Megan and Chris Campbell were simply picking their ten-month old son up from child care when they discovered he had a rather high fever. Rushing him to the pediatrician, they were told he had a virus. Two days later, when the fever rose to 104 degrees and a rash overwhelmed the baby's head and arms, they hurried to the hospital only to be informed that their son had the measles. This was 2008, everyone at the hospital was shocked at the rare appearance. The Campbell's spent three days in the hospital as well as a week at home with the fear that they may lose their baby whose fever spiked at 106 degrees. Marvelously, their son recovered from the disease, but how could a healthy child in the United States even get the measles in the first place? 

Well, a mother brought her sons who had not been vaccinated and had gotten the disease overseas, to the pediatrician's office where Megan Campbell had brought her son for his check-up. The Campbell's son was too young to be vaccinated for the MMR (measles, mumps, rubella) vaccine and therefore easily was infected (Vaccines: Unprotected Stories). This story is just one example of the dangers that come with not vaccinating, but others end in lifelong complications and some even in death. Each person has the power to prevent these devastations, simply by choosing vaccination. So why then, if vaccines can keep people from contracting harmful, and sometimes fatal diseases, do certain people question or even refuse vaccination? Over the years, various misconceptions and concerns have surfaced regarding vaccines, therefore it is imperative to the health of society as a whole that people are properly informed about how vaccines work, about their general safety, and the risks presented by choosing not to vaccinate.

It is safe to assume that most people, whether they choose to vaccinate or choose not to vaccinate, are seeking to do what is best for the health of their children. Unfortunately, a vast amount of the information gathered by parents is through search engines on the internet, which may or may not produce reliable information, the media, or even health professionals who are not properly informed themselves (Pineda). The internet is a helpful tool, but it also is notorious for providing a plethora of false information. Websites that advocate against vaccination flood the internet and much of their core arguments are based on personal experiences being projected to entire populations, or simple misinformation. Media poses another common source of misguided information, whether it be from the news, social media, or celebrities who use their platforms to push their opinions. Not everything one hears or reads is true. As stated by Diego Pineda and Martin G. Myers, "the media enhance the development of misinformation by providing inaccurate information, purporting scientific controversy, granting validity to misinformers, and sowing seeds of doubt" (Pineda). When it comes to acquiring factual information, the majority of people trust their doctors, or at least they should be able to. Therefore, it is crucial for health professionals to be properly updated and informed about the facts of vaccine safety as well as the risks of vaccine preventable diseases. They should also be able to direct parents to other reliable sources that lead them away from misconceptions and towards the truth.

In order to understand the controversy, one must first know the basic facts of how vaccines work within the body to prevent diseases. The body's immune system is built to fight invading organisms through the production of antibodies. Antibodies are produced when the body detects a virus, but it takes a few days for the antibodies to begin working. By this time, it is highly likely that the infection has already caused symptoms which can be rather severe or even fatal, but "the immune system and its antibodies can eventually help stop many infections" ("How Do Vaccines Work?"). Antibodies remain in the body even after the infection is gone and establish memory for the specific disease that they were first created in response to. If that same disease were to attack again the antibodies would recognize it and almost immediately kill it. So how do vaccines work relevant to these natural functions of the immune system? According to the American Academy of Pediatrics, "live vaccines are made up of a weakened version of the bacteria or virus responsible for the disease" ("How do Vaccines Work?"). These bacteria have been inactivated, but their immune exciting response has essentially been preserved. This means that when a vaccine is injected into the body it is detected by white blood cells and the cells respond to the dead bacteria as they would the actual virus, and create specific antibodies. These antibodies remain within the blood stream and are ready to immediately defend if the actual virus were ever to attack ("How do Vaccines Work?"). 

