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FEATURE: Vaccine-avoiders pose health risk, doctors say

When a 30-year-old woman from southern Taiwan returned from a holiday to Japan in May, she bought back an illness that confounded four different doctors on eight separate visits.

On her ninth visit to a fifth doctor, the woman was finally diagnosed correctly. The mysterious disease she suffered from was one that Taiwanese doctors are not used to seeing much of anymore -- measles.

The virtual eradication of the disease from this country after a widespread inoculation program for measles, mumps and rubella is a success story public health experts are proud of. However, the same experts warn that the hard-won victory over the diseases is a fragile one that requires continual vigilance and the cooperation of the public.

Vaccination is strongly recommended in this country and inoculation rates are above 95 percent, Centers for Disease Control (CDC) figures show.

However a small subset of parents in this country, worried about the possible side effects of vaccines, are beginning to challenge vaccinations.

"I tell my patients that their children can't start primary school until they've had their full course of vaccinations," said Huang Li-min (黃立民), a pediatrician at National Taiwan University Hospital.

However, there is no punishment for not inoculating children and, as long as the parent is willing to put up with a barrage of nagging and admonition from doctors and school officials, no requirement that a child must be inoculated before starting school.

"Tell school officials that your [proof of] vaccination is missing," advised one blog commenter to another who wanted to avoid vaccinating her children.

In another blog, a mother explained why she chose not to complete her children's vaccinations.

"I believe in the power of our bodies to heal themselves," said the woman whose Internet handle is "Little Frog."

Liu Ding-ping (劉定萍), director of the vaccine center at the CDC, said that Internet blogs and forums had become hotbeds of anti-vaccine sentiment.

"I've read posts from parents who were practically boasting about how healthy their children were despite them not being vaccinated," she said. "But the reason these children are still healthy is because everybody around them has been vaccinated."

In addition to the online communities, there have also been recent books and articles questioning the safety of vaccines. The United Evening News published an article in January about parents who refused vaccination for their children titled "A new way to respect the body: refuse vaccines."

"We have tried to negotiate with the Ministry of Education [MOE] to make a full course of vaccinations a prerequisite to entering primary school," former health minister Twu Shiing-jer (涂醒哲) said. "However, the MOE believes such a rule would go against the child's right to an education."

"As Taiwan becomes more democratic, we have less power to mandate vaccinations," Twu said.

"However, it could be hard for individuals to judge the pros and cons in this matter," he added. "The fear is that as parents become more opinionated about medical matters, we could follow in the footsteps of Japan."

Hakuyo Ebara, the director of the Ebara Children's Clinic in Hyogo, Japan, said the outbreak of measles that hit Japan this year was the result of the relatively low percentage of children inoculated against the disease in that country after mandatory inoculation laws were lifted in 1994.

"Instead of vaccination, some parents deliberately passed measles from one child to another by swabbing the inside of the sick child's cheek and transferring the swab to a healthy child," Ebara told a panel at a recent vaccination seminar in Taipei.

This was done, Ebara said, because the parents believed that measles did little harm to young children.

Many of the concerns about vaccination involve possible links between vaccinations and autism as well as sudden infant death syndrome. Although public health professionals have long maintained that no study confirms such a link, a minority in many countries still believe there is a connection.
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