All posts tagged vaccines

Image by USACE European District

Welcome! This is the fourteenth post in my vaccine series.  You may have missed  Getting Serious, 10 Bad Reasons Not to Vaccinate, Why “Science” Should Be Carefully Evaluated, What is Herd Immunity All About, How the Immune System Works, Ingredients in Vaccines Part 1, Ingredients in Vaccines, Part 2, Risk-Benefit Analysis: MMR, Risk-Benefit Analysis: DTaP, Risk-Benefit Analysis: Chicken Pox, Hib, Flu,  Risk-Benefit Analysis: Pneumoccocal, Meningococcal and HPV, Risk-Benefit Analysis: Hep A, B and Rotavirus, or What About Alternative Schedules?

Today we’re talking about protecting unvaccinated kids.  Although early studies point to unvaccinated kids being healthier in general (and I believe that children whose immune systems are stimulated naturally and not interfered with chemically are generally healthier), there is still some risk involved.  We’re going to talk about how to protect your child.

Risks to Unvaccinated Children

A lot of parents don’t like to talk about this, but we must.  If you do not vaccinate your child, your child may get measles, mumps, pertussis, or any of these other diseases.  (If you do vaccinate, your child still may get them, also.)  It’s important to realize that even though your child may be stronger, healthier, more able to fight off disease, etc. (going on anecdotal evidence mostly here), it is still entirely possible for your child to become ill.

That’s why, if you haven’t yet, go back and read each of the risk-benefit analysis posts.  It is so important to be familiar with the signs and symptoms of each disease.  Most are not dangerous — like mumps or rubella — but a few are (diphtheria or tetanus), and the dangerous ones require immediate medical attention.  If you believe your child has something that may be dangerous, seek help.

Now, the chances of your child catching most of these things today is not very high, since the diseases don’t really circulate much.  And most of them are fine with home treatment and will not result in permanent damage.  It’s important to weigh the risks and benefits in your particular situation.

Luckily, there are ways to protect your child.

Protection for Children

In a lot of ways, not vaccinating offers its own protection.  Children are not exposed to the dangerous ingredients in vaccines.  Their immune systems develop naturally as they are challenged by colds and other small illnesses.  They have no excess inflammation.

There is more, however, that we can (and should) do for them.

Breastfeeding

I cannot say enough about the importance of breastfeeding.  Breastmilk functions as an immune system for a child who doesn’t yet have one.  It is a dynamic food that contains living cells, immunities, stem cells, and many components we don’t even understand.  It coats the baby’s gut in IgA, which protects the baby’s immature gut from invading pathogens (and also can prevent sensitizing due to undigested food proteins).  When a baby breastfeeds, anything s/he’s been exposed to absorbs into mom’s skin from baby’s saliva.  The mom makes antibodies against this to protect the baby and it gets to him/her via breastmilk at later feedings.  There is no substitute for this, nothing that will provide this same protection.

Failing to breastfeed, I recommend making a homemade formula.  It will not have the same immune benefits but it will offer baby healthy, whole food.

Healthy First Foods

When baby does start solids, choosing healthy, nutrient-dense options is key.  This remains true as baby grows.  Liver, avocados, egg yolks, plain yogurt, etc. are very healthy.   Probiotics should be included (like yogurt, kefir, etc.).  These are very important components of the diet.  For more on starting babies on foods, including what, when, and how (and handling picky toddlers too), read my book, Breast to Bib.

Fat

Fat is a key component of the diet.   Coconut oil is a great source of medium-chain fatty acid lauric acid, which has a protective role in the immune system.  Mom should consume it while breastfeeding, and baby should consume it when s/he’s eating solids.  Grass-fed butter and other sources of saturated fat are also necessary.  A large part of baby’s body and brain are made up of saturated fat and cholesterol, so consuming these in the diet will help proper growth and development and boost immune function.

Probiotics

Ideally, consume probiotics in the form of food everyday.  This includes things like milk kefir, water kefir, kombucha, yogurt, fermented pickles, other cultured vegetables, etc.  Failing this, choose a high-quality probiotic supplement.  Probiotics help to boost gut health and can offer a protective effect.

Cod Liver Oil

The one supplement that I recommend across the board is fermented cod liver oil.  I know — sounds weird, and it’s expensive.  But this is the best source of vitamin D and vitamin A, as well as EPA, DHA, and other healthy components.  It boost immune function in a serious and obvious way (this has been our experience).  All babies who are getting formula should get a dose daily, and babies who eat solids should too.  Breastfed babies should get it via mom.  I offer a baby about 1/8 tsp. to start and work up to 1/2 tsp. by 18 months or so.  Breastfeeding moms should take 1 tbsp. per day.

Sunlight

Sun exposure is critical to health.  Babies should get 15 – 30 minutes per day of midday sun while wearing as little clothing as possible.  A diaper is ideal.  Even if your baby is very fair-skinned (like mine), s/he should not burn during this amount of time, especially if s/he is consuming a diet with adequate cholesterol and saturated fat.  (My kids are the whitest of white…and they can be out for 2+ hours in midday sun with not even a hint of pink.)  Midday sun is best, because the UVB rays that create vitamin D in the body are strongest, according to Dr. Mercola, and the UVA rays that can cause damage are weaker.  Supplements are not a substitute for sun exposure, because they are not the same form of vitamin D.  Sun exposure creates vitamin D sulfate, which is better absorbed and has more functions in the body.  Because vitamin D is produced in the oils on the surface of the skin, avoid bathing for a day or two after sun exposure.  Babies and young children really don’t need to bathe more than once or twice a week anyway, and typically do not need soap.

Herbal Medicines

There are a variety of herbs and herbal medicines that can boost your child’s immunity.  These include echinacea (do not use if allergic to ragweed, and only use if your child has been exposed to something or is ill.  It is not effective after two weeks), elderberry syrup, and others.  I have several home remedies here, and Trilight Health also makes some.

