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The Vaccine “Debate” – Godzilla vs. Bambi

May 3, 2010

Wow.  This one always makes me shake my head and makes me sad.

I recently watched a PBS special on the recent debate being fought in the press over the possible link of childhood vaccines with Autism (or other side effects).

As always, I will give you the objective scientific information on this debate, although it can be easily summarized as follows:

Vaccinate Your Children.

Follow the recommendations of the CDC until such time that you feel your personal knowledge of medical immunology and epidemiology is superior to theirs.

Is there controversy about these two statements?  I’m glad I asked!

Let’s go over the general information first, then I will talk about each vaccine separately.

Back in 1997, there was a small study (since discredited for poor scientific method) in the medical journal Lancet.  In this study, the investigator believed he had found a connection between childhood autism and the MMR vaccine which is given at 12-15 months of age.  This study caused a worldwide panic, and a severe drop in the immunization rates for this vaccine which prevents Measles, Mumps and Rubella.  Multiple large double-blind and placebo controlled studies followed which could show no such connection with this vaccine.  Furthermore, the country of Norway proved to be a monumental source of excellent science.  You see, they keep track of every single vaccine, from every single vaccine lot, given to every single child in the country.  They also keep track of every single side effect from every single inoculation, no matter how small or incidental.  Scientists looked at these records between the years 1991 and 1998, and could not find a single shred of evidence to support the connection between autism and vaccines of any kind, including the MMR vaccine.

The very vocal minority who opposed vaccines then cried out that it was the preservative in the vaccine that was the culprit, and not the vaccine itself.  For many years, childhood vaccines sometimes used a preservative called Thimerosal, which contained small amounts of mercury.  They felt that this systematic “mercury poisoning” was to blame for the autism their children were suffering from.  Studies were then performed to determine if this could possible be the case.  These studies were done even though these children did not have any of the signs of mercury poisoning.  They had autism, but no other signs of mercury intoxication.  These added studies on Thimerosal also were negative for any connection with autism.  Thimerosal has since been taken out of most vaccines.

This same vocal minority took their case to “Vaccine Court”.  You see, there is a large fund of money that is set aside from the profits generated by drug companies who make these vaccines.  This fund is used to compensate children who get a true vaccine-related injury.  The doctors and scientists who make such rulings determined that the children with autism could not blame the vaccines for their syndrome, as no proof of any kind had any scientific validity.

So why the outcry?  And why has this Autism Controversy continued?  It continues because this small minority of people against vaccines is very vocal, and they have celebrity spokespeople  in one Jenny McCarthy and one Jim Carrey.   Now, I loves me some Jenny McCarthy and Jim Carrey on the big screen.  They are both extraordinary talents.  They are also obviously not motivated by money, as both could live handsomely for the rest of their lives without earning another red cent.  Unfortunately, Jenny McCarthy has a son who was diagnosed with Autism soon after receiving his MMR vaccine.  Jenny obviously feels she is in “the right” on this issue and is trying to prevent further injury to future children.  When the data first came out in 1997, I would have been on her side, demanding further studies and urging caution about vaccines until further studies could be done to either confirm or deny the original small study.  However, these studies have been done.  And Re-done.  Then analyzed. Then re-analyzed.  Prospective studies.  Retrospective Studies.  Literature Review Studies.  Backwards.  Forwards.  The medical community tends to be very careful about medical treatment of children.

The studies have now been done, and find no link whatsoever with Autism.

At this point, we should move along.  Further celebrity outcries against vaccines can only do real harm to children who might go unvaccinated due to fear.

There is another reason why the controversy continues.  Most people of our generation have never seen the illnesses which these vaccines protect us from, so they assume they are no longer a threat.  They then, logically to them, make the inference that if there is no threat from the illness, then any threat from the vaccine exceeds the benefit from it.  Of course, the problem with this logic is that these illnesses do still exist.  We eradicated smallpox, and stopped vaccinating against it as soon as we did so!  If we had eradicated any of these illnesses, we would stop vaccinating against them as well.  We thought we had polio eradicated for a short while, but this whole “Vaccine Controversy” has made that impossible.  These illnesses still exist.  You can still get polio, measles, mumps, rubella, diptheria, whooping cough and tetanus.  These illnesses kill small children.  I have personally witnessed a small infant die of Whooping Cough because of failure to immunize.  Just because these illnesses are not seen does not mean they are not a threat.

Let’s talk a little about vaccines and how they work, because there is more to vaccinating your child than prevention of disease to your child.

