A Doctor’s Personal Vaccine Dilemma

June 26, 2008

It began with vaccinations. As a holistic physician who has witnessed all too often the onset of autism shortly after vaccination, I was none too eager to vaccinate my own precious baby. It had taken me 41 years to give birth to what in all probability would be my only child, and I certainly did not want to take any chances.

It had not always been this way. Back in the years when I worked in a clinic on East Broadway, I used to think the mothers who refused vaccinations were crazy. But back then I thought frumkeit (religion) was crazy, too.

I loved working in that clinic, next door to The House of Sages, down the street from the Bialystoker Shul. Eating my potato soup and black bread at the Grand Dairy or my vegetable soup and onion rolls at Gertel’s, I connected with my immigrant ancestors. All my grandparents had lived down here, and all of them had been religious. Over the generations, most had drifted away, from both the neighborhood and the religion—I had been brought up in a secular Jewish home, going to a Conservative “temple” on the holidays. But one branch of the family, my father’s first cousins, had remained staunchly religious, and it was these relatives, in their beards, peyos (sideburns), and sheitels, that I thought of as I strolled down Orchard Street during my lunch hour.

An odd thing happened—I became holistic and religious at the same time. The same questioning of medical conventions brought with it a questioning of religious ones. Or vice versa. The two were so intertwined it’s hard to say which came first.

Coincidental with my foray into holistic medicine, I began venturing to synagogue, first Conservative then Orthodox. Eventually, I became religious and, on my first date through a shadchan (matchmaker), met my husband. For over a decade, I’d been looking to get married and could never seem to find anyone. Then, within months of becoming shomer mitzvoth (religiously observant), I was engaged. I could only conclude that Hakodosh Barochu (The Holy One, Blessed be He) was pleased with my tshuvah (repentance).

In many ways, my husband Yitzchak and I were opposites. While I am intense and ambitious, Yitzchok is easygoing and laidback. His mother told me she gave him the right name because he makes everyone laugh. How true that is! How many times, I nearly choked on my food because of some hilariously inane remark he happened to make.

Yitzchok, like his mother, is an avid sports fan. I don’t particularly care for spectator sports, but watching my husband watch—now that is a sport in itself. Occasionally, my mother-in-law joins him, but at championship games, she is much too nervous to watch. Instead, she waits for the “all-clear,” a phone call signaling that it’s safe to tune in–there is no chance her team could lose. I remember one year, when the New England Patriots were in the Super Bowl, Yitzchok tore himself away from the pre-game show to go to mincha. When I asked him if he were going to pray for the Patriots, he answered scornfully, “I wouldn’t bother G-d about a football game. ” And then, after a pause, “But I will ask Him not to do anything that would upset my mother.”

Yitzchok is very sweet and sincere about his Judaism. While I might attend seminars on Jewish meditation or holistic medicine and Judaism, he simply gets up every morning at 5 A.M. and goes to shul for daf and davening. On fast days he fasts. No meditation, no holistic. Despite our temperamental and avocational differences, we get along well. As a brand new baalas tshuvah (returnee to the faith), I was glad to be married to someone who knew Jewish law, and my husband, in turn, gladly followed his physician wife’s suggestions, giving up cigarettes, starting an exercise program, and eating whatever healthy food I placed in front of him. Essentially, when it came to religion, he was the boss; when it came to health, I was. That is, until little Avi was born.

At first, Yitzchok went along with my decision not to vaccinate. Around this time, I’d begun taking care of a little boy with autism. He’d been perfectly normal until his MMR at 15 months. Then, he developed a high fever, stopped talking, lost all eye contact, and began the repetitive rocking behavior characteristic of autism. It was really frightening. Yitzchok understood my desire not to vaccinate. “OK, Mahjie,” as he calls me in his Boston accent, “I wouldn’t want to hahm him. I guess we’d better skip the shots.”

