Time to outlaw vaccine propaganda: Are we taking the easy way out by labeling vaccine questioners anti-science loonies?

Are lifesaving vaccines being ignored by parents because of illegitimate safety concerns?Boy getting a flu shot

That’s what many prominent health pundits think, including André Picard at the Globe and Mail. When commenting on an apparent rise of whooping cough, Picard wrote that the increase was the result of parents “shunning vaccination in small but significant numbers because of imaginary fears largely concocted by quacks and charlatans.”

Steven Salzberg, a blogger at Forbes Magazine echoed this sentiment pointing to celebrity doctors who “use their medical degrees and their faux concern ‘for the children’ to frighten parents into keeping their kids unvaccinated.” Salzberg also added that the “the media has been complicit in spreading some anti-vaccine misinformation.”

I’d agree that the media might be a problem, adding to the illegitimate vaccine fear floating around, and likely reducing parents’ willingness to immunize their children. And we certainly have our share of charlatans and quacks in cyberspace, aided and abetted by cyberchondriacs of all stripes.

Yet there is real fear among parents, a fear that is palpable. One survey of American parents a few years ago found that the majority of parents agreed that vaccines protect their children from disease but more than 50% expressed concerns regarding serious adverse effects. The same survey found more than 10% of parents had refused at least 1 recommended vaccine. What is at the heart of these concerns? Can it really be due to vaccine fear-mongering?

I don’t think it is. Parents just want to keep potentially harmful things away from their children.  And they turn to health experts for guidance, but here’s my take on things:  health authorities often fail to acknowledge the risks of some vaccines, refuse to discuss uncertainty over a vaccine’s effectiveness, hype the seriousness of common everyday viruses (c’mon folks, really? The flu? Chicken pox?) and keep piling more and more vaccines onto the list of ‘recommended’ childhood shots threatening to turn our kids into pincushions. Now you’ve got a recipe for even more skepticism and fear-mongering.

In July this year many media outlets reported that the U.S. was in the midst of the worst whooping cough epidemic in 70 years, and the US Centers for Disease Control said the US had 2,520 cases up to July 20th this year. It is clear from these data that whooping cough, a disease once controlled by vaccines, was making a return.

For some, the complications of whooping cough can be deadly and it can lead to pneumonia, convulsions, and even brain damage and death. It’s not to be trifled with. You’d certainly want to shelter your child from whooping cough if you could, but the advice around the vaccine is conflicting. Some groups, such as the CDC recommend vaccination of pregnant women and infants yet the vaccine leaflets themselves say it is unknown whether the vaccines cause fetal harm. Some say the vaccine is highly effective, while others point to studies showing even fully vaccinated children still get whooping cough.  No one seems to know how many booster shots you need to keep your child protected.  Clearly this is a breeding ground for confusion.

Swirling masses of conflicting information reveal to me something very genuine: parents raising legitimate concerns over vaccine safety and effectiveness.  One incontrovertible fact is that even if diseases such as whooping cough can, on rare occasions, lead to death, and some children can be injured, sometimes fatally, from vaccines. Thankfully these injuries are also rare, but cases of neurological dysfunction and permanent brain injury linked to vaccines do happen. In the last two years in the US, there have been nearly 2,500 awards for vaccine injury and death made under the US 1986 National Childhood Vaccine Injury Act. More than half those awards involve the whooping cough vaccine.

At the end of the day, most parents just want to know the answer to one simple equation: what is the likelihood that a vaccine will prevent a deadly disease, versus what are the chances of a serious adverse reaction to the vaccine?  Shouldn’t this be a simple question to answer?  But it isn’t.   If public health authorities want to improve vaccination rates, they’d drop the patronizing assurances and start providing the public with some hard evidence of the benefits and harms of immunizing or not immunizing. And the media would help by not scorning parents who ask legitimate questions.  Only then will you see vaccination rates improve.

Vaccine policy does not do nuance well.  Lacking quality information the public will continue to be buffeted by pro-vaccine hectoring or frantically anti-vaccine fear mongering.  And the health of the public could use a whole lot less of both of these.

About the Contributor

Alan Cassels is a pharmaceutical policy researcher at the University of Victoria and the author of Seeking Sickness: Medical Screening and the Misguided Hunt for Disease.

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51 responses to “Time to outlaw vaccine propaganda: Are we taking the easy way out by labeling vaccine questioners anti-science loonies?

  1. -congratulations
    -excellent commentary, Alan
    -perhaps in future comments, could be interesting to consider lack of effetiveness of some pertussis vaccines

    http://jama.jamanetwork.com/article.aspx?articleid=1273011

    http://www.mjainsight.com.au/view?post=Acellular+pertussis+shot+still+the+best+option&post_id=10409&cat=news-and-research

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6128a1.htm

    The U.S. groups of 10-, 13- and 14-year-olds who are experiencing a high illness rate had DTaP vaccinations, which were introduced in 1997 at the same time that the prior DTP vaccine was discontinued.

    The earlier vaccine used whole cell parts made of killed pertussis bacteria, while DTaP uses only small acellular bacteria pieces, not the whole bacteria cell, said Donn Moyer, Washington state Health Department spokesman
    -it is not only a social problem but a pharmacologic one
    -un saludo
    -juan gérvas, md, phd jgervasc@meditex.es
    http://www.equipocesca.org

    • Yes, immunity derived from pertussis vaccine wanes. But guess what? So does the immunity from “natural infection”.
      And it is the natural infection that kills the infants.
      Vaccinate them and you protect them. Vaccinate those in contact with them (cocooning) and you help that process.
      The fact that vaccinated kids may become susceptible again to pertussis when they are in their teens is not really relevant – pertussis caught at that age is pretty harmless.

