I have been asked to guide a discussion for families on the topic of vaccines. I typically do not speak on “vaccines” alone, as I strongly believe there are many decisions that must be made by parents to ensure the health of their children. Making decisions surrounding vaccines is just one aspect of the medical decisions that parents must make for their children. I have included here some links and articles to be used as the “handout” for the discussion that will take place on Wednesday, October 21, 2015.
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Understanding the Vaccine Schedule
Currently, the CDC recommends 32 doses of vaccination before 12 moths of age.
Many of the vaccinations are for diseases that have NEVER been widespread public health concerns.
Some vaccinations are for viruses that cause minimal illness and offer lifelong immunity if experienced normally.
PARENTAL RIGHTS TO INFORMED CONSENT TO VACCINATION MUST BE PRESERVED.
HEPATITIS B – dosed at Birth, 1 month and 6 months Hepatitis B is transmitted by exchange of blood and body fluids (i.e., IV drug use, unprotected sex). A child is considered at risk only if their mother, a primary caregiver or sibling has the virus. This vaccine is given to newborns and infants only because there is a chance they will become part of the at risk population that engages in IV drug use and unsafe sex at some point in the future.
ROTAVIRUS – dosed at 2, 4 and 6 months Rotavirus is one of many pathogens that can cause gastroenteritis, “the stomach bug”, leading to dehydration in small children. Prior to the availability of a vaccine, almost all children became infected with rotavirus by their third birthday. Repeat infections with different viral strains are possible, and most children have several episodes of rotavirus infection in the first years of life. After several infections with different strains of the virus, children acquire immunity to rotavirus. Rotavirus is inconvenient not life threatening. IV fluids for dehydration
DIPHTHERIA – Dosed at 2mo, 4mo, 6mo, 15mo and 4-6 years. Combined with Tetanus and Pertussis Diphtheria is a very rare disease that can harm people at any age. A total of seven cases were reported to the CDC from 1998-2009. Diphtheria affected children when it was prevalent over a century ago. Scattered outbreaks in developed countries in recent decades have affected mostly adults who use drugs and alcohol.
PERTUSSIS (WHOOPING COUGH) 5 doses at 2mo, 4mo, 6mo, 15mo and 4-6 years. Combined with Tetanus and Diptheria. The vaccine has limited strain coverage and poor effectiveness. The vaccine wanes in 2 to 4 years and is associated with a 40-fold increase in pertussis colonization. Older relatives or caregivers often infect infants. The recently vaccinated carry the bacteria asymptomatically and infect others. Australia ended its “cocooning” program in 2012 because the vaccine was ineffective at protecting newborns.
TETANUS – 5 doses at 2mo, 4mo, 6mo, 15mo and 4-6 years. Combined with Diptheria and Pertussis Tetanus is a rare disease that is not transmissible. It affects fewer than 50 people annually and deaths are more likely to occur in persons age 60+. Children are not at risk because tetanus bacteria produce toxins in tissue with an inadequate blood supply (i.e., elderly, diabetics). The vaccine has not been tested to modern standards. Tetanus vaccine can be given at the time of the injury, so there isn’t a need to receive it ahead of time.
FLU (INFLUENZA) – 1-2 annual doses recommended starting at 6 months The independent, international Cochrane Collaboration concluded that, at best, only 10% of the 200 known viruses causing flu and flu-like illness are covered by annual vaccination. Flu vaccines do not reduce working days lost or hospitalization. They are ineffective in preventing illness in children. In children under two, the inactivated vaccine is no better than placebo and safety data are absent. Four Canadian studies showed that people who receive annual flu shots are more likely to catch the flu.
PNEUMOCOCCAL– 4 doses at 2,4, 6 and 12 months The germs responsible for pneumococcal infections are bacteria called Streptococcus pneumoniae. They live in the mucous lining of the nose and in the back of the throat. And when they’re plentiful enough, they can cause an infection in the respiratory tract, middle ear, or sinus cavities. Pnemococcal illness can cause meningitis, pneumonia and ear infections. 60% of pneumococcal infections can be treated effectively with Penicillin.
POLIO – 4 doses at 2,4 and 6 months and 4-6 years The US has been polio-free since 1979 despite the absence of polio vaccination for adults. Booster shots are only recommended for lab techs and other at risk adults. The original polio vaccine caused over 40,000 cases of polio. An early vaccine contained Simian Virus 40 (SV40), which infected millions and has been tied to cancer. Polio is spread via fecal-oral transmission.
MEASLES – 1st dose 12-18 months, 2nd dose 4-6 years, combined with Mumps and Measles Measles is a usually mild disease that can cause complications at any age. Because nutrition-dependent immunological status drives morbidity and mortality risk, high dose vitamin A is used in developing countries. One study reported a 90% lower death rate in infants. Researchers predicted that mass vaccination would eventually cause large outbreaks. In France, there was zero infant mortality tied to recent cases exceeding 20,000; the 10 deaths were largely immunodeficient adults. Contracting measles in childhood may protect against allergic, autoimmune, and degenerative diseases later in life.
MUMPS – 1st dose 12-18 months, 2nd dose 4-6 years, combined with Rubella and Measles Mumps is a usually mild disease that causes more complications in adults. Men can become sterile and pregnant women may have a higher rate of miscarriage. Vaccine immunity wanes and vaccinated children may become vulnerable in college and adulthood.
