14 June 2012

Supreme Court Releases Decision on Child Vaccination

The Supreme Court has just released its decision in the case of M.J.T. v. D.M.D. What makes this decision especially interesting is that, in addition to the usual family law issues, the court was asked to wade into the vaccination debate in the context of the parties' five year old child.

The mother was opposed to the child being vaccinated and had successfully preserved the child from being vaccinated to the date of trial. The father subscribed to a different view. The judge tactfully described the parties' views thusly:
"[84] ... [The father] arranged a meeting for himself and [the mother] with Dr. Simon Dobson, a pediatrician at B.C. Children's Hospital with extensive experience in pediatric immunization. [The mother] asked Dr. Dobson whether he could guarantee that [the child] would not suffer any adverse reaction to the pediatric vaccinations given as part of the immunization program at the hospital. Dr. Dobson advised that no physician could give such a guarantee. Accordingly, [the mother] refused to consider having [the child] vaccinated against any of the common childhood infectious diseases."
At trial, witnesses were called to give evidence about the benefits and risks of vaccinations, and the mother's concerns were more fully developed. She was concerned about the health risks of aluminum adjuvants commonly used in vaccines, the possibility of a connection between vaccination and autism, and vaccinations as a cause of certain fevers and convulsions she and her siblings has suffered as children.

The court accepted the evidence of the father's expert witness, Dr. David Scheifele of UBC and BC Children's Hospital, who addressed the mother's concerns as follows:
"[95] In response to [the mother's] questioning, Dr. Scheifele explained that aluminum adjuvants are important components of some vaccines because they enhance the immune response to the vaccine. He noted that researchers at the United States Food and Drug Administration recently modelled carefully the amounts of aluminum in infants after infant vaccinations using the best available human data. They found that the amount of aluminum in infants’ bodies from vaccines and diet was significantly less than the levels determined to be safe. The researchers concluded that episodic exposures to vaccines containing aluminum adjuvants continue to present an extremely low risk to infants, and that the benefits of using those vaccines outweighed any theoretical risks. 
"[96] [The mother] asked Dr. Scheifele whether he could guarantee that [the child] would not suffer any adverse reaction to any of the vaccinations recommended for children. Dr. Scheifele was clear in his response: medical science can never offer such a guarantee. He reiterated his opinion that the risk of [the child] suffering an adverse reaction is extremely low, and the benefits to [the child] of receiving the vaccinations significantly outweighed the theoretical risks.
"[97] Addressing [the mother's] concern that vaccinations may cause autism, Dr. Scheifele said that studies have convincingly shown that autism does not result from immunization. In any event, autism becomes evident during early childhood; this is no longer a concern for [the child], who is developmentally normal. ... 
"[99] Dr. Scheifele pointed out that at the age of 5, [the child] has passed beyond the peak risk period for benign febrile convulsions without showing any indication of proneness to seizures. The colds, ear infections and cough illnesses he had already experienced did not trigger seizures, thus it was unlikely that vaccination-related fevers would do so. Dr. Scheifele went on to say that in the largest study to date (Huang WT et al., Pediatrics 2010), no increased risk of febrile seizures was detected after immunization with modern pertussis vaccines administered to young children."
The expert concluded:
"[100] After reviewing all of the information provided to him by [the mother] and [the father], Dr. Scheifele stated that he would not hesitate to immunize [the child], who is a normal, healthy child. According to Dr. Scheifele, nothing in [the child's] personal or family history poses a contraindication to routine childhood immunizations or presents any greater risk than that faced by other healthy children. In fact, the risk of giving vaccines at [the child's] age — 5 years — is lower than with vaccinations in the first two years of life."
The court concluded that both parents were "devoted, loving and considered parents," although "neither understood the eccentricities of the other when they decided to marry," and ordered that the parties would have joint custody and joint guardianship of the child, with equal decision-making authority. On the contentious vaccination issue, however, the court held that:
"[176] .... I accept Dr. Scheifele’s opinion that the benefits of immunization to [the child] significantly outweigh any risk of side effects. For that reason, I conclude that [the father] is entitled to make the decision concerning [the child's] immunization."