Then, his mother found out. I love my mother-in-law, I really do. She’s young and full of life and definitely the best person to go shopping with. I couldn’t have asked for a better mother-in-law. But now the real fun began. “I want my grandson to receive all his vaccinations,” she said to Yitzchok in her sweet, high-pitched voice that made her sound more like a teenager than a woman of 68. She put the fear of diphtheria, tetanus, and pertussis into him, not to mention measles, mumps, and rubella. “I just don’t feel comfortable with him not getting vaccinated,” she’d say, nervously brushing a fleck of dust from her blue eyes. Before long I had two people badgering me about vaccines. I’d be changing a diaper, and she’d say, “What an adorable tush—I’d hate to see him miss his shots.” Or, “When are you going to vaccinate? I read about an outbreak of measles in Minnesota.” (No matter that it was the vaccinated kids who got the measles.) And of course, the more she talked about it, the more Yitzchok worried. “Are you sure there’s no hahm in not vaccinating?” he’d say not once but twice, as he watched me deftly wrap Avi up tight in his swaddling cloth, one of the few practical skills I’d learned in my Pediatric internship all those years ago. I assured him that the hahm was in vaccinating.

Meanwhile, I was having a hard time postpartum. I felt as if I couldn’t hold a thought, let alone reason. My mood was all over the place, one minute tearful, the next ecstatic. As for baby care, I was a complete novice. The last time I’d even seen a baby was fifteen years before when my niece was born. True, I’d been a Pediatric resident twenty years before, but doing newborn physicals on fifteen babies a day in the hospital has nothing to do with caring for your own baby. This little bundle of sweetness was all mine, all seven pounds of him, and if he cried and needed to be fed, it was all up to me. And then nursing was another trial. It took a good three weeks of lactation consultations to learn how to do it. And all the while I was pondering the vaccination question.

The pediatrician, a white-haired bicyclist with Groucho eyebrows, favored the shots, but he was willing to let us make the decision. I knew that a lot of parents who didn’t want to vaccinate brought their kids to him. Leaning back in his swivel chair, his little red stethoscope dangling around his neck, he’d say, “If you’re asking me, I’d say vaccinate–that’s what I do.” But he didn’t push us.

Soon enough, my parents got into the act. They sent my uncle, a renowned cardiologist whom I had admired since childhood and the family voice of reason, to speak with me. “I am very distressed, Marjorie, to learn that you are contemplating not vaccinating. I fear this places your son at undue risk…” I didn’t even try to answer; I couldn’t argue medicine with the expert, and moreover, I knew I wouldn’t change his mind.

In an attempt to get Yitzchok on my side, I phoned my mentor, Dr. Jon Stein. A well-known holistic physician, he had taken me under his wing when I first started my practice. He had told me privately of his concerns about vaccines, especially the MMR. I arranged for him to have a paid phone consultation with Yitzchok and me to discuss vaccinations. But speaking for the record, he sang a different tune. “All my kids got vaccinated, and nothing bad ever happened to them.” I felt so betrayed. Yitzchok was saying I told you so.

Now I really felt cornered. In a last ditch effort, I called Richard Moskowitz, an MD homeopath in Boston. He had appeared in a debate in Mothering Magazine, arguing against vaccines. (Andrew Weil argued in favor.) His advice: “Delay, delay, delay; the longer you wait, the safer it is.” An infant, with its immature immune system, liver, and nervous system, stands a greater chance of being harmed than an older child. It made perfect sense. I stood my ground.

It wasn’t easy to have everyone against you, accusing you of hurting your own child. Here is this adorable little baby, totally helpless, dependent on you for everything, that you love with all your soul; the last thing you would want to do is hurt him. Every time Yitzchok or his mother or my parents or uncle would bring up the subject of vaccination, I’d have in my mind the little Goodman kid, who’d gone bad, so to speak, after his MMR. To think of my little Avi, now smiling at me and starting to coo, suddenly lost in his own world, unreachable, and all because of a vaccine. To further drive the lesson home, this was right around the time of year of the annual fundraiser for Shalva, an organization founded by the parents of a child who had became deaf and blind as a result of a DPT vaccine. This didn’t seem to bother Yitzchok. “After all, he said, “They still vaccinated all their other kids.”