RUBELLA – 1st dose 12-18 months, 2nd dose 4-6 years, combined with Mumps and Measles. Rubella is a mild disease in children. The vaccine is recommended for women of childbearing age because rubella can cause harm fetuses. The Cochrane Collaboration has been unable to identify any research that assesses the effectiveness of the rubella component of the MMR vaccine.
CHICKENPOX (VARICELLA) – 1st dose at 12 months, 2nd between 4-5 years Chickenpox is a mild disease in childhood. Vaccination shifts disease onset to adulthood and increases the incidence of shingles, a far more serious disease, in adults. Adult shingles cases have risen in the US since the introduction of the chickenpox vaccine but not in the UK where this vaccine has not been introduced.
HEPATITIS A – 2 doses between 12 and 18 months Hepatitis A is associated with unsafe water and poor sanitation; it is a short-term, usually mild illness.
REMOVAL OF A PERSON’S RIGHT TO INFORMED CONSENT OR REFUSAL OF MEDICAL PROCEDURES IS UNCONCONSTITUTIONAL.
EDUCATION AND CHOICE MUST REMAIN PRIORITIES IN HEALTHCARE DECISION MAKING.
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Vaccines Contain Too Much Aluminum
Most vaccines that do not contain live viruses contain aluminum (only exceptions are the flu vaccine and some forms of the polio vaccine). Aluminum is an adjuvant, which means that it increases the immune response. Without aluminum, the immune response to the vaccine would be too weak, and immunity would not be provided. Vaccines that use live viruses (Like MMR, rotavirus and chickenpox) do not contain aluminum, because the replicating pathogen can generate a strong enough immune response on its own.
Aluminum adjuvants were discovered in 1926 by scientists testing chemicals at random. Aluminum worked very well for stimulating an immune reaction, but they didn’t know why. Aluminum was assumed to be safe because its everywhere on Earth, and a common contaminant in food. Injecting a little bit to activate the immune system seemed like a safe bet. It was a reasonable assumption, but it should have been tested (it wasn’t).
The aluminum in vaccines IS dangerous, for two reasons: 1) there is too much of it, and 2) it is present in an especially dangerous form (more on that later).
According to the US vaccination schedule recommended by the CDC, infants will receive the following (maximum) dosages of Al adjuvant:
Birth (Hep B): 147 mcg/kg (500 mcg for 3.4 kg infant)
2 month: 295 mcg/kg (1475 mcg for 5 kg infant)
4 month: 118 mcg/kg (772 mcg for 6.5 kg infant)
6 month: 184 mcg/kg (1475 mcg for 8 kg infant)
Total: 474mcg/kg 4222 mcg
Hep B ranges from 250-500mcg
DtaP ranges from 170-625mcg
These numbers are based on the maximum possible amount of aluminum, since some vaccines have different amounts, depending on manufacturer. Source link for the aluminum content of vaccines is the Vaccine Education Center of the Children’s Hospital of Philadelphia (CHOP.edu), and Dr Paul Offit.
| Pneumococcal vaccine | 0.125 mg |
| Diphtheria-tetanus-pertussis (DTaP) vaccine– | 0.17-0.625 mg |
| Haemophilus influenzae type b (Hib) vaccine– | 0.225 mg |
| Hib/Hep B vaccine | 0.225 mg |
| Hep A vaccine (for children) | 0.225-0.25 mg |
| Hepatitis B vaccine (Hep B) | 0.225-0.5 mg |
| Hep A/ Hep B vaccine | 0.45 mg |
| DTaP/inactivated polio/ Hep B vaccine | 0.85 mg |
| DTaP/inactivated polio/Hib vaccine | 0.33 mg |
| Human Papillomavirus (HPV) vaccine | 0.225 mg |
| Japanese Encephalitis (JE) vaccine | 0.25 mg |
Note: Aluminum is not present in live-virus vaccines (MMR, chickenpox and rotavirus vaccines).
So how much aluminum is this?
The Childrens Hospital of Philadelphia (CHOP) deceptively tries to reassure the public with the following statement:
“The aluminum contained in vaccines is similar to that found in a liter (about 1 quart or 32 fluid ounces) of infant formula. While infants receive about 4.4 milligrams of aluminum in the first six months of life from vaccines, they receive more than that in their diet. Breast-fed infants ingest about 7 milligrams, formula-fed infants ingest about 38 milligrams, and infants who are fed soy formula ingest almost 117 milligrams of aluminum during the same period.”—Childrens Hospital of Philadelphia and Dr Paul Offit
CHOP states 4.4mg, but we calculated 4.2mg in the first 6 months of vaccines. Close enough.
This statement is misleading because oral absorption of aluminum is about 0.01-1%, typically about 0.3%. The oral absorption of aluminum has been studied extensively. While some substances (e.g. citrate) can increase aluminum absorption, it is always less than 1%. Unabsorbed aluminum is eliminated in the feces. It never enters the body. We will use the 0.3% figure, since this is a typical absorption rate (0.01% and 1% are unusual outliers), and is commonly used.
Over the first 6 months, a baby will absorb:
From breastmilk: 7mg x 0.3% = 21 micrograms (0.021 mg)
From formula: 38mg x 0.3% = 114 micrograms (0.114 mg)
From soy formula: 117mg x 0.3% = 351 micrograms (0.351mg)
What is the comparable absorption of aluminum from vaccines? Since the aluminum is injected, the absorption is 100%. The entirety of the aluminum in the vaccine enters the body. It is absorbed from the site of injection over time.
