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This shows how recuevung vaccinations can more than double you chances to receive multiple other diseases or health problems.

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A complete overview of why parent are hesitant to vaccinate children.

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Abstract

Parental refusal of vaccines is a growing a concern for the increased occurrence of vaccine preventable diseases in children. A number of studies have looked into the reasons that parents refuse, delay, or are hesitant to vaccinate their child(ren). These reasons vary widely between parents, but they can be encompassed in 4 overarching categories. The 4 categories are religious reasons, personal beliefs or philosophical reasons, safety concerns, and a desire for more information from healthcare providers. Parental concerns about vaccines in each category lead to a wide spectrum of decisions varying from parents completely refusing all vaccinations to only delaying vaccinations so that they are more spread out. A large subset of parents admits to having concerns and questions about childhood vaccinations. For this reason, it can be helpful for pharmacists and other healthcare providers to understand the cited reasons for hesitancy so they are better prepared to educate their patients' families. Education is a key player in equipping parents with the necessary information so that they can make responsible immunization decisions for their children.

INDEX TERMS: parental refusal, personal beliefs, religious, safety concerns, vaccine hesitancy

INTRODUCTION

"Vaccine hesitancy" is a relatively new term used in research over the past few years to describe anyone who is doubtful about vaccinations or who chooses to delay or refuse immunizations even when they are readily available.1,2 Vaccines play a vital role in preventing diseases in children, so it is crucial that pharmacists and other healthcare professionals understand the reasons that parents are hesitant or refuse to vaccinate their children. Although there are no federal laws regarding vaccine administration, each state has laws in place dictating which vaccinations are required for children prior to entering schools.3 All 50 states allow medical exemptions for certain patients, such as those who are immune compromised or allergic to various vaccine components. Additionally, there are 30 states that allow exemptions for children whose parents cite religious reasons and 18 states that make special accommodations for those expressing philosophical reasons.3 States that have more lenient laws on vaccination requirements also have an increased rate of exemptions granted; this can lead to greater vulnerability in the population in terms of contracting preventable diseases.4

There have been a number of studies examining the reasons why parents refuse, delay, or are hesitant to vaccinate their children ( Table ). In one such study,5 77% of parents polled reported having concerns about one or more childhood vaccinations. Reasons expressed by parents vary widely but can be classified into 4 overarching categories. These categories are religious reasons, personal beliefs or philosophical reasons, safety concerns, and a desire for more information from healthcare providers. The purpose of this article is to equip pharmacists and other healthcare providers with an understanding of the most heavily cited reasons that influence parents not to vaccinate their children. This will better enable healthcare personnel to provide the education and awareness that patients' families need to make responsible immunization choices.

Table.

Table.

REASONS FOR VACCINE HESITANCY

Within each of the categories described above parents present a spectrum of compliance with vaccination, including delaying vaccinations, only refusing certain ones, or refusing immunizations completely. Religious reasons tend to account for the majority of total vaccine refusal, while parents with personal beliefs against immunization tend to be more willing to compromise and at least partially vaccinate their children. Parents are concerned with doing the best for their children, and hearing reports of potential safety issues or that childhood diseases are not a large threat can hinder them from vaccinating their children.

Religious Reasons

One of the most common reasons parents offer for choosing not to vaccinate their children stems from their religious beliefs. With only 4 states not offering exemptions to families for this reason, it poses a major obstacle to those seeking to increase childhood vaccination rates.3 Religious reasons are distinct from other cited reasons in that they are generally linked to the core beliefs of the parents, and it is very difficult to dissuade these individuals from views against immunization. These choices are not the by-product of ignorance but rather the intentional and calculated decision related to a staunch conviction. In addition, in contrast to other cited reasons for hesitancy, those driven by religious assertions most often are linked to a complete refusal of all vaccines.2

Imdad et al6 conducted a study in New York State and found that the rate of school vaccination exemptions due to religious reasons between 2000 and 2011 increased sharply. In response to this reality, lawmakers put in place guidelines that introduced requirements that mandated that in order for schools to grant religious exemptions, the parents had to demonstrate their "genuine and sincere religious belief" that contradicted the use of vaccinations.6 These burdens of proof are likely to become more popular as an increasing number of parents attempt to use the nebulous loophole of religious freedom to bypass the societal necessity of combating preventable diseases through immunizations. The authors6 further discovered that the counties that had higher exemption rates, ≥ 1%, also had an increase in reported pertussis cases, 33 per 100,000 compared to 20 per 100,000 in counties with lower exemption rates.

Wombwell et al7 evaluated different religions and the reasons that vaccines may violate their religious tenets. The explanation most commonly offered for why specific vaccinations oppose religious tenets involves components of the vaccines.7 The animal-derived gelatin used in producing some vaccines as well as the human fetus tissue used in the rubella component pose the largest concerns.7 By understanding the objections that large portions of the population hold, monies may be strategically targeted for research that can address these concerns and render vaccinations more acceptable for these groups.

Personal Beliefs or Philosophical Reasons

Another common reason that parents give for refusing or delaying vaccinating their children is personal or philosophical reasons. Although only a handful of states allow exemptions for this cause, it must be carefully studied, as it may present opportunities for practitioners to enlighten parents regarding the urgency of protecting the children through preventive measures. Though it seems contrary to human intuition, there is a group of people who see some benefit in having their children contract certain preventable diseases.8 Some parents believe that natural immunity is better for their children than is immunity acquired through vaccinations.8 Others express the belief that if their child contracts a preventable disease, it will be beneficial for the child in the long term, as it will help make the child's immune system stronger as he grows into adulthood.8-10 Some parents believe that the diseases for which we vaccinate are not very prevalent so their children are at minimal risk of contracting these diseases. For this reason, they also believe that the possible negative side effects of vaccine administration outweigh the benefits of the vaccines.9 Many parents do not see the preventable diseases as serious or life-threatening and would prefer to not put extra chemicals into their children's bodies.8,9 Other parents think if their children have healthy diets and lifestyles they are at a decreased risk of contracting preventable childhood diseases. They also are under the assumption that if they were to contract one of the diseases that it would be easily treatable.10

Safety Concerns

A third, and potentially the greatest, reason parents express for refusing vaccinations for their children are concerns about the safety of vaccines. Most of these concerns are based on information these parents have discovered in the media or received from acquaintances. Regardless of whether the stories stem from television, the Internet, radio, or from family and friends, parents are constantly bombarded with other peoples' opinions about vaccinations.2,8,10 All of this information can be overwhelming for some parents to sift through, making it difficult for them to make their own well-informed decision.8,10 Many of the reports and opinions that bombard parents and cause uncertainty are targeted at the safety of vaccines. They raise doubts about both short-term adverse reactions and the possibility of long-lasting negative effects.2,5,9,10 It is these concerns about safety that can cause parents to completely refuse vaccines.

