Let's Open Up Conversations on Vaccines, Not Silence Them.
I’m not one who typically rides the fence. I like to take a stance and then argue adamantly for my point. However, today, I’m not here to promote vaccinations or anti-vaccines. Sorry to those for whom that is an interest. I’m writing to raise an issue regarding the ability and tolerance around thinking critically about vaccines. Vaccines is not a black and white issue and yet there are not enough meaningful conversations happening around the topic when there should be.
Instead of meaningful conversations with people seeking to understand the nature of vaccines and vaccination choices, there are emotional opinions on both sides, which, from what I have witnessed, often leads to name calling and silencing of critical thinking.
Very little of which is actually based on a scientific understanding. Even many medical doctors are failing to appreciate the science that guides their practices, choosing medical opinions over evidence. People on both sides of the debate launch arguments that have very little scientific merit. E.g., “It has been proven that MMR vaccines cause autism” or, alternatively, “It has been proven that MMR vaccines do not cause autism”. Neither statement is true from a scientific perspective. This misunderstanding of how science is done is part of a larger scientific illiteracy problem that we are facing in a society that relies so heavily upon science.
To vaccinate or not is not a black and white, neither from a scientific perspective nor from a personal choice perspective, despite what some may think. If you happen to think it is simple then you are more knowledgeable than the World Health Organization, the Centre for Disease Control, the Food and Drug Administration, Health Canada, and any other infectious disease organization that involves dozens of experts trying to evaluate and balance the benefits with the costs of each and every vaccination, separately, and then when combined for consumer use. Please note the use of terms “Benefits and Costs”. Both exist.
These experts are also trying to regulate the manufacturing of vaccines, which is not black and white either, determine when to start recommending new routine vaccines (e.g., chicken pox, rotavirus, HPV), where to offer them (i.e., which countries are most at risk and at need), and when to stop vaccinations protocols because of safety concerns (e.g., rotavirus in 1999), or when to halt vaccinations due to a possible disease eradicated (e.g., polio) while balancing a million other issues on the subject. There are many factors to be considered. We are fortunate to have such smart people dedicated to our service, indeed.
This very complicated process, at the highest levels, also leaves most healthcare consumers and healthcare providers in the dark much of the time on current knowledge and, in the process, forces them to trust (or mistrust) the authorities on these recommendations. Yet, this apparent lack of knowledge comes despite us living in an unprecedented time where much information is, in some ways, widely available and at our finger tips. At the same time, much important information is physically and intellectually inaccessible, because it is also a commercial commodity. Seeing the full picture is impossible in any domain of science, to which vaccine science is not immune. (Gotta love a good pun!)
Because of this information era, we have entered into a time when healthcare is NOT one-directional. Healthcare is interactive. Healthcare providers are, whether they like it or not, forced to listen to the needs of their patients, some of whom attend appointments prepared with more knowledge on the subject than the healthcare provider themselves. At other times they come with a vast amount of misinformation and propaganda. Understanding how to sift through, understand, and manage the information available (and unavailable) is a challenge at many levels, even for myself as a university instructor trying to educate my students on how to do so.
This new information era is happening in almost every industry, not just healthcare. As a separate teaching scenario, I experience it in the university classroom when I teach to my students who have google at their finger tips and spit out random studies and a wealth of potential knowledge that I simply do not often hold in my one brain. Similarly, sales reps are forced to listen to and work with their customers and the knowledge those customers hold instead of being the messenger of that information. Personal trainers, nutritionists, midwives, principle investigators, CEOs etc. all work with clients and employees who have the power of information readily available and who are using this information to educate (or miseducate) themselves. In addition, the quantified self industry is enabling the individual to collect massive amounts of data about themselves to use (or misuse). Soon, if not already, that information will be combined instantly with knowledge of the average that we have been gathering for centuries on the groups and samples of the population through science. There is already a strong push toward genetically compatible pharmaceuticals (including vaccines).
Information is not only available, it is being avidly sought after, used, transformed, combined, and is influencing how we have been thinking about pretty much everything up until this point. All of this alone is reason enough to have open conversations about topics like vaccinations.
