The War on Unvaccinated America

Three children per thousand (0.03%) in the United States are completely unvaccinated.  Yet, the rise in anger and hostility toward these children and their families is becoming louder then ever before.[*]

If you are reading this, then it is safe to presume that you’ve been in some type of discussion or debate regarding vaccination status.

While we may all agree that selecting any medical intervention or medicine is a personal choice, it seems at the mere mention of vaccination every Tom, Dick and Harry has conjured up an opinion on the subject in a no-holds bar brawl.

In vaccine debates, you’ll most commonly witness juvenile name-calling and low blow attacks or criticism. Parents who choose an alternative schedule will be called ‘self-centered’, ‘stupid’ or ‘anti-doctor’ for not following the advice of their respected physician. [*]

Some will go on to suggest that people who are unvaccinated be somehow labeled to distinguish them out amongst the group or advocate for schools to reveal the vaccine history of their students. [*]

More will suggest that exemptions be revoked completely or at the very least become much more difficult to obtain – requiring an approval and signature from a licensed medical practitioner. 

Others offer more radical opinions (if the above wasn’t radical enough), suggesting Child Protective Services be contacted if a parent chooses to decline vaccines…or that children should be placed in someone else’s care in hopes for better medical care and attention.

It can also be observed where physical harm was wished upon parents or their children if they refuse to vaccinate.

"Fine, so long as these parents are forcibly exposed to the illnesses themselves. And if their children either die, or are permanently injured, criminal charges should be laid. Then we'll see how much they still believe in their voodoo-science......"[*][*]

Does the majority of trepidation and fear expressed against the small group of the unvaccinated stem from the various theories of herd immunity or does it go further than that …is it because there is a group that exists that does not believe, think, dance and act the same as the majority group does?

It's an issue I have with you, parent of the unvaccinated, not actually with your child. It's a feeling that you're not doing your part here; not holding up your end of the bargain. Vaccine efficacy depends, in part, on "herd immunity," and by choosing not to inoculate your child, you are failing the herd. I hold you responsible for the unnecessary illness of babies who were too young to yet be vaccinated. I definitely blame you for your own child's sickness - and I just have to remind you that it was preventable.[*]

A Moral Principle

No human being should view another person as being a means to an end, no matter how desirable that end may seem to be. [*][*][*]

The hazard of having an ideal such as forcible vaccination (barring acute medical reasons) and/or being combative (emotionally, mentally, socially, and physically) to those that resists such beliefs devalues the life of every human being.

The logic of sacrificing a few individuals (without consent) for the greater number of society is nothing novel.  Because of this, we must be diligent to consider the devastation and revolting crimes that was born when such ideals were accepted as truth.[*][*]

Voluntary consent married with adequate comprehension of each medical intervention is exceptionally fundamental as modern-day medicine develops and progresses.

A human body should never be perceived as a weapon in the arsenal of medicine against the war on viruses, cancer, or disease.

What Can be Done?

Whether you decline (or become selective of) vaccination or if you decide to administer all of them according to the current recommended schedule, there should be some development of responsibility in the participation as well as progressive education in your (or your child’s) health.

That should be the underlying principle pressed on parents – NOT mandatory vaccination, specifying vaccine status, public broadcast of vaccine records, contacting government agencies of neglect, or wishing ill of these children/parents.

I like to believe all parents are doing the best they can (am I in the minority?) – choose what works best for your family while honoring the rights of others to make that same choice.

This post reflects the research and concern that I have about vaccination.  I am not a medical professional. It does not represent my opinion of people who choose to vaccinate or not.  Please know that, while my family has made this decision, we respect the rights of all parents to choose to vaccinate if they feel this is best for their child.  I do not have all the answers.  Most of us don’t.  We’re all in this together and we need to make the best decision we can with the information we have.

This post contains some subject matter that was summarized by NVIC’s publication ‘The Moral Right to Conscientious, Personal Belief or Philosophical Exemption to Mandatory Vaccination Laws’ which was published May 2, 1997.

Other references are noted throughout post and marked with an asterisk with corresponding link following that paragraph.

7 Steps To Bliss

Through my teen years to my mid-twenties, I had ‘managed’ depression and anxiety in many defective ways: drugs, promiscuity, self-inflicted injury, alcohol, prescription medication, avoidance. None of these were long-lasting or beneficial.

