Oct 292009
 

 

As a family and community medicine doctor using evidence-based medicine, I am a firm believer in vaccines. They have saved tens of millions of people, mostly children, from debility and death from once-common scourges such as polio, smallpox, rubella, measles and many others. And there is still a long way to go; just here in China are 30 million people with chronic hepatitis B virus. This causes long-term issues with liver cirrhosis and cancer, and millions of Chinese will needlessly suffer and die because of a lack of the vaccine.

And yet many countries are now encountering a rising wave of anti-vaccine sentiment which threatens to turn back the clock 100 years. Already, we are seeing a resurgence in some anti-vaccine neighborhoods of previously defeated diseases such as h. flu meningitis, pertussis and measles. And already, children are dying needlessly in those areas. Why is this happening? Why are parents choosing not to vaccinate given the overwhelming scientific evidence and medical consensus that vaccines’ benefits far outweigh the risks?

This is a big and complicated issue, and Wired magazine does an outstanding job in their new issue with a series of articles called An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All. It’s a terrific review of the series of events that led to this moment, and I encourage all to read it. They also have a good follow up piece, how to win an argument about vaccines. Here’s just one snippet of many sobering facts:

Before smallpox was eradicated with a vaccine, it killed an estimated 500 million people. And just 60 years ago, polio paralyzed 16,000 Americans every year, while rubella caused birth defects and mental retardation in as many as 20,000 newborns. Measles infected 4 million children, killing 3,000 annually, and a bacterium called Haemophilus influenzae type b caused Hib meningitis in more than 15,000 children, leaving many with permanent brain damage. Infant mortality and abbreviated life spans — now regarded as a third world problem — were a first world reality.

  7 Responses to “Why Such An Epidemic of Vaccine Fear?”

  1. Well, might it be because doctors, the medical system itself and medicines (death as an effect of the medicines themselves, not errors) are a leading cause of death in the U.S. , killing roughly 225,000 people a year?

    (The term is iatrogenic death).

    And presumably even even more disabling and chronic conditions have been caused by modern medicine- though this has not been studied to my knowledge.

    These statistics are from the Lancet study below.

    Dead yearly are:

    12,000- unnecessary surgery
    7,000- medication errors in hospitals
    20,000 — other errors in hospitals
    80,000 — infections in hospitals
    106,000- Non error, negative effects of drugs

    These total to 225,000 deaths per year from iatrogenic causes.

    I do not think these statistics even factor in the confirmed yearly deaths from cancer produced as a direct result of diagnostic radiation. This was a study specifically looking at children’s radiation exposures and calculating the actual deaths from their radiation exposures (some 1.5 million diagnostic radiation procedures yearly in the U.S. pediatric population- out of this year’s exposures, over 2,000 will die in their lifetime FROM THAT PARTICULAR exposure). But I don’t have that study onhand, can look it up later. I wrote about it some 3-4 years ago and wrote a heated letter to the BJU team (I since was told that they upgraded their patient informed consent for pediatric CTs although the Xray I know from personal experience with my kids has not changed).

    Anyway I digress, the iatrogenic death figures from above are written plainly here

    http://articles.mercola.com/sites/articles/archive/2000/07/30/doctors-death-part-one.aspx

    but originate from a Lancet study:
    http://www.ncbi.nlm.nih.gov/pubmed/10904513?dopt=Abstract,

    This study was a followup to the Institute of Medicine report on Iatrogenic Death from the prior year.

    With reports like this, I think it is critical for every single mother, father, patient…every person, to research for himself and investigate very carefully each and every health, birth, and medical recommendation they are given and come to their own conclusions.

  2. As a regular reader of several BJ blogs I had the pleasure to read quite some texts by Liora. I am not a doctor or anyhow trained medically, I am just a father of a healthy, happy, vaccinated baby boy born and being raised in our lovely foggy Beijing. As a keen reader of blogs of many kinds, I know there are quite some people out there with different views, sources, backgrounds etc, and I try to respect them and try not to throw my laptop out of the window when I read nonsense, schizophrenic conspirancy theories. Most of the time I laugh about it and after 10 minutes and some coffee I just forget about it. As said, in the last few months I had the pleasure to read a lot of stuff written by Liora and I tried to forget about it, I put it into the conspirancy department and thought, some bored expat housewife is fighting some Don Qichotte-like campaign against vaccines, whatever. But today it is enough. I have to reply. And sorry Dr. Saint Cyr that it is happening in your blog, but I can’t stop myself. Liora, I dont know much about you, your background, experience, education etc. but you are totally insane (sorry to say so). What on earth does the article posted by Dr. Saint Cyr have to do with the stuff you are posting??? ABSOLUTELY NOTHING.
    You don’t like vaccines, you think all doctors try to kill you and your kids by vaccines, x-rays or some evil stare. What do you want? Voodoo, bloodletting, or some other ancient practice??
    Maybe you are afraid of the world, maybe you had some experience in the past which makes you think medicine is evil, I don’t know and actually I don’t care. Just leave us alone with your nonsense, do something useful with your time, don’t make people crazy with your destructive writing. If you do not go to a doctor or vaccinate yourself and your children, it’s fine, but just stop pestering the rest of us, this is even worse than medieval missionaries trying to convert everybody into Christians.
    Don’t get me wrong here, I don’t want to shut anybody up, its just that this person is spreading this stuff everywhere and at a certain point people snap. Have a good day.