Vaccine advocates say two things about this: 1) that the aluminum dissolves and is flushed from the body in a few days, or an amount of time that renders it harmless, and 2) that the aluminum that doesnt dissolve remains harmlessly at the site of injection. Both claims are false. Claim 1 is contradicted by the Flarend study, which shows that only 6% (for hydroxide) and 22% (for phosphate) of Al adjuvant was eliminated after 1 month. Claim 2 is contradicted by studies by Dr Gherardi, which show that the aluminum disperses throughout the body, and into the brain, in nanoparticulate form (i.e. it moves around the body faster than it dissolves).
Gherardi: Slow CCL2-dependent translocation of biopersistent particles from muscle to brain (see Fig. 1)
See this article for an explanation of how vaccine aluminum nanoparticles spread to the brain: http://vaccinepapers.org/al-adjuvant-nanoparticles-can-travel-brain/
We are ignoring these “kinetics” issues for now. This article is only concerned with showing that the amount of aluminum can be expected to be harmful.
The amount from vaccines is 4,200 micrograms. This is 200 times the amount a baby will receive from natural human breastmilk (21 micrograms), since 4,200/21=200. While this large ratio does not necessarily mean that the amount is toxic, the fact that it is so much higher than what is obtained naturally should be cause for concern.
Dr Paul Offit is being enormously deceptive, by implying to unaware readers that orally ingested aluminum can be directly compared to aluminum injected with a vaccine. Dr. Offit is wrong because aluminum has a very low absorption (0.3%). Further, it is a fundamental, basic truth of toxicology that the route of administration (ingestion or injection) is important for determining toxicity, in large part due to the effect of partial absorption when ingested. The low absorption of ingested aluminum is commonly stated in the medical literature, so it appears this critical fact was left out with deceptive intent.
Aluminum is a toxic metal known to cause adverse effects in the brain and bones. How can we determine if the amount of aluminum in vaccines is likely to be toxic? A reasonable way to proceed is to compare it to FDA regulations for aluminum in intravenous solutions. The FDA regulation states:
“Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.”– FDA, 21CFR201.323
The research that the FDA is referring to (Bishop et al, NEJM, 1997) found that infants receiving about 19 mcg/kg/day for more than 10 days (190mcg total) suffered significant mental development impairment compared to infants receiving about 3mcg/kg/day.
Typical intake of aluminum was about 350 micrograms total for the group that suffered mental impairment.
Bishop et al. QUOTE:
“…daily aluminum intake was substantially greater in the infants receiving the standard solutions than in those receiving the aluminum-depleted solutions, 19+/-8 vs. 3+/-1 mcg/kg/day…. For the group of infants receiving the standard solutions for more than 10 days, the Mental Development Index was 10 points less than for those receiving the aluminum-depleted solutions (P=0.02).”
These results are why the FDA regulations restrict the amount of aluminum given to preterm infants to less than 5 mcg/kg/day.
The subjects in this study were preterm infants, born at about 29 weeks gestation. It is known that preterm infants have low kidney function and an undeveloped blood brain barrier, and therefore will be more sensitive to aluminum than full-term healthy infants. However, it is not known how much more sensitive preemies are. Even healthy full term infants have immature kidneys at birth and therefore will be more sensitive to aluminum than older children or adults. The conservative, safe approach is to assume that infant kidney function is roughly comparable with preemie kidney function.
With this kidney difference in mind, lets compare the amount shown to cause mental impairment (19mcg/kg/day for >10 days) with the aluminum dosages in vaccines recommended by the CDC.
Al dosage received at the 2-month date: 295 mcg/kg (1475 mcg for 5 kg infant)
This corresponds to 295/19 = 15.5 days at 19mcg/kg/day. This is well above the 10-days-worth threshold shown to cause mental impairment.
This is a shocking result. At the 2-month vaccination date, an infant will receive, in a single day, an amount of aluminum well above the dosage known to cause impaired mental development in a preterm infant when given over 10 days. Single-day administration will increase toxicity, and the more-developed kidneys of a healthy infant will tend to decrease toxicity. Which factor is larger, and by how much, is not known.
Would you take, in a single day, a cumulative amount of a drug known to cause brain damage when spread out over 10 days? Of course not. An acute large dose of a toxin is always more harmful than the same amount taken over a long period of time. (Large doses taken orally can result in lower absorption, but such is not the case with IV or injected toxins. If you know of exceptions, please write).
Also, it is noted that the dose of aluminum from vaccines is 1475mcg compared to about 350mcg in the infants that suffered mental impairment, about 4-fold higher.
The other vaccination dates convert as follows:
Birth (Hep B): 147 mcg/kg 147/19 = 7.7 days
4 month: 118 mcg/kg 118/19 = 6.2 days
6 month: 184 mcg/kg 184/19 = 9.7 days
The 6-month vaccination dosage is right at the threshold. And of course all four dosages are cumulative.
Certainly, in view of these numbers, and the fact they are cumulative, I believe its reasonable to expect (or believe its “likely”) that aluminum in vaccines is causing brain damage and impaired mental development in infants.
