Baby Dust Diaries

A Life Less Ordinary

Tag: Vaccines (page 1 of 2)

A Civil Debate About Vaccines

conflict-clipart-CLIPART_OF_ProcessI don’t write about vaccines much anymore. The reason is simply that I had read more than enough (several times over enough) to completely convince me that vaccines were a bad idea for both humanity in general and my children specifically (which, contrary to popular press, are BOTH very important to me). It isn’t my passion anymore. Unless someone is talking about “anti-vaxxers” going to jail or having their kids sent into foster care. It is only when you seek to infringe on my right to body integrity that I engage. I no longer play the show me your research and I’ll show you mine game.

I am disheartened that, from my perspective, so many people believe the vaccine propaganda without digging deeper behind these recommended substances being injected into our most vulnerable population. However, what really pains me is how impossible it apparently is to have a civil discussion about the topic.

Last year I was kicked out of a feminist group for, “promoting child abuse” after having a rather civil discussion on vaccines with other members. The group admins believed so strongly that vaccines are an inarguable benefit to children and humanity that they not only couldn’t have a conversation with me about bodily integrity and the right of the state to force medications on autonomous human beings, but that to even bring it up promoted child abuse.

Damn, that is some seriously strong cultural indoctrination.

I *get* that I’m the minority. I know you think I am straight up wrong. I get that you can’t believe I don’t get it. But what I don’t get is that you are going to shame and demean me in your arguments. Honestly, when you notice yourself so vociferously defending a point of view, which is fine, but feeling hot under the collar about it, then maybe you want to examine where feelings that strong are coming from.

An emotional response that strong comes from one of two places. Either you have a personal experience to draw on (for example, you have a child injured by a disease that has a vaccine and you feel the unvaccinated were responsible) or you’ve been subliminally and overtly indoctrinated to feel something by someone else. Who is that? Why did they do that? I’d want to know. And why do they need to use influence and marketing to “sell” this idea so hard? Why don’t the vaccines speak for themselves?

Maybe you feel you have examined these issues and you still feel vaccines are for you. That is great. I’m happy for you. Perhaps you even think that unvaccinated individuals are a danger to others. I imagine that is a painful feeling to have. I know how I feel when I see transphobia against little kids just trying to be comfortable in their skin. I just know I have to speak out – and do so loudly – to give voice to a group that I know is so often silenced. If you truly feel that my choice not to vaccinate my children puts infants, the elderly, and immunocompromised people at risk then I empathize deeply with the compassion for those people that drives your passion. Namaste. That place in me that feels compassion sees the same place in you and I respect your voice in this argument.

Can you see me for one moment? I do care deeply about people for whom measles or chicken pox are deadly. I would never, never have made this decision without researching that aspect of public health and vaccines. I know you think I haven’t researched enough, or in the wrong places, or that I simply don’t understand enough to make what you consider the right choice. I’m not asking you to understand my choice. I’m asking you to see the place of compassion inside that my choice comes from.

The fact is I am not a shitty person. I’m not uncaring. I’m not uneducated or swayed by celebrity worship or an irrational hippie (I’m a quite rational hippie thankyouverymuch). I am a very kind person. If we met in person I’m sure we’d like each other.

You’d undoubtedly call me weird, or crunchy. You most definitely rolled your eyes when I said “vaccine propoganda” (ha! my side uses subliminal bias too.) My medicine cabinet has more brown, glass jars with droppers than things you’d buy at Walgreens. I’m a peace-freak who doesn’t spank her kids or send them to the local schools. I’m a “femi-nazi” and I’ll tell you, at length, why you should never say that. But I’m friends with many people who don’t believe the same things I do. And I think at least some of them would vouch for me being a decent human being. I’m not asking you to *get* me or agree with me.