Fredrickson et al8 found that the most commonly reported reason parents had for refusing one or more vaccines was other people or media reports. Stories in the popular media, such as social media and large-scale news outlets, are often sensationalized to elicit higher ratings and oftentimes spotlight a rare incident in which a child suffers as a result of an unforeseen side effect of a vaccine. Media that cite problems with components of vaccines (such as thimerosal) and report that vaccines can cause autism, brain damage, or behavioral problems cause parents to be more cautious and have more concerns regarding the safety of vaccines.2,5,8-10 Thimerosal, however, has been removed from those vaccines intended for children under 6 years of age for over a decade now.11 Accounts noting these rare occurrences breed fear in the hearts and minds of parents, who overestimate the dangers associated with vaccinations. Some fearful parents balk at the timing of immunizations. Fear can influence some parents to choose to delay vaccines so their child does not receive more than one vaccine at a time.9 They fear that simultaneously administering multiple vaccines may overload their child's immune system, and they think that allowing all of the vaccinations to occur according to the recommended schedule will make the safety risk greater. As a result of this logic, many choose to delay vaccines in order to better protect their children.9,10,12,13 While some may view this as a missed opportunity, others believe that a delayed vaccination schedule is superior to not receiving vaccinations at all. Many parents believe the side effects of vaccines are more extensive than what they are told by their physicians and that the risks outweigh the benefits of vaccinating their children.9,10 Healthy relationships between a practitioner and parent can go a long way toward helping patients in terms of this concern. Trust is paramount and will help put parents at ease and help them overcome unmerited fears.

Desire for Additional Education

The fourth common thread is that parents want more information regarding vaccinations. They want to be able to make informed decisions about their child's healthcare by knowing both the benefits and risks associated with each vaccine.9,10,14 In a study conducted by Gust et al,14 approximately one-third of parents indicated that they did not have enough access to sufficient information, and the majority of those parents did not think their child's provider was easy to talk to. Many parents desire to have more detailed information regarding the side effects and benefits associated with vaccines expressed in a factual way that does not appear to be trying to sway them one way or the other regarding vaccinating their child.8,10

A vital role pharmacists and other healthcare providers can play would involve the provision of unbiased, factual information relating to vaccines as well as the discussion of these materials with the parents.1 There are a number of resources online, including the Centers for Disease Control and Prevention and American Academy of Pediatrics Web sites, as well as print resources that can be provided to parents. Parents want to be able to have open conversations with their child's healthcare provider in which they do not feel judged or attacked.2,8,9 Parents would like to have the freedom to be able to ask questions without judgment. Physicians are one of the most important sources of information for parents who are making decisions about their children's healthcare.2,8,10 In a study conducted by Kennedy et al12 noted that 81.7% of parents said their child's healthcare provider was one of the most important sources of information. When parents do not get the information they want from their providers they seek information from other sources that can potentially mislead and misinform them, causing them to make poor choices for their children.8,10

DISCUSSION AND CONCLUSIONS

If pharmacists and other healthcare providers are able to understand the main concerns parents have about vaccinating their children, they can be better prepared to have informative conversations about immunizations. They will also be able to provide the information parents need to make the best-informed decisions for their children. Parents who are hesitant to vaccinate or who refuse vaccines care about their children and want to do what they can to protect them, just like any other parent. It is important for practitioners to have open and frank conversations with their patients and their families so that the families will understand the benefits of vaccination without feeling attacked or judged for having questions about their child's healthcare.5,8,9

Education and taking time with patients have been shown to result in modest improvement in terms of affecting parents' attitudes about immunization, but the exact messages or tools for healthcare providers should use have not been fully discovered.15 Understanding the source of parents' questions can equip pharmacists, physicians, nurses, and other healthcare providers to speak with patients on a more relatable level and to speak to the areas parents value the most. All healthcare workers should make an effort to stay up to date on the recommended vaccines and to understand why those immunizations are recommended. This information will allow patients to have face-to-face access to reliable information that can help them to make the best decisions for their families. Additional research aimed at evaluating how practitioners can better provide information to parents to help them see the importance and benefits of vaccinations needs to be conducted.

Acknowledgments

At the time of publication, Kristin Bohannon was a Doctor of Pharmacy candidate at Texas Tech University Health Sciences Center School of Pharmacy, Abilene, Texas.

Footnotes

Disclosures The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria.

Articles from The Journal of Pediatric Pharmacology and Therapeutics : JPPT are provided here courtesy of Pediatric Pharmacology Advocacy Group

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Exploring the Reasons Behind Parental Refusal of Vaccines

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Parental refusal of vaccines is a growing a concern for the increased occurrence of vaccine preventable diseases in children. A number of studies have looked into the reasons that parents refuse, delay, or are hesitant to vaccinate their child(ren). These ...

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Some people can be affected by different vaccinations in different ways. This article lists almost all of the different vaccinations and the effects it can have on different people/different groups of people

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The schedule of children’s vaccinations from birth through high school

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Some religions do not allow vaccinations 

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Some religions do not allow vaccinations 

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A few religions do not allow vaccinations and this article mentions some problems people of those religions may face and mentions why they feel vaccinations shouldn’t be apart of their religion.

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Vaccination is considered to be one of the greatest public health achievements in the 20th century, which has helped to build a society free of vaccine preventable diseases and save lives of millions children across the globe ( 1). However, in the 21st century, pediatric practice in the western world witnesses an era of vaccination refusal ( 2). Pediatricians, infectious disease experts, and public health professionals ask themselves why and how "the greatest achievement of public health" became a medical procedure that frightens parents across the globe. Many parents are seeking a legal way to avoid vaccinating their children. The legal systems of some countries predict legal vaccination exemptions. One of the most usual reasons for exemption are medical reasons, followed by the religious, social, and philosophical reasons (personal belief, conscience objection) ( 3- 7).

2013 and 2015 were marked by an outbreak of vaccine-preventable diseases such as measles and pertussis ( 2, 8- 11). These events triggered a worldwide debate regarding vaccination and legal exemption of vaccination and its possible consequences such as social distancing, exclusion from school during a disease outbreak, absence from work, etc ( 12, 13).

