It’s one of those topics where there is fundamental disagreement even about
what counts as fact. —JOhN LANTOS, MD

in Eastern Europe, sometimes see spikes in diphtheria infections, 27 the vaccine continues to appear on the CDC’s schedule of recommended vaccines and is given—in combination with the tetanus and pertussis vaccines—to children at ages 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years. However, as with polio, an American child who has not been vaccinated against diphtheria and does not travel abroad has no quantifiable chance of spreading the disease to another American child.

The same argument can be made about two other diseases on the schedule of routine childhood vaccinations: tetanus and hepatitis B. Tetanus is caused by a bacterium found in the

soil, on dirty, rusty metal, and on dirty needles. A child not vaccinated against tetanus, while at risk for contracting the disease himself, poses no risk to anyone else. 28 Hepatitis B is primarily transmitted through unprotected sex, the sharing of unclean needles, and from an infected mother to her newborn. Unless a child sick with hepatitis B is exchanging blood or other body fluids with another person’s child, an unvaccinated child has no chance of spreading the disease.

Measles is one of the diseases frequently invoked by vaccine proponents to illustrate the irresponsibility and selfishness of parents who choose to not have their children vaccinated.

Above:
Dr. John Lantos,
shown here with his wife,
Martha Montello,
outside their home

and Mortality Weekly Report 52, no. 53 ( 9 January 2004): 1285–1286; www.cdc.gov/mmwr/preview/mmwrhtml/ mm5253a3.htm. 25. According to Tejpratap Tiwari, MD, medical epidemiologist at the CDC, the last reported diphtheria death in a probable (not lab-confirmed) childhood case occurred in an unimmunized four-year-old boy in 1994. Prior to that, the last diphtheria

death in a culture-confirmed childhood case occurred in an unimmunized nine-year-old female in 1982 (e-mail communication, 8 April 2009). 26. See Note 20. 27. Charles R. Vitek and Melinda Wharton, “Diphtheria in the Former Soviet Union: Reemergence of a Pandemic Disease,” Emerging Infectious Diseases 4, no. 4 (October–December 1998): 539–550; www.cdc.gov/

ncidod/eid/vol4no4/adobe/vitek.pdf. 28. Given that tetanus is most commonly contracted by stepping on a rusty nail, some parents wonder why this vaccine would be given to children when they are two months old, and again when they are four months old, as at this age infants have no chance of getting the disease.