      • There are recommendations from the CDC to boost pertussis immunity with Tdap vaccine. This newer vaccine is recommended for children age eleven and older, pregnant women who have not as yet received Tdap vaccine, and all adults who will have contact with an infant under one year of age. Get your Tdap vaccine folks, so that you don’t inadvertently infect an infant who is too young to be immunized:

        http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-td-tdap.pdf

  2. I appreciate your opinion, but that should be stated in large font and bolded: THIS IS MY OPINION.
    As far as health authorities failing to communicate risk, based on the evidence I’ve seen, the risk and potential side effects are clearly presented. Every flu clinic I have attended, every vaccination clinic, every physicians office has reams of information spelling out the potential risks and benefits. So what’s the problem? Let’s just say that those who are opposed to vaccines do not portray the risk of NOT vaccinating children. On the contrary, they rarely make any statements on the hazards of an under vaccinated population.

    • He doesn’t need to state it’s his opinion in bold letters or any other form, it’s inherently assumed due to the forum and method in which it was presented. Since there is a plethora of information from manufacturers on known side effects why is it a problem when a parent makes an informed decision based on that info to avoid those potential risks? The new outbreak of whooping cough has nearly the same potential for long term damage as the vaccine and the majority of those (according to the CDC) that were part of the ‘epidemic’ had been vaccinated and caught a different strain. Vaccines, like EVERY medical intervention are optional and for good reason as there are 100s of variables and 10’s of thousands of genes, nutritional deficiencies, allergies, chemical and environmental exposures that come together to make that individual and each of the 6+ billion of us are slightly different and unique. So even with the best intentions to simply say every one of us should be blindly injected with reactive ingredients regardless of the potential outcomes ‘for the good of the herd’ is unacceptable. If you are so afraid of disease and the possible results of it, then stay home. But I’ll be damned if your fear is going to force me to risk my child for the good of the herd. I’ve made my decision based on info from the EPA, FDA, CDC, manufacturers, and as a parent. Few of the diseases in the schedule are worth the life changing risks that can occur, admittedly according the insert.

      • Wow, the number of errors in your comment are so great I don’t even know where to begin.

        Your claim that the long term risk of pertussis is the same as the vaccine? How about some evidence!

        Your lack of understanding of epidemiology is most prominently shown by the fact you cannot see the difference between a rate of disease occurance and the gross numbers of individuals with a disease.

        Your degree from the University of Google does not impress.

  3. Two of my sons were fully vaccinated when they contracted pertussis during an outbreak of over 150 cases, in 1996; and the number of outbreaks of pertussis in vaccinated populations has increased since then. Clearly, the pertussis vaccine is unreliable. Vaccination is an attempt to provide a short-range bridge to a long-range goal (public health). There are bound to be gaps and holes, and yes, some children will fall through them. That is why vaccine choice is so essential; so that informed parents can weigh both sides of the issue and make decisions that will benefit their children’s health – in the long term.

    • The thing with the pertussis vaccine is individual immunity, and some people’s immunity wears off sooner than others. There’s no way to know this until it happens or one tests the person for immunity. That is not the fault of the vaccine. It goes along with no vaccine will ever build 100 percent immunity in all populations. Also with the pertussis vaccine, about back in the 1990’s they learned people needed a booster for pertussis, and the out breaks were happening in the teen age population. The neat thing about pertussis, even if you contract it naturally, you’re not immune to it for life. So vaccine or natural exposure, some can and will contract pertussis more often than others. You can get it again, and then expose infants like the ones in California. Only infants have that horrible cough with pertussis. Older children and adults who have pertussis often don’t even know they have it, and that’s what is dangerous to infants of the population.

    • The “back story” to the changeover from whole cell pertussis vaccine to acellular vaccine, is because parents were making claims and awarded damages for their children’s encephalopathy manifested after the children received DPT vaccine. Here’s one of many studies of children who were tested for genetic syndromes. Rather than having vaccine encephalopathy, these five children were found to have a rare genetic syndrome Dravet Encephalopathy:

      Correlation does not equal causation.

      http://pediatrics.aappublications.org/content/early/2011/08/11/peds.2010-0887.full.pdf

      implicating

  4. Alan, just to deal with some of your questions. The answer to the first one: Are lifesaving vaccines being ignored by parents because of illegitimate safety concerns? Is a resounding yes. There are numerous vocal groups out in the media and on the internet promoting anti-vaccination rhetoric. There is plenty of research on parental attitudes you could have mentioned. Some examples:

    http://www.sciencedirect.com/science/article/pii/S0264410X05007401

    http://informahealthcare.com/doi/abs/10.1080/02813430510031306

    http://www.sciencedirect.com/science/article/pii/S0895435605003367

    I am a bit surprised you didn’t bother to quote any of the literature on the topic.

    Even more insidious is that some of the anti-vaccine groups attempt to hide their activities under names like Australian Vaccination Network.

    Vaccines, like every other health intervention, comes with risks. It would be much better if doctors and researchers could focus on how to minimise the risks rather than having to fight fires about getting sufficient her immunity to stop diseases. You blog hasn’t helped.

    The one important risk/benefit you totally failed to cover was the risk of a serious epidemic of some of these diseases. My father’s generation were very keen to have their children vaccinated because they had lost siblings and friends to diseases like pertussis and diphtheria. If you haven’t seen children die of these diseases it is no doubt easy to become blasé about them and focus instead on the much smaller negative effects of vaccines.