Skeptics may object that the form of aluminum in vaccines (nanoparticulate Al hydroxide or Al phosphate) is different compared to that delivered by IV or orally (ionic). This is absolutely true. Al adjuvant is more slowly released into the body. However:
1) Injected aluminum adjuvant is MORE harmful than ingested (ionic) aluminum, because nanoparticulate aluminum is carried by white blood cells to sensitive tissues like the brain, and because the particles cannot be readily eliminated through the kidneys. Injected nanoparticulate aluminum travels around the body differently, and studies have shown it winds up in the brain, in nanoparticulate form. This issue is explained here: http://vaccinepapers.org/al-adjuvant-nanoparticles-can-travel-brain/
2) Vaccine advocates routinely use oral dosing experiments as a benchmark for aluminum safety. But the theoretical studies relied on for showing that oral ingestion is safe are wrong and deceptive. This issue is explained here: http://vaccinepapers.org/rigorous-defense-al-adjuvant-wrong/
Papers in this post:
Bishop NJ1, Morley R, Day JP, Lucas A. N England Journal of Medicine 1997 May 29;336(22):1557-61.
Slow CCL2-dependent translocation of biopersistent particles from muscle to brain
Khan Z, Combadière C, Authier FJ, Itier V, Lux F, Exley C, Mahrouf-Yorgov M, Decrouy X, Moretto P, Tillement O, Gherardi RK, Cadusseau J. BMC medicine 2013 Apr 4;11:99.
In vivo absorption of aluminium-containing vaccine adjuvants using 26Al
Flarend, R E. Hem, S L. White, J L. Elmore, D. Suckow, M A. Rudy, A C. Dandashli, E A. Vaccine ; 15(12-13):1314-8
Presidential Candidates on Vaccines: Too many, too soon.
Posted on September 24, 2015 by Kimberly Hartke •
http://www.westonaprice.org/press/presidential-candidates-on-vaccines-too-many-too-soon/
FOR IMMEDIATE RELEASE
Presidential Candidates on Vaccines: Too many, too soon.
Weston A. Price Foundation calls for immediate study
comparing health of vaccinated and unvaccinated children.
WASHINGTON, D.C. –September 24, 2015- Donald Trump, Dr. Ben Carson, and Dr. Rand Paul, three candidates for president, weighed in on the vaccine controversy by stating that there are too many vaccines too soon and many are unnecessary. Trump recounted vaccine damage and regression in children of his staff.
Dr. Carson: “…vaccines are very important, certain ones, the ones that would prevent death or crippling…there are a multitude of vaccines which probably don’t fit in that category.”
Trump: “we’ve had so many instances, people that work for me, just the other day 2 years old, 2 and a half years old the child, the beautiful child went to have the vaccine and came back and a week later got a tremendous fever got very, very sick now is autistic. I only say, I’m in favor of vaccines, do them over a longer period of time, same amount but just in in little sections.”
Dr. Carson: “…we are probably giving way too many [vaccines] in too short a period of time and a lot of pediatricians now recognize that and I think are cutting down on the number and the proximity…and I think that’s appropriate.”
Paul: “I’m also a little concerned about how they’re all bunched up.”
The candidates, some also doctors, acknowledge problems with the aggressive vaccine schedule, a view shared by millions of Americans. As vaccines are studied individually but given in combinations, this concern is valid. No current research demonstrates the safety of administering a variety of vaccines at once. In addition, children receive 49 doses of 14 vaccines by age 6 and a total of 69 doses of 16 vaccines by age 18, but the safety and impact of this vaccine schedule has not been proven.
“The Centers for Disease Control and Prevention (CDC) and most media deny any research exists, but there are in fact hundreds of studies connecting vaccines to a host of injuries including neurological damage, learning and speech delays, autoimmune disease, gastrointestinal disease, seizures, allergies, and more. Moreover, one hundred studies connect vaccines to autism,” , says Leslie Manookian, documentary filmmaker and activist. The website for Manookian’s award-winning documentary, “The Greater Good” contains links to over two hundred such research studies. The public can also easily access studies at PubMed.gov, the US National Library of Medicine National Institutes of Health and various websites.
Given this growing and alarming body of research, combined with the public statements of the presidential candidates, the Weston A. Price Foundation is urgently calling for a study comparing the health outcomes of vaccinated and fully unvaccinated children, a study the CDC has failed to conduct.
Sally Fallon Morell, president of the foundation raised an important question when she asked, “Why will the CDC not conduct the study of vaccinated and unvaccinated children? If they are so confident vaccines are safe, what do they have to fear?”
The heath of American children has never been worse with over 50 percent or 32 million children suffering from a chronic illness or disability such as autism, obesity, allergies, asthma, learning delays and developmental disabilities. Most concerning of all is the fact that science connects all these chronic conditions to vaccines and their ingredients. It is time for CDC to come clean and do the study comparing health outcomes of vaccinated to unvaccinated children.
The Weston A. Price Foundation is a 501(c)(3) nutrition education foundation with the mission of disseminating accurate, science-based information on diet and health. Named after nutrition pioneer Weston A. Price, DDS, author of Nutrition and Physical Degeneration, the Washington, DC-based Foundation publishes a quarterly journal for its 15,000 members, supports 600 local chapters worldwide and hosts a yearly international conference. The Foundation phone number is (202) 363-4394, www.westonaprice.org, info@westonaprice.org.