Despite this, there is a very unfortunate lack of tolerance regarding people’s choice to think critically about what happens to their bodies and to the bodies of their children. It seems to lead some people toward incredibly childish behaviour of name calling, including the most notables: “idiot”, “stupid”, “ridiculous”,”selfish”, and “crazy people”. People who utter these insults appear to feel privileged to do so simply because they have failed to question a standard of practice that, in my opinion, deserves a revisiting if only because people are starting to question it in the first place. But, perhaps, what disturbs me the most is when I hear or see medically-trained friends of mine become so disrespectful with their own condescending and elitist tone. Might I remind you of the Canadian Paediatric Society guidelines:
- Understand the specific parental vaccine concerns;
- Stay on message and using clear language to present evidence of disease risks, and vaccine benefits and risks fairly and accurately;
- Inform parents about the rigour of the vaccine safety system;
- Address issues related to pain from immunization;
- Avoid dismissal of children from a practice because parents refuse to immunize.
A full description of the guidelines can be seen here: http://www.cps.ca/documents/position/working-with-vaccine-hesitant-parents.
It also concerns me when I see or hear my scientifically-trained friends and colleagues who are trained to ask question at the most fundamental level, fail to not only tolerate others who do, but also fail to ask questions in this situation, knowing full well that science and the humans who apply it are not perfect, absolute, or without bias. In science, we encourage different points of view, for the sake of science itself. I have seen many scientists quick to criticize the quality of the evidence people bring forth against vaccine. Fair enough, but to criticize the people is unfair. I ask you, What are you doing to assist in the science illiteracy problem we have, except to call people stupid? Many people are not aware of what good sources are or what bad sources are. Whose job is it to educate people about this? Yours and mine perhaps as people who have been trained to “create knowledge”. In any case, calling someone stupid in this complex world of dynamically changing knowledge is not the answer, in my opinion.
Why Do People Question Whether or Not to Vaccinate?
A holistic, broader view of vaccinations is absolutely necessary. It is by no means black and white as I already mentioned. Being critical of vaccinations is not, in and of itself stupid or idiotic or bad. In fact, vaccinations are based on a foundation of knowledge (science) that is itself a critical-thinking practice. Some people are critical of the standard and do have many questions regarding vaccinations. In fact, many people should have questions because vaccinations are not benign.
Vaccines Are Not Benign.
The very nature of vaccines prevents them from being benign. They are adminiterested in order to launch an immune response. Vaccinations are typically created with live attenuated forms of the virus (like the MMR - measles, mumps, and rubella, vaccine) or, alternatively, a portion of the virus (see Types of Vaccines Links Below). The vaccine is intended to mimic exposure to the disease so that if that same individual were to come into contact with the disease in the future, that individual would be biologically equipped (with immunity like antibodies) to fight the disease and be protected. During the vaccination phases, ideally, the immune response is present enough to create a reaction but dampened enough not to cause a full-out response, including all of it’s typically symptoms. In this way vaccines cannot be benign otherwise they would be ineffective.
Indeed, vaccinations are not benign but very few, if any, medical procedures or interventions are either (e.g., ibuprofen, ultrasounds, SSRIs, colonoscopies, pap tests, all have effects and some amount of risk). In science, we continue to ask questions about how meaningful each risk is and how does that risk weigh up against the benefits, both at an individual level and at a society level when dealing specifically with epidemics and disease eradication.
It is the risks and side effects associated with vaccines that concern people.
Most people who question vaccinations are doing so because they have serious questions and concerns about theirs and their children’s wellbeing. They are not ignoring the potential of an infectious disease in any sort of stupid or crazy way. They are simply trying to weigh the benefits with the costs, including both known and unknown risks and side effects. In this way, the goal of good health is the same for the majority of us.
Those who are sincerely concerned about vaccinations are not DENYING the effects of the infectious diseases, they simply are trying to balance the cost and benefits of such vaccines, similar to how experts at the very top are also trying to do so. If they believed vaccines were all completely benign, we would never stop administering any of them even upon eradication, for fear of a resurgence. But we do remove vaccinations from our protocol, at least partially because we don’t want to vaccinate unnecessarily.
