The Internets, as we all know, are full of Crazy. There are millions of varieties, none of which can ever be comprehensively chronicled. At best, a person can take a series of stabs out into the wisps of the weirdness ether, reeling back in a net full of the ever-changing constellation of online freakishness which soon will either become a tired and played out meme, or just another abandoned hyperlink, broken and forgotten.
Even the great “Internet People” video, which provides as decent of a rundown of said universe as anything else, is itself 3 years old. This website is also a good collection of the freakshow, which sort of makes it famous by declaring it famous in that special Internet modernity kind of way.
But I’m not quite as interested in that sort of online crazy (although everyone is to some extent, obviously) and the whole 4chan “extreme-to-the-Extreme” ideology. I’m more interested in the touchingly sad and yet nearly hilarious corners of things, which can operate back and forth across a certain invisible line in a nearly-vibrational state, flickering between fascinatingly sad and hilariously terrifying. And yes, to even describe these phenomena as “funny” is enough to make one uncomfortable, which is part of what is so interesting about it.
One such example of this was brought to my attention when an irreverent sports gossip site, Deadspin, got sucked into some cross-posting with some extreme horse lovers. The saga of Barbaro and the long-running medical drama (people actually kept online vigils) highlighted a vast (?) group of people who discuss rainbows and unicorns with a staggeringly un-ironic sense. One writer, Dee Mirich, got her own tag on Deadspin as the rowdy assholes utterly shredded her poems and well-wishes to a horse that (yes, we know) cannot, in fact, read. Funny? Oh yes. Sad? I think so.
Another example, less flooded with hipsters and furious typists, is the very serious group of people who populate the “I’m sick” corner of the Internet. Consider, if you will, But You Don’t Look Sick.com.
The site seems to mostly be about the disease Lupus, but also covers various other ailments and discusses coping with assorted diseases, most of which I have never heard of. The cornerstone is an essay about spoons (PDF) which pretty much can be summarized as, “when you have a disease, you have to ration your energy.” This evidently is so amazing to people that they are willing to buy the entire essay printed on a poster. You may also buy a vast variety of other Lupus and spoon-themed items.
If this makes people with lupus (or other ailments) feel better, I guess that’s good. But it also walks the line between kind of funny and kind of sad. And that’s such an interesting line. Lupus isn’t fake. Trick Daddy has it.
Is it? I mean, what constitutes a disease? Fibromyalgia seems pretty fake. There’s obviously some debate about ADHD. Hell, the debate over that one has its own Wiki page. Quality scientific debate there from dispassionate folks, obviously. And there’s a difference in kind between those diseases and these fake diseases (a great list).
So yes, there is something quite sad about the message board poster at The Lupus Site.com whose sig line is a rundown of all of her ailments: “Diagnosed with SLE, Cogan’s Disease, Pigment Dispersion Syndrome ‘eyes’, Raynauds, Ulticaria, Atinic Vascular Erythema” or the one who ends every post noting that she has “Endometriosis, Celiac Disease, Hashimoto’s Thyroiditis, Allergies to most things in nature except animals 
, Allergy induced Asthma, Fibro, Migraines, POTS, and NCS, and Narcolpsy!”
Colors! Emoticons! So Many Diseases!
Yes, there’s something sad about all of these people comparing diagnoses like baseball cards, wanting to be praised for being strong and survivors, creating these online support networks for each other because nobody else will listen to them talk about their problems. And yes, there’s something both sad and dangerous about the fact that they are offering amateur medical advice to each other, diagnosing each other via computer screen based on self-described symptoms. Certainly I would be revolted to see legal advice being dispensed in such a capricious jailhouse manner.
Here we have medical “victims” (of some sort) pretentiously “taking back the power” from the elitism of the well trained medical professionals. Everyone suffers. All advice is equal.
Look, I’m no slave to expertise. I am willing to consider a variety of theories that most people would dismiss as “wingnut.” I think I am well prepared to discern what constitutes a qualified claim supported by evidence. And I’m no apologist for western medicine either. I can talk for many hours about alternative therapies, critiques of science and rationalism, and I’m well aware of the reasons why we need a single-payer universal health care system (hint: in part, so that people aren’t trying to cure each other on message boards).
But this sort of thing is what allows pro-ana groups to flourish. It is why nutjobs like Jenny McCarthy and Jim Carrey can be considered national experts on autism, even though this grim site, the Jenny McCarthy Body Count, is keeping up with the number of corpses on her anti-scientific hands. But hey, anti-vaxxers know just as much science as everybody else, right?
And none of this mentions the fact that Big Pharma profits from the whirling insecurity surrounding an ever-growing universe of named diseases, none of which will ever be cured (but for which various remedial pills can be provided).
And yes, I know that there’s something very Fight Club about lurking in these disease self-help forums, soaking in the people complaining, drifting through their suffering.
Those of us who don’t have these diseases (whether or not they exist) will always struggle to understand those who do (or think they do). And maybe they think that talking about spoons will help us understand them, even if to us, they come across as super weird alienated Internet freaks who take a slight bit of fatigue and turn it into a CDC-baffling medical mystery.
Maybe the start to this post was just wrong. Maybe there is really nothing funny at all about people talking in insular communities about their various medical problems, comparing pharmaceuticals and pain thresholds, even if that comes part and parcel with giving each other electronic “spoons” and carping about their “invisible disabilities.”
These people are obviously lost and disconnected, googling various symptoms to come up with new diagnoses, and many are almost certainly varying degrees of mentally ill. Since all treatments are equally suspect and valid, there may be no helping them at all …
Maybe I’ll go back to the crass butt jokes, Star Wars fan films, and Hitler animations now.
Usually when I visit this site I can count on a few laughs and a “hmm, hadn’t thought of that”, but in the antivax debate you are way off base. Please do not reduce the complexity of this debate by using Jenny McCarthy as the spokesperson.
Many thoughtful parents agonize over the decision to vaccinate, and there are thousands of scientists, doctors, and researchers who disagree with the current vaccine schedule. The debates take place in 2 categories; are there too many vaccines, and are the ingredients safe for use in the smallest humans? To reduce the debate to the old question of mercury is irresponsible. Mercury was toxic (still is actually), and because of parent and responsible physician outrage, it has been removed from MOST vaccines. Mercury cannot be removed from all existing vaccines, so there are trace amounts in a few shot series. To actually remove the mercury the vaccines would need to be destroyed and a new batch created. Big Pharma has deemed this too expensive, but assures parents that the *new* amount is not toxic.
Even ignoring mercury for the moment, here are many other dangerous chemicals used in vaccines. Aluminum for one is toxic in any amount and is used in almost every vaccine manufactured today. Aluminum is the mercury of the future. When my kid has kids doctors will reassure him that all of the aluminum has been removed, or that the *new* levels of aluminum are not toxic.
Additionally, It is impossible for the medical community to test multiple vaccines in combination with each other for fear of lawsuits. Ironically that same logic allows Big Pharma to release new vaccines every few years with the tacit understanding that the market will “correct” their side effect profile. If enough children are made sick or die, they will recall the vaccine. Until a recall is announced, doctors add the new vax to the MUST HAVE list, and pronounce parents who object as unfit.
A massive recall on a vaccine to prevent diarrhea that was introduced in 1996 was completed in 2004. In 2006 the SAME company produced a new vaccine for the same problem (the runs, rarely fatal with medical attention) and doctors promptly put it back on the required immunization schedule. Keep in mind the new vaccine underwent the same *rigorous* testing that the first recalled vax did. The first vax caused some infants intestines to telescope in on themselves, others died because the vax prevented their bodies from absorbing any nutrition. All in the name of preventing diarrhea. So, am I to trust the new vax for fear of being branded crazy? An internet loon?
Are you aware that the average infant receives 4 times as many vaccinations today as you or I did? That the dosage of each vaccine is the SAME as for an adult. We are talking about 6- 8 pounds of infant here. Smaller than most cats. That the vaccines are only tested in isolation for each other? That an infant is *required* to receive 6 shots at 2, 4, and 6 months old? 4 of these shots are considered highly reactive and if an adult tried to get all 6 at once, a doctor would be remiss not to suggest spacing them out to avoid “adverse effects”.
In most, if not all hospitals, infants are given a Hep B shot AT BIRTH! This is an attempt to eradicate Hep B from the US by vaccinating at birth. An admirable goal, but it was studied for 6 months in only 1,000 infants. The lax terms of the study were allowed because the vaccine has been deemed safe (in adults). Also, I am not sure many infants are at risk for Hep B. I for one don’t plan on talking to my kid about unprotected sex or IV drug use until he is at least 18 months old. I hope I won’t be too late.
If the internets taught us nothing else during the massively overblown Swine Flu *outbreak*, it was to be very wary of unnecessary vaccines. A vaccine was developed in reaction to the 1970’s outbreak and it killed 40 people. Only 1 died from the actual flu.
Some vaccines are worth it. Got it. Use a delayed/selective vaccination schedule that shockingly looks much like the schedule you and I were vaccinated under. Disease is horrible, especially when it is preventable. BUT, we cannot be blind to the unintended side effects in our quest to vaccinate against every inconvenient ailment.
Parents have a hard enough time with this decision; they certainly don’t need additional ridicule. Especially the woefully uninformed kind.
There is an amazing *This American Life* episode on the Vaccine debate that includes parents on both ’sides’ and also explains how the media exacerbates public fear on the issue (go figure): http://thislife.org/Radio_Episode.aspx?episode=370
I call bullshit.
The vaccine “debate” is astoundingly simple–If people don’t get them, diseases WILL kill more people. Period.
Rather than placate the “I agonize over the decision” crowd, let me make it pretty simple: if you don’t get your kid immunized, you increase the likelihood that MY kid will get a preventable disease and have serious health problems.
If you don’t like how vaccines are manufactured, complain to the drug companies and your doctor. Seek out vaccines that don’t contain mercury and get them. If you don’t want to stick to a reasonable, keep your kid in an isolation tank until you finish your shots.
If you don’t get your kid vaccinated, please move the hell away from me. I have enough problems dealing with my son’s allergies, so the LAST thing I want to deal with is Whooping Cough, mumps or a virulent strain of diarrhea (which can, in fact be damn problematic).
Jenny McCarthy is a nutjob. Quit drinking the cool-aid and get the damn shot.
The solution is not NEVER vaccinate, the solution is responsible vaccination. The current vaccination schedule is simply not responsible. Perhaps Dave should consider that his kid’s allergies were in all likelihood caused or at least aggravated by over-vaccination.
To overload an infant immune system with unnecessary antibodies (Hep A, Hep B, RotaVirus) is irresponsible. Selective vaccination schedules address all of Dave’s concerns by encouraging parents to vaccinate against Whooping Cough, Diphtheria, Tetanus, Pneumonia, infant flu, Measles, Mumps and Rubella. What it does not encourage is a blanket following of recommendations made by drug companies to increase profit margins.
