This is a bit too late for Bunny, but I thought that anyone with younger kids and/or who's expecting a baby might be interested in this. This is one of the most comprehensive discussions I've seen about the safety of individual vaccines. (I love Dr. Sears!)
La Leche League of Southern California and Nevada Conference 2005 presents
Immunizations: Making an Educated Decision for Your Child
Dr. Bob Sears, MD
Dr. Bob: Ok! Well, let me turn this off. Hey everybody! Can you hear me back there? Good? Is this a good level of talking? All right!
Well, thanks for coming to the talk today. The, uh, this is kind of a tiring talk to give because its almost like a college lecture. Its really a lot of medical information, scientific information. ..(hi sweetie! Shell make it more interesting. ) Ok, so bear with me, Im going to try it make it a little more interesting and upbeat and occasionally funny. If you think I said something funny, I did. I mean, dont wonder...was that funny?...go ahead and laugh because that breaks it up, and its a real kind of tedious topic to get to.
All right. So lets jump into this. Vaccinations. This is the shot schedule that your kids are supposed to get as it stands right now. Your five shots every couple of months in the beginning and then two or three shots after that all throughout the first year and half of life. Um, Im going to basically take you through all those shots and then ask you five questions about each one of those shots.
Basically is the disease that the shot protects against, is that disease common? Is the disease severe? Are the vaccine ingredients safe? Is the side effect profile safe? And, is the disease a public health risk?
Im gonna go through each shot and tell you, and help you to answer yes or no for each of these questions. Because if the answer is Yes for all these questions, then that makes that shot more important. If the answer is No for that shot, then that makes that shot less important. And Im going to go through and try to help you understand each of these five questions for each shot.
IS THE DISEASE COMMON?
Ok, all right. So basically, so some diseases are very common and some diseases that we vaccinate for dont even exist in the US. Ill show you which ones those are. Some diseases are very common but they just dont happen in babies. Or, some diseases happen only in babies but not in older kids. And as a example of that, sometimes parents will come to me and say, Im going to wait until my baby is two years old and then Im going to start giving shots. Well, by then your baby has missed the time period for a lot of those diseases anyway. And so, so if youre going to wait until your baby is two, theres a lot of shots your baby probably doesnt even need. And theres a lot of shots you shouldnt even start if youre waiting until your baby is two. So timing is really critical to understanding when these diseases occur in babies, when they occur in children, and when they occur in teens. (You can probably just let her walk around up here, shes really cute when she
is just walking up here.)
IS THE DISEASE SEVERE?
Ok, severe diseases. Some diseases are very severe and some just arent. Some diseases are completely harmless. Some are dangerous if a child catches it, but not an adult. And some, the other way around. Some diseases are totally harmless for kids but can be severe for adults. So how do you understand all this?
ARE THE INGREDIENTS SAFE?
And the other question is, are the ingredients in this vaccine safe?
Well, youve all heard about mercury, and Im not really even going to talk about mercury because its been taken out of almost all vaccines; so Im not going to dwell on mercury. You could spend two hours talking about mercury. It is still in flu shots, but there is one flu shot that doesnt have mercury. Some shots have a tiny little bit of mercury and Ill show you which ones those are. But, you could get every single shot there is completely mercury-free if you just know which brands to use. I will show which ones those are.
Shots used to have 12 to 25 micrograms of mercury in each shot. If you got three shots you could get about 75 micrograms of mercury in one day, and the FDA says you should only have 1 microgram of mercury in one day. We used to give babies 75 times that much. Now some shots will have less than .3 micrograms, some will have zero, and some shots will have what we call less than .3 micrograms. Less than .05 micrograms in other words. If you compare that to the 25 micrograms that used to be in that shot, its very minimal. So, is it safe to get a shot that has less than .3 mg of mercury? Sure. Its probably fine. When you compare it to what you used to get, its much safer, so if your baby needs a shot and you look at the ingredients and see there is .3 mg of mercury, youre probably safe. Dont let that scare you away from getting that shot.
Some vaccines come in big doses where a doctor takes 10 doses out of a shot and give a shot to ten different kids, and those big bottles tend to have a lot of mercury. The little bottles that only have one shot in them tend to not have mercury. If you are giving your baby shots and the doctor wont tell you whats in there, just ask to see the bottle. If its a big bottle, dont get the shot. It probably has lot of mercury in it. If its a tiny little bottle, then it doesnt have mercury or has only .3 mg and you are probably safe giving that shot. You can see examples of big bottles and small bottles so you know what they look like.
Basically thats where the discussion of mercury is going to end. Its really not an issue anymore for people deciding now whether or not youre going to give shots. We know its bad, weve taken it out.
Now some shots have formaldehyde, and thats not healthy for babies. Some shots have animal tissues or human body tissues used when they make the shots; this is a list where you can look at ingredients, and see all the animal tissues or human body tissues that are used to make some of these shots. Ill show you which ones those are.
Now why does this matter? Why does it matter if we are using animal tissues to make vaccines? Well, so far in our history its mattered a few times.
Number one is that we use monkey kidneys to make the polio vaccine. We still do this. A few decades ago, thousands of people were injected with a polio vaccine where they were using monkeys that had a cancer-causing virus in those monkeys. Some people were injected with vaccines made from batches that had that cancer-causing virus in it. Now, they have tracked those people and they dont think that any of those people have caught that virus, or caught cancer from this virus, but that was a big scare when we discovered this. Now we still use monkey kidneys but we know not to use monkey kidneys from monkeys who have this virus. So now we know to screen for that.
However, this happened again in the 60s. Half a million soldiers were injected with another type of monkey virus because they were using, not sure what part of the monkey, but they were using monkey parts to make this vaccine. Half a million soldiers were injected with a virus that we do know causes brain cancer and lung cancer and lymphoma in humans. Half a million soldiers got injected with this virus. We dont even use that vaccine anymore. But, twice in our history people have been accidentally infected with viruses from monkeys because we didnt know those viruses existed. Now we know to look for those issues. But anytime you see a vaccine that uses a monkey kidney or a human fetus lung or cow blood or anything like that to make the vaccine, you have to listen to that tiny little issue in the back of your mind, that are there little infections in there that we dont know about?
