Vaccines: Separating fact from fiction

When it comes to the arguments about the safety of vaccines, what’s a worried mom to do? Between the scary claims about shots themselves and the scary news about what can happen without them, you might feel like you need a Ph.D. in immunology, toxicology, and biostatistics to make sense of it all. Never fear, Dr. Walt is here. The bottom line: No medical intervention is 100 percent risk-free, and no one but you can choose what’s right for your child. My job is to help that decision come a little easier, so here goes:

More Information:

To help you out, I found an excellent article from Parenting.com that highlights four of the concerns I hear regularly. You can find out more in my book, God’s Design for the Highly Heathy Child, but this article is a good introduction.

Parenting.com dug through the science to get the facts. So, here we go!

When Katie Shutters’s 13-month-old daughter, Averie, was born, she followed the recommended vaccine schedule for two months. Then she did some research and decided to hold off on additional shots until Averie turned 9 months old. “I liked the idea of my breast milk giving her the immunities she needs and allowing her body to work for her instead of some medicine,” says the stay-at-home mom from Indianapolis, Indiana. “She isn’t in daycare, and we don’t travel overseas. I had concerns about injecting her for no reason.”

Eventually Shutters found a doctor who would immunize according to her schedule: “We broke up the MMR [which protects against measles, mumps, and rubella] into three separate shots spread out over a year, and we’re skipping the chicken pox shot,” she says. “Instead, I’d love to find a kid who has chicken pox so we could expose Averie naturally.”

If Shutters’s approach to vaccination sounds familiar, that’s because it is. In fact, most moms don’t have to look far beyond their circle of friends to find a family with serious concerns. It’s not difficult to understand why. For one, it can be torture to watch your child get jabbed repeatedly with a needle. Combine that discomfort with a steady stream of negative publicity — celebrity diatribes, alarmist news and Internet reports, ripped-from-the-headline TV shows — and the wariness seems warranted.

Yet underneath all the debate and impossibly good intentions (after all, everyone hopes to be doing the best for their child no matter how or whether they immunize), there are some solid facts about the benefits of shots that cannot be ignored. “We live thirty years longer now than we did a century ago, thanks to purified water — and vaccines,” says Paul Offit, M.D., chief of infectious diseases at the Children’s Hospital of Philadelphia in Pennsylvania.

But as soon as compliance wanes, the protection we have against many devastating, and sometimes fatal, diseases wanes right along with it. This year’s measles outbreak — the biggest in nearly a decade — may be the first warning shot, says Dr. Offit. Nearly all of the 131 people affected so far, many of them children, were purposely not vaccinated against the disease, according to a new report from the Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia.

“We have to take this seriously,” says Anne Schuchat, M.D., director of the CDC National Center for Immunization and Respiratory Diseases. “I do not want to see the day where thousands of kids get this disease and die when we have the tools to prevent it.”

But, here are four of the most common concerns parents have:

The worry: Vaccines cause autism

What’s behind it: This claim first came to the forefront in 1998, after a British study linked the MMR vaccine to 12 children with autism. Prior to this, there had been some concern that thimerosal, a mercury-based preservative common in many vaccines at the time, also may have been partly or totally to blame for some cases of autism.

The facts: So far, ten studies involving thousands of children have failed to find any connection between the MMR and autism. Plus, the original paper suggesting a connection between the two was formally retracted by 10 of its 13 authors in 2004. Learn more: Understanding autism

As for the thimerosal issue, there’s a bit more backstory worth explaining: First, it’s absolutely true that mercury can be harmful. The kind in contaminated fish and water builds up in the body when ingested and can cause severe nerve damage. However, the type of mercury that’s in thimerosal doesn’t accumulate in the body. “It’s never been linked to any adverse effect,” says William Schaffner, M.D., professor of preventive medicine at Vanderbilt University Medical Center, in Nashville, Tennessee.

Plus, autism rates have continued to rise even after drug companies voluntarily phased out the preservative from all vaccines given to kids (with the exception of some flu shots) in 2001. Clearly, we are far from understanding everything we need to about the range of autistic disorders. And that’s why “the possible link between vaccines and autism has been taken very seriously,” says Dr. Schuchat. “But at this point, after so many studies, it’s safe to say these two hypotheses have been eliminated as possible causes.”

The worry: Too many shots too soon is risky

What’s behind it: Late last year, the parents of 9-year-old Hannah Poling won a lawsuit in which they claimed that their daughter’s autism had been triggered by the five “catch-up” shots for nine diseases she received in one day. She got the injections in 2000, when she was 19 months old. The highly publicized case underscored fears — also raised by actress Jenny McCarthy, who has a son she believes has recovered from autism — that the practice of giving multiple vaccines at once is too much for a small child’s body to handle.