Recently, there have been several cases of measles in Toronto, more than is typical, which is causing some concern to both sides of the debate. Measles itself IS potentially fatal to infants and, even if not fatal, can still come with serious other complications, like respiratory problems. The World Health Organization says there where 194K reported cases and 122K estimated deaths worldwide (http://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measles/en/). It is considered the leading killer of children whose deaths could have been prevented by vaccines. That being said, most cases of measles are considered mild and measles itself is typically rare in our part of the world (thanks largely to vaccinations).
I don’t know of any anti-vaccinator who fails to acknowledge that a measles-induced fatality striking their child would be extremely devastating. That’s rather uncontested. No one wants their child to get measles. (Although, as it stands, I might intentional send my child to play with another who has chicken pox over getting the vaccination…)
The MMR (measles, mumps, and rubella) vaccination, like other vaccinations, is not benign. At least some vaccinations come with some serious adverse effects, particularly those that use live viruses. In a 2012 Cochrane Review (a Cochrane Review is a comprehensive and systematic review of all known studies on a particular topic) entitled Vaccines for Measles, Mumps and Rubella in Children, the researchers report findings that the MMR vaccine is associated with aseptic meningitis and febrile convulsions (i.e., seizures in children). There is also evidence that the MMR vaccine is also be associated with idiopathic thrombocytopaenic purpura.
Which would you rather? Death vs Seizures? Seizures. Which would you rather: Mild Measles vs Seizures? Mid Measles. Which would you rather: MMR vaccine without any side effects or Measles? MMR vaccine without any side effects. Problem is, we don’t get to decide beforehand. Therein lies a dilemma for a parent.
The researchers of the Cochrane review claim that they “could assess no significant association between MMR immunisation and the following conditions: autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn’s disease, demyelinating diseases, or bacterial or viral infections.” Note the wording of this statement. The researchers very properly, scientifically, and intelligently claim that they could “asses no significant association” referring to the fact they did not observe any association. Does that mean no association exists? Of course not, it means statistically, it is unlikely based on the available data or that the data are too scarce to evaluate. For some of those diseases the data are too scarce (e.g., gait disturbances) but for others there is more available (e.g., autism).
In the conclusions of the study, the authors state that “Existing evidence on the safety and effectiveness of MMR vaccine supports current policies of mass immunisation aimed at global measles eradication and in order to reduce morbidity and mortality associated with mumps and rubella.” Indeed, if we want to eradicate measles, we are well within our safety margin of doing so. Yet, some questions still remain. The first is do I want to subject my child to that global mission? If yes, then no judgement shall befall on me. If no, I am selfish. The problem is, for a parent, their primary concern is the wellbeing of their child. And there is potential for guilt and shame in either direction. In many ways, I see the value of remaining ignorant. Even before this child of mine has been born, I have already been faced with the decision of whether or not to get the flu vaccine while pregnant.
These side effects are still worth monitoring and, as a result, there exists a VAERS (Vaccines Adverse Events Reporting System) data base (link included below). VAERS is a way of tracking and alerting relevant authorities of a potential vaccine-related problem quickly, MUCH more quickly than what can be detected through scientific methodology. The VAERS database is available to anyone for searching. You can select any vaccine, any manufacturer, any time period, any location, any age, etc. and find out what incidents have been reported. I would not recommend doing this, however, because it provides a skewed and unscientific collection of incidents that may or may not be related to the vaccine. It merely serves as a collection of possibilities. However, if you feel you have experienced an adverse reaction, it is something worth participating in. Recently, (ahead of print, Jan 30th, 2015), in another Cochrane Review, researchers examined the incidents associated with the MMR vaccine reported in VAERS between 2003 - 2013. They reported that the system “received 3,175 US reports after MMR vaccine in adults. Of these, 168 (5%) were classified as serious, including 7 reports of death. Females accounted for 77% of reports. The most common signs and symptoms for all reports were pyrexia (19%), rash (17%), pain (13%) and arthralgia (13%).” The results of this review show no new safety issues for MMR vaccines compared to the previous decade. Remembering that this was an evaluation of incidents reports, which is very different from what is systematically reviewed and studied scientifically and only represents one snap shot of possibilities. It also fails to acknowledge the potential incidents that go unreported or happen later on or manifest as chronic conditions. These are some of the unknowns that simply are unknown.