When given the background of what vaccines are and how they work, it is easy to understand where certain people may be wary with vaccination safety, especially when it comes to the concern that "vaccines contain toxins, such as mercury, aluminum [and] formaldehyde" (Haelle). According to the CDC, "Chemicals are added to vaccines to inactivate a virus or bacteria and stabilize the vaccine, helping to preserve the vaccine and prevent it from losing its potency over time" (Ingredients of Vaccines) and the concentration of chemicals is minute. Aluminum is a necessary ingredient in vaccines as it "enhance[s] immune response after immunization" (Offit). Research and observation over the years has proven that the trace amounts of aluminum in vaccines does not cause harm to the body and side effects are extremely rare. Furthermore, children are exposed to aluminum in numerous other ways aside from vaccines such as infant formula and even breast milk. According to Paul Offit and Rita Jew's article in "Pediatrics", the amount of aluminum in a vaccine is almost equal to that of a liter of formula for infants (Offit) and as stated by pediatrician Dr. Ari Brown, "you'd have to leave the planet to avoid exposure" (Haelle). Formaldehyde specifically, is only used to "inactivate bacterial products for toxoid vaccines" (Ingredients of Vaccines) as well as kill other bacteria that could contaminate the production of a vaccine, but the level of formaldehyde is significantly smaller than other forms of formaldehyde. Neal Halsey, M.D., a pediatrician and director of the Institute for Vaccine Safety at Johns Hopkins University, says that "our body even naturally produces more formaldehyde than what's in vaccines" (Haelle).  Mercury, perhaps, causes one of the most potent concerns because it is a known neurotoxin, but the mercury that had been used in vaccines, formally called thimerosal, is known as ethyl-mercury which is chemically different from the toxic methyl-mercury (Retroreport). Vaccine manufacturers know that thimerosal does not compromise vaccine safety, but as a cautionary measure, it was removed from all infant vaccines in 2001(Haelle). Other additives have all been tested with an extremely small margin of risk. 

In 1988, a study conducted by scientist and author, Dr. Andrew Wakefield, was published in a United Kingdom scientific journal called "The Lancet." From this study stemmed one of the most commonly feared vaccine misconceptions in society today. According to a video produced by Retroreport for The New York Times, Dr. Andrew Wakefield claimed in his study that he found a strong possibility that the MMR vaccine was linked to the onset of autism in children. The fear that vaccines can somehow cause autism in children has swept over the world, causing numerous people to oppose vaccination and even advocate against it. But Wakefield's study is not the whole story, nor is it the true story. Not only did the study generalize this finding to the entire population based on case studies consisting of 12 children, the findings were later reported to be invalid because "Wakefield distorted the data and acted unethically" (Retroreport). The study was retracted from the journal and over thousands of studies with hundreds of thousands of subjects have since found no correlation between autism and the MMR vaccine. The outlying reason that many autism symptoms surface post-vaccination is because the MMR vaccine is given around the same age that symptoms of autism are noticeable (Heyworth). 

"My child's immune system is immature, so it's safer to delay some vaccines or just get the most important ones" (Haelle). This is just one more of the common concerns among hesitant parents that is not based on scientific evidence. Apprehension toward the large number of shots is understandable if a parent is not educated properly on how the vaccines work and what is really inside of them. In fact, "The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) recommend that healthy children get vaccinated against 14 diseases by age 2" (Heyworth), which can seem like an overwhelming amount to give to a child. Contrary to that misconception, doctors reassure that the child's immune system is exposed to just as many, if not more antigens in a day of simply living life than through vaccines and is more than capable of handling the immunization schedule (Heyworth). The immunization schedule has overwhelming support from the American Academy of Pediatrics and pediatricians all over the country, people who know and understand in depth what vaccines are and how they work. In addition, the number of antigens in vaccines have decreased since the 80s. Antigens are the molecules that contain the virus or bacteria and excite the immune system to produce antibodies. Therefore, even though more shots are being given now than in the past, the child's immune system is more than capable to respond to the antigens and create the antibodies that will protect from the disease if it were to attack in the future. Spacing out or delaying vaccines is not beneficial in any way, instead, it simply puts the child at a higher risk of contracting a deadly disease that could have easily been prevented. Some people wish to omit certain vaccines because they see them as less important, such as the varicella or chickenpox vaccine, but a study observed that forty-five children died from varicella between 1990 and 1994, before the vaccine was introduced in 1995, reiterating the importance of every vaccine in the schedule (Carrol).         