Of course we clean and filter the vaccines, we, you know, detoxify the vaccines and put it through all these processes to clean them, so none of those viruses make it through. But, um, is that process 100% perfect? I hope it is, but its possible that we might discover 20 years from now that there is some little virus in a vaccine that got through. Im not saying there is or will be, Im saying that its happened twice so far, and I hope it doesnt happen again. Just realize there is a risk with animal products with any of the vaccines I show you.
ARE THE SIDE EFFECTS PROFILES SAFE?
Again, going through the five questions. Are side effects, you know, some vaccines have lots of side effects and some have almost no side effects. Ill show you this. Whats the safety profile of the vaccine? Are there introductory issues? These vaccines have been researched in ten to twenty or thirty thousand people, before they are released into the public. The problem is they only research the safety of the vaccine for a few weeks, maybe a couple of months. They dont call up those 30,000 people five years later to see what happened. Its only a few weeks of safety research. So when I say, a vaccine appears to be safe, what I mean is that in the few weeks of safety research nothing really bad happened.
How do we do longterm safety research? We release the vaccine into the public, and over the years say a million kids get the vaccine, and we monitor side effects. Thats how we do longterm safety research. Im going to tell you in a nutshell what that has shown us, from the period of 1991-2001.
What we did, is give 2 billion doses of vaccines. Of those, 18,000 people either died or had a life-threatening illness or had a permanent disability or were put into the hospital with the side effects, for a long time. Eighteen thousand people. Out of 2 billion doses. So what does that mean? Well thats about a one in 10,000 chance of suffering one of those severe effects. If you are wondering, what is my kids chance of having a severe side effect, the best data we have shows it to be about a 1 in 10,000 chance.
IS THE DISEASE A PUBLIC HEALTH RISK?
So the last question to ask is, is it a public health risk? Should you get a vaccine because something is a public, you know, risk? Thats a topic called herd immunity. Meaning, were all protected and if you dont vaccinate, you are protected still because everyone around is vaccinated. So you need to ask yourself, are you obligated to vaccinate because everyone else does? Or can you take advantage of everyone elses vaccinations and dont vaccinate your kids, and your kids are still protected because all the other kids are. The other issue with that is, if you dont vaccinate, are you putting others at risk? Can your child catch diseases and put others at risk? And the other question is, if everyone stopped vaccinating for a disease, what would happen? Would it come back? Would people start dying because the disease made a resurgence? Those are the public health questions that apply to each of these vaccines.
Do vaccines work? Of course they work, at 85-99% depending on what vaccine it is. I wouldnt not get a vaccine because someone told you it doesnt work. Yeah, they work well, not perfectly, but they go a long way to preventing the diseases we are trying to prevent. Dont let anyone tell you that a reason not to vaccinate is because the shots dont work; thats just not really true.
Now let me explain what Im not going to tell you, just so you know where this is going. Im not going to tell you whether or not vaccinating is good or bad. There are lots of good books you can read to tell you how bad shots are, or how good shots are, so Im not going to tell you that. Im not giving my opinion about whether vaccines are evil, or good, um... Im not going to try and tell you to either completely vaccinate or not vaccinate. It doesnt have to an all-or-nothing decision. You can pick and choose. You can think, Hey, that disease sounds bad and the vaccine is safe, so Im going to get that one, but not this one because the disease is harmless and the side effects are hot. So you can pick and choose, and Im hoping to help you with that. Im not here to tell you what to do with you child, Im here to give you information so you can make an educated decision. So thats where Im going.
Now, Im going to try to help you understand each of these questions, the vaccines, the ingredients; I kinda went over all of this. So lets jump into our first disease.
HiB
Hemapholis influenza B is first. HiB. What is this disease? Its meningitis. Ok? It can infect your bones or your blood stream but mainly in children its meningitis. We used to have 20,000 cases a year of this disease. About ten percent of those kids died. A lot of deaths in the mid 80s and 70s. Now, we have about 20 cases of HiB occurring in children every year. So weve gone from 20,000 cases annually to 20 cases. Weve pretty well gotten rid of this disease. Not completely but mostly. We are still vaccinating at 2, 4, and 6 months for HiB, and again at 15 months, because we dont want this coming back. We want to want to decrease the chance that your kid will be in those 20 or 25 cases that still happen every year. So thats why we still vaccinate against HiB.
So how is this vaccine made? Well its not made from the whole germ. They use a few sugars from the outer covering of this germ, they take them out of the germ and put them into a vaccine. There is no way to catch meningitis from this vaccine. It is impossible, because youre not getting the whole germ, just some sugars from it. No animal tissues are used to make this vaccine. There is no formaldehyde, now there is no mercury but there used to be; now there isnt, unless you get a big bottle, which has a lot of mercury. In the small bottles, you dont get mercury. This is one of the purest and safest vaccines, with an extremely safe ingredient profile.
Side effects? Well, you see a little fever, might be a little fussy, but we dont see severe side effects from this vaccine. Of all the side effects reported down the road we just arent seeing severe effects from this. A couple of really severe things have happened, but over millions of doses, so its actually one of the safest vaccines.
So how do you decide, for you baby, to get this or not? Or your toddler, or child? Is the disease common? No; only 20-25 cases each year. Is it a severe disease? Of course it is. We just saw a baby in our practice that had this disease infect a bone behind the ear and needed surgery, IV antibiotics, all kinds of, you know, hospitalizations, because this germ infected one bone behind the ear. The child was not vaccinated, and if the baby had been, he might not have gone through this process. The baby is fine now, no long-term harm, but what Im getting at is that we just saw this disease in our practice and its serious stuff. So it is severe.
Is the ingredient profile safe? I would say yes, very safe. Side effects are safe. Is this a public health risk? If we stopped vaccinating for HiB would it come back? Yeah, I think it would slowly make its way back into the population and we would have an increase of babies dying from it. Are you putting babies at risk if you dont vaccinate? I dont know not really its such a rare disease. But if all of you dont vaccinate then yes, it might pose a public health risk. I score this a 4 of 5 in the level of importance; the only reason I could give to not vaccinate is that the disease today is very rare. Thats the only good reason I can think of to stay away from this vaccine. Also, this is a case of, if you dont vaccinate until your baby is two, you dont really need this because the disease only really occurs in babies two and younger. It very rarely does occur in kids, two to five, but its really only a disease in the first two years of life. So dont bring
a two year old in to start these shots; you should do it when you baby is younger.
