For decades, vaccinations have been considered by many on par with a medical miracle. Parents no longer felt they had to worry about their children getting potentially fatal epidemic illnesses. And doctors no longer felt they had to worry about the treatment of those epidemics.

In recent years, some skeptics, including those in the medical profession, have questioned whether the benefits of immunizing young children are worth what some believe are pretty high costs. The costs, they say, include chronic illness, weakened immune systems and, in some cases, death.

"I just don't think it's worth the risk," said Dr. Paul Malavenda, a chiropractor for 10 years who lives on Key Biscayne. "The job that they're meant to do is not what they're doing. The body has its own immune system which has been created to respond against these diseases. It builds up immunity on its own. I strongly believe the vaccinations are predisposing humans to diseases such as AIDS, cancer, arthritis and osteoporosis."

Dr. Jorge Bertran, a pediatrician on the Key for 10 years, disagreed.

"These people that don't vaccinate their kids, they're taking advantage of the fact that everyone does," Bertran explained. "Their kids are less likely to get sick. It's like speeding. We all go 45 miles an hour and because everyone goes at that speed, things go smoothly. Then, you get somebody going 120 miles down the road. If everyone was going 120, we'd all get killed. But with one person, [the chances of being killed] are less likely."

Two schools

Malavenda and Bertran represent the health care profession's two schools of thought about inoculations. Both are concerned about risk, but they disagree on which risk is greater: the potential side effects of vaccines or the potential side effects of the illnesses that vaccines were designed to eliminate. In both cases, the worst case scenario is fatal.

Bertran believes that fatalities have been vastly reduced by mass inoculation. He said although each vaccine can produce symptoms, the majority of the time more lives are saved than not. Bertran remembers the crippling effects of paralytic polio--the heartbreaking images of helpless children, and even a U.S. president, shackled to iron lungs, crutches and wheelchairs. He remembers infants who choked to death or suffered brain damage from whooping cough. He remembers the birth defects and blindness caused by small pox.

"There used to be 13,000-20,000 cases of paralytic polio reported in the U.S. each year prior to the availability of vaccines," he explained. "But people have forgotten what it's like."

Now, he continued, there are only 3,500 documented cases of polio in the world annually.

"In the world!" he said. "Who knows how many millions were in the world before? You can't just stop taking polio vaccines. You could hop on a plane and go on safari. If we stopped vaccinating everybody for polio in the U.S., gradually the number of cases would get bigger and bigger and then, boom, somebody arrives from somewhere else where there is wild polio virus and, boom, you end up with thousands of kids paralyzed."

Bertran cited additional success stories, such as the widespread use of the HIB vaccine--hemophilus influenza type B meningitis--in 1987, cases of these illnesses, particularly that strain of meningitis, have been reduced by 97 percent.

"I have not seen a case of it since," he recalled. "I'm sure the people who get it is because they didn't get the vaccine. Most of the pediatricians that graduated after 1987 have never seen a case of that."

But Malavenda contends that, although immunizations may have reduce the number of fatalities from acute disease, longer-term effects on the immune system from vaccinations may be just as deadly, adding that very little research has been done on vaccines over long periods of time.

Some health care practitioners, like Malavenda, Mendelsohn and Dr. Richard Moskowitz, a Massachusetts family doctor who practices homeopathy, believe that mass inoculation as well as overuse of antibiotics may contribute to an increase in cases of auto-immune diseases, such as cancer, lupus, juvenile diabetes, leukemia, multiple sclerosis and AIDS.

As Dr. Robert Mendelsohn put it in his book, "How to Raise a Healthy Child...In Spite of Your Doctor": "Have we traded mumps and measles for cancer and leukemia?"

Mendelsohn contends that the reduction in epidemic diseases is due to improved living conditions and in the very least, children should be individually tested for any contraindications that would put them in danger from certain vaccinations.

Moskowitz, who is nationally renown for his stance against mandatory vaccinations, said he has seen more and more cases of weakened immune systems in his 15-year practice in the Boston area.

"They're not affects that are known for a particular vaccine," he explained. "Rather they're nonspecific affects of the vaccination process in general and that's very hard to track."

In one of Moskowitz's typical pediatric cases, for instance, a child with an ear infection is responding well to homeopathic remedies. Then the time comes for the child's booster shots.

"Within two weeks, we're right back to square one...," Moskowitz explained. "What does that say? That says that there's something about the vaccination process per se which is changing the health of that person in a chronic way."

Another instance is measles, which Americans don't usually get in acute form, he said. That's because the chronic form of the disease is what is injected into the body during inoculation.

"That's the way it's designed. It's designed not to produce an acute disease and it's designed to camp out in the cells of the immune system for a long time. My idea is that not only does that give them the chronic measles but it gives them the propensity to react chronically to everything."

Pro-choice

Whichever side of the vaccination argument holds claim to truth, Moskowitz said the real issue is choice and that choice should be completely in the hands of parents.

"The parent is the one who's in the best place to make that decision," Moskowitz explained. "I could imagine it might be different if we were faced with a public health emergency where everyone had to be protected against it whether they want it or not. But that's not happening. These are all done as a matter of policy, so we're cranking out more and more just because some drug company has the ability to do it. The public has no say in that whatsoever and I just don't think that's right."

