Evolution of Vaccination Policy

As a practicing primary care physician for the last 43 years [as of 2014], and as a parent since 1981, I have followed the evolution of vaccination policy and science with interest, and not a little dismay.

The number of vaccines given to children has increased significantly over the last 70 years, from four antigens in about five or six injections in 1949 to as many as 71 vaccine antigens in 53 injections by age 18 today (the number varies slightly from state to state). This includes four vaccines given in two shots to pregnant women (and thus the developing fetus) and 48 vaccine antigens given in 34 injections from birth to age six.

Each vaccine preparation, in addition to the antigen or live virus, contains many other substances, including preservatives (mercury, formaldehyde), adjuvants to hyperstimulate the immune response (aluminum), gelatin, aborted fetal DNA, viral DNA, genetically modified DNA, antibiotics, and so on. We know that the young child's nervous and immune systems are actively developing and uniquely vulnerable, but I wonder how many thinking adults would themselves voluntarily submit to such an invasive drug regimen?

In 1986 the National Vaccine Injury Act was passed, prohibiting individuals who feel they have been harmed by a vaccine from taking vaccine manufacturers, health agencies, or health care workers to court. At the time, vaccine producers were threatening to curtail or discontinue production because of the mounting number of lawsuits claiming injury to children, mostly relating to immunization against diphtheria. Once relieved of all liability, pharmaceutical corporations began rapidly increasing the number of vaccinations brought to market.

Pharmaceutical companies are now actively targeting both adolescents and adults for cradle-to-grave vaccination against shingles, pneumonia, human papilloma virus, influenza, whooping cough, and meningitis. There are many more vaccines in the pipeline. Who wouldn't love a business model with a captive market, no liability concerns, free advertising and promotion by government agencies, and a free enforcement mechanism from local schools? It is, truly, a drug company's dream come true. [continued in part 2]

Evolution of Vaccination Policy (part 2)

Judging from what one reads and hears in the popular media, it is easy to conclude that the science is settled, that the benefits of each vaccine clearly outweigh the risks, and that vaccinations have played the critical role in the decline of deaths due to infectious diseases such as measles, whooping cough, and diphtheria, all of which claimed many lives in the past.

However even a cursory look at the available data quickly reveals that the mortality from almost all infectious disease was in steep decline well before the introduction of vaccination or antibiotics. Diphtheria mortality had fallen 60 percent by the time vaccination was introduced in the 1920s, deaths from pertussis/whooping cough had declined by 98 percent before vaccination was introduced in the late 1940s, measles mortality had dropped 98 percent from its peak in the U.S. by the time measles inoculation was introduced in 1963-and by an impressive 99.96 percent in England when measles vaccination was introduced in 1968. In 1960 there were 380 deaths from measles among a U.S. population of 180,671,000, a rate of 0.24 deaths per 100,000.

The takeaway here is that vaccination played a very minor role in the steep decline in mortality due to infectious disease during the late 19th century and early to mid- 20th century. Improved living standards, better nutrition, sanitary sewage disposal, clean water, and less crowded living conditions all played crucial roles.

Current immunization policy relies on the oft-repeated assertion that vaccines are safe and effective. Yet the Centers for Disease Control and Prevention, the Institute of Medicine, and even the American Academy of Pediatrics have acknowledged that serious reactions, including seizures, progressive encephalopathy, and death, can and do occur. The federal vaccine injury court, which was established at the same time that vaccine manufacturers were exempted from liability, has to date paid $2.6 billion dollars in compensation for vaccine injuries. And there is ample reason to believe that the incidence of vaccine injury is strongly underreported.

[continued in part 3]

Evolution of Vaccination Policy (part 3)

A close examination of data regarding the recent pertussis outbreaks may help illustrate the complexity inherent in immune function, individual susceptibility, and the spread of infectious illness.

In 2011, there were numerous outbreaks of pertussis around the United States, notably in California, Washington, and Vermont. The majority of whooping cough infections in each state were reported among well-vaccinated adolescents and young teens. There was also a slight increase in cases among infants younger than 1 year old.

