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Vaccinations---Pros and Cons

Safe and Effective and should they be government mandated?

Vaccinations--Pros and Cons

Safe and Effective and should they be government mandated?

The number of available vaccines are increasing and so are the questions of parents and concerned individuals who want to be enlightened about the pros and cons.

On another forum, KFC noted that some parents in Belgium are being jailed for refusing to have their children vaccinated against polio. According to a Lifesite news report, 2 sets of parents have been sentenced to five months in prison as well as a hefty fine for their crime. It’s a crime because the polio vaccine is legally mandated in Belgium and France. The article didn’t reveal why the parents have refused to vaccinate their children. However, vaccination has long been a subject of health and ethical concern, especially since the discovery that numerous vaccines, including several versions of the polio vaccine, are made using tissue from aborted fetuses. It’s unclear whether or not Belgium's polio vaccine has been tainted with fetal tissue.

While no vaccine is 100% safe, medical experts and health officials have long insisted the risk of diseases far outweigh the risks associated with vaccines. And that’s where the rub lies. It’s a small percentage, but what if it happens to you? Various anti-vaccination groups argue that long-term health concerns for children who have received vaccinations have not been adequately addressed, with some claiming that vaccination shots can lead to medical problems such as cancer, autism and even SIDS, "sudden infant death syndrome".

In 1986, due to pressure from parents who children had suffered devastating problems after being vaccinated, the government created the National Vaccine Compensation Program and since then has paid out more than 1.2 billion dollars in settlements to compensate families or individuals in which vaccines killed, caused brain-damage or otherwise seriously hurt children.

Right now, we have pretty much employed a "one size fits all" vaccination policy and as specified on the Universal Childhood Immunization Schedule our children as early as only a few days old are required to get certain vaccines. Besides that, there is a concern about the practice of giving a child as many as 6 separate shots or one super shot containing as many as 9 vaccines (some containing mercury) in one visit. It seems that 75% of the settlements cited above concerned the DPT vaccine given to babies at about 2 months old. Turns out they are linking many multiple learning disabilities as a result of a negative reaction to DPT.

In an effort to make this world a better place, and with a billion dollar budget, the drug industry and the medical community are racing forward developing all kinds of vaccines. Case in point is the new HPV vaccine which is supposed to protect against certain strains of human papillomavirus (STD) which lead to cervical cancer. Problem is only a fraction of that budget goes to fund independent studies of side effects and that finally has come to the attention to some in Congress.

Who decides what drugs are forced on children? One parent group based in Ohio supports allowing parents to opt their children out of vaccines and as a result, a dozen or so states have granted a limited medical exemption, a religious exemption, and a philosophical (conscientiously held belief) exemption. Unfortunately, great pressure is put on parents who choose to exempt their children. That happened to me in the case of the small pox vaccine a couple of years ago. The school insisted....and threatened to oust my child...the pressure was on.....and, as for me, I was aware of the medical, religious and philosophical exemptions.

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Reply #1 Top
I'm troubled about our government's mass "one size fits all" vaccination policy. It doesn't make sense for everyone to take the same dose of the same vaccine at the same age while ignoring individual differences, sizes, age, genetics, etc. It doesn't make sense to innoculate perfect newborn babies with doses of mercury and high levels of who knows what to protect them from diseases.

Reply #2 Top

As an addendum:

Gates Foundation Explains Bill Gates Re: Vaccines Reducing Population

by James Tillman

March 8, 2010 (LifeSiteNews.com) - When Microsoft co-founder and population-control advocate Bill Gates spoke recently of using vaccines to reduce world population, he set off a wave of speculation over his possible allusion to covert sterilization programs.  According to the Gates Foundation, however, the multi-billionaire in fact advocates vaccine use to decrease child mortality - something he claims actually decreases population growth.

Gates' comments occurred while he was speaking to a to a TED (Technology, Entertainment, Design) conference on how humans might reduce their CO2 emissions in order to reduce global warming. "Until we get near to zero [carbon emissions]" he claimed, "the temperature will continue to rise" - which he said would lead to "extremely bad" consequences.

Because the quantity of CO2 emitted is related to the human population, Gates briefly mentioned means to reduce the projected world population, including "reproductive health services" - abortion and contraception - as well as vaccines. 

