1. Give It Your Best Shot: The Controversy
Surrounding Modern Day Childhood
Vaccinations
Alyssa Goin
Report Submitted on: May 6th
, 2016
agoin@rams.colostate.edu
JTC300, Section 006

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Table
of
Contents
Letter
of
Transmittal
3
Abstract
4
Introduction
5
What
are
vaccines?
6
Invention
and
Purpose
of
Vaccines
8
Exemptions
8
How
do
vaccines
work?
10
Herd
Immunity
10
Vaccination
and
Developmental
Disorders
12
Conclusion
14
Works
Cited
15
Glossary
17

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Letter of Transmittal
Alyssa Goin
Technical Communications Student
Colorado State University
Fort Collins, Colorado
May 6th
, 2016
Bradley Kaye
Graduate Teaching Assistant
Colorado State University
Fort Collins, Colorado
Dear Mr. Kaye:
The following report is a research project regarding vaccines titled, “Give It Your Best Shot: The
Controversy Surrounding Modern Day Childhood Vaccinations”. The report explores the
arguments given on both sides of the topic, and takes a scientific approach to dissect each claims
respective facts.
If you have any questions about this report or need to request additional information, please feel
free to contact me at alyssagoin@gmail.com .
Thank you in advance for your time and consideration.
Regards,
Alyssa Goin
Enclosure: Informational Report titled, “Give It Your Best Shot: The Controversy Surrounding
Modern Day Childhood Vaccinations”

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Abstract
The
informational
report
titled,
“Give
It
Your
Best
Shot:
The
Controversy
Surrounding
Modern
Day
Childhood
Vaccinations”
was
written
with
a
scientific
scope
and
explores
both
sides
of
the
argument
regarding
immunizing
children.
Vaccinations
and
the
concept
of
immunity
date
back
to
900
AD
when
the
Chinese
used
smallpox
scabs
as
a
way
to
purposely
contract
the
disease.
This
promoted
a
safer
way
for
the
body
to
beat
said
disease,
and
prevented
many
deaths.
With
today’s
technology,
vaccinations
can
now
be
administered
many
different
ways,
and
are
available
for
a
wide
variety
of
communicable
diseases.
There
is
an
immunization
schedule
available
for
parents
with
small
children
that
outlining
when
a
respective
vaccination
should
be
administered
and
what
the
consequences
of
contracting
the
illness
are.
There
are
many
individuals
that
do
not
agree
with
the
state
mandated
required
vaccination
laws,
and
seek
exemptions
for
their
children.
Exemption
categories
include
religious,
medical,
and
philosophical:
all
with
unique
requirements
and
set
standards.
The
report
also
explores
the
topic
of
herd
immunity,
and
what
the
benefits
vaccinations
provide
to
individuals
who
are
immune.
Without
herd
immunity,
many
eradicated
diseases
in
the
United
States
would
surge,
and
would
cause
thousands
of
deaths
each
year
due
to
outbreaks.
Herd
immunity
took
a
large
hit
when
Dr.
Andrew
Wakefield,
a
medical
doctor
of
gastroenterology,
made
false
claims
that
vaccinations
caused
developmental
disorders
in
children.
As
a
result
of
Dr.
Wakefield’s
medical
journal
publication,
the
world
saw
all
time
low
vaccination
numbers.
To
this
day,
nearly
14
years
later,
the
medical
community
is
still
trying
to
make
a
comeback
and
have
parents
trust
vaccines
again.

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Introduction
American culture as it stands today seems to be clouded with the constant rise and fall of
controversy. Spanning from celebrity marriages to world affairs, diet trends to government
spending; the world always has something to say about everything. When it comes to the welfare
of children, the general public goes up in arms about the most appropriate and acceptable plan of
action. Vaccinations do not surpass the scrutiny of millions of parents and caregivers alike.
Every state in the United States of America has some sort of policy requiring vaccines for
children to enter school. However, parents nation wide have reservations about what vaccines are
made of, what health benefits they entail, and why the government feels the need to mandate
them.
A formal report was conducted with a scientific approach. The report will explore
different arguments against vaccines, and the science community’s reaction and response to
them. Typically, the resistance of vaccination surrounds a few common threads: religion, school
and state mandates, ingredients of the vaccines themselves and the outcomes they allegedly
cause. The report will also discuss how Andrew Wakefield, a former medical researcher,
influenced vaccination culture in the late 1990s and the effects his accusations still have today.
The scientific community has very opposing views to individuals who chose not to vaccinate,
and all viewpoints will be discussed and explored with an academic interest in mind.