In Vermont, 74 percent of individuals diagnosed with whooping cough had been "fully and appropriately vaccinated" against pertussis. Vermont Deputy Commissioner of Health Tracy Dolan stated: "We do not have any official explanation for the outbreak and have not linked it to the philosophical exemption." In a July 2012 interview, Ann Schuchat of the Centers for Disease Control's National Center for Immunization and Respiratory Disease stated that: "We know there are places around the country where large numbers of people are not vaccinated [against pertussis]. However, we do not think those exemptors are driving this current wave. We think it is a bad thing that people aren't getting vaccinated or exempting, but we cannot blame this wave on that phenomenon."

It's clear that the pertussis vaccine is not very protective against a disease that already has a very low mortality, likely because the pertussis bacterium has developed resistance, much like bacteria become resistant to antibiotics over time. In a September 2012 article, The New England Journal of Medicine concluded that "protection against pertussis waned during the 5 years after the 5th dose of DTaP [a type of combination vaccine]."

Recent studies suggest that immunized persons, once exposed to wild Bordetella pertussis bacteria, take longer to clear the pertussis bacterium from their respiratory tract than individuals who have had natural pertussis and thus gain natural immunity. These vaccinated individuals can then become asymptomatic carriers of the bacteria and vectors for transmission.

Vaccine-induced immunity is not the same as naturally acquired immunity, and the much touted "herd immunity" resulting from mass vaccination is a far cry from natural herd immunity, the latter being much more protective, long-lasting, and transferrable to nursing infants who are then protected during their most vulnerable stage of development.

Understanding vaccine effects is complicated. The "fence" or "firewall" as Bailey puts it, is in fact a two-way street. Much has been said about all the "junk science" cited by anyone questioning vaccines (Jenny McCarthy, anyone?), but even a cursory peek over that fence will reveal some very good information and science-Mary Holland's Vaccine Epidemic and Suzanne Humphries' Dissolving Illusions, for example.

Lumping skeptical parents with the crazies is a way to avoid legitimate questions. Such as: Should tetanus vaccination be required for entrance to school, given that tetanus is not a communicable disease? Why should hepatitis B immunization be required for school entrance, when the disease is found primarily among adult drug users and sex workers? Do we need to keep immunizing against diseases, such as chickenpox, that are almost always mild?

There is a considerable difference between giving a seriously ill child a proven life-saving medicine versus subjecting a completely healthy child to a drug that is known to cause severe, or even potentially fatal, adverse effects, however small the chance. This is an ethical issue that goes to the heart of our basic human right to informed consent to any drug treatment or medical intervention.

Given the sheer volume of vaccine promotion and propaganda, coupled with the cozy relationship between government, industry, and media, there are sufficient grounds for a healthy skepticism. Individual parents have become the last line of defense (not offense, not a swinging fist), and their choices should be respected and preserved.

There is No Measles Crisis (part 1)

Feb 24, 2015: While vaccination rates have never been higher, Vermont physicians and politicians are claiming that Vermont has a "disturbing low childhood vaccination rate," stirring fear over measles, painting a perfect picture of vaccines always working and never causing harm, and finally concluding: "The time is now to mandate vaccination."

However, a close examination of the Vermont 2013-2014 school data reveals that vaccination rates in Vermont are actually quite high, not "alarmingly low" as many allege. Our exemption statistics are misleadingly skewed by the number of children enrolled in kindergarten with "provisional" exemptions (i.e., those kindergartners who are not yet caught up with all the required vaccinations on autumn enrollment, but intend to be so within six months). With this in mind, the first grade numbers (96 percent MMR coverage in first grade public schools, rising to 98 percent by 12th grade) are actually more accurate proxies for vaccine coverage in kindergarten. Also, the number of students claiming philosophical exemptions has really not increased so much since the sharp jump from 2.5 percent to 5 percent following addition of chickenpox and hepatitis B to the schedule some years ago. If a child opts out of just a single vaccine they are, misleadingly, lumped into the philosophical exemption statistic with children who decline several or all vaccines.

