Exposure to unvaccinated children

Ask The Doctor:
Exposure to unvaccinated children...

I have a 10 month old little boy.  My friend has a little boy who is 13 months old.  Of course our boys spend a lot of time together even though they do little more than look at each other while chewing on whatever they can find. A few days ago, my friend told me she is planning on foregoing vaccinations for her child.  I know this is a personal decision.  However, my son will continue to have his vaccines.  Should I limit play dates since she's not getting her child vaccinated or should I nor worry about it?

First let me say that I appreciate your decision to have your child vaccinated as recommended by the American Academy of Pediatrics and the Center for Disease Control.  Regarding your 10 month old son, you should understand that while most children develop complete protection from the conditions for which they are vaccinated, some individuals do not.  There are some children that do not respond as well as we would like to our vaccines and only develop partial or no protection to these illnesses.  When the community is fully vaccinated these same children with incomplete immunity are protected because everyone they are surrounded by should be disease free.  This therefore this keeps the under protected child safer because they will be less likely to be exposed to those illnesses. This is the so-called “heard immunity” effect.  Also be aware that there are increasing numbers of parents that have decided not to have their child immunized based on unfounded believes that the vaccines are harmful, and they selfishly hide within the “herd” hoping to not be exposed to these illnesses.  Currently, 50% of 13-month-old children in Tennessee have not received their first MMR vaccine and 15% are incompletely protected against whooping cough and bacterial meningitis.  As a result measles rates are skyrocketing and we are seeing more pertussis now than we did in the 1950s.  People forget that one out 1000 children will die from measles, one of 1000 with measles will develop encephalitis (brain infection) with permanent neurologic deficits, and one out of 100 infants who come down with pertussis will die from their illness.

Parents will always have different priorities when it comes to the safety of their children.  From organic foods to fireworks, and from guns in the home to vaccinations; it is absolutely within your right to make decisions regarding what you believe is safe for your child.  I with personally would not want to tempt fate by exposing my child to unvaccinated children.  This is one of the reasons I do not care for children in my practice whose parents have made the same decision.  Doing so would not only encourage that decision, but also expose patients in my practice to potential life threatening infections.