Thirty-five years of medical practice have convinced me that all vaccines carry a significant risk of chronic disease that is inherent in the vaccination process and in fact central to how they work. Yet the growing concerns of parents and legislators and the media reports about them seldom elicit anything beyond automatic, scornful denials by medical and public health authorities alike. Reflecting on this discrepancy, the focal point of this essay, has also helped me appreciate how much the invisibility actually heightens the risk, and how intimately these phenomena are connected, like mirror-images of the same reality, so that it is wisest to study them together.
Since I am mainly a clinician, I will begin with a story. It concerns a twelve-year-old boy whom I know of solely from his mother’s letter, but her words are so heartfelt and so congruent with the rest of my experience that I cannot doubt their veracity:
My son Adam was healthy until his first MMR shot at 15 months. Within 2 weeks he had flu and cold symptoms, which persisted for 6 weeks. Then his eyes became puffy, and he was hospitalized with nephrotic syndrome. A renal biopsy showed “focal sclerosing glomerulonephritis,” but the illness didn’t respond to steroids. I asked if it could be related to the vaccine, but they told me it couldn’t, and we accepted that. Over the next 4 years he was hospitalized repeatedly, and missed many months of school, but finally went into remission, seeming normal and healthy and staying off all medications for about 5 years.
Whenhe turned 10, his pediatrician recommended a booster, saying that a rise in measles cases made it dangerous for him not to be protected. I checked the PDR and other sources but found no contraindication for kidney disease and no listing of nephrosis as a possible adverse reaction, so I agreed to it. In less than 2 weeks he relapsed, with 4+ protein in his urine, swelling, and weight gain, signs that we recognized immediately. He got worse even on Prednisone, and was admitted in hypertensive crisis, with blood in his urine, fluid in his lungs,*and massive weight gain. On Cytoxan, massive doses of Prednisone, and three other drugs, he slowly improved, but missed another 7 months of school.
It’s been 2 years since that horrible episode, and he still needs Captopril daily for high blood pressure, and spills 4+ protein every day. The doctor says he sustained major kidney damage, will always need medication to control his blood pressure, and will worsen as he grows older, necessitating a transplant eventually. This time I was convinced that his condition was related to the vaccine, but still the doctors didn’t take me seriously, and told me it was a coincidence.
I began searching for information, and even contacted the manufacturer of the vaccine. Finally they sent me two case reports of nephrotic syndrome following the MMR vaccine. It’s very difficult for lay people to get information, or even ask questions, since we don’t use the correct medical terms and are made to feel stupid. Please tell me if my ideas are reasonable.
I don’t think my son could tolerate another episode, and I think he’d have normal blood pressure and kidne function today if not for that second vaccination. I also have a great concern for other children who develop nephritic syndrome some weeks after receiving MMR and whose doctors never make the connection. They could all be at great risk if revaccinated. I realize that this letter has taken up a great deal of your time, and I’d appreciate any help you can give me. If we were closer, I’d make an appointment to see you in person, so please feel free to charge me. Thank you.1
Like many others who seek my help, this woman honestly believed that her son had been crippled for life by the MMR vaccine, yet had no intention of suing the drug company that made it, the doctor who administered it, or the Government’s Vaccine Injury Compensation Program (VICP), as she was fully entitled to do. Whether she didn’t think she could win, a conclusion my experience would certainly justify, or simply was not a litigious person, as seems more relevant in her case, the absence of such motive only lends further credence to her story. She wrote to me simply to find a physician to hear and validate the truth of her experience, which neither the pediatrician who gave the shots, the specialists who treated Adam in the hospital, or any of the other doctors she spoke to were willing to do. Although she lived over a thousand miles away, and I had nothing else to offer her, it was more than enough to earn her gratitude.
To those colleagues who feel inclined to discredit such tales, I can only reply that the confidences our patients entrust to us represent the truth as they live it; yet when vaccines are involved, their stories are routinely dismissed out of hand, as if they couldn’t possibly be true or worthy of serious consideration. That was certainly the reaction of every physician involved in Adam’s care, in spite of compelling evidence to the contrary, even after two nearly identical case reports were supplied by the drug company itself. Whether a canny strategy to defeat possible litigation, or the instinctive shielding of a cherished world-view from the threat of change, this defensive and hostile stance is so pervasive in the medical profession as to merit careful study in itself.
Richard Horton, Editor of The Lancet, felt the sting of such censorship himself, after daring to publish an article linking cases of infantile autism and autoimmune colitis to the MMR vaccine:
Today vaccines are largely an untouchable subject, their benefits too obvious to be questioned. Any hint of dissent concerning their clinical effectiveness and overall social value is met with bitter rebuttal and resentment. A former President of the UK Academy of Medical Science actually threatened to get me sacked for publishing work that raised questions about the MMR vaccine, while at a party years later, the partner of a government vaccine specialist asked me, “Will you ever be forgiven?” Forgiven for what? I wondered.2
Dr. Horton himself neither believed in the research nor endorsed its conclusions. His only “mistake,” if mistake it was, lay in permitting the author, a respected British gastroenterologist, to publish his findings without regard for their political correctness. Needless to say, the snubs and threats he faced for rocking the boat were small potatoes in comparison with the reprisals exacted against the author, whose work was summarily dismissed without being tested, and whose career at a major London teaching hospital was abruptly terminated.3
Adam’s misfortune also leads me to wonder how “glomerulonephritis,” “encephalopathy,” “autism,” or any other disease gets to be identified as a bona fide complication of a vaccine, so that the victim becomes eligible to receive compensatory damages in court. In spite of two reports of MMR nephritis documented by the manufacturer, renal failure is still not recognized as an adverse effect of the vaccine, an omission that clearly helped Adam’s doctors discredit his mother’s inquiries.
Similar kinds of editing are incorporated into the Federal guidelines for compensation of the vaccine-injured, which would never have been enacted in the first place without the repeated insistence of various parents’ and patients’ advocacy groups, and continue to be whittled down by the equally determined opposition of vaccine manufacturers, the American Academy of Pediatrics, and other authoritative and influential pro-vaccine groups. The official guidelines recognize only a small number of extreme, life-threatening reactions to particular vaccines, because they occur often enough to attain statistical significance in large populations. Such a policy automatically disqualifies two much larger and partly overlapping classes of phenomena that I see very often in my practice, but that few others seem to notice or show much interest in:
1)exacerbation of the common diseases of childhood (asthma, eczema, ear infections, sinusitis, ADD, autism, etc., according to the susceptibilities of individual patients, and representing
2)a nonspecific effect of the vaccination process itself, for which any vaccine may suffice.
Restricting the issue of vaccine safety to allegedly specific effects of particular vaccines is a major reason why the true extent of vaccine-related illness has always been almost invisible, and will likely remain so until the question is reframed in a more comprehensive way.
An equally important limitation of the official guidelines is their restriction in time, to acute events occurring within a few hours or days afterward,4 soon enough for the vaccine to be thought of as the necessary and sufficient cause of the reaction, more or less independently of any prior susceptibility. In Adam’s case, as in many others, vague, nondescript symptoms were reported quite soon after the vaccine, but the full-blown picture of nephrotic syndrome did not appear, and could not have been recognized or thought of, until 6 weeks after the first shot, and 2 weeks after the second, by which time it was not an acute or fixed injury, but a chronic, self-sustaining illness that has continued to develop and worsen over the years, such that a claim on his behalf would undoubtedly have been rejected even if it had been filed.
In what follows, I will consider five distinct but interrelated aspects of the vaccine issue:
1)specific effects of particular vaccines, the only kind described in the literature;
2) nonspecific effects of the vaccination process, based on cases from my practice;
3)how vaccines actually work inside the human body;
4)some individual vaccines, considered one by one; and
5)some implications of these findings for health policy.
1. SPECIFIC EFFECTS OF PARTICULAR VACCINES.
The vaccination literature makes no mention of adverse effects of the process itself, and documents only a few extreme reactions to certain particular vaccines, like anaphylaxis, subacute sclerosing panencephalitis, encephalopathy, and so forth, some of which are themselves still hotly contested by authorities in the field. Even those that are compensable under the Federal guidelines turn out to be vague, generic terms that are applicable to more than one vaccine. Anaphylaxis, for example, is compensable not only for DPT and its three components, but also for MMR, and will likely implicate some or all of the newer vaccines in the future. So to begin with, I will focus on a few adverse reactions that have already been included in the guidelines, considered for inclusion, or perhaps should be so considered, to ask whether they are indeed specific to one vaccine, or whether that concept might itself be misleading.
I will begin with “DPT encephalopathy,” because it was the first adverse reaction to be made compensable under the Vaccine Injury and Compensation Act of 1986, which it also helped bring about, and is by far the most extensively documented. Here are excerpts of a letter from the mother of a 3-year-old girl, requesting an affidavit in support of her litigation against the child’s doctors and the Canadian government:
Our beautiful daughter was damaged as a result of her 18-month vaccination, which consisted of the DPT, HiB, and oral polio vaccines. One week later, she had a bizarre screaming episode, and is now labeled as “autistic,” or PDD. Last month we took her to the Mayo Clinic, where an MRI showed brain inflammation and demyelination. One of the doctors admitted to us privately that she suffers from post-vaccinal encephalitis.
She had maybe 25 words at 18 months, and was ahead in some developmental milestones, as well as being quite social. After her screaming episode she stopped talking immediately, ignored the neighborhood kids, and made no eye contact, although this happened more slowly, and as new parents we first thought her behavior was “just a phase.” She later
developed hand-flapping and other repetitive, stereotyped behaviors as well.
After 6 months we realized we had a serious problem, and we told her pediatrician that we suspected her 18-month vaccinations were the cause. He agreed that she was autistic, and sent her to a specialist for further evaluation. We insisted to the doctors that she had changed abruptly after the vaccination, beginning with the screaming, and showed him a video of her as an infant and toddler, in which they agreed, she seemed perfectly normal. From photos taken before and after, the damage is obvious: her eyes have lost their gleam, and she looks sad and alone. We were very persistent, but the doctors dismissed it as a coincidence, and no mention of any vaccine was ever included in their reports.5
Leaving aside the extremity of this girl's misfortune, as well as that of her family, and the refusal of her doctors to accept any responsibility for it, I want to call attention to her diagnoses, “encephalopathy,” a wastebasket category for any kind of severe brain damage, and the equally vague term “autism,” which today is commonly associated with the MMR vaccine. Both her sad tale and the legal necessity of fixing a label to it indicate that both of the above are broad, generic, and often interchangeable categories, as they were here, referring to conditions that can and do result from several different vaccines, rather than being characteristic of any particular one.
Here is another case, from the lawyer who represented him, that of a 3-year-old boy who reacted badly to his first DPT shot and suffered permanent brain damage after the second:
Our firm represents a child who was born normal and healthy in every way. After his first DPT at 6 weeks, he began falling off growth charts, exhibited multiple develop-mental delays, and was diagnosed as “failure to thrive,” but then slowly began to recover. At 5 months he received a second DPT, and his delays became much more extreme. He has never recovered. He is now 3 years old, with the mental capacity of an infant of a year and a half. I am convinced that his problems came about as a result of the DPT. In view of what happened after the first shot, he should not have had the second, or at least the pertussis component of it.6
While the information provided was very limited, this case is actually more typical in that the boy’s serious and prolonged reaction to his first DPT, from which he eventually recovered, should have warned and actually did warn his pediatrician against giving him the second, which was indeed postponed, but only for a month. This tragic pattern of a warning ignored, of a lesser version of the same illness with eventual recovery, followed by death or irreversible brain damage after a subsequent vaccination, became a major subtext of the exposé, DPT: A Shot in the Dark, in which medical historian Harris Coulter, and Barbara Loe Fisher, the mother of such a child, collected the haunting stories of over 100 little victims.7 The outcry generated by these and other similar cases encouraged Ms. Fisher and a friend similarly aggrieved to found Dissatisfied Parents Together (DPT), which subsequently became the National Vaccine Information Center, or NVIC, a support and advocacy group for the families and friends of vaccine-injured children.
NVIC today has grown to the extent of providing educational materials, hosting annual conferences, and maintaining a national database and a network of local chapters all over the country. Together with similar groups arising independently in various states and localities, it has worked tirelessly to keep vaccine issues before the public, lobbies and testifies before Congress, and helped to write the Vaccine Injury Compensation Act of 1986, which created the first program for no-fault compensation of vaccine injuries as an alternative to litigation. Yet Coulter and Fisher’s book was withdrawn by the original publisher soon after its release, while an influential group of pediatricians still adamantly refuse to accept even these most egregious cases as having any connection at all with the vaccine.
Thus In 1990, Dr. Edward Mortimer, et al., published a review of DPT encephalopathy in the Journal of the AMA, which claimed that:
No child who was previously normal, without a prior history of seizures, had a seizure in the 3 days following a DPT vaccine that marked the onset of epilepsy or other neurological or developmental abnormality. Our negative findings reinforce those of previous investigators that serious neurological events are rarely if ever caused by DPT.8
In the lead editorial of the same issue, Dr. James Cherry, another prominent vaccine advocate, cited these same data as conclusive proof that DPT encephalopathy is a “myth,” that is, a coincidence, and should therefore be stricken for good from the ever-shrinking list of genuine adverse reactions meriting compensation:
This article [by Dr. Mortimer] is the third controlled study in recent months to examine the risk of seizures and other acute neurological illnesses after the DPT vaccine. In these studies, which involved 230,000 children and 713,000 vaccinations, no evidence of a causal relationship was found between the vaccine and permanent neurological illness.
It is not surprising that physicians tended to blame the vaccine for severe neurological events and deaths. When DPT vaccination was undertaken, we already had smallpox and rabies vaccines and tetanus antitoxin, which caused encephalitis, anaphylaxis, and immune neurological illness. Reactions were also noted in temporal association with early attempts at pertussis vaccination.. These first vaccines were not standardized, and some reactions were the result of excess endotoxin or other vaccine ingredients. But it is clear from these recent studies that the major problem has been the failure to separate sequences from consequences. Now is the last decade of the 20th Century, and it’s time for the myth of “DPT encephalopathy” to end.9
It is curious that Dr. Cherry seeks to exonerate the DPT vaccine by tarring it with the same brush as smallpox, rabies, tetanus antitoxin, and even “vaccine ingredients” like Thimerosal, all of which have been associated with serious neuropathology. In so doing, he also indirectly supports my own sense that terms like “brain damage,” ”encephalitis,” ”encephalopathy,” “autism,” and what he calls “immune neurological illness” all refer to common, generic, or nonspecific reactions to a wide variety of toxins, such as vaccines and chemicals, and also to unidentified or idiopathic causes. To prove that the DPT is innocuous, and that these brain-damaged kids are merely the victims of “coincidence,” he and Dr. Mortimer simply rule out all adverse reactions occurring more than 3 days after the vaccine, according to the same official guidelines that they themselves established.
Adopting a somewhat more judicious approach to reach a similar conclusion, the official report of the Advisory Committee on Immunization Practices (ACIP) does give lip service to the opposing claims of parents and child advocates, but then ties them up in a hopeless tangle of evasions, equivocations, and government bureaucratese :
Rare but serious neurological illnesses, including encephalitis, encephalopathy, and prolonged convulsions, have been anecdotally reported following the whole-cell DPT. Whether the vaccine causes such illnesses or is only coincidentally related to them has been difficult to determine precisely.
The National Childhood Encephalopathy Study and others have provided evidence that the DPT can cause encephalopathy. This occurs rarely, but detailed follow-up indicates that children who had a serious neurological event after DPT were significantly more likely than children in the control group to have chronic CNS dysfunction 10 years later and to have been given the DPT within 7 days of its onset.
The Committee proposed three possible explanations for this association:
1)The illness and dysfunction could have been caused by DPT;
2)The DPT could trigger these events in children with brain or metabolic
abnormalities who might also experience them if other stimuli such as
fever or infection are present; and
3)The DPT might cause the acute event in children with underlying abnormal-
ities that would inevitably have led to the chronic dysfunction even without it.
The data do not support any one explanation over the others. The balance of
evidence was consistent with a causal relationship between the DPT and CNS diseases in children who developed acute neurological illness after the vaccine, but insufficient to determine whether it increases the overall risk of them 10 years later. SIDS is listed on death certificates as cause of death for 5000-6000 infants each year in the United States. Because the peak incidence is at 2-4 months of age, many instances of a close temporal relationship between the DPT and SIDS are to be expected by simple chance.10
But if it is impossible to favor one explanation over the others, then they need not be mutually exclusive, as the report implies. Even an innate or pre-existing tendency to develop such complications by no means disqualifies the vaccine from some kind of causal rôle, since every illness in every patient clearly presupposes both external morbid influences and an individual more or less susceptible, receptive, or sensitized to them. This is the ultimate riddle of all medical practice, which the quest for specific effects of particular vaccines blithely ignores; and it implicates all three possible explanations in at least some degree of genuine causal influence on the pathology that results, ranging from the necessary and sufficient cause, evidently the only kind that the ACIP and the courts seem willing to accept; to a precipitating cause in a patient already potentially or mildly ill; or at least an incidental cause, for which other such influences could just as well be substituted. In any of these three scenarios, the fact remains that something quite bad has happened from giving a vaccine, and that it very likely would not have happened had it not been given. By trying to prove too much, Drs. Mortimer and Cherry thus wind up proving too little; for whatever the degree of causal involvement of a particular vaccine in a particular case, it is decidedly more than a mere coincidence.
As a kind of epilogue to this important riddle, I conclude with the following case of DPT encephalopathy, that of a 6-year-old boy whose mother brought him to see me for homeopathic treatment:
Born at term after a short labor with no complications, he weighed 6 lb., 6 oz., with good Apgar scores. But after receiving the Hep B vaccine on the same day, he did not open his eyes for 2 weeks. Finally he began eating, gained weight, and seemed to develop normally until his first round of DPT and HiB vaccinations at 2 months of age, when he developed a fever of 101˚, arched his back, and began to throw up his formula. The pediatrician diagnosed reflux and a milk allergy, both of which improved somewhat from medication and changing to a non-dairy formula.
At 4 months, he was scheduled for surgery to repair a hypospadias and bilateral inguinal hernias, but was sent home because he reportedly he looked ill and was breathing heavily. He had been babbling and vocalizing a lot, but 2 months later, when the surgery was performed these soundings gradually ceased. At 9 months of age he began banging his head, lost all interest in making sounds, and made no further attempts to speak.
Throughout the first year of life he remained sickly, although seldom acutely ill, ran low fevers at times, and was put on antibiotics for the whole summer with fluid in his ears. That fall and winter he developed nasal congestion, puffy eyelids, red cheeks, and eczema, for which his pediatrician gave steroid creams. He also had constant diarrhea, beginning in the 3rd month; couldn’t eat a lot of the usual foods because of his many allergies and sensitivities; and remained thin and malnourished for years, as low as the 3rd percentile for weight and the 25th for height.
By his first birthday, he seemed to improve, and continued to do quite well until his next round of vaccines at 16 months, after which he relapsed in a very big way. Suspecting the vaccines at this point, his mother studied the medical records and found that his various ailments had dramatically worsened in the weeks following each round, which thus represented important milestones in the progression of his disease:
Birth Hep B Eyes remain closed
2 months Hep B, DPT, Fever, arching back, vomiting, reflux, milk allergy;
HiB, polio diarrhea, food allergies, “failure to thrive”
4 months DPT, HiB, Dyspnea, sickly appearance: surgery delayed polio
6 months DPT, HiB, Hernia repaired; vocalization slowed; sickly polio
9 months Hep B Otitis media, rhinitis, eczema, puffy eyes
16 months MMR, HiB General relapse
18 months DPT, General relapse varicella
30 months None PDD, autism, duodenal ulcers
These of course were her conclusions, which the pediatrician didn’t accept. At 30 months the boy was diagnosed autistic, and improved on a special diet, but still couldn’t tolerate any supplements. When duodenal ulcers were detected and cured with medication, his head-banging stopped, but he remained intolerant of many foods.
When I first saw him at 6 years of age, he couldn’t talk, but used sign language, could understand spoken words, and attended school using combinations of signs, pictures, and speech. Weighed down with regret that she hadn’t seen the vaccine connection sooner, his mother accepted that his condition was irreversible, and patiently studied the Internet in search of alternative therapies on her own, without help from the pediatrician. Since the boy couldn’t tolerate most drugs, she thought of homeopathy as her last hope, but so far I’ve not been able to help him much.11
Although the results of my treatment have been very disappointing so far, he is in some ways typical of my vaccine cases, especially the variety and complexity of the symptom-picture, which never appeared in full force, all at once, or within the narrow VICP guidelines, but rather waxed, waned, and changed without any obvious pattern that his mother or I could discern, until his MMR and HiB vaccines abruptly ended 4 months of excellent progress, and a review of his medical records traced each episode to the round of vaccines that closely preceded it.
Although the mother eventually settled on “DPT encephalopathy” as the only officially-sanctioned diagnostic entity that made sense from her reading, the boy received many different vaccines, usually several at once, and responded in roughly similar ways each time. Maybe this complex picture was closer to Dr. Cherry’s “immune neurological illness,” which in this case included elements of autism, “encephalopathy,” food allergies, and other ailments. Either way, it is impossible and indeed pointless to try to attribute any specific reaction to a particular vaccine, which is my main reason for including this story. Even his post-MMR relapse, which featured the same triad of enterocolitis, autism, and food allergies described by Dr. Wakefield in his MMR patients, doesn’t solve the riddle, since strong indications of these same problems had already surfaced early in infancy. Yet even if he had a pre-existing tendency to react in such ways, as seems likely, it is virtually certain that he would be in much better health today if he had never been vaccinated at all.
