Thursday, February 4, 2010

The Great Vaccine Debate - Part 1

First off, I would like to begin this topic by saying that I am not - under any broad definition - "anti vaccine". It is well-known by the medical and lay communities that vaccines have saved hundreds of thousands of lives since their introduction decades ago, and have virtually wiped out some categories of illnesses that formerly killed large masses of people at a time. So in that sense, I am not anti-vaccine. What I am "anti" is the notion of any one of us, as individuals or as groups - health care providers, the National Institute of Health, the American Association of Pediatrics.. I can go on - irrefutably testifying that we have all the answers regarding vaccine safety nor that we (as a country) are any better off than other countries who do not follow our vaccine schedule. I am not anti-vaccine... If I must label myself, I am pro-safe vaccination schedules and vaccination ingredients - both of which, in my opinion, could use some careful consideration and improvements. If we turn this issue into a debate of the "pros" vs the "anti's", which it has unfortunately become in some subsets, the ones who will suffer most are our children.

I would like to use my blog as a forum for providing general information regarding my opinion on current vaccine practices and not as a source of controversy or debate. I have been feverishly researching this topic for the last 4 years, and have developed some general guidelines for my friends, loved ones, and patients as a result. No one has all the answers, including myself, but I can offer up suggestions for a potentially safer vaccine practice for those who are looking for an alternative to the current same-for-all recommendations in the pediatric medical community.

Here are the points I think are most important when considering vaccinating your children:



1. Never, under any circumstance, vaccinate your children when they are showing any signs of illness or immune dysfunction. This means any symptoms of allergies, illness, rash, or anything abnormal in any of their bodily systems. Children receiving vaccines need to be at their immunological best so that they can actively fight off both the virus in the vaccine in order to develop immunity (the purpose of the vaccine) and the adjuvents (or additives) of the vaccine. Even the slightest illness or allergic reaction can weaken the immune response, leaving the child more susceptible to potential adverse reactions of the vaccine in question.  The common against for this piece of advice is that vaccines are weaker, dead versions of the illness which cannot cause harm because they are inactivated.  This is not always the case, as some vaccines are in fact live viruses.  Most of the generally healthy population can fight off the weakened virus without a problem; however, for children with immune systems that are compromised for any number of reasons this may not be the case.  A recent example of this phenomenon was published by the New England Journal of Medicine regarding the RotaVirus vaccine.  Two infants who were immuno-compromised and received the vaccine ended up acquiring the disease itself rather than the immunity desired.  Read the full study here.

2. One vaccine at a time.  No matter how annoying it is to go back to the office, or how hard your provider tries to convince you otherwise, I strongly suggest that parents do not give more than one vaccine on the same day to any child. Would you want to fight off more than one illness at once? I'd guess not, and your child's immune system would likely agree.  The more an immune system needs to take care of, the less particular attention it can give to properly clearing additives and viruses (live or deactivated) from the system and the more damage they may cause as a result.   Common argument:  Vaccines have been studied over and over and have been found to be generally safe.  There have been many studies done regarding the safety of individual vaccines.  However, there have been no studies which specifically address the effects of multiple vaccines when given in conjunction with one another. 