Anyone who is currently over the age of 10 did not receive vaccinations for Hep A and B, nor for rotavirus, nor for many other *preventable* diseases that now have available vaccinations. We did just fine. I may be crazy, but I don’t remember not being allowed to play with my friends because I hadn’t completed my Hep B series. Perhaps my parents played fast and loose with my health.
Some vaccines are critical for infants as they prevent diseases that disproportionately and severely effect children under the age of 2. Pc, HIB, and Dtap all fall in this category. Vaccinate after the age of 5 for Hep A and B, throw in polio here and go for the gold. Unless a parent is infected, or your child will be spending a significant amount of time in the African bush or an Eastern European orphanage, it is perfectly fine to WAIT a few years on some vaccines. Get them, fine. But wait until the immune system has developed enough so that the vaccines are not an additional strain.
There is a very good reason that even the most vaccine happy doctor will not vaccinate a sick child (even with a mild fever). Vaccines are incredibly taxing. If a child is sick, or has an undiagnosed weak system. The vaccines can cause the system to overreact. One day, I believe vaccinations will no longer have a one size fits all schedule. Infants will be tested for genetic markers of underlying immune disorders and those who have weak systems will be vaccinated differently that those with healthy systems.
I wish Dave had read my post with a bit more attention to detail. I agree that some vaccinations are critical, they do and will continue to save lives. This does not mean that more is better. In fact, more is demonstrably worse. Dave is also right that Jenny McCarthy is an idiot (again, careful reading has benefits). I would never align my self with her “autism cure”, or suggestion that it is fine for parents to not vaccinate at all.
As for the other matters Dave addressed:
It is not possible to avoid mercury in all shots. The Dtap vaccine, no matter which manufacturer has mercury. This is the shot that will stop my kid from giving Dave’s kid Whooping Cough; although I assume Dave’s kid is vaccinated, so transmission is unlikely. Oh, wait. My kid also got that shot — the risk of not vaccinating is too high. All that responsible vaccination requires is weighing the risks and benefits of each vaccine.
In terms of complaining to drug companies and doctors—consider it done. Parents have been complaining for decades, but it is easy to not listen when Big Pharma makes billions of dollars each year peddling the latest vaccine. Although Merck has finally agreed to remanufacture the MMR shot in separate doses for each disease. This shot is particularly reactive, and side effects are significantly less if each component is given individually. Why is your outrage not also directed at Big Pharma for making dangerous products? If the vaccines were safer, everyone would vaccinate. You would then have your free time back to focus on your kid’s allergies.
Keep in mind that some vaccines are only used in the U.S. The RotaTeq vax (diarrhea) is not used by ANY OTHER country in the world as a mandatory vaccination. Are kids in France, Canada, England, or any other “developed” nation dying by the thousands? Are parents refusing to let their child hang out with Paulo because his parents are “anti-vax?”, or suggesting that Giruox remain in an “isolation tank” until he is vaccinated against diarrhea? Do you know how that vaccine is manufactured? 5 different strains of rotavirus are taken from infected cows, cross-bred to increase effectiveness, grown in a mix of monkey kidney cells (VERO cells), and nourished by fetal cow serum. The viruses are then filtered out, put in a liquid solution and given to infants. No thanks. Diarrhea sucks and it is “problematic”, but even severe cases are rarely fatal with medical care. Also, even with the new vaccine, 90% of children still get the rotavirus by age 2. Scary, rife with dangerous side effects, and not effective. No thanks.
Outgrow that knee jerk reaction to an anti-vax post. Read carefully. A thoughtful approach to vaccinations is better for all concerned.
Michelle,
I am a chemist, I work closely with biologists, and I dare say I know a little more than the average dope about both vaccines, virology, and the prevention of disease. Yes, I knee jerk, unapologetically, and deride any suggestion that vaccines do more harm than good as asinine.
Here’s why: parents are idiots. If well read intellectuals advertise the risks associated with vaccines and encourage parents to”pay better attention” and “read carefully,” then parents interpret that as “VACCINES GIVE MY KID AUTISM!!!!” As much as I would like to live in your fantasy land that assumes every parent is up on the latest trends in vaccine cultures, that does not represent reality.
Unfortunately, when the average Joe/Jane reads vaccine studies, they see “X # of people got SICK!!! HOLY SHIT!@$!@%^$” which is what you did when referencing the ‘70 flu numbers (an episode I admittedly know little about). What people FAIL to realize is how bad outbreaks CAN BE when large percentages of the population are NOT vaccinated. People see “Mercury in Vaccines!!!!!” and interpret that as “Vaccines will make my kid DUMB!!!!!”
Since you have already said your peace to the drug companies and your doctor, please don’t spread any FUD about vaccines to the public at large. Somebody, somewhere will read what you wrote and think to themselves, “Gee, this person is all over it, and they think there are problems with vaccines, even if they got their kid immunized. Maybe they just didn’t love their kid as much as we do. Besides, everybody else gets vaccinated! There isn’t really a big risk if we don’t get our kid vaccinated!”
The problem, then, is people “choosing” not to get one stage of the MMR, and then not “choosing” to get the “ineffective” diarrhea vaccine that is “rife with dangerous side effects” bacause they know better than “Big Pharma” (which we all know is out to get us, regardless if I actually DID need a huge dose of antibiotics last year to avoid getting pneumonia–they are just in it for the profits! Nobody’s health EVER improves from taking DRUGS from companies that want to make a PROFIT!!!)
When this happens, then the diseases WILL become problematic again!
So, yea, I still call bullshit. And a big Fuck You for suggesting I caused my kid’s allergies.
PS My sister, who was on your “more reasonable” vaccine schedule more than 30 years ago had many times worse food allergies than my son. My mother has always had allergies which were related to an autoimmune condition she has battled all her life. I won’t tell you how old she is. I also happen to have bad seasonal allergies.
However, it is great to hear that YOU magically know the cause of my son’s condition without EVER HAVING MET HIM and without knowing ANY of his medical history. Glad to hear that you are against “knee jerk reaction to an anti-vax post” but are comfortable stating that “allergies were in all likelihood caused or at least aggravated by over-vaccination”
Brilliant.
Looks like Dave and I aren’t that far apart after all. With his creds as a chemist who works closely with biologists he pays no mind to my outrageous accusations that there is an unavoidable dose (actually 3) of mercury on the current immunization schedule, that some vaccines are Frankenstein like crazy, dangerous, and ineffective, that vaccines have the potential to overload infants immune systems, and that there is really no risk (microscopic unless a parent is infected) to just WAITING a few years to get some of the recommended vaccines. Perhaps it is because these are the facts.
I asked my doctor during one of many vaccine conversations exactly why infants were vaccinated against Hep A and B. She replied that it is “hard” to get teenagers to finish a shot series, so doctors prefer to administer shots to infants. EXCUSE ME? Not even close to good enough. I promised to dutifully march my kid to her office between the ages of 5 and 11 to receive these shot series, no matter how “hard” it may be. There is clear and convincing evidence that an infant’s blood-brain barrier is not complete until the age of 2. Before this magical point, toxic metals can seep from the blood into the brain with relative ease. Remember there is mercury in 3 shots (1 series) and aluminum in most others. There is simply NO harm in waiting on selected shots until after the age of 2.
Dave suggests that while I may be well informed, others (that’s you) who may read these posts will overreact and decide not to vaccinate at all. I hope not. Vaccinations (as I have said again, and again) are one of the reasons we all have the opportunity to drop dead from corn fed beef induced heart attacks, or High Fructose Corn Syrup prompted diabetic comas instead of saying our final farewells to family and friends in our 20’s. However, I have seen no clear and convincing argument for the current vaccination schedule. It is too much, too soon. Must we Super Size everything? Is the rest of the world in mortal danger for following “lax” vaccination schedules (measles, yes. chickenpox and diarrhea, no)? If so, throw away your passport, and lock down the border.
Dave also suggests that Merck is doing the “responsible” parents a disservice by offering the MMR shot in separate components. The logic goes, if it is available in separate shots, then maybe parents won’t get all of the components. Well Dave, that’s true. Perhaps all 38 shots given to infants (before the age of 2) should just be rolled into one huge shot? Sure, we may have a bunch of dead kids on our hands, but shit, at least we know they got their shots. The point is to spread out the highly reactive LIVE VIRUS vaccinations, in the hope that adverse side effects can be minimized. No one is trying to pull a fast one on you. Many will claim that the MMR vaccine has been around for decades before the vast array of adverse effects started appearing. Yep, also (mostly) true. However, this is just further proof that we have no fucking idea how all of these vaccines work together in tiny bodies. And maybe spreading them out and eliminating some that are unnecessary will save lives. Yes Dave, I still think the diarrhea *vaccine* is unnecessary. Reference my previous posts for the many, many reasons.
Finally, I am glad that Dave took some antibiotics to prevent pneumonia. Good call. I took some myself a few months ago to clear up a nasty infection. I don’t remember suggesting that all drugs were evil.
I should also apologize for implying that you were at fault in your son’s allergies. I went too far. But there is truth in the statement that vaccines cause and aggravate many unknown food and environmental allergies by overtaxing immature immune systems. It sounds like you have a clear family history of allergies, and for that I am sorry.
However, the monumental rise in children’s allergies couldn’t have escaped your attention. An infant’s immune system is *taught* to overreact to mild allergens when it is bombarded at an immature age by the dozens of pathogens in vaccines. Another massive culprit in the rise of severe allergies is the total lack of breastfeeding in this country. Infant formula is barely adequate nutrition (also contains high fructose corn syrup and the pesticides used to produce said corn), and it destroys a child’s immune system. If every mother breastfed her child for a MINUMUM of 1 year (or pumped, or bought breast milk from a milk bank), and both parents thoughtfully vaccinated their children we would see a drastic drop in allergies and allergy related illnesses and deaths.
Oh, one more thing. Dave, please talk to your child’s doctor and call Merck, et all and give them a good dose of your outrage. If parents who adhere to the vaccination schedules also express anger to the drug companies, maybe we will see a safer product developed. I do not know anyone who doesn’t want to vaccinate. We just want safer vaccines. Help us, and we are all better off.
With no offense intended to either side of this facinating exchange, i must say that i have never been so glad not to be a breeder.