This more nuanced picture of a nonspecific, multifactorial causality, and an illness adversely influenced by vaccinations but not exclusively caused by them, was further corroborated by a strong family history of allergies and vaccine reactions on his mother’s side, which she didn’t even remember until her son’s dramatic relapse clarified so many things. It turned out that her brother had reacted adversely to the polio vaccine in his youth, and that her mother, who suffered repeated ear infections as a child, had remained incapacitated for a whole year from a flu shot, and was still unbearably sensitive to most chemicals and perfumes. In any case, it seems obvious that a variety of influences acted synergistically in her son’s condition; that a pre-existing tendency to react in a certain way still requires a stimulus to react to; and that the term “DPT encephalopathy” doesn’t begin to describe the complex reality that the boy and his whole family have had to live through.
It is likewise intuitively obvious to me, as to most parents I see, that a family history of serious adverse reactions to one or more vaccines, especially in parents or siblings, places children in a much higher risk pool for a bad outcome from any vaccine, and provides an adequate basis for excusing them from future vaccinations on purely medical grounds. But the quasi-religious zeal of many doctors and public health officials for vaccinating everybody in sight has contributed to a growing tendency to override even such minimal precautions. Just such a case is described in this letter from a mother in New York City:
I am writing about our 3-year-old son, for whom we are seeking a medical exemption from the DPT, MMR, and HiB vaccines. His two older siblings had severe reactions to these shots, with fevers of 105˚, sleeplessness, and marked swelling at the injection site. Until age 6, both of them had recurrent otitis media, while our youngest has not been immunized, and has no ear infections. His only vaccine was oral polio as an infant, which resulted in extreme irritability and insomnia that lasted for weeks, and a repeat dose recently, with the same result.
Our pediatrician has written a letter requesting a medical exemption for him, stating that he is at high risk for adverse reactions, and has even testified in Court on his behalf, but the Judge has ignored her warnings. The State Health Department considers family history irrelevant. According to New York State Law, a letter from a doctor licensed to practice here is sufficient for exemption. But New York City has imposed its own guidelines that give them the final say; so we have ended up in Court.12
Seeking my testimony for their Court hearing, the mother enclosed separate letters from their own pediatrician and an independent specialist whom she consulted just to make sure. Both were Board-Certified, and both affirmed their general belief in vaccinations, but their considered opinion was that the danger of vaccinating the child far outweighed any possible benefit to him or the general public.13,14 Yet even these documents failed to satisfy the pediatrician employed by the New York City Department of Health to rule on medical exemption requests for infants seeking day care.15 Since my testimony was never required, I assume that the parents eventually prevailed, but their experience attests to the punitive and even draconian spirit with which vaccination laws are often enforced, and the difficult, prolonged, and expensive legal action that parents may face in trying to mitigate them.
DPT and SIDS.
For decades the leading cause of death in American infants more than one week and less than one year old, Sudden Infant Death Syndrome, or SIDS, has always seemed baffling to pediatricians. Yet highly pertinent and potentially valuable experimental work on the subject still goes unread and ignored in this country, because its conclusions are unpalatable to the small coterie of doctors who conduct vaccine research, journal editors who publish it, and manufacturers who fund it, which might well be called “the vaccine establishment.”
In 1985, Dr. Viera Scheibner, a senior research scientist investigating SIDS, known as “cot death” in Australia, and Leif Carlsson, an engineer, developed an electronic monitor that made it possible to track the breathing patterns of young infants from an adjoining room. Designed to sound an alarm if breathing fell below a certain minimum rate or amplitude, this simple device immediately produced surprising results:
Parents were reporting alarms while their babies were deeply asleep, often in clusters of 5 to 7 within a 15-minute period. These occurred after the babies were exposed to stress, or a day or two before they developed a cold or cut a tooth. In most cases, they were only breathing shallowly, and soon resumed normal patterns. Some “near-miss” babies who stopped breathing but were found in time and successfully resuscitated showed much higher numbers of alarms than normal, and we realized that they were an important indicator of their general stress level.
Without specifically intending to, we also recorded their breathing before and after they were vaccinated, and the results were extremely significant. We didn’t know that the merits of vaccination were being hotly debated at the time. We saw that DPT vaccinations caused babies a lot of stress, in the form of sometimes major flare-ups of shallow breathing or apnea for at least 45 to 60 days afterward, variable in amplitude but remarkably similar in duration.
Pediatricians to whom we showed our findings pointed to the arrow indicating the time that the vaccination was given, saying “This is the cause!” and to the abnormal breathing pattern on the ensuing days, saying “This is the effect!” In this way we learned that most children who died did so after their DPT shots, so we felt we had to address the issue. But when we approached the same pediatricians with our data and conclusions, we realized we had touched on a very sensitive area.16
All too predictably, the Australian medical community greeted these findings with a stony silence which has continued to this day, and propelled the indefatigable Dr. Scheibner into her second career as an anti-vaccination activist. After more than two decades, the American medical literature has likewise neglected even to mention her pioneering work, and as far as I know has never published a single study to try either to validate or refute it.
An equally wet blanket had already been thrown over the few studies both here and abroad that suspected a link between the DPT vaccine and SIDS even before Dr. Scheibner’s bombshell. In 1979, for example, the Tennessee Health Department reported 4 cases of SIDS occurring within 24 hours of the first DPT vaccination,17 while in a larger study of 70 SIDS cases prompted by these deaths, Dr. William Torch found that two-thirds of them had occurred in proximity to a DPT shot, with
6.5% of them occurring within 12 hours;
13% “ “ “ “ 24 hours;
26% “ “ “ “ 3 days;
37% “ “ “ “ 7 days;
61% “ “ “ “ 14 days; and
70% “ “ “ “ 21 days.18
He concluded, DPT may be a major unrecognized cause of sudden infant death, and the risks may outweigh the benefits. Re-evaluation and possible modification of current policy is indicated by this study.19
Since Torch’s work appeared in a reputable medical journal, it could not simply be ignored, but other studies promptly materialized that repudiated his data and flatly denied that any such link existed. Perhaps the most convincing evidence of all came from Japan, where 57 cases of encephalopathy and 37 deaths were reported from 1970-74, followed by 2 actual SIDS deaths in 1974-75. The ensuing storm of protest persuaded the Japanese government to postpone DPT vaccination entirely until the age of 2,20 and to promote the development of a hopefully safer acellular pertussis vaccine. As even the redoubtable Dr. Cherry and his pro-vaccine colleagues later admitted, the result of this experiment has been that
SIDS disappeared when immunization with whole-cell and acellular pertussis vaccinations were delayed until 24 months of age.21
Yet these same experts never considered adopting such a strategy for our own country, even when the newer acellular vaccine also failed to lower the risk of brain damage to an appreciable extent.22 Today the United States remains the only industrialized country to require the DPT vaccine for all young infants, despite all the evidence against it, and the nearly unanimous opinion of Western European, Japanese, and other foreign medical sources.
MMR and Autism.
First described by the American psychiatrist Leo Kanner in 1943, the neurological condition he called “autism” has likewise never been satisfactorily explained, or even rigorously defined. It could have been mere coincidence that Kanner’s first case appeared not long after the DPT vaccine was first introduced in 1942, but no further evidence of a vaccine link emerged until the late 1990’s. In 1995, Dr. Andrew Wakefield, the British gastroenterologist whose articles appeared in The Lancet, compared 3550 adults vaccinated against the measles as infants with 11,400 of their peers who had not been, and discovered that the vaccinated group were three times more likely to develop Crohn’s disease later in life than their unvaccinated controls, and twice more likely to develop ulcerative colitis.23
This rather shocking result led Wakefield to study the children who reacted adversely to the MMR, many of whom developed normally during the first year of life but then either regressed to an autistic state following the vaccine, or suffered from a variety of digestive symptoms and food and environmental allergies, or both.24 Intestinal biopsies of these adversely affected children and their age-matched controls revealed
1)inflammatory lesions in the small intestines of autistic children that micro-
scopically resembled those of Crohn’s disease and ulcerative colitis;
2)circulating IgC antibodies in the blood of autistic children that were specific to measles, but not to mumps or rubella, the other MMR components;
3)specific measles antigens in the lymphoid tissue of the small intestines in these same children, but none for mumps or rubella; and
4)the absence of such antigens from the intestines of normal children.25
Wakefield’s findings have since been replicated by Japanese investigators,26 and the identical combination of autistic symptoms, enterocolitis, and food and environmental allergies following MMR vaccination have been reported by parents throughout the US, the UK, Canada, Australia, Western Europe, and parts of Asia.27 Further support for his MMR hypothesis has come from two additional sources:
1)the coincidence that the UK, which uses the same diagnostic criteria for autism as we do, reported a dramatic and almost identical increase in autism cases 10 years after our own, at precisely the time when the MMR was introduced into the British Isles;28 and
2)the common experience of holistic physicians in the US that healing or mitigating the food and environmental allergies is proportionately beneficial for the autism and the intestinal lesions as well.29
Yet no proof has yet convinced or is ever likely to convince the vaccine establishment, with its enormous stake in and seemingly unbreakable stranglehold over American health policy. In 1999, Congressman Dan Burton of Indiana, a Conservative Republican who chaired the House Committee on Government Reform, convened hearings on the issue when his own grandson exhibited aberrant behavior after the MMR vaccine, and was eventually diagnosed with autism. Despite the testimony of Dr. Wakefield and others, including the National Institute of Health’s own estimate that the incidence of autism had reached about 1 in 500 by 1996, an increase of over 400% since the 1960’s,30 Dr. Colleen Doyle, the CDC spokesperson, stuck to the official line of the Public Health Service and the American Academy of Pediatrics, that “current scientific evidence does not support a link between vaccination and autism or any other behavior disorder.”31 Similar denials by Dr. Paul Offit of the ACIP led Rep. Burton to retort that Offit’s long-time service as a paid consultant for Merck, the vaccine manufacturer, involved a serious conflict of interest that should have disqualified him from serving on the Committee:
Even if they exclude themselves from voting, people who sit on advisory panels and are paid by pharmaceutical companies still influence other members. Are we letting pharmaceutical companies have too great an influence on decisions that affect the health of our nation?32
In any case, even when it is finally recognized as a bona fide complication of the MMR, which it clearly is, the fact remains that “autism” as a diagnostic category is almost as vague as “encephalopathy,” is equally applicable to DPT cases, as we saw, and will undoubtedly be described following the Hep B and other vaccines in the future.
Hepatitis B and Auto-Immune Disease.
A likely candidate for a specific type of reaction to a particular vaccine is the wide variety of auto-immune diseases that I have witnessed in my practice and read about in the literature following the Hepatitis B vaccine, although they have not made headlines or rated so much as a footnote in the official reports that are widely used to promote it. In fact, the seemingly authoritative and always judicious ACIP pronouncement makes it sound like one of the safest currently available:
Hepatitis B vaccines are safe to administer to adults and children. More than 10 million adults and 2 million infants and children have been vaccinated in the US, and over 12 million children worldwide. Pain at the injection site and fever have been among the most frequently reported side-effects, but no more so than in the controls receiving placebo or DPT. The incidence of anaphylaxis is low. Large-scale programs in Alaska, New Zealand, and Taiwan have not established an association with other adverse events. Any presumed risk that might be causally associated must be balanced against the risk of hepatitis B liver disease.33
In my experience, however, Hep B carries a serious risk of auto-immune diseases of every kind, ranging from systemic lupus erythematosus (SLE) and thyroiditis to major blood dyscrasias, such as cryoglobulinemia, which have also been confirmed by a large volume of anecdotal case reports, and by warnings listed in the PDR by the manufacturers themselves. As we saw, the inevitable effect and quite possibly the main purpose of an ACIP whitewash is to guarantee that the vast majority of private lawsuits and no-fault VICP claims against the vaccine will fail.
Here is a case from my own practice, an 18-year-old college student who became ill soon after his second Hep B vaccination at the age of 10:
The past medical history was unremarkable except that the MMR at 15 months was quickly followed by a systemic illness consisting of fever, malaise, and a generalized rash, which lasted for a full week but then disappeared. Thereafter he seemed to be in good health until the age of 10, when 2 doses of the Hep B vaccine were given, with no apparent ill effects from the first. About a week after the 2nd dose, a swollen lymph node appeared in his neck, together with fever, malaise, joint pains, and other
flu-like symptoms, from which he has never fully recovered. Over the ensuing weeks, he developed large subcutaneous nodules near major joints, an elevated titer of anti-nuclear antibodies (ANA), and an alarmingly high erythrocyte sedimentation rate (ESR), as well as losing 20% of his body weight.
Diagnosing an auto-immune mixed connective-tissue disease similar to disseminated lupus, a rheumatologist kept him on non-steroidal anti-inflammatory drugs (NSAID’s) and Prednisone for the next 6 years, as a result of which both his growth and sexual maturation were seriously retarded. When I first saw him, he had taken no drugs for 6 months, but his face and eyes were still swollen; both cheeks were covered with a diffuse, bright-red erythematous rash; there were more than a dozen extensive, hard subcutaneous nodules scattered over his trunk and limbs, many of them draining a grayish-white serous fluid; and his muscular and sexual development resembled those of a puny 12-year-old.
Over the past 2 years, he has improved a lot under homeopathic treatment, but is still chronically ill, seriously handicapped, and likely to remain so. His parents are certain that the Hep B vaccine was the main cause of his illness, but his voluminous medical record is deafeningly silent on this point.34
A local attorney hired me as a medical expert to write reports and if necessary testify on behalf of several clients who were filing claims for damages from the Hep B vaccine and facing Federal Court hearings under the VICP program. Although I know them solely from reviewing their medical records, the hours of study required for writing detailed reports to the Hearing Officer have helped me to know them better in some ways than my own patients. While rather different from one another in the organs and tissues involved, their illnesses are all quite similar in their underlying pathological style, conforming to the classic pattern of auto-immune diseases, as the following examples illustrate:
An adolescent girl with type 1 juvenile diabetes was otherwise in good health and stable condition before receiving the vaccine. Within a few days of her first dose, she developed fatigue and malaise, her skin became swollen and puffy, and she itched intensely from hives all over her body. Over the next few weeks she also developed joint pains, and the hives made her scratch to the point of drawing blood. Medications brought only temporary relief.
Her elevated sedimentation rate and anti-nuclear antibody or ANA titer indicated an auto-immune illness resembling lupus, but vigorous treatment did not help, and she soon began developing allergic reactions to chemicals and food additives that had never bothered her before, while her diabetes, which had been stable for years, went seriously out of control. After several months her mother broke off the treatment, saying, “Before the shot, she was active, full of life, and not allergic to anything. Now she has to analyze everything she eats, avoids the sun, and has to take her EpiPen wherever she goes. She is allergic to preservatives and food colorings, but has no idea what else will trigger hives and rashes.” After 4 years, her claim is still pending.35
As in all of my Hep B cases, this girl developed a nondescript, flu-like illness soon after the vaccine, which took some weeks to develop diagnosable auto-immune features, while the various organs and tissues affected and her concomitant allergies and hypersensitivities all reflected the individual susceptibility of the patient. Here is another case, which is notable for a different reason:
A previously healthy 31-year-old lab technician developed auto-immune thyroiditis soon after a Hep B vaccine. At 24 her primary-care physician (PCP) gave her two Hep B shots 2 months apart, as required for her training. Fully 3 months after the second Dose, she developed a chronic cough that lasted for many weeks and finally cleared up after several rounds of antibiotics, at which point she took her third dose. Four years later, she took a job in another lab, and showed no Hep B antibodies at all in her blood. Supposing her to be still susceptible to the disease, her new employer insisted that she be revaccinated.
Within a few days after the first dose, she developed a sore throat and cold symptoms, followed by weakness, fatigue, hoarseness, and considerable weight gain, all symptoms of hypothyroidism, which slowly intensified over the next few months to the point that she could no longer ignore them. As yet unaware of the vaccine as a possible culprit, she received a 2nd dose 3 months later, and grew much worse over the ensuing weeks, even developing a more intense version of the same cough she had struggled with after her first round years ago. After waking in the night with palpitations and anxiety, she finally sought medical help.
Correctly suspecting hypothyroidism, her PCP found her TSH or thyroid-stimulating hormone to be over twice the normal level, and put her on Synthroid to correct the deficiency. With still no reason to suspect the vaccine, she took her 3rd dose a few months later, and her symptoms and elevated TSH levels persisted for many months with no improvement, despite double doses of hormone. After hearing that the vaccine had been implicated in thyroiditis, she persuaded the doctor to test for anti-thyroid antibodies, which were indeed found, but still failed to improve when the Synthroid was increased yet again.
Over the past 3 years, her condition has continued to worsen, despite maximum doses of Synthroid and a TSH within the normal range. The last part of her medical record documented a whole series of new ailments, namely, a nodular goiter and difficulty swallowing, which her ENT attributed to weakness of her larynx and pharyngeal muscles, and esophageal reflux (GERD), which he treated with Prilosec. In short, this healthy young woman developed auto-immune thyroiditis, with complications, as a result of her Hep B vaccinations, for which she needs strong drugs and regular medical supervision, and suffers a significant level of chronic disability that will most likely continue for the rest of her life. Perhaps the most clearcut of my Hep B vaccine cases, her claim was summarily dismissed without even a hearing, based on current Federal guidelines.36
This case was particularly interesting because the indication for revaccinating her 4 years after her first series was the absence of specific antibodies in her blood, which is widely interpreted as evidence that the vaccine simply failed to act, while in this instance at least it almost certainly concealed a latent auto-immune process that still might never have bothered her if the second round had not been given. In other words, our reliance on the presence or absence of specific antibodies as the “acid test” of immune status rests on a false assumption about how vaccines really act; consistently produces both false-positive and false-negative results, as I will presently show; and therefore promotes dangerous errors in judgment, as it did here.
My last case is the most complex and ambiguous of my VICP reports, and was in fact dismissed by the Hearing Officer because of its already serious past history. I present it for precisely that reason, because it admirably illustrates the need to broaden and deepen our search beyond the narrow range of allegedly specific reactions to particular vaccines, to include the generic capacity of all vaccines to reactivate or intensify latent or pre-existing conditions:
With a long history of intermittent claudication, a 55-year-old police officer had suffered ischemic occlusion of the abdominal aorta at the age of 34, and successfully underwent an aorto-femoral bypass graft. His application for disability and early retirement was rejected, but through hard work, determination, and a rigorous program of physical therapy and exercise he eventually returned to the force. Eleven years later, a femoral
arteriogram revealed significant narrowing of the lower portion of the femoral artery and aneurysmal dilatation above it, both indicating a high risk of thrombosis and further complications in the future, all ample grounds for exempting him from the Hep B vaccine requirement.
Despite his misgivings, he was told that his health insurance would be cancelled if he refused, and he reluctantly agreed to take it. Within a few days after the 1st dose, he developed a flu-like illness with fever, eye pain, headache, muscle weakness, blurred vision, and a skin rash, a picture suggestive of the “hypersensitivity syndrome” listed by the manufacturer as a side-effect of the vaccine in the PDR. In the face of repeated assurances that the vaccine was harmless and couldn’t possibly cause such a reaction, these symptoms persisted for weeks, and made him even more hesitant about the 2nd dose, but again he had little choice other than accepting the verdict of the State Health Department that it was safe.
Within hours of the second dose, he developed symptoms that were even more intense, chiefly earache, tinnitus, loss of vision, overpowering fatigue, asthma, and high blood pressure, all of which either appeared on or were consistent with the list of adverse reactions detailed by the manufacturer. As a result, the 3rd dose was postponed for 6 months, but even after the long delay his reaction to it was the most rapid and dramatic of all. Within a few days, he complained of severe tinnitus, hearing loss, inability to urinate, and an intensely dark petechial rash, and was diagnosed with “malignant hypertension.” One week later he was officially labeled as “chronically hypertensive,” and his blood pressure remained dangerously high thereafter, in spite of strong medication.
A few months later, he consulted an ophthalmologist for headaches, dizziness, and visual field defects, followed by attacks of unilateral blindness lasting up to 30 minutes, and was finally granted a disability pension after 40 or 50 such episodes made it impossible to perform his duties. After extensive testing, he was diagnosed with “ophthalmic migraine,” but all the medications given for it were ineffective. Within 2 weeks he was hospitalized for chest pain, malaise, and low urine output, at which time his blood pressure, cholesterol, triglycerides, BUN, and creatinine were all found to be dangerously high, and he was given a diagnosis of acute renal failure.
Finding specific antibodies to various fatty substances in the blood, his physician made the additional diagnosis of “anti-phospholipid syndrome,” an auto-immune disorder that poses serious and potentially fatal risks of thrombosis anywhere in the body, and finally connected the dots of his various ailments to the Hep B vaccine. Over the past 8 years since then, his symptoms have persisted in spite of intensive drug treatment, as have his severe hypertension and chronic renal impairment. Now permanently disabled, he remains at high risk not only for stroke and heart attack, but also for peripheral vascular disease and gangrene of the lower extremities, blindness, and irreversible renal failure, with very poor chances of living out a normal life span. Yet his VCIP claim was dismissed without a hearing.37
These VICP cases are also recognizably similar to reports of many other auto-immune diseases from Hep B vaccination described in the literature, such as cryoglobulinemia,38 lupus and rheumatoid arthritis,39 Guillain-Barré syndrome,40 optic neuritis and MS,41 chronic fatigue syndrome (CFS),42 vasculitis,43 and diabetes.44 Yet even “auto-immune disease” is an adverse reaction by no means peculiar or restricted to Hep B. As with the DPT and MMR, many of the same old diagnoses, such as seizures, autism, and demyelinating diseases, keep popping up after Hep B as well. In addition, as I will presently show, the term “auto-immune disease” covers the entire spectrum of non-specific reactions to vaccination per se, and in fact may well turn out to be more or less synonymous with chronicity itself, inasmuch as auto-antibodies and auto-immune phenomena have been turning up virtually everywhere that somebody has thought to look for them.
