Broadcast Wednesday, October 20, 2004

(CBS) Getting vaccinated against deadly diseases like polio, diphtheria and whooping cough used to be a universal childhood ritual. Every child got the shots, and there were no questions asked.

But now, some parents are asking questions, because they fear that
vaccines can cause diseases like autism. And, as more and more of them
refuse to immunize their kids, public health officials fear that those old
childhood diseases could come back.
 
And now, one has: Whooping cough. At its peak, a quarter million people (most of them children) got it every year and 9,000 died from it.

Then, a vaccine made whooping cough (officially called pertussis) just a
vivid name in history books.
 
But history is starting to repeat itself. Today, there are more cases of whooping cough in this country than at any time in 40 years.
 
Correspondent Dan Rather reports.
 
Most of us have forgotten about the dangers of whooping cough and
what it does to a child. That's why Charlotte Arboleda didn't worry much last
fall, when her newborn boy, her third child, developed a cough and runny
nose.
 
"It's very serious, very serious," says Arboleda. "I could have lost him at home that night, on the changing table, in front of his brother and sister."
 
Although Arboleda's older children got all the usual vaccines, 6-week-old Jordy was too young for the whooping cough vaccine. "When his coughing stopped, he stopped breathing. You know, his lips turned a little blue. And he, he lost consciousness for a moment," says Arboleda, who took Jordy to the hospital, where she watched in horror as doctors and nurses struggled for a week to keep Jordy breathing.
 
Even after he went home, Jordy didn't stop coughing for weeks. But
his case isn't unusual. Most people don't know that so far this year, but
there have been major whooping cough outbreaks in 18 states. One of those
outbreaks happened in Westchester County, a New York City suburb of nearly one million. It caught officials, like health commissioner Dr. Joshua
Lipsman, by surprise.
 
"We normally have only about six cases per year of whooping cough,
or pertussis. Since a year ago, we were up to 120 cases. So that's 20 times
as many," says Lipsman.
 
Public health investigators traced the outbreak to a local school,
with children, Lipsman said, who were not vaccinated. "But then [the
outbreak] spread for a variety of reasons," he adds. "I think that part of
our problem has to do with the fact that kids are not getting adequately
vaccinated."
 
A new study shows that's true, and it found something surprising.
 
The study, which was published in July in the medical journal "Pediatrics,"
found that non-vaccinating parents tend to be married, have college
degrees, and higher annual incomes; in other words, people who know about, and have access to, vaccines.
 
This trend worries Dr. Lipsman. Vaccines are not 100 percent effective, so even people who have been vaccinated are at risk from those
who aren't.
 
"If that takes off and we fall below the minimum percentage of the
population that needs to be vaccinated in order for all of us to have the
benefit of vax - what we call herd immunity - we'll begin to see
outbreaks, much bigger outbreaks of these vaccine-preventable diseases," says Lipsman.
 
Parents cite several reasons for not vaccinating their children.
Many think vaccines aren't necessary any more, because the diseases they
prevent are rare in this country. Others believe children should develop "natural
immunity" to disease, instead of with vaccines.
But most believe vaccines, or the mercury-based preservative once
used in some vaccines, can cause diseases like autism, diabetes and multiple
sclerosis -- diseases that have increased in recent years.
 
Many anti-vaccine parents believe the medical establishment, in
collusion with the government and vaccine-makers, is hiding these dangers
from the public.
 
"I don't trust these doctors. I don't trust a lot of the medical field," says Debra Alvo, one of a group of mothers who don't like the idea of vaccinations. Her 2-year-old son has never gotten any shots.
 
"I don't mind if he gets measles. I don't think it's a killer disease as they're touting it to be. No, I feel like my son Julian has a really strong constitution, and if he got something, you know, I would deal with it then."
 
During the country's last big measles outbreak, in 1989, 55,000 got
the disease and 123 died. That's one out of every 500 cases.
 
Arlen Boltax is expecting her third child any week now. She fears
any vaccines could permanently disable her baby.
 
"I usually don't say much because it's, you know, they have their
perspective and that's the training that they receive from their medical
school," says Boltax. "I'm not a scientist. I'm not a doctor. I just feel
that I'm doing what's best for my children."
 
Mary Ellen Donahue has two children. Her youngest was diagnosed with
a form of autism after getting vaccinated. "My feeling is that the diagnosis
of autistic spectrum disorder is a result of something in the shots," says
Donahue. "It could be the mercury, or it could be that it weakened his
immune system."
 
Does she believe that there is a relationship between vaccines and
autism - at least in some children? "I definitely believe that there are
certain children that are susceptible," says Donahue.
 
Many parents get their beliefs about vaccines and autism from
controversial studies like one conducted by British scientist Andrew
Wakefield in 1998.
 
Wakefield, after studying only 12 children, said the measles vaccine
might cause autism, and urged parents not to give their kids the vaccine.
That caused a panic in England. Vaccine rates dropped, and measles cases
rose.
 