DtaP
Moving on the next shot. DtaP. What is DtaP? Thats diptheria, tetanus, and pertussis. We give this at 2, 4, 6, and 18 months. We give a booster at 5. Why do we do all that? Well, ok. Diptheria is just a horrible disease that can kill you, but it just does not exist in the US anymore. I say that, although its not 100% true. We have most years go by with zero cases; one year in the last 20 years we had five cases, but most years we have zero. So practically speaking this disease does not exist in the US. Um, tetanus, you get that from a deep dirty wound. You might be surprised to know we only have 50-100 cases every year of tetanus in the US. It is, and can be, fatal, but only one or two cases every year of tetanus in children. I dont know if these kids are vaccinated or not, but almost all reported cases are adults over 25 who did not keep up with tetanus shots when they were younger. You get a booster at five and then at fifteen but adults dont get that
25 year booster and can catch tetanus. It almost never occurs in children or in infants.
So you ask yourself, if we are giving these shots at ages 2,4, and 6 months, why are we giving shots for two diseases that dont even occur in infants? They dont even really exist much in the US. Why do we do it? Well we do it because of the P in the DTP, pertussis. Whooping cough. That disease does occur in babies. And, it is common. Thats we vaccinate at 2, 4, 6, and 18 months. Because whooping cough, um, it can be fatal for infants. When babies catch it, about 1 in 160 cases will be fatal. About 1 in 100 cases will result in some sort of brain damage. Because the coughing from it is so bad, you cant breathe while coughing and you get a little bit of brain damage from that. Now, most babies that go through whooping cough come out just fine. But there is a 1 in 160 chance of death for babies. Thats we have the 2,4, 6, and 18 month schedule, so babies arent spreading whooping cough.
How common is it? We had almost 20,000 cases last year. In CA we have about 1200-1500 a year, closer to 2000 last year. I see it in my practice about every month. Its not rare at all. And so, thats whooping cough; its common and it can be severe.
So how do they make this vaccine? The basically take each of the three viruses and grow the germs in a petri dish with beef extract. Now Im not sure what beef extract is, but anyone who knows, let me know. Its basically cow that they grind up and make juice from, I dont know. That goes in the petri dish. The beef extract is full of proteins and nutrients that feed the virus. The virus uses the extract to grow. Then they break them up, grind them and destroy them, and take pieces and put them into the vaccine. They then take chemicals produced by those viruses and they put those into the vaccine too. Thats how they make it. Then they filter it, purify it, clean it up. You cant catch the disease from this vaccine because it doesnt have any whole germ in it. Its just a small part.
So what are the worrisome ingredients? Well, there is a little bit of formaldehyde, we know that is toxic and poisonous. They try to filter it out, but a little bit remains. How much? I dont know how much, and I dont know how much is safe, but I know its in there a little bit. Mercury is not in there if its in the big bottle of Tripedia brand, and youve got the .3 mg in the small bottles. For the most part you can get it mercury-free.
Diptheria then... ok, you can get just the tetanus shot without the whole DTP. You can also get the diptheria-tetanus without the P part in there. (I thought that was for older kids... ok. Thats a toy cell phone? I thought that was your real cell phone! Ok honey! You can bring them up here if they get tired of sitting around). But beware: if you get the plain tetanus vaccination you are getting 25 mg of mercury. Many times parents will get a tetanus shot for their child because they think its safer than the DTP vaccine but youre getting lots of mercury with that plain tetanus vaccine. There is no mercury in the DT vaccine without the P. There used to be, but now its out.There is formaldehyde. They use beef hearts instead of beef extracts to nourish these germs when they make it. I dont know if that makes it worse, or better, but just know thats what they use.
Side effects, ok. Has anyone here ever heard that the DTP is the most dangerous vaccine ever? And that the pertussis in particular is really really bad? If we are talking about the older DTP vaccine that is true. We no longer use that vaccine though, and havent been using it since 1998. Now we use the DtaP vaccine which is very different. Anything you read that is older about the DTP vaccine cant be applied to the newer DtaP vaccine, which seems much, much safer. With the new DtaP vaccine we havent really seen any severe side effects happen. It has a pretty good safety profile.
So five questions, and you can briefly go through this. So DT, not common, however, it is severe. Are the ingredients safe? They use beef hearts, a little bit of formaldehyde, and you have to decide for yourself if thats safe or not, because I dont know. The FDA says it is safe and most people believe that, but you have to decide for your family. Is the side effect profile safe? Yes. We just dont see severe side effects happen with this vaccine. Is this a public healthy risk? For diptheria, if everyone stopped vaccinating, then yeah, it would come back and it would be serious. If a whole city stopped vaccinating, it would spread. If your baby isnt vaccinated are you putting others at risk? I dont think so, because its not a common disease, so it would probably be that you would not catch it. Is tetanus a public health threat? Not at all, its not passed from person to person. There are no issues of public health as far as your decision about whether or
not to vaccinate because you dont catch it from other people. You catch it from having a wound. But, the five questions look very different for the pertussis vaccine. It would be nice just to have the pertussis vaccine by itself but we dont have that now. You have to have all three parts. Common disease? Yes. Severe? Yes if its a baby, for older children no. I should point out that pertussis is really only severe for infants under the age of one. If a five year old catches pertussis it can be pretty rough but the fatality risk is virtually zero. Its only risky in infants. Are the ingredients safe? Again, that would be questionable. Is the side effect profile safe? I would say yes, we just dont see any really bad things with this. Pertussis is a huge public health risk, though... weve doubled our cases from 2003-2004. Twice as much and on the rise, and very severe in infants. I just saw a 2 month old with pertussis, not vaccinated, in fact almost all the
cases I see are not vaccinated.. . but I would score it 4 of 5 on level of importance using these five questions. For older kids I score it a 3.