Michelle, I appreciate your thoughtfulness on this subject. You and Dave both have expressed many valid concerns. It is sickening to think that big Pharma is making big bucks off of potentially dangerous or even just unnecessary vaccines. It is also disturbing to think of all the parents who refuse to vaccinate their kids without a proper understanding of how to evaluate vaccine safety, efficacy and necessity. With that being said, I have a few points to make concerning some of the claims made in this debate:
Michelle, there is a lot of literature out there concerning the safety of vaccines. Some of it is good, some not so good. I amassuming that you know how to read a peer-reviewd, scientific article based on emperic evidence and evaluate it for quality. I am assuming that when you mention that the recommended pediatric immunization schedule can overload a child’s “system” and “teach” a child’s immune system to overract to mild allergens, you have a clear idea of what a child’s “system” or “immune system” actually is and how it functions. However, you are not communicating your knowledge appropriately with completely unwarrented claims like “the monumental rise in children’s allergies couldn’t have escaped your attention. An infant’s immune system is *taught* to overreact to mild allergens when it is bombarded at an immature age by the dozens of pathogens in vaccines. Another massive culprit in the rise of severe allergies is the total lack of breastfeeding in this country… If every mother breastfed her child for a MINUMUM of 1 year (or pumped, or bought breast milk from a milk bank), and both parents thoughtfully vaccinated their children we would see a drastic drop in allergies and allergy related illnesses and deaths.”
There are several problems with this. First, the “monumental rise in children’s allergies” is a multi-faceted phenomenon that can be attributed to numerous variables, including an increase in recognition and diagnosis. Even if vaccines did contribute to allergies, I think most people would rather inflict hay fever upon their little one than paralysis from polio. Futhermore, vaccines do not expose babies to pathogens. Pathogens cause disease by physically damaging cells, tissues, and organs. Vaccines contain antigens, which are fragments of proteins, lipids or sugars expressed on the surface of pathogens and allow the immune system to recognize these pathogens as foreign. If you are concerened about live attenuated vaccines, these are live vaccines that have been altered in such a way that they are unable to cause damage to the body (like, the molecular equivalent of chopping the arms and legs off of a would-be gunman.) The baby may experience a local inflammatory response, such as redness or swelling at the site of the injection, but even so, the antibodies produced in response are highly specific for the antigen in question and so it is an extreme extrapolation to say that vaccines “teach” the body to overract to “mild allergens.” I could go into a detailed description of cellular and humoral immunity and B-lymphocyte synthesis of antigen-specific antibodies… but suffice it to say that vaccines teach the body to quickly and efficiently neutralize very specifc, highly virluent pathogens. If a baby’s immune system is overloaded by vaccine, then the vaccines will be ineffective in producing protective levels of antibody, but it is not sound logic to suggest that this is the same thing as massive and systemic immune derangement (Kumar et al., 2005). I hear your concern about the lack of studies pertaining to co-administration of vaccines: so far the literature seems to support co-administration of pentavalent vaccines (five vaccines at once–DTaP, Hib, IPV) as safe and effective (Gold et al., 2007). I found several studies verifying Gold’s conclusions. I could not find any studies that include co-adminstration of rotavirus, pneumococcal and possibly the hep B vaccine along with the pentavalent vaccine, but then again, I did not perform an extensive review of the literature. I searched the first 75 or so hits on PubMed and CINAHL (nursing and allied health) databases for “vaccine safety”, “mercury vaccine safety”, “aluminum vaccine safety,” “co-adminstration vaccine safety”, “pediatric vaccine safety” and other permutations of these keywords, limiting my results to peer-reviewed journals in the past ten years. Plus I’m, you know, blogging. I don’t claim that this is an exhaustive review or anything. I’m open to findings that anyone else brings to the table.
As per your breastfeeding claim, I am a nearly militant supporter of breastfeeding as it confers a plethora of advantages for both mom and baby, pertaining to bonding, growth, and maternal immunity protection for baby up to 6 months of age, and many others (Kumar et al, 2005). Unfortunately, your claim that breastfeeding would eradicate allergies is simply unwarrented. Consider a study by Kramer et al. (2007) published in British Medical Journal that followed over 17,000 mom/baby dyads for over 6 years and found no difference in rates of pediatric allergies between all populations of breastfed babies (short-term, long-term, etc) and non-breastfed babies. To put it lightly, the literature is divided on the matter of breastfeeding and allergies. As per your critique of infant formula, I am sympathetic, but a dislike for formula or formula ingredients alone does not validate a claim that breastfeeding combined with “thoughtful” vaccination will drastically reduce allergic illness and death.
You also mentioned that doctors will not immunize if children have fevers or illness for the risk of overloading their systems. This is simply not true. Doctors don’t immunize sick kids so they won’t get sued by parents (here I will reference my own experience), not because the literature supports the link between sick kids and vaccine problems. In fact, the only medical contraindications for most vaccines are history of anaphylaxis or encephalitis following a previous dose (McPhee & Papadakis, 2009). In general, live attenuated vaccines can’t be given to individuals who are severly immunosuppressed. It’s all there on http://www.cdc.gov, my friend. Perhaps you don’t trust the CDC? I can’t help you there. Search medical journals for independent verification of CDC guidelines.
I also know you think rotavirus is no big deal, especially here in the U.S., but consider the arguments put forth in a review of the new rotavirus vaccine published in Clinical Microbiology Review (2008). The overview finds that the new vaccine is safe and necessary because rotavirus is equally prevalent in developed and non-developed countries and that U.S. kids with rotavirus have a 1 in 7 chance of going to clinic/ER and a 1 in 70 chance of being hospitalized. ER visits and hospitilization carry their own risks and I’d probably rather vaccinate my kid than risk admitting them to a MRSA, VRE incubator of a hospital. Also, the recommendation of vaccination is from a public health perspective: vaccination is intended to reduce the burden on our medical system and our educational system. You may not personally care about reducing the burden on these systems–you may simply care about your child, and that is fine by me. But you can sure as hell bet that those of us entrusted with keeping the health care system afloat to strongly advocate for a safe vaccine that might reduce morbidity and unneccessary strain on an overly-strained health care system. That may be our bias, just as you have yours. Not that it’s “us” against “you”–I personally respect most parents’ choice to hold off on vaccines for non life threatening illness, like chicken pox and Hep A and rotavirus and back off the subject unless they are part of a high-risk population. But you bet I’m going to routinely offer and endorse the vaccines as per current CDC guidelines. Now, there’s always the possibility that CDC information is out of date or even polluted by industry money-makers. This is why you must choose a practitioner who remains current with the body of research and alert to industry practices. I think drug companies typically have too much to lose these days if they put a dangerous drug on the market (esp. one for babies), but I know it happens and the best I can offer you is to say that we in the biz know about this and try to evaluate the info for ourselves. That’s why we take classes that teach us how to read and interpret indecipherable statistical and biomedical reports and such.
As per Hep B, our policy in health care is this: as much as a parent resolves to return and vaccinate a kid later, or as much as they intend to finish a Hep B series, we don’t usually know parents personal attributes and, even if a parent seems pretty with it, we acknowledge that the well-meaning parent can get hit by a bus when as soon as she walks her kid out of the clinic door and then we may have missed our one opportunity to vaccinate the kid. And even if your kid is not travelling to Asia or somewhere where Hep B is endemic, how do I know that she won’t be so traumatized by her mother’s untimely demise that she, in her teen years, turns to IV drug abuse and unsafe sex? I think all IV drug users and partakers of unsafe sex deserve to be protected against Hep B, and the system is designed to prevent as many people from slipping through the cracks as possible. This means we vaccinate at every chance we have to vaccinate. So don’t take it personally when we try to poke your kid. We have piles upon piles of evidence to suggest that the benefits outweigh the risks. Such is the case with the so-called mercury debate and other safety concerns you mentioned. Many of these have been addressed by numerous panels of experts, like advisory boards for the CDC (www.cdc.gov) and the Global Advisory Committee on Vaccine Safety, which was commissioned by the WHO to evaluate vaccine safety. These people have concluded that thiomersol in children’s vaccines does not pose a safety threat and that removal of thiomersol from multi-dose vials actually poses a greater risk of infecting kids with contaminated vaccine. Additionally, they find no link between MMR and autism (Folb et al., 2004).
So, Michelle, I hope I have provided you with arguments that are a bit more sound than Dave’s emphatic “fuck you!” and toxicculture’s brief quip against parents who don’t vaccinate. Let me know if you find anything of interest on the subject.
References (I’ve abbreviated them since this is a blog, not a published paper):
CDC 2009 guidelines and reports, on http://www.cdc.gov
Dennehy, P.H. Rotavirus vaccines: an overview. Clinical Microbiology Reviews. 2008; 21(1): 198-208.
Folb et al. for the GACVS. A global perspective on vaccine safety and public health: the global advisory committee on vaccine safety. American Journal of Public Health. 2004; 94(11): 1926-1931.
Gold et al. Safety and immunogenicity of a fully liquid vaccine containing five-component pertussis-diphtheria-tetanus-inactivated poliomyelitis-Haemophilus influenzae type b conjugate vaccines administered at two, four, six, and 18 months of age. Canadian Journal of Infectious Disease and Medical Microbiology. 2007; 18(4): 241-248.
Kramer et al. Effect of prolonged and exclusive breast feeding on risk of allergy and asthma: cluster randomized trial. British Medical Journal. 2007; 335(7624): 815. Epub 2007 Sept. 11.
Kumar, Abbas & Fausto. (2005). Robbins and cotran pathologic basis of disease (7th ed.). Philadelphia: Elsevier Saunders.
McPhee, S. J. & Papadakis, M. A. (2009). Lange current medical diagnosis and treatment (48th ed.) McGraw-Hill.
p.s. amazing post, toxicculture, even if it did spark Vaccine War ‘09.
Let me begin by saying that I am a bit tired of patronizing statements like “I appreciate your thoughtfulness on the subject”. As if I am just some dumb kid playing in the adult pool. I guarantee that I have done more vaccine specific reading and research that 95% of the doctors out there “poking” kids. Most docs get one or two lectures in medical school on the virtue of vaccines, and that’s it. After med school a rare few continue to read vaccine specific literature, but the vast majority rely on drug company reps and package inserts to further their education. Why is it so shocking that parents are arming themselves with the latest information? Someone damn sure better.
Below I have provided a line-by line of sorts from the previous post. Let me also say that after this post, I believe I have said my peace and barring some crazy ass replies, I am finished.
Even if vaccines did contribute to allergies, I think most people would rather inflict hay fever upon their little one than paralysis from polio.
First, this is not an accurate assessment of available choices. The US has been polio free since 1985; the last case of wild polio in the Western Hemisphere was in 1991. The ONLY Polio cases in the US since 1985 were caused by the oral vaccine.
When the polio vaccine was first developed it was administered in oral form. This oral vaccine was later determined to actually cause polio (about 10 cases a year), since January 2000 it is no longer recommended in for use in the Unites States except in some very unusual circumstances (per CDC guidelines). This is just another example of doctors/scientists/chemists DON’T ALWAYS KNOW what the hell they are doing, so maybe I will just evaluate the risks on my own.
