SLU panel addresses ethical, medical, legal aspects of vaccinating children

Lisa Johnston |

A recent measles outbreak has reignited a discussion about the use of vaccines.

The outbreak, which has been linked to Disneyland in California and has spread to 17 states, was the subject of a panel discussion Feb. 20 at St. Louis University. Hosted by the College for Public Health and Social Justice, the panel consisted of SLU experts from medical, ethical, legal and communications fields.

Exploring vaccine policy from many points of view helps people "see how complex this issue really is," said Dr. Alexander Garza, associate dean of public health practice and the discussion moderator.

In the decade before the measles vaccine became available in 1963, approximately three million to four million people in the United States got measles each year, according to the CDC. An estimated 400-500 people died, and 48,000 were hospitalized every year.

Dr. Daniel Hoft, director of SLU's division of infectious diseases, works as a principal investigator for the university's Vaccine Treatment and Evaluation Unit, one of nine centers in the nation charged by the NIH with studying vaccines. Manufacturing processes help ensure vaccines are safe, and he explained people are exempt from receiving vaccines in rare cases for medical reasons -- allergies, immune-system issues or pregnancies.

However, several experts said there's a growing trend of parents who are opting out of vaccinating their children for religious/philosophical reasons. A large segment of this population includes affluent, educated parents. Laws addressing vaccination requirements in schools vary state to state (see related box); lawmakers in some states, including Illinois, are proposing laws that tighten exemptions for religious reasons.

Dr. Hoft warned that individual rights should not supersede public health, saying, "Public health has to come first."

But both sides of the debate tend to reduce the complexities into generalizations, according to Daniel Bustillos, assistant professor of the Albert Gnaegi Center for Health Care Ethics. Concerns include vaccine safety, connections with "Big Pharma," government abuse (see Tuskegee syphilis experiment), civil liberties and ethical questions about how vaccines are created. Both sides bear guilt for how the debate has become nothing more than a shouting match. "We've started to shout past one another," Bustillos said.

In keeping with American culture of individualism, Bustillos said it's normal for people to look critically at the situation. While we should be free to do so, we must understand that there "are limits to the freedoms we have a right to ... especially when it starts to infringe on the right of others," he said.

Several panelists spoke about the importance of exercising an empathetic approach with parents concerned about vaccinating their children.

"Isn't it the scariest thing in the world to be a parent?" asked Dr. Ken Haller, a SLUCare pediatrician and SLU associate professor of pediatrics. "You spend your entire life thinking, 'Is my kid safe?'"

It's one thing if a child became sick or was in an accident, but "if you did something that hurt your child, that would be an unbearable thing," he said. "And that's what is happening with a lot of parents who have vaccinophobia."

Dr. Haller told the crowd about his recent conversation with a mother who opposed vaccination for her child. He took the time to ask about her thoughts and what she's read. At the end of the conversation, even though the mother didn't agree with his position on vaccinations, she thanked him for listening.

Such moments open future dialogue.

"We have to get past the emotional part so we can move to the cerebral cortex," he said.

Missouri law on immunizations

Missouri law requires that children attending public, private, parochial or parish schools be immunized against certain diseases: polio, rubella, rubella (measles), mumps, tetanus, pertussis, diphtheria, and hepatitis B.

Parents may opt out of immunizing their child for medical or religious beliefs. The Missouri Department of Health and Senior Services provides a medical immunization exemption form that must be signed by a physician. The religious exemption form only needs to be signed by a parent or guardian.

Visit to read the law.

The policy for archdiocesan schools follows the state's immunization requirements. Individual schools are required to report to the state the immunization status of every child, according to Alan Winkelmann, associate superintendent of elementary school administration. 

Church teaching on immunizations

Over the years, the Catholic Church has raised moral concerns about vaccines manufactured with human cell lines derived from voluntarily aborted fetuses.

It has urged Catholics to push for the development of morally acceptable vaccines, but in the absence of such alternatives, has said Catholics must not reject immunizations and "sacrifice the common good of public health" or their children's well-being.

In 2005, the Pontifical Academy for Life released a study titled "Moral Reflections on Vaccines Prepared From Cells Derived From Aborted Human Fetuses" to assist those struggling with the moral implications of getting such vaccines.

The use of such vaccines, it said, carries out "a form of very remote mediate material cooperation" with evil, however practicing Catholics are permitted to use the vaccines, it said, in the absence of ethical alternatives.

The academy said Catholics have a responsibility to push for the creation of morally just, alternative vaccines, but it also said they should not to sacrifice the common good of public health and the well-being of young children and pregnant women because there is no substitute.

— Catholic News Service 

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