My Baby Didn't Need That Vaccine

But I got it for her anyway

If there’s one thing my brain likes more than pointing out other people’s mistakes, it’s pointing out my own — even before I make them. So there I was this morning, frantically asking ChatGPT if I was a bad mother for taking my newborn to get her first round of injection vaccines on the regular schedule — even though I hadn’t finished thinking it through. (My usual evaluation of things that I actually manage to get done seems to be that they are about 70% completed.)

In this case, I still hadn’t wrapped my head around equilibrium effects, hadn’t extended my Fienberg critique to the Harding Center Fact Boxes on vaccines, hadn’t finished the next book on my pile (Vaccines: Truth, Lies, and Controversy, by Peter Gøtzsche). I’m really good at making to-do lists, if by “to-do list” you mean a fantasy about what I might be doing for the next ten years — assuming I didn’t need to eat, sleep, or make sure my favorite little people did those things too.

But here’s what I had figured out: the vaccine schedule isn’t perfect.

In Germany, the RKI (Germany’s CDC) recommends that babies around this age get one oral and two injection vaccines. One of the injection shots is a combination that includes the hepatitis B vaccine (see p. 7 of a very helpful 72-page PDF I’m sure all new parents read cover to cover).

The problem? Hepatitis B is primarily transmitted via sex, shared needles, or childbirth from an infected mother. My daughter has zero risk of exposure. All vaccines carry some risk, however small. So the risk-benefit ratio disfavors this vaccine for my baby.

(What kind of a mother are you if you knowingly do something that jeopardizes your child’s health? Shhhh, we have to go in five minutes…)

This is a policy designed for aggregate-level public health, not personal health optimization. There are countries with worse policies (hello, U.S., where hepatitis B vaccination starts at birth). But there are also better ones — like Denmark, where they vaccinate travelers or high-risk individuals but leave low-risk babies (which is basically all babies there) alone. Zero exposure means zero need justifying zero risk.

(Adam Cifu at Sensible Medicine recently posted a nice table comparing British, Italian, and U.S. vaccination schedules, and argued the Danes are outliers in not recommending hepatitis B vaccination as part of the routine child vaccination schedule.)

So why did I take my baby in for this vaccine, anyway?

Three Reasons I Am Not A Bad Mother

1. Tribal signaling.

I like my pediatrician. I want her to think I’m a good mother, even if I politely decline to share her German enthusiasm for osteopathy (unproven efficacy, non-zero risks — nein, danke). I’m not great at conflict. I’m tired. And I’ve been to enough bad doctors myself to know that you don’t burn bridges with a good one. Especially when you’ve got small kids and few spoons.

2. System logic.

Recommending the hepatitis B shot for everyone, and even packaging it together with other stuff that everyone does need (e.g., the whooping cough vaccine) means that the kids who are truly at heightened risk are more likely to get protected. The burden of this “universal” strategy falls on kids like mine — modern-Western-typical, privileged, low-risk babies. It’s a kind of involuntary noblesse oblige: society giving alms with someone else’s arm. Or my newborn’s pulkes, as the case may be.

3. Satisficing beats optimizing.

To decline the shot would’ve meant extra appointments, separate vaccines, more stress and pain for my baby, and more lost time for me. Every appointment somehow costs me a full day. I didn’t want to triple that. So I took the package deal. Even if it wasn’t ideal for her in rational risk-benefit terms. Which makes it, in some sense, morally wrong.

I actively chose to not do what was best for my child as an individual. I satisficed for us as a unit (one happy baby and one tired mama), and as social beings (patients in this pediatrician’s office), and as community members (denizens of Germany, the state so great you’re not allowed to glorify it). I went along to get along. Because I’m tired. Because I’m trying to choose my battles. Because, most of the time, that’s what gets us (all) through the week.

Even though contemporary paranoid parenting culture says you’re supposed to do everything perfectly all the time and guard your child against every avoidable risk, especially if you’re a mother. I’m just… not. I took my baby in for the normal, stupid vaccines on the normal, stupid vaccine schedule, and came home to rest and reason.

Did I do something wrong? Yes.

Would I do it differently, if I got to do it again? Probably not.

Would I write a blog post about it instead of napping with her when I had the chance? Obviously.