So, what about the safety? Vaccines contain a number of potentially harmful substances. Mercury has gotten the most bad press in recent years, and fortunately it has finally been removed from most vaccines. However, the drug company Merck knew in 1991 that the mercury in vaccines was about 87 times the daily maximum thought to be safe when taken orally (http://articles.latimes.com/2005/feb/08/business/fi-vaccine8
), but this was not publically disclosed until almost 10 years later. The mercury was finally removed in about 2002. Knowing that drug companies have withheld information indicating that their vaccines are harmful in the past, let’s diligently look at the current contents of vaccines. Many vaccines contain human & animal tissues. Yes, they are screened, however, there remains the potential for tiny infectious agents (prions, or whatever) to pass through. This might sound paranoid, but it has happened before, with SV40 from monkeys, a contaminant in the old polio vaccine, which has been associated with cancer: http://aje.oxfordjournals.org/content/160/4/317.full
. Furthermore, voluntarily injecting animal tissue into humans is suspicious for another reason: many human infectious diseases evolved from diseases in our domesticated animals (The common cold came from horses. Influenza came from ducks. Tuberculosis came from goats. Measles & smallpox came from cows. Whooping cough came from pigs. See http://birdflubook.com/resources/Greger_2007_CRM_33(4)_243.pdf
). Formaldehyde, used as a preservative in many vaccines, is a known carcinogen. Polysorbate 80 is contained in many vaccines, and has been associated with anaphylactic shock (http://www.ncbi.nlm.nih.gov/pubmed/16400901
). And MSG is used in some vaccines. It can damage nerve tissue (http://en.wikipedia.org/wiki/Glutamic_acid_(flavor)#Excitotoxicity
Aluminum is used as an “adjuvant” in many vaccines. I find the story with the presence of aluminum in vaccines to be important, and so it gets its own paragraph. To be honest, when I first thoroughly investigated the vaccine issue when my wife was pregnant about three and a half years ago, what I learned about the aluminum content in vaccines frightened me. Aluminum is well-known to cause neurologic harm. Has anyone determined the safe level of aluminum when it is injected into the muscle tissue of infants? The answer is "no" (http://www.ncbi.nlm.nih.gov/pubmed/22235057
). No one has ever measured the levels of aluminum absorption into the bloodstream, and then excretion into the urine, when it is injected in this way. Adjuvants are added to vaccines to stimulate the immune response. The metallic composition of the Earth’s crust, by volume, in decreasing order is: aluminum, iron, calcium, sodium, potassium, magnesium, and then followed by some other lesser ones. The interesting thing here is every metal in the top six, except aluminum, is required for life. Aluminum has no physiologic role in life. Given the fact that it is the most abundant metal in the crust, one would expect it to. This observation causes one to suspect that there may be something biologically harmful about this element (and there is, in the short run - http://www.ncbi.nlm.nih.gov/pubmed/9164811
, and perhaps in the long run - http://www.sciencedaily.com/releases/2007/08/070831210302.htm
). So why is this suspicious metal used as an adjuvant? For two reasons, first, it works stimulating the immune response, although the mechanism isn’t well understood (http://www.ncbi.nlm.nih.gov/pubmed/20153253
). Second, because it is so prevalent, it is very cheap. Without the public demanding it (as was done with mercury), there is little incentive for producers to remove the aluminum when there is only suspicion, not proof, that it is harmful at the levels injected into babies. But, there is good reason to be concerned about this. According to the FDA (http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=201.323
), those with impaired kidney function should get no more than 4 to 5 micrograms per kilogram of bodyweight per day of aluminum in their IV solution, which would be a maximum of 10 to 20 micrograms per day for a newborn. This is alarming because a newborn getting the recommended hepatitis B injection at birth is getting 225-500 micrograms of aluminum (the amount depends on the brand, http://www.chop.edu/service/vaccine-education-center/hot-topics/aluminum.html
, and comparing the amount of injected aluminum to amounts eaten with food as they do at this link is not a valid comparison, since only 0.3% is absorbed when taken orally - http://emedicine.medscape.com/article/165315-overview
), and the amount of injected aluminum keeps going up from there if the standard vaccination schedule is followed (http://www.cdc.gov/vaccines/recs/schedules/downloads/child/0-6yrs-schedule-pr.pdf
). Granted, this is going into the muscle, and not directly into the blood, and most full-term newborns probably have better functioning kidneys than those people studied by the FDA to arrive at the 5 micrograms per kilogram of bodyweight per day limit. The problem is that studies examining aluminum absorption into the bloodstream via this route have not been done, to my knowledge, and I have done an extensive search for this. Parents are well justified in asking for vaccine brands with a lower aluminum content and in perhaps postponing the high aluminum vaccines until the child has gained some additional weight, if they choose to give them at all.
