Tuesday, February 11, 2020

Weighing the Benefits and Risks of Vaccines

I predict that one of the biggest political issues of this decade will be whether government can mandate that children (and potentially everyone else) must be vaccinated against certain diseases.

This issue is already gaining momentum in a number of liberal states where Democrats are pushing legislation to outlaw any kind of exemptions (personal belief, religious etc) on vaccinations in order for children to be able to attend public schools.

There is little doubt that vaccines have had an enormous impact in the prevention of serious and deadly diseases.

Smallpox plagued humanity for centuries. 1 in 10 children died from smallpox in France and Sweden in the 18th century.

It was a scourge in the American colonies at the same time. Here is a graph that shows the incidence of the disease in Boston before and after the introduction of the smallpox vaccine in Boston in 1800.

Smallpox continued to plague a good part of the world until a global vaccination program was initiated in the 1960's. The disease was officially declared eradicated in 1980.

Vaccinations against smallpox stopped being given in the United States in the early 1970's. That is why you only see this vaccination scar on people over the age of 50 who were born in the United States. It is generally on the upper left arm.

Credit: Medical News Today

Vaccines had a similar effect on polio which claimed many deaths as well as paralyzed many more around the world.

Polio has been considered eradicated in the United States since 1979 but the disease is still seen in undeveloped countries elsewhere in the world.

However, despite the good that vaccines have done, they are not without risk. As I have written before in these pages, every time a medical intervention (tests, immunizations, prescription drugs, surgery) is undertaken you are taking a risk. That risk is generally worthwhile because it will make you better in the long run. However, you could end up in worse shape because of the intervention.

Unfortunately, I have seen the adverse effects of vaccines in stark detail with close personal friends. Their perfectly healthy and normal 5-month old daughter suffered a devastating vaccine injury from a DPT shot. She has never been able to speak or care for herself in any way. She is profoundly autistic with little functional abilities and requires around the clock care. The lives of our close friends were irrevocably changed forever 35 years years ago.

It is heartbreaking all these years later to remember what the mother told us.

"I saw the needle go in and I immediately saw her eyes roll back into her head. I knew in that instant that our little girl was gone."

If anyone tells you that there are NO harmful effects from vaccines they are not being truthful. Our friends fought and won a gigantic lawsuit against the vaccine manufacturer. Most will have no adverse effects from a vaccine but some will be injured. Some will be permanently disabled. Some will even die. It is a fact. Injecting vaccines into a human body, like any other medical intervention, requires balancing the potential benefits with the possible risk.

The lawsuit that was brought by our friends and others back in the 1980's caused the pharmaceutical industry to go to Congress and threaten that they might stop making and developing vaccines if they were to continue to be subjected to lawsuits from those that were injured by the vaccines they manufactured.

This resulted in the National Childhood Vaccine Injury Act that was signed into law in 1986 that created a federal no-fault system for compensating vaccine-related injuries and deaths and provided immunity from any lawsuits being brought against pharma companies. The compensation is funded by a "tax" on the vaccines. The pharma companies pay nothing into the fund.

Since that time over $4.2 billon has been awarded for children who have been injured or died from vaccines. The law also requires that any adverse events related to vaccines be reported to a centralized data repository called the Vaccine Adverse Event Reporting System (VAERS) and a Vaccine Information Statement (VIS) be provided to the recipient, parent or guardian of anyone receiving a vaccine with a description of the disease involved and the "risks and benefits" of the vaccine.

I understand that advancements in medicine are constantly evolving but I can't help but wonder if the fact that the pharmaceutical companies have been exempted from any liability in the development of vaccines since 1986 has had anything to do with the dramatic increase in the recommended vaccine schedule for children since that time?

Baby Boomers grew up as children and probably only were immunized according to a very limited schedule.

My children, who were all born before 1986, had a recommended immunization schedule that included 24 doses of various vaccines which they all received.

The schedule as of 2018 looked like this and includes 72 total doses. Note that 21 of these immunizations are recommended before 6 months of age. It seems more are added each year.

Many pediatricians suggest today that all of these are necessary. In fact, a good number of pediatric practices will not even allow your child to be in the practice unless all immunizations are up to date.

Why is this?

A lot of doctors honestly and strongly believe in the benefits of all these vaccines. In addition, doctors are under a lot of pressure by the CDC to report vaccination rates in their patients. Very few doctors want to take a public position counter to the CDC despite what they might personally believe. For example, I know of doctors who defer some vaccinations for their own children.

Some pediatricians receive financial rewards from insurance companies where their compliance rates exceed a certain level. There is also no denying that giving vaccinations also brings money into the practice. Of course, a sick kid with the flu also brings in money so I think the financial angle by vax critics is overstated.

Most people trust what their doctors say and do what they recommend with no questions asked. After all, the docs are the experts. What else is there to do? If questioned, most doctors will claim that vaccines are safe and there are no proven links with autism or other adverse long term effects.

Of course, overlaying all of this is the uncomfortable fact that as vaccination rates have increased so have the rates or autism and children with chronic conditions that we did not see 50 years ago.

We are told that there is no correlation or causation. We are told that the thousands of parents who cite vaccines as the reason for their children's disability or autism do not know what they are talking about.

Autism was virtually unknown when I was growing up in the 1950's and 1960's. There were no special education classrooms. Today every school district in America is dedicating millions of dollars to special education programs.

