica Hammes is an Athens, Georgia-based writer, trapeze instructor, knitter, gardener, comic book enthusiast, and hula hooper. She is mom to Tommy.