Oh, the CDC is also considering dropping polio from the list of recommended vaccines in a few years due to limited worldwide activity that is now best controlled through outbreak control, not blanket immunization. Great work done by vaccines, but also no longer a shot I feel is worth it. Here are some ingredients that I would rather not expose a child to, given there is no risk of transmission: baby calf blood serum, monkey kidney cells, formaldehyde (NO long term studies have been done on the effects of injected formaldehyde, but it is regulated by the EPA, OSHA and CPSC as a carcinogen) and 2-phenoxyethanol (a well recognized toxin often used as a preservative). Having said all of that, the polio vaccine is one of the safest shots given. If polio was a real risk, I would have my child immunized as the risks of exposure would outweigh the risks from the vaccination.
Second, please don’t assume that all vaccines are safer than hay fever. Here is a study of over 100,000 children in Finland who received the HiB vaccine during the first two years of administration. The data showed that children who received the vaccine were significantly more likely to develop child onset diabetes than their peers born two years earlier that did not receive the vaccine. The study also references additional research that shows the vaccine causes diabetes in mice. Autoimmunity 2003; 36(3):123. This vaccine is available without aluminum, but you have to know which brand (ActHIB) and make a special request at your pediatrician’s office. Even knowing this, I still had my kid vaccinated against HiB, because while extremely rare in the US (about 23 cases a year). It is still prevalent around the world and he will be doing some international travel before the age of 2 (when the disease is still serious, after the age of 2 any case would be extremely mild). If we were not planning travel, I may not have had him vaccinated. Again, an individual benefit analysis proves to be the most fruitful option.
Another group of doctors/scientists/authors discuss the relationship between early exposure to infections and vaccinations and the triggering of autoimmune disease, allergies, and skin disorders namely eczema in infants. Acta Dermato-venereologica; 83 (6) :445-450. Here is another study specific to Hep B shots that concludes the shot is most likely a causal agent in autoimmune disorders Rheumatology 1999; 38 (10): 978-983. Do these studies mean that all allergies and autoimmune disorders are linked to vaccines? Certainly not, and it would be irresponsible and counterproductive to suggest such a conclusion. What they do suggest however, is that a careful approach to vaccination is mandated by the serious and permanent nature of “adverse reactions”.
If you are concerned about live attenuated vaccines, these are live vaccines that have been altered in such a way that they are unable to cause damage to the body (like, the molecular equivalent of chopping the arms and legs off of a would-be gunman.).
It is absolutely possible to get measles, mumps and rubella from the MMR vaccine. Occasionally the live-virus strain in the vaccine is not adequately weakened, this does not happen often, but it happens. Please do not claim that transmission is impossible. Unlikely is not the same as impossible. These live-virus vaccines are measurably harder on an infant immune system as the shot contains whole live viruses. The documented side effects (as listed in the vaccine insert) include: measles, flu like symptoms, inflamed pancreas, diabetes, rubella, blood disorders, allergic reactions, life threatening rash, mumps, low platelet levels, and joint/muscle soreness. Do not pretend that these viruses are not capable of doing any damage to a child’s body.
While there is no conclusive research indicating a direct link between the MMR vaccine and Autism, there is evidence the two are casually related. The best guess of researchers at this point is that immune systems that are teetering on the edge (of unknown causes) are somehow “pushed over the edge” by a wonderfully effective, but highly reactive vaccine. Many also believe that it is not the MMR vaccine alone, but a combination of genetic and environmental factors that make an autoimmune reaction likely that could trigger Autism and Autism spectrum disorders. Journal of American Physicians and Surgeons 2004; 9(3): 70-75, and Geier et al., 2004.
Now, let us discuss aluminum which I find to be the most important ingredient to avoid. There has been only one study to determine if aluminum in vaccinations is actually poisoning children. The Cochrane Collaboration published a study in The Lancet journal in 2004 that purported to examine aluminum levels and toxicity. They concluded that aluminum in vaccinations was safe and warranted no further research. Big claim for one study; especially one that is fundamentally flawed. The Cochrane Collaboration didn’t test aluminum levels in children after vaccinations, they did not investigate if aluminum builds up in tissue or bone, they only looked for external signs of aluminum toxicity. This *study* looked at only one aluminum containing vaccine, not all four that are scheduled for simultaneous injection in children. Oh, they also did no independent research—just reviewed available existing studies. On this, I am calling bullshit. (Sears, 2007)
It is indisputable that aluminum builds up in human brains; one study found that aluminum caused patients brains to resemble those of Alzheimer’s patients. (Brain Research Bulletin 2001; 55 : 211-217 Another study showed that even tiny amounts (far less than in vaccines) caused measurable developmental delays in premature infants who were on IV solutions that contained aluminum. The premature infants received 500 micrograms over about 10 days through an IV solution (the control infants had the same IV solution with aluminum filtered out. They showed no developmental delays, kidney impairment, nor evidence of aluminum related progressive dementia). (New England Journal of Medicine 1997; 336(22): 1557-1561
So how much aluminum can infants be safely exposed to? The safest is obviously none; however ASPEN and FDA regulations put the MAXIMUM at 25 micrograms per day. Hmmm, the Hep B shot given just after birth has 250 micrograms. If you give a child all of the recommended shots at 2 months, the will be injected with another 1225 micrograms (amounts vary slightly from brand to brand)!!! And no one has bothered to conduct any vigorous studies? Unbelievable. Criminal actually.
I hear your concern about the lack of studies pertaining to co-administration of vaccines: so far the literature seems to support co-administration of pentavalent vaccines (five vaccines at once–DTaP, Hib, IPV) as safe and effective (Gold et al., 2007). I found several studies verifying Gold’s conclusions.
This study has a few problems. First, it suggests only that the pentavalent vaccination can be counted on to produce as many side effects as separate vaccinations about 96% of the time. That means 4% of the time, it is worse. There is no data to suggest that the pentavalent vaccination produces fewer side effects. Second, this vaccine does contain both aluminum and mercury as well as the potential to trigger autoimmune issues, but neither issue is addressed by Gold.
However, pentavalent is very promising for industrializing countries as the rate of vaccination is much lower, disease is more endemic and the side effects are far less serious than the diseases they prevent. This vaccine has the potential to save thousands of lives in countries where following a vaccination schedule is highly unlikely due to supply problems, lack of education, lack of refrigeration, and dozens of other problems. If this sounds like I do not care if individuals in non-industrialized countries suffer side effects, I apologize. I simply recognize that the rate of infection is much higher and thus avoiding the actual disease if of primary importance. Of course if safer vaccines are manufactured, they should be available to all.
I could not find any studies that include co-adminstration of rotavirus, pneumococcal and possibly the hep B vaccine along with the pentavalent vaccine, but then again, I did not perform an extensive review of the literature.
How frightening is this line. The literature should be absolutely BURSTING with studies that prove it is safe to vaccinate our children in exactly the way we are instructed to do so. The very idea that studies (if they even exist, which I believe they do not) would be difficult or impossible to find is reason enough for outrage.
As per your breastfeeding claim, I am a nearly militant supporter of breastfeeding as it confers a plethora of advantages for both mom and baby, pertaining to bonding, growth, and maternal immunity protection for baby up to 6 months of age, and many others (Kumar et al, 2005).
WOOHOO!!! Thank you!!!! There is strong evidence that breastfed babies definitely have fewer food allergies. One of the reasons is that it’s so much gentler on their stomach and therefore doesn’t cause microscopic lesions in the gut like formula or early feeding of solids can. Those lesions can let stuff through the gut into the bloodstream that lead to allergies. It doesn’t always, or even usually, but it can. There is clear scientific evidence that breast milk contains a wide variety of immune factors that are not present in formula. Those immune factors coat the gut and therefore don’t let pathogens into the breastfed infant’s body. It doesn’t provide total protection against all diseases, but it offers a huge advantage.
IgA, IgG, IgM and IgD are all found in human milk. Of these the most important is IgA, which appears to be both synthesised and stored in the breast. It ‘paints’ the intestinal epithelium and protects the mucosal surfaces against entry of pathogenic bacteria and enteroviruses. It affords protections against E. coli, salmonellae, shigellae, streptococci, staphylococci, pneumococci, poliovirus and the rotaviruses. (Nurse-Midwifery, Helen Varney, Second Edition, p. 419)
Unfortunately, your claim that breastfeeding would eradicate allergies is simply unwarrented.
Didn’t say eradicate, I said drastic drop. This is borne out by the breastfeeding discussion above in combination with a selective/delayed vaccination schedule designed to minimize side effects.
U.S. kids with rotavirus have a 1 in 7 chance of going to clinic/ER and a 1 in 70 chance of being hospitalized.
These are current numbers. That means post-vaccine. The Rotavirus vaccine doesn’t save much in the way of hospital or clinic visits because 90% of those vaccinated will still get sick! Did you also add in the costs for treating those unfortunate infants whose intestines telescope in on themselves after receiving the vaccine? My guess is the cost is a bit higher than IV fluids.
I think drug companies typically have too much to lose these days if they put a dangerous drug on the market (esp. one for babies), but I know it happens and the best I can offer you is to say that we in the biz know about this and try to evaluate the info for ourselves. That’s why we take classes that teach us how to read and interpret indecipherable statistical and biomedical reports and such.
The best that has been offered in terms of a defense of the companies that manufacture and profit from our absurd vaccination schedule is “I think they have too much to lose”. Well, I think not. Perhaps that argument would have been better advanced in a time when drug companies weren’t so diversified. Maybe a simpler time like the 1970’s when drug companies weren’t making billions from restless leg syndrome, antidepressants, or erectile dysfunction. Nope, even here they were concerned first and foremost with their own financial bottom line. See, the first go-round of the DtaP vaccine was a failure. The original DtaP shot used whole-cell Pertussis (what Dave was afraid my kid would give to his), and was linked to numerous neurologic problems, developmental delays, SIDS, and a host of problems. This vaccine was pulled from the market (after many years of research and lawsuits, not because drug companies are likely to “do the right thing”), and a new *safer* DTaP was developed. Also please recall my previous discussion of a Rotavirus vacciene that was also pulled from the market because it was maiming and killing children. That was just a few years ago. Pardon me if I don’t think that drug companies have enough to lose. Especially when you consider what I have to lose. But props to you for taking a statistics class, I took one too and it was rough.
As per Hep B, our policy in health care is this: as much as a parent resolves to return and vaccinate a kid later, or as much as they intend to finish a Hep B series, we don’t usually know parents personal attributes and, even if a parent seems pretty with it, we acknowledge that the well-meaning parent can get hit by a bus when as soon as she walks her kid out of the clinic door and then we may have missed our one opportunity to vaccinate the kid. And even if your kid is not travelling to Asia or somewhere where Hep B is endemic, how do I know that she won’t be so traumatized by her mother’s untimely demise that she, in her teen years, turns to IV drug abuse and unsafe sex? I think all IV drug users and partakers of unsafe sex deserve to be protected against Hep B, and the system is designed to prevent as many people from slipping through the cracks as possible.