Below, I have included some other concerns that are worthy of further thought, namely, the difference between males and females in side effects, potential problems with current manufacturing processes of the vaccine, and yes, why some people are still thinking about the autism link.
Some people who are critical of vaccinations are even concerned about the wellbeing of all humanity.
I, for example, am concerned about a bigger picture of how massive numbers of vaccinated people transforms our species and our immune systems. This is a BIG question! However, in my pursuit of MMR research, I happened upon some clinical reports that indicated that measles (not the vaccine but measles itself) has anti-cancer properties. This was discovered in the 1950s when several cases of measles emerged in some individuals with hematological malignancies, after which time the malignancies regressed. This was summarized in a scientific paper published in Expert Opinion on Biological Therapy in 2013, Volume 13(4) (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810368/pdf/nihms501831.pdf). This serendipitous finding has actually given rise to new technology using portions of the measles virus itself as a vector to deliver anti-cancer treatments. Am I stupid for asking this big question. Surely not. Although my question might be framed to appear more “scientific” because I am privy to scientific jargon, others with much less scientific training are also asking these questions in their particular jargon, often times sounding like “natural fluff”. It’s not natural fluff. It’s a fair question.
I also wonder if broad-spectrum vaccination protocols (like we have today with vaccinating). Between 1975 - 1985 in the US we vaccinated for 3 diseases. Now we vaccinate for 12 (see link below on timeline). Are we compromising our human immune systems in a similar way (conceptually, but not biologically) to the overuse of antibiotics, which is now, undeniably a problem? Equally valid of a question is do we have to wait many years before we can discover this knowledge? Below I refer to the results of a 2012 Cochrane Review of MMR safety and effectiveness. A Cochrane review systematically reviews all studies on the topic and is quite comprehensive. This is the first such review ever and we have been using MMR for over 40 years now.
In fact, in terms of being concerned about humanity, I would maintain these concerns are actually quite selfless. I could get into the idea of culling the herd but I won’t. Last time I did, that didn’t go over very well. And… as someone about to have a child, I can admit that when it comes down to the level of the individual, I’m much less willing to offer up my child for the culling of the herd. ;)
In some ways, these are interesting questions that have nothing to do with me as an individual or my child per se, and, as such, argue against a selfish motive for one who might choose to not vaccinate. In many ways, it becomes a philosophical issue or belief. Those who want to vaccinate appear to believe one line of thinking but the other line might be fair game as well.
Conclusion
I’ve realized in the process of writing this (I’m on about draft 6 now) that I could go on forever. There is ample scientific information that I could bring up to indulge the skeptical mind, enlighten the ignorant mind, or provoke the debaters. Perhaps I will touch on some other topics later one… likely I will. But the point here was to remind those who readily call those who are against mainstream vaccinations “stupid” that, in fact, it is not they who are stupid. Stupidity would be better defined by those who fail to acknowledge that this conversation is not only worthwhile, it IS happening. Our information era is transforming our minds, our healthcare delivery, and our beliefs. To remain knowingly ignorant is a choice in and of itself, indeed, but one that may not serve the masses for the future. Or maybe it would. Like I said, sometimes I wish to remain ignorant (like I choose to remain about the side effects of peanut butter M & Ms).
There are many concerns that exist around vaccinations with good reason and that’s probably a good thing. Those who question vaccinations of any kind, whether concern is directed toward the vast number childhood vaccines routinely administered now, toward the flu vaccine each season, or toward the HPV vaccine serve an important role in our society. On the one hand, they are the epitome of the new information economy in which we now live. We need to learn how to best navigate this information world and work with it. To leave the burden of omniscience to our healthcare providers is not only impossible, it’s likely an incredible weight that they simply cannot bear.
Those who are critical also serve to help us check the medical interventions we sometimes take for granted and may naively and trustingly adopt. This has served us well since Thalidomide was discovered to cause birth defects and deaths.