Religion influences decisions on vaccination ( 14- 16), and religious objection is often used by parents as an excuse to avoid the vaccination of their children ( 5, 17). Some studies show that the number religious exemptions has been increasing ( 18), leading to vaccine preventable disease outbreaks ( 10) such as mumps outbreak in a protestant orthodox group in The Netherlands. Shrivastwa et al ( 19) found religion as predictive factor of children's vaccination status in India. Compared to Hindus, Muslim children had greater chance of being under-vaccinated or unvaccinated compared with the vaccinated children.

In this article we would like to explore whether different religious beliefs are, in itself, real exception for vaccination or they are just a parents' excuse to avoid vaccination.

The view of Catholicism

The most morally questionable issue regarding vaccination in Catholicism is using cell lines derived from a voluntary aborted fetus. The Moral Reflection On Vaccines published by the Pontifical Academy for Life ( 20) suggests that these vaccines should be avoided and proposes a search for alternatives. The examples of such vaccines are cell lines WI-38 (Winstar Institute 38) and MRC-5 (Medical Research council 5), several live vaccines against rubella (Meruvax, Rudivax, M-R-VAX), and vaccines against hepatitis (A-VAQTA and HAVRIX), chicken pox (Varivax), smallpox (AC AM 1000), and poliomyelitis (Polivax) ( 20, 21). In the case where no alternative vaccine is available, the use of the existing vaccine is morally acceptable in order to avoid serious risks for children and for the whole population (especially pregnant women). The moral acceptability of using this vaccine should be comprehended as "passive material cooperation" and "active material cooperation" too, which is cooperation with immoral action without evil intention, permitted only in the case of " extrema ratio," that is in the case of extreme situations such as saving the lives of children. The document also suggests to parents to oppose participation in such medical procedures by their appeal by "objection of conscience" or to seek alternative sources of effective vaccines. Besides this document, the Catholic Church's Magisterium discusses bioethical issues with respect to forbidden sources of human biological materials in two further documents. Dignitas personae ( 22), n. 34-35 speaks of the illicit origin of human sources of biological material, founding its opinions on the dignity of the person, emphasized in the documents Donum vitae ( 23) (I, 4) and Evangelium Vitae ( 24). In the case where ethically acceptable sources of vaccines are not available, it is necessary to weigh the vital importance and the risk of no vaccination. In these cases it becomes also allowed to use, even the, "morally inadvisable" vaccines ( 21).

The Catechism of the Catholic Church ( 25) does not cover the topic of vaccination directly. Indirectly, there are a few canons that could be applied to vaccination issue. The Church recognizes the ability of human intellect to meet the God (canon 39), which is the foundation for the dialog with other religions, philosophy, and science. The canons 1939-1943 emphasize the virtue of solidarity in the world. By spreading spiritual values, the Church has throughout the centuries helped to create better social and cultural conditions for living among different nations. Catholicism should emphasize the importance of taking the risk of side effects of vaccination to strengthen solidarity with other humans. By taking this risk, people participate in the protection of the entire society, including those who cannot be vaccinated because of medical contraindications or have been vaccinated but without adequate immunogenic response ( 20).

Orthodox view

To clarify the Orthodox view on the vaccination process, we chose the example of Russia, a country where the orthodox religion is the leading religion and where historical perspective plays a special role in public, social, and cultural life. The Russian Orthodox Church absolutely acknowledges that vaccination is the main way to achieve progress. However, according to official statistics in Russia, annually 3%-5% of the population refuse to be vaccinated.

Refusal of vaccination and its causes cannot be clear without being familiar with the history of the anti-vaccination lobby. This history begins in 1988 with the article "Well, You Will Think, That It Is Only a Prick?" ( 26). This article claims that vaccination is not just a prick and that it causes serious complications. At present, the tribune of the anti-vaccination movement is the internet, which can provide access to the general population without demanding a true scientific assessment of efficiency and risks of vaccination. One of the motives used by opponents of vaccination is speculation in religious beliefs. Recently the anti-vaccination movement began to spread actively in monasteries, churches, and through a video production. An essentially medical question became "a bone of contention" among the believing people.

This all prompted the official Russian Church to issue an opinion about the topic of vaccination. In September 2008, the department of church charity and social service, the Synod organized a round table "Vaccine's Prevention of Paediatric Problems and Ways of Making the Decision" ( 27, 28). The Synod's final document states: "Vaccination is a powerful tool of prevention of infectious diseases, some of which are extremely dangerous. In some cases inoculations really cause complications that are most often connected with violation of the rules of vaccination, such as its use on weakened children." The Russian Orthodox Church condemned anti-vaccination promotion and forbade the distribution of anti-vaccination literature and audio-video material in its monasteries and temples ( 29).

The position of orthodox doctors and philosophers was reflected in the statement of Church Public Council on Biomedical Ethics of the Moscow Patriarchy and in the statement of the Department of Church Charity and social service of the Moscow Patriarchy and the Ministry of Health and Social Development of the Russian Federation ( 30). These documents unambiguously state that vaccination is a necessary modern measure of infectious diseases prevention, the refusal of which can lead to serious consequences.

At the same time it was noted that some aspects of vaccination demand additional attention. The Russian public has shown concern regarding vaccines against rubella, hepatitis A, and chicken pox, which are produced from the diploidic cells from aborted embryos. There are alternative (so-called "ethical") rubella vaccines received from the cellular line of a rabbit (Japan), hepatitis A vaccines, made from the cellular culture of the monkey (Vero, Japan). However, application of these vaccines is only beginning and it is not widely available, so the diploidic vaccines against these diseases are mostly used.

Protestant view

In Protestantism, there are various denominations without a supreme leading moral figure, such as the Pope in the Catholic Church. Protestantism accentuates individual freedom and gives parents the right to decide whether to vaccinate their children or not. According to Ruijs ( 16, 17), Orthodox Protestant parents who refuse vaccination on religious grounds ( 17) claim that vaccination is an act of interfering with divine providence. Those who actually vaccinated their children consider the side-effects of vaccination as a God's sign that they made a wrong decision. On the other hand, pro-vaccine parents believe vaccination to be a gift of God ( 17). Rujis also found that the religious leaders from the same denomination had different standpoints on vaccination: some do not address the topic of vaccination because it is generally accepted, the others deliberately leave the choice to the members of their congregation, and the third address the negative connotation regarding vaccination in their religious work ( 16).

