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Mandatory Vaccinations Undergo a Year Under the Microscope.


Jane Orient, MD, director of the Association of American Physicians and Surgeons, a 4,000-member doctor group, agrees. "Most of our members think that vaccines in general are a good thing, but we're opposed to mandatory vaccines. We believe that should be between the physician and the patient, and that decision should be made on an individual basis," she tells WebMD.

What are the risks, beyond immediate adverse reactions? Fisher admits there's no proof of cause and effect with some of the claims but a "tremendous amount of anecdotal evidence" pointing to an increase in autism, attention deficit/hyperactivity disorder, asthma, juvenile arthritis, diabetes, and "chronic immune and neurological dysfunction," she says.

Mainstream medical organizations, like the American Academy of Pediatrics and the American Medical Association, back the status quo. Earlier this year, U.S. Surgeon General David Satcher, MD, acknowledged while testifying before a congressional committee that vaccines "have risks," but the government is increasing spending for research into safety and tracking. Satcher said that vaccines are, from a risk-benefit perspective, "perhaps the safest and most efficacious medical intervention of our time."

The CDC has chosen the impact of vaccines universally recommended for children as one of the century's 10 greatest public health achievements. Orenstein tells WebMD that there are some more immediate steps being taken by the government to improve safety. He mentions the removal of the rotavirus vaccine, no longer recommending the "whole cell" pertussis vaccine, and no longer recommending the oral polio vaccine.

Instead, Orenstein says the inactivated-virus polio vaccine, which may be marginally safer, will be used to get rid of the handful of polio cases left. "That's an example of making the schedule, which was already safe -- about one case of polio in about 2.4 million doses, [and] very few programs have that margin of safety -- even safer. In essence, the federal government has been willing to pay $3 million to prevent a single case of polio, since the inactivated [vaccine] is more expensive," Orenstein tells WebMD.

"The immunization system is evolving," he says, "and as we learn more, we make changes. We make changes by perhaps adding more doses, if we find more doses of a certain vaccine are needed for efficacy, and we make changes if there are ways of increasing the safety while maintaining high levels of protection against vaccine-preventable diseases. [T]his is an ongoing process.



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