A book released at the start of this month, "Evidence of Harm" by David Kirby, raises questions about the controversial link between autism and mercury in childhood vaccines.

Besides the mercury-autism link, parents question the benefits of the hepatitis B vaccine, which is administered three times before the age of 18 months. The risk of an adverse reaction from the vaccine -- hospitalization or death -- is roughly the same as the lifetime risk of contracting the disease. Does it seem right, on balance, to put your child's life at risk when he or she could be hit by a car long before sharing an infected needle?

Some 26 vaccinations are recommended for children before age 2, and while doctors keep telling us they are safe, more parents (and doctors) are fighting for the right to decline vaccinations and still enter children in school, day care centers and summer camps.

The debate reflects our fears of polio and smallpox receding into history, even while our confidence in medical professionals and science plummets. What parent believes it's an acceptable risk that his or her 2-year-old could be brain damaged by a DPT (diphtheria, pertussis and tetanus) shot -- as was the son of the founder of the National Vaccine Information Center, Barbara Loe Fisher? Has anyone worried about their kid contracting diphtheria for a good three generations or more?

As our fear of these diseases recedes, as vaccines bring the illnesses under control, what we fear more are the pharmaceuticals themselves.

Alison Fujito of McCandless, a member of the parenthood panel, which contributes to this column, has a son who was born with a mild form of autism known as Asperger's syndrome. She lives with the torment that a vaccine could have contributed to his condition. The past 40 years have witnessed a rise in mass-vaccination policy in the United States, along with a skyrocketing of autism cases to where 1 in 500 children are afflicted.

Alison points out that mercury that was formerly present in nearly all childhood vaccines -- and can now still be found in flu and chicken pox shots -- has been proven to harm the nervous systems of young children, even babies in the womb.

"Look up acrodynia, a condition written about in the early 1900s that sounds exactly like autism and was shown to be caused by teething powder containing mercury," Alison writes. "The disease disappeared when the teething powder was taken off the market."

Medical authorities make mistakes. The rotavirus vaccine, to prevent severe diarrhea, was introduced in August 1998 and withdrawn less than a year later, when it appeared to cause bowel obstructions. Thimerosal, a preservative in many vaccines, has been removed because it is suspected of causing mercury poisoning in infants. Although a link between thimerosal and autism has been disproved in many studies, other studies say the link is real, and Congress has held hearings on the issue.

While medical researchers may find a risk of 1 in 100 acceptable -- or 1 in 1 million -- how can that 1 millionth parent rationalize the risk? Don't the elimination of the rotavirus vaccine and thimerosal demonstrate that immunization policy is imperfect?

In this environment, I think parents should have a right to refuse vaccines. Another parenthood panel member, Sue MacDonald of Cincinnati, a journalist who writes about health issues, says that some vaccines seem more worth having than others. For example, she says, chickenpox means a week of sickness without the vaccine. With it, a child can be sick for five to six days.

"Bottom line," Sue writes, "is it's more income for the drug company and not much health benefit for society."

Another panel member, Donna Wright of Gibsonia, says that alternative health professionals are willing to write letters exempting children from school requirements for vaccines. Presumably, this works for day care and summer camp as well.

It's a lot to ask of parents that we second-guess the medical community. But we have learned to be suspicious. Scientific assessments of acceptable risk don't play well when your child's life is in your hands. It's a lot easier to sign a waiver before surgery saying you know you might die, as an adult, than to sign over that same responsibility for your child.

A newswire story about the Kirby book recommended that anyone with questions visit the Web site www.immunizationinfo.org. So, I did. It is reassuring, but in such a naïve way that I just had to laugh. The site, sponsored by the National Network for Immunization Information, says it is backed by the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society and a host of other mainstream medical organizations. The naivete of the site is that many of us don't take mainstream medical advice at face value any more.

Too bad. The organization's Web site is quite comforting. All that's required is that we trust the authors.

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