As a primary care physician who has been practicing in Vermont for 44 years, I am old enough to remember how common measles used to be, and how little fear or alarm was associated with it. While never mentioned in vaccine promotional brochures, mortality in the United States from most childhood infectious diseases had already dropped precipitously (98 percent decline in the case of measles) prior to the use of vaccines. Better nutrition, refrigeration, sanitation, clean water, less crowding, and so on were most decisive, not vaccines. Measles in parts of Africa and other developing countries, or in overcrowded refugee camps, resembles more the difficult living conditions seen in the U.S. in the early 1900s, and is potentially dangerous. The risk/benefit may favor vaccination in those situations, but that is a very long way from Vermont today. Here, measles carries little risk for the average well-nourished child. Over the past decade there have been about 1,500 reported cases of measles in the U.S. (one in Vermont in 2011), zero deaths, but 88+ deaths following MMR vaccination, and over $3 billion awarded by federal court to parents of all vaccine-injured children.

A hundred or so cases of measles in the U.S. does not by any stretch represent a public health crisis, though mainstream media coverage, thriving on sensationalism, would have us think so.

[continued in part 2]

There is No Measles Crisis (part 2)

Cancer centers, such as Johns Hopkins and Sloan-Kettering, warn their immune-compromised patients to avoid any contact with individuals who have recently received any vaccine, like the MMR, containing live virus, because these vaccinated individuals can shed vaccine virus for weeks to months, putting others with compromised immune systems at risk. Measles vaccination may cause "vaccine measles" that is indistinguishable from wild measles. There is at least one reported case of a vaccinated child transmitting vaccine-strain measles to their healthy sibling. Many may recall that it was for this reason that the live Sabin polio vaccine was abandoned in this country in 2000 in favor of Salk's inactivated polio vaccine.

While wild measles confers robust lifelong immunity, some individuals completely fail to respond to the vaccine (2-10 percent primary failure), while immunity in others wanes significantly (secondary vaccine failure), so that measles is increasingly a problem for adults, with many affected who have been fully vaccinated (note: it is now acknowledged by the CDC and our health department that vaccine failure was the driver behind the recent whooping cough outbreak, not unvaccinated children).

Also, because vaccine immunity fails or wanes over time, women vaccinated in childhood often lack sufficient antibodies against measles by the time they reach childbearing age, and as a result cannot pass this crucial protection on to their nursing infants. Ironically, more very young vulnerable infants are now at increased risk for measles as a direct consequence of the vaccination campaign against measles. "Herd immunity" here is a misnomer, better call it "vaccine herd effect." With an ever-growing number of adults in whom vaccine immunity has failed or waned, it is easy to predict that there will be more and larger measles outbreaks in the future, blamed, incorrectly, entirely on the unvaccinated.

Finally, consider the following, not so uncommon, predicament: immediately following a particular vaccination(s), the child has a prolonged fever, a shrill cry, and loses muscle tone, but after a few days or weeks appears to recover. The parent then, rightly, determines not to repeat that vaccine, but is unable to obtain a medical exemption (parents report these are impossible to get because contraindications are increasingly narrow in definition). Lacking support from their doctor, and without access to the philosophical vaccine exemption, what choice remains for such a caring parent or guardian; homeschool, move to another state, jail?

A hundred or so cases of measles in the U.S. does not by any stretch represent a public health crisis, though mainstream media coverage, thriving on sensationalism, would have us think so. And vested interests pushing mandatory vaccination, so willing to ignore the ethics of medical informed consent, appear delighted to take advantage of this.

Over 1/3 of Measles Cases in the  USA are from the MMR Vaccine

March 2017: Real-Time PCR Rapid Identification of Measles Virus Vaccine Genotype" has determined that more than one out of three cases of measles in the United States is a reaction from a measles vaccine, not “wild-type” measles.
Journal of Clinical Microbiology: DOI: 10.1128/JCM.01879-16