As for SIDS, my suspicion is that it too could follow any vaccine, if given early enough in infancy. This is of course especially true of Hep B, which is routinely given as soon as possible after birth, as this father learned too late to save his newborn son:
For 12 days, Nicholas ate and slept well, like any other baby. On the 13th day, he was given Hep B. When I got home from work, he was crying a lot more than usual, even screaming at times, but we’d just taken him for a checkup, and they told us he was big and healthy. We didn’t know that vaccines can cause problems. Nicholas cried on and off most of the night. When I went to work the next day, he was still crying, and he continued most of the day and evening. The next morning my wife found him in his crib, looking as if he’d been dead for several hours. An autopsy showed he had died of SIDS. The pediatrician said he was one of the healthiest babies he’d ever seen.45
2. NON-SPECIFIC EFFECTS OF THE VACCINATION PROCESS.
Having questioned the specificity of four well-documented reactions to particular vaccines, around which all of the debate has so far been framed, I will now consider the more common and thus more significant adverse reactions that I witness almost routinely in my practice. For the most part, they represent simple intensification of underlying tendencies that were already present, and encompass the full range of common ailments encountered in any practice involving infants and children, like ear infections, eczema, allergies, asthma, sinusitis, ADD, autism, and other behavioral and developmental issues. While the details of their homeopathic treatment are irrelevant here, it is worthy of note that these children respond to the same remedies that would be given in such cases, whether vaccinated or not. I present the following cases as evidence for my conviction that the small number of adverse reactions reported in the literature amount to no more than the tip of a huge iceberg, the bulk of which lie unseen and invisible, both because they blend imperceptibly into the mainstream of clinical medicine, and because vaccines play a major but by no means exclusive rôle in causing them.
Making the Connection.
As we saw, causal connections between vaccines and chronic disease are regularly and systematically obscured by two interrelated circumstances, namely,
1)the usual time lag of two or more weeks between a vaccination event and the onset of diagnosable illness, which automatically eliminates it from consideration, according to the official guidelines, and excludes along with it the very possibility of any reaction that spills over into the chronic dimension, to become a self-sustaining illness; and
2)the general confusion, ambiguity, and low index of suspicion arising from the fact that the reaction is merely an intensification of what the child already has, or what many of his or her friends and classmates are habitually coming down with.
My first vaccine cases were specific to particular vaccines or components, in the sense that 1) distinctive signs of the corresponding natural disease were detected, and 2) in some cases were confirmed by a curative reaction to the “nosode” or homeopathic remedy prepared from the disease or the vaccine itself. In one such case, the presenting complaint was merely a high fever, one of the commonest ways that healthy infants respond to any unbalancing stimulus, and no other symptoms, but an unusually high white-blood-cell count and a preponderance of immature forms on the blood smear:
A 9-month-old girl was brought in with a fever of 105˚F. and no other symptoms. She had had two similar episodes previously at irregular intervals, but the first one came less than 2 weeks after her first DPT shot, because of which her parents decided not to vaccinate her any further. Despite the usual acute remedies and supportive measures, her fever remained at the same level for 48 hours, so I ordered a blood count. The white blood cells (WBC’s) were markedly elevated at 32,000 per cu. mm., within the leukemoid range, with 43% lymphocytes, 11% monocytes, 25% neutrophils (many with toxic granulations), 20% immature “band” forms, and 1% still more primitive metamyelocytes. With nothing else to go on, I showed the slide to a pediatrician friend, who unhesitatingly.identified it as pertussis. With nothing else to go on, I gave her one dose of the homeopathic nosode made from the DPT vaccine, the fever came down to normal in a few hours, and she never had another episode.46
In two other early cases, minor symptoms were traced to the mumps and rubella components of the MMR vaccine by means of peculiar anatomical features suggestive of these diseases, and were similarly healed with the aid of homeopathic nosodes prepared from them:
With a 4-week history of stomach aches, indigestion, loss of appetite, and swollen glands, a 3-year-old boy was brought in with intense cramps, belching, flatulence, and explosive diarrhea. The nose was congested, the lower eyelids quite red, and his parents reported unusual behavior, i. e., untidiness, “wild, noisy” playing, and waking at 2 a.m. The physical exam was unremarkable except for markedly enlarged tonsils and several large, tender suboccipital and posterior auricular lymph nodes, for which the rubella virus has a known predilection.
At that point his mother told me that he had received the MMR vaccine 2 weeks before his illness began, with no apparent reaction to it at the time. After a single oral dose of the homeopathic rubella nosode, his symptoms all disappeared within 48 hours. About 4 months later, his mother brought him back for a slight fever and a 3-week history of cold symptoms and pain in and around the right ear. On physical examination the right eye was quite red, and the whole right side of his face appeared swollen, but especially the cheek and parotid region. Without needing the homeopathic mumps nosode, he responded promptly to the appropriate acute remedy and remained well thereafter.47
In another similar case, involving action on the parotid gland and these same lymph nodes, I noticed that the MMR also appeared to exert a more non-specific effect on the immune system as a whole, such that the boy became more susceptible to whatever other ailments were “going around” the neighborhood:
A 4-year-old boy had been troubled by soreness and enlargement of the posterior auricular nodes for most of the previous year, during which time he had also become increasingly prone to a variety of URI’s, none of them particularly severe. Over the same time period, the mother had also noticed intermittent swelling of both parotids, beginning soon after his belated MMR vaccination at the age of 3. Because the mother was 2 months pregnant, and the boy seemed well at the time, I chose not to treat him until after the birth. When he developed acute bronchitis about a year later, the nodes were again swollen and tender, so I gave him the homeopathic rubella nosode, the cough subsided, and the nodes regressed. Two weeks later, he was back, with a hard, tender swelling resembling a walnut in the right cheek, near the angle of the jaw, with some pain on chewing and opening the mouth wide. After a single dose of the mumps nosode, these symptoms also promptly subsided, and he remained well.48
Ear Infections in Children.
In this last case, the specific reactions to two vaccine components helped me to recognize them, but the reaction as a whole was vague and nondescript, implying a certain generic and underlying susceptibility that was clearly the main health problem to be addressed. But once I moved to Boston, the rapidly increasing frequency of chronic and recurrent ear infections in my practice provided the all-important clue that such non-specific reactions to vaccines are in fact the rule rather than the exception, and with it a large body of evidence that was ubiquitous and ready to hand.
Here is a typical example, a 19-month-old girl whose MMR was followed not long after by a series of ear infections and a bad flare-up of eczema, which she had had only mildly ever since the newborn period:
Already a veteran of 5 ear infections and 5 courses of antibiotics since her MMR vaccine, a 19-month-old girl also developed severe eczema and nasal allergies in the same time period. Although these other complaints had actually begun in her early months, they remained quite mild, with her eczema confined to a few small patches behind the ears and on her face. Showing no obvious reaction to her DPT’s, she acquired her first ear infection with fever not long after weaning and entering day care around her first birthday. After that she seemed fine until her MMR at 15 months, when her ears soon flared up repeatedly, at times with high fever, earache, and listless, clingy behavior, and they never cleared up, despite 5 rounds of antibiotics. At the same time, her allergies became severe and unrelenting, and her eczema spread over her entire body.
Advising the mother not to vaccinate her for a while, and not to give her antibiotics if she got sick, I treated her with the usual homeopathic remedies, and her ears healed up almost immediately, although the eczema and allergies took a bit longer. She is now 12, still has a little eczema and hay fever at times, and I have even detected fluid in her ears occasionally. But her hearing has never been affected, and she remains in very good health. Her mother still chooses not to vaccinate her.49
In this case, while the girl was clearly affected by the MMR more than the DPT, the reaction was limited to a recurrence of the ear infection and intensification of eczema and allergies, all among the commonest illnesses of her age group, as well as the same ones she had already had in the past, so that her mother would not have suspected the vaccine if not for the coincidence of a long period of good health, and the general deterioration soon after giving it.
A second rather similar case helped me to rule out the possibility that otitis media could be an as yet undocumented reaction to the MMR alone. With a history of recurrent ear infections almost continuously since early infancy, this girl of 6 was brought in for treatment of an unusually severe episode following her DPT booster before entering first grade:
Beginning at 5 months of age, the episodes were accompanied by red cheeks, grumpy and irritable behavior, and loss of appetite, but rarely by fever or earache. Afterwards she often complained of runny, itchy eyes, and seemed generally “run-down,” needing more sleep, and likely to catch whatever her friends and relatives were bringing over, which her mother described as “being sick all the time.”
She had had all her shots, which in those halcyon days consisted only of DPT’s at 2, 4, 6, and 18 months, one MMR at 15 months, and another DPT before entering first grade. While the ear infections were always frequent, the last DPT gave rise to an unusually severe episode that lasted 4 months without a break, in spite of the drugs, and finally persuaded her mother to try something different.
With no more vaccines due, the child did beautifully on homeopathic remedies, and quickly outgrew her ear infections, her absenteeism from school, and her sickly reputation. Although I’ve not seen her since, her mother wrote me a letter several years later: “Just a quick note to let you know that she is healthy and doing well. This year she had a record of perfect attendance. Homeopathy has been really good for us!”50
From a large number of similar cases, I understood that these children were reacting to something inherent in the vaccination process itself, rather than to any particular vaccine, because any vaccine would do, and its chief adverse effect was to reactivate whatever disease tendency was already latent in that particular child, or to intensify or make more chronic and intractable the ones that were already manifest.
Here is another common variant, an infant who had already been through 11 ear infections and 11 full courses of antibiotics by the time I first saw her:
Otherwise in good health, a chubby girl of 15 months was brought in for repeated ear infections, which had never cleared up despite 11 rounds of antibiotics. After a good pregnancy and easy labor, her mother chose not to nurse, and the child developed her first ear infection with a fever of 103˚ at 2 months of age, soon after her first DPT, HiB, and polio combination. All later episodes were afebrile, most with fretting, screaming, and pulling at the ear, and were relieved by being carried about; but twice she had no symptoms at all, was treated because the pediatrician found some fluid through the otoscope, and developed persistent diarrhea both times.
I asked the parents to stop vaccinating her for a while, and gave her homeopathic medicines to take, both preventively and as needed in the event of a flare-up. Two weeks later, she came down with a replica of her first episode, with a high fever and intense screaming, for which the acute remedy was given. She came through it easily in a day or two, and by her next visit, 3 months later, she had recovered completely, and was thriving in every way. That was over 3 years ago. Since then, she has had no ear infections, no antibiotics, and no shots.51
This little story is instructive for two reasons. First, the vaccine connection was tenuous, the only definite link being her first episode at 2 months, after her first vaccination series, when her condition became so chronic that the subsequent ones made no obvious difference. Second, her final episode, following homeopathic treatment, was acute, just like her first one, with fever and violent earache, and resulted in complete recovery.
From hers and other such cases, I have learned to regard the ordinary acute illness with fever as a favorable prognostic sign, indicating strong vitality and an immune system that is developing normally, and to worry more about children who seem unable to mount a fever and other acute responses to infection, as the healthy immune system seems “hard-wired” to do. In addition to their specific effect of producing antibodies to the bacterium or virus in question, my experience suggests that vaccines tend to reprogram the child’s developing immune system to respond more chronically and less acutely in general, no matter what the illness.
This global, nonspecific effect on the immune system as a whole is illustrated by the next case, a young boy who reacted somewhat to his early vaccinations and then developed recurrent ear infections, accompanied by failure to thrive:
Already a veteran of 5 ear infections and 5 courses of antibiotics by the time I first saw him, this boy of 16 months was only 6 months old when they began, with a fever of 103˚ and a violent earache, both of which subsided immediately when the eardrum perforated and discharged a quantity of brownish-yellow pus with a foul odor. All later episodes were afebrile.
Although weighing 7 pounds at birth and appearing normal and healthy, he was slow to nurse, and fell behind in growth and gross-motor development; his teeth came in late; and he weighed only 16 pounds when I saw him. Notwithstanding intense crying for days after his first and second rounds of DPT, HiB, and polio vaccines, the 3rd round was uneventful, as was the MMR. His only other problem was diarrhea, which began on antibiotic treatment and had never gone away.
I treated him with nothing but common homeopathic medicines. A few days after his first dose, his diarrhea became more intense and frequent, and he developed a fever of 103˚, his highest ever, but no ear infection. By his next visit, 2 months later, he was well and had made good progress developmentally, with no more ear infections or diarrhea.
A year later, he had another acute ear infection with high fever that lasted for a whole week, even on the antibiotics that his mother could not resist giving him. Until that time, he had had only a few minor colds, no ear infections, and was continuing to grow and develop normally. I repeated the remedies, and then lost track of him for 5 years, until I called back recently and learned that he had had no more ear infections, no antibiotics, and no vaccinations the whole time. His mother had meanwhile obtained her own kit of remedies for household use, found one that proved highly effective for his acute illnesses, and no longer needed my help.52
I will conclude this series of cases with that of a girl who developed a more or less identical clinical picture following two different vaccinations:
A baby girl of 10 months was brought in for otitis media, with high fever, intense earache, and loud screaming, her 5th such episode since 2 months of age, each one beginning soon after finishing the antibiotic from the one before. Even before that, she became fussy when her mother weaned her to go back to work, and developed a florid rash from her milk-based formula. All of these symptoms were intensified soon after her first DPT, HiB, and polio vaccination, culminating 2 weeks later with her first ear infection, with high fever and violent earache. After that she received only the DT, which she didn’t react to at all, except that her ear infections continued as before.
With homeopathic treatment, they stopped soon enough, but came back with a fury 6 months later, when her parents separated, and her father insisted on taking her for the MMR, followed by 3 typical, acute ear infections and 3 rounds of antibiotics in rapid succession. Once again she responded well to homeopathic remedies, and remained in very good health overall, notwithstanding a tendency to relapse whenever she visited her father, who indulged her with dairy products and took her to the doctor for her full quota of vaccines and antibiotics. Now a freshman in college, she still gets sick at times, but her ear infections are gone; her immune system helps her to respond acutely and vigorously; and she recovers promptly each time.53
This girl’s almost identical reaction to two different vaccinations indicated a definite tendency to fall ill in a certain way that was recognizably her own, and already in place to some extent when the vaccines were given, their important and obvious contribution being simply to reactivate and intensify it.
Making Worse What’s Already There: the Common Diseases of Childhood.
Seeing a large number of ear infection cases, and learning to recognize the nonspecific effect of vaccines on the immune system as a whole, opened the way for me to notice a similar effect linking childhood vaccinations with other chronic ailments as well. As with these otitis cases, if the condition was already symptomatic, a dramatic intensification would be observed not long afterward, while if it was quiescent, it would often be reactivated. Here is the simple example of a teen-aged girl, whose distinctive ensemble of childhood complaints resurfaced after more than 10 years, when she was given an MMR booster as a requirement for entering college:
A patient of mine since early childhood, an 18-year-old girl was preparing to leave for college. In primary school, she had been plagued by enuresis and a variety of obsessive-compulsive symptoms, but with the aid of one particular homeopathic medicine she had overcome these problems and remained largely symptom-free for more than 10 years. Within a week after the required MMR booster, her old pattern of bedwetting and OCD behaviors returned in full force, and she came seeking treatment on her own for the first time. The same remedy that had helped her so much as a child was equally effective again, and she completed her first 2 years at a top liberal arts college with a brilliant academic record, repeating the remedy at rare intervals. She has since graduated with honors, served challenging internships abroad without major difficulty, and has not needed the medicine again for a long time.54
As with my ear infection cases, these other adverse reactions were also “nonspecific” in that the clinical picture was a recognizable characteristic of the patient, rather than a statistically significant effect of any particular vaccine; were often associated with a family or past history of similar tendency; and encompassed the same broad spectrum of ailments seen in any pediatric practice, vaccinated or not, including asthma, eczema, sinusitis, ADD, allergies, behavior problems, and so forth.
Moreover, unlike the official candidates for specific reactions to particular vaccines, which are narrowly defined to be as rare as possible, in my experience these nonspecific reactions are common enough to be the rule, rather than the exception, although by no means necessarily minor or trivial, as the following case illustrates:
A 15-month-old boy was brought in for croup, recurrent colds, swollen glands, and developmental issues. Born to a diabetic mother, he weighed 8 lb. at birth, but spent weeks in the Newborn ICU because of “undeveloped lungs,” with cyanosis and unstable blood sugars. In the first 3 months he was quite colicky, with a nasty diarrhea that stopped when her mother eliminated wheat from her diet. At 3 months of age, soon after his first DPT, HiB, and polio vaccination, he became very restless, with swollen glands and a sickly pallor that lasted for months and culminated in a prolonged episode of croup, high fever, and sunken chest, for which he had to be hospitalized and given IV corticosteroids. At home, the cough persisted, and the mother decided to postpone the second round of vaccinations for several more months. But when she eventually agreed to them, the croupy cough and swollen glands reappeared almost immediately, along with more or less exactly the same symptoms as before.
With a marked fear of strangers, the boy came into my office appearing subnormal, drooling profusely, with his mouth hanging open, and hiding behind his mother. After trying a few to no avail, I found a suitable homeopathic remedy for him, and the entire illness cleared up in a few days and never returned. At the follow-up a month later, his mother was ecstatic. For the first time, even in the dead of winter, there was no croup and no swollen glands, he was sleeping well, and seemed much more alert, more interested in his surroundings, and less fearful around strangers. That was 6 years ago, and I’ve not seen him since, but the experience convinced her not to vaccinate any more, and she recently called to tell me that he continues to thrive and develop normally, “like other children his age.”55
Here is another case, a boy with severe allergies and steroid-dependent asthma, who accomplished a sustained remission under homeopathic treatment, but relapsed immediately after a DPT booster:
Asthmatic since the age of 2, and testing positive for a broad spectrum of allergens, a 4-year-old boy was brought in for homeopathic treatment, because even a strict regimen of bronchodilators and inhaled corticosteroids had failed to prevent a series of major attacks the previous fall and winter, several of them requiring prednisone and antibiotics as well. After 6 weeks of homeopathic treatment, he had cut his meds by half, maintained higher peak flows of 150 or more, and for the first time he made it through a cold without asthma or drugs of any kind. Emotionally, too, he was calmer and less wild, even expressing remorse after a fit of rage, which he had never done before.
Early the next fall, during the peak of his allergy season, he was still doing well, on half-doses of Beclovent, and had been energetic and in good health all spring and summer, with peak flows at record levels of 150-175. Then he was given a DPT booster before entering kindergarten, and almost immediately he came down with bronchitis, for which antibiotics were given, and his asthma and allergies returned in full force. Once again, he responded beautifully to the same homeopathic remedy as before, and he has continued to improve over the past 2 years, to the point that he hasn’t needed to come back or take it again.56
To give some idea of the wide range of conditions and varying degrees of severity encompassed by these nonspecific reactions, I will conclude with this story of a little girl with seizures, beginning at 6 months of age, when her parents already felt certain that the vaccines were at fault and decided to discontinue them, although her illness took another 6 months to attain its maximum intensity:
After a preliminary diagnosis of autism was ruled out, a 3-year-old girl was brought in for frequent attacks of “shuddering,” in which she tensed her limbs, shook her head, and stiffened her body. Although the pregnancy had been complicated by first-trimester bleeding, exposure to toxic chemicals, and IV antibiotics during labor for a Strep B infection, the child seemed perfectly healthy at birth, nursed well, and remained alert and energetic for the first 2 months of life.
After her first DPT, HiB, and polio combination, she screamed violently for 3 days, and began spitting up a lot after feedings, a pattern that reappeared later with teething. The shuddering episodes began sporadically at 6 months, after her 3rd round of vaccines, which convinced her parents to discontinue them, but these small seizures persisted, and became more frequent when solid foods were introduced. By her second birthday, they were occurring around 200 times a day, with arms extended and thumbs tucked into her palms.
Naturally intelligent and verbal, her mental development had also been adversely affected by the seizures, which were especially frequent and severe after milk and dairy. Still attached to the breast, she had seemed ready to wean a year earlier, until an ice-cream feast precipitated a terrible relapse, from which she was only starting to recover. Although gentle and sweet-natured most of the time, she also displayed a violent temper at times when her attacks were more frequent, with screaming, biting, and a predilection for smashing things. She was also afraid of loud noises, and of going to sleep.
With her first homeopathic medicine, her parents noticed a definite improvement in her mood and energy, but she became violently ill one day at her play group, with a high fever and explosive diarrhea, and her shuddering attacks continued without letup. After the second medicine, the diarrhea subsided within a week, and the seizures were fewer, briefer, much less intense, and less easily provoked. Her mood, energy, and speech also improved, with fewer angry outbursts. In 3 months, the attacks had almost disappeared, and in 6 months she seemed an altogether different child, active and vivacious, but also calmer and less troubled, in spite of having taken great leaps forward in speech and learning. She has continued to thrive over the years since then, with no shuddering, no tantrums, and no major reactions to occasional dairy treats, but the parents are still dead-set against vaccinating her.57
As we saw, another closely-related indication of a nonspecific reaction is that the child will tend to respond in the same manner to two or more different vaccines, a curiosity that could make it easier or harder to suspect or be sure of the link, depending on the circumstances. Here is the case of a young boy who developed a pattern of recurrent fevers after several different combinations of vaccines, despite the fact that his mother had already postponed them for months because of similar experiences with an older child:
A baby boy of 15 months was brought in for homeopathic treatment because of recurrent fevers after several vaccinations. He was born cyanotic after a Pitocin induction, when his heart rate slowed to 50 per min. during each contraction, and remained somewhat flaccid in the newborn nursery, which led the pediatrician to postpone his Hep B series until 2 and 6 weeks of age, but he continued to eat and sleep poorly in the early months. After stalling off all the others for 9 months, his mother finally agreed to the DPT, HiB, Hep B, and oral polio all at once, because she “didn’t want to do them, but was afraid not to.” Within hours, he developed a hard nodule at the injection site that lasted for 2 weeks and was accompanied by loud screaming whenever she put him down in his crib or car seat.