Media Contacts:
Kimberly Hartke, WAPF publicist 703-860-2711
Leslie Manookian, 208-721-2135
Full quotes from debate:
Carson: There have been numerous studies and they have not demonstrated that there’s any correlation between vaccines and autism…Vaccines are very important, certain ones, the ones that would prevent death or crippling. There are others, there are a multitude of vaccines which probably don’t fit in that category and there should be some discretion in those cases, but you know a lot of this is pushed by big government and I think that’s one of the things that people so vehemently want to get rid of.
Trump: Autism has become an epidemic, 25 years ago 35 years ago you look at the statistics, not even close. It has gotten totally out of control. I am totally in favor of vaccines but I want smaller doses over a longer period of time. Because you take a baby in, and I’ve seen it, and I’ve seen it and I had my children taken care of over a long period of time, over a 2 or 3 year period of time, same exact amount but you take this little beautiful baby and you pump, I mean it looks just like it’s meant for a horse not for a child, and we’ve had so many instances, people that work for me, just the other day 2 years old, 2 and a half years old the child, the beautiful child went to have the vaccine and came back and a week later got a tremendous fever got very, very sick now is autistic. I only say, I’m in favor of vaccines, do them over a longer period of time, same amount but just in in little sections and I think you’re going to have, I think you’re going to see, a big impact on autism.
Carson: But you know the fact of the matter is, we have extremely well documented proof that there’s no autism associated with vaccinations, but it is true that we are probably giving way too many in too short a period of time and a lot of pediatricians now recognize that and I think are cutting down on the number and the proximity in which those are done and I think that’s appropriate.
Paul: I’m all for vaccines but I’m also for freedom. I’m also a little concerned about how they’re all bunched up, my kids had all their vaccines and even if the science doesn’t say bunching em up’s a problem, I ought to have the right to spread my vaccines out a little bit.”
_________________________________
http://www.cbsnews.com/news/fact-check-gop-debate-on-vaccines-and-autism/
http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-schedule.pdf
http://www.greatergoodmovie.org/learn-more/science/
http://adventuresinautism.blogspot.com/2007/06/no-evidence-of-any-link.html
http://www.ncbi.nlm.nih.gov/pubmed
http://vaccinexchange.org/2011/09/06/54-of-children-chronically-ill-report-finds/
http://www.greatergoodmovie.org/learn-more/science/
http://www.greenmedinfo.com/blog/herd-immunity-myth-or-reality
Herd Immunity: Myth or Reality?
Posted on: Saturday, April 5th 2014 at 7:45 pm
Written By: Tetyana Obukhanych, PhD
Tetyana Obukhanych (Ph.D. in immunology from Rockefeller University, New York, NY) is the author of Vaccine Illusion. The book is available in pdf e-book form for immediate download here.
Even though endemic outbreaks of common childhood diseases, such as measles, have been eliminated in some regions after prolonged mass-vaccination efforts, we are still being constantly reminded that reducing vaccination coverage of children in a community poses the risk of a reimported disease outbreak with potentially dire consequences to infants and immuno-compromised individuals. We are also being persuaded that implementing strict vaccination compliance will prevent an outbreak and protect vaccine-ineligible infants via the herd-immunity effect.
There is no question that a disease outbreak can happen in a non-immune community, if a virus gets there. The real question is, how well can high-vaccination compliance ensure herd immunity and protect a community from an outbreak?
Herd Immunity, a Key Principle
Herd immunity is not an immunologic idea, but rather an epidemiologic construct, which theoretically predicts successful disease control when a certain pre-calculated percentage of people in the population are immune from disease. A scholarly article on herd immunity states:
“Along with the growth of interest in herd immunity, there has been a proliferation of views of what it means or even of whether it exists at all. Several authors have written of data on measles, which “challenge” the principle of herd immunity and others cite widely divergent estimates (from 70 to 95 percent) of the magnitude of the herd immunity threshold required for measles eradication.”[1]
Herd immunity has been deemed instrumental in rapid disease eradication. Relying upon the meticulous work of Dr. A. W. Hedrich, who documented annual measles attack rates in relation to the proportion of naturally immune people in the 1900s-1930s, the United States Public Health Service had confidently announced in 1967 its intent to swiftly eradicate measles in the USA over the Winter by vaccinating a sufficient number of still susceptible children.[2] Mass vaccination was implemented, but the expected herd-immunity effect did not materialize and measles epidemics did not stop in 1967.
The concept of herd immunity has been used to justify the idea of vaccinating children against a mild disease, who do not personally benefit from such vaccination, to protect a vulnerable but vaccine-ineligible segment of the population. For example, rubella is not dangerous for children. However, for pregnant women who have not become immune from rubella prior to pregnancy, a rubella infection poses a danger during the first trimester by increasing the risk of fetal developmental abnormalities (congenital rubella). Obviously, vaccination with a live-attenuated viral vaccine, such as the rubella vaccine, is contraindicated during pregnancy.
Perhaps with the good intention to immediately put an end to any risk of congenital rubella in their community, elementary-school children were vaccinated en mass against rubella in 1970 in Casper, Wyoming. Ironically, nine months after this local vaccination campaign, an outbreak of rubella hit Casper. The herd-immunity effect did not materialize and the outbreak involved over one thousand cases and reached several pregnant women. The perplexed authors of the study describing this outbreak wrote:
“The concept that a highly immune group of pre-pubertal children will prevent the spread of rubella in the rest of the community was shown by this epidemic not always to be valid.”[3]
The belief in herd immunity has no doubt been influencing vaccine-related legislation in many U.S. states and other countries. This notion is used as a trump card to justify and mandate legal measures aiming to increase vaccination compliance. An implicit assumption is that liberal vaccine exemptions somehow compromise this precious herd immunity, which the public-health authorities strive to establish and maintain via vaccination.