Public Exposure

Be careful when exposing your young child to the public.  Very tiny babies should be kept at home as much as possible and worn close to your body while out, to discourage any strangers poking the baby in the face.  If there is an outbreak of a particular disease, keep your children home, especially if they are young or there is a young sibling in the house.  If you believe you have been exposed to something, stay home until you know if you are sick or not if at all possible (some things have a long incubation period).  If you get sick, stay home.  I do believe it our responsibility to society not to go out when we know we are ill and could spread illness!  And that goes for everyone, vaccinated or not!

Use Essential Oils

Some people swear by essential oils like tea tree, cinnamon, peppermint, oregano, and others which are antibacterial and antiviral.  These can be mixed with a carrier oil (always do this) and applied to your skin, or put in a diffuser and allowed to mist the room.  Some people swear that by doing these two things, they can avoid a lot of illness.  A diffuser is probably most useful for a baby, as you don’t want to use essential oils on their skin unless absolutely necessary, even diluted.

Allow Minor Illnesses

Your children learn to fight off “the big stuff” by fighting off the small stuff.  Let them get colds and stomach viruses and other minor illnesses.  They’re not fun, but they train your child’s system how to handle future illnesses.  You’ll probably find as your child gets older, s/he gets sick less and less.

Things to Watch Out For

In addition to doing these things to protect your children, there are some things you don’t want to do.

Tylenol

Tylenol is the leading cause of liver failure in the U.S.  It depletes glutathione in the body, which is an essential amino acid that is necessary to fight off illness.  Avoid Tylenol if at all possible and look for other remedies for pain.  You don’t need fever reducers.

Food Additives

Some food additives can reduce immunity, too.  Especially in times of illness, make sure your diet is as clean as possible.  Lots of fat, bone broth, fruits and vegetables, etc.  Avoid packaged foods.

Indoor Play Areas

These can, unfortunately, be breeding grounds for germs because lots of parents bring their kids sick.  Especially if you have a tiny one, skip them!

Hand Sanitizer

Do.not.do.it.  If you must, find one based on essential oils.  The alcohol-based ones kill all the good and bad bacteria, which is no good for your gut health (reducing your immunity), and they’re not as effective at killing the “bad guys” as real soap and water.  Find a sink and wash your hands the right way, and have your kids wash theirs too, especially after playing on a playground or before eating.

Watch Live Vaccines

If you know someone who has just gotten a live virus vaccine, you may choose to wait awhile before being around them, especially if you have a tiny baby or someone who is in fragile health.  These vaccines can and occasionally do shed, which could make your child ill.

Final Thoughts

With these tips, and your own parenting instincts, you can protect your children from the worst complications of illnesses, even if you can’t (and honestly shouldn’t) protect them from everything.

It is not magic.  It is not wishful thinking.  Although vaccine proponents would have you believe that vaccines are the only way to stay healthy, this is simply not true.  Illness and especially serious illness is caused or exacerbated by vitamin deficiencies and other testable issues within the body.  If you use healthy foods to keep the body from deficiency, then you can have optimal immune function and a lowered likelihood of illness or problems.

(That line of thinking probably bothers me the most…that if you believe you can keep your child healthy with a good diet that you are just “believing in magic” or something.  It’s pretty easy.  You can test to see if a child has a vitamin or mineral deficiency.  Those who do, especially magnesium, vitamin A, and vitamin D are at greater risk of complications.  If you feed your child a healthy diet so that these deficiencies do not occur, then your child will be less susceptible.  It’s science, people, not magic!)

How do you protect your children?

Image by USACE European District

Welcome! This is the thirteenth post in my vaccine series.  You may have missed  Getting Serious, 10 Bad Reasons Not to Vaccinate, Why “Science” Should Be Carefully Evaluated, What is Herd Immunity All About, How the Immune System Works, Ingredients in Vaccines Part 1, Ingredients in Vaccines, Part 2, Risk-Benefit Analysis: MMR, Risk-Benefit Analysis: DTaP, Risk-Benefit Analysis: Chicken Pox, Hib, Flu,  Risk-Benefit Analysis: Pneumoccocal, Meningococcal and HPV, or Risk-Benefit Analysis: Hep A, B and Rotavirus.

Today we’re talking about alternative schedules.  If you were as disturbed as I was about some of the vaccines on the schedule, you may have decided to skip certain ones, or at least want to wait until your baby is older before offering some or all of them.  What are the options with alternative schedules, and why do certain doctors recommend against them?

What are Alternative Schedules?

When concern over vaccines become mainstream almost 15 years ago, a lot of parents began saying “It’s too much, too fast.”  They were seeking a way to protect their children without overloading their immature immune systems.  This led to parents choosing the “most important” vaccines only, and/or choosing to begin a more or less complete vaccine schedule at a later age, usually after age 2 years.

There are as many alternative schedules as there are families, since most set them up themselves, in conjunction with their pediatricians (sometimes).  The only “official” alternative schedule out there is the Dr. Robert Sears alternative schedule.  This is still not “official” in that it’s not recommended by any large organization, but it is backed by many alternative-friendly pediatricians.

How do Schedules Differ?

The typical CDC schedule looks like this:

• Birth — Hep B
• 2 months — Hep B, rotavirus, DTaP, Hib, pneumoccocal, polio
• 4 months — Rotavirus, DTaP, Hib, pneumoccocal, polio
• 6 months – Hep B, rotavirus, DTaP, Hib, pneumoccocal, polio, flu (if the right season)
• 12 months — Hib, MMR, pneumoccocal, polio, Hep A, varicella
• 15 – 18 months — DTaP, flu (if seasonal)
• 4 – 6 years — MMR, varicella, DTaP, polio, flu
• Flu vaccine annually, beginning at a minimum of 6 months of age

That is a lot, with babies receiving up to 7 shots in a single visit for up to 9 diseases.  Many parents feel overwhelmed by this and think their babies’ systems are not able to handle it.  Some parents do choose to follow this schedule, but may eliminate Hep B (at least so early), rotavirus, varicella, and flu.  These seem to be most “opted out” of vaccines.

