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Six-week-old Gavin Hubbard of New Hampshire bravely faces his series of five

immunizations in the comforting grasp of Mom.

Dan Habib / Concord Monitor / Corbis

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Correction Appended: May 29, 2008

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Life, if you're a bacterium or virus, boils down to this: finding a pristine

human home to provide for your every need, from food and nutrients to shelter

against biological storms. As a microbial drifter, you can literally travel

the world, hopping from host to host when the opportunity presents itself or

when conditions at your temporary residence start heading south. There's no

worry about taking along life's necessities either—viruses in particular are

adept at traveling light; incapable of reproducing on their own, they think

nothing of co-opting the reproductive machinery of their cellular sponsors to

help them spawn generation after generation of freeloading progeny.

But ever since Jenner, a country doctor in England, inoculated his son

and a handful of other children against smallpox in 1796 by exposing them to

cowpox pus, things have been tougher on humans' most unwelcome intruders. In

the past century, vaccines against diphtheria, polio, pertussis, measles,

mumps and rubella, not to mention the more recent additions of hepatitis B and

chicken pox, have wired humans with powerful immune sentries to ward off

uninvited invasions. And thanks to state laws requiring vaccinations for

youngsters enrolling in kindergarten, the U.S. currently enjoys the highest

immunization rate ever; 77% of children embarking on the first day of school

are

completely up to date on their recommended doses and most of the remaining

children are missing just a few shots.

Yet simmering beneath these national numbers is a trend that's working in the

microbes' favor—and against ours. Spurred by claims that vaccinations can be

linked to autism, increasing numbers of parents are raising questions about

whether vaccines, far from panaceas, are actually harmful to children. When

the immune system of a baby or young child is just coming online, is it such a

good idea to challenge it with antigens to so many bugs? Have the safety,

efficacy and side effects of this flood of inoculations really been worked

through? Just last month the U.S. government, which has always stood by the

safety of vaccines, acknowledged that a 9-year-old Georgia girl with a

preexisting

cellular disease had been made worse by inoculations she had received as an

infant, which " significantly aggravated " the condition, resulting in a brain

disorder with autism-like symptoms.

Though the government stressed that the case was an exceptional one, it

provided exactly the smoking gun that vaccine detractors had been looking for

and

vaccine proponents had been dreading. More and more, all this wrangling over

risks and benefits is leading confused parents simply to opt out of vaccines

altogether. Despite the rules requiring students to be vaccinated, doctors

can issue waivers to kids whose compromised immune system might make vaccines

risky. Additionally, all but two states allow waivers for children whose

parents object to vaccines on religious grounds; 20 allow parents to opt out on

philosophical grounds. Currently, nearly one-half of 1% of kids enrolled in

school are unvaccinated under a medical waiver; 2% to 3% have a nonmedical one,

and the numbers appear to be rising.

Parents of these unimmunized kids know that as long as nearly all the other

children get their shots, there should not be enough pathogen around to sicken

anyone. But that's a fragile shield. Infectious-disease bugs continue to

travel the globe, always ready to launch the next big public-health threat.

Pockets of intentionally unvaccinated children provide a perfect place for a

disease to squat, leading to outbreaks that spread to other unprotected kids,

infants and the elderly. Ongoing measles outbreaks in four states are centered

in such communities; one originated with an unimmunized boy from San Diego who

contracted the virus while traveling in Europe—where the bug was thriving

among intentionally unimmunized people in Switzerland. Dr. Anne Schuchat,

director of the National Center for Immunization and Respiratory Diseases at

the

Centers for Disease Control and Prevention (CDC), says, " We are seeing more

outbreaks that look different, concentrated among intentionally unimmunized

people. I hope they are not the beginning of a worse trend. "

If they are, it's possible that once rampant diseases such as measles, mumps

and whooping cough will storm back, even in developed nations with robust

public-health programs. That is forcing both policymakers and parents to wrestle

with a dilemma that goes to the heart of democracy: whether the common

welfare should trump the individual's right to choose. Parents torn between

what's

good for the world and what's good for their child will—no surprise—choose

the child. But even then, they wonder if that means to opt for the vaccines

and face the potential perils of errant chemistry or to decline the vaccines

and face the dangers of the bugs. There is, as yet, no simple solution, but

answers are emerging.

" Ms. Michele "

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