At 10 months, after his second multi-vaccine event, he developed a fever of 102˚ that lasted for 5 days; and at 14 months, well after his 3rd round, he had 2 more episodes without obvious provocation, accompanied by an unusually intense and prolonged version of his previous screaming behavior. All of these symptoms subsided rapidly after a single dose of the homeopathic DPT nosode. At 18 months, his mother finally agreed to give him the MMR, and 10 days later he came down with another fever that lasted for days, this time with a morbilliform rash on his chest, and the same cranky behavior as before. Again he responded well to remedies, and did well until around his second birthday, when another round of DPT, HiB, and polio vaccines set off a high fever yet another time. This one lasted 3 days, and was followed by a marked aversion to being touched or looked at, and to people coming too close to him, both of which symptoms persisted for many weeks. At that point the mother decided not to vaccinate him any more, and his health has been good ever since.58
Another little boy with swollen tonsils and adenoids, another of the commonest complaints in his age group, responded in his typical fashion to two different vaccinations, such that even his very skeptical and hard-headed parents were finally convinced of the connection that they had refused to take seriously:
A 3-year-old boy was brought in for homeopathic treatment. The previous winter, he had had a series of ear infections, most of them accompanied by high fever, swollen glands, postnasal drip, a loose chest cough, low energy, fluid in the ears, and partial hearing loss, symptoms which tended to persist even when he wasn’t sick. But this year the mother was concerned mainly with his tonsils and adenoids, which were chronically enlarged and seemed to make him more prone to catch whatever acute ailment was going around the neighborhood.
With a series of homeopathic treatments over the next winter and spring, he was sick much less often, his energy improved, and eventually even his tonsils and adenoids receded dramatically, to the point that his pediatrician was amazed and delighted, not least by the fact that his ears were also clear for the first time in his experience. Next fall, the boy received his first Hep B shot and had no immediate reaction to it, but a few weeks later he developed a massive ear infection with high fever, and three smaller ones in the course of the winter. By the time I saw him again, he was again intermittently low in energy, with dark circles and poor hearing, as before.
Despite my request that they wait longer, his parents were anxious to bring his vaccinations up to date, so they gave him the DPT and MMR on the same day. Almost immediately, his tonsils ballooned out to their previous size, followed by another ear infection, a cough, and a bad case of the chicken pox in rapid succession. When they brought him back for treatment, his tonsils and adenoids had reverted to their once prodigious size, his other chronic complaints had similarly relapsed, and the parents were thoroughly convinced, even repentant, but this time it took a bit longer for the remedies to do their work.59
In my practice, based on similar evidence, I have seen and documented adverse reactions to vaccines of this nonspecific type that encompass the full spectrum of common pediatric ailments, including emotional and behavioral problems, such as OCD, night terrors, phobias, depression, tantrums, and fits of uncontrolled rage. From the broad range of such cases I surmise that the possible reactions are limitless, because they are specific to the individuality of the child, rather than that of the particular vaccine, a circumstance which also helps explain why they overlooked by doctors and parents alike, and dismissed as of lesser importance even when the connection is made.
3. HOW VACCINES WORK.
All of these considerations lead me to wonder how vaccines really act inside the human body, that is, what they do and how they do it, whether for good or ill. The phenomena I would like to explain naturally include what is widely known and celebrated about them, that they have drastically reduced the incidence and severity of a number of major infectious diseases, such as measles and polio, and that the serum of vaccinated individuals reliably contains measurable titers of specific antibodies to them. But I am equally anxious to account for the further observations that I have just described and are much less well-known, namely,
1)that all vaccines act specifically, by eliciting or provoking reactions peculiar to themselves;
2)that they also act nonspecifically, by intensifying whatever diseases are active, or (re)activating whatever pathological tendencies are latent, for which any vaccine may suffice; and
3)that adverse reactions of both types tend to be overlooked or ignored, and are therefore seldom credited or taken seriously when the victim or anyone else tries to document or obtain redress for them.
While I certainly hope and expect that what follows will prove to be objectively verifiable, it is at bottom simply an attempt to make sense of my own experience, and comprises a nexus of interrelated facts, observations, reflections, and hypotheses that are coherent and plausible, and make intuitive sense to me. I have also tried to make them clear and intelligible to a literate audience without specialized medical or technical training.
In spite of their pre-eminent importance in medicine and public health, and an abundance of detailed knowledge about how the immune system works, vaccines still need satisfy only the two criteria I mentioned above to be considered effective, namely,
1)that the incidence of the corresponding natural disease declines significantly after administering it on a large scale; and
2)that the serum of vaccinated individuals reliably contain measurable titers of specific antibodies that persist for extended periods of time.
These minimal standards are exactly analogous to those of the drug industry as a whole, which gratuitously assumes that vaccines and other drugs act mainly as they are intended to, to the extent that everything else they do gets lumped together as incidental or “side effects,” relegated to the fine print, and often simply forgotten. In short, the current medical system lacks and does not even seem to want any broader conception of how medicines affect the organism as a whole.
In search of a more comprehensive view, I will begin by contrasting the process of coming down with and recovering from an acute disease, such as the measles, with what happens when the corresponding vaccine is administered instead.
With its marked affinity for the respiratory mucosa, the measles virus is dispersed through the air by sneezing and coughing infected droplets, and then inhaled by susceptible persons on contact with them. For 10 to 14 days, the virus multiplies silently, first in the tonsils adenoids, and accessory lymphoid tissues of the nasopharynx, then in the regional lymph nodes of the head and neck, and finally in the blood, spleen, liver, thymus, and bone marrow, the major visceral organs of the immune system. Throughout this prolonged “incubation” period, the prospective patient typically feels quite well and experiences few or no symptoms of any kind.60
With the first signs and symptoms of illness, circulating antibodies to the virus are already detectable in the blood, in concentrations roughly proportional to its severity.61 In other words, the illness we know as “the measles” is precisely the concerted effort of the immune system to clear the virus from the blood, including inflammation of already sensitized tissues at the portal of entry, activation of B- and T-lymphocytes, macrophages, and the serum complement system, as well as a host of other mechanisms, of which the production of specific antibodies is only one, and depends for its effectiveness on the collaboration of these other processes. Finally, the virus is expelled mainly by sneezing and coughing, exactly the same routes through which it entered in the first place.
Such a magnificent outpouring suggests that coming down with and recovering from acute illnesses of this kind are decisive experiences in the maturation of a healthy immune system. The immunity that results from it is specific, to be sure, in that those recover from the measles will never again be susceptible to it, no matter how many times they are re-exposed in the future. But it is also broadly non-specific, in the equally important sense of "priming" the system to respond rapidly and effectively to other infections it may encounter in the future.
This double-barreled natural immunity acquired through recovering from acute diseases represents an enormous net gain for the health not only of individuals and their descendants, but ultimately also of the community, the nation, and the planet as a whole. First serendipitously aiding the Spanish conquistadores in weakening the Aztec empire, and then “traded” by American settlers in contaminated blankets to exterminate the Indian tribes whose lands they coveted, the measles virus still kills 20% of isolated populations exposed to it for the first time. Many centuries of adaptation were required for our own ancestors to convert it into a routine disease of childhood, such that by the time I caught it at the age of 6, nonspecific mechanisms were already in place to help me recover from this major, week-long illness with no complications or sequelæ. Today I still remember it as a graduation ceremony for my immune system, and a certificate of readiness to handle whatever else might threaten me in the future, which I credit in no small part for the good health I enjoy today. In short, the ability to respond acutely and vigorously to infection ranks among the most fundamental requirements of general health and well-being, a truth so axiomatic that even having to reaffirm it attests to how far we have strayed from a saner and more wholesome conception of life.
Artificial or Vaccine-Induced Immunity.
On the other hand, when the live, attenuated vaccine virus is injected into the blood, a brief inflammatory reaction may be noted at the injection site, with no local sensitization at the portal of entry, no incubation period, no acute illness, and no massive outpouring of the immune system as a whole. Like a conjuror’s trick, vaccination does indeed produce measurable titers of specific antibodies in the blood, but without any illness or generalized inflammatory response, and without any significant improvement in the general health of the recipients, apart from lowering their statistical risk of developing the acute disease in its classic form.
But where the virus goes, how it deceives the immune system into continuing to produce antibodies against it for years at a time, and what price we have to pay for the counterfeit immunity that they represent, are the basic questions that still go unasked. Vaccines seem almost tailor-made to accomplish what the immune system as a whole seems to have evolved in no small part to prevent, namely, to give viruses, bacteria, and other foreign antigens free and immediate access to the visceral immune organs without any easy or obvious way to get rid of them. No mere side effect, the continuous production of specific antibodies for years at a time requires the physical presence of live viruses and other highly antigenic substances inside the cells of the immune system on a more or less permanent basis.
In the case of measles, mumps, rubella, influenza, and the other live-virus vaccines, excellent models already exist to help us understand how this chronicity might occur, and predict the kinds of pathology that would be likely to follow from it. Many viruses are well known for their capacity to survive more or less indefinitely in latent form within the cells of the immune system without provoking acute disease, simply by attaching their DNA or RNA as “episomes” or extra particles to the genome of the host cell and replicating along with it, allowing the cell to perform many of its normal functions, but adding instructions for the synthesis of viral proteins as well.62 Latent viruses of this type have already been implicated in four distinct varieties of chronic disease, namely,
1)recurrent or episodic acute diseases, such as shingles, herpes simplex, genital warts, and the like;
2)“slow” viruses, longer-lasting infections, such as SSPE (subacute sclerosing pan-encephalitis, a rare complication of the measles), Guillain-Barré polyneuritis (after influenza and other viruses), chronic fatigue syndrome (CFS, after infectious mono, Epstein-Barr virus, CMV, et al.), and perhaps AIDS as well;
3)diseases associated with “prions,” infectious proteins of viral origin that contain no DNA or RNA, such as kuru, “mad cow,” and Creuzfeld-Jacob disease; and
4)a variety of tumors, both benign and malignant, such as Burkitt’s lymphoma, Rous sarcoma virus (RSV), et al.
For the past fifty years, most scientists have accepted the formulation of Sir Macfarlane Burnet and others, that the immune system is organized around helping the organism to distinguish "self" from "non-self," i. e., to recognize and tolerate its own cells, on the one hand, and identify and eliminate foreign substances on the other. This is evident in the acute response to infection, as we saw, and also in the rejection of transplanted tissues and organs, both of which result in complete and permanent removal of the offending substances from the body. Latent viruses and any other foreign antigens residing within the genetic material of the host cells would pose surely no less of a threat, not least because expelling them would only be possible by attacking and destroying these cells, thus sowing a rich harvest of auto-immune phenomena, which would differ only in the types of cells affected.
By vaccinating children with live viruses and other foreign antigens, and thus forcing the cells of our immune system to harbor them for years at a time, I am afraid that we are essentially reprogramming their immune mechanism to respond chronically to other infections as well, and indeed to antigenic challenges of every kind. Although some might call it fantasy, speculation, or wild conjecture, this conclusion is amply borne out by the alarming and mysterious explosion in the incidence and severity of chronic ear infections, asthma, allergies, eczema, ADD, autism, and other common diseases of childhood in recent years, and similarly by the case material I have just presented. In any case, it is dangerously misleading, and indeed the exact opposite of the truth, to claim that MMR, for example, somehow “protects” us against measles, mumps, and rubella, by infecting us with these viruses in a chronic and indeed permanent fashion, such that our immune systems are less capable of responding acutely, not only to them, but to everything else as well.
If my reasoning is correct, then all that we have achieved by mandatory vaccination is to have exchanged a few epidemic diseases of the past, many of them already well past their prime, for the much more prevalent and less curable chronic diseases of today, with their suffering and disability amortized at a high rate of interest over the patient’s lifetime, like a home mortgage loan. I doubt that most parents would accept such a devil’s bargain if they were told the truth about it, and if they had any choice in the matter. Nor should we forget the added bonus of opening a Pandora’s box of new mutations and diseases in the future, through in vivo genetic recombination within the cells of the race.
The latency model would certainly apply to the vaccines prepared from live viruses, e. g., the MMR, chickenpox, oral polio, yellow fever, rotavirus, and human papilloma virus (HPV). Those made from killed bacteria (pertussis, HiB, pneumococcus, typhoid), inactivated toxoids (tetanus, diphtheria), tissue extracts (rabies, acellular pertussis, or aP), or recombinant viruses (Hep B), are also designed to remain inside host cells and continue provoking antibody responses over long periods of time, and their more or less successful track record suggests that they do so. But how they manage it is not at all clear. What we do know is that there are three kinds of chemical additives that are deliberately used to promote such long-term carrier states, presumably through conjugation with host-cell immunoglobulins:
1) Adsorbents, chiefly aluminum hydroxide. Vaccines prepared from toxoids and cellular extracts are precipitated onto adsorbents, usually aluminum hydroxide, both to preserve them and enhance their antigenicity.63
Recent studies of aluminum-free pertussis vaccine have shown that the vaccine prepared without adsorbent is much less toxic,64 while metallic aluminum and its salts, widely used in cookware and other products, are also implicated in a broad array of auto-immune, allergic, and neuropathological states, including encephalopathy and Alzheimer’s disease.65
1)Fixatives and preservatives, chiefly formaldehyde. Some bacterial vaccines are first killed or inactivated with formaldehyde, which also fixes and preserves them in that form, much as in embalming the dead.
An efficient and well-known carcinogen,66 even in minute amounts,67 formaldehyde is among the very last things we would want injected into the bloodstream of children for any reason, let alone for the purpose of trapping already dangerous vaccines inside them.
2)Sterilizing preservatives, chiefly Thimerosal. Several vaccines are sterilized or denatured and then preserved with Thimerosal, an inorganic sulphur-mercury salt that prevents bacterial contamination.
Already linked to a broad range of toxic and auto-immune reactions, ranging from allergies to dementia and renal failure,68 mercury salts and Thimerosal in particular have been studied and publicized so widely in recent years that the vaccine manufacturers themselves have been scrambling to discover and develop more palatable alternatives to it.
Clinical and Epidemiological Studies.
Despite nearly universal agreement that many epidemic diseases have declined dramatically in frequency and virulence since specific vaccines were introduced against them, the assumption that the latter deserve most of the credit remains unproven in many cases, and continues to be challenged by leading authorities in the field. In the case of whooping cough, for example, its incidence and severity were already falling precipitously long before the vaccine was first introduced in 1942,69 a fact that prompted a leading epidemiologist of the time to lament that its effectiveness might not be demonstrable:
If mortality from pertussis continues to decline at the same rate during the next 15 years, it will be difficult to show that immunization had any effect in reducing it.70
Much the same could be said of diphtheria, tetanus, typhoid, cholera, TB, and other scourges of long ago, which began to disappear with improvements in public health and sanitation toward the end of the Nineteenth Century, long before the introduction of antibiotics, vaccines, or any medical interventions designed specifically to eradicate them.71 This larger historical dimension led the microbiologist René Dubos to observe that infectious diseases have their own natural history, largely independent of drugs and vaccines, in which asymptomatic infection and symbiosis are vastly more common than acute disease:
It is barely recognized but nevertheless true that animals, plants, and men can live peacefully with their most notorious microbial enemies. The world is obsessed by the fact that poliomyelitis can kill and maim several thousand unfortunate victims every year. But far more extraordinary is the fact that millions upon millions of young people become infected by polio viruses yet suffer no harm from them at all. The dramatic episodes of conflict between men and microbes are what strike the mind. Less readily apprehended is the more common fact that infection occurs without producing disease.72
But the best evidence that vaccines really work dates from the introduction of the Salk or injectable polio vaccine in the 1950’s and the live measles vaccine in the 1960’s, after which the dreaded epidemics of poliomyelitis have practically disappeared from the developed world, while the annual incidence of measles in the United States plummeted from over 400,000 cases to less than 10,000.73 But the disturbing possibility that even the measles vaccine, seemingly one of the most successful, may act in some other way than by producing a genuine immunity is already evident in the circumstance that the disease has continued to break out, even in heavily vaccinated populations, and that the observed differences in incidence and severity between vaccinated and unvaccinated kids have been much smaller than expected.
In 1985, for example, 157 cases of measles were reported in Corpus Christi and the surrounding Nueces County, Texas, over a 3-month period, notwithstanding a vaccination rate of over 99% and supposedly “immune” antibody titers in more than 95%.74 Similarly, in 1989 one Illinois high school reported 69 cases in 3 weeks, despite verified records of vaccination for 99.7% of the students.75 Although both reports oddly omitted the actual numbers of vaccinated and unvaccinated cases, they effectively discredited the widespread myth that unvaccinated children, supposedly the principal reservoir of the disease, pose a threat to their vaccinated classmates, a fear often exploited by health departments to shame reluctant parents into compliance. These outbreaks suggested just the opposite, that if the immunity conferred by the vaccine were genuine, then the unvaccinated children would be a threat to nobody but themselves.
These inconvenient facts could not simply be written off to inactive batches of the vaccine, or explained away on the basis that vaccine-mediated immunity is only partial and temporary in any case, and tends to wear off with increasing age, leaving the child presumably unaffected and just as susceptible as before. As we saw, this was the thinking behind revaccinating the young lab tech with Hep B, since she had no antibodies, with such tragic results, as we saw, whereas these children showed high titers and were supposed to be “immune.” Yet the same reasoning led to the policy of revaccinating with a second booster dose of MMR at a later date, even though that policy was what almost killed Adam, and other studies disproved it decades ago. Thus in 1980, when measles seemed to have been all but eradicated in the United States, the same Dr. Cherry whom we’ve met before found that children previously vaccinated against the measles whose antibody titers had fallen well below supposedly immune levels responded to a second booster dose only minimally and for an unacceptably short time:
In the booster vaccines, there was only a modest initial rise in titer, and after a year the level was almost back to where it had been before the booster. In addition, we noted a lack of “take” in 14 other children, most of whom had probably been immunologically stimulated before. In short, the data suggested that another booster dose might not have any lasting effect on waning immunity.76
Both the outbreaks of measles in supposedly highly immune populations and the failure of Dr. Cherry’s booster shot to remain effective for a long time cast serious doubt on the conventional wisdom that “immunity” is a purely quantitative variable, that the specific antibody titer accurately measures it, and that by requiring a sufficient number of boosters it can be ratcheted up more or less at will. Nevertheless, the outbreaks generated such intense pressure to do something about them that within a few years Dr. Cherry’s research was quietly shelved, the MMR booster was duly mandated, and it remains in force to this day.77
Another suggestive finding that should have attracted more attention emerged from a sustained outbreak of 235 measles cases in Dane County, Wisconsin, over a 9-month period in 1986.78 In addition to the usual cases, only 6% of whom were unvaccinated,79 the authors identified a subset with what they called “mild measles,” consisting of a pale rash, no fever, and very little discomfort or systemic involvement.80 To their surprise, they discovered that this syndrome was far commoner in previously vaccinated kids with no measles antibodies at all than in either the unvaccinated kids or those with high levels of antibody, both of whom were much more likely to develop the typical full-blown disease.81
Once again, this paradoxical result suggested some kind of latent viral activity that was undetected and indeed belied by routine serological testing, echoing Dr. Wakefield’s original finding that children receiving the MMR were much more likely to develop some form of inflammatory bowel disease later in life than their unvaccinated controls. As before, the obvious inference that nobody wants to draw is that artificial, vaccine-mediated immunity is not only counterfeit, but dangerous, conferring a high risk of auto-immune diseases of every description.
4. SOME INDIVIDUAL VACCINES.
With these concerns as background, I will now reconsider several individual vaccines one by one, with primary emphasis on those mandated or strongly recommended for infants and children. Though the same issues are present in every case, variations in degree, and in the seriousness and public health impact of the corresponding natural diseases, make the actual equation somewhat different for each one.
The combined preparation DPT, or DTaP, as the acellular form is now called, comprises three different vaccines. Both serious and potentially fatal diseases, diphtheria and tetanus are bacterial infections that kill and maim entirely by virtue of the toxic high-molecular-weight proteins that they elaborate. Known as toxoids, diphtheria and tetanus “vaccines” are inactivated but still highly antigenic versions of these poisons, which are denatured by heat, fixed in formaldehyde, precipitated by adsorption onto aluminum hydroxide, and preserved and kept sterile by Thimerosal, at least until recently.
Now quite rare in the United States, tetanus infects only a few dozen people annually, in part because of the vaccine, but also because of the extremely specialized conditions it requires. With its natural reservoir in horse manure, and to a lesser extent in the feces of humans who care for horses, the tetanus organism produces spores that are thermostable and can survive in the soil for decades across wide ranges of weather and temperature, but that germinate only under anærobic conditions, i.e., in the absence of oxygen.
Primarily a wound infection, tetanus can develop only by inoculation, either into an area where some tissue damage has already occurred, as in a deep puncture wound by a sharp object contaminated with spores, like the classic “rusty nail,” which then closes over, or else underneath a more superficial infection, which consumes the oxygen available at the site, as in tetanus of the newborn, which formerly killed babies with ordinary infections of the umbilical cord stump. After an incubation period of 3 to 7 days, the chief symptoms of poisoning are “lockjaw” and other spasms and convulsions mediated through the spinal cord and central nervous system. Because it takes as much as 14 days to develop a primary immune response, the toxoid is ineffective if given for the first time after such an injury, while human antitoxin, which is very effective if given early enough, will do very little to mitigate the full-blown disease, which still carries an overall mortality of 10-20%, with or without treatment.
