What Your Doctor May Not Tell You about Children's Vaccinations
What Your Doctor May Not Tell You about Children's Vaccinations
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| ISBN-13: | 9780446535977 |
|---|---|
| Publisher: | Grand Central Publishing |
| Publication date: | 11/01/2007 |
| Series: | What Your Doctor May Not Tell You about Series |
| Sold by: | Hachette Digital, Inc. |
| Format: | eBook |
| Sales rank: | 877,398 |
| File size: | 1 MB |
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What Your Doctor May Not Tell You About(TM) Children's Vaccinations
By Cave, Stephanie
Wellness Central
Copyright © 2010 Cave, StephanieAll right reserved.
ISBN: 9780446555715
Part I
INTRODUCING VACCINES
Chapter 1
The Story of Vaccines
PERHAPS YOU’VE SEEN THE BUMPER STICKERS THAT SAY QUESTION AUTHORITY. Well, that’s what’s happening today with the increasing number of parents who are questioning the safety, the effectiveness, and even the necessity of the vaccines being given to their children and required by state law. Parents—and perhaps you are one of them—are questioning health care providers, state health officials, and one another about vaccinations. They are forming and joining action groups so they can learn more, and do more, about vaccine policies in the United States.
Next to the QUESTION AUTHORITY sticker should be another one that says KNOWLEDGE IS POWER. It’s not a good idea to question authority when you don’t know what you’re talking about, because it won’t help you accomplish your goals. And when the goals are safe health care and a healthy life for your children, the stakes are too high for you to miss the mark.
This chapter introduces you to the information you’ll need to help you understand the world of vaccines and how they can affect you and your children. It explains what vaccines are, types of vaccines, how they are developed, and how they affect the immune system. You will also learn the answer to the question Do I have to vaccinate my child? as well as how to use the rest of this book to answer this question for each of the vaccines required by law and for those that are not.
FIFTEEN VACCINES… AND COUNTING
Today’s parents are primarily concerned about the fifteen vaccines now recommended by the federal government. And there are dozens of other vaccines on the horizon, a future you may need to consider if you are a parent or grandparent. These other vaccines are covered in subsequent chapters. For now, however, here are the ones that are recommended in most states and mandated in some states:
- Hepatitis B—the first vaccine children are typically given
- DTaP—diphtheria, tetanus, pertussis (whooping cough), which is the newer form of the DPT (DTP) vaccine (see chapter 7 for details)
- Hib—Haemophilus influenzae type B
- Polio—the inactivated polio vaccine, or IPV, is the injected form of the polio vaccine, which as of January 1, 2000, was recommended over the oral polio vaccine (OPV) (see following and chapter 9 for more details)
- MMR—measles, mumps, and rubella combination vaccine
- Varicella—chicken pox
- Hepatitis A
- Pneumococcus
- Rotavirus
- Meningitis
- HPV (human papilloma virus)
WHAT IS A VACCINE?
A vaccine is a substance that attempts to protect people against disease. To do that, vaccines are made from the virus or other pathogen (germ) that causes the disease the vaccine is designed to fight. You might say a vaccine uses fire to fight fire: A little bit of the pathogen is specially prepared and usually injected into the body so it can help fight off any “wild,” or naturally acquired, versions of the disease. The purpose of that fight is to develop immunity.
The body has a complex system, called the immune system, that has procedures for producing and maintaining immunity. In short, when you get, say, a cold or flu virus or a bacterial infection, your body responds by producing substances called antibodies, minute protein molecules that fight against (anti) the foreign bodies (the viruses or bacteria). When you recover from the illness, your body retains some of those antibodies so it is ready to fight off the infection should it appear again. This is called immunity.
TWO TYPES OF IMMUNITY
Natural
Natural immunity is gained when viruses or bacteria enter the body, cause a disease, and the disease progresses normally. During the disease process, the body produces antibodies and disease-fighting cells, resulting in a natural immunity that is usually permanent.
When a child is naturally exposed to, say, the measles, the immune system responds immediately. Various immune cells begin to attack and eliminate the invading pathogens and send signals to other cells in the system, triggering them into action. Depending on the strength of the immune system, the body will reduce or even eliminate the disease before the symptoms show. In fact, experts have shown that the frequency of asymptomatic (having no symptoms of disease) infections outnumber clinical illnesses by at least a hundredfold, simply because the immune system has tremendous natural abilities to fight disease.
