There’s a lot of press out there about child vaccinations these days. Typically, the autism/vaccination link and the scandal around it is the favorite topic. As a new father I have a new interest and perspective on these things. For me Autism isn’t the issue. The issue is about how medicine works in this country.
Long story short, medicine is only as good as science and science is “trial and error”. However, many medical practitioners want you to ignore that fact and take their word as law. Some practitioners (purposely or not) use fear and intimidation to push parents into getting all “recommended” treatments. More treatments mean more revenue and more money for the doctor, further reducing the motivation for them to provide individualized care, look for unbiased information (not provided by a drug company), or simply listen calmly to your actual concerns and address them.
Attached below is my response to my local pediatrician who is pushing us to immediately give our daughter all “recommended” vaccinations. She believes that our hesitation has to do with Autism (and popular media) and seems to think we’re ignorant or at least not well informed. We’re not well informed. That’s the problem. We’re down for the vaccinations as long as someone can explain (without FUD) the risk/benefit of each. I want to evaluate any and all proposed treatments on their actual merits and against their actual risks. Crazy, right?
THE VACCINATION CONUNDRUM:
Our goal as educated parents is to protect our children from unnecessary risk. In deciding whether or not to vaccinate, our challenge is to understand the risk of infection for each disease, consider the risk of significant harm from infection and weigh that against the risk of significant harm from the vaccine. Only then can we make an informed decision.
What we know:
- All drugs and vaccines do have side effects.
- Side effects cannot be predicted in a reliable way.
- Drugs and other medical treatments are regularly deprecated by the medical industry due to deaths and debilitations cased by unforeseen side effects.
Educated parents tend to be on “high alert” because:
- The medical industry does not provide adequate information to allow parents to easily weigh the risks.
- Due to lack of time, most doctors are forced to simply convey the information that has been given to them by the drug reps and companies that make these products. Few have time to do their own research.
- There is a clear conflict of interest present here; it is not financially compelling for a drug manufacturer to present the risk/facts in an unbiased way.
Case in point:
The Hepatitis B vaccination is strongly recommended by doctors and hospital staff at the time of birth. This recommendation does not take in to account the extremely low risk of HEP B infection in newborns. The only significant risk of infection is from an HEP B Positive mother. However, the vaccine is recommended for all newborns regardless of whether the mother is infected or not. Also, expecting mothers are not tested for HEP B.
There are two published documents included below relating to HEP B. Vaccination. The first document questions the necessity (due to low risk) of newborn HEP B vaccination and also illustrates that the risk of death and “serious injury” as a result of vaccination outweighed the risk of infection by the disease itself.
The second document relates to a study linking a HEP B vaccine to an increased risk of the development of Multiple Sclerosis.
We chose not to vaccinate our child against HEP B. We had to make a quick decision with little data because the hospital was aggressively pushing the vaccine without providing any detailed information. After reviewing the data available and weighing the risks, I feel we made the right choice about this particular vaccination.
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VACCINE: HEP B (Recommended for all newborns)
PURPOSE: Protect newborn from possible Hepatitis-B infection. Highest risk comes from infected mother. Infection risk is very minimal in the absence of an infected mother.
VACCINE RISK: In addition to deaths and “serious injury” from the vaccine, ongoing research indicates a causal link may be present between certain Hep B vaccines and life threatening or debilitating side effects including the development of Multiple Sclerosis later in life.
Below is a published letter to the editor of “Journal of the American Medical Association”:
Journal of the American Medical Association, Vol. 286 No. 5, August 1, 2001
To the Editor:
In their article on the impact of recommendations regarding the birth dose of Hepatitis B virus (HBV) vaccine, Dr. Daum and colleagues1concluded that “special efforts may be required to make at-birth administration of HBV vaccination universal.” However, since HBV vaccination of newborns has never been shown to be better than vaccination after the maturation of the immune system, this worry about missing the birth dose seems misplaced.
There is no scientific evidence to justify HBV vaccination before the age when those risk factors associated with the HBV transmission (sex, needles, etc.) become relevant. Recent risk-benefit analyses show HBV vaccination among children carries one of the largest unjustified risks and substantial financial costs, second only to the new controversial conjugate pneumococcal vaccine. Specifically, HBV immunization has been associated with 53 deaths and 828 serious injuries, but for 38 million children younger than age 10 years, the total yearly incidence of HBV infection is 191. For children younger than age 14 years, the estimated total mortality secondary to HBV disease is only 11. With such statistics, it is difficult to rationalize HBV vaccination for newborns.
Erdem I. Cantekin, PhD
Department of Otolaryngology
University of Pittsburgh School of Medicine
Children’s Hospital of Pittsburgh
Pittsburgh, PA
Michael Belkin
Bainbridge Island, WA
- Oram RJ, Daum RS, Seal JB, Lauderdale DS. Impact of recommendations to suspend the birth dose of Hepatitis B virus vaccine. JAMA 2001;285:1874-1879.
- Horwin M. Ensuring safe, effective and necessary vaccines for children. Calif West Law Rev. 2001;37:101-148.
- Orient J. Statement by the AAPS in “Vaccines: Public Safety and Personal Choices” before the Government Reform Committee 1999.
Hepatitis B vaccine and the risk of CNS inflammatory demyelination in childhood.
Mikaeloff Y, Caridade G, Suissa S, Tardieu M.
Service de Neurologie Pédiatrique, CHU Bicêtre, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre Cedex, France yann.mikaeloff@bct.aphp.fr
Comment in:
Abstract
BACKGROUND: The risk of CNS inflammatory demyelination associated with hepatitis B (HB) vaccine is debated, with studies reporting conflicting findings.
METHODS: We conducted a population-based case-control study where the cases were children with a first episode of acute CNS inflammatory demyelination in France (1994-2003). Each case was matched on age, sex, and geographic location to up to 12 controls, randomly selected from the general population. Information on vaccinations was confirmed by a copy of the vaccination certificate. The odds ratios (ORs) of CNS inflammatory demyelination associated with HB vaccination were estimated using conditional logistic regression.
RESULTS: The rates of HB vaccination in the 3 years before the index date were 24.4% for the 349 cases and 27.3% for their 2,941 matched controls. HB vaccination within this period was not associated with an increase in the rate of CNS inflammatory demyelination (adjusted OR, 0.74; 0.54-1.02), neither >3 years nor as a function of the number of injections or brand type. When the analysis was restricted to subjects compliant with vaccination, HB vaccine exposure >3 years before index date was associated with an increased trend (1.50; 0.93-2.43), essentially from the Engerix B vaccine (1.74; 1.03-2.95). The OR was particularly elevated for this brand in patients with confirmed multiple sclerosis (2.77; 1.23-6.24).
CONCLUSIONS: Hepatitis B vaccination does not generally increase the risk of CNS inflammatory demyelination in childhood. However, the Engerix B vaccine appears to increase this risk, particularly for confirmed multiple sclerosis, in the longer term. Our results require confirmation in future studies.