  5. This article is incomplete and misleading about the nature of the vaccines that protect an individual from pertussis. Why not go to this science blog where an intelligent lively discussion is taking place?

    http://scienceblogs.com/insolence/2012/08/31/antivaccine-fear-mongering-what-antivaccine-fear-mongering/

    Also by discussing the recommendations for the CDC and then not linking to the actual CDC Vaccine Information Statement, but rather another website which is inaccurate about vaccines, is not good journalism.

  6. “Some groups, such as the CDC recommend vaccination of pregnant women and infants yet the vaccine leaflets themselves say it is unknown whether the vaccines cause fetal harm.”

    Way to leave out the nuance, there. (Also, better to link to the actual insert or CDC than a known anti-vaccine fear-mongering organization.) The vaccine insert says that because the manufacturer has not studied it. However, other individuals have looked at the safety of the vaccine in pregnant women and found no evidence of risk to the mother or the fetus. This sort of sloppy journalism only helps to spread the very fear and uncertainty that those of us supporting nuanced, science-based communication are trying to overcome!

    • Todd W. Here are revised CDC recommendations, that are also endorsed by the ACOG (American College of Obstetricians and Gynecologists) for immunizing pregnant women with the adult booster
      (Tdap) vaccine, protective against tetanus-diphtheria-pertussis.

      http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a4.htm?s_cid=mm6041a4_e

      The vaccine is also recommended for older family members and caregivers who will have exposure to an infant less that one year of age.

      (Tdap

    • Spot on Todd W. How about a link to the Vaccine Safety Datalink that monitors vaccine safety in practically real time, from data entered into patients’ charts at ten large managed care organizations. There are more

      That’s a very valid point Todd W. At a minimum, why didn’t Mr. Cassels
      link to some reputable websites instead of that notorious anti-vaccine website?

      How about linking to the Vaccine Safety Datalink, which closely monitor vaccine efficacy and vaccine safety through data entered by staff at ten large medical care organizations. There are more than 75 reports available here:

      http://www.cdc.gov/vaccinesafety/Activities/vsd.html

      that

  7. “In the last two years in the US, there have been nearly 2,500 awards for vaccine injury and death made under the US 1986 National Childhood Vaccine Injury Act.”

    [Citation needed.]

    This is blatantly false. If you’d bothered to check the statistics from the VICP web site, you’d have seen that there have been 2,975 awards since 1988. More evidence of sloppy journalism that only serves to erroneously and irresponsibly feed into parental fears.

  8. There are also revised recommendations for pregnant women who have not been immunized with Tdap vaccine, prior to their pregnancy…and for older family members and caregivers who expect to have close contact with an infant less than one year of age.

    Haven’t we had enough infant hospitalization, deaths and disabilities from this serious, sometime deadly bacterial illness?

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a4.htm?s_cid=mm6041a4_e

    Perhaps Mr. Cassell would like to visit a science-based medicine blog to discuss his article?

    http://scienceblogs.com/insolence/2012/08/31/antivaccine-fear-mongering-what-antivaccine-fear-mongering/

    to ha

  9. Mr. Cassels, please tell us about your education. Because I have my doubts of how well you learned basic arithmetic when you claim that there are only two years between 1988 and 2012: In the last two years in the US, there have been nearly 2,500 awards for vaccine injury and death made under the US 1986 National Childhood Vaccine Injury Act. Is this the typical type of sloppy research you do at the University of Victoria?

    Mr. C

    • If Mr. Cassels had done some research he would have realized that claims of vaccine injury have been thoroughly investigated Many of the claims of vaccine injury made by parents, including those which received awards from the Vaccine Courts under the National Childhood Vaccine Injury Act, have now been determined to be caused by genetic diseases:

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603512/

  10. The title of Mr. Cassels’ article is…

    “Time to outlaw vaccine propaganda: Are we taking the easy way out by labeling vaccine questioners anti-science loonies?”

    Now, just who is spreading rumors about vaccines by, using his bully pulpit to heighten parents’ fears about vaccines, by stating this?

    “….I don’t think it is. Parents just want to keep potentially harmful things away from their children. And they turn to health experts for guidance, but here’s my take on things: health authorities often fail to acknowledge the risks of some vaccines, refuse to discuss uncertainty over a vaccine’s effectiveness, hype the seriousness of common everyday viruses (c’mon folks, really? The flu? Chicken pox?) and keep piling more and more vaccines onto the list of ‘recommended’ childhood shots threatening to turn our kids into pincushions. Now you’ve got a recipe for even more skepticism and fear-mongering.”

    Have you ever heard of the VISs (Vaccine Information Statements) that are required to be given to patients/parents BEFORE any vaccine is administered, Mr. Cassels?

    Why are you minimizing the seriousness of influenza and varicella Mr. Cassels? “C’mon” tell us, with some links to reliable websites. (Your link to the NVIC, is not a reliable website)

    ” Threatening to turn our kids into pin cushions”, Mr. Cassels?

    Which vaccines, in your expert opinion, are necessary and which are not necessary, Mr. Cassels? Please provide links to reliable web sites that show that any vaccine is more “risky” than the actual disease that the vaccine prevents.

  11. Wow, any questioning the party line certainly brings out the vitriol. Spit-flecked invective doesn’t win converts, it makes people wonder why some topics aren’t allowed to be discussed. Cassels openly questions vaccine dogma, your reply is dissent will not be tolerated. Is it any wonder parents no longer trust your edicts? Instead, why not answer the questions parents have? Here’s a few:

    Why is a one-size-fits-all vaccine schedule required despite differences children’s genetics, health, socio-economic status, or family autoimmune history?