Notwithstanding the impressive array of adjuvants used to prepare it, tetanus toxoid has a long and generally favorable track record of safety and effectiveness, although various neuropathological states, such as tranverse myelitis, encephalopathy, and Guillain-Barré polyneuritis have definitely been associated with it.82 Of all the vaccines, it is the one most widely requested by parents for their children under my care. What I like the most about it is that it has to be given by injection, that is, a puncture wound, like the disease itself. But it is somewhat difficult to obtain except in combination with diphtheria toxoid (DT), or with diphtheria and pertussis (DPT), because of which it is begun much earlier in life than is desirable or necessary. My advice to parents who want it is to wait until kids begin playing independently at a distance from whoever is watching them, typically around 3 years of age. By then most will have come down with and recovered from enough acute febrile illnesses to indicate that their immune systems are developing normally; for them, tetanus toxoid is unlikely to be a problem.
Typically beginning as a respiratory infection with swollen glands and a foul-smelling infection of the mouth and throat, diphtheria has become very uncommon in the United States, but still occurs sporadically in small, isolated outbreaks, especially among recent migrants from countries where it remains more prevalent, such as the former Soviet republics of Eastern Europe and Central Asia.83 Its overall mortality of 2-10% is attributable almost entirely to the toxin, another high-molecular-weight protein, which is ulcerating and destructive to all cells, but particularly to the vital tissues nearby, notably the larynx, and secondarily to the heart and kidneys via the blood. As with tetanus, the antitoxin is quite effective if used early enough, when the disease is unfortunately still nondescript and easily mistaken for commoner types of pharyngitis, but much less so when the clinical picture is well-developed and easily recognizable.
As with tetanus, diphtheria toxoid confers some degree of immunity against the toxin, but not the infection, and only for a limited period of time. In surveys of heavily vaccinated populations, like the Danes and Italians, for example, more than 20% of adults were found to have antibody titers well below the level considered immune,84 while in Sweden rather low titers were found in 70% of the women, 50% of the men, and 19% of the children.85 As might be expected, although antibody titers do not measure immunity very well, small outbreaks of diphtheria have continued to occur in these areas,86 and some authorities believe that the disease could actually make a comeback. Many parents of the children I see do not seem to mind giving the DT, even those who are quite leery of vaccines in general, an attitude that makes me wonder if these toxoids might indeed be less likely to enter the long-term carrier state I spoke of earlier, and to that extent less dangerous as well.
Rightly or wrongly, almost all of the uproar over the DPT vaccine has been focused on the pertussis component, which was assumed to be the main culprit in the encephalopathy scandals of the 1980’s, and played a major role in creating the anti-vaccination movement in the United States, as we saw. To some extent, the acrimony of the debate is related to the seriousness of the disease, notably in very young infants less than 6 months of age, in whom it has been fatal on very rare occasions, because of pneumonia or laryngeal edema and obstruction of a passage already minute to begin with.
Beginning as a nondescript upper-respiratory illness resembling a cold, pertussis may last up to 10 to 14 days before the characteristic “whooping” cough develops, by which time it is no longer highly contagious, and antibiotics are of use mainly to prevent pneumonia and secondary infections, both common causes of death in the past. Often persisting for 6 weeks or more, and subject to reactivation by new coughs and colds even months later, the intense, fatiguing, and sometimes alarming paroxysms actually represent an allergic hypersensitivity state of the larynx to the bacterial breakdown products, rather than a continuing infection, while the organism itself is notoriously fastidious and difficult to culture, requiring special laboratory facilities. For both reasons, the disease often goes undiagnosed and unreported. Albeit more hypothetical than real, the specter of death in very young infants has generated most of the pressure for vaccinating early, even at birth or in the newborn period, as was successfully carried out in a recent pilot study in Sweden.87
The original whole-cell vaccine was prepared from a culture of the organism that had been denatured by heat, while the new acellular version consists of purified toxin antigens and the filamentous hemagglutinin, both denatured by formaldehyde, combined with the DT toxoids, and preserved with Thimerosal. Although the incidence of minor allergic reactions has been reportedly lower, the risks of death and brain damage have remained more or less unchanged with DTaP.88 As for the disease, while much less common and less virulent than it was before 1940, it is still fairly widespread, and capable of small outbreaks even in highly-vaccinated areas, which also suggests that the vaccine, like the DT toxoids, is neither strikingly effective nor very long-lasting. Having seen my share of pertussis cases, with a full quota of both success and failure in treating them homeopathically, like most parents I would happily spare children and adults alike having to endure such a prolonged, nasty, and at times terrifying ordeal if a safe and effective preventive were available.
Unfortunately, neither the vaccine we had nor the one we have now fulfills these promises well enough in my view to make it worth the risk. In newborns, although breast milk contains no specific antibodies to speak of, nursing still confers the best general protection they will ever have or need. I’ve seen more than enough of what the vaccine can do to infants and young children, while even its staunchest proponents balk at giving it to kids over 7, because of even higher risks of adverse reactions. I usually advise parents to take their chances, using Pertussin, the homeopathic nosode, for short-term prophylaxis if there are cases in the school or neighborhood, or the plant remedy Drosera if their children are exposed and already symptomatic.89
I grew up with polio. Kids in my neighborhood got sick with polio viruses, and in my college years I knew several who had been crippled by them. My brother and I were not allowed to swim in public swimming pools, then widely known as “polio palaces,” and I still remember lining up in school to receive my polio shot as soon as it became available. So here, too, I can well understand why parents would want to protect their kids from this much-dreaded disease, whose victims either died or, like FDR, were left crippled for life. Along with tetanus, it has always been the most popular and least controversial of the vaccines among the parents with children in my practice, most of whom eventually receive it at some point.
On the other hand, naturally-occurring polio viruses elicit no signs or symptoms of illness in well over 95% of those who are exposed to and infected by them, while an equally high percentage of those who do become symptomatic develop nothing more serious than a simple gastroenteritis, with or without a head cold, differing very little from other common intestinal “bugs.”90 Even in peak epidemic years, the full-blown picture of paralytic poliomyelitis, with its characteristic destructive lesions in the spinal cord and medulla oblongata, affected only a minute fraction of those exposed to the virus, indicating both a neuropathic strain and a high degree of anatomical susceptibility in the patient.91 Since polio viruses were ubiquitous in the 1940’s and early 1950’s, before the vaccine was introduced, and were found routinely in samples of city sewage wherever they were looked for,92 natural immunity to them was already about as effective, prolonged, and indeed universal as it ever can be, an achievement that no artificial substitute could come close to.
In short, the calculus both for and against universal vaccination is a bit complicated, with advantages and drawbacks to both the injectable and the oral preparations. Killed with formalin and preserved with 2-phenoxyethanol, the original Salk vaccine is acceptably safe and reasonably effective, but protects only against the internal migration of the virus to the spinal cord, not against the virus itself, which continues to survive in the intestinal tract, and to elicit natural immune responses there. It is effective for only 5 or 10 years, and like tetanus toxoid, must be repeated throughout life.
Introduced in 1961, the Sabin vaccine is an attenuated version of the known neuropathic strains 1, 2, and 3 of the live virus, and is administered orally, thus conferring artificial immunity against them in their own natural habitat. It therefore lasts much longer, and is easier to administer on a mass scale. But it can revert to virulence, especially in the parents and other close contacts of vaccinees,93 and is grown and propagated in monkey kidney cells, with further risks of cross-contamination with SV-40 and other simian viruses.94
Finally, those people who were anatomically susceptible to the wild-type virus must still be sensitive in some manner and degree to the attenuated strains as well, which raises the possibility of long-term latent or carrier states within the same motor neurons that are targeted by the disease. Even the heroic effort to eliminate paralytic polio on a global scale, which has been spectacularly successful politically, must therefore be weighed against the dangers and miscalculations that always seem to crop up in the wake of our seemingly irresistible drive to beat nature at her own game, to eliminate what can never be wholly eliminated, our susceptibility to disease itself. This is also the reason why the few cases of vaccine-associated paralytic polio have recently caused the oral vaccine to be discontinued in the United States, even though it is about as safe and effective as any vaccine can ever be.
In my opinion, neither the triple MMR vaccine nor its separate components should ever be given to populations like ours, which through centuries of adaptation had already achieved an optimal level of natural immunity to all three diseases. In the pre-vaccine era, measles, mumps, and rubella were contracted by almost all children of school age, the vast majority of whom recovered without complications or sequelæ, and enjoyed permanent, lifelong immunity as a result. In addition, as we saw, the ability to mount and recover from such illnesses provided an important nonspecific stimulus to the maturation of the immune system and its capacity to deal with other infections in the future. Successful recovery from these infections thus represented an enormous net gain for the individual and the race.
Whereas the DPT and polio vaccines are directed against diseases that are serious and potentially life-threatening, the MMR was the first to be employed purely as a matter of policy, against diseases that were not an urgent public health threat, and indeed for no other reason than to show off the power and efficacy of the vaccination concept as an alternative to the treatment of viral infections, for which effective conventional medicines were and still are lacking.
Notwithstanding the dramatic reductions in the incidence of these diseases since the triple vaccine was mandated in the 1960’s, the short-sightedness of this policy is evident in the fact that the groups most vulnerable to them now are adolescents and young adults of reproductive age,95 the bearers of our future, in whom the risk of pneumonia and other complications is far higher,96 and the infants and young children of vaccinated mothers, whose milk no longer contains measles antibodies to get them started.97 When taken together with the evidence already cited of chronic auto-immune diseases in vaccinees, both as children and later in life, these ominous trends go far to discredit the official calculus that looks only for incidence figures and antibody titers, and shuns any broader or deeper perspective.
Attenuated by serial passage in a culture of chick embryo cells, the triple MMR vaccine contains live measles, mumps, and rubella viruses, is contraindicated in patients with serious egg allergies,98 and may in fact cause or exacerbate these problems as well. If anything, the case for vaccinating against mumps and rubella is even flimsier than for the measles. Also known as epidemic parotitis, mumps is essentially a benign, self-limited disease in the vast majority of children who acquire it before puberty, and recovery usually confers lifelong immunity, whereas in vaccinated adolescents and young adults, the group now most susceptible to it, the risks of major complications like meningoencephalitis and testicular or ovarian involvement are much higher.99
Similarly, rubella in young children is an illness so mild that it regularly escapes detection,100 while teens and young adults carry a much higher risk of arthritis, purpura, and other systemic complications.101 For all of these reasons, children would likely benefit more from being exposed to these illnesses in grade school, as in the pre-vaccine era, both to protect them against future complications, and to facilitate their normal immunological development, both with minimal risk.
Hæmophilus influenzæ B (HiB).
Originally developed to prevent outbreaks of bacterial meningitis in infants and pre-school children in large, crowded day-care centers, the HiB vaccine has been adapted to a broader and ever more ambitious agenda that is typical for the industry, and raises timely economic, political, and scientific issues that I have referred to only in passing.
The first vaccine to be prepared against a bacterium that already resides in the normal flora of the healthy throat, HiB is aimed at the B strain of Hæmophilus influenzæ, which has sometimes been associated with serious diseases, like epiglottitis, pneumonia, endocarditis, and meningitis, as well as common ailments that occasionally become more serious, such as ear infections, sinusitis, and laryngitis. Since bacterial meningitis can be fatal or leave permanent brain damage in spite of the most vigorous antibiotic treatment, the vaccine establishment saw no downside in trying to prevent outbreaks by vaccinating children of two years and older who were being cared for in large public facilities. But after a small pilot project of this kind, the vaccine was soon mandated for all children at 18 months, and finally came to be administered along with the DPT at 2, 4, 6, and 18 months, often in the same preparation.
Since it began in the late 1980’s, the campaign to promote HiB was accepted by nearly all pediatricians without a murmur, and the vaccine has in fact produced modest reductions in the incidence and severity of all diseases involving this organism,102 including otitis media,103 which by then had become a major public health problem in its own right. Yet this seemingly glorious triumph for the vaccination concept has upstaged the obvious risk of new and more hostile species occupying the vacancy it has left behind, or otherwise altering the normal ecological balance of the nasopharynx and respiratory tract as a whole, possibilities that do not seem to have occurred to, let alone bothered these experts. Apart from its known side effects, which include the Guillain-Barré syndrome,104 thrombocytopenic purpura,105 and invasive HiB disease in the first two weeks of the vaccination, with very low levels of specific antibody,106 this reckless tampering with complex microflora and homeostatic mechanisms to achieve purely limited, short-term goals warrants at least a temporary moratorium on the HiB vaccine until more comprehensive studies are carried out.
Introduced in the early 1990’s, the Hepatitis B vaccine raises a different set of issues. Widespread but only infrequently fatal, Hepatitis B disease may present acutely, chronically, or both, and occasionally leads to cirrhosis and irreversible liver damage, both of which carry high risks of liver cancer and death. Transmitted primarily through contaminated blood, and to a much lesser extent by sexual contact, the disease has long been a major source of ill health among IV drug users, whose depressed immune systems are also much less likely to deal with it effectively or at least keep it at bay. In the 1980’s, the medical system belatedly took notice when Hepatitis B and C, AIDS, and other blood-borne diseases began to appear as contaminants in donated blood, a scandal that finally pressured blood banks into more rigorous screening procedures.107
Because the clandestine subculture of IV drug use has always remained for the most part beyond the reach of the medical system, campaigns of selective Hep B vaccination aimed at these high-risk groups have never been effective. In 1991, mandatory universal vaccination was finally introduced, as a last resort for exerting some degree of leverage over this more and more intractable problem. The desperate and improbable strategy that was actually adopted involved vaccinating all newborn infants in the hospital, so that even those who became addicts in their teens and twenties might be somewhat less likely to acquire the disease, while the blood supply would also be protected to that extent at least. Sound far-fetched? Most pediatricians thought so, at least in the beginning:
“I don’t see what the rush is,” said one pediatrician at a UCSF conference, and neither did his audience. Only about a third of the 400 attendees said they were giving the vaccine routinely to infants. “We’re trying to prevent a disease 25-30 years from now,” he added. Others felt that children receive too many vaccines in the first year, and that each injection is a disagreeable experience which may adversely effect their compliance in the future.108
Letters of protest began pouring in, many of them dubious that the vaccine would last long enough to do any good, and correctly predicting that boosters would also be needed later:
The patient handout falsely assures parents that the protective effects will last throughout the child’s life, while the article admits that antibody levels decline over time, and booster shots may be needed. Since adolescence begins the period of greatest exposure, immunizing then might be more effective, and compliance would be higher.109
Nevertheless, most pediatricians remained strongly committed to the concept of vaccination as a front-line strategy for fighting disease, and by the mid-1990’s the majority were actively on board with the Hep B campaign, just as reports of adverse auto-immune reactions began to appear in large numbers, and as usual it became their task to launder and sanitize them.
Also one of the first of its kind, the Hep B vaccine is a product of bio-engineering, a genetically recombinant form of the virus that is antigenically active but allegedly no longer capable of replicating itself, and to that extent no longer “alive.” Thus blithely ignoring the ultra-microscopic realm of episomes and intracellular viral fragments, this purely semantic distinction is widely invoked to defeat compensation claims for Hep B-related auto-immune diseases, as we saw. While these word games may have postponed another major scandal for a little while, even the polite objections of ten years ago are sufficient to predict a noisy failure for this hare-brained scheme of vaccinating all newborns against a disease that very few of them will ever come into contact with.
While quickly smoothed over and all too easily forgotten, this mini-disaster and the peculiar mentality that engendered it should be kept under glass as a perfect specimen of the fanatical zeal for vaccinating everybody against everything that still rules the industry, and thus as a cautionary tale for what undoubtedly lies ahead. In 1996, the Journal of the AMA published a CDC report advocating mass vaccination against rotavirus, a major source of infectious diarrhea:
Rotavirus is the most common cause of severe diarrhea among young children in the U. S. Of children up to 5 years old, approximately 70% will become ill with the virus, of whom 1 in 8 will see a physician and 1 in 80 will be hospitalized. Though it causes few deaths in this country, it causes 50,000 hospitalizations and $550 million in direct medical costs annually. Safe live oral vaccines have been developed that will prevent 50-60% of the diarrhea and 70-100% of the severest cases. The decision to implement a national vaccination program will be based on the expected reduction in severe outcomes and its cost-effectiveness. A previous study found it would yield net savings of $80 million in health care costs and $465 million in social costs, based on a price of $20 per dose.110
By their own math, however, the authors calculated a savings of only $300 in social costs and a net loss of $100 million in health care costs that could only be offset by lowering the cost of the vaccine to the break-even point of $9 per dose.111 Entitled “When is Too Much Too Much?” an editorial in the New England Journal of Medicine took up the same issue and concluded that the program would be extremely effective in the developing world, where rotavirus and other infectious diarrheas pose a genuine public health emergency of colossal proportions, resulting in countless preventable deaths, but affordable and thus profitable only in affluent countries like our own:
Diarrhea is no longer a serious threat in the United States. It remains common, but its severity has diminished to about 300 deaths per year. On the other hand, the rotavirus vaccine is safe and can prevent nearly half of all infections, 80% of the severe episodes, and virtually all of the dehydration. An effective program of vaccination would significantly reduce mortality, hospitalization, and other medical costs, estimated at $500-600 million annually, as well as indirect costs, including lost wages for parents and the cost of child care. When is too much too much? One hundred preventable deaths per year are too many, and $500 million in direct health care costs is too high. Hence a safe and effective vaccine, even at $30 per dose, can be
recommended for routine use in the U. S. and other developed countries.112
Quickly rubber-stamped by the ACIP, the rotavirus vaccine was duly mandated in 1998 for all infants, even though 5 cases of intussusception, a life-threatening form of intestinal obstruction, had already been reported in the trial population of 10,000 children, a risk of about 0.05%.113 In the first 8 months of the program, large numbers of new cases were discovered, and the vaccine was quietly withdrawn pending a further investigation, which established "a strong temporal and specific causal association" between the vaccine and this life-threatening complication, which was far more prevalent than the trials had indicated.114 The vaccine was then hastily recalled, and the whole affair was hushed up as if it had never happened.
In the concluding section I will say more about the narrowness of the cost-benefit calculation, which ignores the possibility of chronic, nonspecific effects such as I have described, and also about the fascinating process by which vaccines are given fast-track approval for general use with at most nominal regulation and oversight. Let it suffice for the moment to affirm that the rotavirus vaccine fiasco would never have happened without the zealous and even crusading attitude, usually left unstated but here made explicit, that even the smallest number of preventable deaths are unacceptable, and that mass vaccination is always an appropriate strategy to consider for eliminating them.
In a land so notoriously ruled by dollars and cents, these supremely uneconomical ideas both assume that vaccination is inherently safe, and indeed an unmixed blessing for the health of individuals and nations alike, and that whatever adverse effects a particular vaccine or batch may have, there is nothing cumulative about them, so that it is perfectly safe and indeed of great benefit to pile on as many as we wish. Even apart from other considerations, the vast bulk of such nonspecific reactions as I have described are more than adequate to prove both assumptions false. With the new biotechnology consortiums now capable of manufacturing vaccines against viruses and bacteria almost as fast as they can identify them, and for no more pressing reason than their technical capacity to make them, the obvious unwisdom of giving away our public health and welfare to private, for-profit enterprises is an issue that is already ubiquitous and becomes even more threatening with each new campaign.
Many of the same issues are illustrated even more pointedly by the history of the varicella or chickenpox vaccine, which was first developed by Merck in the 1960’s, but was never used on a large scale until the Clinton years, when official enthusiasm for all vaccines attained such dizzying heights that an appealing rationale could at last be discovered for marketing it. Even then it was by no means an easy sell, since the chickenpox had long since become an illness so innocuous to most people that even the AMA Encyclopedia of Medicine described it as “a common, mild infectious disease to which all healthy children should be exposed at an age when it is no more than an inconvenience.”115 Even the American Academy of Pediatrics, which yields to no one in its quasi-religious fervor for vaccines of every kind, affirmed in a 1996 brochure that:
Most healthy children who get chickenpox experience no complications from it. When adults get it, it usually lasts longer and is more severe, often developing into pneumonia. Adults are almost 10 times more likely to be hospitalized for the disease and more than 20 times more likely to die from it.116
Bucking these more traditional, common-sense attitudes, the manufacturers’ successful campaign to win a government mandate for universal vaccination of all young children represents a brilliant coup for them and the industry as a whole, culminating in “sweetheart” deals with state health departments and Federal agencies guaranteeing tens of millions of doses at their own chosen price. How did they pull it off? While nobody claimed that the disease was serious or even required medical attention in most cases, the Clinton Administration’s oft-repeated boasts about the cost-effectiveness of vaccination as a favored health strategy enabled manufacturers to argue that the huge savings in social costs, chiefly in lost wages and extra day care, would make the vaccine a bargain for parents, as alleged in this flier from the American Academy of Family Physicians (AAFP), which was distributed to parents as their kids were offered up:
Why is a vaccine needed? Chickenpox is usually a mild illness, but can cause problems like brain swelling, pneumonia, and skin infections. It may be very serious in infants and adults. Because it is so contagious, children shouldn’t go to school until all the sores have dried or crusted. Many parents miss work during the illness, and lost pay can be a significant cost to them.117
Just as with Hep B, many pediatricians were lukewarm to the program at first, and compliance was very low. Here is a letter from one such in 1997, expressing exactly the same concerns that had already proved accurate in the case of the MMR, namely, the waning immunity in adolescents and young adults, associated with more severe illness and a higher risk of complications:
Chickenpox has been a benign disease of preschool and school-age children. While immunization is supposedly axiomatic for public health, vaccinating all kids against chickenpox is a bad idea. It is unknown whether long-term immunity arises from an attack of the disease, or from the virus repeatedly boosting it in our communities, or howlong immunity will last after vaccination. Over time, mass vaccination will eradicate most naturally occurring varicella and its booster effect. If the immunity of vaccinated kids wanes with age, and unvaccinated kids escape disease because contagion is rarer, life-threatening outbreaks may occur as they grow older. Since morbidity and mortality are increased in fetuses and after childhood, an ever-expanding population of adults with unboosted or waning immunity may be created, including pregnant women.118
As usual, these hesitations and warnings were drowned out by special pleading from well-known voices within the vaccine establishment. In a JAMA Editorial entitled, “Just Do It!” two prominent Yale pediatricians concluded their pep talk with this exhortation to the faint-hearted:
Do the benefits of universal immunization outweigh the risks? Many studies show the risk of complications from varicella in normal children, and there is evidence that they have been underestimated. Others show that the vaccine is cost-effective. Why would we deny children protection from this unpleasant rite of passage when the evidence is so favorable? It’s time to stop procrastinating, and JUST DO IT!119
Similar in many ways to HiB, the Pneumococcus vaccine raises many of the same issues. A pathogenic strain of Streptococci in some individuals, the “pneumococcus,” or Streptococcus pneumoniæ, shares some of the same capsular polysaccharide antigens with Hæmophilus influenzæ B that are the basis for their virulence, and the source of both vaccines. The organism also occupies a similar niche in the normal flora of the pharynx, and has been implicated in many of the same diseases, i. e., otitis media, sinusitis, pneumonia, meningitis, and endocarditis. Long before HiB, this vaccine was introduced during the 1970’s to prevent bacterial pneumonia in the elderly, especially in overcrowded nursing homes and residential facilities, where pneumococci are the species most frequently isolated. But it proved at best only marginally effective in this already debilitated population, as in this study of ambulatory but high-risk middle-aged and elderly patients in the VA system:
We conducted a randomized, double-blind, placebo-controlled trial to test the efficacy of a pneumococcal polysaccharide vaccine in 2295 patients with one or more of the following high-risk factors: age over 55, diabetes, alcoholism, and chronic pulmonary, hepatic, or renal disease. We were unable to prove any efficacy of the vaccine in preventing either pneumonia or bronchitis in this population.120
As a result of such studies, the vaccine was not very popular with either the target population or their doctors, who continued to use it without much enthusiasm. So matters stood until the Clinton era, when the war on childhood ear infections reached its climax, and the conventional strategy of aggressive antibiotic treatment was exposed as a dismal failure. In the late 1990’s, the pneumococcus vaccine was recycled for pediatric use, when it was found to be somewhat effective in preventing otitis media, in which the pneumococcus plays a major role.121 Here at last was the marketing strategy that everyone had been waiting for, and ever since the vaccine has been promoted aggressively, first for little kids, but also more recently for adolescents, young adults, mature adults, and even middle-aged fifty-somethings of the AARP set,122 as if it might eventually be made into a panacea for everyone, and perhaps need to be repeated throughout life.