Those who are critical force a standard of practice to be questioned. In many ways this reminds me of the animal right’s activists who have fought long and hard against animal use in science and elsewhere. As a result, animal housing and treatment standards in science have greatly improved, which I have witness first-hand and very much appreciate.
For the sake of science, health, and personal decision making, its important that we keep the lines of communication open between those who readily adopt a vaccination schedule and those who do not. We need to know what people are thinking, why they are thinking this, and we need to listen to these very valid concerns to help us better determine a health and safety protocol. In 1990 the CDC established a Vaccine Safety Database but one of the known drawbacks of this database is that few unvaccinated children are listed in the database, possibly because parents aren’t providing this data in fear of being judged. If they are not part of a database, against whom are we comparing the data? What we need are databases that contain data from all groups of in our populations.
People ask me often if I’m going to vaccinate. The answer is currently unknown. I know that I chose not to get the flu shot while pregnant (and never opt for it), I would rather have my child get chicken pox naturally, and I’m not sure about anything else. I will evaluate each vaccine on a case-by-case basis because they are all different. I am both a vaccinator, and an anti-vaccinator, or neither. For MMR, I am torn and do have to do more research. Several additional concerns regarding the MMR vaccine are listed below after the resources.
The unfortunate reality is that understanding the landscape of vaccines is a complex educational experience, even for myself, someone who has a PhD in science. Currently, there is no good mechanism for gathering this information efficiently or without judgement. We are forced to trust in higher organizations and experts. That is the foundation of our medical system. But perhaps that is a foundation worth examining in an era where on the one hand we pride ourselves with having information readily available but on the other hand we criticize people who take it upon themselves to learn.
In any case, silencing people’s opinions and attempts at finding information and making personal decisions is not appropriate nor is it warranted. There are a million questions regarding vaccines out there. Who’s prepared to answer them in an intelligent, respectful, and meaningful manner? I appreciate the conversation currently happening on my FB post. Sincere questions are being asked. Sincere responses are being delivered. Thank you.
Resources
Vaccine Adverse Reporting System
is a national vaccine safety surveillance program co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS is a post-marketing safety surveillance program, collecting information about adverse events (possible side effects) that occur after the administration of vaccines licensed for use in the United States. http://vaers.hhs.gov/index
Animation on Types of Vaccines: http://www.historyofvaccines.org/content/types-vaccines
History of Immunization Timeline: http://www.historyofvaccines.org/content/history-immunization-schedule
Other History of Vaccines Information: http://www.historyofvaccines.org/
http://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements
Number of Cases of Measles in Canada for 2014: http://www.phac-aspc.gc.ca/mrwr-rhrr/2014/w53/index-eng.php
FYI: Here are some other concerns regarding the MMR vaccine I happened upon.
1. Skepticism Over “New” Vaccines
Well, in terms of the MMR vaccine, it has been around long enough that we have decent data on the effectiveness and side effects. Other vaccines are under more scrutiny, like the relatively new chickenpox vaccine and the HPV vaccine. I was conducting my post-doctoral research in the faculty of medicine at Dalhousie when the HPV vaccine came out. I remember many women in the lab insisting that we all get vaccinated. The fear tactic was working to some degree but in the end, I felt unwilling to be a test subject in this early round of immunizations (and never did get the vaccination). I was happy to let others be the test subjects on that one and still am. If I had a teenage right now, I admit, I would investigate in more depth before deciding either way. I know there is a lot of hype over Gardasil these days (see http://www.thestar.com/news/canada/2015/02/05/hpv-vaccine-gardasil-has-a-dark-side-star-investigation-finds.html). Indeed, there are potential adverse effects to the vaccine. This should never be denied. Again, vaccines are not benign. And therefore, a parent must make a decision weighing the potential risks agains the potential benefits of this vaccine in particular. Stupid? Absolutely not. Good critical thinking. Indeed.
