Parents don't want their children to be hurt.

But what poses the greater risk: vaccines, or the diseases they're made to prevent? Should all children undergo vaccination — and its risks — to prevent a relatively rare, but potentially dangerous disease?

These were among the questions debated Tuesday at a forum in Shoreline on vaccines, the second of four around the nation held by the U.S. Centers for Disease Control and Prevention (CDC). The CDC will decide whether to add a vaccine for bacterial meningitis to the list of those recommended for infants.

For a full day, more than 100 people wrestled with questions of safety, cost and effectiveness of a vaccine for meningococcal meningitis, one of several types of the disease, which can cause inflammation of the membranes covering the brain and spinal cord.

In groups and alone, parents, health providers, grandparents and others who signed up online to take part in the meeting dissected graphs and statistics, listened to CDC vaccine officials and delved into their own experiences and values.

Michael Belkin of Bainbridge Island was there, holding a bundle of reports of vaccine-caused adverse events, his views shaped by the death 13 years ago of his 5-week-old daughter after she got a hepatitis B vaccine.

Lori Buher of La Conner was also there, telling of her anguish when her athletic teen son lost his legs and fingers to meningitis eight years ago. "Everybody thinks it won't happen to them — we were like that, too."

When her son, Carl Buher, stood, khaki shorts exposing his artificial legs, the room was quiet as he related in a matter-of-fact way how the fast-moving illness overtook him at age 14. He respects the right of parents to make a decision, but he wants everyone to know there's a vaccine that can prevent the disease. "As a survivor, I feel it's my job to do it."

Karen Crisalli Winter of Seattle recalled how her 23-year-old friend quickly died after contracting meningitis. But she worried that a CDC recommendation would become a mandate, and the wishes of parents who don't want to vaccinate their children would be ignored, further polarizing pro- and anti-vaccine parents.

"We have got to find a better solution," she urged. "This is a complicated issue — there is grief on all sides."

The vaccine, recently approved for infants as young as 9 months, likely will be as expensive as the version used for teens: about $100. Other formulations of meningitis vaccine are now in the approval pipeline.

But unless the CDC and the federal Advisory Committee on Immunization Practices (ACIP) officially recommend it for infants, insurers likely won't cover it, nor will programs that provide free vaccines for low-income children.

While bacterial meningitis is relatively rare, it is often deadly. Children under age 5 account for nearly a quarter of the 1,000 cases of meningitis in the United States each year. About 30 of those children die, according to the CDC, and about 35 will have a lifelong disability.

The current vaccine, which only covers about a third of the causes of bacterial meningitis in infants, would protect against about 75 of the 250 cases in children. In Washington in the past five years, 35 infants under age 1 got meningitis.

At the meeting, freedom of choice was a top theme. A few people accused the CDC of giving them a sales pitch, and Rebecca Campbell of Seattle said the conference seemed orchestrated to approve vaccines. Another said the group seemed unrepresentative of the population, many of whom would not be able to attend an all-day weekday meeting.

A pro-vaccine group, in a news release before the meeting, wondered why the CDC was bothering to have these meetings.

"Since when does the general public have the knowledge to evaluate the risks or benefits of a new vaccine?" asked Dr. Josh Bloom, director of Chemical and Pharmaceutical Sciences for the American Council on Science and Health, in a statement.

Glen Nowak of the CDC's National Center for Immunization and Respiratory Diseases, who helped lead the meeting, said while the process doesn't attempt to create any sort of scientifically valid random sample of citizens, it gives the CDC a good idea of what happens when people wrestle with the complexities and statistics along with their beliefs.

Pushed to decide as if they were in charge, in the end, 53 percent of the participants voted to add the vaccine to the schedule for all children, 31 percent voted against recommending routine use but for adding it to the government's Vaccine for Children Program, and 16 percent voted against recommending or paying for it for poor children.

It will be some time before the CDC and ACIP make a decision, Nowak said.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com

http://seattletimes.nwsource.com/html/localnews/2015589930_vaccines13m.html

July 12, 2011