Vaccinated
Vaccinated immunity is artificial and often temporary. When the vaccines are injected into the body, they bypass many of the body’s natural defenses. In a sense, the vaccine, along with the toxic additives in the solution, is thrust into the body unannounced. This “surprise” forces the body to overcompensate by producing more disease-fighting cells than it would if the infection were natural. This overstresses the body in two ways—it not only overproduces immune system cells but must also fight the infection (introduced by the vaccine), along with the chemicals and other additives in the vaccine. (These additives are discussed in chapter 2.)
Which is better, natural or vaccinated immunity? The answer may be a little of both. In any case, in order to find out, the least we (parents, researchers, medical professionals, lawmakers) should do is take a close look at the current vaccination schedule, each of the vaccines, and the research on the pros and cons of arbitrarily vaccinating all children. Currently most children are subjected to vaccinations beginning at birth or at two months of age, long before the immune system is ready to even begin to respond. Is this practice safe or wise? Are there alternatives? I believe there are, and it is my hope that you will find some alternatives for yourself in this book.
The main purpose of a vaccine is to stimulate the formation of antibodies at a concentration high enough to stop the pathogen in its tracks, and thus prevent those who get the vaccine from getting the disease. As long as you maintain a certain concentration for a specific disease, you have immunity.
Vaccination is no guarantee that your child or you will not get the disease. A small amount of the infectious agent can get past the antibodies and cause individuals to experience some mild symptoms, or occasionally even worse effects of the disease. (More on this topic in subsequent chapters.) However, in most cases, the vaccine prevents more serious symptoms from occurring. An up-to-date list of the vaccines recommended by the US government can be seen at or downloaded from www.aap.org/family/parents/immunize.htm. An in-depth explanation of each of these vaccines can be found in chapters 6 through 17. Included in these explanations is the Vaccine Information Statement (VIS). A VIS is an information sheet, produced by the Centers for Disease Control and Prevention, which informs vaccine recipients or their parents or legal guardians about the benefits and risks of the vaccine. Doctors are required by law to distribute a VIS for all mandated childhood vaccines.
AN INFANT’S IMMUNE SYSTEM
Infants come into the world with antibodies they have gotten from their mother through the placenta. Infants who are breast-fed continue to receive many important antibodies in the colostrum (the thick, yellowish pre-milk that is secreted during the first few days after a woman gives birth) and breast milk. Commercial infant formulas, although inferior to mother’s milk, also provide essential nutrients for infants’ health.
During the first year of life, the immunity an infant gets from its mother at birth wears off. To help boost the fading ability to fight certain diseases, vaccines are given. The idea behind vaccines is to provide just enough of the disease-causing substance to trick the body into producing antibodies against it. Once the antibodies are produced, they stay around, protecting the child against the disease they were designed to fight. Some vaccines provide this protection for life after just one or two shots; others require additional boosts of immunity.
The problem many doctors and parents have with vaccines given during the first few months of life is that an infant’s immune system cannot adequately respond to a vaccine until he or she is four to six months old. I believe we need to look not only at the timing of these vaccinations—when they are given and how many are given at one time—but also at the ingredients in them and the dangers they may pose.
WANTED: DEAD OR ALIVE?
Vaccines have traditionally come in two basic forms: dead (inactivated or killed) and live. The vast majority of both forms are delivered one of two ways: via injection under the skin (subcutaneous) or into the muscle (intramuscular). (Polio and typhoid vaccines are also available in oral form.) In some cases, both live and killed vaccines are available to treat the same disease.
A third type of vaccine, the recombinant DNA vaccine, is the product of genetic engineering. It is the newest form, but there are questions about safety and efficacy.
Live Vaccines
Live vaccines are made in a laboratory from the living organism (usually a virus) that causes the disease. Live vaccines are attenuated, or weakened, so they will cause the body’s immune system to generate an immune response without (hopefully) causing the disease. Some people, however, do respond to a vaccination by developing symptoms of the disease, although in most cases they are mild. Examples of live attenuated virus include polio (oral), measles, mumps, chicken pox, rubella, influenza, rotavirus, HPV, and yellow fever. Live bacterial vaccines include one for typhoid fever and Bacillus-Calmette-Guerin (BCG) vaccine, which is used for tuberculosis.
Some experts claim that the immune system responds to live, attenuated vaccines the same way it does to a natural infection; others disagree (see “Two Types of Immunity,” above). In fact, even proponents of live vaccines agree that live vaccines can cause a mild version of the disease they are designed to prevent. People who question the wisdom of giving live vaccines, especially to infants and young children, say these vaccines may have much more serious consequences, pointing to the correlation with autism and autoimmune diseases (see chapters 4 and 5).