In contrast, the Dr. Sears’ (alternative) schedule looks like this:

• 2 months: DTaP, Rotavirus
• 3 months: Pneumoccocal, Hib
• 4 months: DTaP, Rotavirus
• 5 months: Pneumoccocal, Hib
• 6 months: DTaP, Rotavirus
• 7 months: Pneumococcal, Hib
• 9 months: Polio
• 12 months: MMR, Polio
• 15 months: Pneumoccocal, Hib
• 18 months: DTaP, Chickenpox
• 2 years: Polio
• 2 1/2 years: Hep B, Hep A (start Hep B at birth if any close relatives or caregivers have Hep B)
• 3 years: Hep B
• 3 1/2 years: Hep B, Hep A
• 4 years: DTaP, Polio
• 5 years: MMR
• 6 years: Chickenpox

All of the same vaccines are on this schedule as on the original CDC version, but there are no more than two shots per visit, and no more than four antigens.  The shots start at two months instead of birth (unless the baby’s mother or immediate caregivers have Hep B) and there are many more visits on this schedule.  The baby receives shots nearly every month.  Dr. Sears does have a delayed/selective schedule but I couldn’t find a copy.

Another type of alternative schedule might look like this:

• 2 months: DTaP
• 4 months: DTaP
• 6 months: DTaP
• 12 months: MMR, polio
• 4 – 6 years: MMR, DTaP, polio

In this version (which I made up based on conversations I’ve had with parents), the schedule is pared down to closer to what the 1980s schedule looked like, and polio is delayed until an older age since it is not a serious threat at this time.

Another type may look like this:

• 2 years: DTaP, MMR, (polio)
• 4 – 6 years: DTaP, MMR, (polio)

This gives two options: to offer polio or not.  Some parents may opt for polio but not MMR.  Shots are not started until age 2 years to allow the blood-brain barrier to close, and only a couple doses are needed.  Some parents who start out thinking they won’t get any vaccines ultimately end up on a severely limited schedule like this one because they believe that ultimately, when kids are older, vaccines are protective.

Reasoning Behind the CDC Schedule

Some doctors are absolutely against any alterations in the schedule.  There are even those who will kick parents out of their practices for not following the exact CDC schedule, with no room for discussion.

Their reasoning stems from a few major points.

The Schedule as Is is “Carefully Studied”

Doctors and researchers state that the current schedule, as written, has been carefully studied to be optimal.  However, there are no studies that actually look at the effects of the full schedule on a developing child’s system, and certainly no double-blind, placebo-controlled studies.

Vaccines are Given When Risk is Greatest

It’s true that pertussis risk is greatest in very young babies, under 6 months of age.  Babies are vaccinated as early as they possibly can be (when they are supposed to develop sufficient antibodies) for each disease.  MMR isn’t offered until a minimum of 9 months because it fails to afford much protection before then; but it is offered as soon as it is considered effective.  Older children are not as nearly as high a risk of most of these diseases as babies are, which is why many doctors feel that it is best to vaccinate as early as possible and protect them when they really need it.

An opposing perspective is that breastfeeding and choosing carefully how and when to expose baby to the public may help protect them at very young ages, and that by the time they are older, they will not really need the vaccine(s) because they are no longer at serious risk.

Babies Respond Better to Lots of Antigens

One source I read claimed that babies ought to get all their vaccines at once because they actually respond better to more when their immune systems are immature.  This is a highly suspect claim, however.

Number of Visits

There is a concern with alternative schedules that if the shots are spaced out to do one or two a month that the sheer number of visits required would mean that parents wouldn’t want to bring their children in as often as required.  There are co-pays to think about and the time to make and attend each visit with the baby.  Doctors are worried parents would simply stop vaccinating or stop doing all the vaccines or doses.

Of these fours claims, only one — that diseases are most risky in very young babies — is worth considering in this argument.  The final claim is a minor concern, but for parents who are determined to space out the shots and still feel they are important to get, they will find a way to make the number of visits work.

Reasoning Behind Alternative Schedules

Parents are concerned about many issues when they are looking for an alternative schedule.

Blood-Brain Barrier

The blood-brain barrier doesn’t close until around age 2, meaning that it’s much easier for the toxic ingredients in the shots to cross this and cause neurological damage.

Quantity of Aluminum in Shots

Infants on the CDC schedule may get as many as 1225 mcg of aluminum in one visit, according to Dr. Sears.  Although no safety studies have been completed on aluminum in vaccines, he estimates that babies can probably handle around 30 – 50 mcg at once depending on weight.  He also notes that although babies do consume aluminum through breastmilk (and formula — soy formula has an incredibly alarming amount), that aluminum that is consumed by mouth is not the same as that which is injected.  Aluminum can lead to neurological damage, especially in younger babies.

Unnecessary Shots

Many parents believe that a lot of the newer shots on the schedule simply aren’t necessary, like flu, varicella, Hep B, Hep A, etc.  These shots have been added in the last 10 or so years and these diseases usually were not much of problem for children prior to adding these vaccines.  (See the individual risk-benefit analysis posts for more on that.)  They feel that their children do not need these shots at all and that offering them may do more harm than good.

Newer Shots

Some parents trust shots that have been on the market for twenty years or longer (shots from the 60s, 70s, and 80s), but do not trust those that have been created and approved in the last 10 – 15 years.  They feel that they have not been tested as well or proven safe over time.

Too Much, Too Soon

Some parents are concerned about the effects of so many vaccines at once on the baby’s immune system, which has never been completely studied.  There remains concern about vaccines being related to autoimmune disease.

Concern for Adverse Reactions

One area we haven’t talked about in detail is the very real and very scary adverse reactions that can occur after vaccination.  For parents who personally had a bad reaction, or whose parents, siblings, or other children did — the possibility is too real not to consider when making choices about future vaccines.   Vaccine injury isn’t to be taken lightly.  Although many doctors would have you believe that it’s “incredibly rare” or even “never happens,” this is simply false.  It happens.  Don’t use scare tactics or individual stories to make your decisions, but be aware that injuries can occur, especially in sensitive individuals (those with immune system disorders, mitochondrial disorders, multiple allergies, etc.).

What To Do?

There are legitimate concerns about the vaccine schedule, and in not vaccinating young babies.  It is up to each parent to decide which shots they feel are most important, if any.  The risk-benefit analysis posts can help you decide which you feel are important.