  3. Thank you, thank you, thank you for your own statements in this matter and even more for the links to Wired magazine, especially the ‘How to win an Argument”-list!

    The problem of course being that the “anti-immunization crowd” (Wired) will only take evidence against vaccines as evidence. They will tell us not to listen to the (evil, bought out) mass media so easily – but expect us to believe media that likes to call itself “independent”, with trust-envoking names like conspiracy dot com or something. Statistics will not be trusted, unless it’s statistics for their cause. And so on…

    And over-all, not only from reading the article on Wired but from personal experience, I can only deduct that probably people who are against vaccines tend to be generally more inclined towards insanity than your general population – which makes arguing all the more difficult and explains why they are so much more “visible”, f.e. in blogs.

  4. Aroil, I don’t think it’s polite to call anyone “insane”, so I hope we can keep a more civil tone, thanks. But, in general, of course I do agree with you and with Kate’s basic premise, that I feel there is overwhelming evidence over the last 100 years that vaccines have done far, far more benefits than harm. And yes, there are issues with iatrogenic (ie, doctor-caused) deaths, but again I think it’s fairly clear that, while maybe there are tens of thousands of iatrogenic deaths per year, certainly there are magnitudes more of prevented deaths and healthier people due to the assistance of doctors. I think doctors should always be vigilant and never arrogant, and always have an open mind. But I am very proud of my profession and what we all do!

  5. Dear Aroil,

    Surely you can see how the question “Why such and Epidemic of Vaccine Fear?” is related to my answer (and I paraphrase)
    “Because we have rightly so, lost faith in medicine.”

    *Some* of what Medicine does on a mass scale HURTS some people, even KILLS some people and patients need to be fully informed of the risks of common medical procedures – ahem, like vaccines, medicines, procedures and diagnostic radiation.

    Maybe you HAVE read a lot about the subject. If so, I can respect your point of view. But this is the way I see it, and this is also what the literature (and Medicine’s own agencies and publications) have been suggesting – especially recently.

    I post here at myhealth in the comments section about many topics, and often have published studies to share, so your disparaging tone with me is very inappropriate and reveals the narrowmindnedness of your biases.

    As for my background, I do perhaps have more contact with hospitals and doctors than most people. I have two special needs kids and a third who is pretty typical.

    When my older daughter was recommended to have a CT scan at age 3.5 because the doctor “could feel her spleen, which is unusual,” do you think they told me that getting a scan would significantly raise her risk of dying early of cancer in her lifetime, provoked by the radiation received that very day? Nooooo.

    By the time I got over to the CT machine with her, I didn’t want to do the test, and gently asked is there another way of getting the information, like an Ultrasound? The tech, like the doctor before (one of the more cautious ones, probably the best in Beijing) and everyone ALL told me not to worry my pretty little head about it, and that this procedure was SAFE and the information would be so so important to have that yes we should go ahead and do it. Well, we did a U/S instead and her spleen was fine.

    So when I see in a newsletter a year later a whole bunch of studies informing me of the the exact rate children given CT scans today will be dying early, well, Hell Yes, I’m angry.

    Angry that the system deprives patients of actual facts and figures, stripping every patient of the fundamental human right to choose our children’s and our own fate- and then acts like those few who bother to dig up package inserts, look up ingredients’ MSDS info, look up stuff in the Merck manual, or who don’t jump right away at their suggestions are troublemakers.

    Angry that every day the Hippocratic Oath “First Do No Harm” is violated and patients don’t even know it. And angry most of all that most people live in such a hypnotic state that they don’t even seem to want to know the rest of the story. Most of us, especially parents, read package labels on food carefully. These same parents, most of them, their faces become like deer in headlights when informed about known toxins in certain medical products and certainly in most vaccines.