I’m just asking that you can stop for a moment and not see me as an “antivaxxer.” I’m not your enemy. I am a friend. My life isn’t like yours. My choices aren’t like yours. But I worry about my kids all the time just like you. I think about their health and do things to make them as healthy as possible. I also care about humanity and I care very much that babies die around the world, just like you do. I think deeply on issues like white, western privilege and how this discussion would be different if I didn’t live in a place with access to healthcare, sanitation, and nutritious food, just like you do.

Do you want to send the police to my house to put my kids in foster care? Do you want them to be held down and injected against their will? I am such a pariah to you that you want me HURT and ROBBED of dignity and my own children? If you had to be the one to hold them down after ripping them from my arms would it change your answer?

I hope you answered no. If we can’t look past our own thoughts and, even briefly, see the humanity in each other then what is all this even for?

Vaccines and Feminism

I think the vaccine debate is often a hidden misogyny. Saying things like “2 seconds on Google” or calling those who don't vax “anti-vax truthers” implies that non-vaxers are stupid, alarmist, and selfish.

I love and respect science which I worked in for a decade. But, believing in science doesn't mean I have to ignore non-science. Science can't explain why acupuncture works but it does. Science says vitamin E doesn't reduce pre-menstural breast tenderness but I have 20 years of experience that says otherwise. That's fine. If the science isn't there then the medical profession should steer clear but we – individual people – don't have to steer clear. It is the same with vaccines.

Like the story of a mother whose daughter got a vaccine on Friday and by monday morning had pulled all of her hair out. She is a statistical anomaly and therefore her mother is just being hysterical. That's misogyny. We have no respect for motherhood, mothers, or the choices women make for their families.

While worrying about measles I think we should also worry about how we treat women and women's choices in the process.

I don't consider myself anit-vax. To be anti-vax would mean I want to end the practice of vaccination. I don't. The science is clear that vaccines produce the intended effect (reduction of childhood illness and loss of work productivity of parents due to illness) at an acceptable societal risk. If I were a government policy maker I would look at the science and recommend vaccination.

However, I would also respect a person's right to choose. I would never want to live in a country that mandated medication. Would you?

The fact is that Dr. Offit (an infamous pro-vaccine expert) and I agree on many things:

* vaccines produce antibodies

* vaccines reduce the occurrence of clinical illness

* vaccines reduce work absences

* vaccines are effective in the majority of those who take them

* vaccines don't work in 5-35% of people who take them – even after boosters.

* a small percentage of people will have a vaccine reaction that is moderate to severe.

A minute on the last one: Yes, vaccine proponents know and admit that sometimes vaccines harm – even kill. An infant that dies after the HepB vaccine because of a yeast allergy is an example of a person for whom a vaccine was NOT the best choice for health. No one disputes this.

And yet Mr. Offit and I disagree on a few points.

* the risk is negligible.

* the risk/benefit is not needed on a per-patient basis – a one-size-fits-all plan is sufficient

* the small number of adverse reactions is an acceptable risk for the wealth of good vaccines do.

I'm a conscientious parent. I don't do anything on a one-size-fits all plan for my three kids. I weigh the specific information about my child with the risk/benefit of a treatment. As with childbirth, education, nutrition, etc. I've done extensive research from good old medical journals and the CDC's own website. I never once consulted Jenny McCarthy (/eyeroll). My choice is that the benefits of vaccination did not outweigh the risk which was elevated in my case due to a family history of adverse vaccine reactions.

This is a right that should be respected. Respected because this is a free country where we can make our own decisions about our bodies. Respected because I should be respected as a woman and a mother as capable of making decisions for myself and my kids

Of course, some then say that I'm being “selfish” and putting others in harm's way. This is a difficult one because my obligation to society is very important to me. I would never take lightly the idea that my actions effect others. I don't “hide in the herd” and hope other people keep vaccinating.

The fact is I don't believe that non-vaccinated kids are anymore dangerous to can't-be-vaxed people than vaccinated children. There is plenty of science that agrees with me.