    Why do children require 48 vaccine doses by age six, when we received less than half that amount when we were kids?

    Why does the US recommend far more vaccine doses than other first world countries? Why has the US infant mortality rate flat-lined since about the mid-1990’s when other first world countries continue to show large improvements?

    Why is required that children be “protected” against diseases that were considered harmless when we were children such as chicken pox and the flu? Why are such inconvenient disease lumped in with truly dangerous diseases like diphtheria in the schedule?

    How can you be so sure the dramatic expansion in the vaccine schedule isn’t linked to the staggering increase in childhood autoimmune disorders such as asthma, allergies, anaphylaxis, juvenile diabetes, celiac and Crohn’s disease? Can you at least acknowledge parent’s concern that repeated artificial stimulation of an infant’s immune system might be involved? How do you explain the increase?

    Why have other formerly widespread infectious diseases such as scarlet fever and typhoid also disappeared despite no vaccinations? Can you acknowledge the role of nutrition, clean water, and sanitation? If vaccine hesitancy portends a return to the “days of the iron lung”, why did the two diseases mentioned above disappear without vaccines?

    Do you understand that saying, “we have no idea what causes autism but we know it can’t be vaccines” sounds like BS?

    Why must infants be protected against hepatitis B, a disease of IV drug users and prostitutes, when an infant has virtually zero chance of catching it if the mother is not infected (easily tested)?

    The schedule is designed so even the “tough nuts” are cracked. Why must all children repeatedly receive the full booster regimen when a simple titer test can easily demonstrate immunity? The majority of children gain immunity without the full booster schedule. If the child already had adequate titers, further boosters provide no benefit yet they still entail risk as an invasive medical procedure. How can that be ethically justified?

    These are the types of questions parents have. Instead of engaging us as thoughtful adults, we are vilified as dangerous and irresponsible anti-vaccine nuts. While I’m sure the smug sanctimoniousness feels really good, it isn’t working. Parents no longer trust you.

    • Go to http://www.sciencebasedmedicine.org/ and you will find several articles that each of those points. It is a much more thorough and reliable source of information than the one Mr. Cassels linked to.

      You did ask: Why must all children repeatedly receive the full booster regimen when a simple titer test can easily demonstrate immunity?

      How are blood titers simple? It requires a blood draw using a needle much larger than any vaccine. Then it requires extra testing that may not be reliable. It is most likely much more costly than getting a vaccine. Do you have a citation that I can find on PubMed that shows it is as good as making sure kids (and adults) are protected from infections?

      Another question: Do you get your tetanus boosters every ten years?

      • Did Mr. Cassels really state this?
        “And they turn to health experts for guidance, but here’s my take on things: health authorities often fail to acknowledge the risks of some vaccines, refuse to discuss uncertainty over a vaccine’s effectiveness, hype the seriousness of common everyday viruses (c’mon folks, really? The flu? Chicken pox?) and keep piling more and more vaccines onto the list of ‘recommended’ childhood shots threatening to turn our kids into pincushions. Now you’ve got a recipe for even more skepticism and fear-mongering.”

        “C’mon folks, really”? Whose opinion do you value more? Someone who only claims *expertise* or the collective knowledge of thousands of scientists/researchers who are specialists in immunology and epidemiology, and who have reviewed the data collected since the varicella vaccine became available in the United States in 1995?

        Still others on this thread, advance their “own” theory that the varicella vaccine DOES NOT CONFER lasting immunity.

        About that statement that the 2-shot series of varicella vaccine does NOT confer lifelong immunity…that is being monitored closely. No one has any secret knowledge about the vaccine’s ability to confer lifelong immunity…or not.

        I had a friendly discussion with another member of the science community on a science blog. We provided each other with published research…which is after all…one of the purposes of science blogs.

        You would have to know the length of time it took to study other similarly manufactured vaccines, such as rubella, to determine whether or not a vaccine against a virus confers, lifelong immunity.

        You would have to determine when the point arrived that there was universal acceptance of a vaccine, uniform reporting requirements of individual cases/outbreaks and breakthroughs of a disease in a fully immunized population and the history of enhanced surveillance, since a vaccine was placed on the Recommended Childhood Vaccine Schedule.

        We fully discussed the theory that constant “boosting” of immunity after a person, by exposure to others with the disease , is responsible for the “seemingly” lifelong immunity that the wild-type disease infection confers.

        The rubella vaccine first became widely available in the USA in 1970 and was immediately accepted by the general public. Babies who received that vaccine are at least 40 years old and few of them had exposure to the natural disease…most haven’t. Pre-employment testing of doctors, nurses, allied medical professionals and ancillary staff (clerical, housekeeping) is a requirement for employment in every hospital, every nursing and group home, every clinic, etc. and shows lifelong immunity conferred by the rubella vaccine…without any constant “boosting” by exposure to the virus.

        http://www.chop.edu/service/parents-possessing-accessing-communicating-knowledge-about-vaccines/vaccine-preventable-diseases/chicken-pox.html

        “Natural immunity

        Q. I would rather my child develop natural immunity to chickenpox, so that he is at less risk of developing chickenpox as an adult.

        A. The good news is that regardless of whether we become immune to chickenpox from getting a vaccine or having the disease, our immune memory will protect us as adults. While there used to be a concern that the chickenpox vaccine would not provide lifelong immunity, data has not supported this concern. Immunity lasts at least 20 years and based on experience with the rubella vaccine, which is made the same way, is expected to be lifelong. Because the chickenpox vaccine affords immunity without the possibility of complications typically associated with natural infection, the vaccine offers immunity without the risk of disease.”