Talk to your pediatrician about this, too.  If the doctor says “CDC or nothing,” walk out.  Find someone who will treat you like an intelligent person and have a conversation with you, and find a way to meet your needs.

No one else can tell you what to do.  Read through all the material and talk to a medical professional you trust, and come up with a schedule that you feel fits your family’s needs.

How do you handle vaccines?  If you do an alternative schedule, what do you do and why?

Image by USACE European District

Welcome! This is the twelfth post in my vaccine series.  You may have missed  Getting Serious, 10 Bad Reasons Not to Vaccinate, Why “Science” Should Be Carefully Evaluated, What is Herd Immunity All About, How the Immune System Works, Ingredients in Vaccines Part 1, Ingredients in Vaccines, Part 2, Risk-Benefit Analysis: MMR, Risk-Benefit Analysis: DTaP, Risk-Benefit Analysis: Chicken Pox, Hib, Flu or Risk-Benefit Analysis: Pneumoccocal, Meningococcal and HPV.

Today we do the last in the risk-benefit analysis posts, concentrating on Hep A, Hep B, and rotavirus.

Hepatitis A

What is Hep A?

Hepatitis A is an infection of the liver.  It is spread infected feces, getting into the mouth.  (It would be spread through unwashed produce potentially, employees who don’t wash their hands after using the bathroom in restaurants, etc.)  Pre- vaccine, it caused about 100 deaths per year.  It is asymptomatic 70% of the time in children and 30% of the time in adults.

Interestingly, WHO has no position paper on Hep A.

Normal course of the illness

There is approximately a 28-day incubation.  Early symptoms are abrupt and include fever, fatigue, nausea, loss of appetite, stomach discomfort, dark urine, and jaundice.  This usually persists for about 2 months, but may last up to 6 months.

Complications

The greatest “complication” was loss of productivity, as adults lost an average of 27 days of work from hepatitis A infection.  No illness-related complications are mentioned by the CDC.

Case fatality rate is approximately 0.3%, but may as high as 2% in certain populations.

There is no treatment for Hep A, but the infection usually clears in a month or two with no lasting damage.

Vaccine Use

A 2-dose series is recommended starting at 12 months of age, with the second dose coming at 18 or 24 months.  Two doses are recommended for anyone over age 2 who has not yet had the vaccine series yet, especially those at high risk.

Side Effects

There were 1867 adverse reactions reported to VAERS in 2011.  132 of these were considered “serious,” or about 7%.  These include itching, rashes, localized pain, redness, fainting, fever, severe headaches, nausea, vomiting, fatigue, dizziness, seizures, death.

Bottom Line

Hepatitis A is not very common and often causes no symptoms.  When it does, symptoms are generally mild and resolve without lasting damage.  Those who are not at “high risk” should not consider this vaccine (strong words — but there is so little risk from this disease).  It is possible that with natural liver supports (kombucha, dandelion root, etc.) that any potential Hep A infection could be cleared more easily (possible, I am not a medical professional).  The vaccine, on the other hand, presents a very real risk.

Hepatitis B

What is Hep B?

This is another strain of Hepatitis, and it has made news recently because the vaccine has been recommended for newborns for a few years now.  It is another form of liver infection, and it is one of the leading causes of both acute and chronic hepatitis and cirrhosis (liver failure).

Normal course of the illness

There is approximately a 90-day incubation period for this illness.  Early symptoms include fatigue, loss of appetite, nausea, vomiting, abdominal pain, fever, headache, joint pain, dark urine, etc.  3 – 10 days later, this is followed by jaundice (yellowing of the skin caused by bile, which indicates the liver isn’t functioning normally).  This lasts 1 – 3 weeks before resolving, typically without incident.

Most cases result in complete recovery and immunity to future infection.  Up to 50% of cases are asymptomatic.

Complications

1 – 2% of the time, hepatitis B becomes “fulminant” or serious.  This has a case fatality rate of 63 – 93% (only for the chronic cases, not all cases).

About 5% of Hep B infections become chronic.  Up to 90% of babies infected by their mothers become chronic, and 30 – 50% of children who are infected before age 5 also become chronic.

Most people with chronic infection are asymptomatic most of the time.  However, 25% die early from cirrhosis or cancer.  People with chronic infection are 12 to 300 times more likely to end up with liver cancer than those without Hep B infections.  4000 to 5500 people die each year from Hep B-related cancer or cirrhosis.

Interferon is used to treat chronic cases, and is successful 25 – 50% of the time.  Otherwise there is no treatment, only managing the symptoms.

Vaccine Use

Hep B vaccines are given to 12-hour old babies before they leave the hospital.  Doses are also recommended at 2 and 4 months, and occasionally again at 12 months.

According to the package insert, this vaccine shows antibodies for about 21 days and has an efficacy of 50 – 90%.  It has not been studied for use or safety in a pediatric population.  Another version has been studied in a pediatric population (which is the version used in babies).

Interestingly, the CDC’s chart on interpreting the serologic tests for Hep B shows that the results showing immunity from a vaccine and those showing immunity from natural infection are entirely different.

Side Effects

There were 1133 adverse events reported to VAERS in 2011.  152 were serious, or about 13% (this is on the high side).  Symptoms included severe pain, nausea, vomiting, fainting, redness, swelling, fever, inconsolable crying, dizziness, headache, diarrhea, seizures, death.

One study notes that Hep B vaccination in newborns “triples the risk of autism.”  Another study found that the full 3-shot series lead to a 9-fold increase in autism.

Bottom Line

Hep B can be serious, especially in at-risk populations (like newborns born to infected mothers).   Vaccination of all newborns, however, is clearly dangerous.  This is a vaccine where the child’s relative risk needs to be carefully considered vs. the risk of vaccination.  Most newborns probably would do better without it.

Rotavirus

What is Rotavirus?

Rotavirus is a common virus that causes diarrhea illness.  Most babies will have had it at some point before age 5.  It is usually not serious in developed countries with access to clean water and medical care.