Killed Vaccines
A killed, or inactivated, vaccine consists of all or part of the disease-causing organism that has been killed or rendered inactive. Unlike live vaccines, killed vaccines cannot reproduce, so they are not able to cause the disease they are designed to prevent. They trigger a weaker response by the immune system than do live vaccines. They also tend to be safer than live vaccines for people who have a weakened immune system, for pregnant women, and for children younger than one year.
Most killed vaccines are protein-based, like the bacteria they mimic. Some of these bacteria are coated with sugars called polysaccharides. When scientists tried to develop vaccines for sugar-coated bacteria, they found that pure polysaccharide vaccines didn’t work well in infants. But when they joined (conjugated) the polysaccharide to a protein, the vaccines were much more effective for infants and young children.
Inactivated vaccines are used for the following diseases: cholera, hepatitis A, hepatitis B, influenza, pertussis (whooping cough), polio (injected), rabies, and typhoid.
Another type of inactivated vaccine is the toxoid. These vaccines are made by inactivating the toxins (poisons) produced by bacteria and viruses. The vaccines against diphtheria and tetanus are toxoids.
Recombinant DNA Vaccines
Another type of vaccine is a recombinant DNA (genetically engineered) vaccine. The hepatitis B vaccine is one example. Rather than using the entire organism, recombinant DNA vaccines are made by taking specific genes from the infectious agent (viruses or bacteria) and adding them to the vaccine culture. For example, hepatitis B vaccine is made by inserting a portion of the hepatitis B virus gene into baker’s yeast, the culture in which this vaccine is produced.
Experts say recombinant DNA vaccines are more effective and safer than other types of vaccines because they don’t contain the entire infectious agent and thus cannot cause an actual infection. However, the greatest concern about recombinant DNA vaccines is that they may cause the immune system to produce antibodies, which in turn attack parts of the body and cause health problems. Much is still unknown about the effects of recombinant DNA vaccines.
ONE SHOT, TWO SHOTS, THREE SHOTS, FOUR?
It would be nice if we could protect children against all threats of childhood diseases, such as chicken pox, measles, diphtheria, whooping cough, and polio, in one strategically administered—and completely safe—shot or pill. Unfortunately, that is not the case. In fact, children receive more than forty-five doses of fourteen vaccinations by the age of five years. Not only do children need a separate vaccine for most diseases (hepatitis B, polio, Hib, and chicken pox are single vaccines; DTaP and MMR are multiple), they also need more than one dose of most vaccines. The one or more additional doses of a vaccine given to help ensure the protection provided by the original dose(s) are called boosters. Booster doses are given a few months or sometimes years after the original dose. For example, the first three DTaP shots are the original doses given to establish immunity. The next two shots at twelve to eighteen months and at four to six years are boosters, as is the recommended Tdap for adolescents.
Are Boosters Necessary?
To determine whether children need a booster, doctors can check their titers—the measurement of the amount or concentration of a substance in a solution. In the case of vaccines, it refers to the amount of antibodies present in patients’ blood and serum. If the antibody titer is high enough to make them immune to specific diseases, they may not need a booster. Researchers are finding that some of the vaccines routinely given do actually confer immunity for longer periods of time than was originally thought. Unfortunately, doctors don’t usually check a person’s titers before giving a booster. If the practice of checking titers were put into place, we would probably be able to eliminate some of the boosters now being given to our children, and thus reduce the risk of adverse effects. Parents can consider asking that titers be checked before a booster is given. The titers for measles, mumps, and rubella seem to be more reliable than others.
WHERE IT BEGAN: A BRIEF HISTORY OF VACCINES
Vaccines are not a new idea, although the early forms would not be popular in today’s world. One of the first recorded attempts at vaccine-like treatments occurred sometime during the seventh century when a group of Buddhists decided they could become immune to the effects of snake venom by drinking the foul substance. In sixteenth-century China, writings describe how people were inoculated against smallpox by placing the powdered scabs from infected children into the noses of healthy children. These people had the right idea—they realized they could help prevent a disease or condition by exposing themselves to a form of the substance that caused it—but they didn’t fully understand what they were doing at the time.
A more scientific approach was used in the late eighteenth century by Edward Jenner, who discovered that inoculating people with the animal disease cowpox made them immune to the deadly human disease smallpox. This was an interesting concept, and fortunately for Jenner it helped save lives, but the use of an animal disease to treat humans also presented the possibility that other diseases could be introduced along with the intended virus. Another approach was needed.
Between the time Jenner published his work in 1798 and Louis Pasteur developed the first rabies vaccine for humans in 1885, several scientists, including Pasteur, were investigating this problem. During that time, Pasteur enhanced the concept of attenuation, which is the use of a weakened form of a virus to provide immunity. Pasteur found that a weakened form of chicken cholera (an attenuated form) was highly effective in preventing the disease. Attenuated vaccines are widely used today.