Yet a sizeable number of pediatricians have declined to jump on the bandwagon, and continue to express many of the same doubts and reservations that made this oft-remodeled vaccine such a late bloomer. In 2001, for example, a report of the Finnish Otitis Media Study Group claimed that the new vaccine was effective in preventing ear infections, but several letters quickly punched gaping holes in it:
In the report, the data argue strongly against its conclusion. In 94% of those
vaccinated, otitis media would not have been prevented. The data also demonstrate a 33% increase in the incidence of otitis media from serotypes that were not included in the vaccine, which was our greatest fear.123
The manufacturer concludes that the new vaccine is effective for prevention. Given the 95% confidence interval of -4 to 16%, the data do not support this conclusion. As the authors admit, the negative number indicates that the treated group could have had more episodes than the controls. In 1999 these same data were presented to the FDA, which rejected the use of this vaccine in otitis media. But the most interesting results are ecological. In a short time the predicted serotype replacement, observed with other bacterial vaccines, was realized. With this clear warning sign, it is perilous to push this vaccine.124
But perhaps the most telling criticism came from this pediatrician in Holland, where ear infections are common, but not treated aggressively, or even considered to be a major health problem:
According to the protocol, all infants received 4 vaccinations, which led to the prevention of only 6% of cases. More could be gained by changing our attitude toward acute otitis media, which in the Netherlands is seen as a self-limiting disease. Often parents do not take their children to the doctor for it, and antibiotics are only moderately effective anyway, even in the youngest. As has been shown, educating parents and doctors will lead to a decrease in antibiotic prescriptions.125
Nevertheless, despite considerable evidence that it is neither safe nor very effective, the pneumococcus vaccine continues to be used very widely and promoted with every available resource, and past experience gives every reason to expect that it will soon be mandated, at least for children, once these comparatively minor quibbles are swept aside.
Prepared from live influenza viruses that are attenuated by serial passage through a nutrient medium of chick embryo cells, the flu vaccine is inactivated by formalin, split by hydrocarbon ethers into purified antigenic fractions, and preserved with Thimerosal. Its unique challenge, and the source of its extreme but risky profitability, lie in the fact that influenza viruses are highly mutable from year to year, and the particular subtypes for each subsequent outbreak cannot be known with certainty in advance. This means that these vaccines must be recreated and marketed anew every year, before the epidemic, based on extrapolation from common animal reservoirs, i.e., to some extent on guesswork, and are apt to be at best only partially effective, with some degree of cross-reactivity.
As with the pneumococcus, influenza vaccines were originally developed to prevent pneumonia and other serious complications of the disease in the elderly, especially among debilitated patients in nursing homes and assisted-living facilities. Unfortunately, careful studies of this high-risk population yielded no better than mixed results, and at times no results at all,126 while serious adverse reactions, like the dreaded Guillain-Barré Syndrome (GBS), were reported with some frequency. In the 1978-79 flu season, the long-awaited “swine flu” epidemic never materialized, but over 40,000,000 people were given the vaccine, and several hundred cases of the crippling and potentially fatal GBS polyneuropathy were officially confirmed within 10 weeks of receiving it, representing a five- or six-fold increase over its prevalence among the unvaccinated,127 while unofficial reports suggested a rate much higher than that. As expected, authoritative-sounding studies quickly appeared to discredit any possible causal link to the vaccine,128 but a large volume of legal claims were settled on the quiet by the manufacturer.
The annual flu shot nevertheless remains a popular ritual with many doctors and their elderly patients; but as with the pneumococcus vaccine, the “hard sell” for making it compulsory had to wait until the Clinton years, when vaccination came to be seen as the strategy of first and last resort against a host of major health problems that had seemed intractable and unresponsive to other solutions, like AIDS, otitis media, hepatitis B, the annual flue epidemics, and the newer viral diseases.
Building on the example of chickenpox, with its narrowly economic rationale, the influential American Academy of Family Practice (AAFP) took the lead by recommending that annual flu shots be offered to all adults aged 50 or older.129 In an interview with Family Practice News, Dr. H. F. Young, AAFP Director of Scientific Affairs, emphasized the major economic benefit of preventing absenteeism from work,130 while Dr. Gregory Poland of the National Coalition for Adult Immunization cited the increased risk of flu complications, such as heart disease, asthma, emphysema, cancer, and diabetes, in this age group.131
With remarkable speed, the same arguments caught on for vaccinating all schoolchildren on a yearly basis, which a 1999 study claimed would not only save hundreds of millions of dollars in lost wages, but also eliminate the major reservoir of the disease.132 Facing no strong or concerted opposition, and promising the same estimable benefits, the vaccine was finally offered to healthy young adults in the work force,133 and even to pregnant women, in order to protect their newborns from the risk of bronchiolitis and RSV, according to one imaginative CDC scientist.134 Just as with pneumococcus, the flu vaccine is clearly being groomed for mandatory use on a yearly basis for the entire U. S. population, with no official acknowledgement of even the possibility of a serious downside to the idea.
Anthrax, Smallpox, and Bioterrorism.
Mandated for all U. S. military personnel serving in the Middle East from the time of the first Gulf War in 1991, the anthrax vaccine has been controversial from the start. First, there was considerable speculation about its possible role in “Gulf War syndrome,” a diverse assortment of still-unexplained diseases reported by a high percentage of returning veterans from that theater, and assiduously downplayed and covered up by officials of the Clinton and Bush Administrations. As reported in the Boston Globe, this account of one such veteran was typical of many:
Frank Landry’s chest has been hurting a lot. He can’t ride a bike, climb stairs, or play with his children. He wheezes, even with medication, sleeps propped up on 3 pillows, and suffers from diarrhea and stomach pain. The worst of it is, he doesn’t know what is wrong. All he knows is that he left the United States 2 years ago in perfect health, to serve in the Gulf War as a Staff Sergeant specializing in chemical, biological, and nuclear weapons, and he returned coughing up phlegm, with mouth sores, and too short of breath to resume his sales job, as well as dropping from 150 to 128 pounds.
Landry is one of many Gulf War veterans who report a variety of mysterious ailments, such as joint pains, hair loss, skin lesions, bleeding gums, digestive disturbances, and more. They don’t know what causes them, but Landry’s best guess is the anthrax vaccine. He had never had lung problems before receiving it, and within an hour or two he began to wheeze. 6 hours later, he was very congested, and felt as if his chest were filled with water. He has never been well since.
He can’t work, and accepts $1000 a month in food stamps and Aid to Dependent Children, because he has 2 children, and his wife has a bad back and can’t work either. They’ve sold most of their possessions to raise cash and pay the rent, and he worries about what is to come, since the Government denies that his problems are service-related and has reclassified him as “fit for duty.” Yet he’s not bitter about the Army. He volunteered, knowing the risks: “I was 18, illiterate, and worked in a machine shop. I had no future. They gave me a life and an education.” No diagnosis has ever been made. All he knows is, he can’t breathe, can’t work, and can’t support his family. And he’s only 29 years old.135
A recent survey discovered that more than 230,000 of the 600,000 troops returning from the first Gulf War have sought medical care for a variety of chronic ailments that began while serving there; that 185,000 have filed disability claims as a result of them, a shockingly high percentage, and that 10,000 have died;136 yet no official diagnosis or explanation has ever been offered. So matters stood until the late 1990’s, when in its enthusiasm for the vaccination concept the Clinton Administration required that all military personnel receive the anthrax vaccine, and the much-vaunted discipline of the Armed Forces began to crack. By 1999, several hundred officers and enlisted men from all branches had accepted dishonorable discharge rather than submit to the shots, as the Army reluctantly admitted in another Boston Globe feature story:
In Maine, where he grew up, Zack Johnson didn’t have a reputation for civil disobedience. He was so laid-back and law-abiding that his parents called him “Mr. Light ‘n’ Easy.” But the 22-year-old Naval Airman faces a Court-Martial because no threat of biological weapons, or a jail sentence, or even the loss of the GI Bill he planned to use for college could persuade him to take the anthrax vaccine. Ten Marines were court-martialed in California last month for the same reason. An Army spokesperson says that over 300,000 military personnel have had the shot, and 175 to 200 have refused it, too few to affect battle-readiness. But Mark Zaid, an attorney representing the 10 Marines, said, “Some Air National Guard units have lost a third of their flight crews and can’t be deployed any more. He estimates the number of refusals at 300 to 500.137
In a related story from the New York Times, the Surgeon-General of the Army acknowledged the seriousness of the problem:
The happy military career of Jeffrey Bettendorf ended abruptly Wednesday. A senior airman with an untarnished record, Bettendorf was dishonorably discharged for refusing to take the anthrax vaccine, because he believed that the Pentagon had never proved its safety or effectiveness. Facing rebellion from a growing number of cases, the Pentagon dismissed them as insignificant, but stopped counting how many had refused. “It speaks to an undercurrent of distrust of the Government and the military,” said Lt. Gen. Ronald Blanck, Surgeon-General of the Army, which oversees the anthrax program.
The Marine Corps in particular has been hit hard. Resisters note that there is no way to test the vaccine against the anthrax used in weapons, and criticize the lack of follow-up research on those who did receive it during the Gulf War. They also point to 2 FDA reports critical of the manufacturer, Michigan Biologic, a state agency, which was sold last year to BioPort, a private company. One month later, Bioport was awarded a $29 million contract to produce the vaccine for the Pentagon, which insists that it is safe and effective.
But reassurances are not enough for Marine Lance Cpl. Jason Austin, who read that the vaccine can cause sterility, refused to take it with 4 others in his antitank missile platoon, and now faces a Court-Martial. While their numbers are small, they can upset the readiness of their units, notably in the Reserve and National Guard, whose members can resign more easily than those on active duty. In January, nine A-10 pilots with the Connecticut Air National Guard, a quarter of their squadron, quit rather than be vaccinated. At Travis AFB in California, where Airman Bettendorf served, 11 of 40 Reserve pilots in his squadron refused to take the vaccine, leaving them short-handed just before heading to the Persian Gulf.138
As news of these refusals and disciplinary actions spread, several high-ranking officers listened to, came to share in, and in some cases took responsibility for the concerns of their subordinates. Newly appointed Commander of an F-16 fighter squadron, Lt. Colonel Thomas Heemstra, a pilot and decorated combat veteran of 20 years’ experience, decided to investigate the vaccine himself, and was outraged to learn about the health problems many servicemen and -women had suffered because of it, as well as the disrespect, ridicule, and inadequate medical care they endured from the top brass, the Defense Department, and the Veterans Administration.
As he later described in his book, Col. Heemstra invited Dr. Meryl Nass, a Government consultant, to address his squadron at a local pizzeria, when the Wing Commander in charge of the base refused to allow her to speak there.139 Lasting over five hours, her presentation included first-hand accounts by three former Michigan National Guardsmen who had been disabled by the vaccine and treated harshly by their superiors, as a result of which all twenty of the pilots who attended refused the vaccine, and were promptly cashiered, including the Colonel himself.140 The same fate befell Major Sonnie Bates, another highly-decorated combat pilot of long experience, who was also dishonorably discharged, and later testified before Congress about the wide variety of auto-immune complaints he witnessed in military personnel after taking the shot.141
As the scandal spread through the ranks, other investigators learned that many Gulf War syndrome patients who developed auto-immune disorders after the anthrax vaccine also showed positive in blood tests for antibodies to squalene, a fat-soluble substance that was still being used by BioPort as an experimental adjuvant in the vaccine, despite strong FDA warnings in the past, and solemn assurances by the Pentagon that they had abandoned the practice.142 Partly to counter the bad press, Admiral William Crowe, former Chairman of the Joint Chiefs of Staff, was named to BioPort’s Board of Directors and given a 13% stake in the company in return for blessing the anthrax venture.143 Ironically, Admiral Crowe had previously brokered the sale of weapons-grade anthrax to Saddam Hussein by Donald Rumsfeld, President Reagan’s special emissary, clearly intended for use against the Kurds and Iranians.144
Just weeks after the attacks of September 11, 2001, and the Bush Administration’s official declaration of the global “War on Terror,” spores of weapons-grade anthrax made their way through the Postal Service to the offices of CBS Television News and Democratic Congressional leaders, resulting in 22 cases of cutaneous and pulmonary anthrax, and five deaths. Although the perpetrators of these crimes have never been caught or identified, and the results of an extensive Federal investigation have never been made public, it soon leaked out that the material had been manufactured at the U. S. Army Biological Warfare Laboratory, while the whole country trembled with the realization that even such minute amounts were sufficient to infect and kill people, and that the Government is essentially powerless to stop a large-scale biological attack by a determined enemy.
These fears were then assiduously cultivated by the Bush Administration, to win support for its proposed militarization of public health under the Patriot Act and the vast Homeland Security bureaucracy that had been created to implement it, but the prospect of vaccinating the entire population brought back the bitter aftertaste of the military’s incestuous relationship with BioPort, as well as its cover-up of the Gulf War syndrome, and the plan never got off the ground.
In the overheated climate of the September 11 attacks, the equally abortive campaign to vaccinate everyone against smallpox is in some ways even more revealing. For the first time, amid the tragedy, heroism, and confusion displayed at Ground Zero, the whole country began to take seriously the possibility and indeed the likelihood of further attacks with nuclear, chemical, and biological weapons in the future. Because anthrax cannot be transmitted from person to person, the spores must come into direct physical contact with each individual victim, such that their range is effectively limited to the environs of a large city. Smallpox, on the other hand, which is highly contagious and capable of propagating itself to populations far beyond the target area, conjures up deep mythic and historic fears of plague and pestilence, to the point that many authorities advocated vaccinating everyone with vaccinia, or cowpox, the original “vaccine” that had been used for 200 years, and had in fact succeeded in eliminating smallpox from the world. Yet when the Administration attempted to obtain large quantities of it, and President Bush made a photo-op of cheerfully rolling up his own sleeve to receive it, the public remained surprisingly cool to the idea. Even when a scaled-down plan was made optional and offered to doctors, nurses, firemen, and other emergency personnel, very few of them actually took it,145 and the predicted adverse reactions were widely publicized whenever they occurred.146
Given the almost universal propensity to ignore the adverse effects of vaccinating our children and everybody else, against a host of diseases both great and small, this odd combination of solicitude and cold feet regarding a vaccine that had been so familiar and so effective over such a long period of time is utterly fascinating to me. How these same people can then resume taking their annual flu shots and bringing in their babies for one disease after another without so much as a murmur has to be reckoned among the great unsolved mysteries of our time.
Yet, taken purely on its own merits, there is also plenty of good sense in it, for it means either that the actual threat of the vaccine is seen as greater than the hypothetical threat of the disease, or that the public simply does not believe that the vaccine can reliably stop a determined enemy from doing us harm. In my view, both reservations are well taken. Larry Brilliant, M. D., an epidemiologist formerly with the WHO, said it as well as anyone:
If Saddam has smallpox, he might use it if he were about to be killed, but he also has the capacity to alter the virus to make it vaccine-proof. Why would he use a virus that we have a vaccine against? It makes no sense. If Al-Qaeda has it, I don’t believe they’d use it either. They want victory for a people, a culture, a religion. Smallpox is the ultimate boomerang. If released at Chicago-O’Hare, it’s only a matter of days before it hits Mecca and Medina. It’s not a weapon for war unless one seeks the destruction of
Professor David Rosner of Columbia gives another equally excellent argument in favor of the same conclusion:
Smallpox is the only disease to have been eradicated through human intervention. Yet we saw in it the chance to create a new and better weapon of mass destruction. Both the United States and Russia kept the virus in storage, awaiting the opportunity to terrorize the world. Both made it immune to the vaccine that had eradicated it by genetically altering the virus. Even if it could be used as a weapon, the fear of it is being used to make fundamental changes in public health. Mundane but indispensable activities, like making sure our water is safe to drink, our air isn’t too polluted to breathe, and our food isn’t too spoiled to eat, are being sacrificed for fear of smallpox, which plays into Bush’s strategy of militarizing public health.148
5. IMPLICATIONS FOR HEALTH POLICY.
In conclusion, I want to identify some of the underlying themes and implications of our present vaccine policy, in the light of the broader, more comprehensive viewpoint that I have sketched out, and to consider them in sufficient detail to try to resolve the contradictions and inadequacies that follow from them. I do not favor either abolition or uncritical acceptance, either of specific vaccines, or of the general strategy of using them to prevent disease. What I seek is the mental clarity to accommodate all the data, both for and against, to provide a more adequate basis for policy in the future. In particular, I will propose the following changes:
1)reducing the cumulative effect of vaccines by limiting the total load, or number of vaccination events, and developing rational criteria for selecting them;
2)dispensing with the aura of religious sanctity surrounding vaccinations, and judging them solely by the standards of science, like any other medical procedure;
3)promoting and strengthening both public deliberation and Government regulation of vaccination policy, in order to minimize sweetheart deals, cronyism, and the privatization of public health, based largely on the profit motive;
4)broadening the cost-benefit analysis, to include the medical and social costs of the chronic diseases in which vaccines are implicated;
5)designing new research on vaccine safety and efficacy, using a more holistic, patient-centered model for the total health picture of vaccine recipients, and covering a period of years sufficient to include the chronic dimension; and
6)liberalizing the vaccine laws, by making them optional, except in time of a public health emergency, and authorizing parents to choose which vaccines, if any, their children will receive.
The More, the Merrier.
We have already noted the familiar sequence whereby vaccines originally intended for a limited purpose or target population are awarded a larger and larger market share, up to and including the prized Government mandate requiring them of everyone. This easy slide into universalization could not occur without the deep and abiding faith that vaccines are inherently and profoundly beneficial to everyone, and in no sense a public health risk, except perhaps to a very few abnormally hypersensitive individuals. Under these circumstances, it might seem acceptable or even obligatory to pile on as many as possible, to promote them to the fullest possible extent, and to enforce maximum compliance with every new mandate.
Very much in this spirit, leading vaccine advocates writing in medical journals and news magazines routinely exhort physicians to improve their vaccination rates, offer useful tips for overcoming patient resistance, and ignore or downplay the documented risks and contraindications that still crop up in the literature, and that parents still consistently worry about. Part pep talk and part sales pitch, such motivational efforts have long since reached out far beyond any narrowly defined pediatric constituency to target other age groups as well.
In “Adult Immunizations: How Are We Doing?” a typical example of the genre, a well-known specialist in infectious diseases offers a rough calculation of the number of lives that could be saved by vaccinating adults with the same zeal and thoroughness that we bestow on our children:
More than 300,000 lives could be saved yearly if adult immunization recommendations were implemented. Secretary of Health and Human Services Donna Shalala announced that the number of immunized preschoolers had reached the highest level in history, up to 75% from just 55% four years ago. Unfortunately, immunization of the adult population has not been equally emphasized, in spite of the fact that the preponderance of deaths from vaccine-preventable diseases occur in this age group.
Between 50,000 and 70,000 adults die each year from influenza, pneumococcal infection, and hepatitis B. This exceeds the number of automobile fatalities, and far outweighs the mortality of these diseases in children. Apathy about vaccinating adults can be traced to emphasis on childhood vaccines, unnecessarily confusing guidelines, doubts about safety and efficacy, and concern about reimbursement.