And then there was a period in my life where my perception of the world and my purpose in it shifted. I began recognizing myself in others and appreciating myself for who I truly am (who we all are): each of us unique and with a divine purpose - who is happy, sometimes.

Come ‘on – we aren’t ALWAYS happy. My goal in this post is not to act like if you do any of the following things in your life you will be a happy person - In fact, ‘happy’ is a loaded word.  

Am I a much ‘happier’ person now that I incorporate the following list into my life – sure. But that doesn’t mean I don’t feel sad or angry or overwhelmed at times.

I think the key is actually feeling the uncomfortable emotion at that time – which is the opposite of what we automatically think or what may be acceptable. I mean, who wants to feel sad? Who wants to feel pissed off?

But the thing is, if you stuff it – then you will eventually feel it and its going to more drawn out and gritty then if you would have just dealt with it all at that time.

However, I digress…let’s just agree that feeling sad or angry isn’t ‘right or wrong’ anymore then being happy or peaceful.

The following has helped me find joy within myself and I hope it does the same for you.

Step 1    Take Care of Yourself

I mean really take care of yourself. This may be of the most influential step listed.

Some Most of us were never taught nor had a role model in our lives that provided a decent example on how to take care of our bodies. And an occasional gym and health class in high school doesn’t quite lend a knowledgeable foundation to use throughout a lifetime.

Luckily, all a person needs to the willingness to learn and to love themselves - if you are reading this, then there is a good chance you are at least doing one of these two.

Obviously, nutrition directly effects your physical, mental (focus) and emotional energy. Start by being more aware of what you eat. Watch a documentary (Food Inc and Forks Over Knives is excellent).

Foods that possess clinical evidence to combat depression are foods with omega-3 fatty acids (think salmon and tuna) and folic acid (such as spinach and avocado). [*][*][*][*][*][*]

If there was a superstar in your arsenal of self care then it would most definitely be exercise.

Chemically speaking, getting physical has been repeatedly supported by science to be as effective as antidepressants – with no side effects (well, maybe a smaller waistline and higher self esteem). [*][*][*][*][*][*][*][*]

Here is a really good read with more information on how to start taking care of yourself: What it means to really take care of yourself.

Step 2    Drop the Comparisons

You might not now it yet – but I’m going to let you in on something...

Comparing yourself to others is poisonous.

Social comparisons and over thinking situations is simply a (bad) habit – it’s not something that we were instinctually born to do. Which is a good thing – it means we can learn to stop.

If you find yourself stewing over an event, rehashing something someone has done/said to you or simply being critical of another – stop.

‘Well, it’s not that easy’

Yes. Yes - it is. Stop right now and do something else. 

What someone else is doing is their business (unless it is hurting someone obviously); mind your own business because it’s bad for your health.

If you are hell bent on comparing yourself to someone, then compare yourself to an earlier version of yourself. 

Step 3   Do Something Creative or New

Becoming aware of your emotions seems easy, yet as we grow up get really good at two things that hinder our ability to do this (1) denial (2) denial.

If you are wondering exactly how to become better aware of what you are truly feeling then incorporating something creative in your life is hands down the most effective way to ‘tune in’ - simply draw, dance, sing, or listen/play music.

When you are being creative, you automatically become more aware of your emotions not to mention it is an amazing way to release/vent/express any negative emotions simmering inside.

If you aren’t that creative (or even if you are) then go somewhere or do something new.

Go to the museum. Start reading a new book. Go for a bike ride. Take a class. Volunteer.

When we do something new you are altering the levels of dopamine in the brain which is intrinsically link to depression/enjoyment. [*]

Step 4    EXPRESS Gratitude

Talk about beating a dead horse – we hear over and over again how important it is to be grateful in our lives.

Sure, people generically say they are grateful for the wonderful things in their life (kids, house, friends, family, job, etc.) but exactly how do they express it?

What action results from your gratefulness?

This is the key that isn’t mentioned – probably because people generally don’t want to have to exert any extra effort into the things in their life. (Another reason why step 1 is so crucial-where else are you going to get the extra energy needs to be expressing gratitude all day?)

Try this first step – tell someone how grateful you are to have them in your life…and then tell them again the next day.

Smile at someone that you appreciate.

Say thank you and make sure you look at the person when saying it.

