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Tuesday, November 18, 2008




nicola michael c. Tauraso, M.D.

As I re-enter the private practice of medicine as a Pediatrician, I am beginning to realize that what started as a small group of parents not willing to have certain vaccines given to their children has grown into a much larger and organized group. These parents, especially in my home town, are being asked to leave some pediatric practices because of their insistence on not administering vaccines to their children. I do not yet know why these pediatric practice are taking this position, probably because of the potential liability issue.

Let us discuss for a moment the potential liability issue. If the general medical community takes the position that giving certain vaccines in the pediatric age group is the expected level of medical care, is the pediatrician who acquiesces to the wishes of the parent not to administer a vaccine practicing substandard medicine? The parents are more concerned about the potential side reactions of some vaccines than they are to preventing the disease the vaccine is supposed to accomplish.

A side reaction to a vaccine is always a potential threat, but when a reaction occurs in your child in real time, it is no more a potential threat. It is a real event. The usual parent is little concerned about preventing a disease outbreak than s/he is to preventing a reaction in his child.

The pediatrician is constantly concerned, legally and morally, about being judged by his peers (and, of course, his malpractice carrier) that he is practicing according to the level of care expected by the medical community. I am sure that legally, that, as long as the physician indicates his recommendation that the vaccines are recommended by the Academy of Pediatrics and the United States Center for Disease Control, his liability ceases.

I do know that in some states where some religious sects, such as Jehovah Witness, take the position that their child with appendicitis not have the necessary life-saving operation to save the child’s life, the state takes temporary custody of the child, orders the operation, and finally returns custody back to the parents. Additionally, I know these parents are not prosecuted for parental neglect after the fact. The physician, on the other hand, must take the position that the operation is necessary and must do whatever he can to insure that the operation is performed.

On the one hand, I sympathize with the parent who desires that her child be healthy and not experience a vaccine reaction, on the other hand, I am also concerned about each of us contributing to the establishment of the necessary herd immunity which vaccines are supposed to achieve.

When I went to Medical school in 1956, I saw hospital wards in Boston hospitals with 20- 30 iron lungs – a remnant of the devastating polio epidemics which occurred just a few years earlier. After the advent of the polio vaccine, polio ceased to be a significant public health problem, and we did not nor see iron lungs anymore. Perhaps a few are stored in hospital basements for people who are afflicted with the ascending paralysis called Guillian Barre Syndrome, which, by the way, can be a potential adverse reaction to influenza vaccine administration.

Polio vaccine, one of the more effective vaccines, has essentially eliminated Polio. For Polio to be effectively controlled it is necessary that as many individuals as possible be immunized in order to decrease the carriers of the virus. Individuals who refuse Polio vaccine are essentially benefitting from those who take the vaccine. So, if a few do not take the vaccine and so many others are, those who do not are being protected by those who do. As more decide not to take the vaccine, there will come a time when there are not enough immunized individuals to prevent an outbreak.

The same can be said of measles, mumps, rubella, whooping cough, hepatitis, etc. – all diseases which at one time contributed to significant morbidity and mortality in infants, children, and young adults. Years ago many children died before age 10 years solely because of the childhood diseases just mentioned. Now we do not see this.

For a moment, let’s discuss German Measles, Rubella. At one time not too long ago one of the greatest causes of defective congenitally deformed babies was the mother having rubella. This cause of newborn abnormalities is a rarity today because of Rubella vaccine.

Just a short time before that the greatest cause of infant blindness was the mother infected with the gonorrhea bacterium. This blindness is completely prevented and cured with the administration of either silver nitrate or penicillin drops in the eyes of newborn babies. This is now state law in almost every state and the drops are administered even before the baby leaves the birthing room. No permission is granted. It is just done as a matter of good public health.

The general public does not know the diseases which plagued us just a few years ago. This unawareness leads to ignorance about what is needed to establish a level of public health which benefits the general community.

Perhaps, in the Middle Ages when rats infected with the plague over ran Europe, if the population knew it was the flea-infested rats which spread the disease which killed more than 50% of the people of Europe, they might have been able to do something about the Black Plague.

Just slightly over 100 years ago the largest epidemic of Yellow Fever which killed thousands of people occurred in Philadelphia. When it was discovered that the disease was spread by infected mosquitos, the solution was at hand. Yellow Fever is not a disease we see anywhere in the United States today.

The global eradication of smallpox in 1977 is one of the marvels of modern public health achieved with a concerted effort of vaccination, isolation, and elimination of the carrier.

I am writing this Blog hopefully to inform parents of the importance of early childhood immunizations for prevention of diseases which can harm their children. Those who decide not to administer the recommended immunizations should be aware that they may be causing the potential of ill health not only to their own children but also to others.

I felt it necessary to add this addendum after I posted the Blog earlier today. There is developing a group of physicians who are offering an alternative approach to childhood immunizations. Some believe that the very small infant’s immune system may not be sufficiently mature to handle some vaccines sometimes. They are offering the following recommendations:

1. Wait until the child is at least 2 years old.
2. Do not give more than one vaccination at a time.
3. Never vaccinate when the child is sick.
4. Be sure that the vaccines are thimerosal-free.
5. Supplement the child with extra cod liver oil, vitamin C and B12 before each shot.
6. Obtain a medical exemption, if the child has had a bad reaction to a vaccination before or if there is a personal or family history of vaccine reactions, convulsions or neurological disorders, severe allergies and/or immune system disorders.

Please feel free to write me if you have concerns which I have not addressed.

nicola michael c. Tauraso, M.D.)
Director, Tauraso Medical Clinic
7051 Poole Jones Road
Frederick, MD 21702
Web site: www.drtauraso.com
Blog site: http://www.drtauraso.com/blog/index.htm
Email: drtauraso@drtauraso.com

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