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Discussion
What
are
vaccines?
In order to establish an informed audience, background factual information is crucial to
have an even starting point. Like most controversial topics, the medical community and pro-
vaccination advocators believe that the most resistance of vaccination comes from the lack of
knowledge of what vaccinations actually are. According to vaccines.gov, the formal definition of
vaccine is, “a product that produces immunity from a disease and can be administered through
needle injections, by mouth, or by aerosol” (“Basics”). According to the same website, an
immunization is, “the process by which a person or animal becomes protected from a disease.
Vaccines cause immunization, and there are also some diseases that cause immunization after an
individual recovers from the disease” (“Basics”). Often times, these two vocabulary words are
used interchangeably and it is imperative to note the correlation between the two.
All vaccines that are mandated by the states go through an extensive process in order to
be administered to the public, much like medications are. The Federal Drug Agency, also known
as the FDA, leads vaccine regulation with help from an internal branch called Center for
Biologics Evaluation and Research, also known as CBER. The development of vaccines is
government funded, while private companies are responsible for lab tests, manufacturing for the
masses, and distributing the final product to health care providers. According to the FDA
frequently asked questions report, the average development period for a new vaccination is 16
months ("U.S. Food and Drug Administration."). The sixteen month timeframe does not include
the lab testing and public safety analysis, which in most cases can take up to ten years. The
lengthy time period is to ensure all adversities are diminished before given to the public for
widespread distribution.

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After parents have a baby, health care providers offer an immunization schedule to ensure
that all vaccinations are completed. Below is an example of what the Center for Disease Control
and Prevention, also known as the CDC, provides to the public.
Figure
1:
Center
for
Disease
Control
and
Prevention
Recommended
Immunizations
for
Children
It provides a timeline-like outlook over the first six years of a child’s life, and when the best time
is to immunize for various vaccines. The key at the bottom of the image explains that the yellow
boxes indicate a range of months when the vaccine can be given, and what to do if you miss the
time frame recommended. The pamphlet continues with a description of what each immunization
is, how the disease is passed from each individual, and what the disease looks like if contracted.
d RV
4 months of age, DTaP, PCV,
b, Polio, and RV
6 months of age, HepB (6-18
onths), DTaP, PCV, Hib, Polio
-18 months), RV, and Influenza
early, 6 months through 18
ars)*
12 months of age, MMR (12-15
onths), PCV (12-15 months)
†
,
b (12-15 months), Varicella
2-15 months), HepA (12-23
onths)§
, and Influenza (yearly, 6
onths through 18 years)*
4-6 years, DTaP, IPV, MMR,
ricella, and Influenza (yearly, 6
o ars)*
1 2
Birth month months
HepB
RV
HepB
DTaP
Hib
PCV
IPV
Shaded boxes indicate the
vaccine can be given during
shown age range.
4 6
months months
HepB
RV RV
DTaP DTaP
Hib Hib
PCV PCV
IPV IPV
DTaP
PCV
Hib
Influenza (Yearly)*
HepA§
MMR
Varicella
12 15 18 19–23 2–3
months months months months years
4–6
years
DTaP
IPV
MMR
Varicella
At 1 month of age, HepB (1-2
months),
At 2 months of age, HepB (1-2
months), DTaP, PCV, Hib, Polio,
an
At
Hi
At
m
(6
(y
ye
At
m
Hi
(1
m
m
At
Va
m nths through 18 ye
See back page
for more
information on
vaccine-
preventable
diseases and the
vaccines that
prevent them.
2016 Recommended Immunizations for Children from Birth Through 6 Years Old
Is your family
growing? To protect
your new baby and
yourself against whooping
cough, get a Tdap vaccine
in the third trimester
of each pregnancy. Talk
to your doctor for more
details.
For more information, call toll free
1-800-CDC-INFO (1-800-232-4636)
or visit
http://www.cdc.gov/vaccines
FOOTNOTES: * Two doses given at least four weeks apart are recommended for children aged 6 months through 8 years of
age who are getting an influenza (flu) vaccine for the first time and for some other children in this age group.
§ Two doses of HepA vaccine are needed for lasting protection. The first dose of HepA vaccine should be
given between 12 months and 23 months of age. The second dose should be given 6 to 18 months later.
HepA vaccination may be given to any child 12 months and older to protect against HepA. Children and
adolescents who did not receive the HepA vaccine and are at high-risk, should be vaccinated against HepA.
If your child has any medical conditions that put him at risk for infection or is traveling outside the
United States, talk to your child’s doctor about additional vaccines that he may need.
NOTE: If your child misses a shot,
you don’t need to start over,
just go back to your child’s
doctor for the next shot.
Talk with your child’s doctor
if you have questions
about vaccines.