Jewish view

Israeli legislation has been traditionally influenced by religious law in the matters of birth, marriage, and death. However, Jewish theology tells us nothing explicit about today's medicine. Vaccination was unknown in Biblical and Talmudic times, but methods for preserving health and life, particularly cleanliness, were known. God made the man not only to His physical image and likeness, but to His mental image and likeness. When God commanded mankind to "be fruitful and multiply," He left it up to people to decide how to do this. It is clear, however, that we cannot be fruitful and multiply unless we are healthy. We must use our minds, our power of thinking to decide how to preserve our health. These were the seeds of preventive medicine. We use the intelligence that God gave us to go beyond the raw nature which God created, and to preserve the health which we need to obey His commandments. Vaccination is one of the practices we developed from these seeds. It should be considered in the sense of Pikuakh nefesh - the act that saves lives ( 31), or the protection of the children and neighbors.

The distinguished religious Jewish organization, the Orthodox Union "strongly urges all parents to vaccinate their healthy children on the timetable recommended by their pediatricians" ( 32).

Although the Israeli law does not require vaccination, the government is trying to exercise pressure by denying child allowance payments to parents who do not vaccinate their children. This step has attracted opposition on the grounds of interference with individual rights. It is, however, not a matter of parents' rights, but of the children's right to health. The controversy has not yet been settled ( 33). When children are concerned, and serious risks to health or life are involved, it is irresponsible to ignore the almost universal weight of medical opinion. Children should be vaccinated, as almost all Israeli parents agree with it ( 34).

Islamic view

The Qur'ān and the Islamic tradition forbid the use of certain food - haram (pig flesh). Other animals are licit - halal - depending on how they die ( 31). This problem is reflected in medicine regarding the use of gelatin in medical products. If gelatin is derived from halal animal it is permissible to use it. If someone finds him or herself in a situation where there is no halal alternative, the person is not guilty of using no- halal option based on the "law of necessity." The vaccines are important for medical purpose, not for diet, therefore haram ingredients could be permitted (transformation of haram components to halal products). According to Islamic tradition, vaccination serves to protect life, to respect the principle of preventing harm ( izalat aldharar), and public interest ( maslahat al ummah). Vaccination protects others, which is why the law of necessity should be considered. It has a purpose in prevention, therefore its components cannot be judged as a diet ( 31).

Buddhist view

Buddhism claims that life is one, which means that all forms of life are essentially related to one another and share a common essence. Even though there are different expressions of life, their lives are basically the same and they only differ in their external forms of being. Buddhism also believes in the Wheel of Rebirth, meaning that all forms of life will be reincarnated according to the karma they accumulated while living. Someday, in the process of reincarnation when all karma has been completely exhausted, the wheel of rebirth can be stopped. In order to reach this Nirvana, every Buddhist must carefully observe the 8-fold Path and the Ten Precepts that help prevent any accumulation of karma. These precepts include: not taking life, not stealing, being chaste, not lying, not drinking intoxicants, etc ( 35). The first of the five precepts in Pali reads as Panatipata veramani sikkhapadam samadiyami meaning that "I undertake the training rule to abstain from taking life." Here the word pana refers to any living being that has breath and consciousness.

The Mahayana Brahajala Sutra explains the first precept in this way: "A disciple of the Buddha shall not himself kill, encourage others to kill, kill by expedient means, praise killing, rejoice at witnessing killing, or kill through incantation or deviant mantras. He must not create the causes, conditions, methods, or karma of killing, and shall not intentionally kill any living creature" ( 36, 37).

Modern Buddhists will generally use vaccines to make sure their health is protected. But according to the essential teaching of Buddhism, if the vaccine is derived from any life form its use is debatable. The first of the Ten Buddhist Precepts is "not taking life." However, early Buddhism was never confronted with the question whether a fetus is a life form. Buddhism basically forbids any act that will lead to the destruction of any potential life. Therefore, Buddhism requires its followers to treat all life kindly ( 38).

On the other hand, Buddhist biomedical researchers who experiment on life forms believe that the purpose of biomedical research is to save rather than to sacrifice life. Buddhist biomedical researchers do the experiments for the love of life, for instance, they experiment on the donated tissues or samples, thereby accumulating no bad karma. The modern view of Buddhism will stress the importance of saving life rather than taking life ( 39). Generally speaking, Buddhist teaching is rather conservative in terms of using any life form to create vaccine.

Japanese view

There have been many religious forms in Japan. However, Japanese people do not have a clear belief system called "religion." So that "Japanese religion" means "Japanese metaphysical common sense." This metaphysical sense has been formed by integrating and mixing Buddhism, Taoism, and Confucianism, based on the indigenous Shinto ( 40- 42). Here "metaphysical" means "a way of seeing or thinking of the universe or the total reality," which is the core of religion. Religious forms are various, but their metaphysical core is consistent.

The universe for Japanese people is a moving network of various relations of things and actions, like an infinite living system. They believe in an unknowable and willful entity reflecting the universe like a virtual focus in a mirror, which has been called Kami (gods), Hotoke (Buddha), or Ten (Heaven). This mysterious entity orders and gives people the whole necessary connections of universe, which is called Michi (Tao or Way) or Ri (Logos or Ratio). Based on their religious common sense background, Japanese people accept all relations of things and actions as they are and feel very familiar with everything relating to them. Moreover, with gratitude, they hold memorial services for used tools or for sacrificed laboratory animals ( 43). Therefore, they tend to reject all biomedical practices, technologies, or effects considered as unnatural. This is very obvious in the case of organ-transplant and vaccination. This "unnatural" implies the complex feelings of certain deviation or excess from the standard course of things.

Since Meiji Revolution (1868), Japanese people have basically acknowledged modern biomedicine, and they have gradually accepted vaccination as its symbol. In 1948, new Japanese government made vaccination mandatory. Thus, after 1962, vaccination has been practiced collectively and compulsory. But, in 1994, it was suddenly proclaimed optional under the pressure of the public taking side effects as dangerous.

Concluding remarks

Vaccination refusal among the parents of pediatric population is emerging globally, regardless of religious or political background or geographical location. In many countries legal systems advise how to react to vaccination refusal ( 44). For example, in Croatia vaccination is mandatory, the law is clear, but the practice of vaccination and the court judgments are not standardized. The legislators are unlikely to enact legal limitations of religious or philosophical exemption ( 4, 5).

The number of vaccination refusals based on religious exemption is increasing. The question is whether religious freedom is a threat to public health, in this case to the vaccination system ( 45).

There are many publications regarding the religious exception of vaccination ( 6, 14, 15) based on the rights of religious freedom. Most of these publications refer to religious exemption for immunization. However, religion can provide perspectives on vaccination that are rarely used in debates on this topic. For example, the notions of solidarity, risk sharing, or taking the risk of vaccination for those who cannot be vaccinated because of medical contraindication or because of their conditions.