“Herd immunity” – a term stolen from natural disease vectors and used in vaccination despite no experimental verification of it working the same in induced immunity – is very debatable. But, let's say we believe whole-heartedly in herd immunity. There are still other ways in which vaccinated children also pose a threat to the non-vaccinated. For example, serotype replacement with HiB, carrier status with whooping cough, and vaccine shedding with live viruses like flumist and chicken pox.

These are agreed upon cases where a vaccine actually harms the herd. The decision that Dr. Offit makes is that this is an acceptable harm. That's fine. I don't make the same decision.

My children are a harm to an immunocompromised person when they are sick or carrying illness. I meet my obligation to the community by keeping my kids healthy and then keeping them home when they are ill. Vaccinated children are a harm to an immunocompromised person when they are sick or carrying illness. They are less likely to be sick (with vaccine available diseases) but just as likely to be carrying illness.

So here are some things that are terribly misogynystic to say to a mother (sarcasm in parenthesis):

* you just don't remember the death and destruction before vaccines (because, yes, I'm incapable of using history to make decisions and if I can't see it it doesn't exist)

* you don't understand the science (let's talk about the immune system and see who knows more)

* you just follow Jenny McCarthy (yes, I'm a vapid celebrity devotee because I'm a girl and girls are like, totally superficial)

* you are harming your children (OMG, this parenting thing is sooo hard! When will they feed themselves?)

* you are harming your community (whatever that's their problem I don't want a stinky chemical in my precious and pure children)

* you are just a conspiracy theorist or “truther” and thus anti-science (I'm a girl, math is so hard!)

I know an awful lot of non-vaxing moms and none of them are alarmist or uneducated on vaccines. None of them are shitty moms that don't care about their kids. They are smart, compassionate, wonderful mothers who have made a decision for their families that should be respected even if you disagree with it.

I'm all about common ground. I know that vaccines are a heated issue. I don't expect pro-vax people to completely understand my viewpoint. I do expect that we can both respect the humanity in each of us.

 

5 Ways to Restore Trust in the US Vaccination Program

 

The CDC, FDA, Pharma companies, and Paul Offit really want to find a way to get everyone to trust vaccines.  At least that is what they say.  After saying this they usually throw out the same arguments:

  • “young” parents don’t understand how horrible the diseases are
  • autism isn’t caused by vaccinations
  • parents are getting mis-information from quack websites

I’ve mentioned before that these arguments are simply not true for the vast majority of non-vaccinating parents.  We aren’t too young (and thus as implied too stupid) to understand.  We aren’t afraid of autism.  We are in fact quite informed about vaccines from sites that are well respected and even vaccine-biased like the CDC’s Pink Book.  Studies showthat vaccine refusers are educated people who have put much time into making this difficult decision for their families.

I’m left with the distinct feeling that these people don’t really want to restore trust.  They are too busy denigrating those lacking trust as loons and blind celebrity sycophants.  This got me thinking.  What would make me vaccinate my kids?  What would really restore MY trust in the program and the organizations/companies promoting it?

Here are my four steps for restoring faith in the US Vaccination program:


1. Conduct Placebo-controlled Longitudinal Studies

Placebo-controlled means that there is a control group that receives a placebo that is compared to the test group receiving the vaccine.  Studies like this are never done.  The “controls” in most vaccine trials also receive a vaccine albeit a different one than is being studied.  This is like testing the efficacy of Aspirin and giving the control group Excedrin (which includes Aspirin).  Any results would be impossible to interpret as deriving from Aspirin intake. Longitudinal is another important factor since it is false to assume that the effects of any drug are confined to the 7 days following exposure (as is done in most vaccine trials) especially in a drug that not only acts on the immune system but is intended to have long term effects (e.g. immunity).