    I suppose you’re right in a way. It is unfair to totally blame Doctors on a personal level when so many other things are wrong: the alphabet soup agencies also do far less than the ideal to protect the common citizen over commercial interests for one thing. Have you ever read the story about how Aspartame was finally approved by the FDA for mass consumption after being classified as a nerve toxin previously? It’s because Donald Rumsfeld, who had financial connections to Searle, got it pushed through the approval process even though it breaks down to methanol, and further breaks down into formaldehyde (carcinogenic and very toxic) and formic acid and something called DKP which is a a brain tumor forming agent.

    Also, good hearted doctors may suffer vindictive lawsuits in a cultural climate like we have today where people don’t take any responsibility for their own health but rather defer to “experts” about most everything under the sun. We have been conditioned (for oh about the last 40+ years) that “experts” know best- best about parenting, best about politics, best about medicine, as if only qualified professionals have the right or even the ability to read and digest the literature on any given subject. This mindset creates a blind dependence on authorities. So in this scenario, when something goes wrong the patient rightly blames the doctor. So giving fully informed consent would almost certainly protect doctors as well as patients. Patients who know the actual risks, options, and margins of error on the outset and who are told so are empowered. I urge patients to empower themselves, because busy doctors don’t have the time or ability to do this.

    I would have NO TROUBLE with patients choosing to vaccinate themselves if every doctor sat down with patients, and went over the package insert at the very least (NOT the useless propaganda sheet, the VIS, the package insert). Better yet for that doctor to get titers drawn beforehand, because you do not need to vaccinate at all if wild exposure took place (which it does all the time) or previous vaccines are still active in the system. Even better yet still, if the doctor does even a teeny tiny literature review on his own. Because there’s ample evidence of the occasional “harms” as they call them, and recurring questions about the basics of immune function. There are new questions in relation to the role of metals in the cellular metabolism. There are new questions about the gut being very involved in immune function and brain development. And finally there are many studies that do not shine favorably on vaccine effectiveness. There are many papers about disease epidemics in fully or nearly fully vaccinated populations but somehow the sanctity of vaccines remains unquestioned.

    And to answer some of your other issues. If you have read so much written by me, then surely you ran across the story somewhere of my daughter who was damaged from vaccines.

    That was the start of a huge learning curve for me 6.5 years ago. For the record, I was very, VERY much in favor of vaccines. And fluoride, and aspartame, and mercury fillings, and BPA plastics, and everything else I now know to be harmful. I thought people who were too cautious were wacky. In short, I was pretty mainstream (we were both in favor of breastfeeding and eating sort of healthy.)

    So, against my husband’s hesitations, I dutifully marched baby up there and vaccinated her to the day practically at birth, one month and two months. Then she got sick. Very sick. And my life was forever changed.

    She reacted some but not violently to the Hep B’s and TB (BCG) shots at 24 hours of age (Huashan Hospital/American-Sino OBGYN in Shanghai.) As an aside, now I know her TB shot did not “take” – but I did not know what to look for at the time. She had no mark whatsoever on her arm except the needle prick. No bump, no boil, no open crusty sore indicative of immune response. I also did not know studies show a widely variable (zero to 80%) efficacy rate. Efficacy meaning you can show antibody reaction after vaccination. This is not the same thing as Effectiveness which means real world prevention of disease, which BCG has mostly shown zero effectiveness but appears to protect some against leprosy of all things.

    So anyway she definitely only got the risks from that shot, and zero benefit). She did whimper all night both times, slept just 5 minutes at a time, woke up whimpering all night, that kind of thing). I wondered if it was the garlic I had eaten for supper coming through the breastmilk. Silly me. Turns out that BCG is also not supposed to be given to immunocompromised infants. She reacted similarly (mild sleep disturbances, started projectile vomiting and showing signs of GERD) after her 1 month hep B shot at Worldlink in Shanghai. (They just call it dyspepsia in some package inserts making it sound so benign).

    But at 2 months, she got the DPT shot and oral polio (Fudan Clinic, in Shanghai, May 5, 2006 at age 2 months) she got pufffy. Photos of that time show an ill baby. Her stool changed permanently. Green and slimy/mucousy. She had runny stool with undigested food till she was over FOUR years old. Never had a solid stool till age 4.5 (over a year of biomedical intervention to heal her to that stage).

    She was sick. Sick in her gut, where, if you’re not a doctor and had never read about any of this, well I’ll tell you, polio virus replicates in the gut. It’s passed from person to person by the fecal-oral route typically. You NEVER give a baby with IgA deficiency or immune dysfunction a live virus vaccine, every doctor knows that. YET they don’t bother to test babies for this. And as few as 1 in 300 babies have IgA deficiency. And now the research is coming out the past ten years showing huge correlations from gut function to immune system function and brain function. Her high pitched screaming, sensory disturbances, sleep disturbances (20 minute cycles only in the daytimes, and would wake up screaming) all seem to indicate encephalitis of some sort. Brain swelling can certainly happen as a result of natural infection- and a literature review will tell you it can happen as a result of some vaccines as well. Certainly it is well known as a potential complication of live virus vaccines. And the DPT is well known for its reactivity and rare but documented cases of brain damage.