"Now if we do a really great job on new vaccines, health care, reproductive health services, we lower that by perhaps 10 or 15 percent," he said.

Gates is well-known for funding pro-abortion population control measures - but Gates' vaccine reference immediately launched speculation regarding the use such drugs to disseminate sterilizing agents on a large scale.

Previous vaccination programs have been shown to have covertly been used to sterilize women.  In 1995, the Supreme Court of the Philippines found that vaccines used in a UNICEF anti-tetanus vaccination program contained B-hCG, which when given in a vaccine, permanently destroys women's ability to sustain a pregnancy.  Aproximately three million women had already been given the vaccine.

Despite this, Gates claims to operate on the seemingly paradoxical view that decreasing child mortality also decreases population growth. In response to LifeSiteNews.com's query, the Gates Foundation - noting that Gates spoke at the TED event solely in a personal capacity - pointed out that Gates said in his 2009 Annual Letter that a "surprising but critical fact [is] that reducing the number of [infant] deaths actually reduces population growth." 

He continued by explaining the theory that parents will have more children when infant mortality is high, so as to ensure that several children will survive to take care of them as they grow old.

"If you improve health in a society ... surprisingly, population growth goes down," Gates told CNN in 2008.  "And that's because a parent needs to have some children survive into adulthood to take care of them when they're old."

"And so, if they think having six children is what they need to do to have at least two survive, that's what they'll do. And amazingly, across the entire world, as health improves, then the population growth actually is reduced."

The Bill and Melinda Gates Foundation recently pledged ten billion dollars to help vaccinate children around the world.

Reply #3 Top

Vaccines save lives. Period. Anyone who doesn't fully immunize their children is an idiot. Period.

Reply #4 Top

Vaccines save lives. Period. Anyone who doesn't fully immunize their children is an idiot. Period.

I understand what you're saying (and agree with your first sentence), guess I just don't like how you say it. I'm sure the loved ones of anyone passing away from a vaccine might also feel like an idiot. It is sometimes hard to determine allergies especially in young children, especially fatal ones. One does take a risk, although for most a small one. Since your qualifier in the above statement is "anyone", I disagree. If I knew my child had a bad reaction to a component to a vaccine, I would be an idiot for seeking a vaccination for him or her, regardless of your opinion. Broad statements such as yours rarely apply 100%, but you are entitled to your opinion. Period.

1044 reported dead (non-idiots, but I'm sure that label gives their families great comfort) in the US since 1988, a small number compared to those protected IMO, but no less difficult for those affected families. Source http://www.hrsa.gov/vaccinecompensation/statistics_report.htm

Claims Filed and Compensated or Dismissed by Vaccine
August 12, 2010

Vaccines Listed in Claims as Reported by Petitioners

Vaccine(s)FiledCompensated Dismissed 
InjuryDeathTotal
DT (diphtheria-tetanus) 63 9 72 21 48
DTP
(diphtheria-tetanus-whole cell pertussis)
3,282 696 3,978 1,265 2,677
DTP-HIB 16 8 24 3 19
DTaP
(diphtheria-tetanus-acellular pertussis)
291 74 365 101 122
DTaP-Hep B-IPV 42 18 60 12 11
DTaP-HIB 6 1 7 4 0
DTaP-IPV-HIB 3 1 4 0 0
Td (tetanus-diphtheria) 153 3 156 67 58
Tdap 32 0 32 5 1
Tetanus 67 2 69 26 34
Hepatitis A (Hep A) 26 1 27 4 8
Hepatitis B (Hep B) 555 48 603 171 281
Hep A- Hep B 7 0 7 4 1
Hep B-HIB 7 0 7 2 2
HIB (Haemophilus influenzae type b) 19 3 22 7 5
HPV (human papillomarvirus) 74 8 82 2 4
Influenza (Trivalent) 476 29 505 170 45
IPV (Inactivated Polio) 262 14 276 7 266
OPV (Oral Polio) 280 27 307 157 148
Measles 144 19 163 55 107
Meningococcal 14 1 15 2 0
MMR (measles-mumps-rubella) 814 52 866 304 344
MMR-Varicella 20 1 21 3 1
MR 15 0 15 6 9
Mumps 10 0 10 1 9
Pertussis 5 3 8 2 6
Pneumococcal Conjugate 25 3 28 6 16
Rotavirus 44 1 45 21 12
Rubella 189 4 193 70 123
Varicella 56 3 59 28 15
Nonqualified2 70 9 79 0 78
Unspecified3 5,401 6 5,407 2 781
TOTAL 12,468 1,044 13,512 2,529 5,232
Reply #5 Top

Nitro -

Claims/compensation data, unfortunately, have a very non-scientific connection to actual cause-and-effect relationships (just ask John Edwards).  Even if one accepts that every one of those deaths (less than 50 per year in a country of some 300 million) was directly caused by the vaccine received, the risk of the disease far exceeds the risk of the vaccine, by orders of magnitude.