Vaccines can have both short-term and long-term side effects. The short-term side effects are better understood. Quite commonly, vaccines cause vomiting, diarrhea, headaches, rashes, etc. More rarely, they may cause Guillain-Barre syndrome, encephalitis, SIDS, paralysis, and vision problems. More information about these can be found on the vaccine product inserts (http://www.immunize.org/packageinserts/
). The long-term side effects may include autism (http://www.ncbi.nlm.nih.gov/pubmed/21993250
), ADHD, learning disorders, and autoimmune diseases (http://www.ncbi.nlm.nih.gov/pubmed/9115571
). All of these seem more prevalent now than they did 20 years ago, perhaps due to the increased number of vaccinations given today.
Here are some more links related to vaccine safety:
In 2011, it was reported that there were many more cases of adverse reactions to the measles vaccine than there were cases of measles: http://therefusers.com/refusers-newsroom/6-times-more-measles-vaccine-adverse-reaction-reports-than-measles-cases-in-2011/
For Hep B, the risk of a serious vaccine reaction may be 100 times greater than the risk of contracting Hep B: http://articles.mercola.com/sites/articles/archive/2008/01/02/hepatitis-b-vaccine-part-four.aspx
A correlation was found between higher numbers of infant vaccinations and increased infant mortality (although, to be fair, I do believe that there have been other, similar studies which found no correlation): http://het.sagepub.com/content/30/9/1420
. If this correlation holds up, a potential explanation for it is here: http://www.ncbi.nlm.nih.gov/pubmed/2785591
. The HIB vaccine is known to suppress the immune system in the first week after injection, leaving infants more susceptible to infection during those days.
Infant deaths in Japan caused the suspension of two vaccines: http://www.physorg.com/news/2011-03-japan-baby-vaccines-deaths.html
The CDC admits vaccines can trigger symptoms of autism: http://www.huffingtonpost.com/david-kirby/cnn-cdc-and-some-truth_b_94040.html
The nation of Finland says the swine flu vaccine causes narcolepsy: http://www.naturalnews.com/033816_swine_flu_vaccines_neurological_disorders.html
Flu vaccine recall: http://www.dailymail.co.uk/health/article-2054160/300-000-doses-flu-vaccine-Preflucel-withdrawn-alert-effects.html
Vaccines are known to cause cancer in cats: http://www.theledger.com/article/20120218/COLUMNISTS/202185001
The esteemed Dr. Maurice Hilleman (http://en.wikipedia.org/wiki/Maurice_Hilleman
) had some disturbing things to say in an interview about vaccine safety in the 1950s (information not released to the public at the time): http://tv.naturalnews.com/v.asp?v=13EAAF22CDA367BB3C2F94D2CD90EF7B
. I fully acknowledge that vaccines today are quite a bit safer than what they were then.
The vast majority of cases of polio in India today are a result of the oral polio vaccine, and not the wild polio virus: http://www.telegraphindia.com/1120116/jsp/frontpage/story_15011108.jsp
. It must be mentioned, however, that the oral polio vaccine is not used in the United States. Most Western countries inject a dead polio virus, without this risk.
