An extremely important issue that has been getting increasing discussion recently is the issue of the pros and cons of the government mandating a large number of required vaccinations in children, starting at birth (12 hours old). The number of recommended vaccines by the American Academy of Pediatrics (AAP), the Center for Disease Control and Prevention (CDC), and the American Academy of Family Physicians (AAFP) is 48 before the age of 6. The number of government mandated vaccines may be larger or smaller than the above recommended number, and varies with the state, with NJ requiring the largest number at 60 (with four added just starting in September 2008).
On one side of this debate is the medical/health establishment, including the AAP, CDC, and AAFP, who claim that requiring such a large number of vaccinations is just good health policy that is needed to stop the spread of dangerous infectious diseases. They point to statistics that show the large decrease of infectious diseases since various vaccines were introduced. For example, in 1920 Diphtheria had 147,991 reported cases resulting in 894 deaths. The Diphtheria vaccine was introduced in 1923, and in 2002 it had only 1 reported case. In the first half of the 20th century, every year Polio had tens of thousands of cases resulting in over 1,000 deaths. The Salk Polio vaccine was introduced in 1955 and the Sabin Polio vaccine was introduced in 1962, and today cases of Polio in the U.S. are extremely rare (but some cautions on such statistics later in this article).
On the other side of this debate are various grassroots organizations, like the National Vaccine Information Center (NVIC) and the New Jersey Coalition for Vaccination Choice (NJCVC), whose members include a large number of parents who claim that their children were vaccine-injured, but also include doctors, nurses, other healthcare professionals, as well as other professionals. These grassroots organizations claim that vaccines contain a lot of toxic material and can be harmful. They point to the sharp increase of chronically ill and disabled children [who have, e.g., Autism, Attention Deficit Hyperactivity Disorder (ADHD), asthma, diabetes] during the last 30-40 years when the number of government-required vaccines has more than tripled. For example, in 1970, 1 child in 2,500 developed autism; today 1 child in 150 develops autism. In 1970, 1 child in 1,750 was diabetic; today 1 child in 450 becomes diabetic.
How can we reconcile the claims of these two sides? To answer this, we need to address at least the following four questions:
- How much health benefits have really resulted from vaccines?
- How much health risks can result from vaccines?
- Are there comprehensive and conflict-of-interest-free medical review bodies that recommend or decide on the vaccination policies and guidelines?
- Should exemptions to vaccination be provided?
Health Benefits of Vaccines: With the exception of the Smallpox vaccine which was developed in 1796, essentially all other vaccines were developed or began widespread use only in the 20th century, with many in the second half of the 20th century. It is true that there has been a very large decrease in various infectious diseases in the U.S. since various vaccines were introduced (see, e.g., the two examples cited at the beginning of this article). However, it is also true that there has been a continuous significant decrease in various infectious diseases in the U.S. in the last 100+ years due to overall improvements in the living conditions of the general population.
The CDC document “Achievements in Public Health, 1900-1999: Control of Infectious Diseases” (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm) states “The 19th century shift in population from country to city that accompanied industrialization and immigration led to overcrowding in poor housing served by inadequate or nonexistent public water supplies and waste-disposal system. These conditions resulted in repeated outbreaks of cholera, dysentery, TB, typhoid fever, influenza, yellow fever, and malaria.”
The CDC article goes on to state “By 1900, however, the incidence of many of these diseases had begun to decline because of public health improvements, implementation of which continued into the 20th century. … From the 1930s through the 1950s, state and local health departments made substantial progress in disease prevention activities, including sewage disposal, water treatment, food safety, organized solid waste disposal, and public education about hygienic practices (e.g., foodhandling and handwashing). Chlorination and other treatments of drinking water began in the early 1900s and became widespread public health practices, further decreasing the incidence of waterborne diseases.”
Let us discuss more about the Polio statistics since that is often used to illustrate the effectiveness of vaccine. The website (http://www.cispimmunize.org/fam/ImpactofVaccines.pdf) of the Childhood Immunization Support Program (CISP), which is a program under the AAP and CDC, gives the following statistics “Between 1951-1954, an average 16,316 paralytic Polio cases reported; 1,879 deaths.” It also states “Polio caused by wild-type viruses eliminated from the Western Hemisphere in 1991.” This seems to be extremely impressive. However, the following information should also be made known (http://www.vaclib.org/basic/Neil_Z_Miller_Peer-Reviewed_Study.pdf):
- From 1923 to 1953, before Salk’s Polio vaccine was introduced, the Polio death rate in the U.S. had already declined on its own by 47%, presumably from the overall improvements in the living conditions of the general population as previously mentioned.