PNEUMOCOCCIS
Pneumococcis. This is the bacteria that causes meningitis. We dont want your babies to catch it so we vaccinate at 2, 4, 6, 15 months to protect them. This is one form of meningitis. How common is it? Well, we dont know because no one has ever reported it, because it was so common no one kept data on it. Some estimations show how much it goes around... just guesses but not hard numbers. I dont think Ive ever seen a case of it, maybe one or two, but its pretty rare. The numbers we do have, when we surveyed five large cities across the US... forget that. Were actually looking at something else, I lost my place there. Ok, what is now being reported now that we are tracking the disease is about 750 cases each year in the last few years in children under five, getting meningitis and being hospitalized. Almost are kids under age two. If you include adults, the number is 2 to 3 thousand cases per year. This is not all the cases, just the ones that doctors think
to report. I am sure the numbers are a lot higher.
How do they make the vaccine? The vaccine is called Prevnar. They take the germ, grow it in a soy culture, take some sugars out of the germs and throw the rest away, then put those sugars in the vaccine. So there is no way to get meningitis from this vaccine. All right?
So the what are the ingredients to think about? Well, there are no animal tissues. No formaldehyde, like we have in the DtaP. Theres really no dangerous ingredients used in this vaccine, no mercury. Its a pretty safe ingredient list.
Side effects. Well, one of the drawbacks with this vaccine is that we see more kids with fever, swelling, fussiness, redness where they get the shot, a much higher proportion of kids react to this vaccine when compared with all the other vaccines. We have had some reports of seizures after the vaccine. There has been, what else, well, we dont have decades of data or safety research, weve only been using it since about 2000. I want you to see whats been reported in the first two years after using it, we have about 30 million doses. We have about 4000 reports of side effects and about 600 of those are serious reports. Of the serious reactions about 400 were seizures, about 117 deaths reported after the administration of this vaccine, mysterious deaths and things like that. So thats how I look at it, whats being reported.
So you ask yourself, do you get this or not? What do you do? Well, the disease is pretty common. The disease is severe. The ingredient profile looks safe, but the side effect profile, we get a lot more than with other vaccines. Some high fevers, seizures, fussy babies. Is it a public health risk? Oh yeah, it is. So I scored this vaccine as a 4 of 5 in level of importance. My only real issue is the side effects are seen more often than in other vaccines.
So Im just going to summarize here. Dont you feel like youre back in college or something? Ok, so Ive shown you two kinds of meningitis, both are pretty severe, in babies, whooping cough, another disease severe in babies, HiB, however, pretty rare. The other two diseases arent rare. The side effect profile of these three shots are actually the safest profiles compared to next shots were going to see. They are safer than the ones Im going to be moving onto. So, severe diseases, fairly common, safer side effect profiles. Higher on the list of importance.
MMR
Now Im moving onto measles, mumps, and rubella. We give the vaccine at age one, because before age one it just doesnt work. There is no reason to give it before then because the body doesnt recognize it and it wont work. So we do it age one and again at age five. Because by then it does work pretty good.
Measles, about one in 500 cases are fatal. That might be higher or lower than you thought, but its not a terrible, fatal disease that kills everyone that has it. Fatal about one in 500 cases. We have about 50 to 100 cases every year. Not a lot. CA has about 20 cases a year. Mumps is so mild, most kids who have it , you dont even know theyve caught it. Its so mild that it passes you by and you dont even know. But in teenagers and adults its severe, it can make you sterile, cause arthritis, heart stress, kidney problems, brain issues, very severe in adults, but rarely fatal. How common is it? We have about 250 cases every year in the US. There are likely more but thats is what is being reported. So its not like its all over the place, and in children you see about 50 cases a year. Rubella, or German measles, is a completely harmless infection for children. We have only about 20 cases per year of rubella in children. But its probably going unrecognized in
the US because its so harmless, you dont go to the doctor, and also, its so rare the doctor doesnt know what it is because hes never seen it. Rubella for the most part is extremely rare.
Why do we vaccinate for rubella? Because it can cause birth defects in babies. If a pregnant mom catches it and it infects her fetus that baby can get birth defects. We have about 3 babies a year being born with birth defects from rubella. And in the past 20 years its been about ten babies per year. Not a lot. Thankfully.
So how do they make this vaccine? There was a fetus who had rubella in the 60s, they aborted the fetus, they removed the virus from the fetus, and that is the same virus they have been using all this time. They just keep having the virus grow itself, reproduce itself, and thats what they use. The measles and mumps viruses are taken from chick embryos. They infect the chicken embryos then take the viruses out of the embryos. I dont know why they do that, thats just what they do. They put the viruses in a petri dish and then add the blood from a cow fetus, the liquid part, and that nourishes the virus allowing them to multiply to get more for the vaccines. Then they take human blood units that are donated, they filter the protein out and put the protein in the petri dish, and that protein nourishes the viruses as well. Thats how they make this vaccine. They make sure there is no HIV, hepatitis, they make sure there are no infections from the whole process.
But, the viruses that are injected into you in this shot are alive. They are living viruses. Theyre weakened, but they are alive and they can infect you.
So, there are at least a couple of issues that you would at least want to be aware of. They are using human blood products to make the vaccine. Of course they screen and filter it and try to get out any infections that might be there. They use blood from a cow fetus, to help grow it. There are proteins from the chicken embryos where they harvest the measles and mumps viruses, proteins are actually floating around in the final vaccine because they arent able to filter them all out. So youre getting proteins from chicken embryos. Now is that harmful? I dont know, I just know thats what listed in the package insert.
So side effects. There are a lot of side effects. Im not going to read through them all, but if you are listening to this on tape or reading this, trust me, they are bad. Bleeding problems, inflammation of blood vessels, visual problems, rash, but anyway, one of the major ones that I want you to know... if you get the MMR, children have a tiny risk of getting arthritis. Real sore joints, fevers. But adult women who get it, if you are adult woman and you choose to get the MMR for whatever reason, you have a 12-26% chance of suffering from a severe form of arthritis. A small percentage of those women will have arthritis for many years. Now why does this apply to you? Because, if you have a baby, whoever provides your prenatal care checks to see if you have immunity. If you do, dont worry. If you dont have any rubella immunity, the nurse is going to give you rubella shot. They might not even ask you first. I mean there you are, enjoying your new baby, and
the nurse comes in, says, I need to give you this shot, and you think, ok, whatever, so she gives you this shot that now puts you at real high risk for arthritis. Thats is listed in the package insert. So if you as adult woman learn that you do not have immunity you have to look at the risks, ask yourself how bad is rubella and look at the real risk of arthritis. So decide for yourself and dont let someone decide for you.