Although in this paper the authors did not cover all religions, they reflect on religions and social environment of the society which they come from. The majority of religions respect life as a basic value and therefore oppose the use of vaccines derived from aborted human fetuses (Catholicism) or any form of life (Buddhism). But if these vaccines serve to protect many more lives they are permitted. Regarding this, we should not consider vaccination opposed to the theological base and values. Following this idea, religion is not in contradiction with vaccination and public health. It is only individual parents or religious leaders and their questionable interpretation of religious practices that are opposed to vaccination, no religion as such. In order to protect vaccination from the questionable religious interpretation we should bring closer to the public the basic theological perspective. The society of the 21st century, just as many societies and cultures in the history of human civilization, use religion as an excuse for wars, discrimination, and now for vaccination refusal. The question is whether the public is aware of the teachings of their religion on these issues. One of the first steps in resolving the situation should be the appropriate communication ( 46- 48) to illuminate the essence of theological perspectives regarding vaccination.

References

34. Leavit F. Personal observation.

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Religious exception for vaccination or religious excuses for avoiding vaccination

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Vaccination is considered to be one of the greatest public health achievements in the 20th century, which has helped to build a society free of vaccine preventable diseases and save lives of millions children across the globe ( 1). However, in the 21st century, pediatric practice in the western world witnesses an era of vaccination refusal ( 2).

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This shows which religions are okay with vaccinations and which religions do not allow it

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Most religions have no prohibition against vaccinations, however some have considerations, concerns or restrictions regarding vaccination in general, particular reasons for vaccination, or specific vaccine ingredients. Below is a list of the current position of some of the more common religious faiths.

Buddhism - Buddhism has no central authority that determines doctrine. Vaccination is widely accepted in predominantly Buddhist countries.

Christianity - The Christian faith consists of multiple different denominations, which may differ in theological approach to vaccines.

The following Christian denominations have no theological objection to vaccination:

Roman Catholicism

Eastern Orthodox

Oriental Orthodox

Amish

Anglican

Baptist

The Church of Jesus Christ of Latter-Day Saints (Mormon)

Congregational

Episcopalian

Jehovah's Witness - Note: This denomination originally denounced vaccination, but revised this doctrine in 1952. An article in a recent issue of the church's newsletter promotes vaccination to avoid infectious diseases.

Lutheran

Mennonite

Methodist (including African Methodist Episcopal)

Quaker

Pentecostal

Presbyterian

Seventh-Day Adventist

Unitarian-Universalist

The following denominations do have a theological objection to vaccination:

Church of Christ, Scientist - One of the basic teachings of this denomination is that disease can be cured or prevented by focused prayer. Christian Scientists usually decline all forms of medical intervention, including vaccination.

Dutch Reformed Congregations - This denomination has a tradition of declining immunizations. Some members decline vaccination on the basis that it interferes with divine providence. However, others within the faith accept immunization as a gift from God to be used with gratitude.

Faith healing denominations including:

Faith Tabernacle

Church of the First Born

Faith Assembly

End Time Ministries

Hinduism - Hinduism has no prohibition against vaccines. While Hindus venerate cows, trace bovine components of certain vaccines have not been identified as a theological concern.

Islam - Islam has no prohibition to vaccination. There have been several gatherings of Muslim leaders, scholars, and philosophers to address the theological implications of ingredients in food and drugs, including vaccination. The Organization of Islamic Conference and 15th annual conference of the International Fiqh Council both concluded that vaccination is acceptable under Islam. The Islamic Organization for Medical Sciences concluded that porcine gelatin used in vaccines is acceptable. Some muftis (experts in Islamic law) hold that immunization is obligatory (wajib) when the disease risk is high and the vaccine has benefits that far outweigh its risk. Jainism - Jains follow a path of non-violence toward all living beings including microscopic organisms. Jains do allow cooking, the use of soap and antibiotics, and vaccination, because this destruction of microorganisms, even though regretted, is necessary to protect other lives.

Judaism - Judaism supports vaccination as an action to maintain health, and also as a parental responsibility to protect children against future infection. In Judaism the concept of Pikuakh nefesh, acting to save one's own or another's life, is a primary value. While some vaccines containing porcine derived gelatin, Jewish scholars, agree that porcine gelatin in injectable form is acceptable.

Scientology: in an interview for BeliefNet, Rev. John Carmichael of the Church of Scientology stated that there are no precepts or strictures about vaccinations within Scientology.

For more information about religious beliefs regarding immunizations, please refer to the following: Religion and Vaccines (John Hopkins Bloomberg School of Public Health)

Grabenstein JD. What the world's religions teach, applied to vaccines and immune globulins. Vaccine. 2013 Apr 12;31(16):2011-23. doi: 10.1016/j.vaccine.2013.02.026. Epub 2013 Feb 26. PubMed PMID: 23499565.

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Vanderbilt Faculty & Staff Health and Wellness

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Most religions have no prohibition against vaccinations, however some have considerations, concerns or restrictions regarding vaccination in general, particular reasons for vaccination, or specific vaccine ingredients. Below is a list of the current position of some of the more common religious faiths. Buddhism - Buddhism has no central authority that determines doctrine.

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This poster lists most of the dangerous effects known to come as a side effect for some people after taking some vaccinations

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Mentions how most insuarnace policies cover vaccinations and informs readers of the rules of vaccination such as you must do it on time every time for it to truly be effectful.

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Centers for Disease Control and Prevention

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Immunization is one of the best ways parents can protect their infants from 14 serious childhood diseases before age 2. Vaccinate your child according to the CDC's recommended immunization schedule for safe, proven disease protection.
Diseases that vaccine prevent can be very serious-even deadly-especially for infants and young children. Vaccines reduce your child's risk of infection by working with their body's natural defenses to help them safely develop immunity to disease. Immunizations have helped improve the health of children in the United States. Most parents today have never seen first-hand the devastating consequences that vaccine-preventable diseases have on a family or community. Although most of these diseases are not common in the United States, they still exist around the world, so it is important to protect your child with vaccines.

Protect Your Child from Serious Diseases

One example of the seriousness of vaccine-preventable diseases is the increase in whooping cough (pertussis) cases and outbreaks reported over the last few decades. In 2016, more than 17,000 cases of whooping cough were reported to CDC. Whooping cough can be deadly, especially for young babies who are too young to get their own vaccines. Since 2010, there have been tens of thousands of whooping cough cases reported each year nationwide, with a peak of more than 48,000 cases reported in 2012. One recent study showed that many whooping cough deaths among babies could be prevented if all babies received the first dose on time at 2 months old, when they are old enough to get vaccinated.

