1. Has the number of routine vaccinations significantly changed within the last generation?
Yes. Actually the number of vaccines on the CDC’s recommended vaccination schedule for children under the age of two has increased from 10 to 36 since Congress passed a law in 1986 (recently upheld by the U.S. Supreme Court) that vaccine-injured citizens cannot sue the vaccine manufacturer responsible for the production of the vaccine. See "Vaccine Injury Compensation Program" and "Increase in USA vaccination schedule versus other countries"
2. Aren't all of the vaccines on the USA schedule routinely administered to children in developed countries all over the world?
No. The USA has more vaccines on its schedule than any country in the world, due to the addition of many new vaccines since the 1986 federal law that prevents vaccine-injured citizens from suing a vaccine manufacturer. Countries such as Denmark, Canada, and Japan have significantly fewer recommended vaccines but yet have healthier child populations (as referenced in "Increase in USA vaccination schedule versus other countries").
3. Isn't it a law that I have to vaccinate my child per the required schedule?
No. You are not required by law to vaccinate per what the CDC calls the "recommended schedule". However, U.S. federal and state governments began enacting laws and regulations beginning in the late 1970's to deny access to public schools, nurseries, daycare facilities, and welfare benefits if a child is not vaccinated per the schedule, unless the child has a valid vaccine exemption on file. Vaccine exemptions can be for philosophical, religious, or medical reasons, and can be used to justify an alternative vaccination schedule (e.g. delaying or forgoing certain vaccines, but taking others on schedule) or to not vaccinate. Laws regarding the types of exemptions and the process for obtaining them vary by state to state; for more information, see "NVIC Vaccine Exemption Laws".
4. What is the difference between the SmartVax philosophy and the Max-Vax philosophy?
Both are "pro-vax" philosophies that view vaccines as an important tool for optimizing public health. SmartVax stresses an unbiased scientific approach that weighs the benefits and risks of each vaccine in consideration of an individual child’s health status. A SmartVax approach includes the study of adverse vaccine-injury events that don't appear until years later as well as supporting research to promote new safer and more effective vaccines. The SmartVax approach also supports parent's choice and other mechanisms that provide checks-and-balances on the vaccine policy-makers. MaxVax philosophy stresses pushing more and more vaccines into the schedule, without study of long-term vaccine-injury events or a well-thought out public health rationale, and supports the federal government's unchecked power to add vaccines to the schedule.
5. What are the risks from the diseases addressed by the USA vaccination schedule?
The risks differ greatly based on the nature of the disease and for each individual person. Many recently-added vaccines address diseases with extremely low risks given current public health standards within the United States. Other vaccines address diseases that carry a higher risk. The "Weigh The Risks" section estimates the overall risk from diseases to a child not vaccinated before age 5 as being much lower than the risk of vaccine-injury, even if vaccination rates were to drop below a point where herd immunity was lost. Much of the disease risk is attributable to two specific disease sources, the measles virus and the Hib bacteria (which can cause pneumonia and acute bacterial meningitis).
6. To avoid possible vaccine-injuries, do I need to make a choice between fully vaccinating or not vaccinating at all?
No. You could make a decision to delay a vaccine for a few months to reduce vaccine-injury risk. For example, a large study indicated that delaying the vaccine for whooping cough by three months could avoid a 1 in 13 risk of developing vaccine-induced asthma. Additionally, vaccines can be postponed until a health condition that potentially impacts the immune system, such as premature birth or active illness requiring the use of antibiotics, can be resolved. This could result in both safer and more effective administration of vaccines. The vaccine schedule can also be altered to reduce the number of vaccines given in one visit.
7. Can you give me an example of how SmartVax and Max-Vax philosophies differ?
The addition of the Hepatitis B vaccine to the USA schedule in 1991 to be given to all infants on the day of birth is an example of the Max-Vax approach to immunization policy. This vaccine approach was designed to protect an infant from the possibility of developing Hepatitis B disease from a HepB positive mother. SmartVax proponents recognize that clinical research has indicated risk associated with vaccination at this early an age, prior to the ability to make any assessment of an infant’s immune function. Therefore, the SmartVax approach supports the practice of most countries, such as Canada, Denmark and the UK, in which the mother is tested for HepB prior to the birth of the child. Vaccination and supporting treatments are then only given to the infant if the mother tests positive for HepB (a reported risk of 1 in 480 or estimated risk of 1 in 216, per "Why give a baby a HepB shot at birth"), thus preventing unnecessary vaccinations in a vulnerable population. Unless needed because the mother is HepB-positive, SmartVax proponents recognize that the other transmission factors ('dirty needles' during illegal drug use and unsafe sex) are not present in the life of an infant or young child and instead indicate that vaccination should occur later in life (such as during the early teen years). This approach is both safer and likely more effective as a public health policy, as a HepB vaccine given at birth often loses its protective effect before the late teen years during which disease risk is highest.
8. What tools are available to assist parents in reaching a decision about how to vaccinate?
See "A SmartVax Approach to Vaccines", which provides steps for reaching a decision on how to vaccinate. This section includes information regarding the risks and benefits of each vaccine, a downloadable tool for creating an individualized vaccine schedule, and suggestions on how to prepare for the pediatrician appointments. If a pediatrician is not willing to discuss these issues regarding your child’s healthcare in a thoughtful and respectful manner, then you may want to consider another pediatrician who is willing to treat your child as an individual.
9. What rights do citizens have in regards to vaccination policy?
Very few. Parents can seek a philosophical or religious exemption in some states, but Max-Vax proponents are actively seeking to over-turn these state laws in order to enforce compulsory vaccination without exemptions. Under a 1986 law, citizens cannot sue manufacturers for vaccine-injury; they can only petition for vaccine-injury compensation at a government administrative hearing (see "Vaccine Injury Compensation Program"). In recent years, vaccines have routinely been "fast-tracked" for approval by the FDA and quickly added to the routine immunization schedule by the CDC without full safety testing and without testing in conjunction with others vaccines in the manner they will be administered in practice. Once 'recommended' by a committee affiliated with the CDC, most states move quickly to require a children receive the new vaccine in order to have access to public school, daycare, nurseries, or welfare benefits. The U.S. Department of Health & Human Services (which includes the FDA, CDC, and NIH) is the defendant in the administrative vaccine-injury hearings, and thus has a financial stake in not funding the research on vaccine-injuries that is needed. A SmartVax consumer advocacy movement is needed to educate the public and its political representatives about the need for unbiased scientific research and the establishment of checks-and-balances on vaccine policy-makers.