Protests against the use of vaccines are nothing new. When Pasteur introduced his rabies vaccine for humans in 1885, both doctors and the public rallied against its use. At the turn of the century, British troops fighting in the Boer War in South Africa strongly protested being inoculated against the serious disease typhoid.
Many exciting events and discoveries occurred in the world of vaccines in the decades that followed (see “Milestones in Vaccine Development and Use,” below). Perhaps the biggest boon to the immunization movement was the development of polio vaccines, one by Jonas Salk and the other by Albert Sabin. The fear of polio by the public was so great that mass immunization with Salk’s injectable vaccine beginning in 1955 was welcomed with open arms. Salk’s vaccine could not provide complete protection against all three polio viruses, so Sabin’s live oral vaccine—introduced in 1961 and offering broader immunity—quickly became the more commonly used. The oral vaccine is no longer recommended because it’s been proven to actually cause polio in some recipients and in the close contacts of those recently vaccinated.
History is still being made. New vaccines and new formulations of existing vaccines are being developed all the time. Chapter 19 looks at some of the vaccines on the horizon.
MILESTONES IN VACCINEDEVELOPMENT AND USE
1906: Vaccine against whooping cough (pertussis) developed.
1921–1928: Vaccine against diphtheria developed.
1933: Tetanus vaccine available.
1940s: Combination diphtheria, tetanus, and pertussis (DTP) vaccine developed.
1946: DTP vaccine available.
1954: Jonas Salk develops first polio vaccine (injectable) in the United States.
1955: Polio vaccine is licensed and distributed free through the Poliomyelitis Vaccination Assistance Act.
1963: Oral polio vaccine by Abert Sabin is licensed.
1963: Measles vaccine licensed.
1968: Mumps vaccine developed.
1969: Rubella vaccine licensed.
1978: Pneumococcal vaccine becomes available.
1979: MMR vaccine added to routine childhood vaccination schedule.
1981: Japan licenses DTaP vaccine, a safer version of the DTP vaccine.
1982: Hepatitis B vaccine becomes available. Parents of children who were injured by the DPT vaccine form Dissatisfied Parents Together (later to evolve into the National Vaccine Information Center) to lobby for safer pertussis vaccine in DPT shots.
1986: First recombinant hepatitis B vaccine licensed. Congress passes the National Childhood Vaccine Injury Act.
1987: Hemophilus influenza type B (Hib) vaccine licensed.
1991: The CDC recommends that all infants receive the hepatitis B vaccine; the United States licenses DTaP vaccine for children eighteen months and older. The hepatitis B, Hib, and DTaP are given at the same visit for the first time.
1995: Varicella vaccine licensed.
1996: The FDA licenses safer DTaP vaccine for children under eighteen months old and the CDC’s Advisory Committee on Immunization Policy (ACIP) recommends that the DTaP vaccine be used instead of the original DTP shot.
1998: The French government suspends hepatitis B vaccination programs in schools because of reports of multiple sclerosis and other immune and brain problems. Rotavirus vaccine approved for infants.
1999: The genetically engineered vaccine for rotavirus is removed from the market after many vaccinated infants become seriously ill with bowel blockage and at least one dies. Congressional hearings on vaccine safety begin. Manufacturers are asked to eliminate or significantly reduce the amount of mercury in vaccines.
2000: The CDC recommends using the injectable polio vaccine instead of the oral form because the latter caused up to ten cases of polio per year. A new pneumococcal vaccine—Prevnar—is recommended for infants.
2002: Lyme vaccine pulled off the market. Pentavalent (DTaP, hepatitis B, IPV) licensed. CDC recommends the influenza vaccine for children as young as six months of age.
2003: Smallpox vaccine recommended for first responders.
2005: Meningitis vaccine licensed.
2006: New rotavirus vaccine (RotaTeq) licensed.
2007: HPV (Gardasil) vaccine licensed.
DO I HAVE TO VACCINATE MY CHILD?
This question is being asked more and more often by parents as they hear and read about the association between vaccines and various serious health conditions. Although there are no federal mandates that force parents to have their children vaccinated, state laws essentially act as such. Many parents are unaware that they can get an exemption from vaccinating their child for medical, philosophical, or religious reasons, depending on the laws of their particular state. An explanation of state laws and exemptions and how to get them is found in chapter 20.