Despite scientific evidence, vaccine hesitancy among certain people continues to threaten the health of entire communities. Since the introduction of vaccines, a variety of diseases including measles, mumps, pertussis (whooping cough), and other potentially fatal illnesses, have dramatically decreased in number. This is a tremendous accomplishment for medicine, but it is beginning to backfire. As stated by Seth Mnookin, Associate Director of the M.I.T. Graduate Program in Science Writing, "vaccines have become the victim of their own success" (Retroreport), meaning that because vaccines have drastically decreased the amount of diseases prevalent in the United States, people are falsely believing that they no longer need to vaccinate their children, when in reality that is not the case. Unfortunately, choosing not to vaccinate does nothing but harm to their own children, putting them and the people around them at risk. The concept of "herd immunity" refers to the need for at least eighty to ninety percent of a community to be vaccinated in order to keep a disease from resurfacing and spreading (Heyworth). When specifically speaking in reference to the measles, the need for a strong herd immunity is about ninety-four percent (Retroreport).  In the year 2000, the elimination of the measles was officially documented (Measles Cases and Outbreaks), but because the number of parents who are not vaccinating their children has been increasing since then, there have been several measles outbreaks across the country, providing a prime example as to the importance of vaccinating against all of the recommended diseases. The largest case being when "the U.S. experienced 23 measles outbreaks in 2014, including one large outbreak of 383 cases, occurring primarily among unvaccinated Amish communities in Ohio" (Measles Cases and Outbreaks). In addition to that, the most recent outbreak was in 2015, with measles cases occurring in multiple states, but all rooting from an outbreak in California at Disneyland. With diseases such as measles and others, it is imperative that the people in a community who are able to get vaccinated do so because if not they are putting children that are not old enough to receive their shots or whose parents did not vaccinate them, at a high risk of becoming sick. In the words of Megan Campbell who experienced this issue first hand as she watched her ten-month old son suffer from the measles, "people who choose not to vaccinate their children actually make a choice for other children and put them at risk" (Measles Cases and Outbreaks). 

Both choices, when it comes to vaccinating or not vaccinating, pose some sort of risks, but weighing the risks and discerning what information is actually supported by scientific fact is crucial. The danger here is that vaccine-preventable diseases are not extremely prevalent within society and do not spark much fear, therefore the much higher risks associated with not vaccinating are not as easily conceptualized compared to the possible direct effects of vaccines, such as mild inflammation or fever. "Without fear of these diseases, parents have begun to fear hypothetical vaccine-safety risks regardless of whether they are substantiated by facts" (Measles and Outbreaks). On the other hand, the possible slight fever or inflammation one's child gets after being vaccinated causes a concern based off of something tangible and visible. Although these small side effects can occur, they often disappear quickly, causing no harm and leaving no damage. There also have been rare cases where serious vaccine side effects have required compensation from vaccine courts, "but most doctors say that the odds of experiencing a vaccine-related injury are greatly outweighed by the dangers of catching a vaccine-preventable disease" (Heyworth). Also according to Heyworth's article, a rare side effect of the measles vaccine can temporarily reduce platelets from which there is a risk of fatality for 1 in 30,000 children, whereas there is a fatality risk of 1 in 2,000 for those who get the measles disease. Then there is the issue of perceived risks based on vaccine myths, such as autism. Despite a plethora of evidence, certain people continue to believe and even advocate against vaccines because of the myth that they can cause autism. Perceived risks such as these are simply not grounded in scientific truth. Furthermore, "if the FDA determines that a vaccine poses a real risk to more than a tiny percentage of children, the agency won't let it be used" (Heyworth). All in all, millions of people have been vaccinated over the years with extremely rare cases of serious side effects causing serious complications or fatalities and the truth is that vaccines have prevented an uncountable number of illnesses, saved numerous lives, and dramatically decreased rates of serious diseases across the United States and all over the world. 

No matter the reason one might have for opting out of vaccinating their child, the possible risks still stand. Sure, not every child is the same and neither is every situation, but each person has a responsibility to their child as well as their community to vaccinate and help in preserving the health of society as a whole. Heyworth expresses that "at the heart of the vaccine debate is the idea that when you immunize your children you don't just protect them -- you help shield your entire community," and that really is the point. Overall, people need to be educated on how exactly vaccines work and why the specific immunization schedule is what it is.