The number of patients for whom specific vaccines are contraindicated is vastly out-weighed by those who fail to be immunized because of the following, which are not contraindications, but are commonly thought to be:
1)reactions to previous vaccines that consisted only of mild to moderate local redness, tenderness, and swelling, or fever less than 104˚;
2)mild acute illness, with or without low-grade fever;
3)current antibiotic treatment, or convalescence from a recent illness;
4)household contact with a pregnant woman;
5)recent exposure to infectious disease;
7)a history of allergies, including those to penicillin and most other antibiotics (except neomycin, used in the MMR vaccine, and streptomycin, used in the oral polio, both of which are contraindicated); and
8)a family history of allergies, adverse vaccine reactions, or seizures.149
In other articles, the same solicitude is expressed for adolescents and young adults, who have likewise been neglected by our preference for infants and small children:
Vaccination programs focusing on infants and children have decreased the occurrence of many vaccine-preventable diseases. However, many adolescents (ages 11-21) and young adults (ages 22-39) continue to be affected adversely by hepatitis B, measles, rubella, and chickenpox, for example, because our vaccination programs have not focused on these age groups. Any not previously or adequately vaccinated should be brought up to date with Hep B, MMR, DT, chickenpox, and pneumococcus, and Hep A and influenza should be offered to those at high risk.150
But the most convincing proof for the universality of the concept is its current extension even to pregnant women, who have always been exempted and indeed considered inviolate in the past, out of now evidently obsolete concern for the safety of their unborn:
Adult immunization rated have fallen short of national goals, partly because of mis-conceptions about the safety of vaccines. The danger is magnified during pregnancy, when physicians are hesitant to give vaccines, and patients to accept them. Routine vaccines that are generally safe to administer during pregnancy include DT, influenza, and Hep B. Others, like meningococcus and rabies, may be considered. Those contra-indicated because of the theoretical risk are MMR, varicella, and BCG. But inadvertent administration of any of the above is not an indication for termination of the pregnancy.151
Ironically, it is generally agreed that at least mandated child vaccinations have not only achieved their stated objectives, but in many cases far exceeded them. In the United Kingdom, where vaccines are optional, the National Health Service pays substantial bonuses to physicians who achieve vaccination rates of 80% of the kids in their practices, and double amounts to those reaching 90%.152 In this country, by contrast, our preference for laws and penalties has helped keep vaccination rates for children of preschool age at record heights. Thus, according to the CDC’s own National Immunization Survey, coverage targets were met or exceeded for all recommended vaccines by 1995:
Data from the survey show that 95% of children aged 19 to 35 months received at least 3 doses of DPT, 92% received at least 3 doses of HiB, 90% received the MMR, 88% received polio, and 68% the Hep B. In fact, the 1996 goals were reached for all these vaccines in 1995. The agency also noted that 1 million preschool children still need at least one of the recommended vaccines to be fully protected.153
Even in California, where alternative medicine is widely popular and a thriving subculture openly questions conventional medical practices, personal exemptions have remained at very low levels, as shown in this official 2001 study:
Nisha Gandhi of the California Department of Health Services examined school immunization records for all children in the state. In the fall of 2000, personal belief exemptions were recorded for 0.77%, or about 4000 of the 526,000 attending kindergarten. Seventh-graders have higher exemption rates, probably because of the Hep B requirement. Of about 500,000 7th-grade students, 1.3% had personal belief exemptions in their records.154
Amid the fanfare of self-congratulation at these accomplishments, it is rarely noted or commented on that they are far in excess of what is actually needed to prevent sustained outbreaks of even the most highly contagious diseases, like measles and chickenpox, both of which have attack rates of almost 100% in people exposed to them for the first time. Thus a 1992 study of 1011 children with measles in the Milwaukee area over a 9-month period found that
Modest improvements in low levels of immunization among 2-year-olds confer substantial protection against measles outbreaks. Coverage of 80% or less may be sufficient to prevent sustained outbreaks in an urban community.155
In any case, the rarely explicit subtext of these calculations and promotions is that it is wholly permissible, and indeed highly desirable, to pile on as many different vaccines in as many doses as we think fit. But the evidence that I presented earlier all points to exactly the opposite conclusion; for if all vaccines tend to activate, reactivate, or intensify whatever latent or manifest chronic disease tendencies already exist in each individual patient, then adverse reactions are not rare or incidental, but rather inherent in their mode of action.
If my hypothesis is correct, that vaccines essentially reprogram the immune system to respond chronically and nonspecifically, not only to the vaccines, but to other infections and antigenic challenges in the future, then what every parent fears must also be true, that the risk of adverse reactions is in some measure proportional to the total number of vaccinations given, a prediction which also provides a simple test of the validity of the hypothesis.
As if unaware of or merely indifferent to such a possibility, in 2004 the ACIP published its Recommended Childhood and Adolescent Immunization Schedule, as updated according to then current policy guidelines:
3 Hep B shots in the first 24 months, beginning at birth;
3 DPT shots at 2, 4, and 6 months, and a 4th at 24 months;
3 HiB shots at 2, 4, and 6 months, and a 4th at 12-18 months;
3 pneumococcus shots at 2, 4, and 6 months, and a 4th at 12-18 months;
2 IPV polio shots at 2 and 4 months, and a 3rd at 6-24 months;
1 MMR shot at 12-18 months;
1 chickenpox shot at 12-24 months; and
1 flu shot yearly, beginning at 6 months.156
This adds up to a total of 22 vaccination events for every infant in the first two years of life, many of them containing two or more separate vaccine components, and beginning with newborn babies in the hospital nursery, as their very first immunological experience. And that is only the beginning. From preschool age through high school, according to the same list, children and adolescents are supposed to receive
16 flu shots, 1 per year from 2-18 years of age;
3 or 4 Hep A shots recommended, from 2-18 years of age;
1 DPT at 4-6 years, followed by a DT at 11-12 years;
1 IPV at 4-6 years;
1 MMR at 4-6 years; and (very likely)
1 chickenpox at 4-6 years.157
This adds 25 more mandatory or recommended vaccination events for all children between the ages of 2 and 18 years, for a grand total of 47 by the time they enter college, not to mention the additional boosters they will become eligible for, first as young adults, and on into middle and old age, as well as whatever new vaccines undoubtedly lie in store for them in the future. Thus slowly, incrementally, and inexorably, purely as a matter of policy and without any clear public health emergency, vaccination has become the normal, acceptable means for reducing the incidence of any identifiable acute infectious disease whatsoever, often simply to save money lost from productive work, a strategy which now involves every individual in age group, necessitates repeated doses throughout life, and eagerly anticipates adding still more vaccines awaiting development in the future.
To halt and ultimately roll back this juggernaut will require drastic reductions in the total vaccine load borne by every age group, especially infants and young children. I would begin by postponing all vaccines for as long as possible, ideally until two and a half or 3 years of age, to give young immune systems ample time to develop in a wholesome and more natural way, by learning how to mount fevers and vigorous, acute responses to infection, before they are partially reprogrammed by vaccination in a more chronic direction. A second step involves preserving a clear distinction between
1)foreign micro-organisms that represent a clear threat to life and limb, such as diphtheria, tetanus, and polio, which I will say more about presently;
2)organisms that already live in our bodies as part of the normal flora, such as the pneumococcus, ß-hemolytic Streptococcus, Stalphylococcus aureus, and Hæmophilus influenzæ, which we would be much wiser to learn to make friends with;
3)those that are primarily nuisances that we elect to vaccinate against for economic or other policy reasons, such as influenza, measles, mumps, rubella, and chickenpox, which centuries of herd immunity had already transformed into normal diseases of childhood well before the vaccine era, and should therefore be allowed to take their course; and last,
4)problem diseases that we feel helpless to influence in any other way, like hepatitis A and B and AIDS, which are most effectively prevented by basic hygienic and lifestyle measures.
With no urgent medical need for it, the MMR is the prime example of a vaccine that was brilliantly successful as a public relations stunt to showcase the vaccination concept. Virtually erasing these three ubiquitous acute diseases of childhood in less than twenty years proved to doctors and the general public that vaccination could work as a public health strategy in the most visible way. Yet, as we saw, it is wholly counterproductive to inflict MMR on such populations as ours, which after centuries of adaptation had already tamed these viruses into routine diseases of childhood that most kids in reasonably good health would benefit substantially from coming down with and recovering from. Exactly the same is true of the chickenpox.
In industrialized countries like the United States, a reasonable case could be made both for and against vaccinating all children with DT and polio, so it would make the most sense to make them available to everyone who wants them. As for pertussis, although the disease is certainly intense and prolonged, I cannot support large-scale vaccination unless a vaccine is developed with a much better safety record than any we now have. Since much of the pressure to vaccinate early is ascribed to the risk of death from pertussis in very young infants, dispensing with that vaccine would also help parents to wait longer before giving the DT and polio as well.
I believe it is also profoundly misguided to vaccinate against organisms already resident in the normal flora, like HiB and pneumococcus, some strains of which are occasionally implicated in serious, invasive disease, but also occupy an important niche in the ecology of our nasopharynx, and are therefore too important to our defense against foreign organisms for us to make war on. As we have seen, the result of attempting to do so has been simply to favor the development of mutant and resistant strains, like the HiB and pneumococcus themselves, many of which will undoubtedly prove even less friendly. Exactly the same arguments would apply to future vaccines against the ß-hemolytic Streptococcus and methicillin-resistant Staphylococcus aureus (MRSA), which also represent occasionally pathogenic strains of common species that we have lived with more or less successfully for centuries.
Far from being one of the safest vaccines, in my experience Hep B is among the worst in current use, as I have tried to show, and even if a much safer one were available, it would still be a mad and reckless stratagem to vaccinate tens and hundreds of millions of healthy children against a disease that very few of them will ever meet. Vaccinating whole populations in advance of bio-terrorist threats like anthrax and smallpox is equally useless, as we saw, because the process of weaponization renders these organisms impervious to vaccines, and also unnecessary, since the likelihood of their use remains vanishingly small.
A Sacrament of Modern Medicine.
To be sure, vaccinating everybody against everything is a hugely profitable venture, especially when guaranteed by “sweetheart” deals with state health departments, foreign governments, and various federal and international agencies, often involving millions and millions of doses at their chosen price. In the rotavirus debâcle, for example, the vaccine was never made available to the poor countries that could have benefited from it, because its set price was far beyond their reach, while the U. S. Government never asked the manufacturer to lower it, and even gave them free access into the domestic market, where it filled no obvious or pressing need.
Unrestrained by market forces, abetted by corporate welfare at taxpayers’ expense, and rubber-stamped by their allies in government, the biotech industry has further exacerbated these problems by creating new vaccines against whatever micro-organisms that they choose, almost as fast as they can identify, isolate, and propagate them, and often for no better reason than their technical capacity to do so. A new crop of vaccines is therefore a sure bet for the future, some on the drawing board, others already in stock and awaiting only the right marketing strategy at the opportune moment:
While its incidence has declined in the past decade, hepatitis A is still responsible for about 60% of acute viral hepatitis in the United States. It seems unfortunate that out-breaks continue to occur in one of the most affluent countries in the world, given that a highly immunogenic, safe, and effective vaccine is available. Routine vaccination in early childhood would lead to a dramatic reduction in the infection within a decade. The failure to begin such a program is a missed opportunity.158
Yet corporate greed and worldly ambition are only the most familiar and obvious side of the story, the motives that many if not all industries share. In degree, and even in kind, vaccines are uniquely blessed and indeed sanctified above all other industrial products by their almost universal acclaim and virtually unchallenged supremacy at the mythic level, as a veritable panacea for an embattled health care system that seems in deep trouble almost everywhere else.
No purely financial or commercial motive can wholly explain the sincere and nearly universal veneration paid to the idea of vaccination by doctors and patients alike, which not only exempts vaccines from the ordeal of criticism that every new medical or scientific discovery must rightly endure, but also makes the mere hint of disapproval seem disloyal, if not sacrilegious, and inspires the physicians who administer them to volunteer their own children for such experiments. That is why the vaccination project must ultimately be understood in sacramental terms, as a kind of baptismal initiation into the religion of modern medicine.159
Delusions of grandeur are evident in the theology of Dr. Paul Offit, the Merck consultant we have met before, who claimed in a 2002 article that young infants are capable of generating protective humoral and cellular responses to many vaccines simultaneously, perhaps as many as 10,000 at a time, by what he called “a conservative estimate.”160 The self-righteous fanaticism that mandatory vaccination has so often inspired is also regularly invoked to justify abuses and infringements of the rights of children, their parents, and the public at large.
From the 1940’s through the Reagan era, compliance with vaccination laws was achieved mainly by intense social pressure to conform that doctors, school boards, friends, neighbors, and parents alike brought to bear against deviant parents, whose unvaccinated kids were regarded as the chief reservoir of the few diseases at issue, and therefore a substantial threat to the vaccinated kids and everyone else as well.
During the Clinton years, as the number of required vaccinations and the public resistance to them began to escalate, the Government and public health authorities proposed and began to implement a tracking system for identification and surveillance of non-compliant parents, based on computerized databases, that raised widespread alarm and fears of “Big Brother” overriding personal privacy, despite official denials and reassurances to the contrary:
Community- and state-based immunization registries are computerized information systems that contain data about children’s vaccinations and represent an important tool to increase and sustain high vaccination coverage. Such registries consolidate records from multiple providers, provide need assessments for each child, generate reminder and recall notices, produce an official record, and provide coverage assessments. One objective is to increase to 95% the proportion of children less than 6 years of age who are enrolled in such a registry. Substantial challenges remain, mainly balancing the need to protect the privacy of patients and providers with the need to gather and share information, to protect the public health, and to benefit individuals. Since 1994, more than $178 million in Federal funds have been awarded to state and local health departments to develop such registries.161
With the added impetus of President Bush’s “War on Terror” and the vast Homeland Security apparatus created in its name, the immediate threat to privacy began to frighten health activists, human rights groups, and legal experts, as in the following news release that was sent to me over the Internet:
CDC attorneys have advanced health policy legislation that suspends civil rights in case of a declared biological emergency. According to the Boston Globe, the Model Emergency Health Powers Act would give governors and public health officials the power to arrest, transport, quarantine, drug, and vaccinate anyone suspected of carrying a potentially infectious disease. Another Boston Globe article by Professors Lawrence Gostin of Georgetown Law Center and John Hodge of Johns Hopkins that tried to balance the need to control disease with protecting individual rights was promptly removed from the paper’s website.
The law is said to give state public health authorities virtually absolute dictatorial power, with scant legal recourse for interned individuals. The bill’s definition of a “public health emergency” is highly subjective. One case of smallpox in a public school could trigger the governor to declare such a state. Once it is declared, the Constitution, Bill of Rights, and most civil liberties are suspended, with states declaring ownership of private properties.
Under the law, persons refusing to submit to medical exams and/or tests are subject to misdemeanor charges and enforced isolation. If authorities suspect that individuals may have been exposed to “infectious diseases,” again broadly defined, or otherwise pose a risk to public health, detention may be ordered for them. If an attack is carried out, or even suspected, thousands could be held in isolation camps, and physicians assisted by police will be required to perform medical tests and exams. Individuals may then be forcibly vaccinated or medicated, and those refusing would be guilty of a misdemeanor and subject to arrest, isolation, or quarantine, while the state and public health authorities would be exempt from liability associated with the death or injury of detainees or damage to their property.162
Similarly, in a substantial number of divorce and child custody hearings that have come to my attention, the plaintiff, almost always the husband or ex-husband, seeks to win or regain physical custody of his minor child or children, on the grounds that his wife or ex-wife was negligent or unfit as a parent, for failing to comply with the vaccination laws, even if he had willingly acquiesced in her conduct, and had made no move to challenge it, for all the time that they were together.163
Even in Canada, where vaccinations are optional but are held in comparable esteem by the medical establishment, the Quebec College of Physicians revoked the medical license of Dr. Guylaine Lanctôt, an outspoken critic of routine vaccination, simply for espousing ideas that they found to be “derogatory to the honor and dignity of the medical profession,” and for disseminating information to the public that they proclaimed to be “inaccurate, deceptive, inappropriate, and contrary to accepted medical science.”164
Mandatory vaccination has also lurked behind the scenes in the criminal prosecution of parents for “shaken-baby syndrome,” a form of encephalopathy secondary to traumatic brain injury from child abuse. In an infamous case from Florida, the father is still serving a life term in the state penitentiary, even though the Medical Examiner’s testimony that convicted him had been falsified in several key respects,165 while my own review of the baby’s medical records, corroborated by those of several other physicians, found them entirely consistent with the possibility of an encephalopathic reaction to the DPT vaccine, which he had received only a few days earlier.
But my favorite illustration of the sacramental power of the vaccination concept lies in the voluntary and largely unconscious self-censorship practiced in its favor by the news media, which almost never report that vaccines actually hurt anybody, apart from statements attributed to interested parties, such as parents or medical experts. The only exception to this rule that I know of was the following 1993 headline and article from the Boston Globe, that let the cat out of the bag just this once:
INOCULATIONS PUT ASPIN IN HOSPITAL.
Defense Secretary Les Aspin was in “clearly improved” condition, but remained in the Intensive Care Unit of Georgetown University Hospital yesterday, after suffering breathing difficulties triggered by routine inoculations. “He’s definitely on the road to recovery,” a spokesman said, but would remain in the ICU to be monitored, because he has a history of heart problems, and fluid had collected in his lungs. According to medical specialists, shortness of breath can develop in patients with similar heart problems when the lungs fill with fluid. He entered the hospital because of shortness of breath, aggravated by “a mild, pre-existing heart condition,” the Pentagon said. He became ill the day after receiving a number of immunization shots in preparation for overseas travel.166
Although Secretary Aspin’s hospitalization remained newsworthy for several more days, there was no further mention of his vaccinations, so that readers who missed the original story were given the impression that he had merely suffered an aggravation or flare-up of his pre-existing heart condition, as was true enough, thus admirably illustrating the theme of invisibility which provided the basic subtext and indeed the starting point of this essay.
To dispel this aura of sanctity that hallows the vaccination concept and protects it from closer scrutiny, it is enough to show that vaccines are no panacea for the health care system, and the solution that I advocate is no more shocking or radical than merely to see them for what they are, instruments of medical science, with the power to do good as well as harm, just like any other drug or procedure; to hold them to the same standards of safety and efficacy; and to oblige them to run the same gauntlet of open criticism and lively debate.
I have always wondered, who gets to decide that a disease represents such an urgent threat to the public health that everyone has to be vaccinated against it, whether they want to be or not? But merely asking the question is enough to remind us of what we already know, that these important deliberations invariably take place behind closed doors, without any public input or oversight. It cannot be very far from the truth to picture a Government conference room in Washington, in which officials of the CDC, the FDA, the ACIP, possibly the American Academy of Pediatrics, and of course the manufacturers themselves, decide which vaccine to recommend or mandate next, and what marketing strategy would be best suited to promoting it. Whatever the outcome, these captains of the medical-industrial complex rarely seem to encounter a vaccine that they dislike.
I can certainly imagine an emergency situation where swift action may need to be taken for the public good that many people of conscience might strongly disagree with. But that is not the issue here. None of the diseases that we vaccinate against poses an urgent threat to the health of the nation, and all of the vaccines now in use are marketed largely for reasons of policy, as we saw, whether to save lost wages, to gain access to a subpopulation that would otherwise be elusive, to eradicate a disease that was a problem in the past, or simply to continue making a lot of money for the manufacturer.
Like many other physicians, I believe it is unwise and indeed illegitimate to privatize our health care system to the extent of surrendering decisions in the public domain that clearly affect the health of everyone to private corporations whose primary duty to their stockholders is to make a profit. In conformity with the laws and practices of all other civilized countries, I consider health care to be a basic human right of everyone, not merely a privilege of the few who can afford to pay whatever the providers feel entitled to charge for it, as our own President and Congress still adamantly insist. In my view, vaccinating our children is far too important to be decided in back-room deals behind closed doors, and merits being opened to public debate and discussion at every stage.
I do not believe and have never claimed that all vaccines are wholly bad or evil and to be avoided under all circumstances. As in my previous writings on the subject, my aim here is simply to demonstrate a major downside to their use that is rarely acknowledged or talked about, and that needs to be studied carefully and factored into all our future deliberations about them. I therefore advocate a simple pro-choice position, namely, that under most circumstances, in the absence of a genuine public health emergency, it should be left to the parents to decide which vaccines, if any, will be given to their children.
Developing adequate vaccine policies will also require more comprehensive studies of their adverse effects and actual mechanisms of action than any yet undertaken, and to succeed they will have to be designed in a new and radically different way. At a minimum, this will entail looking beyond the prevalence of the corresponding acute diseases and their circulating antibody titers, our current standards of efficacy, both of which correlate poorly with meaningful immunity, as we have seen.
Similarly, with regard to safety, calculating the risk of adverse reactions must also include learning how to recognize and identify their whole spectrum of non-specific effects, which will require three major changes in research methodology. First, such an investigation will have to explore the full range of adverse effects of each vaccine and vaccine combination on the organism as a total energy system, involving every organ and tissue of the body, as well as more global measures of health and well-being, such as neurological development, learning skills, sensory integration, school performance, mental and emotional maturation, and suffering and disability from illness and disease. Second, they will have to be carried out for years or decades, enough time to reveal significant chronic patterns and a thus a longer view of child health. Finally, the total health picture of children receiving vaccines will have to be compared with that of their matched controls who do not receive them, an obvious requirement that gives special priority to locating a large subpopulation of unvaccinated children. Far from being the “spoilers” they are generally thought to be, these children and the parents who choose not to vaccinate them represent our last, best hope for such studies to be carried out, and are thus owed a major debt of gratitude.
At the present time, owing to the profusion of different vaccines and combinations, it is probably impossible to study each vaccine separately. For a start, the most sensible plan would be to compare the total health picture of children vaccinated according to the official schedule with those minimally vaccinated at the age of 3 with tetanus and polio alone, and finally with those not vaccinated at all. Because of what I have said so far, I would expect both the lightly vaccinated and the unvaccinated kids to turn out substantially healthier, freer from chronic disease, more alert mentally, and more stable emotionally than their fully-vaccinated counterparts, and therefore to outperform them in school, with fewer absences, higher test scores, and so forth. I hope I'm wrong, but there are plenty of good reasons for my concern.