The CDC says: “The immune correlates of protection from rotavirus are poorly understood. Serum and mucosal antibodies against VP7 and VP4 are probably important for protection from disease. Cell-mediated immunity probably plays a role in recovery from infection and in protection.”  Which means they are ‘not sure’ about any of these things (how immunity to rotavirus occurs).

One rotavirus infection is not usually considered to confer permanent immunity.  However, subsequent infections are milder and may be asymptomatic.

Normal Course of the Illness

Incubation is usually about two days.  This is followed by fatigue, nausea, mild fever (in some), and watery diarrhea for 3 – 7 days.  Other infections can cause the same symptoms, so rotavirus can only be diagnosed via laboratory test.

Infection is rare in infants under 3 months of age, and is most likely to be symptomatic in children 3 months to 3 years.  Older children and adults are often asymptomatic.

Complications

In young children (especially), rotavirus can lead to severe diarrhea, dehydration, electrolyte imbalance, and acidosis.  This is especially likely in those with compromised immune systems.

Rotavirus accounts for up to 70% of all hospitalizations due to diarrhea.  Rotavirus caused 20 – 60 deaths per year before the vaccine (in the U.S.).  Another “notable” complication is the up to $1 billion in lost productivity from parents having to miss work to care for sick children.

Vaccine Use

Rotavirus is a live-virus, oral vaccine that is recommended for use in children at 2, 4, and 6 months.  Infants 15 weeks or older who have not received a dose cannot be vaccinated, and the final dose must be completed before 8 months.  (The risk of intussusception increases with age, and the danger of rotavirus itself decreases).

In studies completed in third world countries, severe disease was prevented by the vaccine in roughly 2.5 out of 100 vaccinated babies.  The overall efficacy ranged from 49 to 77%.  ”Efficacy” clearly increased in countries where the disease was not a great threat anyway (suggesting that, in fact, it was not the vaccine that was responsible).

About 25% of babies shed the live virus for a couple weeks following vaccination.

Side Effects

There were 905 adverse events reported to VAERS in 2011.  254 of these were considered serious, or about 28% (this is off the charts high!).  These included intussusception, fever, fatigue, inconsolable crying, vomiting, diarrhea, high-pitched crying, swelling, blood in stool, seizures, death.

All together, all vaccines (not just rotavirus) caused 94 deaths in 2011.

Bottom Line

This is an incredibly dangerous vaccine.  Average rate of “serious” effects is 3 – 7%.  ”High” is 10 – 15%.  28% is simply unacceptable.  The vaccine also sheds the live virus in about 25% of cases.  The vaccine also doesn’t appear to work all that well; the “increase” in efficacy in areas where rotavirus is not much of a threat is clearly not due to the vaccine, but to the other environmental changes responsible for the lowered likelihood of infection.  The illness is not very dangerous if a child has access to breastmilk and medical care, and a relatively clean environment (such as in a developed country).  This is a vaccine that many “alternative” pediatricians don’t even offer.  I would never give this one, personally, even if I were doing others.

Final Thoughts

We’re done with the risk-benefit analyses!  That was quite a lot of work.  There is clearly a greater argument for some vaccines than others.  Always, always read the links provided within the text and always ask questions at the doctors’ office.  Ask for the package inserts.  Make sure you are making an informed choice!

Coming up we’ll be talking about ways to protect unvaccinated children, alternative schedules, and how to deal with those pesky vaccine pushers.

Image by USACE European District

Welcome!  This is the eleventh post in my vaccine series.  You may have missed  Getting Serious, 10 Bad Reasons Not to Vaccinate, Why “Science” Should Be Carefully Evaluated, What is Herd Immunity All About, How the Immune System Works, Ingredients in Vaccines Part 1, Ingredients in Vaccines, Part 2, Risk-Benefit Analysis: MMR, Risk-Benefit Analysis: DTaP or Risk-Benefit Analysis: Chicken Pox, Hib, Flu.

Today we continue on our risk-benefit analysis.  Somehow, I can’t believe that it takes me five posts to get through all of these…there are 15 diseases that we “normally” vaccinate against, plus additional ones sometimes?  That seems like way too many!

Anyway.  Let’s dive in!

Pnemoccocal

What is pneumococcal?

This is a disease that causes bacterial pneumonia, meningitis, and bacteremia, which are more serious in small children and the elderly.  Between 5 and 70% of people are asymptomatic carriers of this bacteria.  It is not known if being a carrier creates immunity in the person.  Pneumonia is traditionally treated with antibiotics like penicillin, but this is not always effective, which is why the vaccine was developed.

There are 90 types of this bacteria, but just 10 of them are responsible for over 60% of infections.

Outbreaks are uncommon and mostly occur in closed settings like childcare facilities or nursing homes.  Prior to vaccine use, the case incidence was just 167 per 100,000 per year in the U.S.  Most cases occur in children under age 2.

Risk factors include lack of exclusive breastfeeding, indoor air pollution, and nutritional deficiencies.

Normal course of illness

Incubation is short — 1 to 3 days.  Onset is sudden and includes fever, chills, productive cough (producing rusty sputum), shortness of breath, rapid breathing, fatigue, and weakness.  Occasionally, headaches, nausea, and vomiting will occur.

This bacteria can also cause sinus infections and ear infections more commonly (although since testing for the specific strain of bacteria for these milder infections usually doesn’t occur, it is hard to say how often this strain causes these illnesses).

Complications

For pneumonia, the case fatality rate is 5 – 7%, and approximately 175,000 hospitalizations occur each year.

For bacteremia (which can occur with pneumonia), the fatality rate is about 20%, and there are 50,000 hospitalizations each year.

For meningitis, the fatality rate is about 30%, and there are 3000 – 6000 cases per year.  It is the cause of up to 20% of all bacterial meningitis cases (the pneumoccocal strain).

After enduring this infection, nearly 60% of patients may have one of the following: hearing loss, mental retardation, motor abnormalities, or seizures.

An estimated 200 children died each year of this disease before vaccine use.

Vaccine Use

The vaccine that is currently recommended in the US is usually referred to as PCV-13 (because it contains 13 different strains).  This is a conjugate vaccine.