More side effects. Here is a list of neurological side effects reported after the MMR vaccine. The brain can become inflamed, swollen, you can go into a coma-like state, you can be paralyzed, have seizures, various nerves can stop working, you can actually get meningitis as well. All these, including arthritis, can also occur if you catch these diseases as an adult, by the way. If as an adult you get these diseases you could have any of the side effects Ive just mentioned. The package insert says that they do believe there have been cases of brain swelling that are attributable to the MMR vaccine. They keep getting reports of brain reports and people going into an almost coma-like state. But thankfully the data shows it to be one case per million doses. So its rare. Its there, but rare. The chance is almost zero. But because we vaccinate so many, someone is going to have a bad side effect from time to time.
Weve all heard of a link between MMR and autism. To really talk about it and explain that relationship Id need a whole hour. But in my 30 second version: in autistic children they are finding the measles virus infecting the intestines. And its not wild measles, its vaccine-related measles. They are finding it in a lot of the intestines of autistic children, but not their siblings. Their siblings are tested and they dont find the measles there. They are finding the same thing in the spinal fluid of a lot of autistic children but not in their siblings. So the theory is that measles infection in the vaccine is somehow triggering autism. Thats all I have time to say on it now, there are lot of details there, beyond the scope of this talk. I cant tell you for sure whether or not there is a connection, but there is enough research there to at least suggest its something we really need to study, to figure out what that connection is, or at least to figure out
whats happening.
A lot of parents want to give the MMR seperately so you get only one virus at a time. You probably do experience less side effects this way, but its kind of a lot of trouble.
So what do you do with the MMR vaccine? Lets apply the five questions we just went through and see. Are the diseases common? No. Are they severe? No, they are not. Are the ingredients safe? Well, we talked about the chicken embryo proteins, the human blood proteins, the whole manufacturing process seems to me to be questionable about how safe it is to inject it into your child. Is the side effect profile safe? Its one of the riskier ones. Its got a long list of possible side effects. It is a public health risk in that if we stopped vaccinating the diseases would escalate and then we would start to have problems with the disease. I gave the MMR a 1 out of 5 in importance; I gave it that low score because its a public health issue, and we could possibly start seeing birth defects related to rubella if we stop vaccinating. Now for teenagers and adults, the diseases can be pretty severe. So I raise that rating to 2 out of 5 for a teenager.
HEP B
Moving on to hepatitis B. This is a sexually transmitted disease. Or you can get it from you know, sharing IV needles, accidentally coming into contact with blood... and because we know babies are sexually active, we give this to them at 2, 4, and 9 months. No really. Ok. Why do we do this? Well, heres why. In the 1990s someone did a research study that suggested 30,000 children every year maybe getting infected with Hep B in the US. They didnt prove it by testing 100,000 children or anything, they just, you know, used math and statistics and population research to make a guess that about 30,000 children are infected. Everyone freaked out so we started giving babies this shot. And the fear is that about 1% of, or less than that, of adults, carry Hep B. So maybe 1% of half a percent of women have Hep B in them, so when they have a baby, the blood exposure to the baby through the birth canal could give that baby Hep B. So we thought if we give every baby a
shot for it, we could protect that small percentage of babies born to mothers who have Hep B. So thats how this all originated. We wanted to protect this supposed 30,000 kids a year supposedly getting Hep B in the birth process.
Well, what does the actual research show? Back when we started Hep B vaccine we had about 11,000 cases per year in the US. Now I told you we made a guess that we had about 30,000 cases a year in children alone, not to mention the, you know, 30 to 50 thousand of adults every year. But what is actually being reported in research is about 11,000 cases a year, almost all adults. Only 100-200 are children. So the whole scare reason that started the whole Hep B really turned out not to be completely true, there really arent nearly as many cases as we thought. Since weve been vaccinating the cases of Hep B being reported have gone down by about half, which is good. Um, but, ok, how much is being reported now? Now we have about 30 babies each year in the US being born with Hep B, about 30 toddlers or preschoolers, and about 70 older kids, elementary and junior high age. Thats a lot less than the 30,000 that we thought, that we worried about happening. In teens
and young adults we see about 1300 cases a year. So my conclusion, a conclusion anyway, is that its not really an infant disease. Unless you are a Hep B positive mom, if you are, you should absolutely get the vaccine, along with another shot your baby would get when being born that will prevent them from getting Hep B, um, but, if you are not Hep B positive I cant think of any good reasons to get this vaccine.
If a dad is Hep B positive, or someone else who lives in the house, chances are the dads blood will get onto the kids, just in course of raising kids. Dads, you know when dads shave, they might bleed a little bit, so theres blood on the face, so they kiss their kids or the kids touch the face, and the blood gets into the kid. So if you have someone Hep B positive in the family I think it would be important to vaccinate the babies, maybe everyone in the family. I told you this, about 1% of people in the US have Hep B, but 12% of Europeans, Middle Easterners, Africans, uh, South Americans, Asians, they have Hep B. Thats a lot, a lot of babies being born to Hep B mothers. So its a great idea to vaccinate for Hep B in a country where Hep B is very prevalent.
Ok. How do they make this vaccine? Well, its basically simple. They got yeast cells and taught them how to make a Hep B protein. They dont make the whole germ, just a Hep B protein. They take that protein and put it in the vaccine. No animal tissues, just a, its a pretty safe manufacturing process. However they use formaldehyde in this brand, Recondovax.. . there is another brand, Injurix, that does not use formaldehyde. Mercury is, there is a tiny bit present, .025 mg in the Injurix brand, but no mercury in the Recondovax. But if you get the big bottle, there is a lot of mercury in that bottle. You would not want to get a vaccine from the big bottle.