Ok. As long as we are engaging in absurd analogies, I think all children deserve to live and I also care about IV drug users. My proof of this statement is a (fictional and absurd) story about a child with aluminum related developmental delays who can’t correctly read a stop sign and is hit by a bus crossing the street. Her mother, severely traumatized by her daughter’s untimely demise, turns to unsafe sex and drug use. Luckily the mother who was vaccinated under a reasonable schedule 40 years ago, had her Hep B series when she was about 15. So, she may die a dirty whore in an alley, but she is unlikely to contract Hep B.
Bottom Line: The current vaccination schedule is at best overzealous, and at worst it is a criminally negligent assault on children. Wait until the blood/brain barrier is fully developed before giving non-essential vaccinations. There is NO reason not to follow a selective or delayed vaccination schedule if you do your homework. Spread out vaccinations to maximize a child’s ability to filter out aluminum and mercury in between shot series. Talk to a doctor about a developing a delayed vaccination schedule. Hep A and Hep B are not necessary for infants (unless a parent or caretaker is infected). These shots can be safely delayed until the blood/brain barrier is complete (after age 2). Get the MMR shots when they are once again offered as individual vaccines. Rotavirus seems to be a personal preference vaccine (the term is used lightly here since 90% of vaccinated children still get a case in the first 2 years).
Whitney,
Thanks for the crushing post. I actually hadn’t heard the statistics regarding the use of thiomersol vs. infection rates in vaccines, but that is an interesting finding. I would still like to have a mercury-free vaccine, if for no other reason public perception, but people forget rather quickly that mercury used to be used as a laxative! The difference in bio-availability of different mercury complexes is quite stark, so the thiomersol studies actually do make a lot of sense (just don’t try and play with methyl mercury!)
Michelle,
While I have no interest in engagingly in line-by-line debate, and since it would be redundant at this point, I’ll highlight a couple of things:
1) The breastfeeding argument is a red herring. My kid was almost exclusively breastfed for the first year of his life and he is still breastfeeding. He is almost two. The causation between breastfeeding and allergy prevention is not well established. Make an immunology argument there next time since that link is way more solid. Besides, any way you slice it, breastfeeding is good, but it won’t give you mumps immunity.
2) I have friends who work at both Merck and Lilly, and they both are keenly aware of the health benefits and risks associated with their drugs, especially in light of the Vioxx fiasco. (That is an entirely different discussion for a different time, but suffice it to say that marketing people should not be involved in science discussions!)
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Finally, and to reiterate my original point, the fact that this discussion is happening at all is troubling. By encouraging people (yes, that is you, whomever you are) to distrust vaccines, a culture in which public health is put at risk is established. The math is VERY MUCH on the side of vaccinating children, yes, even for the chicken pox!
Please, if you are reading this comment thread and are on the fence about a particular vaccine, DO NOT rely on random internet posts and alarmist books about vaccines! Talk to your doctor, and if you don’t trust him/her, look up the published, peer reviewed research (Whitney has given a great start!) and avoid Google like the plague (Oh, wait, that is bacterial, not viral–no vaccine for yersinia pestis . . . )
Above all, please, if you are traveling overseas, get your kid vaccinated before your trip! Because other countries are NOT following our vaccine schedules, then young children are especially at risk.
Michelle,
After reading your response, I reread my own post and regretted the confrontational tone of it, as well as a few of the less sound “arguments” I made. The truth is, when I hear people support major decisions based on misleading generalizations (something like ‘vaccines are pathogens that overwhelm a child’s system’) I feel the need to get a little more specific about how immunity and immunization actually work, because claims like that, or claims that “diarrhea” is not a major concern, are similar to my equally lame claim that big Pharma doesn’t release dangerous drugs because it’s too much of a pain in the neck for them. Unfortunately, these are topics that are so broad in scope and so amazingly detailed and complex that they don’t lend themselves well to debate in a bloggy medium. The consequence is that we sometimes resort to unsound or incomplete reasoning. The truth is that we probably agree on these things more than you know–I think your decision to do your research and select the appropriate immunizations for your child based on your future plans (travel) and your demographic data (as in, you live in the U.S. and have access to medical care and such) is what every parent should do, and your research led to the correct decisions for your family. My example of the child’s mother getting hit by the bus was merely to illustrate the issue from a public health standpoint, not an individual one. Health care providers, especially ones that work in underserved areas like NM (where I am), approach many interventions around the assumption that this may be the patient’s only point of contact with the health care system, and that we must use the opportunity to provide the patient with everything they might need in the future, like screenings, immunizations, prescriptions, education, referral, etc. Although we obtain data about the patient’s past medical, surgical, and social history, the lifestyle and demographic data screening tools we use are pretty generic and so it is up to the patient, or the parent of the patient, to give us some context for tailoring our care. Were I your provider, I probably would have vigorously agreed with your decision to hold off on Hep B provided I knew a little about you. I vigorously agree with any patient who decides to hold off on care that is not medically necessary or is not beneficial in terms of prevention, or even care that they don’t want for themselves. I suppose this comes down to where you draw the “ethics” line as a health care worker: I vigorously agree with an informed parent’s decision to hold off on Hep B until the child is a little older, and I vigorously disagree with a parent’s decision to withhold a blood transfusion from their unconscious, hemorrhaging, critically-ill child because of religious beliefs (I have been in this situation.) I think the majority of the vaccine debate falls somewhere in the middle of these two examples, which is why it’s a lightning-rod issue. You are making a decision on behalf of a completely helpless being, and it is a decision that has both personal and public health ramifications, so you can’t expect those of us in health care to not respond when you surround the issue of immunizations with images of dead children and telescoped guts and all that. I know you’ve also said that vaccines save lives, and I know you vaccinated your child against the majority of life-threating illnesses so I know that we are probably in agreement as far as your individual risk/benefits analysis for your baby is concerned. But when you say that a vaccine with a rare adverse event was killing and maiming children, or that the inclusion of aluminum in vaccines is criminal, or that the current CDC schedule of immunizations is the overzealous product of vaccine happy docs and money-grubbing big Pharma, it is hard for me not to cringe a little and try to bring the debate back to the center a little.
When it comes to the issue of vaccination and risk/benefits analysis, you must bear in mind that the risk/benefits analysis is much different for populations of people than for individual patients. When the CDC determines things like whether or not to place a vaccine on the recommended schedule of vaccines, they are doing a risk/benefits analysis for the entire U.S. population, and they are accounding for risks or costs that affect enormous entities like the health care system and the educational system. Therefore, the decision to place the rotavirus vaccine on the schedule of recommendations is because pediatric rotavirus in the U.S. costs 50-70 lives per year, hundreds of millions in medical care and billions in societal costs–not to mention 800,000 deaths worldwide (Smith et al., 2003)–Note that these are PRE-VACCINATION numbers. This is weighed against the vaccine’s risks for individuals: in the case of the RotaShield vaccine that was REMOVED from the market, a .0001 to .0002 risk of intussusception, or 1 in 5.000 to 10,000 (Murphy et al., 2001). The vaccine was on the market for less than a year and was pulled from the market because our national system for monitoring vaccine safety, VAERS, received reports of anywhere from 9-15 cases of intussusception, depending on the source (Smith et al., 2003 say 15, Cale and Klein, 2002 say 9). And when you’re critiquing the pharmaceutical buisiness, you must also bear in mind that the task of introducing drugs to the public is inherently risky. Even placebo causes side effects like nausea and diarrhea, and even placebo has therapeutic effects like diminishing dyskinedia in Parkinson’s (Goetz et al., 2008). We expect to see side effects and we expect to see the occassional adverse events (like intussusception) in any population receiving biologically active drugs. It happens. That’s probably why health care providers had to provide a consent form with a risk/benefit disucssion for parents to sign before legally being allowed to give the baby the vaccine (like the consent form provided for Hep B immunization, that also clearly states that all parents the right to refuse the vaccine for their child.) But one of the challenges of pharmaceutical reserach is that it is extremely hard to detect very rare adverse events, like intussusception, during the clinical trial phases of a new drug. You’d have to have a sample size of over 20,000 to detect even one case of intussusception in the treatment population–The old RotaShield vaccine had a sample just above 10K, and the new RotaTeq vaccine expanded these numbers to 70k. This is one of the reasons why some drugs get put on the market and then promptly pulled off the market. I’m sure there are darker forces at work in many situations, but I personally think it is overly simplistic to demonize the entire pharmaceutical industry along with all the scholars, scientists and researchers who investigate these issues. An adverse drug event that results in the drug being pulled from the market is not the equivalent of “maiming and killing children,” even if it is tempting to conclude that because we don’t like big corporations that make big bucks. And hey, Michelle, I’m not a fan of the pharmaceutical industry or anything. I’m really not. I have my moments of outrage, like over the use of Procrit in post-chemo patients. But I don’t find myself up in arms over the the Rotashield failure. The mechanims of how exactly the vaccine contributed intussusception are still very poorly understood and controversial.
As per the new RotaTeq vaccine, I don’t know where you’re getting your numbers as to its ineffectiveness. The overview of the vaccine’s efficacy from Brown University’s Division of Pediatric Disease states that RotaTeq’s efficacy against severe gastroenteritis was 98%, and that the vaccine reduced the number of doctor office visits by 68%, ER visits by 94%, and hospitalizations from rotavirus gastroenteritis by 96% (Dennehy, 2008). In her overview, Dennehy also breaks down the risk of intussusception being equal between treament and control groups. I know it is not smart to base your opinion off of one article, but everything I’ve read so far seems to reach the same conclusion. I’ll keep my eye out for additional data.
As per your concerns over mercury and aluminum–this is where an understanding of the tricky interplay between chemistry and phisiology comes in handy–like an understanding of the difference between oral aluminum vs. parenteral aluminum, circulating aluminum, aluminum bioavailability, methyl mercury vs. ethyl mercury, etc. I am not an expert on this stuff either, and I’m too tired to explain to you what I do know. And so I can’t personally put your fears of aluminum to rest. I did finally find an article that monitored the safety of Dtap/IPV(polio)/Hib/PRP(tetanus) AND Hep B given together. The study concluded it was safe and effective (Capeding et al., 2008, in a WHO bulletin). I found another article that co-administered all the shots, incluidng Hep B and rotavirus, but one of the authors was from GlaxcoSmithKlen so I won’t cite it. Needless to say, they concluded safety and efficacy.