Herd Immunity, a Flawed Concept
Although the evidence for vaccination-based herd immunity is yet to materialize, there is plenty of evidence to the contrary. Just a single publication by Poland & Jacobson (1994) reports on 18 different measles outbreaks throughout North America, occurring in school populations with very-high vaccination coverage for measles (71% to 99.8%). In these outbreaks, vaccinated children constituted 30% to 100% of measles cases. Many more similar outbreaks, occurring after 1994, can be found by searching epidemiologic literature.
Before the 1990s, only a single dose of the measles vaccine was on the childhood schedule in North America. Frequent occurrence of measles outbreaks in highly vaccinated communities have been blamed by the medical establishment on what they thought was a failure-prone, single-shot vaccination strategy. The second MMR (measles-mumps-rubella) shot was introduced in the United States and Canada in the 1990s, followed by the elimination of the endemic measles virus from North America by 2002.
In 2011, an imported measles outbreak – and the largest in the post-elimination era – hit a community in Quebec, Canada with 95-97% measles vaccination compliance in the era of double vaccination against measles. If double vaccination is not enough to patch those alleged vaccine failures and ensure the elusive herd immunity, should we then look forward to triple (or, might as well, quadruple) MMR vaccination strategy to see how that might work out with respect to herd immunity? Or, should we instead re-examine the herd immunity concept itself?
The herd-immunity concept is based on a faulty assumption that vaccination elicits in an individual a state equivalent to bona fide immunity (life-long resistance to viral infection). As with any garbage in-garbage out type of theory, the expectations of the herd-immunity theory are bound to fail in the real world.
Ochsenbein et al. (2000) conducted an experiment in mice, in which they compared the effect of injecting mice with two preparations of the vesicular stomatitis virus (VSV). They immunized mice with either unmodified VSV (live virus) or ultraviolet light-inactivated VSV incapable of replication (dead virus). Then they tested the capacity of the serum from the two groups of immunized animals to neutralize live VSV over the 300 days following immunization.
The injection of the live-virus preparation induced long-lasting virus-neutralization capacity of the serum in mice, which persisted for the whole duration of the study (300 days). In contrast, the injection of the dead-virus preparation induced much lower levels of virus-neutralizing serum titers to start with. Virus-neutralizing serum titers reached a peak at 20 days post-immunization and then started to wane rapidly. They went below the level detectable by the neutralization test by the end of the study period (300 days). The conclusion of this experiment was that a procedure that attenuates or inactivates the virus also diminishes its ability to induce long-lasting virus-neutralizing serum titers upon immunization of animals.
Vaccines against viral childhood diseases are similarly prepared by first isolating the virus from a sick person, then rendering it artificially attenuated or inactivated to make a vaccine. The attenuation or inactivation of a wild virus to become a vaccine-strain virus is done to reduce the likelihood of it inducing the disease symptoms or complications, although this happens anyway in some cases. The process of attenuation, while making a vaccine virus “safer” than the original wild virus, as far as disease symptoms are concerned, also limits the durability of vaccine protection. In fact, all vaccines are by necessity either attenuated or inactivated microorganisms or their isolated pieces mixed with adjuvants; and, therefore, the protective effect of any vaccine is bound to wane sooner or later.
The protective threshold for measles-virus neutralizing serum titers in humans is known.[4] Also known is the duration of time after vaccination with MMR when measles-virus neutralizing serum titers drop below the protective level in a segment of the population. [5]
The Boston University Measles Study
In 1990, a blood drive was conducted among the students of Boston University a month before the campus was hit with a measles outbreak. Due to these natural circumstances, researchers happened to have access to blood samples of many students who either got measles or were spared from the disease during the outbreak. The levels of measles virus-neutralizing serum titers were appropriately measured by the plaque reduction neutralization (PRN) technique, a month prior to and two months after the exposure. Pre-exposure PRN titers were then correlated with the degree of protection from measles: (1) no detectable infection or disease; (2) serologically confirmed measles infection with a modified clinical course of disease; or (3) full-blown measles. By the way, eight out of nine students who ended up getting full-blown measles, had been vaccinated against measles in their childhood.
The outcome of the Boston University measles outbreak study by Chen et al. (1990) was the following:
(a) In all previously vaccinated students who experienced full-blown measles, pre-exposure PRN titers were below 120;
(b) 70% of students whose pre-exposure PRN titers were between 120 and 1052, ended up having a serologically confirmed measles infection, but since their altered disease symptoms did not conform to the clinical measles case definition, they were categorized as non-cases during the outbreak; and
(c) Students with pre-exposure PRN titers in excess of 1052 were for the most part protected both from the typical clinical disease and measles infection.
During the outbreak, many students with pre-exposure PRN titers between 120 and 1052, who were officially categorized as non-cases, nevertheless had most of the viral-disease symptoms, including cough, photophobia, headache, and fever. These “non-cases” ended up with high post-exposure measles PRN titers, just as the disease cases did, suggesting that they were able to replicate the virus during their illness and possibly transmit it.