If a child does not meet state vaccination requirements, goes to school, and the truth is discovered, the school can have the child removed. There have also been instances in which state officials have charged parents with neglect for failing to vaccinate children with all mandated vaccines.
Before parents make decisions not to vaccinate a child and deal with the consequences, they need to have full access to information that allows them to weigh the risks and benefits of the growing number of recommended vaccines. Parents need to know that there are legal avenues they can take to exempt their children from receiving vaccinations.
PROGRAMS THAT PROTECT CHILDREN
As parents and physicians have seen an increasing number of injuries associated with vaccinations, government and private-sector organizations have formed to ensure that children harmed by vaccines will receive some compensation and that parents have access to all available information about the pros and cons of vaccination. There are dozens of such groups and programs, but some of the main ones designed to help protect our children include:
• National Vaccine Information Center (NVIC)
• National Childhood Vaccine Injury Compensation Program
• Vaccine Adverse Events Reporting System (VAERS)
Details about these organizations and others and the services they provide are discussed throughout this book, and there is a list in the appendix.
BOTTOM LINE
We are fortunate that we have stopped the epidemics of smallpox, polio, diphtheria, and measles. Vaccines have become a part of our world—for the current health of our children and for future generations. But because each act of administering small bits of disease and foreign substances to children opens the door to the possibility of debilitating consequences or even death, every possible attempt must be made to ensure that today’s vaccines and those in the future are as safe as possible.
I am not suggesting that we return to the days without vaccines. But we must seriously address what appears to be an obvious link between the epidemic of developmental delays and autoimmune diseases, and the increasing number of mandatory vaccines. All parents should know the advantages as well as the dangers associated with every vaccine, every time it is given. They should know the positive and negative consequences of refusing to have their children vaccinated, and be made aware of how they can go about getting exemptions. And the government, industry, health care professionals, and parents must band together to get the research needed to determine the safety of these vaccines. The stakes are too high for us to do otherwise.
NOTES
Ad Hoc Group for the Study of Pertussis Vaccines. Lancet 1 (1988): 955–60.
Blennow, M., and M. Granstrom. “Adverse Reactions and Serologic Response to a Booster Dose of Acellular Pertussis Vaccine in Children Immunized with Acellular or Whole-Cell Vaccine as Infants.” Pediatrics 84 (1989): 62–67.
Diodati, Catherine J. M. Immunization: History, Ethics, Law and Health. Ontario, Canada: Integral Aspects, 1999, 50 passim.
The Group on Immunization Education of the Society of Teachers of Family Medicine Web site: www.immunizationed.org.
The Journal of Family Practice Web site: www.jfponline.com.
National Institute of Molecular Biology and Biotechnology, at www.upd.edu.ph/~mbb/. Information on recombinant DNA vaccines.
Saroso, J. S., et al. “A Controlled Field Trial of Plain and Aluminum Hydroxide–Absorbed Cholera Vaccines in Surabaya, Indonesia, During 1973–75.” Bulletin of the World Health Organization 56 (1978): 619.
“Vaccines Across the Life Span.” Journal of Family Practice, February 2007.
World Health Organization Web site: www.who.int/vaccine-diseases/safety/parents.
Continues...
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Table of Contents
Introduction xiii
Part I Introducing Vaccines
Chapter 1 The Story of Vaccines 3
Chapter 2 How Safe Are Vaccines? 19
Chapter 3 Mercury in Vaccines: Shots of Danger? 40
Chapter 4 The Autism Debate 62
Chapter 5 When the Body Attacks Itself: Autoimmune Disorders 90
Part II The Vaccines
Chapter 6 Hepatitis B 121
Chapter 7 DTP/DTaP: Diphtheria, Tetanus, Pertussis 145
Chapter 8 Hib: Haemophilus Influenzae Type B Vaccine 165
Chapter 9 Polio 175
Chapter 10 MMR: Measles, Mumps, Rubella 193
Chapter 11 Varicella (Chicken Pox) 214
Chapter 12 Hepatitis A 229
Chapter 13 Pneumococcal Disease 234
Chapter 14 Meningococcal Disease 241
Chapter 15 Influenza 246
Chapter 16 Rotavirus 254
Chapter 17 Human Papilloma Virus 257
Chapter 18 Vaccines for World Travelers 262
Chapter 19 Vaccines of the Future: Sooner than You Think? 266
Part III Tools for Parents
Chapter 20 Parents, the Law, and Insurance Companies 279
Chapter 21 What You Can Do to Ensure Your Child's Safety 298
Chapter 22 The Vaccine Adverse Events Reporting System 313
Appendix Organizations and Web Sites 321
Glossary 331
Suggested Reading List 337
Index 339