Pause and give some of your time to think about a few reasons associated with why you are grateful for something.

When we give time and effort to appreciate the things in our life those things and people increase in value in our lives.

Step 5    Continually Forgive Yourself

No one can beat you up better then you.

The kicker – you’re really good at and you may not even be aware that you are doing it.

There are many things in my life that I look back and think – wow, I would never do those things today. However, all of those ‘mistakes’ have contributed in helping me becoming the person I am today.

Before you are able to forgive anyone in your life, you must be willing to cut yourself a break.

At some point in your life, you’ll come to realize that you did the best you could given the conditions of your life at that time. Once we realize that about ourselves – you understand that it applies to everyone else and forgiveness of others becomes easier.

Step 6   Practice a Spiritual Life

There is something to be said about what happens when we recognize that life is bigger than us.

Not only does science substantiated the claim that spirituality diminishes depression, but the way you experience life is transformed when you consider that we’re all in this together. [*][*][*][*]

Live your faith.

Practice it.

What have you done in the past 24 hours that expresses your most deeply held beliefs?

Step 7    Love VS Fear

Love and fear are ultimately the most powerful and basic forms of human emotion.

Both of these emotions hold the potential to inspire extreme behavior (dying for another/killing another). But it seems that fear tends to paralyze rather than empower.

This step isn’t as easy as simply deciding one day to live from a fear-based outlook to one that is based on love. It takes a shift in perspective and may take practice and patience.

For me, I recognize that every breath that is taken in this life is a precious gift bestowed to us for one purpose and that is to love each other the best we can.

Do not focus on what is not your purpose. Obstacles in life cannot be controlled.

In fact, the challenges in your life are not by accident.

What this world has been trying to tell you this whole time is… “I love you and everything will be alright.” (and don’t we all need to hear this)

Once we hear this message - more importantly, once you experience it – it’s effortless to come from a place of love and share that with the world. 

Ditch the Well-Child Visit?

The care of children has always been a part of the human experience. So it may come as a surprise to learn that the birth of the pediatric discipline emerged less then a century ago. 

In the early 1900’s, medical licensing codes were introduced and the large influx of new medical professionals began to create specialization within the field of medicine. Pediatrics is one example of a broader trend seen in institutional medicine emerging at that time: specialization.

****

Although the average parent might not be aware of it, the current approach to well child visits in the US has been under scrutiny by the medical community for over a decade – and a push to reform the content and structure surrounding children’s care is gaining momentum. 

What are the current limitations to the messiah of pediatric preventative care we know as ‘well child visits’ ….and what does this mean to parents?

Read on…

What is a Well-Child Visit?

A well-child visit is an appointment made with a primary pediatrician while a child is not sick in which the objective is to assess development, administer scheduled vaccines, perform age-appropriate screenings and provide advice about nutrition and various preventive measures parents can incorporate into their daily lives.

International Comparison

For me, I always like to start with good ol’ comparison to the rest of the world.

Yep, that’s right, we’re not the only kids on the block.

Here in the states, we are among a very small number (if not the only) of countries on the globe to place all well-child care under the responsibility of a single primary care provider. We expect in-office visits by one pediatrician to effectively complete developmental screenings, psychosocial assessments, and to lend guidance about preventative measures and nutrition.[*][*]



Current US Schedule of Well-Child Care



Is there a superior way of pediatric care and assessment being currently utilized in other parts of the world?

Well, when you look at Sweden, Australia and the UK (for example) they use “health visitors” (nurses with public training) to make home visits to assess children’s development and to take time to discuss concerns parents might have(how awesome is this). In other European countries, public clinics offer developmental services in conjunction with home visits.[*]

One country that seems to be getting it right is Sweden – Swedish parents understand that they go to a general practitioner if their child is sick, a public health nurse for various developmental services, and a pediatrician for complex medical problems. This unique system provides comprehensive, continuous care, without coordinating services in a pediatric practice.[*] 

The Evidence in Screening/Prevention

One of the principal reasons for parents to attend well-child care visits regularly is the early surveillance of childhood developmental issues.

