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Vaccines: Fact and Fiction

the worry: Vaccines contain toxins

what's behind it: Vaccines do contain a variety of substances besides the viral or bacterial components. There are preservatives as well as adjuvants, which are substances that help vaccines grab the attention of the immune system and prompt it to create antibodies. One adjuvant that some are focusing on is aluminum, which at chronic high levels can contribute to nerve, brain, and kidney damage. Because several new vaccines containing aluminum have been added to the schedule, some parents and doctors worry that the extra exposure might push levels out of the safety zone -- particularly given that there's already aluminum pretty much everywhere: in water, breast milk, formula, and the air we breathe. "I'm concerned that health officials haven't done any human-infant research to make sure the amount of aluminum in the vaccines is safe," says Dr. Sears.

the facts: Everyday exposure to aluminum is generally not considered hazardous -- most adults ingest 7 to 9 milligrams (mg) every day through food alone (up to 200 mg if they pop antacids), and formula contains anywhere from .05 mg/L to .93 mg/L. Very little of the aluminum taken in orally is absorbed, and what does make it into the bloodstream is excreted within days. Although the aluminum in vaccines is, of course, injected, there doesn't seem to be evidence it poses any danger for healthy kids. The amount of aluminum injected is no more than .85 mg per dose, and the CDC, the Institute of Medicine, and the World Health Organization have all deemed the levels babies receive from shots to be safe.

However, if you still have concerns, you can ask your doctor to choose low- or no-aluminum vaccines when possible. In the instances when it's not, Dr. Sears will work with aluminum-wary parents by having them bring their babies in once a month between 2 and 7 months of age (rather than bimonthly) so that they get just one aluminum-containing shot at a time. "If doctors don't meet worried parents halfway, the problem of kids not getting vaccinated will continue," says Dr. Sears.

the worry: It's healthier to contract some diseases naturally

what's behind it: The immunity one develops against chicken pox and measles after having the illness is more complete than the protection from the shot. Because that fact is so appealing, chicken pox and measles parties -- where parents intentionally expose a child to the viruses -- have been around for years, and are now on the upswing. Rebecca Foster threw one after her husband, Kevin Burget, came down with shingles, an illness that's caused by the same virus behind chicken pox. The Brooklyn couple had elected not to vaccinate their then 2-year-old son, Hart, against chicken pox (he'd had all his other shots), and they seized the opportunity for the toddler to get it from his dad. The two shared lots of hugs and lots of cups -- and sure enough, Hart picked up the pox. "He hardly itched. It was very mild -- not like the horror stories we'd heard," says Foster. Knowing other parents might want their kids exposed, the couple posted a notice on a local e-mail listserve inviting interested families to come over; two ultimately showed up for a playdate with Hart, during which sharing everything, including lollipops, was encouraged. The visiting kids didn't get sick, but their parents were highly grateful for the chance. "They brought presents," says Foster.

the facts: The potential complications of both chicken pox and measles are far more dangerous than any posed by the shots. "Many young parents think these infections are trivial," Dr. Schaffner says, "which only means they've never seen a child seriously ill with either of them." Consider this: Complications include seizures, pneumonia, or encephalitis (brain inflammation); one or two of every thousand children who come down with measles die or are mentally impaired. In pregnant women, measles can cause miscarriage and premature birth. Chicken pox can lead to staph or strep infections.

Dr. Myers has seen the effects of those infections firsthand. He recalls a 19-month-old whose parents decided he was getting too many shots at once and left off the chicken pox vaccine. "The boy came to our hospital with staph and strep skin infections. It required powerful antibiotics to save him."

To be fair, most kids who get the pox will not end up in the hospital. But, like Dr. Myers's patient, a few will -- and there's a good chance their parents never would have believed it could happen to them. "We'd all love to have absolute truths and guarantees, but that's not always attainable," says Dr. Shoffner. Vaccines are no exception. "We have to make the best decisions we can with the best information available to us."