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Invention
and
Purpose
of
Vaccinations
The concept of immunizations, although appearing modern, date back to 900 A.D. when
the Chinese developed a method called variolation. Variolation as defined by the U.S National
Library of Medicine as, “the deliberate infection with smallpox…dried smallpox scabs were
blown into the nose of an individual who then contracted a mild form of the disease. Upon
recovery, the individual was immune to smallpox. Between 1% to 2% of those variolated died as
compared to 30% who died when they contracted the disease naturally” ("Smallpox:
Variolation"). The Chinese had ultimately discovered the primitive concept of immunity. If an
individual was exposed to minimal doses of a communicable disease and allowed the body to
naturally kill it off, the individual would become immune and it would be impossible to catch the
same disease. The human body uses memory b-cells as an immediate defense against re-
infection, protecting the body for the rest of an individual’s life. This is why an individual can
only contract chicken pox once in a lifetime. When the success of the procedure spread through
word of mouth, people all over the world starting using it to prevent contracting deadly diseases.
Modern day injections were later discovered by a British physician named Edward Jenner in
1796 and have continued to be developed to this day (“The History of Vaccination”). With
today’s technology, various vaccines can also be given by aerosol spray and capsule form.
Exemptions
Vaccination mandates are controlled by state governments and vary depending where the
child is enrolling for school. According to the National Vaccine Information Center, there are
three different circumstances under which a child can be exempt from submitting vaccination
records to their prospective school: philosophical, religious, and medical ("Vaccine Exemptions
FAQs."). Philosophical exemptions, also known as conscientious or personal, are defined as,

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“individuals who hold conscientious objections to one or more vaccines” ("Vaccine Exemptions
FAQs."). Since all mandates are decided by the state, philosophical exemptions have the most
fluctuating requirements. Due to a vague definition of what a conscientious exemption entails, it
is extremely difficult to receive. Religious exemptions can be utilized by anyone with a strict
practice of any religion opposed to medical intervention. If a state does not grant religious
exemptions of vaccinations, it is a direct infringement on an individual’s rights as a citizen of the
United States. Much like philosophical exemptions, religious exemption requirements vary
dramatically from state to state. According to the National Vaccine Information Center,
exemption requirements can range anywhere from a written expression of a religious affiliation
or a signed document from a pastor or religious leader ("Vaccine Exemptions FAQs."). Finally,
medical exemptions are for individuals who can prove immunity to a communicable disease that
a vaccine is needed for, or that receiving said immunization would have a direct negative effect
on the child’s well being. Written consent must be obtained by a medical doctor or doctor of
osteopathy. Although medical exemptions are allowed in all 50 states, they are extremely hard to
attain due to the fact that a state’s health department official can deny almost all claims of harm
to a child. Below is an
illustration representing the 50
states and the exemptions
allowed.

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How
do
vaccines
work?
As a way to better understand the controversy surrounding childhood vaccinations, it is
important to explore different arguments each side has, and the respective response the opposing
belief responds with. Health care professionals are faced with a myriad of questions every day
from curious parents and caretakers, and it is imperative to explore the facts. A common concern
is immunizations manufactured to prevent diseases such as measles, mumps, and influenza
contain a live strain of the disease, and can ultimately cause the disease it was made to prevent.
However, according the World Health Organization’s webpage on frequently asked questions for
vaccines, it is reported that, “Vaccines interact with the immune system to produce an immune
response similar to that produced by the natural infection, but they do not cause the disease or
put the immunized person at risk of its potential complications” ("What Are Some of the Myths
and Facts about Vaccination?"). When an individual is vaccinated, the strain that is injected is
much more mild and less active than it would be if contracted through human contact. The
immunization is modified to react with an individual’s immune system a certain way, ensuring
that complications are avoided and a minimal risk. For example, many consumers of the annual
flu shot report having flu-like symptoms after receiving the shot. The reaction is more likely a
result of a previously contracted illness rather than a result of the immunization itself. Mild
reactions to vaccines defer consumers away from continuing the vaccination schedule, but what
many people do not realize is the reactions are much less severe and safer than the disease itself.
Herd
Immunity
A common misconception about immunizations is the idea of community immunity, also
known as “herd immunity”. According to the National Institute for Allergy and Infectious
Diseases (NIAID), herd immunity is defined, “When a critical portion of a community is
immunized against a contagious disease, most members of the community are protected against