But last February, the editors of the journal Lancet, which first
published Wakefield's study, disavowed it. They learned that Wakefield was
paid by lawyers planning to sue vaccine makers while doing the study.
And a study of more than 530,000 Danish children found that those
who didn't get the measles vaccine were just as likely to get autism as
children who were vaccinated. The study was published in the New England Journal of Medicine in November, 2002. It looked at 537,303 Danish children, and found that "the risk of autism was similar in vaccinated and unvaccinated
children."
 
That, along with other studies, lead most scientists and doctors to
say fears about vaccines and autism are not based in fact.
 
"I'm prepared to say that vax don't cause autism," says Dr. Paul
Offit, one of the country's leading researchers into vaccines for
children.
 
"When you choose not to get a vax, you're not going to lower your risk of
autism. All you're going to do is increase your risk of getting a severe
and potentially fatal infection."
 
And he believes that the studies support it.

This debate is all in a day's work for Dr. Lisa Thebner, a pediatrician in a large Manhattan practice. She says many parents ask questions, but "there's a small percentage who, even having those concerns addressed still seem to have a fear of vaccines and want to withhold them."
 
When parents tell her that they don't want their children vaccinated, what does she say? "I tell them that it is their responsibility," says Thebner. "If they are thinking about not immunizing their child, that they must do the homework. That there's too much info for them to just base their decision on gestalt, on rumor, on hearsay or on anecdotes."
 
Thebner shows parents the key scientific studies, which say vaccines
are safe, and protect both individuals and society as a whole. But that
doesn't convince some parents. "At that point, I say, 'I don't think that
we're philosophically then in alignment in terms of how we would perceive
the care of our children,'" says Thebner. "I would encourage them to
choose another pediatrician."
 
The most prominent organization claiming vaccines are unsafe is the
National Vaccine Information Center, or the NVIC. Barbara Loe Fisher, who
referred 60 Minutes to the parents mentioned in this story, heads the
group.
 
"The mass use of multiple vaccines in early childhood to prevent all
infections is the biggest medical experiment that has ever been conducted
on the human race. And I think the jury is still out as to whether or not it
will be medical science's greatest achievement, or its most tragic
failure," says Fisher.
 
But hasn't wiping out the killers of children with smallpox and
polio been a great benefit to our society - and the world? "Whether or not,
because we have done that and saved the world from those two diseases, it
is biologically wise to prevent all infection in childhood, is an outstanding
scientific question that has yet to be answered," says Fisher.
 
Her group operates out of modest offices in a strip mall in Vienna,
Va., near Washington. But the NVIC's reach is global. Its widely read Web
site questions the safety of virtually every vaccine commonly given to
children.
 
"When I talk to doctors and research scientists, they say there is
no scientific evidence to support that there's a cause-and-effect between the
vaccines and the rising numbers of these other problems," says Rather.
"That science has not been done, because those who hold the money in
this country for research, government and the pharmaceutical industry, are
not allowing those studies to be conducted," says Fisher.

But 60 Minutes found nearly 900 studies, and more than 4,000 articles on vaccine safety in medical and scientific journals just since 1990.
 
"If they were willing to look at all the studies that were done with
vaccines, they would find that they are, I think without question, the
safest, best-tested thing we put into our bodies," says Offit. "I think
they have a better safety record than vitamins, a better safety record that,
than cough-and-cold preparations, a better safety record than antibiotics."
Offit immunizes his own children and he says he's dismayed by the
growing number of parents who won't.
 
"When I see children come in with serious and occasionally fatal
illness that is preventable, it just, it really breaks my heart. And I
don't know any other lesser way to say it, other than to say that if more people
choose not to get a vax, then what will happen is these diseases will come
back," says Offit. "And it's just a very high price to pay for a knowledge
that we should already have in hand."
"Health is not just the absence of infectious disease. Health is also the absence of chronic disease," says Fisher. "And the argument is, could mass-vaccinations be a co-factor in the rise of chronic disease and disability?"
 
"I think questioning vaccines is perfectly reasonable. But I think
that when one looks at the data, and sees that vax are safe and effective
and...still...says, 'Well, I think there's a conspiracy to sell vaccines'
or 'I think my doctor's lying to me,' I think that's when you cross some sort
of critical line," says Offit. "What I'm asking is that people trust their
experts. And that's sort of a hard thing to politically accept."
 
This is more than an academic debate to mothers like Charlotte
Arboleda. When asked what she would tell parents who believe vaccines
against childhood diseases are no longer necessary, she said: "If the
could have seen my baby in the hospital at six weeks old, I would tell them 'you need to know how that feels. You know, this is preventable. There's no
reason for him to have gotten that sick.' They should feel that, and then
decide."
 
While all states still require some vaccinations for school-age
children, many now give exemptions to parents who don't want their
children immunized.
 
The pertussis, or whooping cough, vaccine, in conjunction with
diphtheria and tetanus vaccines, is given in a series of four shots to
infants between the ages of 2 months and 18 months. But the pertussis
vaccine tends to lose effectiveness after about 10 years. This means
children vaccinated as infants are vulnerable to whooping cough when they
reach adolescence. They may retain some residual immunity, and they're
much stronger than infants, so cases in teenagers are likely to be much less
serious.
 
The FDA is considering licensing a whooping cough "booster" vaccine
for teenagers that would protect them for many years. Pediatricians will
have the latest information on this vaccination