Measles cases and outbreaks still occur in the United States. Thanks to an effective vaccine, measles isn't as common in the U.S. anymore, but it still a common disease in many parts of the world, including Europe, Africa, Asia, and the Pacific. Measles is brought into the United States by unvaccinated U.S. residents and visitors who get infected when they are in other countries. Measles can spread easily when it reaches a community in the U.S. where groups of people are unvaccinated. The disease can be serious and can cause pneumonia, encephalitis (swelling of the brain), and even death. Young children are at highest risk for serious complications from measles. Learn more about measles.

Vaccinating your baby according to the recommended immunization schedule gives him the best protection against 14 serious childhood illnesses-like measles and whooping cough-before he is 2 years old. The recommended schedule is designed to protect infants and children early in life, when they are most vulnerable and before they are exposed to potentially life-threatening diseases.

The recommended immunization schedule for babies includes vaccination protection against all of the following diseases:

The Diseases Vaccines Prevent

Vaccinate On Time, Every Time

Visit CDC's vaccine website for parents.

Even though there are outbreaks of some vaccine-preventable diseases in the United States, the spread of disease usually slows or stops because most people are vaccinated or protected through immunity against the disease. If we stopped vaccinating, even the few cases we have in this country could very quickly become tens or hundreds of thousands of cases.

Fortunately, most parents choose to vaccinate their children and immunization rates in this country are at or near record high levels. In fact, less than 1 percent of children do not receive any vaccines. However, some children have not received all of their vaccines, so they are not fully protected. It's important that children receive all doses of the vaccines according to the recommended immunization schedule. Not receiving all doses of a vaccine leaves a child vulnerable to catching serious diseases.

That's why it's important to make sure that your child is up to date on his immunizations. Call your pediatrician to find out if your child is due for any vaccinations.

Paying for Vaccination

Most health insurance plans cover the cost of vaccinations, but you should check with your insurance provider before going to the doctor. If you don't have health insurance, or your insurance policy doesn't cover all recommended childhood vaccines,* your child may be eligible for vaccines through the Vaccines for Children (VFC) program.

The VFC Program helps families of eligible children who might not otherwise have access to recommended childhood vaccines. This federal program provides vaccines for eligible children at no cost for the vaccine itself, although you may have to pay an administration fee. These fees help providers cover the costs of giving the vaccines, including storing the vaccines and paying staff members to give vaccines to patients.

Children younger than 19 years of age are eligible for VFC vaccines if they are:

American Indian or Alaska Native

Medicaid-eligible

Uninsured

Underinsured*

A child that meets one or more of the above eligibility requirements is eligible to receive VFC vaccine from a provider enrolled in the VFC program. VFC vaccines cannot be denied to an eligible child if the family can't afford to pay the administration fee.
*Children under 19 years old may also be eligible for the VFC program if they are "underinsured" - they may have insurance, but their insurance doesn't cover any vaccines or it doesn't cover certain recommended vaccines for children 18 years and younger.
Have Questions about Immunization?

Talk with your child's health care professional, contact your local or state health department, or call the CDC at 800-CDC-INFO (800-232-4636).

Visit CDC's vaccine website for parents.

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Immunization is one of the best ways parents can protect their infants from 14 serious childhood diseases before age 2. Vaccinate your child according to the CDC's recommended immunization schedule for safe, proven disease protection. Diseases that vaccine prevent can be very serious-even deadly-especially for infants and young children.

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This shows the morbidity rate for most if not all of the things you get vaccinated for. It shows the rate before there was a vaccination and it shows the US’s current rate with people recieveing vaccinations.

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Lists the complications and side effects vaccines can cause. Is a very in depth piece on minor -serious complications vaccinating a child can cause

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A vaccine is a medical product. Vaccines, though they are designed to protect from disease, can cause side effects, just as any medication can.

Most side effects from vaccination are mild, such as soreness, swelling, or redness at the injection site. Some vaccines are associated with fever, rash, and achiness. Serious side effects are rare, but may include seizure or life-threatening allergic reaction.

A possible side effect resulting from a vaccination is known as an adverse event.

Each year, American babies (1 year old and younger) receive more than 10 million vaccinations. During the first year of life, a significant number of babies suffer serious, life-threatening illnesses and medical events, such as Sudden Infant Death Syndrome (SIDS). Additionally, it is during the first year that congenital conditions may become evident. Therefore, due to chance alone, many babies will experience a medical event in close proximity to a vaccination. This does not mean, though, that the event is in fact related to the immunization. The challenge is to determine when a medical event is directly related to a vaccination.

The Food and Drug and Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have set up systems to monitor and analyze reported adverse events and to determine whether they are likely related to vaccination.

Types of Side Effects

To understand the range of possible vaccination side effects events, it is useful to compare a vaccine with relatively few associated side effects, such as the vaccine for Haemophilus influenza type B, with a vaccine known to have many potential side effects, such as the infrequently used smallpox vaccine (given to military personnel and others who might be first responders in the event of a bioterror attack).

Haemophilus influenza type B is a bacterium that can cause serious infections, including meningitis, pneumonia, epiglottitis, and sepsis. The CDC recommends that children receive a series of Hib vaccinations starting when they are two months old.

Smallpox is a serious infection, fatal In 30% to 40% of cases, and caused by the Variola major or Variola minor virus. No wild smallpox cases have been reported since the 1970s. The World Health Organization has declared it eradicated.

The information below about side effects of Hib and smallpox vaccination is from the Centers for Disease Control and Prevention.

Hib Vaccine Side Effects

Redness, warmth, or swelling where the shot was given (up to 1 out of 4 children)

Fever over 101°F (up to 1 out of 20 children)

No serious side effects have been related to the Hib vaccine.

Smallpox (Vaccinia) Vaccine Side Effects

Mild to Moderate Problems

Mild rash, lasting 2-4 days.

Swelling and tenderness of lymph nodes, lasting 2-4 weeks after the blister has healed.

Fever of over 100°F (about 70% of children, 17% of adults) or over 102°F (about 15%-20% of children, under 2% of adults).

Secondary blister elsewhere on the body (about 1 per 1,900).

Moderate to Severe Problems

Serious eye infection, or loss of vision, due to spread of vaccine virus to the eye.

Rash on entire body (as many as 1 per 4,000).