Surprisingly, experts have been questioning the evidence supporting regular developmental screening, behavioral screening, and psychosocial assessments for years simply due to the lack of research backing it up.[*][*][*][*]

Social and psychological assessments, for example, are effective with an assessment in an in-home environment and particular parent-child evaluations. However, in an office setting, the validity of these assessments is absent.[*] 

As for child behavioral problems during the first 3 years of life, the published literature confirms the absence of a universal diagnostic classification. The diversity among check-lists and questionnaires provided to parents and used by pediatricians for review have never been examined in terms of effectiveness.[*] 

If you are using well-child care as a preventative measure in developmental and behavioral issues, then it would be wise to re-examine this impression. Problems of this type in children are increasing and occurring at younger ages. The large majority of pediatricians are NOT addressing developmental and psychosocial issue adequately.[*] 

The current system in place in the US for preventative care in children in not very scientific, nor is supported by evidence of effectiveness. [*][*]   

Trying harder will not work – changing systems of care will. Parents need to act as a catalyst, requiring more from doctors and educating themselves about what is proven by research to be effective care.[*]

There is a very strong need for better, more rational, scientific guidance regarding preventive care for children – especially as it affects their development.

Well Vaccine-Child Visits & The Time Crunch

Instead of a schedule based on key transition points in development, the U.S. pediatric well-child schedule is driven by the current immunization recommendations.   

If you thought pediatric well-child office visits lack in developmental/psychosocial assessment, then it is revoltingly deficient in communicating information about vaccines.

In one study published in JAMA Pediatrics, researchers studied the information exchange regarding vaccination during well child visits. Only 5% of families actually read the materials provided by practitioners with pediatricians prompting questions regarding vaccination 16% of the time.[*]

The median time spent on the discussion of vaccines being administered during a well-child visit was about 2 minutes (with a cumulative discussion of vaccination within the first 2 years of life estimated to be less then 10 minutes). [*] 




Check out NVIC’s Ask 8 –

 Questions to ask before you vaccinate

  

Well-child visits are touted as key times for communication between parents and their care provider but this dialogue among parents and care providers is not occurring.

The study mentioned above gathered information from 7 pediatric practices and presented the following timetable during a well-child visit[*]:

(time listed in minutes)

4.9 = physical exam

1.9 = vaccine discussion

9.5 = discussed other health concerns

0 = vaccine administration (performed by a nurse 1.6 minutes)

16 minutes = Total median time spent with primary doctor during well-child visits

The time allotted during a well-child visit is not enough to effectively address what the actual visit is intended to do. 

Is it simply too much for one primary physician to accomplish? Certainly.

Are parents relying significantly on the pediatrician to prompt dialogue, questions and concerns? Maybe.

All or Nothing?

With my oldest daughter, we went to every well-child visit.

With my youngest, we attended none.

After my experience with both extremes – I do believe there should be some happy medium between the two.

Obviously, if you are planning to vaccinate on schedule according to the ACIP/CDC national immunization program, then attending all well-child visits would be logical because you have to go to the doctor anyway to administer the intended vaccines.

However, if you are planning on delaying or altering the vaccine schedule in an exclusive approach then attending only a few would be reasonable as well since the research and evidence supporting the excessive amount of visits early in life is lacking.  

When we rejected all well-child visits, I believe we missed out on the ability to build a relationship between our pediatrician that could have been beneficial.  Although we did not need her services or advice, there is something to be said about the possibility of the relationship between doctors and parents.

My past experience (aka being “fired”) with pediatricians most likely played a role in my refusing all well-child care – and looking back, I think that was unfortunate.  

I hope this post helps you to re-examine the confidence we hold in the ability of a primary pediatrician to solely assess behavioral/social/psychological development, lend nutritional advice, and provide evidence-based information.

I hope this also motivates parents to be more diligent in learning/researching more about health outside of the doctor’s office.

In my experience, I’ve learned 3 critical details in a successful well-child visit :

(1) When you do attend a well-child visit, go with your partner (if there is absolutely no way to schedule this, then have someone attend that is supportive) and never go without a written list of questions, concerns, topics to discuss.

(2) Don’t be anxious to leave a practice if you are not a good fit with their policies or their position on certain practices. The doctor/patient(guardian) relationship is just that: a relationship – NOT a dictatorship.

(3) If you unsure about a particular medical procedure (vaccines, screening, testing, etc)- NEVER decide in-office at a well-child care visit. Always give yourself time to review the information provided by the doctor, to do your own research, and time resolve what is the best choice for your child. Simply state you are there to collect information and you will schedule another appointment it you decide that is necessary.