One more note: What I can say is that aluminum is not in vaccines in order to poison children. It is in vaccines because the vaccine does not work without an adjuvant, and aluminum, so far, is the ONLY adjuvant widely approved for human use (Zaharoff et al., 2007–btw, I tried REALLY hard to get my paws one some of Zaharoff’s citations, because they would be key to this debate–THEY are the studies conducted on adjuvant safety and efficacy–but I couldn’t find them on PubMed. Look for Vogel et al 1995, Gherardi et al 2001, and the big one, an article I want badly called Vaccine Adjuvants: Current State and Future Trends, by Petrovky et al in Immunology and Cell Biology 2004). So aluminum is in vaccines because vaccines don’t work without it–it’s been in vaccines for over 60 years. The other adjuvant that’s occasionally used causes a two-fold increase of cancer in mice, so I’m not sure we want to ditch the aluminum just yet. But there’s NO DOUBT that aluminim is not perfect and probably side effects and adverse events in some individuals. The market for newer, safer adjuvants is wide, wide open. If you really want to literally invest in your campaign agaisnt aluminum, you might want to invest in David Zarahoff and friends. They made an adjuvant out of chitosan that’s derived from the chitin of crustaceans, and so far it’s looking promising. Until something else hits the market, I think your suggestion of spacing out shots seems like an easy solution. I’m very interested in this topic and will continue to research it.
SO… I am sorry that you thought I was being patronizing when I said that I appreciate your thoughfulness. I do appreciate your thoughtfulness. I wish you appreciated mine. I took time and effort to respond to your concerns. It never hurts to be informed on all the different sides of an issue. I really appreciate the evidence you brought to the table: I looked for some of the articles you mentioned but was unable to find them online. In particular, I’d be interested in your “Hib increases risk of diabetes” article and your article about aluminum in IV solutions causing problems to babies. Would you mind posting a full citation, with authors, so that I can find them at my library? The online catalog is clearly insufficient. And if you think I’m being patronizing, I’m not. You’ve already brought some important things to my attention, like the fact that there’s a research deficit regarding effects of the total dosage of aluminum in the arsenal of pediatric vaccines.
if anyone is actually interested in my references, I’d be happy to provide full citations.
Whitny ,
I appreciate your comments, and thank you for engaging in what I believe has been a
very productive discussion. You must know how rare your level of interest is within the medical profession. This is not to imply that doctors don’t care, it’s just that they are busy. The sheer quantity of patients and illnesses precludes much in the way of in depth independent research. Add in the mountains of insurance paperwork, and I am surprised physicians show up for work at all. Knowing this, I felt it was my responsibility to make the best decisions possible for my kid. Your analysis of vaccination recommendations as a cost benefit calculation for the whole of society is exactly the reason it is critical for parents who have concerns to personalize those recommendations.
As you correctly write, children who are vaccinated are completely helpless in the decision making process. They certainly deserve to be protected from disease, especially those that are preventable. Where I draw the line is at a blanket acceptance of a vaccine schedule that I know, and you agree, is overzealous. This schedule also exposes children to the highest levels humans have ever seen of injectable aluminum. If the writers of toxiccuture are concerned that our food supply has become a science experiment, take a close look at our vaccination schedule.
As far as I can tell this is where we agree:
A delayed vaccination schedule is perfectly acceptable from a physician and public health perspective, if the schedule is created in consultation with a doctor. The negligible risk of infection during a delayed schedule is balanced by the small risks of age specific adverse reactions.
Hep A and B, in particular (unless a parent or caregiver is infected) can be delayed until well after the blood-brain barrier is complete. This is after the age of 2. However, if a parent chooses to delay these shots, they take on the additional responsibility of taking a toddler or young child for vaccinations. It is not acceptable to skip these shots completely, but if a parent is concerned about side effects or aluminum exposure, waiting is usually just fine.
There is simply not enough research on how the current recommended vaccines operate in conjunction with each other. That testing a combo shot such as pentavalent in combination with Hep B and *maybe* Rotavirus is not the same as testing 4 separate shots in addition to Hep B and rota. Especially when you consider my concerns are not really about the actual antigens, but rather with the other ingredients in the vaccines which are markedly higher when given in 4 individual shots vs the pentavalent.
That aluminum is an unsafe, injectable component of many vaccines. Where we part ways here is in the degree of damage aluminum can cause. I tend to believe the limited research that shows aluminum can cause developmental delays. I understand why you are hesitant. I also agree that for the time being there is no acceptable substitute for aluminum; it is what currently makes vaccines effective by allowing the body to more efficiently recognize and respond to the introduced antigen. Perhaps we would both wish for vaccine manufacturers to take the threat of aluminum to heart and increase funding to find an acceptable substitute. Your information on Zarahoff’s research is fascinating, and I am excited to look into it. In light of conflicting (and I believe inadequate research) data, spacing out aluminum containing shots is an acceptable and safe method of vaccination.
These are virtually the same points I made in my first post. But, I have truly enjoyed this exchange and I hope it also proved that the vaccination debate is SO MUCH more than Generation Rescue and Jenny McCarthy.
P.S. Dave you are right, breastfeeding was a red herring. But I can’t resist reminding anyone who will listen how important it is to breastfeed our children. Especially when you consider the obstacles women face when breastfeeding in the US. It is a shame how few pediatricians are willing to push the subject with mothers who value convenience and a false modesty over health. Congrats to both you and your wife for a long breastfeeding relationship.
Cites for studies:
Classen J.B., Classen D.C., Autoimmunity 2003; 36(3): 123
Spike in child onset diabetes after HiB vaccination
Bishop N.J., Morley R., Day J.P., Lucas A., New England Journal of Medicine 1997; 336(22) : 1557-1561
Aluminum Neurotoxicity in premature infants
“Dave you are right, breastfeeding was a red herring. But I can’t resist reminding anyone who will listen how important it is to breastfeed our children.”
I will stand up and cheer that we can agree on this!
Thanks for the citations, Michelle, and for the very productive discussion. It is a fascinating topic. I wanted to leave you with the full citation for the Zaharoff in case you want to read it:
Zaharoff, D., Rogers, C., Hance, K. W., Schlom, J., & Greiner, J. Chitosan solution enhances both humoral and cell-mediated immune responses in subcutaneous injection. Vaccine. 2007; 25(11): 2085-2094.
On a tangential side note, there’s also a vaccine against Alzheimer’s in the making:
Cao, C., Lin, X., Wahi, M., Jackson, A., and Potter, H. Successful adjuvant-free vaccination of BALB/c mice with mutated amyloid B peptides. BMC Neuroscience. 2008; 9:25 (retrieved online from PubMed Central 6/7/09) (PMCID: PMC2270279)
I predict majorly fiery debate over this one.
Ok. Guys. Like. Seriously. I know I need to leave this alone, but how funny that one our research PhD’s at the UNM College of Nursing sent me this article today, totally unprompted. Now, let me preface this by saying:
Yes. It’s from Newsweek. Dude. I know. I will never forget the time that I, at the tender age of 14, brought a Newsweek article to my first ever debate meeting and was ridiculed to the point of tears and shunned for the next two years. But Michelle, I’m only posting this because it mentions the Geiers report you cited and the oh-so-groundbreaking Lancet study in particular. This Newsweek article also includes a nice little self-serving timeline. The timeline, however, is useful in terms of getting a sense of the evolution and interplay of both the mercury-causes-autism debate and the MMR-causes-autism debate, and of the emergence and evolution of autism as a medical diagnosis. Anyhow, I can see why parents and even health care providers are just woefully confused at this point.
article:
http://www.newsweek.com/id/185853/page/1
timeline:
http://www.newsweek.com/id/186133
Ok. So. For real. Stop, right? Well, I can’t. Here’s an analysis from a colleague of mine, who breifly reviewed one a British study that found no link between the rise in autism and the MMR vaccine. The study concluded that autism rates rose while vaccination rates remained steady, thereby weakening the case for a correlation between the two. My colleague does not reach a conclusion, she merely points out some of the strengths and weaknesses of the study. Enjoy!
The Global Advisory Committee on Vaccine Safety (GACVS) advises and assesses implications of vaccine safety for worldwide practice and World Health Organization (WHO) policies. In an article from the American Journal of Public Health, recommendations from the GACVS on major issues, including MMR and autism, were discussed. A detailed review, conducted by an independent researcher had been completed. “Taking into consideration study design and limitations”, eleven epidemiological studies were reviewed (Folb, et al., 2004, p. 6), as well as three laboratory studies. The review concluded that existing studies revealed no evidence of a causal association between the risk of autism/autistic spectrum disorders and the MMR vaccine. It is the opinion of the GACVS that additional studies are unlikely to add to the existing data, but a better understanding of the causes of autism is needed (Folb, et al., 2004).
To assess the strength of the evidence provided, a review of an existing study cited in the article has been done. The topic of discussion is a time-trend analysis of the relation of MMR vaccine and the incidence of autism. Burns and Grove (2009) explain a time-series analysis is designed to analyze changes and to uncover a pattern in the data. This pattern reveals concepts that are important to the study of human responses over time. The objective: “To estimate changes in the risk of autism and assess the relation of autism to the mumps, measles, and rubella (MMR) vaccine” (Kaye, J.A., Melero-Montes, M., & Jick, H., 2001, p.1). The data is from the UK general practice research database, which has been noted as a strength in the study. The use of population based data was necessary to obtain a non-biased, retrospective approach. The population consists of 305 children ages 12 years or younger diagnosed with autism in 1988-99, and a specific, annual birth cohort of 114 boys age 2-5 years born 1988-93 who had a first recorded diagnosis of autism during 1990-99. The annual birth cohort adds to the strength of this study as it “assesses more precisely the possibility of a temporal association between MMR vaccination and the risk of autism”(Kaye, J.A., Montes-Melero, M., & Jick, H., 2001, p.3). Statistical analyses were performed using STATA version 7.0. The annual birth cohorts were analyzed separately and an exponential formula was used to estimate the four year cumulative incidence (risk) of diagnosed autism. These analyses appear strong in a multivariate statistical technique. Results showed an increase in newly diagnosed autism from 0.3 per 10,000 in 1988 to 2.1 per 10,000 in 1999. Peak incidence at 3 and 4 years of age, 83% cases were boys. The annual birth cohort of 114 boys revealed an increase risk of autism in 2 to 5 year old boys from 8 per 10,000 boys born in 1988 to 29 per 10,000 boys born in 1993. For the same annual birth cohorts the prevalence of MMR vaccination was over 95%. In conclusion, the data provides no correlation between the virtually constant prevalence of MMR vaccination and the rapid increase in the risk of autism over time (Kaye, J.A., Melero-Montes, M., & Jick, H., 2001).
The weakness of a time trend analysis to evaluate the relation of an exposure to an illness was also acknowledged in the study. Along with how the correlation of such a study may be coincidental or due to other factors. However, the researchers justify how the results from this study deviate from such a weakness. The way the illness of autism rises rapidly, while the MMR exposure is steady, proves the exposure cannot be the causal explanation. Thereby proving a strong design and fulfilling the objective.
Burns, N., & Grove, S.K. (2009). The practice of nursing research: Appraisal, synthesis, and generation of evidence (6th ed.). St. Louis: Saunders Elsevier.