True, most children sail through vaccination without any obvious detriment. My problem was I knew too much. I knew that the mercury levels far exceeded safe doses, even for adults, but that in the interests of public health, the EPA had ignored its own standards. I also knew of the connection between measles virus and autoimmune disease, such as MS, a development that doesn’t manifest until years later, and therefore is difficult to ascribe to vaccination. On the other hand, I also knew that autism is a complex condition with no single cause, and that, as with any disease, it likely requires a genetic predisposition. So, in other words, Avi was probably safe. Yet, knowing what I knew, I couldn’t bring myself to take the chance, not when childhood diseases were no longer a threat. It just didn’t seem necessary.

And yet, I was beginning to doubt myself, not on the medical question, but on a personal one. Was this issue worth threatening our shalom bayis (peaceful home)? Here I was 41 years old, finally happily married, with a beautiful baby boy; surely I had a lot to be thankful for. Shouldn’t I just have bitachon and emunah (faith and belief) and go ahead with the shots? After all, we had come this far. But then, there was the scientist in me always wanting to stay in charge. When the obstetrician had wanted to run prenatal tests for Down’s Syndrome, Yitzchok had said, “Why ruin the pregnancy? Just have bitachon and emunah.” I’d listened to him then, and it had been a breath of fresh air. Why not now? Yet, it’s hard to ignore a lifetime of scientific training for a mere two years of religious learning. Whenever I became overly anxious about something, my mother-in-law, would say, “Don’t worry, Hashem has a way of working these things out.” I appreciated this approach intellectually, but emotionally was another story. You don’t go from “I have to stay on top of all the details” to “Hashem will take care of it” overnight. That kind of emunah takes time to grow.

Vaccinate, not vaccinate. Day in and day out, I’d argue with myself and with Yitzchok. Nowadays, it would have been an easier decision. They have since removed the mercury preservative from the vaccines, and, as a result of the autism epidemic, guidelines exist for vaccinating more safely. But back then, I really didn’t know where to turn. Then, just when I was at my wit’s end, the solution appeared. It was right there, on my kitchen counter. It was a fine June morning, I had just come downstairs for breakfast, and there it was—a cigarette. I picked up the small white cylinder with amazement and dread. Hadn’t Yitzchok quit smoking two years ago? Had he really been poisoning his body all this time? Feeling sick, I brought the odious object to him.

“What’s this?” I demanded, trembling with rage and disappointment. Other times, there had been excuses, like when he came home smelling of smoke and told me about the chain-smoking schnorer he’d driven to Boro Park. But this time, there were no stories. (He really did drive a chain-smoking schnorer to Boro Park, but he neglected to admit that he himself had never given up smoking.)

“I’m sorry,” he stammered, a pained look on his face. “Please forgive me. I really did try to quit… it’s not so easy. Please forgive me. I will quit. Give me ‘til Yom Tov, and then I’ll quit, I promise.”

I wanted to believe him, I really did. But they don’t call smoking an addiction for nothing. This was not going to be easy. Suddenly I had an idea. We were standing in the hallway by the side door. Yitzchok had been just about to leave for work when I confronted him.

“OK,” I said, “let’s make a deal. When you quit smoking, I’ll vaccinate Avi. Deal?”

Surprisingly, he looked relieved. I think the evasions had been a strain. Opening his hands in a gesture of resignation, he said, “Deal.”

I never heard about it again.

(To be fair, he did finally quit smoking when Avi was ten, but by that time, the pediatrician told us to forget about the vaccinations.) I have never regretted my decision, and I’m still working on my bituchon and emunah.

Marjorie Ordene is a physician and writer.

The words of this author reflect his/her own opinions and do not necessarily represent the official position of the Orthodox Union.