    • Well that is “quite a few” questions…
      Firstly can I ask where you have seen any vaccination supporter spew out “spit-flecked invective”, because I can’t see any, just appropriately accurate and rational criticism.
      1. “A one-size fits all” vaccine schedule is not used. Clinicians follow the recommended schedule as a guide, and are meant to make individual adjustments for differing clinical situations or histories. The idea that some of your putative “reasons” to vary the schedule are based in factual science is false. Anyhow, family autoimmune histories, or genetics etc do not mean the schedule needs to be altered. Do you have evidence that they do?
      2. “48 vaccines versus half that number when we were kids”: Firstly, it isn’t 46 vaccines by age 6, it is actually In case you hadn’t noticed, medical research advances and scientific progress happens. We can now prevent nasty diseases like rotavirus, HiB, pneumococcus, meningococcus and flu. We couldn’t 30 years ago. Have you seen kids die from any of these diseases? I have, quite a few. But that was in the past, and I haven’t seen a death from HiB in over 15 years, to take one example.
      3. The US infant mortality rate is quite unrelated to the number of vaccines on the schedule. Attempts to link the 2 are specious and quite unsound epidemiologically speaking, since infant mortality is linked to many, many different things, and deaths as a side effect of infant vaccines is astoundingly rare and would not impact the figures significantly.
      4. Our parents worried about us dying from diphtheria and polio, rather than chicken pox, simply because it was less likely to happen. Now that we have prevented polio and diphtheria and other previously dreaded diseases, the relative importance of deaths from flu, rota, chickenpox etc has increased, and they make significant contributions to infant mortality. We can vaccinate to prevent this happening, so we do. Simple.
      5. The likely cause of increases in asthma and allergies may relate in part to lifestyle, diet and environmental issues, and the hygiene hypothesis explains most of the rise. I am not aware there is an increase in celiac disease or Crohn’s – can you provide references for these? Vaccines are merely a convenient target for antivaccination lobbyists, since they can accuse vaccines of causing anything and everything they can think of, and then turn around and say “well, can you prove vaccines are not the cause?”
      6. Sanitation has lead to a drop in diseases spread primarily by fecal contamination such as typhoid. Scarlet fever is merely a type of strep throat which has a potent exotoxin – over the years the strains of strep have varied and the toxigenic strains declined, but are still present and the main reason there is no widespread scarlet fever is probably because antibiotics have eliminated most of the strains responsible. The problem you will notice with almost all the diseases we vaccinate against is that they are spread by INHALATION – so sanitation/hygiene has zero effect against most of these.
      7. We know vaccines don’t cause autism because scores of studies have specifically looked for a link and drawn a complete blank. It is possible not to know the full explanation as to why some diseases occur, but to definitively exclude certain things from the possible causes. For instance, we don’t know what causes Crohn’s disease, but we can say it isn’t due to diabetes, or sleeping in a blue-painted bedroom and that doesn’t sound like BS, does it?
      8. HepB is common in drug users, but many cases of HepB still arise from untested mothers. The rest arise from blood/bodily fluid contact in infancy/childhood between family members or other adults. There are about 3500 deaths annually from HepB cases in the US, with 30-40% estimated to have occurred in childhood. So vaccinating in infancy could avert around 1000 deaths (and far more cases of severe liver disease)
      9. It is simpler and more cost effective to offer some vaccine boosters rather than test for antibodies and then vaccinate only those with low levels. Offered the choice of a vaccine shot for my kid as opposed to a blood test (far more traumatic and invasive) and then probably a shot, I’d take the former. Even if my kid didn’t really need the booster, I’m happy for him to get the boost. It’s likely to be entirely safe – after all the first dose or two didn’t harm him, did they? If a parent insists on blood tests, fine by me, but it introduces a whole further layer of unnecessary complexity.

      • Dingo199 – Thanks for replying. We just got back online from a power failure, so I have limited time before heading out the door. Here’s some responses.

        Pediatricians within the US (can’t speak for Canada) routinely follow the CDC schedule (http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf). The American Academy of Pediatricians advises all members (virtually all US pediatricians) to vaccinate to the schedule. Count the doses, not the shots, but the doses. There are 48 by age six if you follow that schedule. MMR is three doses, as is DTaP. In 1983, the number of doses was 23. In the sixties it was about a dozen. You can’t argue with the fact that the schedule has increased dramatically in the last generation. Infants routinely receive seven vaccine doses in a single office visit. I take it you are in the business, look at the schedule. Eight doses at two months, seven doses at four months, up to nine doses at 6 months depending how they are spread.

        Regarding infant mortality, what in the hell is the point of giving kids all these shots if it doesn’t reduce it? I made the point that the US schedule has doubled in the last generation, but infant mortality hasn’t budged. You can’t make the point all these extra shots are saving kids if kids aren’t being saved. Seems simple enough.

        As to autism, there are not “scores of studies”, but fourteen that are cited by the vaccine industry. Of these, they focus exclusively on MMR and thimerisol. Look again at the schedule. MMR is two shots or six doses out of the 48 total. None of the others have been studied. So you don’t know that vaccines are exonerated, you know that a small number of industry and CDC-funded studies could not find a statistically significant relationship between MMR or thimerisol and autism. In the meantime, thousands of parents report their children regressed into autism after vaccination. The medical community says its a coincidence, parents are just looking for someone to blame for their misfortune. So why then are autism rates are now 1 in 88 in the US, when they were 1 in 4000 a generation ago? What is causing this? Until the medical industry can explain the autism increase, vaccines will always be suspect.