The facts: Hannah Poling was born with a disorder that affects her mitochondria (the structures within cells that produce energy). And though the family won the settlement on the theory that this underlying vulnerability could have made her more susceptible to vaccine injury, there’s actually no proof that she — or any other child with mitochondrial disease — was in fact at any increased risk, says neurologist John Shoffner, M.D., associate professor of biology at Georgia State University, in Atlanta, Georgia, one of the doctors who diagnosed Hannah’s disorder. Read about first-year autism warning signs

“There is no evidence that the contents of vaccines are the cause of autism or mitochondrial disorders,” he says. What’s more, because even common illnesses like colds, the flu, and rotavirus can cause significant harm to these children, doctors strongly advise they receive all the recommended shots.

So what does all of this mean for parents of healthy kids? Not much — getting more than one shot at a time isn’t the huge physical stress it seems to be. Their immune systems handle far greater challenges from everyday exposure to germs on shared toys, doorknobs, and the playroom floor.

As Dr. Offit explains it: Think about the bugs that caused your child’s last ear infection. Each single bacterium has 2,000 to 3,000 components that stimulate an immune response from the body. As those bacteria multiply, the challenge to the immune system increases exponentially. Your baby feels awful and likely has a high fever and lots of pain. The body pulls out the stops to fight it off. Now compare that to this: “The entire fourteen-shot course of childhood vaccinations contains only about 150 immunological components altogether,” says Dr. Offit. This is about a tenth of the challenge posed by exposure to just one microscopic germ.

What’s more, the bacteria and viruses used in vaccines are either killed or altered, says Martin Myers, M.D., author of “Do Vaccines Cause That?!” There are just enough to induce immunity, but not enough to make someone sick — and certainly not enough to overload the immune system of a healthy child. As with any medical intervention, side effects, including soreness, rashes, and fever, are possible, but most are mild and short-lived. In rare instances, some children experience fever-induced seizures following shots, but though these are frightening, they cause no permanent harm.

One common response to these concerns is to break up combination vaccines (which may contain up to five inoculations in one) or to spread them out. But that carries significant risks of its own. “Too often, an immunization delayed is an immunization missed,” says Dr. Schaffner. “It’s hard enough for parents to keep track.” Keep track of your child’s vaccines with Parenting.com’s Vaccine Tracker Log

More troubling, during the gaps, kids are susceptible to catching serious diseases they could have been protected from. Vaccines are scheduled when they are for precise reasons: It’s a balance between finding the time when the baby’s immune system can respond and knowing when he’s most in danger of catching the infection, says Dr. Schuchat. Give a shot late and a child is left unprotected at his most vulnerable time.

Robert Sears, M.D., author of The Vaccine Book: Making the Right Decision for Your Child, offers parents an alternative to the American Academy of Pediatrics schedule — but he does so with Dr. Schuchat’s concerns in mind. There are certain vaccines, including those that protect against meningitis, rotavirus, and pertussis, that he does not recommend delaying for the same reason she gives. However, he willingly offers families the option of postponing hepatitis A and B as well as polio, mainly because these illnesses do not pose the same threat to infants as the others.

The worry: Vaccines contain toxins

What’s behind it: Vaccines do contain a variety of substances besides the viral or bacterial components. There are preservatives as well as adjuvants, which are substances that help vaccines grab the attention of the immune system and prompt it to create antibodies. One adjuvant that some are focusing on is aluminum, which at chronic high levels can contribute to nerve, brain, and kidney damage.

Because several new vaccines containing aluminum have been added to the schedule, some parents and doctors worry that the extra exposure might push levels out of the safety zone — particularly given that there’s already aluminum pretty much everywhere: in water, breast milk, formula, and the air we breathe. “I’m concerned that health officials haven’t done any human-infant research to make sure the amount of aluminum in the vaccines is safe,” says Dr. Sears.

The facts: Everyday exposure to aluminum is generally not considered hazardous — most adults ingest 7 to 9 milligrams (mg) every day through food alone (up to 200 mg if they pop antacids), and formula contains anywhere from .05 mg/L to .93 mg/L. Very little of the aluminum taken in orally is absorbed, and what does make it into the bloodstream is excreted within days. Although the aluminum in vaccines is, of course, injected, there doesn’t seem to be evidence it poses any danger for healthy kids. The amount of aluminum injected is no more than .85 mg per dose, and the CDC, the Institute of Medicine, and the World Health Organization have all deemed the levels babies receive from shots to be safe.