Vaccinating your child not only prevents disease to your child but also prevents disease to other children, including children who cannot be vaccinated safely due to allergy to the vaccine, dysfunctional immune systems or other medical issues with the vaccine.

We call this immunity passed on to other children in the population, “Herd Immunity”. It is based on the fact that if 99/100 children are immune to an illness, it will be very hard for the 1 unimmunized child to get the illness since no one around him can contract it and pass it to him.  As fewer and fewer children are immunized, this herd immunity wanes and we see outbreaks of the illness.  When fewer than 80% of a population is immunized, we begin to see a collapse of Herd Immunity, and major outbreaks of devastating illness.  We have seen this occur in many areas of the country.  There was even a Whooping Cough outbreak in my own city of Northbrook/Glenview, here in illinois, where several hundred high school students became ill.  It did not lead to any deaths, thankfully, since Whooping Cough is not lethal to adults.  It could have been devastating if the local population of infants had not been properly immunized.  They were, and this saved countless infants from severe illness.  When a parent makes the decision to not vaccinate their child, they are not only putting their own child at risk, they are also putting their neighbor’s children at risk.  There have even been lawsuits against families that conferred these illnesses to other children due to failure to vaccinate.

So, why is it that so many children seemed to be diagnosed with Autism right after an immunization?  Well, the simple fact is this.  Children get vaccines at all of the following ages:  2 weeks, 2 months, 4 months, 6 months, 12 months, 15 months and 18 months.  As you can see, since we are given immunizations so frequently, it might often seem “coincidental” with a vaccine.  “My child got the DPT vaccine and 2 weeks later was diagnosed with autism!”.  As you can see, about 14 weeks of the first 70 weeks of life are spent within 2 weeks of a shot!  1 in 5 diagnoses of Autism would occur in that time frame merely by chance alone!  Second, it just so happens that pediatricians begin to see behavioral changes that are linked with autism right around 12-18 months.  This is when we begin to see children fail to reach usual developmental milestones, and begin to test kids for developmental delay.  Those with Autism will likely be diagnosed soon thereafter.  Guess what?  We give the MMR at 12 or 15 months of age.  It’s a temporal coincidence.  Just because something occurs at the same time does not mean that it is to blame.  The rooster crows when the sun rises, but I’m pretty sure that the crowing isn’t what caused the sun to rise!  Same goes for vaccines; they just happen to be given right around the time an astute pediatrician will begin to notice the behaviors consistent with Autism.

Ok.  So we need to vaccinate our children.  There seems to be absolutely no substance to any argument against vaccination.  Vaccination is the #1 cause of improved lifespan in the world.  Vaccination has done more to improve infant mortality, improve human lifespan, and reduce human disease, than any other medical advancement.  Ever.

So, do we really need to vaccinate against ALL those illnesses?  Let’s talk about them separately for a moment, because there is some possible controversy about a couple of them, or at least their timing.

All of the following immunizations are Medical Slam-Dunks.  They should be done, on time, in all children who can safely be vaccinated.  There is no reasonable argument against them.  They save lives and terrible illness, and protect the whole population from these illnesses: DPT (Diphtheria, Pertussis, Tetanus), MMR (Measles, Mumps, Rubella), HIB (Hemophilus Influenza B which can cause a form of meningitis and a lethal form of epiglottitis), IPV (inactivated Polio).  Get them now.  Get them like they were going out of style.

The following vaccines have all been proven to save lives, and in some cases, save the world/parents a lot of money:  Varicella Zoster (Chickenpox), RotaVirus (Rotavirus, a terrible form of highly contagious diarrhea that leads to millions of infant hospitalizations).  These two illnesses do not typically cause lethal illness in this country (although Rotavirus is a major killer in 3rd world countries), but a single case of chickenpox can cause illness in another child (it is very contagious) who might have a poor immune system and possible die of the Chickenpox (I’ve seen one case of Varicella Encephalitis, which was lethal, although it was in an adult).  A single case of chickenpox can also lead to a parent not being able to work for 10-14 days until the child recovers, leading to major monetary losses.  There is some controversy about the Varicella vaccine only because we don’t know how long it will confer protection.  We may need to give booster shots every 10 years, or instead of having children getting chickenpox (which confers lifelong immunity against getting it again), we now have adults getting chickenpox (which is far far more serious and deadly in an adult!).  Controversial…perhaps a little.  Again, the CDC knows more about medical epidemiology and immunology than I ever will, so as long as they recommend universal immunization, I am going to take their advice.