Folb, P.I., Bernatowska, E., Chen, R., Clemens, J., Dodoo, A.N., Ellenberg, S., et al. (2004). A global perspective on vaccine safety and public health: The global advisory committee on vaccine safety. American Journal of Public Health 94(11). Retrieved June 10, 2009, from PubMed database.
Kaye, J.A., Melero-Montes, M., & Jick, H. (2001). Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. British Medical Journal 322(7284). Retrieved June 10, 2009, from PubMed database.
Top US Panel: Some Vaccine-Autism Research is “Appropriate,” “Worthwhile” and “Warranted”
http://www.huffingtonpost.com/david-kirby/top-us-panel-some-vaccine_b_211843.html
On Tuesday, the Federal Government’s leading immunization advisory panel unanimously approved a sweeping list of vaccine safety research recommendations for the US Department of Health and Human Services, including several that are directly or indirectly linked to the vaccine-autism debate. The endorsement, from the highly influential National Vaccine Advisory Committee, will surely intensify the argument.
Proponents of continued research into possible relationships between vaccination and a wide variety of immunological, metabolic and neurodevelopmental disorders will be cheered by many of the recommendations, while their critics will take comfort in noting that the NVAC declared that the epidemiological evidence to date assured them there is no link between vaccines and autism, at least within “the general population.”
Still, major gaps in research plague our complete understanding of vaccine safety, the committee seemed to be saying. We don’t really know how our current immunization schedule might affect certain susceptible populations that might be at greater risk for vaccine injury. It is plausible that some children — for a variety of reasons — cannot handle the one-size-fits-all vaccine schedule and its many ingredients. Those subgroups should be separated out and studied on their own, the NVAC said.
Despite its rejection of vaccines as a general cause of autism, the panel nonetheless backed two vaccine-autism related measures — plus a lengthy list of study ideas that mirror what autism and vaccine-safety advocates have been requesting for years. Many of those advocates had direct input into the formulation of the groundbreaking document.
Call it the “democratization of science.” The very idea must drive some people to fits of apoplexy, but I see it as a healthy sign of a responsive — and responsible — government.
As a bit of background, the CDC’s Immunization Safety Office (ISO) created a 5-year research agenda for vaccine safety issues and asked the NVAC to review and critique the plan — and to propose new measures as the panel saw fit. The NVAC in turn reached out for public comment from around the country. To their credit, panelists listened very carefully.
A Controversial Vaccinated vs. Unvaccinated Study
Without influence from autism and vaccine safety groups, it is unlikely that the august NVAC (see roster of NVAC members, including experts from CDC, HHS, academia and the pharmaceutical industry) would have unanimously endorsed first-step measures to study and compare vaccinated, unvaccinated, and “alternatively vaccinated” groups of children for a number of immunological and neurological disorders — including autism.
The controversial idea was not part of the CDC’s original research agenda. But NVAC soon discovered that, “Members of the public, stakeholders, and the Interagency Autism Coordinating Committee (or IACC, the Federal Government’s central autism research body) have articulated an interest in a study of vaccinated vs. unvaccinated children to determine if there are differences in health outcomes between groups with varying exposures to vaccines.”
How and whether to conduct such studies — which would be costly, complicated and subject to ethical questions — is a hot-button question in itself. For example, prospective clinical trials, where children would be randomized into vaccinated and placebo groups, would be patently unethical, and therefore impossible.
But public participants in the NVAC process suggested an alternative plan: An “observational study” to look at “natural variation in vaccination schedules, including some children where vaccination is declined through parental intent,” the NVAC wrote. In other words, if parents decided not to vaccinate their kids on time, or at all — even after they had been strongly urged to do so — then it would not be unethical to enroll their children in an observational study of health outcomes.
Some autism parents and others also lobbied hard to include comparison studies of vaccines and vaccine ingredients in test-tube and animal models, (for example, vaccine-vs-placebo clinical trials on infant primates), and NVAC concurred. “Consideration should be given to broad biomedical research including laboratory studies, and animal studies,” the panel wrote.
But first, NVAC wants to study the feasibility of doing such studies, at least on kids.
An “external expert committee,” such as the Institute of Medicine, the NVAC said, should consider “strengths and weaknesses, ethical issues and feasibility, including timelines and cost” of various ways to study vaccinated, unvaccinated and possibly, partially vaccinated children or “children vaccinated by alternative immunization schedules.”
Such studies should look at outcomes like biomarkers for immune and metabolic dysfunction (for example, autoimmunity and mitochondrial problems) plus “neurodevelopmental outcomes, allergies, asthma, immune-mediated diseases, and other developmental disabilities such as epilepsy, intellectual disability and learning disabilities,” the panelists said.
Most parents I know could not agree more with that assessment. But that was not all.
“The inclusion of autism as an outcome is desired,” the NVAC declared, in what can only be described as a major victory for many ASD advocates.
Finally, in yet another nod to parents, the NVAC added: “This review should be conducted expeditiously, in a transparent manner, and involving broad public and stakeholder input.”
.
A three-day-old request for an interview with someone at NVAC is still pending. Meanwhile, James Moody, an attorney for the mercury-autism group Safe Minds, called the unanimous vote a “huge win” for parents who want more vaccine research, but said the idea deserved more than just a commitment to a feasibility study.
“All the other recommendations are to actually do particular research projects, so why is this one singled out?” he told me. “Of course, all projects must be methodologically sound and ethical, etc., but why do we need a separate study for this? I think it is just kicking the can down the road, and I made that point in public comment at the NVAC.”
And there is a serious risk of delay, he said. The IOM could take up to two years to do a feasibility study, and the idea could also “easily be buried or killed at IOM.”
But, Moody added, the NVAC report is “a huge admission as to a crucial gap in necessary safety science — and furthers the ethics point that the current vaccine schedule has not been shown to be minimally safe and therefore is unethical mass population human research.”
“Plus,” he said, “ignorance and uncertainty are the enemies of public confidence in vaccines.”
Autism is “Appropriate” to Study as Clinical Outcome of Vaccination
As part of its 5-year plan, the CDC’s Immunization Safety Office proposed looking at a number of possible “clinical outcomes” following vaccination. Many autism parents and others have been urging science and the government to investigate these same potential links for years.
The advocates will be pleased to learn that NVAC concurs with them and with CDC that such clinical outcomes are “appropriate” for study. The outcomes include:
Autoimmune diseases — which might include asthma, diabetes and some ASD symptoms.
Central nervous system demyelinating disorders — which might include MS and acute disseminated encephalomyelitis, or ADEM, which the federal Vaccine Injury Compensation Program, or vaccine court, recently said was a precursor to ASD in one child’s case.
Encephalitis — brain swelling, often seen in ASD.
Encephalopathy — any type of brain disease or damage.
Complications from post-vaccine fever — such as the autism case of Hannah Poling, from vaccine court.
Also on the list of clinical outcomes to study: “Neurodevelopmental disorders, including autism spectrum disorder.”
The committee chose to comment specifically — and only — on the clinical outcome of ASD. “The relationship between vaccine exposure and autism/ASD is an area of intense public interest,” the panelists said. But they were, “assured by the many epidemiological studies that have demonstrated no association between vaccination and autism spectrum disorders in the general population.”
For example, in 2004 the IOM concluded that “the evidence favors rejection of a causal relationship at the population level between MMR vaccine (or thimerosal) and ASD.”
On the other hand, as the NVAC rightfully acknowledged, the IOM included a very important caveat in its 2004 report: “Further research on the possible occurrence of ASD in a small number of children subsequent to MMR vaccination is warranted.”
“Importance” of Studying the Mitochondria-Vaccine-Autism Link
The NVAC said that the conclusions of the 2004 IOM report “regarding the lack of a population-level relationship between MMR and thimerosal-containing vaccines and ASD risk remain sound.” But, it added, “Recent developments around mitochondrial dysfunction reinforce the importance of studies of (vaccine injury) in rigorously defined subsets of the ASD spectrum.”
And though vaccination, “almost certainly does not account for the recent rise in ASD diagnoses,” public concerns over vaccines, and the fact that ASD is such a common and severe disorder warrant, “additional study in well defined subpopulations.”
One reason for the “important” caveat about high-risk subgroups, the NVAC wrote, was “recent case studies and research reports around the incidence of mitochondrial dysfunction in children with ASD,” which have been estimated at somewhere between 7%-to-30% of all ASD children, and possibly higher among children who regressed following normal development.
In December, researchers from Cleveland Clinic, Harvard and Johns Hopkins Univeristy wrote in PLoS Online that mitochondrial dysfunction “may be present in a substantial percentage of children with ASD.” And they said there “might be no difference between the inflammatory or catabolic stress of vaccinations and that of common childhood diseases, which are known precipitants of mitochondrial regression.”
“Large population-based studies will be needed to identify a possible relationship of vaccination with autistic regression in persons with mitochondrial cytopathies,” the authors wrote, and it looks like members of the NVAC concur.
Mitochondrial dysfunction, “carries an established risk of brain damage subsequent to infectious disease,” the NVAC wrote. “Thus, a small and specific subset of the general population (such as those with mitochondrial dysfunction) may be at elevated risk of reduced neurological functioning, possibly including developing ASD, subsequent to live virus vaccination.”
The NVAC added that, “the size of the subpopulation is too small for population-level epidemiological studies to have sufficient power and precision to detect such a risk factor,” which is exactly with what many autism parents and researchers have been saying for quite some time.
But just how “small” is that subpopulation? Is it only 1-in-5,000, as some research suggests?
The NVAC wrote that mitochondrial dysfunction is “rare at the population level.” But recent investigations have suggested that genetic susceptibilities for mitochondrial dysfunction are far more common than anyone previously realized.
In August, the United Mitochondrial Disease Foundation announced a “landmark research finding” showing that at least one-in-200 healthy humans, “harbors a pathogenic mitochondrial mutation that potentially causes disease.” The finding was published in the American Journal of Human Genetics.
And another autism researcher at the Kennedy Krieger Institute in Baltimore told me that between one-in-400 to one-in-50 people may have specific nuclear DNA mutations that could also confer risk for mitochondrial dysfunction.
Vaccines and Regressive Autism Are “Of Particular Interest”
“In the context of vaccination research, the ASD clinical subset of particular interest is regressive autism” the NVAC wrote. The panelists said the regressive form of ASD was found in about 15% of all cases, though even some of the studies they cited seemed to refute this.
Last year, for example, Ambulatory Pediatrics reported that 15% of ASD children studied had lost both language and social skills. But another 41% lost either language or social skills. To the parents, at least, that meant that 56% of the ASD children had regressed in some form. As the authors of this study said, the percentage of regressive cases in ASD varies, “depending on the definition used.” And, they concluded, “Requiring loss of language significantly underestimates the frequency of developmental regression.”
And the PLoS Online article about mitochondrial autism stated that, of the 25 children in the chart review, 56% (14) had “regression of previously acquired skills.” That rate was significantly above the roughly “one third of autistic children” who are reported to have regressed, the authors said.