Severe rash on people with eczema (as many as 1 per 26,000).

Encephalitis (severe brain reaction), which can lead to permanent brain damage (as many as 1 per 83,000).

Severe infection beginning at the vaccination site (as many as 1 per 667,000, mostly in people with weakened immune systems).

Death (1-2 per million, mostly in people with weakened immune systems).

For every million people vaccinated for smallpox, between 14 and 52 could have a life-threatening reaction to smallpox vaccine.

How Do I Find Out the Side Effects for Different Vaccines?

When you or a child gets a vaccine, the health care provider gives you a handout known as the Vaccine Information Statement (VIS). The VIS describes common and rare side effects, if any are known, of the vaccine. Your health care provider will probably discuss possible side effects with you. VIS downloads are also available through the CDC's website.

Package inserts produced by the vaccine manufacturer also provide information about adverse events. Additionally, these inserts usually show rates of adverse events in experimental and control groups during pre-market testing of the vaccine.

How Are Adverse Events Monitored?

VAERS

The CDC and FDA established The Vaccine Adverse Event Reporting System in 1990. The goal of VAERS, according to the CDC, is "to detect possible signals of adverse events associated with vaccines." (A signal in this case is evidence of a possible adverse event that emerges in the data collected.) About 30,000 events are reported each year to VAERS. Between 10% and 15% of these reports describe serious medical events that result in hospitalization, life-threatening illness, disability, or death.

VAERS is a voluntary reporting system. Anyone, such as a parent, a health care provider, or friend of the patient, who suspects an association between a vaccination and an adverse event may report that event and information about it to VAERS. The CDC then investigates the event and tries to find out whether the adverse event was in fact caused by the vaccination.

The CDC states that they monitor VAERS data to

Detect new, unusual, or rare vaccine adverse events

Monitor increases in known adverse events

Identify potential patient risk factors for particular types of adverse events

Identify vaccine lots with increased numbers or types of reported adverse events

Assess the safety of newly licensed vaccines

Not all adverse events reported to VAERS are in fact caused by a vaccination. The two occurrences may be related in time only. And, it is probable that not all adverse events resulting from vaccination are reported to VAERS. The CDC states that many adverse events such as swelling at the injection site are underreported. Serious adverse events, according to the CDC, "are probably more likely to be reported than minor ones, especially when they occur soon after vaccination, even if they may be coincidental and related to other causes."

VAERS has successfully identified several rare adverse events related to vaccination. Among them are

An intestinal problem after the first vaccine for rotavirus was introduced (the vaccine was withdrawn in 1999)

Neurologic and gastrointestinal diseases related to yellow fever vaccine

Additionally, according to Plotkin et al., VAERS identified a need for further investigation of MMR association with a blood clotting disorder, encephalopathy after MMR, and syncope after immunization (Plotkin SA et al. Vaccines, 5 th ed. Philadelphia: Saunders, 2008).

Vaccine Safety Datalink

The CDC established this system in 1990. The VSD is a collection of linked databases containing information from large medical groups. The linked databases allow officials to gather data about vaccination among the populations served by the medical groups. Researchers can access the data by proposing studies to the CDC and having them approved.

The VSD has some drawbacks. For example, few completely unvaccinated children are listed in the database. The medical groups providing information to VSD may have patient populations that are not representative of large populations in general. Additionally, the data come not from randomized, controlled, blinded trials but from actual medical practice. Therefore, it may be difficult to control and evaluate the data.

Rapid Cycle Analysis is a program of the VSD, launched in 2005. It monitors real-time data to compare rates of adverse events in recently vaccinated people with rates among unvaccinated people. The system is used mainly to monitor new vaccines. Among the new vaccines being monitored in Rapid Cycle Analysis are the conjugated meningococcal vaccine, rotavirus vaccine, MMRV vaccine, Tdap vaccine, and the HPV vaccine. Possible associations between adverse events and vaccination are then studied further.

Vaccine Injury Compensation

For information on systems for compensating individuals who have been harmed by vaccines, see our article on Vaccine Injury Compensation Programs.
Last update 17 January 2018

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A vaccine is a medical product. Vaccines, though they are designed to protect from disease, can cause side effects, just as any medication can. Most side effects from vaccination are mild, such as soreness, swelling, or redness at the injection site. Some vaccines are associated with fever, rash, and achiness.

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Lists reasons and thoroughly explains why they are valid and how they will improve the life of a child.

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Vaccines.gov helps you find nearby pharmacies in the United States.

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This article shows a list of the most common vaccination kids receive. It also lightly touches upon the theory that vaccinations are the reasons illnesses from past generations are not common anymore

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vaccine preventable diseases~ polio~ chicken pox~ measles~ whooping cough~ tetanus~ infections~ mumps~ rubella~ hpv~ hepa~ hepb

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If you follow the immunization guidelines recommended by the American Academy of Pediatrics (AAP), you can help make your child healthier than was ever possible in earlier generations.

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This image shows two girls who got small -pox on the same day from the same source, however one was vaccinated and one was not and the effects are shown.

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This article is pro that kids should be immunized. It mentions many of the immunizations parents can provide their children with and mentions sideffects and the rarity of harmful or dangerous side effects. It was written by an MD and was written recently so its a professional using modern information.

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Babies are born with protection against some diseases because antibodies (proteins made by the body to fight disease) were passed to them by their mothers through the placenta. After birth, breastfed babies get the continued benefits of more antibodies in breast milk. But in both cases, the protection is temporary.

Immunization (vaccination) is a way to create immunity to some diseases. This is done by using small amounts of a killed or weakened microorganism that causes the disease.

Microorganisms can be viruses (such as the measles virus) or they can be bacteria (such as pneumococcus). Vaccines stimulate the immune system to react as if there were a real infection - it fends off the "infection" and remembers the organism so that it can fight it quickly should it enter the body later.

What Are the Types of Vaccines?

There are a few different types of vaccines. They include:

Attenuated (weakened) live viruses are used in some vaccines such as in the measles, mumps, and rubella (MMR) vaccine.

Killed (inactivated) viruses or bacteria are used in some vaccines, such as in IPV.

Toxoid vaccines contain an inactivated toxin produced by the bacterium. For example, the diphtheria and tetanus vaccines are toxoid vaccines.

Conjugate vaccines (such as Hib) contain parts of bacteria combined with proteins.

The American Academy of Pediatrics (AAP) recommends that kids get combination vaccines (rather than single vaccines) whenever possible. Many vaccines are offered in combination to help reduce the number of shots a child receives.

What Vaccines Do Kids Need?

