With school starting soon, ensuring your child is properly immunized not only is a good idea for health reasons—it’s required. In Missouri, children entering school must be current on a number of immunizations, although religious and medical exemptions are allowed with proper documentation.

Physicians agree that immunization is an important part of children’s health, yet they recognize that parents may have questions and concerns. “So much information is available to patients and their families—some are accurate, but some are completely false,” notes Dr. Ellen Nicastro, a Mercy Clinic pediatrician with Mercy Children’s Hospital.

The link between autism and immunization continues to be one of the most common concerns voiced by parents. “This all results from a poorly done study that was published in a well-respected journal, The Lancet,” Nicastro says. “However, more recently, it was disclosed that the author of the study had purposely falsified data. The Lancet took the rare step of withdrawing the article. Since that time, many rigorous studies have shown there is no link between vaccines and autism.”

A related worry about the safety and purity of immunizations also continues to pop up in Nicastro’s practice. “The ingredients of vaccines have been carefully chosen to preserve the actual vaccine, and also stimulate the patient’s body to mount an immune response for a specific disease. Years of studies and experience go behind vaccine manufacturing, and these ingredients are all safe,” she says, adding that “in the past, there had been great concern over a form of mercury, thimerosal, which was present in vaccines. This ingredient has been removed from most early childhood vaccines, although subsequent studies have proved that thimerosal is not harmful.”

In fact, these concerns have caused public health problems in other parts of the world, notes Dr. Joel Koenig, a pediatrician with Town and Country Pediatrics and on staff at Missouri Baptist Medical Center. “Unwarranted concerns about the MMR (measles, mumps and rubella vaccine) and autism led to a decrease in vaccination rates in the United Kingdom,” he says. “Although most children in Wales had been vaccinated, there has been an outbreak there and some people have died from it.”

In addition, failure to immunize a child can put other children at risk. “Those children that remain susceptible because of a parental choice to not vaccinate increase the risk to other children who are unable to receive immunizations for real medical conditions,” says Dr. Matthew Broom, a pediatrician at SSM Cardinal Glennon Children’s Medical Center and assistant professor at Saint Louis University School of Medicine.

“Placing others at risk, particularly those who could become acutely ill and suffer the consequences of vaccine-preventable diseases, is a poor decision and one that truly affects society,” he adds.

Children must be immunized against diphtheria, tetanus, whooping cough (pertussus), polio, measles, mumps, rubella, hepatitis B and chicken pox (varicella). Physicians often also recommend immunizations to prevent hepatitis A, human papilloma virus (HPV), meningitis and influenza.

Specific information about required immunizations is available from your child’s primary-care physician, school districts, and the Missouri Department of Health and Senior Services (

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