Side Effects

There were 4110 adverse effects reported to VAERS in 2011.  (Remember that it is estimated that between 1 and 10% of all side effects are actually reported.)   488 of these (or a bit over 10%) were considered serious.  These include rash, fever, seizures, swelling, vomiting, headache, soreness, inconsolable crying, headache, stiff neck, and more.

VAERS reports 45 deaths from the vaccine in 2011.

Bottom Line

This can be a scary disease, but it seems much more likely to occur in children who are not breastfed, are nutritionally deficient, or have an underlying condition.  It is not common in other populations.  It has never been an “outbreak” disease.  It has never caused significant complication or death rates, at least not among children (it does in the elderly).  The vaccine has a high rate of reactions and a significant percentage are serious.  As reported to VAERS, 25% as many children die from the vaccine as the disease (and if this reporting is as low as estimated, then more children die of the vaccine than the disease).  It is extremely important to protect children by breastfeeding, avoiding large childcare centers if possible, and feeding a healthy diet.

HPV

What is HPV?

HPV, or human papillomavirus, is a sexually-transmitted disease that can, in some cases, lead to cervical cancer.  This vaccine isn’t on the infant schedule (currently), but is now recommended for both girls and boys as pre-teens.  There have been some attempts to add it to the infant schedule, however, but nothing concrete has been said.

There are over 100 strains of HPV that have been identified.  Types 16 and 18 are “high risk” types that are present in 70% of all cervical cancer cases.  It is considered necessary to develop HPV in order to develop cervical cancer, although having HPV does not necessarily mean one will have cervical cancer (i.e. cancer doesn’t occur without HPV, but HPV can occur without cancer).  The vast majority of women who do have HPV will not get cancer.

Normal course of illness

HPV infection happens at the basal epithelium (on the cervix).  It is transmitted through sexual contact.  Most of these will resolve spontaneously, and not cause any chronic infection or further issues.  For the most part, there is no clinical disease or symptoms.  Risk factors include number of sexual partners, promiscuous behavior, smoking, and inconsistent condom use.

A small number will go on to experience chronic infection.  5 to 30% will have multiple strains.  Low-risk types 6 and 11 are responsible for 90% of genital warts.

Complications

In some rare cases, genital warts or different types of cancer can occur.  About 11,000 cases of cancer related to HPV occur per year, and nearly 4000 women will die.

Vaccine Use

Vaccine is recommended in boys and girls ages 9 – 24, and requires three doses.  It contains protection against strains 6, 11, 16, and 18 (Gardasil).  Another vaccine protects against 16 and 18 (Cervarix).  Protection lasts about 5 years.

WHO says: “The mechanisms by which these vaccines induce protection have not been fully defined…”  The “control” in the Cervarix study was a hepatitis A vaccine.

Side Effects

There were 1470 reports to VAERS in 2011.  These included fainting, redness, swelling, headache, fatigue, nausea, blindness, chronic joint pain, vomiting, appendicitis, seizures, pancreatitis, diabetes, cancer, death, and more.  94 of these were serious.

Bottom Line

This vaccine has been reported as incredibly dangerous, with many girls fainting and some left with permanent damage to their bodies, and some girls dying.  Since HPV is easily preventable by avoiding sex with multiple partners, taking appropriate precautions in this area seems far wiser than getting this vaccine.  Additionally, the vast majority of HPV infections do not lead to any serious problems.  Pap tests every 2 – 3 years to check for abnormal cells are a safer idea than this vaccine.

Meningococcal

What is meningococcal?

This is a type of bacteria that causes an illness called meningitis, an inflammation in the meninges in the brain.  This can be very serious and can cause permanent damage or death.  It is, however, relatively rare.  Until recently, this vaccine was only recommended for college students, but is now on the infant schedule.

Crowding, smoking, HIV infection all increase the likelihood of getting this disease.  Maternal antibodies (even from asymptomatic infection) and breastfeeding are protective.

Normal course of illness

The majority of people who are colonized with this bacteria will not get sick at all — less than 1% will develop any symptoms.  Of those who do, about 50% will actually end up with meningitis (less than 0.5% of those who “catch” the bacteria).

The incubation is 3 – 4 days typically, with a range of 2 – 10.  Meningitis is the most common infection that results, but in up to 20% of cases, meningococcemia or sepsis (an infection of the bloodstream) occurs.  Also possible, but less likely, are pneumonia, ear infections, arthritis, and epiglottitis (infection of the epiglottis in the throat).

Symptoms include poor appetite, fever, irritability, fatigue, nausea, vomiting, diarrhea, photophobia (light sensitivity) and convulsions.  A hemorrhagic rash is characteristic.

Complications

Death occurs in 9 – 12% of meningitis patients.  Meningococcemia may cause death is up to 40% of cases.

Up to 20% of patients who survive may have hearing loss, loss of limbs, neurological damage, or other permanent damage.

Vaccine Use

This vaccine is “recommended” for high risk groups starting from 9 months of age.  Two doses are recommended at least 8 weeks apart.  Not all infants will receive this vaccine.  Length of protection is unknown.

Side Effects

According to the package insert (Menactra), greater than 10% of recipients had fever, soreness, swelling, irritability, abnormal crying, drowsiness, appetite loss, vomiting.  There is some evidence that conjugate vaccines (including this, Hib, and pneumococcal) have been linked to increased rates of autism because of the way they work, their ability to produce a much stronger reaction than normal and that these infections are brain-based.

According to VAERS, there were 1541 adverse events reported in 2011.  These include nausea, fever, fainting, seizures, neck pain, diarrhea, Guillain Barre, headache, rash, diabetes, death, and more.   45 were classified as “serious,” or about 3%.  (Fainting episodes were not classified as serious, but occurred about 6% of the time.)

Bottom Line

This vaccine is really recommended for “high risk” groups.  Most babies will be protected by their mother’s antibodies.  As usual, maintaining a healthy lifestyle will be highly protective for most people.  Those with immune deficiencies are most at risk.  The vaccine itself has quite a few adverse reactions and given the rare nature of the infection, is probably not worth it.