No such thing as a perfect, 100% harmless vaccine, though - some adverse effects, some leading to death, are inevitable.  Life is a crap shoot, but I like my chances better immunized than not.  Not having been much plagued by vaccine-preventable diseases for the past generation or three, we tend to take their relative absence for granted.  And the number of diseases becoming vaccine-preventable is steadily rising over time.

Having said all that, they should under no circumstances be mandatory as a condition of existence.  Immunization requirements for school and certain occupations can hardly be avoided, but there will always be exceptions. 

Reply #6 Top

Quoting Bunnahabhain, reply 3
Vaccines save lives. Period. Anyone who doesn't fully immunize their children is an idiot. Period.

A dead child hardly gets the benefits of vaccinations.  Many vaccines are good, but the government has gone overboard.  There has to be some reasonableness between vaccinating for any bug and for the major ones.

Many of the child hood vaccines today have not proven their worth (not most, just many).  I want my child safe, not a vegetable.

Reply #7 Top

Claims/compensation data, unfortunately, have a very non-scientific connection to actual cause-and-effect relationships (just ask John Edwards).

Daiwa - I agree about what you say about claims. I just used this data to illustrate that vaccination deaths do occur, even if only a small percentage. I'm sure the courts found reasonable cause in some cases. Would it matter if it were only one? Probably not to most, but I'm sure one family would disagree. I just found it a bit overboard to label one an idiot due to both real and imagined reasons not to vaccinate. Personally I'm willing to accept the risk, I'll hold my judgment of others on the issue.

Case in point: Over a million men and women in the military received the Anthrax vaccination. Some did get sick, not sure if anyone died. Not sure if their will be long term effects. One had to have it or be discharged for refusal, no questions, and some were. Did it save a life? Well no anthrax was encountered (to my knowledge, not counting the stateside cases) so we might never know. We might also never know if the vaccine has any long term effect, but it may affect many of us if it does. Like anything the fear of the disease must out weigh the fear of the cure.

Reply #8 Top

Many of the child hood vaccines today have not proven their worth (not most, just many). I want my child safe, not a vegetable.

Well said.

Reply #9 Top

I agree - no one should be called an idiot for declining a vaccination.

Reply #10 Top

Quoting Bunnahabhain, reply 3
Vaccines save lives. Period.

Maybe some of the older vaccines, but I wonder about the newer ones especially in the rise of autism and Alzheimer's disease.

NITRO, you are good at providing handy dandy charts and I wonder if there are any long term studies have been done to determine degrees in health in the vaccinated populations vs the unvaccinated ones?  

Thimerosal (mercury) was first used in vaccines in 1931. Autism diagnosisis (sp?) exploded in the 90's when babies got these vaccines in the first year of birth. 

In 1985, studies done of the Amish community (that does not vaccinate) has no diseases.  

Quoting Bunnahabhain, reply 3
Anyone who doesn't fully immunize their children is an idiot. Period.

Not really. Why? Because many families have suffered because there are definite problems directly related to "routine" vaccinations that are mandated by the government.

 

Reply #11 Top

There has been a long term massive study done in Denmark.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124634/

The medical records of over half a million children were studied over seven year (the nature of Denmark's health system made this possible) - about 100 000 children had not been given the MMR vaccine.  The autism rates were statically the same between the groups (the exact numbers were lower in the vaccinated group).

The principle reason that there are more people with Alzheimer's disease is that there are more old people.  The only things that have been shown to have even a slight causal link with Alzheimer's disease have a very weak link and are far less importance to the disease than simply getting older.

 

The diseases that vaccines have been created for kill, measles kills hundreds of thousands a year.  One in 3000 who get it die of it.   