The following vaccinations and schedules are recommended by the AAP. Some variations are normal and recommendations change often as new vaccines are developed. Your doctor will talk to you about the right vaccinations and schedule for your child.

Recommended vaccinations:

Vaccine Concerns

Some parents may hesitate to have their kids vaccinated because they're worried that the children will have serious reactions or may get the illness the vaccine is supposed to prevent. But because the components of vaccines are weakened or killed - and in some cases, only parts of the microorganism are used - they're unlikely to cause any serious illness.

Some vaccines may cause mild reactions, such as soreness where the shot was given or fever, but serious reactions are rare. The risks of vaccinations are small compared with the health risks of the diseases they're intended to prevent.

Immunizations are one of the best means of protection against contagious diseases.

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Babies are born with protection against some diseases because antibodies (proteins made by the body to fight disease) were passed to them by their mothers through the placenta. After birth, breastfed babies get the continued benefits of more antibodies in breast milk. But in both cases, the protection is temporary.

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Questions answered by professionals in the healthcare world and video explaining the importance of vaccinations

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Childhood vaccines: Tough questions, straight answers

Do vaccines cause autism? Is it OK to skip certain vaccines? Get the facts on these and other common questions.
By Mayo Clinic Staff
Part of taking care of kids is setting them up for a healthy future. Vaccines play a big part in health.

Vaccines for illnesses such as diphtheria, rotavirus, polio, tetanus, whooping cough, also called pertussis, and others are given in the first year of life. If these diseases seem uncommon it's because vaccines are doing their job.

Still, you might wonder about the benefits and risks of childhood vaccines. Here are answers to some common questions about childhood vaccines.

Is natural immunity better than vaccination?

No. In general, it is better to prevent sickness by getting vaccinated rather than getting an infection.

Getting infected with a germ may provide some people with a longer lasting immune response but at higher risk. For example, getting a Haemophilus influenzae type b (Hib) bacterial infection could lead to permanent deafness, brain damage or even death.

Childhood vaccines protect kids from serious diseases and complications. Vaccines also lower the chance of spreading a disease.

Do vaccines cause autism?

No. Vaccines do not cause autism. Researchers haven't found a connection between autism and childhood vaccines. The original study that ignited the controversy in 1998 was removed from the scientific record, also called retracted, in 2010.

Are vaccine side effects dangerous?

Most vaccine side effects are not dangerous. Any medicine, including vaccines, can cause side effects. Most of the time, these side effects are minor. Some examples are a low-grade fever, headache, fussiness or soreness at the injection site.

Rarely, a child might experience a severe side effect, such as an allergic reaction or a seizure. These are rare side effects, and caregivers and health care providers monitor for them after vaccination.

Of course, vaccines aren't given to children who have known allergies to specific parts of the vaccine. And if your child has a life-threatening reaction to one vaccine, further doses of that vaccine won't be given.

The risk of a vaccine causing serious harm or death is very small. The benefits of getting a vaccine are much greater than the possible side effects for almost all children.

Why are vaccines given so early?

Most babies are born with developing immune systems. Vaccination makes sure a baby has as much protection from disease and disease complications as is safely possible. It also helps prevent babies and children from spreading illness to others.

Vaccines for children are timed carefully. Vaccines are given when protection inherited from the mother fades and the child's immune system is ready, but before kids come in contact with the germs that cause real infections.

Is it OK to pick and choose vaccines?

It's not a good idea to skip some vaccines. That leaves your child without protection. It allows a child to spread disease to others. For some children, such as kids being treated for cancer, their main protection from disease is the immunity of the people around them.

And because diseases are still spreading in many parts of the world, skipping vaccines puts your child at risk in the future.
Have more questions? Read the vaccine guidance from Mayo Clinic.
If you are worried about a certain vaccine, talk about your concerns with your child's health care provider. If your child falls behind the standard vaccine schedule, ask your child's health care provider how to catch up.

Mayo Clinic Minute: Why and when children should be vaccinated

Elizabeth Cozine, M.D.: Vaccination prevents a child from getting an illness. It also prevents them from spreading an illness.

Jason Howland: Dr. Elizabeth Cozine, a Mayo Clinic family physician, says the Centers for Disease Control and Prevention has a standard immunization schedule for school-age children that begins with ages 4 to 6.

Dr. Cozine: ...which we think of as kindergarten shots. So that's measles, mumps, rubella and varicella.

Jason Howland: She says the next set of routine immunizations is at age 11...

Dr. Cozine: ...which is tetanus, diphtheria and pertussis, and the meningococcal immunization.

Jason Howland: It's also recommended every child get an annual flu shot. And HPV vaccination, which prevents cancer, can start as early as age 9. Dr. Cozine says it's important to educate families on the importance of childhood vaccinations. She likens it to seat belt safety.

Dr. Cozine: Immunizations are no different. If we have opportunities to protect our children against serious illness and potentially even death, even if the risk of that illness or the risk of death from that illness is really quite low, I'm all for it.

Jason Howland: For the Mayo Clinic News Network, I'm Jason Howland.

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Show references

1. Timing and spacing of immunobiologics. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/timing.html. Accessed Feb. 27, 2023.

2. Infants and children birth through age 6. U.S. Department of Health and Human Services. https://www.hhs.gov/immunization/who-and-when/index.html. Accessed Feb. 27, 2023.

3. Drutz J, et al. Autism spectrum disorder and chronic disease: No evidence for vaccines or thimerosal as a contributing factor. https://www.uptodate.com/contents/search. Accessed Feb. 27, 2023.

4. Drutz J, et al. Standard immunizations for children and adolescents: Overview. https://www.uptodate.com/contents/search. Accessed Feb. 27, 2023.

5. Your child's first vaccines. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/multi.html. Accessed Feb. 27, 2023.

6. Vaccine recommendations. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/hcp/adults/for-practice/standards/recommend.html. Accessed Feb. 27, 2023.

7. The editors of the Lancet. Retraction: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet. 2010. doi:10.1016/S0140-6736(10)60175-4.

8. How vaccines strengthen your baby's immune system. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/parents/why-vaccinate/strengthen-baby-immune.html. Accessed Feb. 27, 2023.

9. H. influenzae: Diagnosis, treatment, and complications. Centers for Disease Control and prevention. https://www.cdc.gov/hi-disease/about/diagnosis-treatment.html. Accessed Feb. 27, 2023.

See more In-depth

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Vaccines: Tough questions, straight answers

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When it comes to childhood vaccines, misinformation is common. Get the facts about vaccine safety from health experts.