    Now, she is 7. Dr. Richard can’t say so, and I respect him for this, but he has met my daughter in question. And my son and of course myself. (Not my youngest daughter if memory serves, though).

    The stress of living with a chronically ill child who as a baby and toddler was incredibly hard to parent (due to the shreiking, oversensitivity to sounds, fabrics, noises, you name it, waking up SHREIKING, crying for many long hours every day, for months/years to the point that anytime I thought her name the SCREAMING was inside my head…..

    Well, living with any chronically ill autistic like child does take its toll. But to know that I was disenfranchised, unable to protect her, because I was too stupid to question my blind assumptions, my deep belief in vaccines and the medical system…it’s hard. To wonder if I might’ve been able to prevent this all, that I could have had my whole, sweet, easy and lovely baby like she was born as….well, that does take its toll. I’m not insane. But because of my experiences and independent literature reviews, I do view medicine differently than some people. I’m passionate about what I have learned. I want to see people, parents, patients making fully informed and good decisions for their own health, and taking more responsibility for themselves as well.

  6. Hi, Dr. Richard

    If you have a study or report in regard to your statement

    “Already, we are seeing a resurgence in some anti-vaccine neighborhoods of previously defeated diseases such as h. flu meningitis, pertussis and measles. And already, children are dying needlessly in those areas. ”

    I would really love to see it. Thanks!

    And this http://lib.bioinfo.pl/pmid:19561423 is a really interesting study about pertussis outbreak in a 90% or more Up To Date vaccinated school age population in Canada. They found the main risks of getting pertussis had nothing to do with vaccination status, that the risk factor was “going to school or daycare”/

    So regarding outbreaks, like th pertussis outbreak in California, why is the “take home message” in pieces like the Wired article that more people need to get vaccinated to prevent these things.

    Given the fact that outbreaks can and do happen in fully or very nearly fully vaccinated and revaccinated populations, might the better conclusion be: “Gee it seems the vaccine isn’t very effective” or to align with the study’s conclusions “Keep your older kids home to protect your newborn babies”

    I think people should question everything. Especially the “conclusions” and “fixes” we are fed through media when there are definitely multiple explanations – possibly explanations more aligned with the literature than “everyone needs more vaccinations”. They say right in the study that vaccinated individuals were carrying B. Pertussis, sometimes asymptomatically, sometimes not.

  7. Dear Liora,
    well, one very good reason to still get vaccinations, and especially in light of what you are saying about going or not going to daycare being a factor, is given in the Wired article,
    “illustrated by a 2002 study published in The Journal of Infectious Diseases. Looking at 3,292 cases of measles in the Netherlands, the study found that the risk of contracting the disease was lower if you were completely unvaccinated and living in a highly vaccinated community than if you were completely vaccinated and living in a relatively unvaccinated community. Why? Because vaccines don’t always take. What does that mean? You can’t minimize your individual risk unless your herd, your friends and neighbors, also buy in.”
    So, in fact, even if there are numbers suggesting vaccinations might not be effective (I think their are even more numbers suggesting they are, in fact, effective, but I’m playing along with your argument here…), this might only be true on an individual level, not on a group level. In other (possibly more polemic) words: If you don’t want to protect your own children, maybe you want to protect mine and your neighbors’? Unless of course, you are keeping them at home to protect them. Well, that really doesn’t sound like a good solution to me (or feasable, for that matter).

    And besides, you are not citing the numbers here, but it would be interesting to see what it says in the Canadian study about other risk factors and what the statistical differences were there (f.e., if vaccination status came in second as risk factor or by how much the impact was lower than the daycare factor etc).

    By the way, I was very sorry to read about your personal experiences with this. This sounds like a big burden to carry.
    I do know a little bit about statistics though and about how people tend to explain things. So I just would like to point out this: In their first year, babies are vaccinated about every two months. That means that if they get sick in their first year their is pretty much no chance it wouldn’t be in some temporal proximity to a vaccination. This does not mean their is a causal relation. Co-incidence in the very sense of the word is a very powerful thing. Things keep happening at (roughly) the same time – and we tend to see them in some connection because of it, but sometimes there just is none. This is why we need many cases and statistics to see a bigger picture of whether two things are actually related somehow or just happened at the same time and/or place.

    Best, Kate

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