By Shayna Eliav, MS, RN for COLlive.com
As most of you already know, religious exemptions for vaccination can no longer be accepted in NYS schools. For quite a few families this has drastic implications.
School will begin on Tuesday, but some children whose parents registered them in hopes that the law would be overturned are now at a loss of what to do. Should they homeschool? Should they enroll them in “unofficial” schools which are not enforcing the law? Online programs are popping up—programs which, al kol panim, have no experience providing online education which, from experience, I can attest requires great organization, forethought, and resources in order to be successful. Children are at risk for being in educational environments which are not suited to their needs, because their parents believe that the risks of potential vaccine injury outweigh the risks of taking them out of school. I disagree. Please allow me to share why.
Going back a decade or so, I had a reputation for encouraging women to question everything— especially related to how they approached their pregnancies, childbirth, and caring for their babies—but really it extended to their approach to healthcare in general. I wanted them to think for themselves and make their own choices, to be empowered. While I didn’t overtly include anti-vaccine information in any of my classes or talks, I personally didn’t vaccinate, and was open about that fact to whoever asked me my opinion. I now realize that I likely have a share in the increase of families who chose not to vaccinate. While I still believe that people should make choices they feel are right for their families, the reality is that the choice to vaccinate has real ramifications. For one, it means that kids are vulnerable to disease exposure, and secondly, in the current legal situation, it means that some kids’ lives will be very different than they would otherwise because their parents choose to put their choice not to vaccinate above their children’s educational best interests. I want to talk to you as one parent (and now, a nurse and a midwife) to another parent—to think very carefully about choice. I will share how my thoughts on the topic shifted, and maybe that will help you see things a bit differently, or feel peace of mind.
About 5 years ago I had a child in a startup school which, to put it simply, wasn’t right for him or our family. We were desperate to get him into the school that his older brothers had attended. It wasn’t perfect, but it was stable and we knew what we would be working with. I called and begged for 2 years to try to get a spot for him. Finally, my persistence paid off, but there was just one hitch—the honhola knew that our older kids weren’t vaccinated, and they had changed their vaccination policy for incoming children. Our son had a spot, but only if I gave my word to vaccinate him. I knew at that point what I had to do. I couldn’t in good conscience allow his self-image to be damaged and his educational needs neglected because I had fears about vaccine risks, mostly based on someone I trusted telling me that vaccines might be associated with autism, as well as scary YouTube videos showing children who appeared to have been damaged or killed by vaccines. Whether our son would have some side-effect from a vaccine was a “maybe.” But it wasn’t even a question that staying in the wrong environment was going to have definite side effects.
At this same time, I was in nursing school. I started to develop an appreciation for medicine as the complex art and science that it is. I took care of patients with Hepatitis B, for example, and realized that, indeed, an ounce of prevention is worth a pound of cure. Not everything could be “fixed.” Then I continued onto midwifery school. I learned how to read research, and draw comparisons. I realized that virtually nothing is black and white, that there truly are risks and benefits to basically everything— including doing nothing. In my anti-vaccine years, I saw a zero risk of my child getting any of these illnesses compared to some risk—I didn’t know how great or small—of my child having an adverse reaction. That was an incorrect view. As we have seen recently, these illnesses can and do reappear from time to time. All it takes is reduced herd immunity and a carrier who transmits the disease. I know. My 18 year-old son got the Measles while in yeshiva in Israel this past year.
You see, I had begun vaccinating my younger children for school, but I wasn’t really thinking about the older ones. Yes, I knew about the outbreak, and yes, I told him to go get vaccinated—which he did—but it was too late. The MMR takes about 2 weeks to create antibodies, and the disease take about 10-12 days to incubate, so when he broke out a week after the shot, it was clear that he had been exposed before he ever got the shot, and we had unfortunately missed the boat.
Fortunately, B”H, my son recovered well. But I cannot adequately convey my concern as he called me that Friday morning, languishing in his dorm for the past 48 hours, not able to keep anything down, terribly weak, with a bad cough and a high fever. It was the winter and there were just 5 hours left to Shabbos in Eretz Yisrael. It was the middle of the night for me, and it took me a bit to get with the program, but I “came to” enough to have him check his throat for Koplik’s spots. When he confirmed that he had them, I realized that it was a classic case of Measles. I also realized that he couldn’t stay in yeshiva—not for his sake, nor for others’. Nor could I reach the honhola member who would help me understand what his medical insurance “benefits” we had so cheaply purchased offer him.