It has to be something that was introduced to the environment or into children's bodies in the last 50 years, doesn't it? What other explanation is there for it?  Some say that it is caused by greater sensitivity and awareness to the issue. That surely is part of it. However, does that explain this massive increase alone?

We have gone from 1 in 10,000 in the 1970's to 1 in 59 children being on the autism spectrum today and no one can tell us why that is?

For boys, it is even worse. It is now 1 in 34 boys.

In the meantime, due to the fact that pharma companies have no liability for vaccine injuries there is not much incentive for them (or anyone else) to do the research and studies to find out if there is a possible link.

One pediatrician in Oregon opened his medical records to an independent study of any link between vaccines and autism in his own practice. Paul Thomas has practiced pediatrics for over 30 years in Beaverton, Oregon and he says he became more cautious about vaccines (most specifically MMR) when he saw several troubling cases of autism in his practice.

Thomas does not require parents to vaccinate and he also does not discourage it. He actually recommends a modified schedule which he calls the "Vaccine-Friendly Plan" which he wrote a book about. The key element of the plan is to utilize a slower evidence-based schedule that specifically calls for no more than one shot containing aluminum at a time. Aluminum is used in many vaccines and is suspected by some to be associated with autism.

Thomas recently commissioned an independent pediatrician, neonatologist and informatics expert to pull the data from the 3,345 patients born into his practice since 2008 for the study.

Out of 715 unvaccinated children, just one was diagnosed with autism. (1 in 715)

Out of 2,629 Vaccine-Friendly Plan (alternative schedule), just six were diagnosed. (1 in 438)

Compare those to the 1 in 59 number above and it does make you wonder doesn't it?

This background may also allow you to better understand why some parents may want to more carefully weigh the decision on whether to vaccinate. Does the benefit truly justify the risk in all cases?

As I have done more research on the subject of vaccines, I have to say it has raised a lot of questions in my mind that I had not previously considered. I also do not understand why it is that anyone who might ask legitimate questions is immediately labeled an anti-Vaxxer.

For example, consider the HepB vaccine that is recommended to be given at birth. Hepatitis B is only transmitted from the mother to the child or through sex and infected needles. What is the purpose of giving this vaccine to a newborn baby whose mother does not have the disease? Does it really have to be given at birth?

I also don't understand why legislatures in states such as California, Oregon, New Jersey and New York are so intent to take away the rights and freedoms of parents who might to want to more closely question the risks compared to the benefits of certain vaccines.

For example, New York wants to mandate that every children born after January 1, 2009 must receive the HPV vaccine and an annual flu shot.

Gardasil, the best known HPV vaccine, has resulted in over 60,000 injuries and 500 deaths according to VAERS. Moreover, the latest data shows that HPV (which is the virus which is said to later cause cancer of the cervix) has been effective in controlling the virus in young women but it is still an open question whether that means that cancer rates will fall over time.

The head of immunizations for the UK Health Service recently said this about the HPV vaccine.

"Due to the long time period between initial HPV infection and development of cancer, it is not possible for trials to use cervical cancer rates as a way to measure how effective HPV vaccines are".

In effect, the trial is being done right now with young women and men who receive the HPV vaccine. It may prove to eliminate the disease. However, in the meantime, there are short term costs in injuries and deaths. Is that cost worth the benefit? Nobody really knows.

Does anyone know enough right now in order to mandate that vaccine?

In addition, the flu vaccine is often ineffective for the current year's strain. If a flu vaccine is mandated for children would you be as comfortable if it was also mandated for you each year? Have you been vaccinated against HepB yourself?

The push by some states to push for stronger mandates on vaccinations has now led to at least one state pushing back the other way.

A bill introduced by the House Majority Leader in South Dakota would eliminate all vaccine mandates in the state that already are in existence. It would provide total individual freedom on this and other medical decisions in South Dakota.

Does a total vaccine exemption make any more sense than a total vaccine mandate?

The entire vaccine question is like many other issues that we see debated every day in the United States.

Where do individual freedoms end and the public interest begin?

We see it on the abortion issue. When does the public interest to protect life override a woman's right to choose?

We see it on gun rights. When does the individual right to bear arms have to be restricted in the public interest?

How do we weigh the competing interests between individual rights and the public interest?

It may be an easy call to mandate vaccinations when you are dealing with a highly contagious disease that has the potential to kill millions.

However, what if we are talking about diseases like measles, chicken pox and the like that a large part of the population has endured in the past with relatively small effect? Or a virus that may cause cervical cancer at sometime in the future where the risk increases substantially the more partners you have over a lifetime?

You also have the question of why it is that, if vaccines are protective and effective, why are those that are not vaccinated considered a threat to those who are vaccinated?

I don't know the answers to most of these questions.

I do predict that the question of vaccine mandates is going to be a big issue in the next decade.

My advice to you is to get better educated on the issue.

Ask more questions of your doctor and read and understand the benefits and risks of what someone wants to put into your body or that of your child or another loved one. There are real benefits in vaccines. However, there are also risks.

Understand that there has been little research on the longer term side effects of many vaccines because there is not enough incentive for anyone to do it. I understand the reasons why the 1986 law was enacted but the unintended consequence may be that no one really has skin in the game to answer some of the tough questions posed above. Pharma companies may have also directed more resources to vaccines for the simple reason that they are more profitable than other products because they bear no liability if things go wrong.

It is also clear that when it comes to vaccines there is a lot more talk about their benefits than there are about their risks. Should there be a more balance conversation on the subject?

If we are going down the road of stronger mandates everyone needs to better understand, and be able to weigh, those risks.

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