3. Always, always, always, always ask to read the package insert in your child's vaccine.  I will not get into the scientific details here, but some common vaccine additives have been linked to numerous neurological and immunological dysfunction later in life - both big and small.  If any particular additives concern you, be sure to read the package insert to be 100% sure what ingredients your vaccine contains.  If your doctor refuses to allow you to see it, find a new doctor.  If you see something you do not like in the list of additives, ask for an alternative vaccine.  All current mandatory vaccines are made by at least 2 companies, with not all ingredients being alike.  Sometimes it may be finding the lesser of two evils, but there is always a choice.  Your doctor can order vaccines (though you may need to pay more) that you specifically request and you can return when they arrive.  The most politically-charged and controversial (thus far) of these additives is Mercury (in the form of Thimerosal).  I will try to provide a cheat sheet here, but would advise you to do your own research, as this is not a comprehensive list of vaccines that contain the additive. According to the FDA, some mercury-containing vaccines (some of them used in children and pregnant or perspective mothers) include the DT vaccine (two of them by Sanofi Pasteur, Inc.), the DtaP vaccine (Tripedia2 Sanofi Pasteur, Inc), two TD vaccines (Mass Public Health and Sanofi Pasteur), the TT (Sanofi Pasteur), the Hep B (GlaxoSmithKline Biologicals), the Hep A/Hep B, (GlaxoSmithKline Biologicals), the Japanese Encephalitis (Research Foundation for Microbial Diseases of Osaka University), and the Meningococcal (Sanofi Pasteur).*  Also according the FDA's website outlining vaccine administration for children there is up to 300 picograms of mercury in the DtaP shot (Tripedia by Sanofi Pasteur, listed as the third item), 25,000 picograms of mercury in one of the pediatric flu shots (Fluzone by Sanofi Pasteur), and 12,500 picograms of mercury in another flu shot (Fluvirin by Novartis Vaccines and Diagnostics Ltd).  The intranasal spray formulation of the flu vaccine is typically free of Thimerosal, but cannot be given to children under age 2 as it is a live virus.
Common Counter-Argument:  In a letter to ABC the American Association of Pediatrics wrote: "No mercury is used as a preservative in routinely offered childhood vaccinations."  This is partially inaccurate, as mercury is still in 16 vaccines including 5 pediatric vaccines such as 3 flu shots, the HEP-B and the DtaP (many listed above). The statement is partially accurate because the mercury (Thimerosal) in these vaccines is not in fact in there as a preservative, but rather as an adjuvent, a by-product, or an antibacterial agent instead.  I will say to our healthcare system's credit that mercury exposure has been reduced by approximately 65-75% within the last decade or so, which is a step in the right direction.  Until it is 100% I would recommend avoiding it if possible.

*Sources: (1) Attempts At Eradicating Infectious Diseases Are Putting Our Children At Risk, National Vaccine Information Center. By Barbara Loe Fisher, President, National Vaccine Information Center 
(2) FDA's Current List of Vaccine Ingredients



<< continued in part 2 >>

2 comments:

  1. Some would argue that Thimerosal has been studied and has been declared safe. Also, it is made of ethyl mercury which is found to not cross the blood-brain barrier, so how could it do neurological damage?

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  2. Thanks for your comment. I have a few general responses to that inquiry. Here are points to consider:
    Methylmercury and ethylmercury are both forms of organic mercury. Because organic mercury crosses cell membranes, including those of the blood-brain barrier, it is generally considered to be the neurotoxic form of mercury. An extensive body of literature has emerged over the last five decades, detailing the toxicity of methylmercury to children. This is the form of mercury that is found in seafood, coal burning facilities, and other environmental contaminants. This form of mercury can stay in the body for 70 days before being cleared - more than any other form of mercury. Ethylmercury is the form that is found in Thimerosal-containing vaccines - NOT methylmercury. Ethylmercury has been found to quickly convert itself to inorganic mercury, and be eliminated by the body in 10-20 days on average. This is indeed a significant difference when compared to the methyl- form. However, the American Academy of Pediatrics' website states, "While the rapid elimination of ethylmercury rules out the possibility of its bioaccumulation after vaccination, given the temporal spacing of vaccines in children, experimental data suggest that the rapid conversion of ethylmercury to inorganic mercury may result in the production of inorganic mercury with a longer half-life and more delayed diffusion out of target organs (the concept of inorganic mercury "trapping")."
    Ethylmercury is indeed a much weaker enemy to the human body than its dangerous methyl- counterpart, and the two should not be compared equivocally. Also, several studies by the CDC and other bodies across the globe have shown no connection between Thimerosal and any specific neurological condition (including autism). However, the infant brain is known to be 10-15 times more susceptible to injury from methylmercury exposure than the child or adult brain (AAP website). One vaccine with a miniscule amount of ethylmercury may not be enough to noticeably hurt a child. Heck, even two - we don't know. But knowing that the infant brain can be this much more susceptible to ANY compound than is the older child or adult brain, I think this warrants the elimination of Thimerosal - which has been proven to have some harmful effects, despite its not "causing" specific neurological disorders - nonetheless. Remember, there are other poisons we (and our children) are inadvertently ingesting daily which are increasing the detox burden on our bodies.

    As a side note, some studies (such as this one http://het.sagepub.com/cgi/content/refs/18/3/174) have shown pesticides and other environmental toxins to damage the function of the blood brain barrier, making it permeable to things it wouldnt normally be permeable. Ethyl mercury can in fact cross the blood brain barrier, although not as easily as methylmercury. Nonetheless, if you can help keep unnecessary toxins out of the body (not limited to vaccines, by any means) in the first place, you have eliminated the risk of the toxins reaching the brain.
    We live in a toxic world nowadays, and our defenses need to be up. Bottom line - if there are vaccines without Thimerosal available, ask for them.

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