The NVAC repeated the oft-quoted statement that, “the temporal occurrence of this regression and the vaccination schedule is not evidence of a causal relationship,” but it added: “Regressive autism does fit the recommendations of the IOM (immunization) committee for further research in rigorously defined subsets of ASD.”
Such studies might entail, “comparison of immune cytokine profiles between regressive and non-regressive ASD to screen for differential immune system profiles, or prospective vaccination response profiling in siblings of children with regressive ASD, a subpopulation who are at higher risk (somewhere between 3%-35% increased risk, depending on the study and number of siblings affected),” the NVAC wrote.
Most autism parents I know have been saying for years that their regressive ASD kids have very abnormal immune cytokine profiles.
“Worthwhile” to Study Vaccine Injuries and the Risk of Autism
Another autism subpopulation that should be included in vaccine studies is what the NVAC called “the intersection of ASD cases with (clearly defined vaccine outcomes) such as fever, febrile seizure, or hypotonic-hypo-responsive episode (HHE).”
Do these adverse effects correlate with ASD? “It would be worthwhile to assess,” the NVAC wrote. “On a molecular level, it might be feasible to compare ASD cases with history of adverse events following immunization against cognitively normal controls with a similar history of adverse events, to assess whether there are significant differences in immune response profiles between groups.”
The obvious place to do these analyses, it seems to me, is the Omnibus Autism Proceedings in vaccine court, where some 5,000 regressive cases are pending. And, more than 1,300 vaccine court cases were already paid out for encephalopathy and seizure disorders. We will soon learn how many of those children also have an ASD, though I can confirm now that it appears to be far, far higher than the1-in-150 rate reported by CDC.
Study At-Risk Subpopulations, Including Families With Autoimmunity and Prior Vaccine Injury
Are certain subpopulations at increased risk for vaccine injury? What are the potential biological mechanisms for those injuries? Are there certain “risk windows” in these groups, such as times when substantial neurodevelopment is occurring?”
Again, many parents and researchers have been asking these same questions for years – and now they are in official good company.
Both the CDC and the NVAC now agree that it is “important” to study vaccine injury susceptibility in “special populations,” such as premature and low birth weight infants, pregnant women, adults over 65 years, people with immunodeficiency, people with autoimmune disorders, and children with “inborn errors of metabolism.”
NVAC declared that “these groups are at increased risk for many adverse health outcomes” following immunization.
Autoimmunity, in particular, has been a big concern among advocates of vaccine-autism research. That’s partly because children with ASD are five times more likely to come from families with a history of autoimmune disorders.
The NVAC now agrees with the CDC that autoimmunity and adverse events from vaccination “is appropriate to study in several contexts,” including the “study of correlations between vaccine exposure and autoimmune disease onset, and the possibility that predisposition to autoimmune disease might indicate more global immune dysregulation and thereby increase risk of adverse events.”
But NVAC went even further that the CDC agenda by recommending that children with “a well-documented family history of autoimmune disorders,” be added to the list of potentially vulnerable subpopulations.
And there was more. The NVAC recommended adding other high-risk subpopulations to study for adverse events, including “children with siblings or parents who experienced an adverse event following immunization,” and “children who have previously suffered an adverse event following immunization.”
And, the NVAC added, results from such studies could provide, “opportunities to develop profiles that might be used to prevent AEFI by screening out children at elevated risk of AEFI.
Once again, these are many of the same things that thousands of autism parents and their supporters have been asking about for years. I imagine that most of them will be extremely grateful to the NVAC.
Study Multiple and Simultaneous Vaccination and “Alternative” Schedules
Many parents have questioned whether their child was adversely impacted by receiving too many vaccines — either over time, or at once. This line of inquiry has earned them scorn and ridicule in some scientific circles – but not among some of the world’s leading vaccine experts at the CDC and the National Vaccine Advisory Committee.
A 2002 IOM report determined that there was inadequate evidence to support or reject an association between multiple vaccinations and allergic diseases and asthma. “Since publication of that report, there are several new publications in the literature with respect to diabetes and asthma,” the NVAC said.
As for simultaneous vaccination, the NVAC said the following: “Although the compatibility of candidate vaccines with routinely used vaccines is evaluated during development, the potential exists for complex interactions amongst vaccines that may not be apparent until large scale use post-licensure, such as with the use of MMRV.” The quadruple-combo MMRV vaccine — measles, mumps, rubella plus varicella (chicken pox) — was found post-licensure to double the risk of seizures.
And, in a move sure to hearten some parents and displease some doctors — the NVAC suggested that the CDC, “consider studies to examine more alternative immunization schedules vs. the current one.”
And given the fact that parents are ALREADY deviating from the recommended schedule, this may have an unintended benefit: “to study immune system disorders and other relevant vaccine safety outcomes” due to multiple vaccination.
The same may hold true for simultaneous vaccination, the NVAC speculated, by asking: “Is there sufficient variation in the sequence in which vaccines are administered in practice to allow for an assessment of the safety of simultaneous vaccination?” Likewise, “if there is sufficient variation in the timing of vaccine administration,” then CDC “should consider outcomes of interest and consider appropriate studies,” the panel wrote.
Study Cumulative Exposures to Vaccine Components and Adverse Events
Many people who reject any vaccine-autism link often state that the number of antigens per vaccine has fallen substantially over time, so they could not implicated in any vaccine injury. But what about non-antigen components?
The NVAC said these were “appropriate to study” and recommended that CDC “evaluate cumulative levels of non-antigen component exposure possible through the schedule of recommended vaccinations.”
“The determination of which ingredients have a higher priority for study should be based both on the intrinsic nature of the compound and potential levels of exposure,” the panel wrote.
And, in another move that was in line with many parents’ and scientists’ wishes, the NVAC wrote:
“Risk assessment should consider other environmental exposures. Cumulative exposures should be considered when environmental exposures are comparable to vaccine ingredient exposures. For a cumulative assessment, exposures in the ambient environment should be considered, including the same substance or substances that are structurally similar and may possibly share a similar mode of action. There may also be situations where consideration of interactions between vaccine ingredients and environmental exposures is worthwhile.”
This is particularly true for thimerosal. In fact, the CDC 5-Year agenda proposed studying nearly ALL non-antigen components — except for thimerosal.
But the NVAC recommended that the study of thimerosal and adverse vaccine events should continue.
Don’t Stop Looking at Thimerosal and Neurodevelopmental Disorders
Again, the NVAC said it was assured that epidemiological studies to date, “have demonstrated that thimerosal in vaccines is not associated with autism spectrum disorders in the general population.”
But there have been “a few studies that have suggested that thimerosal exposure may be a risk factor for tics. First there was the 2003 CDC Verstraeten study, “in which there were inconclusive findings,” the NVAC said, adding that, “This study has been criticized for its methods.”
But a second study, based on the same CDC data, “with improved methods,” showed statistically significant associations not only with tics, but also speech and language delays. “Protective associations” with thimerosal were detected for other neuropsychological disorders, however. And a third study in the UK also suggested a relationship between thimerosal and tics, the NVAC said.
The CDC had proposed looking at thimerosal and tics and/or Tourette syndrome (the presence of both phonic and motor tics) and the NVAC agreed that this was appropriate.
But the vaccine experts at NVAC added: “Because two of the studies above also found associations between thimerosal and speech and language delay,” these were also valid outcomes to study, and should be included.
Finally, in a move that surprised thimerosal critics, the NVAC called for a reanalysis of the most recent CDC study, “Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years,” published in the New England Journal of Medicine.
That study found that prenatal and postnatal thimerosal exposure had no “consistent pattern of effect.” Even so, the NVAC wrote that, “further evidence on whether any associations suggested are real, spurious, or artificial is needed.”
The NVAC also questioned certain “methodological considerations” on data collection and analysis in the NEJM study, including the “failure to evaluate the cumulative exposure to thimerosal and methyl mercury prenatally and thimerosal after birth, and cumulative prenatal and infant exposure.” Yet again, this is an issue that groups like Safe Minds have insisted should be investigated.
“The (CDC) Immunization Safety Office (should) sponsor an external and multidisciplinary reanalysis” of the study, the NVAC wrote. It also called for a reassessment of the children selected for the study, to “examine who did and did not agree to participate, in order to assess the potential for selection bias.” The study had a very low response rate of just 30%.
It will be very interesting, to say the least, to see how the Obama Administration responds to this comprehensive and thoughtful list of vaccine safety issues — including the lingering billion-dollar question about vaccines and autism in a small subgroup of children.
NOTE: A draft of the recommendations, which have been approved “with minor modifications,” can be found here- The final report will be posted shortly.
Autism
On Tuesday, the Federal Government’s leading immunization advisory panel unanimously approved a sweeping list of vaccine safety research recommendations for the US Department of Health and Human Servi…
On Tuesday, the Federal Government’s leading immunization advisory panel unanimously approved a sweeping list of vaccine safety research recommendations for the US Department of Health and Human Servi…
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Stop the presses!!!! A health advisory committee recommends studying adverse reactions to vaccines???
The unfortunate use of the study to advance the conspiracy theorists’ claims is exactly what THIS GROUP warned against in its 1990 Report of the Subcommittee on Adverse Reactions (http://www.hhs.gov/nvpo/nvac/Adverse%20Reactions%209-18-90.pdf)
“All vaccines used in the US today are licensed as safe and effective. Adverse reactions to vaccines, including injuries and very rare deaths, are a reality. It is important that the US have more and better information about the vaccines and the vaccination circumstances which result in adverse reactions. However, it must be recognized that misinformation about suspected vaccine reactions can impair vaccine use and result in a resurgence of preventable childhood disease. The public should be alerted to the fact that not all events that follow receipt of vaccines are caused by the vaccine itself. ”
Before copying and pasting an entire Huffpo opinion piece, try reading up on some of the actual recommendations of the panel. (you can find the report the HuffPo references here: http://www.hhs.gov/nvpo/nvac/documents/NVACVaccineSafetyWGReport041409.pdf )
Astoundingly, the report recommends studying WAY MORE than what is highlighted in the HuffPo piece, including a big section on studying the effects of influenza vaccines. Why no highlights of THOSE recommendations? Why no rant about these recommendations supporting the idea that the flu vaccine will give me herpes (just like dirty toilet seats)? I’ll go out on a limb and answer my rhetorical question: Jenny McCarthy didn’t make the recommendation, so there isn’t any press concern. Sad.
Backseat driving is just annoying, but back seat doctoring can kill people.
Oh ma gawd! Vaccine court!!!
Yea, I got a kick out of “Vaccine Court” too.
http://xkcd.com/574/
Couldn’t resist, but you have to read down to the bottom for the best punchline.
[...] not to get vaccinated this fall. News about fast tracking the flu vaccine triggers media-implanted concern over vaccine safety in many people. I cannot unimplant this concern (beside, concernectomy is not covered by your [...]