Final Thoughts

As always, I caution you to ask questions of your doctors before accepting any treatment, and ask to see the package inserts.  If the doctor cannot produce them or is unwilling or unable to answer your questions, skip the vaccines at that visit and find someone who can do this.  Take into consideration your particular situation when making decisions and be sure to read through the links provided within the text for more information.

Image by USACE European District

Welcome!  This is the tenth post in my vaccine series.  You may have missed  Getting Serious, 10 Bad Reasons Not to Vaccinate, Why “Science” Should Be Carefully Evaluated, What is Herd Immunity All About, How the Immune System Works, Ingredients in Vaccines Part 1, Ingredients in Vaccines, Part 2, Risk-Benefit Analysis: MMR, or Risk-Benefit Analysis: DTaP.

Hib

Hib is a relatively new addition to the vaccine schedule, and one that parents are warned to take seriously. Why? What is it like and how serious is it?

What is Hib?

Haemophilus influenza type B, also known as “Hib” is a potentially severe respiratory infection. It is a bacterial infection that often causes a secondary infection following the flu, and it is the leading cause of meningitis. There are really six strains of this bacteria, but 95% of infections are caused by type b.

There are approximately 3 million cases each year, worldwide, and the majority of these occur in developing countries.

Up to 3% of infants and small children are asymptomatic carriers and could pass the infection along unknowingly. Most children, in the pre- vaccine era, acquired immunity through asymptomatic infection by the age of 5, and when grown, passed this to their children via pregnancy/breastfeeding, making babies under 6 months effectively immune.

Only a tiny fraction of those who carry this bacteria asymptomatically in their nasal passage will ever go on to develop symptomatic disease.  The chances of developing it if directly exposed are between 0% and 2.7%, depending on the circumstances.

Risk factors include low socioeconomic status, being a racial minority, living in a crowded home or large family, low parental education level, attending group childcare, and having a chronic disease.

Breastfeeding provides protection against Hib.

Normal Course of Hib

Most often, Hib infects the nasal passages. In some people, the infection gets into the bloodstream and affects distant body sites, especially the meninges in the brain. The way the infection gets into the bloodstream is unknown. 50 – 65% of cases will result in meningitis. Symptoms include stiff neck, sore throat, and changes in mental status.  It usually affects children in the 6 – 12 month range, and rarely affects children over 5 years.

Typically, Hib requires hospitalization and a 10-day course of antibiotics, and possibly a combination of a couple different types.  Most people recover without incident, although Hib is serious.

Hib infection in children under age 2 is not considered to provide immunity, and vaccination is recommended following illness.

Complications

Pneumonia is also possible. So is epiglottitis, an infection of part of the throat. Septic arthritis and cellulitis can also result.

Worldwide, 3 – 20% of those who actually contract the illness (which is a very tiny percentage of those who have the bacteria present in their bodies) will die. In the US, this is about 2 – 5%.

In the UK, there was actually an increase in Hib cases from 1999 – 2002, despite vaccination occurring routinely since 1992.  One theory is that by reducing the harmless colonization in the nasal passages, children were unable to get needed “boosters” and thus were more likely to become ill.

Vaccine Use

The initial Hib vaccination came out in 1985 and was used only until 1988.  It was not effective in children under 18 months, and efficacy in older children varied from 85% to -69% (“negative” because vaccinated children were 69% more likely to get Hib than non-vaccinated children).  This version is no longer available.

Two more versions were created and used in infants as young as six weeks, but are also no longer available.  Currently, there is a third vaccine available, a “conjugate” form, which is recommended at 2, 4, and 6 months, with a booster at 12 – 15 months and has an efficacy of 95 – 100%.  Children who delay vaccination until past age 2 are typically offered only one dose, if any, since the risk of disease drops dramatically.

Vaccine Side Effects

There were 810 side effects reported to the VAERS database in 2011.  121 of these were considered “serious” by VAERS, which is about 15% (this is an extremely high percentage; 3 – 4 times as many as other vaccines).  Side effects include fever, rash, lethargy, vomiting, diarrhea, seizure, difficulty breathing, swelling limbs, cellulitis, inconsolable crying.  Most common side effects are fever and pain at the injection site (which CDC says occur in up to 30% of those vaccinated).  A fair number experienced vomiting and diarrhea.

Bottom Line

Hib was a little odd to research.  It has some similarities to polio (affects brain/spinal area; many cases are asymptomatic; uncertain how exactly the pathology occurs; unlikely for those in contact with ill individual to also get sick).  It also seems that the disease itself is very uncommon, and that in certain cases the vaccine has increased the likelihood of catching it.  Breastfeeding appears to be extremely important to protect young infants who are most vulnerable to the disease.  Up to 15% of the vaccine reactions are serious, meaning it comes with quite a risk.  It’s likely that there’s a lot of research here that has simply not been done yet, and that in many cases, the best protection is exclusive breastfeeding combined with a healthy lifestyle.

Varicella

What is varicella?

Varicella is the clinical name for chicken pox, a relatively minor viral infection that causes an itchy red rash and fever for about a week. Prior to vaccine use, almost all children got the chicken pox. In fact, the vast majority of the current generation of parents (including me) have had it and know exactly what it is like. The same virus is also responsible for shingles.

It is interesting to note that WHO has no position paper on varicella vaccination, and that varicella vaccination typically does not occur in other countries, only in the USA.

Normal Course of varicella

Incubation is 10 – 21 days, usually around two weeks. This is followed by 1 – 2 days of fever and tiredness, especially in teens/adults; it is not always seen in children. The eruption of the rash follows this. The rash begins usually on the head, following by the body, then arms and legs. Spots continue to erupt in crops over 2 – 4 days. The spots mature and then eventually crust over. Most children will have 200 to 500 spots.
Chicken pox is generally mild, with low to moderate fever (up to 102), fatigue, and itching. It usually lasts about a week, and complications are rare except in children who have a known immune system issue.

Shingles also results from the same virus and why it occurs is not well understood. It is more likely if a child has chicken pox prior to 18 months, is exposed while in utero, or is immune compromised. Older people are more likely to get it than younger people (this is changing as more and more people are vaccinated, though – cases have been discovered increasingly in children and even infants). This produces a painful, itchy rash.