Side effects, ok. So these are all the side effects that have been reported since theyve been giving the Hep B vaccine. Some liver damage, some heart problems, bleeding problems, visual problems, some people come down with Lupus, arthritis, some neurologic problems like migraines, numbness, weakness, some paralysis , a few cases of Multiple Schlerosis have happened after having the Hep B shot, seizures. Those are all the possible side effects listed on the package insert. The problem is that I cant say how common these side effects are, only that theyve been reported since this vaccine came into use. Ok, I want to talk about, well, remember at the beginning of this when I said there had been 18,000 severe reaction over 2 billion doses? Well how does it apply to the Hep B vaccines? They took the Hep B alone, and analyzed data, and got about 6000 severe reactions reported including 150 deaths. 73 of those deaths were in children. Now obviously all these
deaths arent directly related to the Hep B vaccine, but these are deaths that occurred and the doctor realized, oh, they just had the Hep B vaccine last week, and so they mail, send it in as a possible reaction. I dont know how many deaths are truly caused by the vaccination, but this is just the data that I can show you. So there is a little bit of risk there when you look at the possible side effects.
So should you give your baby this vaccine? Well, the disease is rare. Is it severe? Yeah, Hep B is a very severe disease for babies. Are the ingredients safe? Yeah, we dont have any weird ingredients in this vaccine. Are the side effects safe? I dont know; there are a lot of possible side effects listed for this vaccine, so, I dont give it a point there. Is it a public health risk for your baby? No. If you dont give your baby this shot you are not putting other babies at risk. Your baby isnt sexually active, other babies arent sexually active, so theres no public health issue regarding babies. Its a huge public health issue for teenagers and for moms who carry Hep B, when they deliver a baby. So the big health issue is for teens. So for teens I give it a 3 out of 5 possible points, and for babies I give it a 2 out of five in the importance ranking.
CHICKEN POX/VARICELLA
Moving on to chicken pox. We give babies a chicken pox shot at age one. (You guys still with me? Im trying to make it nice and clear without getting bogged down in too many details.) Ok, well we give chicken pox at age one. Um, chicken pox is on the decline, we dont see nearly as many cases of it as we used to. Chicken pox is only fatal in about 1 in 65,000 cases. All right, so, deaths from chicken pox are almost unheard of. We used to have about 50 deaths from chicken pox each year, which was tragic, when chicken pox was real common, but now its not so common and we have very few deaths.
How do they make this vaccine? Well, they had a kid with chicken pox and they sucked some of the virus out of him, so they got the whole chicken pox virus. Then they took a human fetus, and Im not sure where that human fetus came from, but they took a human fetus, they took the lungs out, and they put the lungs into the petri dish, then they put the chicken pox in the petri dish, and the virus used the human fetus lung tissue to grow itself and expand. And so thats how they keep replicating the virus to use for the vaccine. And this is in the package insert. Then they take guinea pig cells, and they put the virus in with guinea pig cells so it has a different kind of cell to nourish it and grow and multiply. Then they have a third group of human cells, not the fetus but another group of human cells, with, where there is blood from a cows fetus put in with these human cells to nourish them, then they put the chicken pox virus into there. It grows and
multiplies, and they get a whole bunch of virus that way, and they put that into the vaccine. Its a live, a living virus, so it can infect you. The virus of course is weakened so hopefully it wont infect you, but it can.
So, there is no mercury, great. But you know the human cells, not the fetus lung cells, but that third group of cells, the human cells, well the proteins and DNA cells are injected into you, and that is listed in the package insert. There is a little bit of, the cow fetus blood, there is a little bit of that which is injected into you as well.
So the chicken pox vaccine side effects. Well, you can have bleeding problems, your brain can get inflamed, seizures, you can have a bad rash, but all those things can happen if you catch the disease as well. If you get the disease these things can happen, if you get the shot these things can happen. Thankfully its all very rare, the disease or the shot having the effects, both are very rare.
So where does this disease, where does this shot rank for your babies? Is the disease common? Yeah. Is it severe? No. Are the ingredients safe? Its very questionable, because this is such an unusual manufacturing process. Is the side effect profile safe? Well, the side effects listed, thankfully are very rare, but they can be pretty severe for the few people that they do affect. Is chicken pox a public health risk? Yes, if you dont vaccinate your child, you are increasing the likelihood that others around you will catch the disease. So I would score this vaccine as a 2 out of 5 on the level of importance. Mainly because its a common disease and a public health risk, but for the other factors I give it a lower ranking.
POLIO
Ok, you might be interested to know that only 1 in 250 cases of polio will actually cause paralysis. Little fact I did not used to know. We havent had a case of polio here in the US in about 25 years. Except for one person, an immigrant, who brought it in. No other immigrants brought it in. We still have polio in at least seven other countries in Africa and Asia. But, we dont have it in Central America, South America, or in Western Europe. So polio is thankfully gone from our country. We still give the vaccine at 2, 4, 18 months and 5 years, to keep, obviously, to keep polio out of our country. We dont use the live oral polio vaccine anymore because that can actually make you paralyzed, so we dont that anymore. We give you the injected polio vaccine. So if youve heard that you can catch polio from the vaccine, thats no longer true, you cant catch it from the vaccine any more.
How do they make it? Well they got some monkey kidneys and they grow the virus in those monkey kidneys. Then they get a baby cows blood and take the liquid out and pour that in with the monkey kidneys and thats what they use to nourish the virus. Its filtered out, and the virus, the virus is killed. So there is no way it can infect you. So the ingredients, there is a little bit of formaldehyde that is left over in this vaccine, there are proteins from that baby cows blood that are in the liquid that are injected into you, residual proteins. They do use monkey kidney cells which I talked about at the beginning of this talk, about what has happened in the past with monkey kidneys. Obviously there arent monkey kidney cells in the final product, they filter them out, but um, they are there in the process.
Side effects. Well thankfully we dont really see any side effects, except maybe a little fever, a little fussy, that kind of thing. But bad side effects, we dont really see that kind of thing.