        Regarding the “anti-vaccine lobbyists”, just who are these people? Who is making money off of asking parents to consider the safety of what is being injected into their children? Vaccines are a $20 billion business, not some massive philanthropic outreach. Who do you think has more lobbyists, a bunch of ragtag parents or Merck? Who is contributing the the war chests of state legislatures as they write state laws mandating vaccination for school attendance? The public records are out there, it’s Merck, Pfizer, Sanofi, and GSK, not the parents of autistic children.

        You mentioned rotavirus, HiB, pneumococcus, meningococcus and flu. Let’s take them one by one and add in a few others. First off rotavirus, the US is one of a small number of industrialized countries that recommends this vaccine. Did you know the first version of the vaccine caused intestinal intussusception in infants and was pulled off the market? RV was not a major health threat in the US, yet the vaccine manufacturers were compelled to rush a dangerous product to market, with the FDA all to happy to rubber stamp it. The CDC almost immediatelly put it on the schedule for universal administration. Kids payed the price for that.

        HiB was a real problem and I’ll grant you that one.

        Pneumococcus is probably the worst of the bunch. Pfizer’s PCV 7 contained seven pneumococcal strains out of more than 90 known strains to date. Unsurprisingly, the incidence of the seven dropped. Unfortunately, a strain not included in the vaccine (19A) experienced explosive growth as nature abhors a vacuum. Worse yet, 19A is antibiotic resistant, unlike the seven it replaced. Public health agencies now warn against giving PCV7 due to the unintended consequences. Pfizer’s solution was PCV13 containing 19A and a few other strains. I’m sure we’ll have PCV25 a few years down the road as more strains proliferate to fill the void. Where does it stop?

        I find it strange that you mention meningococcus, as their is no Meningococcal vaccine on the US schedule (see the link). MenC is given in Canada, but not the US.

        The flu vaccine for children is beyond ridiculous. Pediatric flu deaths have long been less that a few dozen a year in a country with over 50 million minors. It’s a good bet you’re more likely to be killed in a car accident driving to the pediatrician’s office than killed by the flu. Yes, it probably makes sense in the elderly, but not in children, the risk of the disease is infinitesimal.

        Regarding Hep B neither my wife nor I are drug users, and neither of us have the disease. So why were both my kids given the vaccine four hours after birth without our knowledge? Look at the schedule, it is given at birth. This is an insane risk with no benefit to 99.99+% of infants. Of course if the mother has the disease the vaccine makes sense. But why universal administration at birth? Sheer insanity.

        Last of all is chicken pox. This Merck vaccine has been rejected by many industrialized countries as they understand it’s double edged sword nature. Chicken pox is harmless in children and provides lifelong immunity. The vaccine does not. Vaccinated children will need boosters every ten years (possibly sooner, no one knows) or risk getting the disease as adults when it can be truly dangerous. The next issue is shingles. The growth of shingles in the elderly is directly attributed to the chicken pox vaccine. Adults used to be periodically exposed to children with chicken pox thus strengthening their immunity towards shingles. Since the vaccine started in the mid 1990’s, adults are no longer exposed to chicken pox. The shingles outbreak among the elderly is the result of this massive real-time experiment. A harmless childhood disease was eradicated, the seniors pay the price. This was predicted before the vaccine was introduced and is the exact reason the UK did not adopt the vaccine. However, this didn’t stop Merck from cashing in, the FDA from approving it, The CDC from putting it on the schedule, nor pediatricians from doling it out.

        The problem with the schedule is there is no individual risk vs. benefit analysis, the assumption is that the benefit ALWAYS outweighs the risk regardless of the child, the disease, or the vaccine. Unintended consequences are rarely considered, as evidenced by the pnuemococcal and chicken pox vaccine problems. Worst of all, no dissent will be tolerated. Criticizing vaccine safety is professional suicide in the medical industry.

        Bottom line – as a parent this decision is mine, not the state’s, not the school district’s, not some pediatrician’s and certainly not Merck’s. We are open to vaccinating our children provided the benefit outweighs the risk in our individual case. We are not ant-vaccine, but we are vehemently anti-schedule. Our numbers are growing, we are not going away. The medical industry in general, and the American Academy of Pediatricians in particular, better learn to address our concerns instead of condescendingly dismissing them.

      • Jeff, there are far too many misconceptions you allude to for me to counter in a simple response-type blog of this sort. I could answer every single one of your concerns, but it would probably take several hours and thousands of words of text and references. I am also unsure it would help – you clearly are not just “any parent” asking questions, but one who has already widely assimilated the antivaccine propaganda and made their mind up (your knowledge of all the antivaccine tropes and the “14” studies demonstrates this.)

        Perhaps I can explain just one of your misunderstandings regarding chicken pox. It is not harmless in kids – it kills between 40-100 each year, and many more suffer from damage due to varicella encephalitis. It has not been rejected by countries because of its double-edged sword nature, but because they have decided it is unlikely to be particularly cost effective at this time. But as data accrues from the US this will be no doubt be reviewed.

        Immunity from natural chickenpox is only lifelong in the sense that it is partial – people never eliminate the virus and as immunity wanes as you get older, the latent virus reactivates and causes attacks of shingles. Your acknowledgement that people need natural boosters from chickenpox exposure shows you appreciate immunity is not lifelong or complete, so why say it is?

        Shingles is nasty and debilitating, and many countries are recommending over 65s get zoster vaccine to boost their fading immunity and keep shingles at bay.

        The vaccine is no different – you get infection with VZV but without the primary illness, but you might still get shingles as immunity to it fades. This isn’t a problem – all people could get booster vaccines against shingles as they get older.