Subsequent Measles Vaccine Observations
A study by LeBaron et al. (2007) was conducted to determine the duration of measles virus-neutralization serum titers after the receipt of the second MMR shot. The study enrolled several hundred healthy Caucasian children from rural U.S. areas free of measles outbreaks for the duration of the study. About a quarter of these children generated relatively high titers in response to vaccination, although not nearly as high as the titers after a natural infection would be. The rest responded modestly, and some very poorly. The titers in all children, regardless of being high, moderate, or low, reached a peak in a month after the MMR booster, then came down in six months to the pre-booster levels and continued to decline gradually over the next 5-10 years of observation.
In the above study, only about a top quarter of children (called high responders) were able to maintain PRN titers in excess of 1000 units 10 years following their second MMR shot, received at the age of five. These children are therefore likely to still be protected from the measles infection by the time they are adolescents.
The least-efficient vaccine responders (bottom 5%) had their PRN titers fall below 120 units within 5-10 years after the second MMR shot. This percentage of vaccinated children is expected to have full-blown, clinically identifiable measles upon exposure when they get a bit older. This is the reason why vaccinated (and even twice-vaccinated) people show up as disease cases in numbers equal to or even exceeding the unvaccinated cases in communities with very high (>95%) vaccination coverage. Rapid loss of vaccine protection in low responders is the reason for the paradox of a “vaccine-preventable” disease becoming the disease of the vaccinated in highly vaccinated communities. Such disease cases (and outbreaks driven by them) are not due to random vaccine failures, they are anticipated vaccine failures.
For the majority of children, the PRN titers fall between 120 and 1000 by the time they reach adolescence. These individuals can acquire infection upon exposure and be potentially contagious during an outbreak, although they might experience a modified course of measles and therefore not be labeled as measles cases for the purposes of reporting.
High Vaccination Compliance Is No Guarantee
Measles cases imported into North America after the eradication of the endemic virus in the early 2000s had typically resulted in small or no sustained outbreaks in the last decade, in part due to the vigilance of the public-health authorities in quarantine implementation. However, the 2011 imported outbreak of measles in Quebec, Canada, characterized by de Serreset al. (2013), appeared to be ominously different. Strict quarantine measures were not implemented, possibly because of the assumption that the region was well under herd immunity due to an exceptionally high and uniform vaccination compliance for measles (95-97%) in this region. The consequences of relying on non-existent herd immunity as opposed to quarantine in curbing an imported disease outbreak were very telling.
Imported by a high-school teacher during the Spring break trip abroad (he himself having been vaccinated for measles in his childhood), the outbreak spread swiftly from this index case, involved more than 600 individuals, and lasted for half a year. Nearly 50% of the measles cases were twice-vaccinated individuals. As would be predicted by the waning nature of vaccine-based protection, the contribution of twice-vaccinated children to disease cases increased with age. Twice-vaccinated cases constituted only 4.1% of the 5-9 age group, but 18% of the 10-14 age group, and 22% of the 15-19 age group. Unfortunately, the study did not assess how many previously vaccinated individuals ended up getting a measles infection with a modified course of disease and thus were not counted as disease cases for the purposes of reporting, yet were spreading the virus around in the community.
The medical establishment assumes that vaccinated children, if they themselves get infected with the virus or even develop full-blown (called breakthrough) disease, cannot transmit it to others. Some cite a paper published in the prestigiousJournal of American Medical Association (JAMA) as providing evidence for this assumption. Indeed, the title of the article reads “Failure of Vaccinated Children to Transmit Measles.”[6] However, careful examination of the study design reveals that it did not properly address the question it purported to address: whether vaccinated children who get infected during an outbreak can or cannot transmit the virus.
The results of the study clearly show that during an outbreak of measles in an Iowa community in 1970s, which involved both vaccinated and unvaccinated children, non-sick vaccinated children were unlikely to transmit measles to their younger preschool siblings, many of whom could have been recently vaccinated themselves and therefore not vulnerable to measles anyway during that particular outbreak. The vaccination status of those younger siblings was not determined (or disclosed) by the study. Curiously, the study shows that non-sick unvaccinated children also “failed” to transmit measles (which they obviously didn’t contract during that particular outbreak) to their younger preschool siblings with undisclosed vaccination status. If this tells us anything about the failure of the vaccinated children to transmit the virus, then this failure has nothing to do with their vaccination status. But wouldn’t a paper entitled “Failure of Unvaccinated Children to Transmit Measles” be egregiously out of place in JAMA?
The Real Objective
Let us now remind ourselves that the touted purpose of establishing herd immunity via a high degree of vaccination compliance is to be able to promptly cease any outbreak of a benign childhood disease so that a vulnerable but vaccine-ineligible population (i.e., infants or individuals taking immuno-suppressive medications) could avoid contracting the disease that is dangerous only at their age or given their state of health. To prevent an outbreak, 70-95% of the population, according to very-broad theoretical estimates, has to be truly immune – that is, resistant to viral infection, not just protected from developing the full range of symptoms that conform to the accepted clinical definition of the disease. However, even 100% vaccination compliance can at best make only a quarter of the population become resistant to infection for more than ten years. This makes it apparent that stable herd immunity cannot be achieved via childhood vaccination in the long term regardless of the degree of vaccination compliance.
