Shots in the dark: who should decide which vaccinations children receive?

Reason, July, 1999 by Sue A. Blevins

Lyla Rose Belkin was an alert and lively baby at five weeks old. Her parents, Michael and Lorna Belkin, say she had never been sick until she received a mandatory hepatitis B shot on September 16, 1998. "That night she became agitated and feisty," her father recalls. "Then she fell asleep and never woke up." Doctors told the Belkins that Lyla must have died from Sudden Infant Death Syndrome, a catchall diagnosis.

For weeks, Michael and Lorna agonized over what could have caused their daughter's death. They wondered if the hepatitis B vaccination might have had something to do with it. Most doctors scoffed at their question and assured them the vaccine was safe. That's when they began investigating their baby's risk of contracting hepatitis B.

After much research, Michael Belkin says: "It's ridiculous to give this vaccine to a newborn. How is a baby possibly going to get hepatitis B?" Unlike diseases that are transmitted via air and casual contact, hepatitis B is transmitted by direct contact with blood and other body fluids. Those at risk include intravenous drug users, sexually active individuals, blood transfusion recipients, health care workers, and babies born to infected mothers.

Why, then, are government officials making hepatitis B vaccination mandatory for attending day care? Why have 42 states added the vaccine to their lists of immunizations required for attending school?

Since public health officials have failed to reach the high-risk populations, they are making hepatitis B vaccination compulsory for all children, even infants who clearly are not at risk. What better time to force medical care on people than during their first weeks of life, when they are too young to refuse the shots or to complain about side effects? The director of the U.S. Centers for Disease Control and Prevention's Immunization Program has publicly acknowledged that "infants are considered the easiest to immunize."

But what makes sense to the CDC doesn't necessarily make sense to a parent. Michael Belkin, who studied statistics and econometrics at the University of California at Berkeley and consults for some of the largest financial institutions on Wall Street, understands risk-benefit analysis. "Vaccination can be a lifesaver if an epidemic is raging," he says, "but in this case the risk of vaccination outweighs the risk of infants getting the disease. I believe the mandatory policy for hepatitis B vaccination should be completely revoked."

He's not alone. Across the country, parents are discovering that a vaccine of dubious benefit and unknown risk is being foisted on their children without debate. With hundreds of new vaccines under development, the fate of the hepatitis B vaccine is being closely watched. If it is successfully mandated for children in all 50 states, a precedent will be set for other vaccines against diseases that are not highly contagious and that can easily be prevented by abstaining from high-risk behavior.

Vaccine side effects, by contrast, are unpredictable. In January, ABC's 20/20 aired a segment about adults and children who suffered debilitating symptoms after receiving the hepatitis B vaccine. ABC reported that since the federal government began urging routine hepatitis B shots for infants in 1991, at least 274 newborns had died after receiving the vaccination. An additional 2,600 infants had suffered serious medical problems.

It is well established that a small percentage of children will suffer adverse reactions or die from routine childhood vaccines. That's why the federal government established the National Vaccine Injury Compensation Program in 1986. By 1997, the program had awarded nearly $1 billion to more than 1,000 families whose children suffered catastrophic reactions to government-mandated vaccines. For deaths, the awards are capped at $250,000 per death, plus attorney's fees and costs.

The risks specific to hepatitis B vaccination remain uncertain. Before the vaccine was approved by the Food and Drug Administration, researchers tested it in some 650 healthy infants and children up to 10 years old. After monitoring the subjects for five days following vaccination, the researchers concluded that "no serious adverse reactions attributable to the vaccine have been reported." But they conceded that, "as with any vaccine, there is the possibility that broad use...could reveal adverse reactions not observed in clinical trials." The insert in the vaccine package - which parents rarely see - lists a host of serious side effects that have been reported (in less than 1 percent of injections) since then, including arthritis, Guillain-Barre Syndrome, lupus, and multiple sclerosis.

Bonnie Dunbar, a cellular biologist at Baylor College of Medicine, began researching hepatitis B vaccine reactions after her brother developed autoimmune and neurological dysfunction following vaccination. She is investigating whether the vaccine tricks the immune systems of genetically susceptible people into attacking their own bodies. "I have worked in autoimmunity and vaccine development for over 20 years," she says. "After carrying out extensive literature research on this vaccine, it is apparent that the serious adverse side effects may be much more significant than generally known. Because it is not clear that adequate long-term follow-up information was collected in the clinical trial data, many of these effects might not have been observed."