        The fact that with fewer kids getting chickenpox and acting as natural boosters to their grandparents has caused a very modest and likely temporary rise in shingles in the elderly is a sign of how effective the vaccine works in kids, and the answer is to also ensure the elderly get boosters.

        Your argument seems to be that to lessen the risk of elderly people getting shingles, we should let kids all run the risk of encephalitis and death.

        Look at it from the perspective of the grandmother of a child who has died from chickenpox. Do you think she would be happy that she won’t get shingles, because she got a natural immunity boost from exposure to her dying child?

        Try asking some grandparents. Would they rather have a booster vaccine shot aged 65, or let their families run the risks of chickenpox (however small you think they are) just to slightly lessen their own risks of shingles? I can’t even think of a grandparent I know who could be so selfish.

      • dingo199:

        Jeff, there are far too many misconceptions you allude to for me to counter in a simple response-type blog of this sort. I could answer every single one of your concerns, but it would probably take several hours and thousands of words of text and references.

        That is why I referred him to http://www.sciencebasedmedicine.org. But as I read his comments, I notice I have seen them before on another website. His questions were answered, but he does not seem to like the answers. So, all you can do is just remind him that there are several good resources, but not the one used by Mr. Cassels (who seems to have no real medical/science background, just public policy stuff).

  12. Wow Jeff C. that’s quite a long post and quite a few facts about vaccines from your point of view, without any citations. Could you condense your objections to the vaccine schedule and the vaccine-preventable diseases into several shorter paragraphs?

    Why not list each vaccine in the schedule separately and provide a short synopsis of why you object to each one? Why not prioritize, according to your expertise, which vaccines you think are important and which are not…and please provide citations from first-tier peer reviewed journals to back up you opinion.

    BTW Jeff…this statement of yours is incorrect, “I find it strange that you mention meningococcus, as their is no Meningococcal vaccine on the US schedule (see the link). MenC is given in Canada, but not the US.” There are two types of meningococcal vaccine and it is recommended for certain young children who have specific risk factors:

    http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf

    “Children between 9 and 23 months of age, and anyone else with certain medical conditions need 2 doses for adequate protection. Ask your doctor about the number and timing of doses, and the need for booster doses.
    MCV4 is the preferred vaccine for people in these groups who are 9 months through 55 years of age. MPSV4 can be used for adults older than 55.”

  13. Jeff,

    Just to tackle a couple of your misconceptions. Firstly, rotovirus vaccine was provided in 28 countries in 2010 – somewhat more than a handful. http://www.who.int/immunization_monitoring/Global_Immunization_Data.pdf The WHO, after reviewing studies in Africa and Asia has recommended it be added to the schedule in all countries to help reduce the 450,000 deaths from rotovirus per year. http://www.who.int/wer/2009/wer8451_52.pdf

    However, it is not just mortality that is important; it is also the health impacts of contracting these diseases we vaccinate against. 1 in 20 cases of measles results in pneumonia and 1 in 50 of those children will contract encephalitis. 1 in 12 cases results in ear infection with some leading to permanent hearing loss. Subacute sclerosing panencephalitis occurs in about 1 in 100,000 cases of measles. Diarrhea occurs in about 1 in 12 cases of measles. Usually it is not a major problem, but can lead to hospitalisation. In total, up to a quarter of children under 5 who contact measles may need hospitalization even if only 1 in 500 die in developed nations.

    • Another antivaccine trope I hate is the one that has Jeff droning on about infant mortality rates. According to the antivaxers, the US IMR still remains “higher” than other developed countries because the vaccine schedule has more shots in it than it did before.

      In fact, US IMR has actually declined steadily over the last century (as vaccines have been introduced) – I don’t claim the reverse of what the antivaxers do (namely to insist that this association is causal). You see, IMR is made up of many different elements. For starters antenatal health is a crucial influence and 40% of the IMR is neonatal death, which would of course be unaffected by any vaccines added to the schedule. In addition, in the US, any live birth is counted as “live” and deaths are then part of the IMR stats. Yet in many other countries, babies born alive who die in the first day may not be counted, or not counted because they were under a certain gestational age or weight. Many countries class a baby less than 500gm which dies as a “still birth” and not an infant death, as happens in the US. All these factors conspire to keep US mortality slightly higher than the rate in similarly developed countries. Then there are many socio-economic factors, with pockets of populations in the US with much higher IMR because of deprivation and health issues – again nothing to do with vaccines, but contributing to keeping US average IMRs higher than in countries without these conditions.

      Vaccines have nothing to do with it.

      When people play the “Vaccines cause the IMR to be high” card, I give them this:

      http://www.vaccinetimes.com/vaccines-and-auto-deaths-a-k-a-i-can-play-with-excel-too/

      Of course, Gorski debunked the concept as well:

      http://www.sciencebasedmedicine.org/index.php/vaccine-schedules-and-infant-mortality-a-false-relationship-promoted-by-the-anti-vaccine-movement/

  14. This was a refreshingly honest article.
    By (1) refusing to acknowledge real risks from vaccines and (2) exaggerating the benefits from vaccines, the medical community has lost much credibility.
    I would also add that the studies proving the safety of mercury and the MMR shot do not stand up to scrutiny, further undermining the credibility of medical institutions like the FDA, CDC, NIH, etc.

    • I would also add that the studies proving the safety of mercury and the MMR shot do not stand up to scrutiny,

      Citation needed.

    • Paul, the medical community HAS acknowledged the real risks from vaccines. Read that word again – R E A L.