To overhaul what has been preset for decades is not going to happen in our life time, but that doesn’t mean that we should give up – or worse, accept the current state as is.

The methods for pediatric care are changing, slowly. Pediatricians may see interdisciplinary care (ex. the care model seen in Europe nations with many care providers imparting assessment and care to children) as a threat, but new models suggested by researchers (such as home care, vaccine clinics, group education, etc) is the next level of children’s health care which would improve quality and efficiency to the field of pediatric medicine.[*]

Other posts you might find informative:

5 Useless Medical Practices Used on Children

How Your Doctor is Taught to Deal with Questions About Vaccines

2012 Changes to the Immunization Schedule

Linear Thinking in Modern Medicine

How Can I Get My Husband To Understand Vaccines?

Below is the information I presented to my husband when we first were learning about vaccines and the diseases they are intended to prevent.

The information is pretty rudimentary; however, I believe this has an advantage because  (1) it is easy to get confused when starting to learn about vaccines in general and (2) it can be challenging to communicate everything you are learning (especially if the other person is not as committed to the learning... yet).

I think learning about the diseases prior facilitates a better understanding and foundation.

I encourage you to learn more about each disease in greater detail. Check out the links under the main title to learn more.

Hepatitis B
Virus that infects the liver

Prevalence
less then 2%in US

Transmission
unprotected sex, blood transfusions, re-use of contaminated needles & syringes, and vertical transmission

Treatment
More than 95% of people who become infected as adults or older children will stage a full recovery and develop protective immunity to the virus. Of those infected between the age of one to six, 70% will clear the infection

More info on Hep B Disease and Vaccine:
CDC Pinkbook - Hep B
NVIC - Hep B
Hep B - This Disease & Vaccine 



Rotavirus
Stomach Flu

Prevalence
average of 35 deaths/year in US

Transmission
faecal-oral route, via contact with contaminated hands, surfaces and objects

Treatment
Hydration; Rotavirus infections rarely cause other complications and for a well managed child the prognosis is excellent

More Information on Rotavirus:
CDC Pinkbook - Rotavirus
NVIC - Rotavirus
Rotavirus - The Disease & Vaccine


Diphtheria
Respitory tract infection, characterized by sore throat, and  low fever

Prevalence
3 recorded cases in US from 2000-07

Transmission
direct physical contact or breathing the aerosolized secretions of infected individuals

Treatment
Infected child or adult receives a special antitoxin. Diphtheria is also treated with antibiotics, such as penicillin

More Info on Diphtheria:
CDC Pinkbook - Diphtheria
NVIC - Diphtheria



Tetanus
prolonged contraction of skeletal muscle fibers

Prevalence
approx. 43 cases annually

Transmission
Infection generally occurs through wound contamination and often involves a cut or deep puncture wound.Heroin Uses at higher risk. From 1998-2000, 75% of the deaths in the US were in patients older than 60 years

Treatment
Immune globulin, given intramuscularly, is the immediate treatment of unimmunized individuals exposed to material likely to contain the tetanus bacteria. Treatment includes bed rest and quiet conditions.



Pertussis
Whooping Cough

Prevalence
5,000-7,000 annually in the United States

Transmission
airborne discharges from the mucous membranes of infected people, who are most contagious during the catarrhal stage

Treatment
Treatment with an effective antibiotic

More Information in Pertussis:
CDC Pinkbook - Pertussis
NVIC - Pertussis
The Perfect Storm: How the increase in pertussis vaccine usage is causing an 'epidemic'



Haemophilus Influenzae Type B
Bacterial Infection

Prevalence
3 out 100,000

Transmission
contact with discharges or droplets from the nose or throat of an infected person

Treatment
Treatment with antibiotics should be started

More Information on Hib -
CDC Pinkbook - Hib
NVIC - Hib



Pneumococcal
pneumonia

Prevalence
500,000/year in US

Transmission
Respiratory droplets from the nose or mouth of an infected person

Treatment
Treatment with penicillin

Additional Notes:
The Vaccines and Immunizations of the Centers for Disease Control and Prevention recommends for:
 - 65 years old or older
 - You have a serious long-term health problem such as heart disease, sickle cell disease, alcoholism, lung disease (not including asthma), diabetes, or liver cirrhosis
 - Your resistance to infection is lowered due AIDS or Cancer
 - You are an Alaskan Native or from certain Native American populations
*twice as high in African Americans than in caucasians

