The Vaccination Debate

If you thought religion and politics were the most taboo topics at the dinner table, there is now definitely a third hot button topic to add to the list. The vaccine debate has become such a contentious issue that even many leading functional doctors and researchers with expertise on the subject prefer not to speak out. Regardless of what they may say, someone will likely be offended. And, knowing the answers are not black and white, there doesn’t seem to be enough room in print to truly delve deep into the topic.

Recently, pro-vaccination groups have become so frustrated with the layperson dispensing medical advice that their new mantra seems to be “just do it.” Yet anti-vaccine voices continue to fear the conflict of interest between pharmaceutical companies and doctors, and highlight a list of potential risks of vaccinating, which they believe can compromise long-term immune function and health.

How can the average person wade through these murky waters (that sometimes feel shark-infested!) and get sound advice for their children without offending their doctor or peers, but also avoiding being swept away by all the pseudo-science online?

Let’s take a closer look at both sides of the debate.

The pro-vaccine debate

Most traditional medical doctors would say this is not even a debate. For them, the research is clear that vaccines save million of lives every year, therefore everyone should vaccinate their children. Most physicians will concede, and rightly so, that there are side-effects to vaccinations but state these negative reactions are very few and far between. For the overwhelming majority of physicians, protecting your child from preventable deadly diseases is an easy choice, especially for infant immune systems that have not yet matured to protect themselves fully from pathogens.

Overall, the research supports that vaccines are very safe and provide necessary and life saving protection to infants. The recent outbreak of measles in Disneyland this year is evidence that if too many people “opt out” of vaccinations, it compromises the health of other children. Herd immunity is a reality and you must have upward of 80-90% of the community vaccinated to provide protection to all. ¹

Of course, the trump card for the pro-vaccination camp is the impressive list of deadly diseases that have been eradicated (or almost eradicated) since the use of vaccines. This includes diphtheria, influenza, hepatits A and B, measles, mumps, pertussis, pneumococcal disease, polio, rubella, congenital rubella, smallpox, tetanus and varicella. This great medical achievement has required years of research and dedication of generations of talented scientists and physicians and has saved millions of lives in the process. However, they argue that if a just 10% of the population is not fully vaccinated, these modern advances begin to lose their effectiveness.

Anti-vaccine arguments

The anti-vaccine debate seems to stem around a couple of key areas, neither of which is the heavily rumored link between the MMR vaccine and autism, which has been strongly refuted in the clinical literature.²

First, there is a concern that vaccines can cause harm and alter immune function in the long-term, leading to a greater risk of autoimmune conditions as we age. According to the Center for Disease Control (CDC) all vaccines do carry the risk of life-threatening allergic reaction, however this occurs in one child per million.³ Although the likelihood of these reactions is extremely small, for any parent of a child who has had a reaction to a vaccine, they would argue not small enough.

The National Vaccine Information Center (NVIC) states that certain vaccines may be linked to asthma, diabetes, chronic inflammation, autism, learning disabilities and other disorders.⁴ Of course, from a scientific perspective, the difficulty is that association is not proof of causation and, therefore, any number of other factors may have also contributed to these adverse reactions.

Those opposed to vaccinations also fear the adjuvants added to vaccines that are required to trigger the immune reaction that ultimately facilitates acquired immunity. Some researchers and physicians believe common adjuvants like thimerosal, aluminum, mercury, and formaldehyde possess potentially significant negative risks to children, even at the levels classified as acceptable and safe by the CDC.

On top of that there is concern about the sheer number of vaccines given today. In 1980, the CDC recommended 23 doses of 7 vaccines, whereas by 2013 the recommendations had dramatically increased to 49 doses of 14 vaccines between birth and 6 months. Can a newly forming immune system cope with this high burden of adjuvants? The pro-vaccine group believes it poses no threat; the anti-vaccine group believes this may predispose the population to increased risk of autoimmune conditions later in life.

From 2001 to 2009 rates of autoimmune diseases – like lupus, celiac disease, and type-1 diabetes – have increased dramatically and the CDC is unsure why this is happening.⁵

Environmental factors have been suggested as the most likely cause, however the rise in number of vaccinations does parallel the rise in autoimmune conditions over the past few decades. It has been suggested that vaccine use (or excessive use of vaccines and accompanying adjuvants) may negatively impact newly forming immune systems in infants and young children, scrambling the body’s immune response mechanism and leading to a greater likelihood of autoimmune type reactions. While there are some plausible biochemical pathways to support this, it would be virtually impossible to prove in a double-blinded placebo controlled study.

Perhaps the major hurdle that many patients have is the intimate connection between the pharmaceutical companies and the CDC, in what is a hugely profitable industry. With former employees of the CDC transitioning to the big pharmaceutical companies, how can the average person have 100% trust in a watchdog that is closely tied to the industry they regulate? While the majority of these fears may be unfounded, this type of relationship represents a clear conflict of interest, in particular in light of the rapid rise in number of vaccinations over the past 30 years.

Lastly, the right to “informed consent” is an ethical principle in medicine. It is the process of getting permission before conducting any healthcare intervention on a person. The fact that some states are now wanting to implement a 100% mandatory vaccination schedule goes against this medical principle and seems to add fuel to the fire for the anti-vaccine camp.

So, where does that leave us?

Today, there is so much rhetoric on either side of the debate it’s no wonder the average parent is confused and frustrated. For a parent whose child has suffered serious negative consequences from vaccination, they will likely regret allowing their child to be exposed, no matter if they are the one in a million affected. For the doctor, seeing a parent choose to not vaccinate and watch that child contract a completely preventable disease and risk spreading illness to others leaves a similar scar and frustration around fears of vaccination.

No one will argue against Mary Glodé, M.D., professor of pediatrics at the University of Colorado in Denver who states “immunizations are simply one of the greatest public health achievements.” However, expert immunology researchers also admit that “for the immune molecules that we know are important, almost nothing is understood about their mechanism,” highlighting there is much more to immunity than merely the antibody response of vaccines.⁶

The bottom line: I believe an open discussion with your family and doctor will lead to the best plan for you.

References

[1]Hyong Kim T, Johnstone J, Loeb M. Vaccine herd effect. Scand J Infect Dis. 2011 Sep; 43(9): 683–689.

[2]Demicheli V et al. Vaccines for measles, mumps and rubella in children. Cochraine Database Syt Rev. 2012 Feb 15;2:CD004407.

[3]CDC, “Possible Side-Effects from Vaccines,” www.cdc.gov, Feb. 4, 2014.

[4]National Vaccine Information Center, “Autism,” nvic.org

[5]//www.medicalnewstoday.com/articles/246960.php. Viewed Aug 10th, 2015.

[6]Garay, P. and McAllister K. Novel Roles for Immune Molecules in Neural Development: Implications for Neurodevelopmental Disorders. Front Synaptic Neurosci. 2010; 2: 136.