The common complaint amongst vaccine evangelists regarding this request is that it would be unethical to withhold a vaccines from the control group because they are so clearly beneficial that to deny them would be a human rights violation.  This is absurd.  The Declaration of Helsinki, the World Medical Associations governing document on combining medical research with medical treatment, has clearly defined provisions for the use of placebo.  When there is an existing “proven” therapy (as vaccine promoters would claim) then placebo-control is permissible under the following circumstances (according to the 2002 clarification of the Declaration of Helsinki);

  • Where for compelling and scientifically sound methodological reasons its use is necessary to determine the efficacy or safety of a prophylactic, diagnostic or therapeutic method; or
  • Where a prophylactic, diagnostic or therapeutic method is being investigated for a minor condition and the patients who receive placebo will not be subject to any additional risk of serious or irreversible harm.

So, for example, it would be unethical (and unconscionable) to give a placebo to a control group of women with stage IV breast cancer when there is treatment available.  The thing with vaccines is that the person receiving the vaccine is healthy and not suffering from any disease.  It would therefore not be an ethical conflict to offer a placebo since the recipient would not be subject to risk or harm.  (note: “risk” is touchy since I’m sure someone would say the risk of the vaccine-available disease is increased.  However between the unknown efficacy of vaccination – i.e. it doesn’t work for everyone and requires frequent boosters – and, more importantly there not being a current outbreak of said disease, the real risk is limited).

Don’t forget, of course, that patients in a study are also provided the right of informed consent prior to enrolling in the study.  Thus if they personally felt the risk was too high they could decline participation.

The second complaint about conducting this type of study is that it would be impossible to find a group willing to enroll in a study that denied them vaccines.  I beg to differ since the number of american’s completely refusing vaccines is on the rise, but the complaint then becomes that it would be “impossible to control confounding factors”  like nutrition and environment.  Um, yeah, you can never control everything that’s why you can use statistics to account for socio-economic status, diet, and a host of other things.

Lastly, I’ve heard that “we” don’t want to divert meager research dollars to vaccines which are “proven” safe and effective.  Ok.  Whatever.  This is how you restore trust in vaccines.  If the errosion of vaccine compliance is less important than the other research then that’s the decision you are making.  If vaccines and vaccine compliance is as all-powerfully important (due to “herd” immunity) as you keep saying then put your money where your mouth is and prove it.

Seriously, it is totally doable and someone needs to do it.  What are you afraid of?

 

2.  Support Informed Consent

Informed consent has been a cornerstone of medicine since the Nuremburg Trials.  Informed Consent is the policy that doctors disclose information about a treatment course in a thorough enough manner to allow the patient to make a decision to proceed or decline.  According to the AMA, informed consent includes the doctor informing the patient of,

  • The patient’s diagnosis, if known;
  • The nature and purpose of a proposed treatment or procedure;
  • The risks and benefits of a proposed treatment or procedure;
  • Alternatives (regardless of their cost or the extent to which the treatment options are covered by health insurance);
  • The risks and benefits of the alternative treatment or procedure; and
  • The risks and benefits of not receiving or undergoing a treatment or procedure.

This is not only a crucial part of medicine but of a free society as well.  Public health does not trump individual choice in a carte blanche manner.  The state must have compelling cause to force medical treatment on an individual such as an epidemic.

It is actually required by law that physicians provide patients with a Vaccine Information Sheet (VIS) prior to each vaccination.  Raise your hand if you’ve gotten one!  That’s what I thought.  Most parents aren’t even informed what shots the child is getting.  It is just routine “shots” that are not explained or questioned.  Even if your doctor is one of the ones that hand out the VIS – the VIS is very misleading and has only a smidge of actual information.  For example, the Hep B VIS has the following statistics to inform parents;

  • In 2005, about 51,000 people became infected with hepatitis B.
  • About 1.25 million people in the United States have chronic HBV infection.
  • Each year about 3,000 to 5,000 people die from cirrhosis or liver cancer caused by HBV.

ZOMG!  Gimme that shot!  Well, actually that doesn’t give me much information that I can use.

How suceptible is my child?

2007 Hep B Incidence by Age and Sex (source: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5803a1.htm )

Hep B infection is almost non-existent in children under 15.  The VIS information is so grossly misleading as to be useless.

Also, the Hepatitis B Foundation talks about risk factors for HepB transmission:

[box]HBV is spread by blood or sexual contact.