Reply #12 Top

Thimerosal (mercury) was first used in vaccines in 1931. Autism diagnosisis (sp?) exploded in the 90's when babies got these vaccines in the first year of birth.

Hurricanes have exploded in the last 30 years (the number, not the intensity).  Why?  Better information - they find them out in the middle of the Atlantic now where before they were almost never reported there.

Coincidence does not prove causality.  I would say the detection methods have improved significantly in the last 80 years and probably has an impact on the reported cases.

Statistics can be made to lie by almost anyone.  But an informed and educated person will always spot the lie and expose it.

Reply #13 Top
There is no connection between thimerosal and autism. None whatsoever. Ther is a direct connection between the banning of DDT and increased deaths from malaria, though.
Reply #14 Top

Ther is a direct connection between the banning of DDT and increased deaths from malaria, though.

Actually the connection is indirect.  A direct connection would be the lack of DDT in a person causes Malaria.  The actual fact is that the banning of DDT caused an explosion in Mosquitoes that lead to a rise in Malaria.  Definite causality there, just not direct.  The Middleman is Mosquitoes.

Reply #15 Top

In an effort to make this world a better place, and with a billion dollar budget, the drug industry and the medical community are racing forward developing all kinds of vaccines. Case in point is the new HPV vaccine which is supposed to protect against certain strains of human papillomavirus (STD) which lead to cervical cancer. Problem is only a fraction of that budget goes to fund independent studies of side effects and that finally has come to the attention to some in Congress.

 

As an addendum .....Here is the latest news item regarding the HPV vaccine Gardasil.

What went wrong with Gardasil sales?

March 22, 2011 (LifeSiteNews.com) - The Gardasil vaccine, introduced in 2006 to prevent cervical cancer caused by HPV (Human Papillomavirus), was backed by a massive marketing campaign by its manufacturers, the U.S. drug company, Merck Frosst. The drug was approved by federal and provincial public health agencies in Canada, who claimed it was safe for young girls, aged 9-15 years, even though there were only limited data available on the effects of the drug on pre-teen and early teenage girls.

The Gardasil campaign in Canada was also enhanced by a provision, in the Conservatives 2007 federal budget, to provide $300 million to the country’s provinces to distribute Gardasil. The provinces could not resist the money and used it to vaccinate thousands of young Canadian girls.

Public demand for this drug was created by the media, mindlessly and uncritically parroting the claims of the manufacturers in their hard driving marketing campaign.

With all this going for it, Gardasil grossed over $1.1 billion U.S. within nine months after hitting the market. By that time, Merck Frosst had distributed 13 million doses of the vaccine, which had been approved in 86 countries.

Marketplace Dud

Four years later, however, Gardasil has turned into a marketplace dud. In Merck’s second quarter in 2010, the company reported an 18% year-over-year drop in sales and its shares dropped nearly 3%. What happened to Gardasil sales, which led to this financial setback?

It turns out that Gardasil’s flat and declining sales are due to a design flaw. To be completely immunized, women and girls have to receive a series of three injections over six months. Many women and girls didn’t do so. For example, according to the U.S. Center for Disease Control, in their report of August 2010, although 44% of teenagers had received the HPV vaccine in 2009, only 27% of them received all three doses of the vaccine.

There is no evidence to support the possibility that only one injection effectively protects against cervical cancer.

The reasons for the failure to obtain all three injections may be due, at least, in part, to the following:

  • Many parents are not comfortable vaccinating young children against a virus they can only get if they are having sex;
  • Merck was unable to counter the bad press that arose when the side effects of the HPV vaccine Gardasil became known; and
  • Competition from another pharmaceutical company, GlaxcoSmithKline, whose product, Cervarix, hit the market in 2009.

Although Merck is still pushing the drug into other markets (the drug was approved in 2009 for male use, and Merck has signed a deal to sell Gardasil in China), it is believed a full comeback is unlikely.

It seems that the real problem is that the public is not ready for a cancer vaccine that requires multiple injections, claiming to prevent cervical cancer which is caused most commonly by sexual activity.

This article was originally published in the January/February 2010 edition of Reality magazine and is re-published with permission.

 

Reply #16 Top

It seems that the real problem is that the public is not ready for a cancer vaccine that requires multiple injections, claiming to prevent cervical cancer which is caused most commonly by sexual activity.