However, if you still have concerns, you can ask your doctor to choose low- or no-aluminum vaccines when possible. In the instances when it’s not, Dr. Sears will work with aluminum-wary parents by having them bring their babies in once a month between 2 and 7 months of age (rather than bimonthly) so that they get just one aluminum-containing shot at a time. “If doctors don’t meet worried parents halfway, the problem of kids not getting vaccinated will continue,” says Dr. Sears.

For more information on thimerosal click here. Also, see my previous blogs on thimerosal:

The worry: It’s healthier to contract some diseases naturally

What’s behind it: The immunity one develops against chicken pox and measles after having the illness is more complete than the protection from the shot. Because that fact is so appealing, chicken pox and measles parties — where parents intentionally expose a child to the viruses — have been around for years, and are now on the upswing.

Rebecca Foster threw one after her husband, Kevin Burget, came down with shingles, an illness that’s caused by the same virus behind chicken pox. The Brooklyn, New York, couple had elected not to vaccinate their then 2-year-old son, Hart, against chicken pox (he’d had all his other shots), and they seized the opportunity for the toddler to get it from his dad. The two shared lots of hugs and lots of cups — and sure enough, Hart picked up the pox. “He hardly itched. It was very mild — not like the horror stories we’d heard,” says Foster. What’s ailing your child? Find out with Parenting.com’s symptom checker

Knowing other parents might want their kids exposed, the couple posted a notice on a local e-mail listserve inviting interested families to come over; two ultimately showed up for a playdate with Hart, during which sharing everything, including lollipops, was encouraged. The visiting kids didn’t get sick, but their parents were highly grateful for the chance. “They brought presents,” says Foster.

The facts: The potential complications of both chicken pox and measles are far more dangerous than any posed by the shots. “Many young parents think these infections are trivial,” Dr. Schaffner says, “which only means they’ve never seen a child seriously ill with either of them.” Consider this: Complications include seizures, pneumonia, or encephalitis (brain inflammation); one or two of every thousand children who come down with measles die or are mentally impaired. In pregnant women, measles can cause miscarriage and premature birth. Chicken pox can lead to staph or strep infections.

Dr. Myers has seen the effects of those infections firsthand. He recalls a 19-month-old whose parents decided he was getting too many shots at once and left off the chicken pox vaccine. “The boy came to our hospital with staph and strep skin infections. It required powerful antibiotics to save him.”

To be fair, most kids who get chicken pox will not end up in the hospital. But, like Dr. Myers’s patient, a few will — and there’s a good chance their parents never would have believed it could happen to them. “We’d all love to have absolute truths and guarantees, but that’s not always attainable,” says Dr. Shoffner. Vaccines are no exception. “We have to make the best decisions we can with the best information available to us.”

6 thoughts on “Vaccines: Separating fact from fiction

  • Dad Fourkids

    “We live thirty years longer now than we did a century ago, thanks to purified water — and vaccines,” says Paul Offit, M.D., chief of
    infectious diseases at the Children’s Hospital of Philadelphia in Pennsylvania.”

    This is a “belief” that is held by someone who does not have a good understanding of how numbers work when looking at life expectancy. The bit about vaccines being one of the two facors to bring about the remarkable change is just the typical cheerleader sell that those who market vaccines as universal panacea need to get into the media at every chance.

    Life expectancy has indeed increased (although it plateaued pretty early in teh US despite our position at the top of the heap). It is very difficult to compare life 100+ years ago with today, because so many factors have changed between ten and now that it is impossible to peg the change on just one or two factors.

    I do not believe that anyone would argue that clean water (which actually goes coupled with sanitary handling of waste) is the single most important factor to longer, healthier lives. Afica, Central America and Sourthern Asia still have enormous problems with the health of their people because they do not have safe water supplies.

    But have vaccines actually saved so many people that it has had an major impact? According to the statistics kept by the US govt, the mortality of once common diseases like Measles and pertussis had declined by more than 80% before we introduced the mass vaccination prorgams. So did deaths from diseases like cholera and typhous, for which we do not routinely vaccinate, so it is actually unlikely vaccinations had a significant impact upon life expectancy.

    What has had a tremendous inmpact, second only to clean water/sanitary waste treatment is the changing job market we have. There are few jobs which hold as much risk as farming, especially in the last decades before the turn of the 20th century when mechanization blossomed with powerful but dangerous machines. We have shifted greatly from our agrarian roots and the percentage of the workforce growing our food has plummeted, putting millions into safer livelihoods.

    Our factories as well became more and more automated, and saftey became a common issue in plants that must comply with OSHA and other labor standards completely absent before WW2. Coupled with this is the shift from blue collar to white collar in the overall market, putting more people into desk jobs as opposed to those requiring back-breaking labor.