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that disease because there is little opportunity for an outbreak” ("Community Immunity."). Many
anti-vaccine promoters believe that since the majority of the population is immunized, and many
of the contagious diseases are eradicated in the United States, they are therefore protected from
contracting anything at all. Below is an image from the NIAID further explaining the theory of
herd immunity. The image below (Figure 3) pictorially explains three different scenarios. First,
the top photo shows what happens if a group of non-immunized people come in contact with
someone who is also not immunized, but carrying a contagious disease. There is no barrier to
stop the spread of said disease, resulting in an outbreak. The middle picture depicts the same
scenario, except with only a fraction of the population immunized. Contagious individuals
influence the spread of the disease and there is a smaller outbreak, but an outbreak nonetheless.
In the final picture, most of the population is immunized so when contagious individuals
integrate, the outbreak is non-existent
and the illness can be contained. The
third scenario is by far the most
favorable, and reduces the amount of
illnesses and possible deaths. Herd
immunity is a crucial concept that when
understood, can save thousands of lives
per year.
Figure
2
Herd
Immunity

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Vaccination
and
Developmental
Disorders
In the late 1990s, hysteria broke out when a medical doctor and gastroenterologist in the
United Kingdom by the name of Andrew Wakefield made an accusation against the vaccination
industry. Dr. Wakefield published a paper in the Lancet; a medical journal that is, “committed to
applying scientific knowledge to improve health and advance human progress” (The Lancet).
The article, written and published in 1998, made a claim that the measles-mumps-rubella
vaccine, also known as MMR, caused developmental disorders in children. The developmental
disorders included autism and delayed learning. According to the article titled “Vaccines and
Autism: A Tale of Shifting Hypotheses” in the Oxford Journal of Medicine, Dr. Wakefield
claimed that eight children started to show signs of delayed developmental disorders within one
month of receiving the vaccine. He stated that all eight children showed signs of lymphoid
nodular hyperplasia ultimately caused by the MMR vaccine (Plotkin, Gerber, and Offit). The
article goes on to explain the lymphoid nodular hyperplasia, or intestinal inflammation, causes
the lining of the intestine to break down, exposing the body to proteins that normally do not enter
the vascular system. Eventually, said proteins go to the brain and, according to Dr. Wakefield,
cause autism (Plotkin).
Naturally, parents with young children, regardless of age, panicked. Many parents who
had already vaccinated their children feared for what could possibly come, and parents who had
not yet vaccinated their young children refused not only the MMR vaccine, but vaccinations in
general. As a result of Dr. Wakefield’s report in the Lancet, in the years 2003 and 2004, only 80
percent of children were vaccinated for MMR ("Measles Vaccination Rates in UK Recover after
14 Years."). While this number may seem relatively high, “The World Health Organisation
(WHO) recommends that 95% of children are vaccinated against measles in order to protect

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everyone through herd immunity” ("Measles Vaccination Rates in UK Recover after 14 Years.").
The panic spread throughout the world, and communities were stricken with low immunization
rates and high infectious disease rates. Healthcare providers worldwide took action against Dr.
Wakefield’s claim, and began making strides towards better educating the general public on the
importance of immunizations.
In 2012, nearly fourteen years after Dr. Andrew Wakefield and his colleagues published
their influential work in the Lancet, it was discovered to be fraudulent work. A British journalist
by the name of Brian Deer did some investigative work on Dr. Wakefield’s reports. Deer
discovered that, “despite the assertion in Dr. Wakefield's paper that the 12 children studied were
normal until they had the MMR shot, 5 had previously documented developmental problems.
Mr. Deer also found that all the cases were somehow misrepresented when he compared data
from medical records and the children's parents” ("Study Linking Vaccine to Autism Is Called
Fraud."). Dr. Wakefield had intentionally misrepresented data on a medical journal, skewing the
results of an experiment to favor his hypothesis. As a result, he caused widespread, global panic.
The General Medical Council of Great Britain launched a full-scale investigation into the
fraudulent claims made by health care professionals. The investigation included reports such as
collecting blood samples from children at a birthday party for his son for research, and
discovering that most of his research funds came from parents looking for revenge against
immunization manufacturers (Burns).
Dr. Andrew Wakefield, who was stripped of his medical license in 2011, still has a
substantial group of supporters. In April of 2016, Dr. Andrew Wakefield released a movie titled
“Vaxxed: From Cover Up to Catastrophe” that is to discuss the link between autism and
immunizations. Although it was initially approved to be shown at the Tribeca Film Festival, it