So how do I rate this shot? Well, the disease is rare, but it is severe. The ingredients are a little bit questionable but the side effect profile is very safe. Its not a public health threat in the US because it doesnt exist. So I score this as a 2 out of 5 for importance for babies in the US. I will point out that the side effects look really safe, so if you are going to be traveling to a country that has polio, I would feel very safe about getting this vaccine. If you are going to, parts of Africa or Asia where the disease exists, well the side effects just dont seem to happen.
SUMMARY
To summarize, I rated Prevnar meningitis, whooping cough, and HiB meningitis as a 4 out of 5 on the level of importance for babies. I rated Hep B, chicken pox, polio, kind of about 2 out of 5 just because they dont seem as important in the rating of diseases that you need to vaccinate against. MMR I rated a 1 out of 5, for measles-mumps- rubella. Mainly because of the side effects, the ingredients, and those diseases are pretty rare now, thankfully, so I put that low on the scale of importance.
So heres our vaccination schedule. Now what do you do this? What should you do? I cant tell you what you should do. I am going to tell you what you can do and how you might put all this information together. Its called selective vaccination. It means getting the shots that are more important and safer and not getting shots that are not important and are riskier. Um, most of the patients in my practice get all the shots, we do all the routine shots. We do them a little differently though, we only do two shots at one time. One or two. But if you are going to, I mean we do have patients that dont get all their shots, some of them dont get any shots. But the ones that do get some, they get the ones that are more important. Here is kind of what they do, they do the meningitis shots, they do the whooping cough or pertussis shots, one or two at a time.
How does that look on the schedule? Well say the mom comes in and says, hey, my babys not having sex, so lets skip Hep B for now. And Im like, well, if your daughter comes home from a date riding on the back of motorcycle with a new tattoo on her bottom, you might want to reconsider. But ok, skip it for now. Then the mom might say, well polio doesnt really exist in the US, so lets not do polio. And then she might say, you know, chicken pox with human lungs that use to make that, thats kind of weird, and the mom says, maybe Ill just let my kid catch that. So then the profile, the side effect profile of the MMR, that side effect profile is the most severe of all the vaccines, and a lot of parents come to me and tell me that they just dont like the list of side effects that theyve read so they just want to skip MMR. Um, so what does that leave us with? Well, basically that leaves the meningitisis and whooping cough.
I keep changing how I do this in my office but Im thinking of doing it this way: give the baby the whooping cough and the Prevnar shot, at 2 months, right at the beginning, because those are the worst of the diseases. Then well do like another whooping cough and a Hib meningitis, remember HiB is a rare meningitis but it does occur, well do two meningitisis together, and we go through and see. Basically the baby gets pertussis protection, meningitis protection, and then we throw a tetanus booster in there when they are five year olds just to give them some tetanus protection. Right now I might do DT because its mercury-free, and hopefully one day well have a mercury-free tetanus by itself, in the next few years so you can just do that.
This is kind of the list of the most important and the safest vaccines. What about no shots? Some babies arent getting any shots. So if a patient comes to me and says, I dont want any shots, I say, ok, thats your choice, but you better breastfeed for at least a year, and it would be best if you went to two years. And I try to make them commit to two years of breastfeeding so that the kid will have that protection. If I have a non-vaccinated baby I tell the family, please dont put your baby in daycare. Consider not putting your baby in the church nursery, especially during the winter months. And, Ill say if you are breastfeeding and your baby is not in daycare, then you are in the safest group of babies. And if you dont want shots, ok, Ill still be your doctor and I wont give you a hard time because you are in a safe population. I get really scared if a bottle-fed, daycare family comes to me and says, I dont want any shots. That scares me because the baby
could get whooping cough, the baby might get meningitis, its a whole different situation. If you have a lot of older siblings in school who are getting sick, I say you just have to breastfeed that baby if you arent doing shots. I mean at least, the minimum of two years. If you have several older kids, thats just so they dont get the baby sick.
Vaccines for travel, ok, these are the four diseases you might encounter during travel. I mean, if you get all the shots you are protected. If you decide not to get shots and you travel to third-world countries, these are diseases you might come across. Diphtheria, polio, HiB, HiB might be common wherever youre going, and tetanus, I mean its not like tetanus is more prevalent in another country but if you were to get wounded in a jungle with no tetanus shots around you might be in trouble. So if you are going to travel and you think you might get wounded where youre going you might want to get a tetanus shot before you go.
Teenagers, well, talk about Hep B. Talk about rubella, you think about the arthritis risk from that rubella shot. Should you vaccinate your teenage daughters for rubella? I dont know. If, well, I do have an answer. You can have a blood test to see if your daughter actually caught rubella as a child and you never knew it. If she did, you dont need the shot. Chicken pox can be severe if teenagers or adults catch it, so if you dont do the shot, and your kids never get chicken pox, you can get a blood test to see if they had it and you never knew it, then theyre fine. But if you do a blood test and it shows they never had it, you might think about doing the shot before the teenage years because it can be pretty bad for teenagers.
Now the good news for all the babies is that in ten years when you have the think about this again, chicken pox will probably be gone. It probably wont be here anymore. So dont stress now about chicken pox. Wait ten years then think about it. Again, you can get a blood test for immunity for your teenagers to see if theyve had any of these diseases. If you feel like you want any of these shots, get a blood test on your teen, first, and you might be able to avoid some of those shots.
All right, were in the home stretch. I think Im about done. That might be it. A couple of more slides. In fact I need to come back to this one. There are some books you can read, something pretty informative, gives you a lot about the pros and the cons of each shot, well these are a couple of good books. I dont know if Ill ever get around to writing something myself, I might. A couple of websites for you too. If you want to know where to get all these disease statistics, its the CDC website, CDC.gov. Click on the left column for state health statistics then click on morbidity tables, then you figure out how to pull up the tables that show you the diseases youre interested in. Your local public health department also sends out information about the diseases you can get, about whats in your community. I do want to end the talk on this slide.