      What is does not acknowledge are spurious and imaginary links with whatever medical problem trope is flavor of the month in the antivaccine community (autism, epilepsy, SIDS etc).

      In addition, the risks from the diseases are NOT exaggerated. Without vaccination there would be a return to the prevaccine era, when 500 kids died each year from measles, hundreds more from meningitis, we would see a return of dreaded diseases like diphtheria (as happened in the ex USSR states when the all stopped vaccinating after breakaway from Russia in the 1990s) and diseases like polio persisting and spreading globally.

    • I forgot to add, Just look at Europe, and the measles epidemics they have there with tens of thousands of cases, all because of low vaccine rates. Measles is now endemic in the UK again, thanks to Wakefield. The risks are real, and not exaggerated.

      • dingo199

        Minor correction: measles is endemic to the UK again thanks to Wakefild…and a complicit media eagerly promoting his false and fraudulent claims. Many eagerly repeated him without checking facts. But, of course, American journalists, such as Mr. Cassels, would never ignore that whole fact-checking part.

    • paul5of6

      Please show where the medical community refuses to acknowledge the real risks of vaccines. If you look at the FDA and CDC web sites, you’ll quickly find discussions of the real risks of vaccines, as well as the real risks of the diseases they prevent. What you will not find are imaginary risks. If you feel otherwise, please provide a link to a valid source illustrating your claim.

  15. - Many vaccine critics have studied the subjec,t including from unbiased sources for years and know more than the average doctor.
    – Nobody knows all the potential longterm risks for a vaccine. It is therefore impossible to weigh benefits against risks.
    – Vaccines destabilise the immune system.
    – Immune response is not the same as immunity.
    – Presence of antibodies cannot be correlated to immunity.
    – Infectious diseases are shown to decline before introduction of vaccine programs. The diseases decline as populations gain stronger natural immunity: they need access to clean water,sanitation, nutrition, shelter etc.
    – Herd immunity applies to naturally contracted diseases, not to vaccines. Vaccinating a large per cent of the population does not protect the rest from infectious diseases.

    http://www.theepochtimes.com/n2/health/forced-vaccinations-government-and-the-public-interest-2-27045.html

    – Vaccines containing live strains present shedding/secondary transmission where the vaccinated act as reservoirs of infection and infect the unvaccinated.

    (Vaccination is simply injecting with a vaccine. It is not the same as immunisation!)

    • @mindanoiha

      - Many vaccine critics have studied the subjec,t including from unbiased sources for years and think they know more than the average doctor.

      Fixed that for ya.

      - Nobody knows all the potential longterm risks for a vaccine. It is therefore impossible to weigh benefits against risks.

      Nobody knows all the potential longterm risks of eating locally grown apples or driving in a car. It is therefore impossible to weigh benefits against risks. See the flaw in your argument?

      - Vaccines destabilise the immune system.

      [Citation needed.] Vaccines cause the immune system to respond in the same manner as it would from a wild infection.

      - Immune response is not the same as immunity.

      So you’d agree, then, that immune response from an infection is not the same as immunity?

      - Presence of antibodies cannot be correlated to immunity.

      Actually, it can be. We look at presence of antibodies and rates of infection after exposure and see that the presence of antibodies generally correlates with lack of infection.

      - Infectious diseases are shown to decline before introduction of vaccine programs.

      [Citation needed.] While mortality rates have generally declined before introduction of vaccines (thanks to improved medical care that keeps people from dying), incidence has not declined markedly until after immunization. (e.g., see graph here).

      - Herd immunity applies to naturally contracted diseases, not to vaccines.

      Incorrect. Since vaccination prevents infection, it also contributes to herd immunity. Herd immunity can decline as people do not get immunized or their immunity (from either infection or immunization) wanes.

      - Vaccines containing live strains present shedding/secondary transmission where the vaccinated act as reservoirs of infection and infect the unvaccinated.

      Shedding very rarely results in infection of non-immunized individuals. Those concerned about shedding should wait several days before interacting with others, just as they would when they know they are sick. The difference is that if you are infected, you will shed virus and infect others before you are even aware that you are ill; with vaccination, you can control your exposure to others.

    • Mr. Best, which vaccine on the current American pediatric schedule is only available with thimerosal. According to this list half of the influenza vaccines are thimerosal free.

  16. Chris, The pediatric schedule is no longer the preferred manner for the sadistic scum in Pharma to intentionally cause autism and other brain damage to babies. Shooting flu shots full of mercury into pregnant women gives the fetuses 200 times the alleged “safe” dose of mercury. This causes spontaneous miscarriages, SIDS, autism and other horrors. Now, please shove your disingenuous questions up your ass.

    • Hey there, Sunshine!

      I suppose you have some citations to support your spurious claims? The sources should show the “safe” dose of ethylmercury (as opposed to the EPA’s guidelines for methylmercury, which is a completely different and far more dangerous substance), demonstrate that the amount a pregnant woman receives in a single dose of thimerosal-containing flu vaccine is above that safe dose for ethylmercury, show how much of the ethylmercury crosses the placental barrier, and shows that whatever amount of ethylmercury that manages to get across the placenta to the fetus results in “spontaneous miscarriages, SIDS, autism and other horrors.” If you can’t put up, then best close yer yap.

      It is interesting that although the amount of thimerosal that children receive via vaccination (either via the childhood schedule or TC flu vaccine given to pregnant women) has gone down, there has been no reduction in “miscarriages, SIDS, autism and other horrors” that you would like to blame on vaccines.

  17. Pingback: A wrong way and a right way to discuss vaccine safety and effectiveness « Science-Based Pharmacy·

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