Normal variations in the gene pool (i.e., personal, immuno-genetic profile) affect how efficiently antigens get processed and presented to the immune system for the purposes of antibody production. This might be one of the reasons why only a fraction of children can respond well to vaccination (i.e., can generate and maintain high enough antibody titers for many years), whereas other apparently healthy children do not. Would re-vaccinating those whose personal immuno-genetics do not favor high antibody production in response to the measles vaccine, correct their inherently low degree of vaccine responsiveness? The research that attests to the futility of such an endeavor is gleaned from observations summed up by Dr. Gregory Poland:
“In studies of measles, post-immunization measles antibody in the ‘low positive’ range did not protect against clinical measles when subjects were exposed to the wild measles virus, whereas high levels were protective. Furthermore, non-responders to a single dose of measles vaccine, who demonstrated an antibody response only after a second immunization, were still six times more likely than were responders to a single dose of measles vaccine to develop measles on exposure to wild virus. Others examined ‘poor responders,’ who were re-immunized and developed poor or low-level antibody responses only to lose detectable antibody and develop measles on exposure 2-5 years later.”[7]
The answer is clear: poor responders remain poor responders to further vaccination and cannot contribute to herd immunity from viral diseases in the long run. Then why would the medical establishment insist that vaccine-based herd immunity is even possible if only stricter or more frequent vaccination measures were implemented? Why, for the sake of an unattainable idea, would pediatricians and public-health officials pester those families who choose to shield their children from potential vaccine injuries or to ensure their children’s health via natural vaccine-independent strategies?
A Self-Defeating Public Venture
The biomedical belief that a vaccine-exempt child endangers society by not contributing to herd immunity is preposterous, because vaccinating every single child by the required schedule cannot maintain the desired herd immunity anyway. It is time to let go of the bigotry against those seeking vaccination exemptions for their children. Instead, we should turn our attention to the outcome of mass-vaccination campaigns that lies ahead.
As I have explained elsewhere, mass vaccination of children initially achieves rapid results in disease reduction through attempted viral eradication only because it hitch hikes on top of the permanently immune majority of adults who acquired their real immunity naturally in the pre-vaccination era.[8] The problem is, however, that the proportion of vaccinated but non-immune young adults is now growing, while the proportion of the older immune population is diminishing due to old age. Thus, over time mass vaccination makes us lose rather than gain cumulative immunity in the adult population. At this stage the struggle to control imported outbreaks is going to become an uphill battle regardless of vaccine compliance, with the Quebec experience of 2011 being a harbinger for more of such outbreaks to come.
Mass vaccination eventually ceases endemic disease outbreaks by removing virus circulation in the community, instead of inducing permanent immunity in the vaccinated. However, viral diseases, although reduced in incidence in many countries, are not fully eradicated from all parts of the World. A region-specific elimination of viral exposure by means of mass vaccination at the time when the virus is present globally is hardly good news. Prolonged mass childhood vaccination is a measure of disease control that with time makes our entire adult population (but more importantly infants) more and more defenseless against the incompletely eradicated virus, which can be easily re-imported. Why do we then choose to put so much effort into a self-defeating public-health venture?
Two epidemiologists, who have recognized the potential problem of this waning vaccine-based protection and have included this parameter into their herd-immunity modeling, predict:
“For infectious diseases where immunization can offer lifelong protection, a variety of simple models can be used to explain the utility of vaccination as a control method. However, for many diseases, immunity wanes over time…. Here we show how vaccination can have a range of unexpected consequences. We predict that, after a long disease-free period, the introduction of infection will lead to far larger epidemics than that predicted by standard models. These results have clear implications for the long-term success of any vaccination campaign and highlight the need for a sound understanding of the immunological mechanisms of immunity and vaccination.”[9]
The medical establishment got it all in reverse: it is not vaccine-exempt children who endanger us all, it is the effects of prolonged mass-vaccination campaigns that have done so. When would the medical establishment (and the media) start paying attention to the long-term consequences of mass-vaccination measures instead of hastily and unjustifiably blaming every outbreak on the unvaccinated?
[1] Fine PEM, “Herd immunity: history, theory, practice,” Epid Rev 15, 265-302 (1993).
[2] Sencer DJ, Dull HB, Langmuir AD, “Epidemiologic basis for eradication of measles in 1967,” Public Health Rep 82, 253-256 (1967).
[3] Klock LE, Rachelefsky GS, “Failure of rubella herd immunity during an epidemic,” N Engl J Med 288, 69-72 (1973).
[4] Chen RT, et al., “Measles antibody: reevaluation of protective titers,” J Infect Dis 162, 1036-1042 (1990).
[5] LeBaron CW, et al., “Persistence of measles antibodies after 2 doses of measles vaccine in a post-elimination environment,” Arch Pediatr Adolesc Med 161, 294-301 (2007).
[6] Brandling-Bennet AD, Landrigan PJ, Baker EL, “Failure of vaccinated children to transmit measles,” JAMA 224, 616-618 (1973).
[7] Poland GA, “Variability in immune response to pathogens: using measles vaccine to probe immunogenetic determinants of response,” Am J Hum Genet 62, 215-220 (1998).
[8] Heffernan JM, Keeling MJ, “Implication of vaccination and waning immunity,” Proc R. Soc. B 276, 2071-2080 (2009).