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was later pulled by film festival creator Robert de Niro in fear that a there would be negative
public health discussions following the film (Ryzik).
To this day, some families with small children are still fearful that vaccinating will lead
to developmental disorders such as autism. Dr. Wakefield’s accusation, although proven
fraudulent by the medical community, has created a ripple effect of negative connotations and
distress.
Conclusion
No matter how advanced American culture or technology becomes, controversy will
always plague society. It is a fact of life that every body has an opinion, and the diversity
opinions bring is part of what makes the United States such an influential and powerful country.
As stated before, immunizations are not safe from controversy, and are heavily debated on both
sides. The medical community and its opposers are constantly going head to head on whether it
is ethical or not to vaccinate. As a Health and Exercise science major, it is personally difficult to
find truth in anti-vaccination claims. Science does not lie, and in the amount of research and tests
that are performed prior to administering said immunizations is ample. There is always a back-
story to why there is a negative claim against immunizations, and it is up to the consumers to
research and decide for themselves. When deciding whether or not to immunize your future
children, remember that your decision doesn’t just affect your immediate family, but ultimately
the well being and safety of others around you. Educate yourself on the pros and cons of both
sides of the argument, and take into consideration the prosperity of the greater good.

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Works
Cited
"Basics." Vaccines.gov. Department of Health and Human Services, n.d. Web. 22 Apr. 2016.
Burns, John F. "British Medical Council Bars Doctor Who Linked Vaccine With Autism." The
New York Times. The New York Times, 24 May 2010. Web. 22 Apr. 2016.
" Community Immunity." National Institute of Allergy and Infectious Diseases. U.S Department
of Health and Human Services, 21 Oct. 2010. Web. 22 Apr. 2016.
Plotkin, Stanley, Jeffrey S. Gerber, and Paul A. Offit. "Clinical Infectious Diseases." Vaccines
and Autism: A Tale of Shifting Hypotheses. Oxford University Press, 2009. Web. 22 Apr.
2016.
"Measles Vaccination Rates in UK Recover after 14 Years." The Blog. Vaccines Today, 27 Dec.
2013. Web. 22 Apr. 2016.
Ryzik, Melena. "Anti-Vaccine Film, Pulled From Tribeca Film Festival, Draws Crowd at
Showing." The New York Times. The New York Times, 01 Apr. 2016. Web. 22 Apr.
2016.
"Smallpox: Variolation." History of Medicine. U.S. National Library of Medicine, 18 Oct. 2002.
Web. 21 Apr. 2016.
"Study Linking Vaccine to Autism Is Called Fraud." The New York Times. The New York
Times, 06 Jan. 2011. Web. 22 Apr. 2016.
"The History of Vaccination." Vaccinations. National Health Service of England, 7 July 2014.
Web. 22 Apr. 2016.
The Lancet. The Lancet, 2016. Web. 22 Apr. 2016.

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"U.S. Food and Drug Administration." Common Ingredients in U.S. Licensed Vaccines. U.S
Food and Drug Administration, 31 Dec. 2014. Web. 15 Apr. 2016.
"Vaccine Exemptions FAQs." Vaccine Exemption Information. National Vaccine Information
Center (NVIC), n.d. Web. 22 Apr. 2016.
"What Are Some of the Myths and Facts about Vaccination?" World Health Organization, Mar.
2016. Web. 22 Apr. 2016.

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Glossary
Memory
B-­‐Cell:
An
individual’s
immediate
immune
response
that
prevents
contracting
the
same
sickness
twice
CBER:
Center for Biologics Evaluation and Research, branch within the Food and Drug
Administration
Herd
Immunity: When a critical portion of a community is immunized against a contagious
disease, most members of the community are protected against that disease because there
is little opportunity for an outbreak
Immunization:
the process by which a person or animal becomes protected from a disease.
Vaccines cause immunization, and there are also some diseases that cause immunization
after an individual recovers from the disease
FDA:
Food
and
Drug
Administration,
branch
of
Department
of
Health
and
Human
Sciences
of
the
United
States
Government
Vaccine:
a product that produces immunity from a disease and can be administered through
needle injections, by mouth, or by aerosol
Variolation:
the deliberate infection of smallpox