This same concern can be applied to the rampant use of the influenza vaccines, and newly introduced varicella (Chickenpox), pneumococcal, Hep B, and Hep A. Each of these are relatively new, compounded by the fact that we now have a hefty vaccination schedule with little (to my knowledge) evaluation of the impact of this collection of vaccinations during a very short span of a young child. We are at an unprecedented time in history with the number of vaccinations we administer. This might be a really fortunate time… or it might be really risky time being the subjects in a huge global study. Worth questioning? Indeed!!
2. How the Vaccine is Produced
Does the average person understand how vaccines are made and what is included in the vehicle by which they are injected? No. When someone sees a list it can become quite concerning. That’s a worthy topic but I’m afraid I haven’t dug into that yet. Instead, I became interested in how vaccines are made, and more important, that our current demand is causing a need to re-examine a quicker method. For a quick animation overview of how vaccines are made, check out a link from the CDC: http://www.historyofvaccines.org/content/how-vaccines-are-made. This does not deal with that goes into the vehicle used to administer the vaccine, mind you.
In a 2012 scientific paper published in Vaccine (Volume 30, p 2715–2727), researchers Hess and colleagues explain that our demands for vaccines in industrialized nations has caused us to exhaust our current manufacturing capacity (using chicken embryo fibroblasts as the cell culture where we have been mostly growing the viruses, or pathogens, used for making vaccines). Chicken embryo fibroblasts is, apparently, the primary host for MMR vaccine production. However, this high demand has prompted the need to find new cell culture hosts (why I’m not entirely sure, I admit) and in efforts to do this quickly, scientists are left without adequate time to fully test the safety. Hess claims this does posses a potential residual risk to humans because some of the new hosts are known to be tumourigenic (i.e., causes tumours to grow) in animals with compromised immune systems. A question that arises is, Will this translate to infants we are inoculating whom we know have immature immune systems? Earlier in the paper, Hess reminds us of the lesson when a live attenuated oral polio vaccine that was administered to millions of people between 1955 and 1963 (presumably in the US), which inadvertently contained the Simian Virus 40, as a contaminant of the poliovirus vaccine manufactured in primary monkey kidney cells. SV40 belongs to a family of viruses known to be tumourigenic. Now, the SV40 present in the vaccine does not appear to have had “a clear [known] role in the pathogenesis of human SV40-associated tumours” however, “childhood brain tumours such as ependymoma and choroid plexus tumours, as well as thyroid, pituitary and parotid gland tumours showed an increase in incidence” following the use of the contaminated vaccine.
Now, a degree of trust is in order to assure that organizations like the WHO and the FDA are adequately equipped to ensure this does not happen again, but safety, efficacy, purity. But as recently as 1999 the rotavirus vaccine, which was only introduced in 1998, was pulled because of serious adverse affects connected with the vaccine. Upon further investigation it was determined that the side effects, although quite severe, were in fact quite rare, but it was not until 2006 that it was re-introduced as part of the US recommended vaccination schedule.
3. The Link With Autism
Lastly, I can’t help but touch on the autism debate because this is the place where I see and hear the slurs of “stupid” most often. Let’s back up a bit with some history on the subject. Many years ago (1998) a study established a potential link between autism and MMR. What raised most of the concerns, I suspect, was that the lead researcher of the study (Wakefield) went on to publicly claim he would have hesitations about administering the vaccine to his own children despite, in the conclusions of the paper reporting “We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunization. Further investigations are needed to examine this syndrome and its possible relation to this vaccine.” The conclusions in the paper in no way lead to public claims afterwards. What they suggested was the need for further research. Later on, upon investigation of Wakefield, ethical concerns about how he conducted the study were raised, which eventually lead to the retraction of the paper itself.
