MANCHESTER — Pediatricians understand that parents want to do the right thing for their children. Most parents understand that those of us drawn to caring for children are deeply committed to providing sound advice for families and the best care we can for children. The decision to not vaccinate an individual child is really up to that parent and family.

The unimmunized child is at risk of a severe and sometimes life-threatening infection. If that child remains at home, the risk of spreading that infection may be low and limited to family members and neighbors. That risk is highly multiplied if an unimmunized child goes out into the populated world of day care and school, putting the health of other children and immunologically vulnerable community members at risk.

The greater the number of un- or underimmunized children, the greater the risk to community members who are unable to have immunizations for health reasons. Un- and underimmunized children in day care or school are at much greater risk than immunized children of developing life-threatening illnesses such as pneumonia and meningitis.

Many children will be fussy and sore after vaccination, but these symptoms usually respond to pain medications like Tylenol or ibuprofen. Rarely, a child will experience a febrile seizure, but the seizure risk is much lower than if the child had the actual infection. Very rarely, children can have a severe allergic reaction – in the case of the measles vaccine, there are an estimated three or four allergic reactions for every 10 million doses.

Years of misinformation about vaccinations have been exaggerated by the internet and taken root in the public mind. A voice has risen that speaks with absolute certainty that vaccines are harmful and parents should ignore decades of research. Particularly tenacious is the myth that the measles vaccine damages a child’s brain. Actually, the opposite is true. Children who contract wild-type measles “naturally” may develop an infection that causes a slow scarring of their brain, leading to loss of brain function, regression of developmental abilities and severe brain damage. The vaccine prevents this disorder!

L.D. 798, which would end non-medical exemptions from childhood vaccinations, recognizes the best science and protects children in our public spaces whose parents have chosen to immunize: making the choice to keep their children and their neighbors safe. The Maine chapter of the American Academy of Pediatrics firmly supports this legislation.

The immunization of children against infectious agents is one of the most important health interventions of the 20th century. By one account, pediatric immunizations prevent 2.5 million deaths in children each year worldwide.

Despite this success, some parents continue to refuse immunizations for their children, increasing the potential for harm to other persons in four ways. First, an unimmunized child who contracts disease poses a potential threat to other unimmunized children. Second, even in a fully immunized population, a small percentage of immunized individuals will either remain or become susceptible to disease, though they’ve done everything they can to protect themselves through immunization. Third, children who cannot be immunized because of underlying medical conditions derive important benefit from herd immunity and may be harmed by contracting disease from those who remain unimmunized. Finally, immunized individuals are harmed by the cost of medical care for those who choose not to immunize their children and whose children then contract vaccine-preventable disease.

Childhood immunization mandates in the U.S. have been upheld repeatedly as a reasonable exercise of the government’s police power in the absence of an epidemic or even a single case. They also have been found to be constitutional in cases in which the laws conflict with individuals’ religious beliefs.

Therefore, the Maine Chapter of the American Academy of Pediatrics supports the use of appropriate public health measures, education and incentives for immunization. Because unimmunized children do pose a risk to children who lack immunity to vaccine-preventable infections, the group also supports legislation like L.D. 798 to make immunization a condition for school entry.