Ah, I disagree that the real problem is merely that the vaccine requires multiple injections. Rather I think the related stories are more indicative of the real problem with Gardasil.


Reply #17 Top

CRAZY California does it again. Here's a news item from July 5.

 

California bill gives minors access to STD immunization without parental consent

SACRAMENTO, July 5, 2011 (LifeSiteNews.com) – A proposed law in California that would allow minors to obtain vaccines for sexually transmitted diseases without parental consent is being strenuously opposed by the state’s Catholic bishops.

California law currently permits children age 12 and older to consent for themselves to diagnosis and treatment for sexually transmitted diseases. The proposed law, AB 499, would extend that right to include preventative care, such as immunizations.

The bill has been approved by the State Assembly and was passed by the Senate Judiciary Committee on June 14th.

If passed, the bill would give minors access to controversial vaccines intended to prevent Human Papillomavirus (HPV), an STD which can cause cervical cancer in women.

“This bill appears to be an ‘end run’ following the failure in 2007 to mandate HPV vaccination for all girls entering public junior high school — a measure strongly opposed by parents’ rights groups and vetoed by the Governor,” said an action alert from the state’s bishops.

Gardasil, approved by the CDC for use on females age 9 – 26 in 2006 and on males age 9 – 26 in 2009, and Cervarix, approved for females age 10 – 25 in 2009, are the two HPV vaccines currently on the market. Gardasil can be given to males as protection against genital warts.

The CDC maintains their safety and effectiveness, and recommends full immunization against HPV, which requires three doses of the vaccine.

The bishop’s action alert, however, noted that 21,171 adverse reactions and 91 deaths associated with Gardasil had been reported to the Vaccine Adverse Event Reporting System as of January 15, 2011.

According to the CDC website, there have been 39 reports of adverse events associated with Cervarix as of June 2011. The drug’s safety has also been called into question in England, where 12-year-old Ashleigh Cave collapsed shortly after receiving the vaccine at school and was left paralyzed from the waist down.

The bishop’s action alert questions whether minors should be considered to have mature enough judgment to make their own decision about drugs of such questionable history.

“Most parents are involved in the lives of their minor children and need to know if they are seeking medical care — regardless of whether the care is curative or preventative,” said the statement.

According to a National Catholic Register report, William May, chairman of the California-based lay apostolate, Catholics for the Common Good, pointed out in his testimony against the bill at a Senate Judiciary Committee Hearing, that without parental involvement, adverse reactions to the vaccine may go unnoticed and untreated.

“Children can be easily intimidated or influenced by the authority of adults,” said May “There is money to be made by administering these vaccines and other drugs by the drug companies and service providers, like Planned Parenthood. What protects children from coercion driven by the profit motive?”

Reply #18 Top

Quoting lulapilgrim, reply 17
SACRAMENTO, July 5, 2011 (LifeSiteNews.com) – A proposed law in California that would allow minors to obtain vaccines for sexually transmitted diseases without parental consent is being strenuously opposed by the state’s Catholic bishops.

I'm glad the bishops under Archbishop Gomez, are getting involved urging rejection of this bill. Can you imagine permitting children as young as 12 years old obtaining the HPV vaccination without parental notification or consent? 

 


Reply #19 Top

Short answer - No.

But I can imagine anything happening in Kalifornia.

They used to say that California was the leading edge of all trends, that everything 'good' started there and spread to the rest of the country.  That's a very frightening notion now.

EDIT: This is a forerunner of what will happen with full implementation of Obamacare - the alleged potential 'cost to society' will be used as justification for usurpation of all parental authority and personal autonomy.  Kalifornia's next step will be making them mandatory, not just permissible without parental consent.

Reply #21 Top

The alleged benefits of expanded taxpayer-funded health insurance are going to be harder to justify, let alone prove, if the information in this timely piece is any indication.

Reply #22 Top

Kalifornia's next step will be making them mandatory, not just permissible without parental consent.

But I can imagine anything happening in Kalifornia.

Just when I think it can't get any worse, it does. Turns out California has been on track to mandate these STD vaccines at least as far back as 2007. But it's not only California.

Check out this story from 2007. http://townhall.com/columnists/lindachavez/2007/02/23/parents_dilemma

And note who's mentioned in the 3rd paragraph...