More information on pneumococcal:
CDC Pinkbook - pneumococcal
NVIC - pneumococcal



Influenza
Flu

Prevalence
see below in additional notes

Transmission
Transmitted through the air by coughs or sneezes. Also be transmitted by direct contact with bird droppings or nasal secretions, or through contact with contaminated surfaces

Treatment
Plenty of rest, drink plenty of liquids, avoid using alcohol and tobacco and, if necessary, take medications such as acetaminophen to relieve fever

Additional Notes:
Most people will recover completely in about one to two weeks

According to the World Health Organization: "Every winter, tens of millions of people get the flu. Most are only ill and out of work for a week,
yet the elderly are at a higher risk of death from the illness.

The group most vulnerable to flu, the elderly, is also the least affected by the vaccine, with an average efficacy rate ranging from 40-50% at age 65,
and 15-30% past age 70

In the United States
a person aged 50–64 is nearly ten times more likely to die an influenza-associated death than a younger person

More Information on Influenza:
CDC Pinkbook - Influenza
NVIC - Influenza
Flu Vaccine Inhibits Your Heterosubtypic Immunity (and why the heck its important)
Buying into the hype of this year's flu shot?



Measles
infection of the respiratory system caused by a virus, rash on skin

Prevalence
131 cases-No deaths, (11 of the cases had received the vaccine)

Transmission
Airborne pathogen which spreads primarily via the respiratory system

Treatment
Most patients with uncomplicated measles will recover with rest and supportive treatment.

More information on Measles:
CDC Pinkbook - Measles
NVIC - Measles


Mumps

Prevalence
disease is self-limiting, and general outcome is relatively good with life long immunity

Transmission
When an infected person coughs or sneezes

Treatment
intermittent ice or heat to the affected neck, acetaminophen/paracetamol (Tylenol) for pain relief

Additional Notes:
Prior to the development of vaccination and the introduction of a vaccine, it was a common childhood disease worldwide
The disease is generally self-limited, running its course before receding, with no specific treatment apart from controlling the symptoms with painkillers.

After the illness, life-long immunity to mumps generally occurs

More Information on Mumps:
CDC Pinkbook - Mumps
NVIC - Mumps



Rubella
German Measles

Prevalence
CDC annouced elimination in 2004 in the US

Transmission
airborne droplet emission from the upper respiratory tract

Treatment
No specific treatment-disease lasts for 1-3 days

Additional Notes:
Disease is often mild and attacks often pass unnoticed
Children recover more quickly than adults.
The disease can last one to three days.

More information on Rubella:
CDC Pinkbook - Rubella
NVIC - Rubella



Varicella
Chicken Pox

Prevalence
.0023% death rate in the United States

Transmission
inhalation of airborne respiratory droplets

Treatment
anti-itching creams and lotions

Additional Notes:
More severe in adult males than in adult females or children.

More information on Varicella:
CDC Pinkbook - Varicella
NVIC - Varicella
Chickenpox Party-RSVP?
Chickenpox vaccine-strain virus reverting back to virulence


Hepatitis A

Prevalence
640 people in 2003 (this was considered an outbreak)

Transmission
HAV is found in the feces of infected persons & those who are at higher risk include travelers to developing countries where there is a higher incidence rate, and those having sexual contact or drug use with infected persons

Treatment
There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol eat a well-balanced diet, and stay hydrated

Additional Notes:
Hepatitis A does not have a chronic stage, is not progressive, and does not cause permanent liver damage.
Following infection, the immune system makes antibodies against HAV that confer immunity against future infection.

Young children who are infected with hepatitis A typically have a milder form of the disease, usually lasting from 1–3 weeks, whereas adults tend to experience a much more severe form of the disease

More information on Hep A:
CDC Pinkbook - Hep A
NVIC - Hep A


More General Posts Regarding Safety of Vaccines:
Vaccine schedule touted as 'not unsafe'
87 Published Works on Vaccines and Adverse Health Concerns
Vaccine Trials & the Use of Placebos
How your doctor is taught to deal with questions about vaccines
Natural immunity vs artificial immunity
Anti-vaccine vs pro-vaccine
Stages parents experience on their journey to understanding vaccines