Complications

A number of complications are possible, but they are rare. The skin lesions (spots) may become infected with strep or staph bacteria. Pneumonia also sometimes occurs. Rarely, encephalitis occurs (less than 2 in 10,000 cases).  Hospitalization occurs in about 2 or 3 out of every 1000 cases.

The chances of death from varicella is about 1 in 60,000. In healthy children aged 1 – 14 years, it is only 1 in 100,000. (Adults have 25 times the chance of death.)

Vaccine Use

This vaccine is cultured in aborted fetal tissue.  It is a live-virus vaccine, which may shed and could spread or cause chicken pox.

Two doses are recommended: one at 12 – 15 months, and one at 4 – 6 years.  Prior to the booster dose, up 17% of vaccinated children were still getting chicken pox (up to 40% in some areas) if the disease circulated in elementary schools.  The vaccine is supposed to be 70 – 90% effective against infection.

Receiving another live-virus vaccine at the same time as varicella (like MMR) increase the risk of catching a minor case of chicken pox from the shot by 2.5 times.

Seroconversion (showing appropriate antibodies on the titre test) does not always correlate with protection, according to the CDC.  (Which should make us question if we are really protected in general…the titre test is ‘the’ way they ‘prove’ immunity.)

Vaccine Side Effects

There were 2810 adverse reactions reported to VAERS in 2011.  121 were serious, or about 4%.  Reactions include rash, itching, fainting, fever, nausea, vomiting, headache, seizures, chicken pox, death, and more.  Fever, rash, and fainting are relatively common.

Bottom Line

In the vast, vast majority of cases, chicken pox is not a serious disease.  Gaining natural immunity through infection and re-exposure to other wild cases during one’s life protects against shingles.  Without this, young children and even babies are getting shingles.  The vaccine has been proven not to be very effective.  It also causes fainting frequently.  A child who is not immune-compromised is not really at risk of complications from chicken pox, and getting it could even be beneficial given the risk of shingles later in life.

Influenza

What is influenza?

Influenza, or “flu,” is a seasonal illness that many have had at least once in their lifetime.  Flu shots are recommended each year to protect against that year’s circulating strains.  It is not typically dangerous except to very small children or elderly children.  Most flu deaths occur in people over 65 and are due to complications from the flu.

2009 H1N1 is noted as a “global pandemic” according to the CDC.  It estimates this flu sickened 60 million people and killed 12,500 (no source cited for data).  (I’m pretty sure, since I obviously lived through this “pandemic” that these numbers are sharply inflated.  Anyone who complained of any flu-like symptoms during this time was counted as having H1N1.  I even went to the hospital after fainting when I was 7 months pregnant — this would have been in May 2009 — and they mentioned I might have it.  I did not have any flu symptoms.  But I was probably counted.  A lot of this sort of thing went on to try to scare people and sell vaccines, unfortunately.  Plus, since the CDC calls it ‘an estimate’ and cites no source for its data, it’s not really believable.  Looking at their own graph further down the page, there was no significant increase in cases or deaths; there was, however, in 2006, which was not hyped like it was in 2009.)

Normal Course of influzenza

Incubation is 1 – 4 days.  Typically, a low to moderate fever occurs, with chills and body aches.  Lack of appetite and fatigue are also common.  This lasts 2 – 4 days on average before clearing up.

Complications

Pneumonia is the most common complication of the flu, and usually occurs in the elderly.  Reye syndrome also occurs in children given aspirin.  Worsening of chronic heart issues or chronic bronchitis occur occasionally as well.

Hospitalization rates for children 0 – 4 years is estimated to be 1 in 1000.  Healthy children 5 – 18 years are not at great risk of complications.  About 5 – 7 out of every 100 children see a doctor for a flu-related visit (or with “flu-like symptoms”) each year, and many of the children are given antibiotics (which are largely unnecessary).

Death occurs 1 in every 1000 to 2000 cases, and 90% of flu deaths in a given year are people over 65.

Vaccine Use

The flu shot contains H3N2 and H1N1 group A strains, and a group B strain each year, according to the CDC.  However, it also says on another page that the vaccine “may be updated” each year and that immunity wanes over time, which is why annual vaccination is recommended.  It appears that the strains are generally not changed each year as we have been told; they are “possibly” changed time to time.

The shot has not been studied in pregnancy women.  It has not been studied for efficacy (according to the package inserts).  There is no proof it works.  It is recommended for every person over the age of 6 months annually.  This is a new recommendation in the last few years; it used to be recommended only for older or susceptible people.

Flu vaccine has not been tested or approved for children under 4 (Fluvirin by Novartis).  Fluarix is only approved in people over 3 years and not in pregnant women.  Flulaval has also not been approved for children (at all) or pregnant women.  All of these state: “…there have been no controlled trials indicating a decrease in influenza disease after vaccination.”

Vaccine Side Effects

There were 7,342 incidents reported to VAERS in 2011 (the high number is likely due to the greater number of people receiving this vaccine compared to the childhood ones).  498 of these were serious, or about 6.7%.

This vaccine contains thimerosal (Flulaval).  Side effects include fainting, fever, soreness, headache, chills, fatigue, ear ache, nausea, vomiting, altered mental status, death, Guillaine-Barre, and more.

Bottom Line

The flu shot has no demonstrated clinical efficacy in reducing flu infections.  It is not approved in young children, who are more at risk of complications (than older children).  The flu is an extremely minor, if annoying illness that causes no serious complications in healthy individuals.  Keeping one’s vitamin D levels high reduces the risk in actuality and without side effects.  The risk of complications from the vaccine, especially since it is recommended annually for everyone, is greater than the risk from the disease in almost all cases.  There appears to be no point whatsoever in taking the flu vaccine.

Final Thoughts

This is another interesting crop of diseases.  Make sure to read the WHO and CDC sites for yourself, as well as checking package inserts.  There have been recent reports of doctors claiming ingredients like aluminum were “made illegal years ago” when in fact that is not the case.  Always ask to see the current package inserts and do not accept any vaccination from a doctor who is unable to provide them.

How do you feel about these three diseases?