Does any of this prove that there is no association between autism and MMR. No, not exactly. And are those people who still believe it “stupid”? Before you answer that, consider this. The science of that study was actually just inconclusive. As a result scientists have continued to investigate a potential link between MMR vaccination and autism. Fortunately, each study has failed to show support for a link between autism and MMR. Collectively, the lot of studies is quite suggestive that there is no link between MMR and autism. There have been studies published as recently as 2014, yet would we consider these MD/PhD researchers stupid themselves for studying the potential link? Or, are the funders stupid for funding these studies? Not in my opinion. In fact they are doing they due diligence as researchers to exhaust as many possible confounding factors as they can to adequately conclude there is no link. In general, scientific methodology provides tremendous guidelines on how a scientist can draw conclusions which inevitable entails lots of studies to provide support for or against a hypothesis (not proof). When making conclusions, scientist are not stating facts. They are most often stating statistical likelihoods. This process is incredibly tedious but it is the foundation of science. Many studies are required to ensure one can properly draw conclusions but this means we rarely can yes definitely yes or no to any particular phenomenon? Unfortunately not. Which means, technically those critical of science are within reason. That being said, improving science literacy so non-scientists understand what “likely” and “unlikely” actually means in science is worthwhile endeavour. Regarding MMR and autism, Does the MMR vaccine cause it? Possibly… but at this point all of the evidence is pointing toward it not.
Autism Retraction paper retraction article https://www.sciencenews.org/blog/deleted-scenes/journal-retracts-flawed-study-linking-mmr-vaccine-and-autism
4. Males and Females React Differently To Vaccinations
Now, this is probably not a concern that many non-scientists have thought of. As a sex differences researcher and thinker, it interests me. I recently learned that females are at a significant disadvantage compared to males in terms of adverse reactions to the MMR vaccine, according to several published studies. I.e., females are more likely to have a bad reaction to the MMR vaccine than are males. This REALLY disturbs me because it relates to a larger issue to which I happen to be privy as a scientist. The issue is that currently, and for a long time, there exists an unfortunate practice in science to conduct most studies using males laboratory animals only. The rationale has been that females make data more “messy” because they have an estrus (aka menstrual) cycle, which in rats its 4-5 days compared to the average 28 days in humans. The cycle causes hormones to fluctuate and the potentially confounding effects of those hormones can indeed, make data “messy”. Eliminating females from basic science studies has typically been an easier and cheaper way of failing to acknowledge or account for the effects of these hormones. That’s all fine if you’re a male. But for us females, these messy hormonal effects are potentially have VERY important and may dictate how females will respond (sometimes quite adversely) to pharmaceuticals, including vaccines like MMR, when we move on to clinical trials with humans and when drugs go to market. This sex bias is such a serious issue that the National Institute of Health (NIH) has demanded a change at the basic laboratory level (see resources below for a link). But with respect to vaccinations, this information can influence a decision on (and the practice of) how/when/why/who/if to vaccinate.
NIH Sex Bias
http://www.nature.com/news/policy-nih-to-balance-sex-in-cell-and-animal-studies-1.15195
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3008499/
A Point (Stab?) About A Conflict of Interest with Pharmaceutical Companies
A general distrust of Big Phama is here and does not seem to be going anywhere. Are concerns about their conflict of interest valid? Indeed. Big Pharma has to answer to shareholders who are interested (and invested in) making money. Therefore, their bottom line is to make money. Do they cut corners, wiggle around, suppress results, and otherwise do sketchy things to show and earn their profits and fail to reveal information that may interfere with that. Indeed. I have witnessed it and know many other scientist who have too. Personally, I have sat in research talks by former pharmaceutical researchers who have shown data that was suppressed when they were part of that company. My own data, which wasn’t terrible impactful in any direction, but nonetheless was also suppressed because it did not align with the company’s other data. How were they able to do that? Easily, they supplied the drug to me for free but, in exchange, had power over how, when, and if I was able to speak about the data. In the end, I was not able to.
Big pharma also actively (but more passively) funnels money into the training of medical doctors despite apparent efforts to separate the two at face value. The money comes indirectly and in creative ways so that it is not an obvious link because despite not wanting to take the money on principle, the training of medical doctors is expensive and big pharma gladly foots much of the bill.
The Principle Investigators of some Big Pharmaceutical companies have also been known sit on funding boards for the major health funding agencies in Canada.
Should it all be thought about critically? Indeed! Is this enough of a reason for people to be skeptical of vaccination promotions? Maybe. Maybe not. But in any case, it’s NOT a reason to silence those who are critical. It’s a reason to open up conversations and shed light on an industry standard with which some of our population disagrees. I, for one, am highly critical of the influence pharmaceutical companies and their money have on our healthcare perspectives, providers, and policies.