- The standards for defining Polio were changed when the Polio vaccine was introduced. With the old definition, a person only had to exhibit paralytic symptoms for 24 hours to be declared a Polio patient. With the new definition, for a person to be declared a Polio patient, he/she has to exhibit paralytic symptoms for at least 60 days and residual paralysis had to be confirmed twice by laboratory tests during the course of the disease. Furthermore, prior to 1955, Polio, Aseptic Meningitis, and Coxsackle virus infections were recorded as Polio, but after 1955, Polio, Aseptic Meningitis, and Coxsacle virus infections are recorded as separate diseases. With the above changes of definition, the number of Polio cases would definitely decrease even if nothing else has changed.
- Salk’s injectable Polio vaccine was actually introduced twice. The first time was in 1954. However, shortly thereafter hundreds of people contracted Polio from Salk’s vaccine, and many died. The Salk vaccine used “killed” (or “inactivated”) viral matter to trigger an antibody response hopefully without causing the disease. Apparently, the “killed-virus” in the vaccine used in 1954 was not completely inactivated. Salk redeveloped the vaccine, and introduced the new vaccine in 1955.
Shortly after Sabin’s oral Polio vaccine (which uses a weakened form of a live virus instead of Salk’s “killed” virus) was introduced in 1962, it quickly replaced Salk’s Polio vaccine because it was cheaper to make, easier to take, and appeared to provide greater protection. However, it cannot be given to people with compromised immune systems, and it is capable of causing Polio in some recipients of the vaccine, and in individuals with compromised immune systems who come into close contact with recently vaccinated children. In 1976, Salk testified that Sabin’s live-virus vaccine (used almost exclusively in the U.S. from the early 1960s to 2000) was the “principal if not sole cause” of all reported Polio cases in the U.S. since 1961. Then in 1992, the CDC published an admission that the live-virus vaccine had become the dominant cause of Polio in the U.S. Therefore, in January 2000, CDC updated its recommendation so that only the Salk vaccine should be used, and the Sabin vaccine should only be used in “special circumstances.”
It seems that whether vaccinations have provided such overwhelming benefits with negligible risks as the medical/health establishment would want us to believe may not be such a slam-dunk issue. Although there may be significant benefits, the risks are not necessarily negligible. In particular, perhaps there may be certain susceptible groups who may have a higher probability of having adverse reactions to any particular vaccine. Furthermore, when taking into consideration the large number of required vaccinations and often multiple simultaneous vaccinations, one wonders what the risks are when all these foreign and potentially toxic substances are introduced into the bodies of small children.
Health Risks from Vaccines: The underlying basis of how a vaccine for a particular disease works is to introduce (or inoculate) a weak form of the cause of that disease into the person’s body triggering the generation of antibodies that can prevent that person from getting that disease. What is inoculated into the body could be a dead or weakened live virus or bacterium, or a subunit of that dead or weakened live virus or bacterium, or other material. Furthermore, in order to prevent the vaccine from bacterial and fungal contamination, preservatives such as a mercury preservative called thimerosal (also spelled as thiomersal) and formaldehyde are added to various vaccines. Vaccines began using thimerosal starting in the 1930s.
Vaccines may damage children in several ways. Live or weakened virus vaccines can actually produce the infection that the vaccine is supposed to prevent. For example, live Polio, as in the Sabin Polio vaccine, should never be administered to a child who comes in contact with an HIV patient, for the weakened virus can “leap” to the HIV patient and produce Polio. Reports exist of normal parents who have developed Polio from the viral vaccine given to their children.
A second mechanism of damage comes from neurotoxic materials often found in vaccines. Thimerosal is the most widely discussed, since it contains mercury, which could be extremely toxic to the neuro-system of even adults. The amount of mercury varies with the particular vaccine. Even when the amount may appear not be large, there could still be significant risks. For example, a vaccine may contain about 17 micrograms (mcg) of mercury, which is an amount found in a 6 oz. can of tuna fish. However, two cans of tuna fish a week already push a 130-pound woman over the EPA’s safe level, and half a can of tuna fish a week could push a 4- or 5-year old child over the safe level. When you consider that the vaccine mercury dosage goes into the child with one application, and not spread over a week, even one vaccine may already not be safe. Furthermore, children often take multiple vaccines during the same visit to the doctor. For example, at 4 months and 6 months, they could get respectively 50 mcg and 62.5 mcg of mercury from the multiple vaccinations during one office visit, which is several times above the safe limit! In addition, if the nurse giving the injection did not shake the vial according to directions before drawing out the vaccine dose, there is a chance that the child receiving the last dose from the vial could get as much as 10 times the usual amount in one dose! With increasing public pressure, the CDC and AAP finally in 1999 asked vaccine manufacturers to remove thimerosal from vaccines as soon as possible. Although thimerosal has been phased out in some vaccines, many vaccines still contain thimerosal, including the flu vaccine which is one of the four newly added required vaccinations in NJ for children between six months and five years old who want to attend a licensed daycare or pre-school.