Vaccine Laws and Exemptions.
To achieve even these modest reforms will also require modification of our present laws and the allowable exemptions from them. Under our Constitution, which leaves to the states all powers not explicitly granted to the Federal Government, both vaccination and the practice of medicine fall mostly within the jurisdiction of each state, a provision that allows for some important differences among them. Regarding mandatory vaccination, all states grant medical exemptions, based on the recommendation of a Board-certified pediatrician or other licensed physician, but in most cases these are only valid for one vaccine at a time, for one of its very few documented effects, and for a year or at most a few years at a time, after which it has to be renewed. Because of these stringent limitations, the medical exemption is not an accurate reflection of how my patients feel, and even when it is, is by no means uniformly successful.
All but two of states recognize a so-called “religious” exemption, in many cases based on membership in some Church or denomination which is on record as being opposed to vaccination, such as Christian Science or the Jehovah’s Witnesses. Roughly half of these have broadened its scope to allow a “philosophical” objection, i. e., a deeply-held but purely personal conviction. In Massachusetts, where I practice, the law as written still uses the narrower word “religious,” but the courts have interpreted it extremely liberally, to extend into the personal realm of the individual conscience.
Much closer to the actual beliefs, attitudes, and special circumstances I typically encounter in my practice, the religious exemption has generally been honored whenever my patients have invoked it, but even in Massachusetts, serious difficulties remain that it does not address. Even in its most liberal construction, the religious or philosophical exemption requires an across-the-board rejection of all vaccinations on principle, in the “abolitionist” or “conscientious objector” mold. In other words, these laws protect the right of any citizen to be a kook or a deviant, to dissent from established beliefs by being equally rigid and inflexible in opposition. It does not allow parents to make an intelligent medical decision for their children, such as choosing some vaccines, but not others. Although this more nuanced “pro-choice” position is honored de facto by open-minded physicians, nurses, and school boards in certain areas, such wording has not yet been written into the laws of any state, and draft laws proposing such changes have so far been rejected by every state legislature that has considered them, although by smaller and smaller margins every year.
As the biotech industry continues to crank out more and more new vaccines without limit or restraint, and ever-broader applications are found for the ones already in use, the instinctive belief of most parents that the total number of vaccinations does indeed matter provides the best guarantee that the optional or pro-choice position will eventually prevail. As their ultimate strategy for circumventing even this modest ceiling on their profits, the vaccine manufacturers are busy at work developing a single monster vaccine, containing a dozen or more individual components, and administered in a single dose, whether injected, ingested, or inhaled, to be repeated only at rare intervals, and thus presumably arousing less public outcry.
Cost-Benefit Analysis and the “Bottom Line.”
After all of the pros and cons of the issue have been dissected, the vaccine establishment still holds one last trump card, an argument so widely accepted that even its critics have seldom dared to challenge it, namely, the claim that vaccinations are equally safe and effective for reducing the costs of health care. As we saw, this viewpoint attained its greatest ascendancy during the Clinton years, although its origins lie further back. Borrowing the popular “cost-benefit analysis” from economists, who devised it as a tool for subdividing the gargantuan Federal budget into a list of supposedly discrete “line items,” vaccination advocates eagerly applied it to calculate the ratio between the cost of vaccinating a group of people against a particular disease and the cost of treating the same people for the disease, if it had been allowed to spread without the vaccine. This calculation was performed in three steps, more or less as follows:
1)estimating the number of additional cases of the disease to be expected in an unvaccinated population;
2)multiplying it by the cost of caring for each case, including doctor and hospital fees, medicines, and lost wages, to obtain the total medical and social costs saved by the health care system; and
3)dividing this total by the cost of vaccinating, i. e., the unit cost of the vaccination, multiplied by the number of doses administered, to calculate the “benefit-cost ratio.”
Thus in 1992, even before President Clinton took office, Dr. Georges Peter, a respected Professor of Pediatrics at Brown University Medical School, capably summarized the economic case for universal vaccination, based on its high benefit-cost ratio:
One of the most important medical developments in the 20th century has been the control of once-common childhood infectious diseases by the administration of highly effective vaccines. With the exception of safe water, no other modality, not even anti-biotics, has had such a major effect on mortality reduction and population growth.
Of particular importance in the current era of escalating health care costs is the fact that effective childhood vaccines are highly economical and thus represent an efficient use of society’s resources. A highly favorable benefit-cost ratio (the ratio of the reduction in costs of the disease to the costs of the vaccination program) has been substantiated by many studies in the United States. For example, the MMR vaccine program led to savings of nearly $1.4 billion in disease costs in 1983, with a benefit-cost ratio of 14.4:1. According to a similar analysis, for each dollar spent on pertussis vaccination, $2.10 is saved in health care costs.168
As we saw, these became the favored calculations for clinching the argument in favor of the most recent vaccines, and for silencing opposition to them. Unfortunately, they overlook the rampant but still hidden epidemic of non-specific effects that I have described, including otitis media, asthma, eczema, sinusitis, auto-immune disorders, allergies, ADHD, autism, behavioral, emotional, and developmental problems, and indeed the entire spectrum of common pediatric diseases, each of which contributes its own huge and rapidly-growing share of those same soaring costs that the vaccines are supposedly keeping down. To give just one example, here is an excerpt from a study of otitis media that was published way back in 1982:
Otitis media is the most frequent diagnosis made by physicians who care for children. It has been estimated that approximately $2 billion is spent annually on medical and surgical treatment of this disease in the United States. This figure includes expenses for the estimated 1 million children who receive tympanostomy tubes, and 600,000 who undergo tonsillectomy and adenoidectomy procedures each year, which are mainly for the prevention of such infections.169
These figures would of course have been much higher had they been calculated today, or even at the time of Professor Peter’s study, not to mention comparable figures for asthma, autism, ADD, and the rest, each of which has attained epidemic proportions in recent years. I have never claimed that vaccines are solely responsible for creating these diseases, and cannot estimate with any degree of accuracy the percentage of their total medical and social costs that are attributable to the adverse reactions I have described. But simply to recognize that such reactions occur with the kind of frequency that I see in my practice, coupled with the fact that so many vaccines are required of every child, is enough to conclude that this hidden factor must be one of enormous magnitude, and that the benefit-cost ratio will look shockingly different once we factor it in.
I therefore propose that a panel of leading medical economists be appointed to a bipartisan Government Commission, with the understanding that its deliberations will be conducted in a public forum, and its final report will include a wide range of testimony from all sectors of the public, the medical profession, and the public health community. The purpose of this Commission will be to compare the true costs both of the required and the recommended vaccines vis-à-vis the common pediatric diseases in the following more comprehensive way:
1)by adding together the total medical and social costs of the common pediatric diseases (otitis media, asthma, eczema, allergies, sinusitis, autism, learning disabilities, ADD, and so forth);
2)by estimating the fraction of those costs attributable to vaccinations, perhaps 20%, which I fear is well below the true proportion; and
3)by multiplying the first total by the second fraction, to obtain the total medical and social costs of giving our children all of the required and recommended vaccines on the currently approved schedule, i. e., 22 vaccination events by age 2, and 47 by age 18.
Even now, without knowing the exact percentage or the total amount involved, it is obvious that these still hidden costs exceed by several orders of magnitude any savings that even the staunchest vaccine proponents have ever claimed for them. Far from being a bargain, I can say with assurance that vaccines are not only exorbitantly expensive in this most fundamental sense, but that they bear a major portion of responsibility for the crippling financial burden of the present health care system as a whole, a crisis to which our leaders in Government, the insurance industry, and the medical profession offer no more credible explanation, solution, or response than merely to shake their heads in confusion and disbelief.
Finally, even if by some miracle our vaccination programs were effective in achieving their stated goals, I submit that these goals themselves are of highly questionable value. As the great René Dubos once aptly warned, in words sounding even more prophetic today,
The faith in the magical power of drugs often blunts the critical senses, and comes close at times to a mass hysteria involving scientists and laymen alike. Men want miracles today as much today as in the past. If they do not join one of the newer cults, they satisfy this need by worshipping at the altar of modern science. This faith in the magical power of drugs is not new. It helped give medicine the authority of a priest-hood, and to recreate the glamour of ancient mysteries.170
The idea of eradicating measles, polio, and all the rest has come to seem irresistibly attractive to us, simply because the power of medical science makes it seem technically possible, because we worship every victory of biotechnology over Nature just as the bullfight celebrates the triumph of human intelligence over the brute beast. Yet is it not self-evidently absurd to suppose that, even if we could somehow manage to eliminate, one by one, measles, polio, and all the other acute diseases of mankind, we would be any the healthier for it, or that other still more dreadful ailments would not quickly rise up to take their places?
As we saw, trading off the epidemic diseases of the past, which end quickly in recovery or death, for the ubiquitous chronic diseases of today, with their cumulative suffering and disability compounded over the lifetime of the patient, is surely no bargain. The religious zeal of the vaccine establishment thus becomes an appropriate metaphor for the privatization and commercialism of the American medical enterprise as a whole, with its idolatrous worship of biomedical science and technology, and its identification, expropriation, and commodification of every available life function for the twin purpose of power and profit. The deeply irreligious and infinitely hazardous myth that purely technical solutions can be found for illness and all other human problems seems seductively attractive, because it bypasses the problem of healing, which is truly a miracle in the sense that it requires art and caring and individualized attention, and therefore can always fail to occur.
1. Unpublished letter to the author.
2. Horton, R., "Vaccine Myths," in Health Wars, New York Review Books,
2003, pp. 207-208.
3. Ibid., p. 206.
4. Morbidity and Mortality Weekly Report (MMWR), Journal of the AMA
(JAMA) 260:198, 8 April 1988.
Specific Effects of Particular Vaccines.
5. Unpublished letter to the author.
6. Unpublished letter to the author.
7. Coulter, H., and Fisher, B. L., DPT: A Shot in the Dark, Harcourt Brace Jovanovich, 1985.
8. Mortimer, E., et al., "The Risk of Seizures and Encephalopathy after
Immunization with the DTP Vaccine," JAMA 263:1641, 23 March 1990.
9. Cherry, J., "Pertussis Vaccine Encephalopathy: It's Time to Recognize It
as the Myth That It Is," Editorial, JAMA, op. cit., 23 March 1990.
10. "Update: Vaccine Side Effects, Adverse Reactions, Contraindications
and Precautions," Advisory Committee on Immunization Practices
(ACIP), MMWR 45:22, September 1996.
11. Unpublished case.
12. Unpublished letter to the author.
13. Ibid., unpublished enclosure.
14. Ibid., unpublished enclosure.
15. Ibid., unpublished enclosure, New York City Health Department.
16. Scheibner, V., Vaccination: A Medical Assault on the Immune System,
New Atlantean Press, 1993, pp. xiii-xv, passim.
17. Bernier, R., et al., "DTP Vaccination and Sudden Infant Deaths in
Tennessee," Journal of Pediatrics 101:419, 1982.
18. Torch, W., "DPT Immunization: A Potential Cause of SIDS,"
Neurology 32:169, 1982.
20. Noble, G., et al., "Acellular and Whole-Cell Pertussis Vaccines in
Japan," JAMA 257:1351, 1987.
21. Cherry, J., et al., Supplement, "Report of Task Force on Pertussis and
Pertussis Immunization," Pediatrics 81:939, 1988.
22. Noble, 1987, op. cit.
23. Wakefield, A., et al., "Measles Vaccine: A Risk Factor for Inflammatory Bowel Disease?" Lancet 345:1071, 1995.
24. Wakefield, "Ileal-Lymphoid Nodular Hyperplasia, Nonspecific Colitis, and Pervasive Developmental Disorder in Children," Lancet 351:637, 1998.
26. Wakefield, "MMR, Enterocolitis, and Autism," National Vaccine Information Center (NVIC) international Conference Presentations, November 2002.
29. Megson, M., "Genetics, Vaccine Injury, Getting Well," NVIC Presentations, op. cit., 2002.
30. Family Practice News, May 15, 2000, p. 49.
33. ACIP "Update," MMWR 1996, op. cit., pp. 7-8, passim.
34. Unpublished case.
35. L. K. vs. Secretary of HHS, No. 99-624V.
36. T. O. vs. Secretary of HHS, No. 99-635V.
37. J. O. vs. Secretary of HHS, No. 99-636V.
38. Mathieu, E., et al., "Cryoglobulinemia after Hep B Vaccination," Letter, New England Journal of Medicine (NEJM) 335:356, 1 August 1996.
39. "Hepatitis B Vaccine," The Vaccine Reaction, NVIC Special Report, September 1998.
Non-Specific Effects of the Vaccination Process.
46. Moskowitz, R., "The Case Against Immunizations," Journal of the American Institute of Homeopathy (JAIH) 76:7, March 1983.
49. Unpublished case.
50. Moskowitz, "Childhood Ear Infections," JAIH 87:137, Autumn 1994.
51. Moskowitz, Resonance: The Homeopathic Point of View, Xlibris, 2001, pp. 177-178.
52. Moskowitz, "Ear Infections," op. cit.
54. Moskowitz, Resonance, op. cit., pp. 185-186.
55. Ibid., pp. 209-210.
56. Ibid., pp. 215-216.
57. Ibid., pp. 275-276.
58. Unpublished case.
59. Unpublished case.
How Vaccines Work.
60. Davis, B., et al., Microbiology, 2nd Ed., Harper, 1973, p. 1346.
62. Ibid., p. 1418.
63. Neustaedter, R., The Vaccine Guide, North Atlantic, 2002, pp. 69-74.
64. Ibid., pp. 70-71.
65. Ibid., pp. 71-72.
66. Ibid., pp. 76-77.
68. Ibid., pp. 74-76.
69. Mortimer, "Pertussis Immunization," Hospital Practice, October 1980, p. 103.
71. Dubos, R., Mirage of Health, Harper, 1959, p. 73.
72. Ibid., p. 74.
73. Cherry, "The New Epidemiology of Measles and Rubella," Hospital Practice, July 1980, p. 49.
74. Gustafson, T., et al., "Measles Outbreak in a Fully-Immunized Secondary School Population," NEJM 316:771, 26 March 1987.
75. Chen, R., et al., American Journal of Epidemiology 129:173, 1989.
76. Cherry, "Measles," op. cit., p. 52.
77. "The Measles Epidemic," JAMA 266:1547, 18 September 1991.
78. Edmondson, M., et al., "Mild Measles and Secondary Vaccine Failure During a Sustained Outbreak in a Highly Vaccinated Population," JAMA 263:2467, 9 May 1990.
Some Individual Vaccines.
82. Neustaedter, op. cit., pp. 258-260.
83. MMWR, reported in JAMA 273:1250, 26 April 1995.
84. Rappuoli, R., "Molecular Epidemiology of the 1984-1986 Outbreak of Diphtheria in Sweden," NEJM 318:12, 17 January 1988.
86. Family Practice News, 15 June 1998, p. 19.
87. Family Practice News, 1 May 2004, p. 8.
88. Noble, 1987, op. cit.
89. Moskowitz, "Unvaccinated Kids: What's Next for Them (and Us)?"Mothering, January 1987.
90. Davis, 1973, op. cit., p. 1290ff.
91. Ibid., p. 1280.
92. Burnet, M., and White, D., Natural History of Infectious Disease, Cambridge, 1972, p. 93.
93. Nkowane, B., et al., "Vaccine-Associated Paralytic Poliomyelitis," JAMA 257:1335,13 March 1987.
94. Wechsler, P., "A Shot in the Dark," New York Magazine, 11 November 1996, pp. 39-44.
95. Markowitz, L., et al., "Patterns of Transmission in Measles Outbreaks in the United States, 1985-1986," NEJM 320:75, 12 January 1989.
96. Infectious Diseases, April 1979.
97. "Measles Surveillance in the United States, 1991," MMWR 49:1, 1992.
98. "Hypersensitivity to Eggs," MMR package insert, Merck & Company.
99. Phillips, C., "Mumps," in Vaughan, V., Nelson's Textbook of Pediatrics, 11th Ed., Saunders, 1979, p. 892.
100. Phillips, "Rubella," in Vaughan, 1979, op. cit., p. 863.
101. Ibid., p. 862.
102. Adams, J., "Decline of Childhood Hæmophilus influenzæ Disease in the HiB Vaccine Era," JAMA 269:221, 13 January 1993.
103. Family Practice News, 1 October 1997, p. 9.
104. "Adverse Events Associated with HiB Vaccine," WHO Printout, www.who.int/vaccines/diseases/safety/infobank/hib.
106. Daum, R., et al., "Decline in Serum Antibody to H. influenzæ B Capsule in the Immediate Post-Vaccination Period," Journal of Pediatrics 114:742, 1989.
107. Boston Globe, 11 June 1991, p. 9.
108. Family Practice News, 1 August 1992, p. 23.
109. Pevsner, J., Letter, American Family Physician, January 1994.
110. Tucker, A., et al., "Cost-Effectiveness Analysis of a Rotavirus Immunization Program for the United States," JAMA 279:1371, 6 May 1998.
112. Keusch, G., and Cash, R., "A Vaccine Against Rotavirus: When Is Too Much Too Much?" Editorial, NEJM 337:1228, 23 October 1997.
113. Murphy, T., et al., "Intussusception Among Infants Given an Oral Rotavirus Vaccine," NEJM 344:564, 22 February 2001.
115. AMA Encyclopedia of Medicine, 1989, quoted in "Chickenpox: The Disease and the Vaccine," Massachusetts Citizens for Vaccination Choice (MCVC) Handout.
116. American Academy of Pediatrics brochure, 1996, quoted in MCVC, op. cit.
117. "The Vaccine for Chickenpox," American Family Physician 53:652, 1 February 1996, Patient Information Handout.
118. Spingarn, R., and Benjamin, J., Letter, NEJM 338:683, 5 March 1998.
119. Shapiro, E., and LaRussa, P., "Vaccination for Varicella: Just Do It!" Editorial, JAMA 278:1529, 12 November 1997.
120. Simberkoff, M., et al., "Efficacy of Pneumococcal Vaccine in High-Risk Patients," NEJM 315:1318, 20 November 1986.
121. Eskola, J., "Efficacy of a Pneumococcal Conjugate Vaccine Against Acute Otitis Media," NEJM 344:403, 8 February 2001.
122. Family Practice News, 15 April 2000, p. 1.
123. Lavin, A., Letter, NEJM 344:1719, 31 May 2001.
124. Cantekin, E., Letter, Ibid.
125. Damoiseaux, R., Letter, Ibid.
126. Medical World News, 14 April 1986.
127. Hurwitz, E., et al., "Guillain-Barré Syndrome and the 1978-1979 Influenza Vaccine," NEJM 304:1557, 25 June 1981.
129. Family Practice News, 1 June 1999, p. 1.
132. Family Practice News, 15 August 2002, p. 30.
133. Nichol, K., "The Effectiveness of Vaccination Against Influenza in Healthy Working Adults," NEJM 333:889, 5 October 1995.
134. Family Practice News, 15 August 2002, p. 30.
135. Boston Globe, 25 August 1992, p. 57.
136. Heemstra, T., Anthrax: A Deadly Shot in the Dark, Crystal Communications, 2002, p. 46.
137. Boston Globe, 3 August 1999, p. 1.
138. New York Times, 11 March 1999, via Internet.
139. Heemstra, op. cit., pp. 31-35.
140. Ibid., p. 64.
141. Bates, S., "Anthrax Vaccination in the Military," NVIC Presentations, op. cit., 2002.
142. Matsumoto, G., "The Pentagon's Toxic Secret," Vanity Fair, May 1999, pp. 82-98.
143. Heemstra, op. cit., p. 107.
145. Family Practice News, 15 July 2002, p. 10.
146. Family Practice News, 1 May 2004, p. 41.
147. Moskowitz, ed., "Smallpox," AIH Bioterrorism Report, JAIH 96:121, Summer 2003.
Implications for Health Policy.
149. Eickhoff, T., "Adult Immunizations: How Are We Doing?" Hospital Practice, 15 November 1996, p. 107.
150. Averhoff, F., et al., "Immunization of Adolescents," American Family Physician 55:159, 1 January 1997.
151. Sur, D., "Vaccinations in Pregnancy," American Family Physician 68:299, 15 July 2003.
152. Private communication from Andrew Tyler, London Evening Standard, cited in Moskowitz, "Vaccination: A Sacrament of Modern Medicine," JAIH 84:96, December 1991.
153. Family Practice News, 1 April 1997, p. 2.
154. Family Practice News, 1 September 2001, p. 2.
155. Schenker, T., et al., "Measles Herd Immunity," JAMA 267:823, 1992.
156. "Recommended Childhood and Adolescent Immunization Schedule," ACIP, Family Practice News, 1 January 2004, p. 9.
158. Koff, R., "The Case for Routine Childhood Vaccination Against Hepatitis A," Editorial, NEJM 340:644, 25 February 1999.
159. Moskowitz, "A Sacrament," op. cit.
160. Sherry Tenpenny, D.O., "Expert Believes Infants Can Tolerate 10,000 Vaccines," www.mercola.com.
161. MMWR, reported in JAMA 283:2381, 10 May 2000.
163. Private communications with the author.
164. The Vaccine Reaction, NVIC Newsletter, January 1996, pp. 3-5.
165. Orlando Sentinel, 28 August 2004, p. 1.
166. Boston Globe, 23 February 1993, p. 1.
167. Peter, G., "Childhood Immunizations," NEJM 327:1794, 19 December 1992.
168. Bluestone, C., "Otitis Media in Children," NEJM 306:1399, 10 June 1982.
169. Dubos, op. cit., p. 157.