But Hashem had our back. My amazingly dedicated sister in law who lives an hour from yeshiva said that he was certainly welcome in their home. Like most people of their generation, my brother and sister in law had received only one dose of measles vaccine which conferred about a 93% rate of immunity. At least no kids were in the home thank G-d. But my brother in law still had to go to work. What if he was one of the unlucky 7% who still got sick (like those in Michigan), and then passed it onto co-workers, the consequences could be devastating if they were also from that 7% minority and happened to have pregnant wives, who are at high risk for preterm labor from measles infection (as happened here in New York), or young, unimmunized babies who are most vulnerable to complications of the disease? Or what if the unassuming taxi driver who took my son from Tsfas to Haifa just trying to make a living became ill (of course I didn’t allow him to take a bus in that condition)? And my sister in law who suffers from diabetes and asthma— pretty high risk for developing pneumonia, G-d forbid. I was staring the potential consequences of my right to make a healthcare choice for my son in the face. It didn’t look good, and it didn’t feel ethical or moral or empowering. I felt stupid and selfish, to be honest. BH, as far as we know, no one else got sick because of our son. Why? One very simple reason: those other people were vaccinated, and were part of the majority for whom it had been effective.
But it doesn’t completely end there. For the next 10 years I will be worrying about the possibility of SSPE (a rare, but real, delayed consequence of measles). You probably think I’m overreacting. Look it up. It’s bad. Hashem yerachem.
I began to realize how close we all are to illness— even if it seems to be far away. It’s a perception that we have, based on subjective information. You don’t know anyone with Hep B or polio so you don’t worry about it. But what if your son decides to go on shlichus in Haiti or somewhere in Central America where they have lots of diseases, including Diptheria and high rates of Tuberculosis? Will you change your mind, or stick to your theory that vaccines are too risky? Will you trust the CDC to check their travel advisory or keep assuming they are corrupt? Did you think about what the level of medical care is in those places or who would care for him if he suddenly became ill, the way my son did? What if he wants to backpack in India where there are still cases of wild polio? Life is long and choices change.
This is true for Hep B too. Although it’s BH mostly not applicable to our community, times are changing. The opioid crisis is at our door. Kids are experimenting, and just this week an email came into my inbox that someone who appears ehrlich and frum, was sentenced for visiting an underage human trafficking victim. What about his wife and kids? There is so much potential for emotional damage there, which is not the subject of this article, but thanks to vaccines, risk of Hep B and HPV don’t have to be part of their painful problem. Even varicella can have devastating consequences—usually not as chicken pox, but later in life as Shingles. About 1 in 3 people who have the varicella virus in their systems develop Shingles. About 2% of those live with long-term nerve pain, and in a smaller number, the virus affects their eye. This happened to my mother. She lost vision in one eye and requires frequent medical care.
None of this means that people don’t have vaccine reactions. They do. I’m not sure we have totally accurate numbers on how many reactions actually occur, and this is certainly a source of frustration for a lot of people who don’t trust vaccines. I understand. But don’t throw the baby out with the bathwater. We know that thousands of lives are saved by vaccines. We know that enormous suffering is prevented. Most things with benefits—just like driving cars—come with some risks. This is life. But we buckle up and we proceed. In theory, with this new law in place, you can still delay your child’s vaccines a bit, space them out, and decline some if you choose (rotavirus and Hep C are examples of recommended but not required vaccines).
You may be surprised how few vaccinations the average school-aged child actually has to get in order to go to school. I can’t tell you the exact risk your child might have of vaccine injury. But I want you to remember that if and when you vaccinate your child, you are giving him or her years (in some cases, a lifetime) of protection against deadly illnesses which are out there. You don’t know what their world will be like in 40 or 50 years when you are gone. You don’t know where they might travel, or who they might encounter, or what choices they might make. Look at the big picture. And look carefully at today too. Does that online or “alternative” school option you are considering really fit their needs? How are they going to feel leaving their friends and being expected to perform in a completely different way? How might that affect your relationship? Kids are so vulnerable today. We can’t gamble with their mental health.
I hope that the story of my own transformation about views on disease, vaccines, and the consequences of our choices as parents has been helpful to you. We are entrusted with a sacred responsibility, and it’s not easy to always know what is right. I further refer you to Simon Jacobson’s informative review of letters from the Rebbe’s Igros Kodesh on the topic of vaccines.
My best wishes to you and your family for a kesiva v’chasima tova. May we all have a year of abundant health and blessings in every area of life.