Gardasil, an anti-HPV vaccine produced by Merck & Co., was recently approved by the Food and Drug Administration, and the company is aggressively marketing it through television ads and lobbying state legislatures to mandate vaccinations of all young girls. Gov. Rick Perry of Texas, who signed an executive order requiring sixth-grade girls to receive the shots, is under fire because his former chief of staff is now a lobbyist for Merck.

Mandating STD vaccines amounts to a war against children and for me, this shoots Rick Perry out of the running.

 

Reply #23 Top

Myfist0,

Thank you for the video #20. Good job finding one that goes directly to the question, should vaccines be government mandated?  

I find this quote at the end of the video ....1:20:45  

"And in fact, the responsible for health of children is this. Society rests primarily on children's parents and parents should have the right to opt out of vaccination.

The right to informed consent of vaccinations can be defined as a human right becasue vaccination is a medical intervention that carries a risk of injury or death and if you cannot make a choice about whether or not you are going to put yourself or child at risk, for a vaccine that could kill or injure you then how can we say we are free in America?"

Reply #24 Top

While there is a counter-argument, I believe it is legitimate, permissible and responsible for government to require certain vaccinations in certain circumstances, as a condition of admission to public school, for instance.  Or as a condition of travel to locales with known high risk for certain preventable diseases, or employment in certain high-exposure jobs or professions.  A person still has a choice in those cases to decline, go elsewhere or do something else.  But mandating that every child be forced to receive them is wrong.  As much as I'm in favor of vaccines, including Gardasil (at an appropriate age), as on balance efficacious and safe, no human with the right of self-determination should be forced against their will to be immunized against anything.  Vaccination has a track record of safety and astounding effectiveness unmatched by almost anything modern medicine has achieved and should be voluntarily embraced.

I want my granddaughters to be as safe as possible from the risks of passively-acquired, preventable communicable diseases when they attend public school and have no issue with requiring children who attend public school to be vaccinated.  And I'll want them to be vaccinated against meningococcal meningitis if/when they live in a dorm at college, public or private.  If asked, I will encourage them to be immunized with Gardisil if/when their parents decide the time is right or once they reach the age of consent.*

However, STD vaccinations uniquely relate to active individual behavioral risk, as opposed to passive risk; IMO, parental consent for administration to minors should be absolutely mandatory and the state has no business requiring them as a condition of school attendance.  No child is going to run the risk of acquiring HPV simply by virtue of their presence at school (there is zero risk absent intercourse), unlike the other communicable diseases preventable by vaccination.  I'm quite surprised, and disappointed, that Perry signed off on that.

*Although it's a different issue, I am somewhat concerned about anything that subliminally enables risk-taking by hormonally-infused teens & young adults by providing a false sense of safety, which Gardisil arguably does (not that withholding Gardisil would favorably influence risk-taking, mind you).  Genital herpes is a far greater risk than HPV, and there's no vaccine or curative treatment for that, though condom use is highly effective in prevention, as is abstinence.

Reply #25 Top

Quoting Daiwa, reply 24
While there is a counter-argument, I believe it is legitimate, permissible and responsible for government to require certain vaccinations in certain circumstances, as a condition of admission to public school, for instance.

No, this is a great mistake giving government way too much power.  This is effectively government mandated vaccines...forced medical intervention on healthy children that is known to carry risks of injury or death.

 

Quoting Daiwa, reply 24
Vaccination has a track record of safety and astounding effectiveness unmatched by almost anything modern medicine has achieved and should be voluntarily embraced.

Adults are free to assume vaccination risks for reasons of their choice. But risk is not something that government, in a free society, should ordinarily force people to accept. And that is exactly what is happening in the case of federal vaccine recommendations that are transformed into mandates by state health departments that schools require as a condition of attendance.

Over the years serious questions have been raised about vaccine safety. While there is alot of good, there is a lot of hanky panky behind vaccines. Today, most children are required to get up to 33 immunizations before they can be admitted to public school. Yet, parents are questioning the necessity of so many vaccines. From the video we learn that they are starting to ask which is the greater risk...getting and being injured by the disease, or being injured sometimes permanently, by the vaccine that purports to protect against it?

Parents must be included in the decision making process. Rather than requiring vaccinations as a condition of admission to public schools, States must allow, without prejudice, medical exemptions, religious exemptions and conscientious exemptions.