The third, and probably the most important mechanism of vaccine damage, is allergic reactions and the development of an auto-immune response, stimulated by the vaccine and its adjuvant (a subsidiary ingredient in a medicine that acts as an assistant). Vaccines always contain adjuvants (e.g., aluminum), which are substances known to amplify the body’s response to the vaccine. These adjuvants are known to sometimes cause allergic and auto-immune responses on their own. It is important to note that different people may have different degrees of such allergic reactions.
Although vaccines with their toxin substances may not result in adverse reactions in most patients, there could be a subgroup of patients who for one reason or another may be more susceptible to reacting negatively to the vaccines. Often the adverse reaction may lead to life-long serious health problems, or even death. This is one of the reasons why parents should be given the option to decide whether or not their children should be vaccinated, at least for those vaccines where such susceptible group analysis has not been thoroughly performed.
Existence of Comprehensive and Conflict-of-Interest-Free Review Bodies: If there are significant risks to vaccines, how did these vaccines get approval from government review/approval organizations like the CDC? Why did it take so many years before CDC asked the vaccine manufacturers not to include thimerosal in their vaccines? Why don’t federal oversight bodies such as the CDC and the U.S. Food and Drug Administration (FDA) require more comprehensive research before approving a vaccine? Why has there been so little research on susceptibility groups for vaccines? Why do organizations like the AAP and CDC strongly recommend such a large number of vaccines?
One reason is money. The pharmaceutical industry is a very rich and influential industry. It has a lot of lobbyists, funds a lot of research projects, contributes a lot of money to organizations like the AAP, and is able to place many of their advocates on relevant organizations and committees that make decisions or provide guidelines on vaccination. The pharmaceutical industry doesn’t want to rock the boat that generates billions of dollars of income every year. Here are several reports of this relationship and potential conflicts of interest.
- Katie Couric of CBS on 7/25/08 aired a 4-minute segment on such conflict of interest: http://www.youtube.com/watch?v=_WsUTjtnApQ&feature=related. It questioned just how independent are the experts who are backing the government’s vaccination schedule. It seems that many of these experts and the AAP have strong financial ties to the pharmaceutical industry whose products they promote and defend.
- Dr. Bernadine Healy, the former Director of the National Institutes of Health and the most well-known medical voice yet to break with her colleagues on the vaccine-autism question, says the government (including the FDA and CDC) doesn’t want to pursue—and has intentionally avoided—studies that might support the hypothesis that there is a causal link between vaccines and autism because that hypothesis could be “damaging to the public health community” by scaring people to not get their children vaccinated and the fear of what such studies might show. She blasts the Institute of Medicine’s report the government used to insist there is no link between thimerosal and autism and to deny that there may be causality between vaccines and autism. She advocates that more comprehensive research should be done on identifying susceptibility groups for various vaccines.
- In her testimony before the Committee on Oversight and Government Reform of the U.S. House of Representatives on 7/18/2000, Dr. Stephanie Cave, who treats hundreds of autistic children, said “It is rare that we find any child with a developmental problem who does not have increased levels of mercury in the urine. … It is imperative that we stop giving heavy metals to children through vaccines when their bodies can least handle such an insult.”
Another reason is just lack of training on the vaccination issue for medical students and doctors. For example, Dr. Deborah Ginsburg, a family practice physician in NJ, who graduated in 1992 from the UCLA Medical School (which is one of the top medical schools in the U.S.), said that while in medical school their only training on the issue of vaccines was that vaccines are safe and their job is to make sure that their patients should follow the vaccination schedule. The end result is that most doctors just follow the recommendations of the AAP, even though the AAP may be heavily influenced by the pharmaceutical industry.