    Equally as important is the improvements in OB-GYN services. Childbirth used to take a lot of people, mothers and babies alike, and the wider access to proper medical care at this most wonderous time has saved far more babies than the DPT or MMR ever could. We have come so far in fact, that we are now keeping alive babies who never could have made it even 30 years ago, and it has come to the point that some question if we as a society might be better served if we allowed some of them to die from their medical frailties.

    [DISCLAIMER: This is not my personal opinion, and I find it disgusting that some would argue that the defective babies should be allowed to perish. But I do understand the rationale behind it, looking at the situation with the mindset of “herd husbandry”. And in that regard, it is consistant with the mandatory vaccination policy espoused by many, which places the good of the herd over the safety of the individuals.]

    Finally, we are keeping people alive much longer, attributable to wider access to health care, new techniques which have reduced the risk with surgery, and better management of chronic illnesses.

    These changes in our society are the true reasons we have sen our life expectancy increase in the last century. Vaccination played such a minor role in this that it is almost immaterial. This iswhy when the “experts” tried to quntify the impact vaccines had on targeted disease mentality they could not present raw data. Instead, they had to use a logarithm based upon extrapolated statistics. The explanation that this shows the rate in change is disingenuous at best. Any time you approach zero the rate of change approaches infinity. That doesn’t change the fact that the biggest change overall was in the first 90% decline, which for measles (for one example) occured by the end of WW2, a decade and a half before the first measles vaccine was even licensed.

  • In response to the comment above, let me point out that the CDC undertook an evaluation of the top ten public health achievements of the 20th century, published as a series of MMWR articles in 1999. For a discussion of the contribution of immunization to the decline in infectious diseases, see MMWR July 30, 1999 / 48(29);621-629, available at http://www.cdc.gov/mmwr.

    That said, it is true that the overall impact of vaccines has been more on medical care costs and on morbidity, than on mortality and years of life lost, here in the U.S. That does not mean that the impact is not significant to the society. Ask the family that has lost a child to a vaccine-preventable disease.

  • Dad FourKids and Dr. Finger,

    Thanks for your comments. My sense is that the data indicate that vaccines have been, after water sanitation and sewer services, one of the top three public health interventions of the last 100 years. I’m thankful to the Lord for them all — and hope we can help spread them to developing countries around the world.

  • John Fryer

    Hi

    The arguments for and against vaccines have been long, reflecting the 200 year history.

    One hundred years in, the Nobel Prize Winner Charles Richet found that repeat vaccinations with the same antigen led to certain anaphylaxis.

    Put simply, it means that a normal prophylactic vaccine can set up a chain of adverse events which can be as severe as sudden death but in any event are not good for the subject injected.

    I am not aware of any science that has repudiated his findings.

    I am aware of current legislation that denies anaphylactic shock after a time lapse of just four hours after a vaccination.

    For Harry Clark this presented a problem to him as he died 6 hours after his 2 month vaccination against DTP receiving not just the adverse reaction of anaphylaxis but possibly that of mercury destruction of brain cells?

    The problem did not just affect the boy but his parents who were both charged with violent aggression and murder of the child, the proceedings initiated in fact by the very nurse and doctor that injected him to death the same day. See John Batt Stolen Innocence.

    Vaccinations for anyone in this family needed to be given on a needs only basis and not on a one size fits all schedule, disregarding health status, age and vulnerability and reaction to the vaccines. Sadly even after this experience the family still followed the medical advice for the next child but luckily the the doctors would not vaccinate on the one size fits all schedule and the child fortunately remains healthy and safely vaccine protected.

    Common sense suggest that vaccines are needed where they are safe, where they work and where protection lasts until such time that they are beneficial. TB vaccines don’t work and we do need protection from TB. Vaccines for many illnesses do not exist. Vaccines for many illnesses are not needed on a massive scale when the illness is no longer a concern or may not even exist. Measles has caused the death of one person in more than a decade and this person had been vaccinated. The cost may or not be the perpetual bad health to 12 million people exposed not to death from measles but gut disorders and maybe more from this vaccine.

    I am not aware of any safety studies that should permit GMO vaccines for our children while prohibiting GMO food to be eaten by the parents of the child because of harm from the modified food stuff again on our gut and organs.

    Finally if complete blaze of publicity and complete blame for any adverse reaction is not attributed to vaccines then the public will rightly be wary of vaccination and parents like Mrs Sally Clark will be put in prison wrongly.

  • Lisa

    When using Dr. Paul Offit as a source please disclose he holds the patent for the Roto Virus vaccine. He recently sold his rights to Merck for an undisclosed sum. He also earns the bulk of his income from the Pharmaceutical Industry and his chair at the hospital is funded by the Pharmaceutical Industry. He is not an independant source.

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