Younger doctors are less likely to believe that vaccines are safe: http://children.webmd.com/vaccines/news/20111021/survey-younger-doctors-more-skeptical-of-vaccines
No honest physician would ever claim that vaccines have no risk. Nevertheless, it is worrisome that there are no studies on the long-term effects of vaccines, particularly when taken in large numbers, as kids are asked to today (for example I was vaccinated against seven diseases in the late 70s / early 80s, but now the number recommended is about 16). The financial incentive of the drug companies to carry out long-term studies of this sort is small as long as most parents continue to vaccinate. Yes, pretty much all medical interventions and definitely all drugs have side effects. The difference between vaccines and most other drugs is that vaccines are given to healthy people. Thus, a much smaller rate of side effects are tolerable. The burden of proof is on the drug companies to demonstrate the safety of vaccines. When it comes to the flu, the two options drug companies have are vaccines and anti-virals. The most popular anti-viral is Tamiflu. If one looked at the Tamiflu study a few years ago, one would have thought that it was a good idea to take. But then it was shown that the study was flawed, and in fact fraudulent (http://www.theatlantic.com/magazine/archive/2009/12/the-truth-about-tamiflu/7801/
). A degree of skepticism when it comes to things of this sort seems warranted.
When choosing whether or not to give a particular vaccine, lifestyle factors are a consideration. A baby staying with a parent at home is quite a bit less likely to attract a contagious disease than one in a daycare setting. There are also some natural ways to strengthen a child’s defenses: breastfeeding (breastmilk contains protective antibodies providing “passive immunity”, http://www.ncbi.nlm.nih.gov/pubmed/22106709
), eating fruits and vegetables (contain antioxidants - http://www.ncbi.nlm.nih.gov/pubmed/22111516
, and vitamin A appears to have a protective effect with measles - http://www.ncbi.nlm.nih.gov/pubmed/21868478
), sunshine exposure (due to the production of vitamin D, http://www.ncbi.nlm.nih.gov/pubmed/16959053
), moderate exercising (http://my.clevelandclinic.org/disorders/chronic_fatigue_syndrome/hic_diet_exercise_stress_and_the_immune_system.aspx
), letting them play in the dirt (see the “hygiene hypothesis”, http://en.wikipedia.org/wiki/Hygiene_hypothesis
), co-sleeping (due to the oxytocin released from the skin-to-skin contact, http://www.ncbi.nlm.nih.gov/pubmed/21215526
), and minimizing exposure to smoke (http://www.ncbi.nlm.nih.gov/pubmed/22363418
) and other unnatural chemicals in the environment (thus choosing organic foods is likely better). Natural approaches, like these, have been subject to an observational study of approximately 10 million years in length. One can compare this to vaccines, which had their origins with Jenner’s work in the late 1700’s on smallpox. For this reason, in addition to the fact that these natural approaches don’t carry the negative side effects that drugs do, it is reasonable to ask that vaccines pass a more stringent test for us to accept them than these more natural approaches. Unfortunately, the degree to which these natural approaches protect against diseases for which there is a vaccine is not known. Here is an informal survey finding unvaccinated kids tend to be healthier (yes, there is likely a reporting bias here, and yes, unvaccinated kids do tend to come from families which are more health conscious, but still I include it since it seems relevant): http://www.thehealthyhomeeconomist.com/survey-results-are-unvaccinated-children-healthier/
. Unfortunately, a more scientific study of this sort has never been done (many in the anti-vaccine crowd say this is because the government & drug companies are afraid of what the result would be).
I feel that, in order to be a responsible parent, each one of the 16 or so child vaccinations should be considered separately. Some of the vaccines are likely more dangerous than others as far as safety is concerned. And the negative effects of vaccines would increase the more vaccines that are given. It seems the negative effects are worse the younger the child is (due to bodyweight), and so delaying vaccinations, rather than not giving them at all, is an option. For example, Dr. Donald Miller, a cardiac surgeon and professor of surgery at the University of Washington, recommends no vaccinations until the child is two years old. After that he advises that vaccines be administered one at a time, every six months, in an effort to minimize any negative impact they may have. When the number of serious adverse reactions to the vaccine is larger than the number of cases of the actual disease in a population, and the severity of the adverse reactions is comparable or worse than the severity of the disease itself, and when one is mindful of other factors such as the potential unreported cases of adverse reactions and of the potential unreported cases of disease as well as the potential long term consequences of both, then I think a rational individual is well justified in questioning the utility of the vaccine at that moment (http://www.ncbi.nlm.nih.gov/pubmed/3096132
). Incidence rates of disease vary over space and time, and it is important for parents to keep up to date on this, as much as possible.