If you are going to get shots, you can decrease your childs chance of having a reaction to the shots by giving them Vitamin A and Vitamin C. It shows the doses there. I guess Ill read it for those of you listening to this. Ok, for a few days before the shots and for 2 weeks after the shots, give your baby Vitamin A, you can buy it in the store either as a multivitamin or you can get Vitamin A mixed with a couple of other vitamins, and you can get Vitamin A drops by themselves. For your toddlers and your older kids you can give it cod liver oil, its actually better to use that than the drugstore vitamin A. Give them anywhere from 1000 to 3000 units of Vitamin A. And, every day, give it for those days that I mentioned. Then Vitamin C, on the day of the shot and for a few days after. Give babies about 150 mg twice a day, give children 250 mg twice a day, give teens or adults about 5000 mg of Vitamin C twice a day. This will decrease your, well, it may
decrease your chance of side effects. Obviously not guaranteed, but it might. So I can leave that up for you if youre furiously writing. And I have some time for some questions now, so if you have a question, Ill start at the front and work my way back.
Q and A
Q: At what age would a non-vaccinated child be ok to go into a church nursery or preschool?
A: Id say over age two. Once they hit two, these diseases dont seem to happen much at all.
Q: Do you have to start shots at 2 months? Can you wait 3 or 4 months?
A: Yeah, you can start anytime. Its just time without protection. But yeah, if you are low risk, thats fine. You can start anytime. Or, if you start and decide you dont want to do it, you can stop. You dont have to finish them. Theres no harm if you stop.
Q: How is the Hep B given? Is it given in combination with other shots?
A: Well you can buy the Hep B by itself, or mixed with HiB, or mixed with... oh... something else, one other mix. It may be that your doctor doesnt buy it by itself, but it is available by itself. Your doctor doesnt have to buy it for you.
Q: Are doctors obligated to provide shots in single doses?
A: I dont think they are obligated to provide that, but most doctors are now agreeing to provide mercury-free vaccinations. I mean, I dont really know how to answer that.
Q: Does research show a correlation between the administration of vaccines and the development of autoimmune diseases in kids that are genetically predisposed, and if so, would a reaction in one sibling indicate the chance of the same type of reaction happening with subsequent siblings?
A: Well, one way I can answer that is to say that there are autoimmune diseases that are on the list of side effects. Logically that would mean, probably yes, these children would be at more risk. I dont think anyone has done the research on that, so I cant answer that part. But it is logical that there would be a higher risk.
Q: What age is optimal for the varicella vaccine?
A: Any age between one and twelve.
Q: If your doctor wont provide single dose shots, where can you go to get the vaccines of your choice?A: No, I mean, they have to come through a doctor, so I guess you could go to another doctor. Like if an HMO wont provide what you want you could just pay cash at another office to get what you want. You could go to your doctor and give the money for the vaccine and say, could you please order me a single dose of this vaccine, heres the money for it and money for shipping and an extra $5 for the trouble, that kind of thing. You could try. Depends, your doctor may or may not do that.
Q: What is your opinion of homeopathic vaccines?
A: I know nothing about it, Ive never researched that, so I know nothing about homeopathic vaccines. Its probably better than doing nothing. But honestly I dont know much about it. Maybe I should. Do you know where I could learn about it? A website or something?
Q: Why do you prefer to give one or two shots at a time? And how safe is the flu shot?
A: It decreases your risk of side effects. The safety of a flu shot? Well, the flu shot you spray in your nose has a lot more side effects, and I dont like that vaccine and I wont give it. I see a lot of kids get flu symptoms from the flu vaccine. We dont give it routinely but just give it to kids who really might need it. I dont use it as a part of routine shots. I probably should make it part of this talk, and I probably should, but I dont have a complete answer, sorry.
Q: Which shots did you give to your children?
A: Ok, next question! No really, I am not going to answer that. I will tell my patients that in a confidential setting if they ask.
Q: What about vaccinations for public schools?
A: Yeah, school systems. Well any public school, every single one in California has to let you in regardless of your shots. Now they wont tell you that, I mean they wont offer that information to you. But when you register for school they give you a blue card to write your vaccines on, on the back of it is a place for you to sign saying you are declining vaccines. And the law in California says that they have to let you in. They can hassle you all they want but they have to let you in. A private school can keep you out for refusing shots. Most wont but they legally can do that.
Q: How severe would a side effect have to be for you to forego the shot?
A: For me, probably severe swelling, where the whole arm or leg gets swollen, real severe swelling, not just a little like a bug bite. Real high fever more than three days. Severe screaming or irritability for a couple of days. Because all these things can happen but if its for a few hours, I think its fine. Or any of the severe list of side effects, I wouldnt do that shot again.
Q: If your child has been sick, how long should you wait to have shots?
A: You should wait until youre well for a couple of weeks, but if youve taken antibiotics you should wait longer, three or four weeks. Thats my personal opinion and have no research to back that up, thats just what I suggest.
Q: Would you consider being in places with a high international population to be risky?
A: No, I wouldnt consider being in downtown Las Angeles or going to LAX to put you at any greater risk than in your normal life.
Q: I have a two year old with no vaccines and we are about to be traveling in Asia. What shots would you recommend?
A: Still breastfeeding? Ok, well, those four, Diphtheria, polio, Hib meningitis, Prevnar meningitis, tetanus. I mean those are all potential diseases you could get. You would probably need two shots of each. Well, shes over two so shes beyond the main risk of meningitis. The risk of the meningitisis are probably the same here as anywhere you would travel. So if you wouldnt vaccinate for it here, you wouldnt vaccinate for it just because you travel. HiB is different, its rare here, but it might be all over the place where youre going, It can occur over age two, its rare but it can occur. Its questionable. You could get DT, polio.
Q: Should you have the five year boosters if youve done the rest of the shots?
A: It really comes down to looking at the diseases. I cant really give an answer. You have a polio booster, MMR booster, and a DtaP booster at age five. You would just have to decide, look at those diseases and make your own decision.
Q: I have heard that there are cases of children and infants with Hep B, and no one knows how they got it. Is that true?
A: Correct. There are in fact cases of children with Hep B and no one knows how they contracted it. You assume it was accidental, they came into contact with someones saliva, or blood or something, a freak accident. That does happen, absolutely, but its very rare. Its so rare, you just have to decide what you want to do.
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