Sharon Hamilton, a licensed midwife who is also a strong proponent of informed choice for the 60 clients she sees each year, agreed.

"People should not be forced to submit their children to vaccinations if they don't want to," said Hamilton, whose clients include Key Biscayners. "That's wrong. If parents choose to vaccinate, their child will be immune to exposure to diseases by those who are not. So what's the problem? It's like everybody has to wear blue shoes on Tuesday. Hello! This is America. We're loosing so many of our rights, it's disconcerting. We're being led like lemmings over the cliff."

Proponents of informed choice also say that vaccinations are no guarantee against getting sick.

Jackie Simms, a mother of four who unsuccessfully fought for legislation to include a personal beliefs exemption to Florida's mandatory inoculation law, has personal experience with this.

"I think people think they're 100 percent safe from that disease because they have been vaccinated and that's not so," Simms said. "There are records of children who get those diseases after being vaccinated. I'm one of them. I was vaccinated as a child and I had all of them--measles, mumps, whooping cough."

Hamilton said the diseases that Simms got as a child were at one time treated as normal childhood illnesses that had to run their course in order to provide lifetime immunity, not only to that disease but to others as well.

"A lot of the illnesses for which children receive vaccinations used to be considered normal childhood illnesses, such as measles, mumps, rubella. No one was concerned when you got them."

Middle of the road

Hamilton and Moskowitz said somewhere between the choice to vaccinate or not, there lies a middle-of-the-road approach to immunizing children, such as waiting until their immune systems are somewhat developed. Children in the U.S. are usually vaccinated as early as two months old.

"It's one thing to take a healthy three-year-old and give him tetanus toxoid," Moskowitz explained. "That's a perfectly reasonable decision. It's quite another to bombard a newborn baby with their first immunizations as their first immunicological experience."

Hamilton said in Florida, law mandates that by the time children reach kindergarten, they are required to have received multiple shots in order to be admitted into school.

"That's insane. When I was a kid, we had two vaccinations: you got small pox vaccine and polio vaccine. It's kind of crazy. When you go to the doctor for your two-month visit and you get two vaccines, we don't know that the body can make antibodies for six different diseases at once."

Hamilton said while she feels the best choice is to wait until the child's immune system more developed, the decision really should depend upon the needs of the individual.

"If you're home with your child and your kids don't go to school until they're four or five years old, then postpone the vaccination until then," she explained. "If you're a working mom who goes back to work at six weeks and you have to put your baby in day care, then vaccinate your child. It's based on need rather than somebody's rules."

But decisions based on personal needs concern Bertran.

"It's not a matter of only what happens to them," he said, "but they can be a source of infection to others. Most of these vaccines start at two months of age, so basically most babies are not vaccinated before then. So, the risks from diseases in nature and from others who are not vaccinated are high for infants...We shouldn't pose a risk to other people."

Playing God

Moskowitz said risk is inherent to life and chided the medical profession for its attempts to control the inevitable.

"Can anybody seriously believe that if we somehow manage to eradicate every known infectious disease that others would not rise up to take their place?" he implored. "It's inconceivable, the presumption that we should tinker with the evolutionary process like that...It's just so unlikely. To me its similar to reckless driving, only it's on a huge scale."

Moskowitz said physicians' faith in mass inoculation can look a lot like dogma.

"You don't have to impute bad motives to these people," he said. "They think they're doing a great thing. They're volunteering their children for these experiments. I'm not suggesting that they're just money-grubbing about this...This is religion we're talking about here in the sense that we expect everyone to do it whether they want to or not for a higher purpose, and we waive the rules of long-term scientific study."

He continued, "We are bending the knee to the right and power of the medical community to fool around with evolutionary power. That's the feeling I get for the guff parents take for trying to take a different route, like a conscientious objector to Christianity in the Middle Ages. It was not something you kept your head for."

Bertran contended that most Americans would prefer to play God than let nature take its course when it comes to disease.

"Let's say there's going to be an AIDS vaccine tomorrow," he said. "I guarantee there's going to be a line from here to the Rickenbacker of people trying to get the vaccine."

Speaking of religion, Malavenda and his chiropractic colleagues feel so strongly about the harm caused by vaccinations that they have formed a religious affiliation specifically so that their clients can qualify for religious exemption to mandatory vaccine laws. Despite their outspoken stance, Malavenda said health care practitioners who don't tow the party line face an uphill battle at times.

"When you're going up against issues like this," he explained, "you're going up against big companies, which is pharmaceutical companies. When you understand that a pharmaceutical company will spend $22 million a day on advertising, its a huge issue."

Bertran disagreed, explaining that despite the suspicions of those who distrust traditional medicine, most doctors are primarily concerned with saving lives and not just cashing in.

"For those who like to make money, [not vaccinating] would be wonderful," Bertran joked. "The hospitals would be full of sick people. But it would be a happy day when they make a vaccine for the common cold and no one would ever have to go to the doctor. I would be the happiest person in the world."

Read Part One of this series about the pros and cons of inoculating small children.

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