And there is a lot more to it than this. I feel that this post, although long, is just scratching the surface. There are many other factors which I didn’t address here, such as: no vaccine provides complete immunity and immunity often decreases over time (http://www.huffingtonpost.com/2011/09/19/whooping-cough-vaccine-three-years_n_970139.html
), there are different strains of some of the diseases and the vaccine is often only effective against some of the strains, the diseases tend to become more or less serious as the child ages, the pneumococcal and haemophilus meningitis bacteria are part of the normal flora of a lot of people so unlike chicken-pox and measles you can't rely on herd immunity for these, the distinction between humoral and cell-mediated immunity (vaccines are generally better at providing humoral immunity than cell-mediated immunity, whereas natural exposure does a better job at providing both - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3238379/pdf/nihms343066.pdf
), and of course I haven’t gone into the specifics of each disease (its prevalence, its severity, its transmission, effectiveness of that vaccine, etc.), but these data are available. Some of the diseases, like chicken pox, become more dangerous as children get older. Suppose a child isn’t given the chicken pox vaccine, and doesn’t develop chicken pox as a child. In this case, as an early teen the child can be given “titer” (a blood test) to see whether or not they happened to be exposed to the disease enough during childhood to acquire immunity. If not, the parents can choose to vaccinate at that time. Other places for vaccine information, besides google and pubmed, are the Centers for Disease Control (http://www.cdc.gov/vaccinesafety/index.html
) and the National Vaccine Information Center (http://www.nvic.org/
). The Morbidity Mortality Weekly Report at the CDC is a great place to read about current infectious disease trends (http://www.cdc.gov/mmwr/
). Information regarding diseases in other countries can be found here http://wwwnc.cdc.gov/travel/
(useful if travelling). To repeat myself: each vaccine needs to be considered separately. I urge parents to read about the issue on their own, and not blindly follow the advice of their pediatrician. I have talked to three different pediatricians about many of the issues regarding vaccinations that I have mentioned here. In each case much of it was new to them.
I am opposed to any proposed system of mandatory vaccination. I strongly feel that it is an individual right to choose. A couple months ago, I sketched a framework for secular ethics on my facebook page. Within that framework, mandatory vaccination is clearly unethical. Furthermore, the fact that vaccines are currently voluntary is an incentive to vaccine manufacturers to continually strive to improve the safety of their product. Were vaccines to be forced, that progress would slow or stop. For example, if vaccination rates started to fall significantly because of fears of aluminum, the drug companies would either do the aluminum safety research or find a safer adjuvant. This happened before, with mercury. Removing the aluminum from vaccines would be more difficult than removing the mercury, because mercury was not used as an adjuvant, and thus the manufacturers would likely need a big incentive from the consumers in order to make the change. It is often argued that society as a whole would be better off if everyone vaccinated (the utilitarian argument). However, it is not clear that this would really be the case if they were forced to do so, due to this effect of slowing improvements in safety. And philosophically, it is my argument that the initiation of the use of force will always result in a net long-term decrease in overall happiness. I’ve written about this before on my facebook page.
When it comes to the issue of social responsibility, insights can be gleaned from the branch of mathematics known as “game theory” (http://www.pnas.org/content/101/36/13391.full.pdf
). Unvaccinated kids benefit from "herd immunity" (the protection of all the vaccinated kids around them) without risking taking the vaccines themselves. Is this selfish? I don’t think so, because not vaccinating will stimulate improvements in vaccine safety. Plus, outbreaks can still occur even in a completely vaccinated population (see http://www.ncbi.nlm.nih.gov/pubmed/3821823
), so it’s not like the unvaccinated kids can always be blamed for that. Of course, if you’re going to delay / skip some vaccines, I think it would be better if you did so for legitimate scientific concerns regarding vaccine safety, rather than the pseudoscience often propagated by those in the anti-vaccine camp asserting that vaccines are ineffective. And finally, are you supposed to make decisions that are good for the population as a whole? Or do you base your decision on what's best for your own child as an individual? I think we all put our children first in most situations.