A clear example of the influence of the pharmaceutical industry is that as part of the Homeland Security Bill (H.R. 5710) that was passed by Congress in 2002, the bill contains a provision that shields the pharmaceutical industry from lawsuits for injuries caused by FDA-approved vaccines, such as mercury containing pediatric vaccines possibly associated with the development of autism in many children. Although lawsuits for damages from vaccine injuries are still allowed, any compensation given to the plaintiff comes not from the vaccine manufacturer, but from a federal government fund that is funded by tax dollars! This is such a contrast to other situations, such as with lawsuits against the tobacco industry. If the pharmaceutical industry claims that vaccines are extremely safe, then why isn’t it willing to stand up in court to prove its innocence and take the consequence?
In November 2007, the federal government conceded a vaccine-autism lawsuit in the Court of Federal Claims, where the plaintiff claimed that mercury-containing vaccines were the cause of her autism. The damage compensation (not published) will not be provided by the vaccine manufacturer, but from our tax dollars. There are almost 5,000 other such cases pending in Federal “Vaccine Court.”
Exemptions from Vaccinations: In almost every state, religious and medical exemptions to mandated vaccinations are provided, although the exact nature of the exemptions could vary from state to state. However, as discussed below, the current exemption process is far from sufficient.
In NJ, one can request a religious exemption by showing how the administration of immunizing agents conflicts with the person’s exercise of bona fide religious tenets or practices. General philosophical or moral objection to immunization is not sufficient for an exemption on religious grounds.
In NJ, one can request a medical exemption by submitting a written statement from a physician indicating that an immunization is medically contraindicated for a specific period of time for that person and the reason(s) for the medical contraindication, based upon valid medical reasons as enumerated by the Advisory Committee on Immunization Practices (ACIP) of the United States Public Health Service or the AAP guidelines. However, in practice it may not be easy to get a medical exemption. According to NJ Assemblywoman Charlotte Vandervalk: “The medical exemption is worthless. I have seen first-hand how a doctor’s letter explaining the medical risk to a particular child was overruled by the Board of Health.”
Because of the difficulty and arbitrariness of obtaining a medical exemption, Assemblywoman Vandervalk has recently introduced a “Conscientious Belief Exemption” bill (No. 260) to the 213th Legislature of NJ (http://www.njvaccinationchoice.org/A260.pdf). This bill would allow a person to request an exemption to an immunization on the grounds of a sincerely held or moral objection to the immunization. It would make it significantly easier to obtain an exemption.
Summary: Vaccines have helped to reduce the amount of infectious diseases, although overall improvements in the living conditions of the general population have also helped to reduce these infectious diseases. However, vaccines also introduce risks, with perhaps significant and dangerous risks for certain susceptible groups. The number of mandated vaccines has more than tripled during the last 30-40 years, while during this same period, the number of chronically ill and disabled children has also increased dramatically. According to the National Vaccine Information Center, today 1 child in 6 is learning disabled, 1 child in 9 has asthma, 1 child in 150 develops autism (in NJ, 1 boy in 60 develops autism), and 1 child in 450 becomes diabetic. Each of these current numbers is significantly higher than the corresponding number 30-40 years ago.
It seems clear that we must have a more comprehensive research and analysis of the benefits/risks tradeoff of vaccines. Such research and analysis and the resulting setting of government policies and guidelines should be performed by people who do not have a conflict of interest. The research and analysis should not be confined to average statistics for the population as a whole, but also trying to identify potentially susceptible groups who are more prone to adverse reactions from the vaccines. We must not adopt the attitude of one size fits all. We must allow people or their parents to make the decision whether they should be vaccinated for a particular vaccine if they belong to a susceptible group for that vaccine, or if conflict-of-interest-free comprehensive research and analysis has not been performed on the benefits/risks tradeoff for that particular vaccine. We must hold vaccine manufacturers accountable for any damage arising from the use of their vaccines.
Because the vaccination issue impacts the health and lives of our children and grandchildren, which are our most precious possession, it should be an issue of highest importance. It is important to keep in mind that most of the people in the pro vaccination-choice camp are not necessarily against vaccines in general, but they do object to the government mandating them to give a large number of vaccinations to their children when some of those vaccinations could result in serious health problems or even deaths for their children. When enough research and analysis have been done in a comprehensive and unbiased method, including on the cumulative effects of multiple vaccinations simultaneously or over a short period of time, then perhaps we can come up with a solution which can reconcile the positions of the two camps mentioned at the beginning of this article.
 I want to thank Louise Kuo Habakus for first pointing out to me the importance of this issue.