That being said, profits also drive investment, which allows more research, and can also entice great thinkers/scientistic to invest their brain power and careers into basic and clinical research. We need that too. Shades of grey.
FAQs
Should I vaccinate for all diseases?
Good question. We should take each vaccine on a case-by-case basis.
Is the flu vaccine the same as the MMR vaccine?
Quick answer: no. And people can be anti-flu vaccinators but still choose to vaccinate for other infectious diseases. I’m likely one of those people.
When should I Vaccinate? Can I delay the schedule until my child’s immune system is stronger?
This pertains to a delayed schedule. There is some evidence about introducing the MMR vaccine earlier without any more negative effects (http://www.ncbi.nlm.nih.gov/pubmed/25573106) but I cannot find anything on a delayed schedule that is of interest to many people. Dr. Sears is apparently the resource there but I have yet to finish his book.
What is the likelihood that my child will be exposed to the virus?
Depends on the disease. Measles is rare. HPV is very likely but relatively unlikely to lead to cervical cancer providing routine pap smears are continued.
Why do vaccines come together when in nature a child would rarely get, for example, Measles, Mumps, and Rubella all together?
Good question. The answer appears to be that lumping vaccines ups the compliance, requires fewer trips to the doctor, and reduces side effects associated with the needle injection. It’s also cheaper for the healthcare system. I also read that the immunity as a result of the early vaccination for mumps and rubella might not be sufficient for later-life protection. Sidenote: I read in some scientific paper (here I think: http://www.ncbi.nlm.nih.gov/pubmed/23026688) that Rubella and Mumps are not typically considered a childhood disease, which begs the question, why are they given early on anyway. Some suggest they should be separated.
Can/should I separate them?
Often times no. They come prepared by the pharmaceutical companies.
Are there any benefits to not vaccinating?
I mentioned the thing about anti-cancer properties. Their may be benefits that we have neglected to consider. Culling the herd is one that I hesitate to mention, partially because it sounds so vile and partially because I know that if “my child” was affected I would likely change my mind. But from the perspective of someone who also believes our world is over populated with humans, I think culling is a good thing. Again, but not if it’s “my child”. There may also be benefits at an individual level. I heard, for example, that people who had NOT received the flu vaccine over the past 5 years were less likely to develop the flu this season. But I have not followed up on that. The point is interesting and worth exploring as a general concept related to vaccinations.
Are there alternative options to vaccination? Are there other things I can do that will protect against infectious diseases?
Scientifically, I don’t know. Eating healthy, staying healthy, being healthy, maybe. Reducing our stress to stay healthy? Maybe. I just don’t know of any science mostly because I haven’t gotten a chance to look into that yet.
Can the length of time I breastfeed affect my child’s need for vaccinations?
I don’t know. I need to look into this. During my MMR reading I saw something that suggested that women who were vaccinated against MMR produced fewer antibodies than those who were actually infected with measles and that those vaccinated provided less protection through their breast milk. Antibodies in breast milk seems to interfere with vaccinations success in children. Some evidence suggest even withholding breast milk for 30 minutes before children get shots. Other evidence I read suggested that immunity is passed from mom to baby passively in utero and only lasts on average 4 months post-natally. I’m sure there is a TONNE more research out there that I have yet to read. I will post more.
How effective are vaccinations and how long do they last?
If can depend on the vaccination, on the company that manufactured it, and the strain of virus used in its vaccination. That’s why boosters are given. Booster protocols differ according to vaccinations and change over time with new evidence to inform long-term immunity.
Are some people more likely to experience greater efficacy with a vaccination than others?
yes, there is some evidence that people can be more or less susceptible to the immunity provided by the vaccinations based on their genetic make-up. I believe some science is being conducted on genetically-compatible vaccines as a result, similar to efforts to match other drugs to a persons genetic make-up. I remember reading something about Japanese people being more (or less) responsive to the MMR vaccine, but I cannot remember any details.
Are healthcare providers the biggest sources of vaccine-preventable diseases?