The following vaccine is a wonderful vaccine, but it has demanded some attention because of when we give it.  The Hepatitis B vaccine protects against a strain of hepatitis that can lead to liver failure and death.  So why is it controversial?  Because Hepatitis B is mostly a sexually transmitted disease.  It is a blood born illness, just like HIV.  It is passed through sexual contact, shared needles and blood transfusions.  It is 4000 times more contagious than HIV though.  So why do we immunize children against an illness that is mostly confined to adults?  Well, firstly, notice the word MOSTLY.  Children do sometimes get blood transfusions.  Also, children are a “captive audience”.  They are getting vaccines all the time as it is, so giving another one in the same schedule assures that everyone will be vaccinated against it.  It’s funny, but when we wait until adulthood to vaccinate, the number of people who actually get vaccinated declines dramatically!  Adults just can’t be trusted to get good medical care, but it would appear that children are much more likely to be available for the vaccination.

Please listen to the experts.  As bright, talented and personable as Jenny McCarthy might be, she is just fighting a battle based out of emotion, and not science.  It is sad, of course, that her child is afflicted with Autism, and I’m sure she feels the appropriate need to know WHY, or to blame someone other than bad luck. The ballots are in, though, and vaccines are not the culprit.

Maybe medical science will find out what the culprit is, but for now, I think vaccines need to be declared innocent in the court of public and medical opinion.

Get vaccinated and get your children vaccinated!

The following link nicely illustrates the battle between Science (Godzilla) and Bambi (The Anti-Vaccine Folks).

Good Health!

Dr Mike

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7 Comments
  1. I have a child with Autism, Aspergers Syndrome specifically. I’m with the camp that believes that the link between Autism and vaccinations is a lot of crap. Maybe it is because I have a healthcare background, and think scientifically. I see many of the same markers of autism in her father which leads me to believe that my daughter’s autism is genetic. He was adopted so it is hard to really know if that’s true, but I sure would rather vaccinate my daughter against the spread of diseases which she is much more likely to develop without them.than she is to develop autism from them. Great article!

  2. Stephanie Bowker permalink

    Excellent post. I agree in all particulars*. One question though–I thought that in addition to the points you raise about it, Hepatitis B could also be spread by fecal contamination, and, because kids aren’t always great with their personal hygiene, there’s a real risk of transmission in day-care and nursery school settings.

    *Except, of course, that I disagree about Jenny McCarthy having any actual talent:)

  3. Hepatitis A is transmitted by fecal contamination.
    Hep B and C are only blood born, like HIV.

  4. ” Unfortunately, Jenny McCarthy has a son who was diagnosed with Autism soon after receiving his MMR vaccine. ”

    the thing is, we don’t know this. Her son was diagnosed at age 2 1/2. She hasn’t said said when he got the MMR but if it was on schedule he was 12 months old.

    She was asked to clarify this in her Frontline interview, but she dodged the question.

  5. bamm hartman permalink

    Okay, so I’m an adult with awesome health insurance. It’s probably reasonable to expect that my parents didn’t vaccinate me against Hep B, is it reasonable to expect there are other vaccines I did not receive? And what might those be? (It’s also reasonable to expect there’s no real way to know for certain what vaccines I did or did not get since I don’t remember who my doctor would have been back in those days.)

    And, how do I approach my doctor to get said vaccines? Is it just a, “hey, I’ve never been vaccinated against these terrible things and I think maybe that getting vaccinated is the new grunge?”

    Also, I participated in an HPV vaccination study a while back and heard there’s a spiffy new vaccine out there. Since I have no way of knowing if I received the vaccine or placebo during the study (or which vaccine was even being tested at the time), would I be at any risk if I asked my doctor for the vaccine now?

  6. Hep B, Hep A, HPV and HIB are all vaccinated now and you were probably not vaccinated against them.

    HepB is a 3 shot series, and is worth getting.
    HepA – probably only imperative if you are traveling to an endemic region.
    HPV – only approved for “young” women at the moment, but new studies are being done for older women and men. Your doctor might give it to you, “off label”.
    HIB – Hemophilus Influenza B – a bacteria that causes horrific disease in young children (Epiglottis and Meningitis). You probably do not need this, as the diseases do not strike adults, and “herd” immunity is probably protecting you. I have not seen a case of HIB disease since residency because of the vaccine.

    The chickenpox vaccine is also given but you probably got chickenpox itself as kid!

  7. I spent many year working with individuals with autism before I began medical school and this vaccine myth has been one of my biggest pet peeves for years. You state the facts very elegantly.

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