To protect sexual partners, members of the household, or colleagues at work, the following measures to prevent transmission of HBV are recommended:

  • Using latex condoms when having sex; sexual contacts should be vaccinated
  • Never sharing personal grooming items that may be contaminated with blood such as razors, toothbrushes, or nail clippers
  • Cover open sores, cuts or scratches
  • Clean any blood-contaminated surfaces with bleach

The following activities are NOT associated with spread of HBV:

  • Sharing of food and utensils
  • Kissing, hugging
  • Handshakes or casual contact
  • Coughing or sneezing

[/box]And that is if you are a known carrier of HepB – something you usually know when you are pregnant.  I would be in favor for HepB vaccination of infants of mothers with known HepB or with unknown HepB status.

Anyways, I could go on and on for each vaccine.  My point is the VIS is clearly vague at best and misleading more likely.  This is not informed consent because it is not informed.  I’m going to write this because it will make me do it: I want to make my versions of the VIS – not biased, just with real numbers and what I think a mom should know before she jabs her 12 hour old infant.

 

3.  Support Universal and Unfettered Vaccine Choice

Vaccine choice has three arms;

1.  National Standardization of Legal Exemptions

Every state allows exemptions to mandatory vaccination laws.  There are four kinds of exemptions:[box]

  • Natural Immunity – proving you have natural immunity from contracting the disease.  For example Ohio’s law states, “A pupil who has had natural chicken pox, and presents a signed statement from the pupil’s parent, guardian, or physician to that effect, is not required to be immunized against chicken pox.
  • Medical Contraindication – for medical reasons you are unable to be vaccinated e.g. being allergic to a vaccine ingredient, immunodeficient, etc.  Ohio’s law states, “A child whose physician certifies in writing that such immunization against any disease is medically contraindicated is not required to be immunized against that disease.
  • Religious Objection – In Ohio this reads as “religious convictions” but it differs state to state.  All states, except Mississippi and West Virginia, allow religious exemptions.  The problem is some states put a huge burden of proof on the parent to “prove” their reason is religious or to be part of an “bona fide” church that opposes vaccination.  For example, in Ohio I must only submit a letter signed by me that I oppose vaccination for religious reasons.  Period.  In New York, on the other hand, I would have to “apply” for religious exemption and prove that my reasons were purely religious and sincerely held. The idea of a school district deciding my sincerity in any objective manner gives me chills.  (From what I understand NY also does not have a natural immunity exemption.) Some states require specific forms, in person counseling, and notarization – which disadvantage the poor.  The AMA is actually actively promoting the abolishment of religious exemptions (section H-440.970 on page 406) and this whole organization exists to end religious exemption on numerous issues.
  • Philosophical Objection – In Ohio this is stated as “reasons of conscious”.  Only 20 states allow this type of exemption and it is even more controversial.  It seems we as a culture believe that a religious conviction is an order of magnitude more “real” than other types of convictions?  I have both religious and philosophical objections to vaccines and I honestly don’t know how to separate the two.  Paul Offit and the AAP are vociferous about eliminating philosophical exemptions.

[/box]

 

2. Information Dissemination on Exemptions – If you have the legal right to exemption it does little if there is a systemic approach of concealment and coercion.  In Ohio, for example, I challenge you to find information about legal exemptions on the Department of Health website.  It would be exceedingly rare to find a school that has a simple exemption check box on the “MANDATORY” vaccine sheets or staff that will let you know about them.  In my 3 weeks in perinatal and 5 weeks in the NICU I talked to many nurses and doctors about vaccination (offering flu shot for me and HepB for the boys) and without question they all said “well you’ll need it before they get to school.”  They were truly astonished when I told them that Ohio has exemptions and the vaccines are not really mandatory.  I don’t think this is collusion on the medical personnel’s part, simply a complete and utter lack of education on the topic.  Clearly, however, at some level of government it has been decided that parents shouldn’t be openly offered their legal rights.

Worse yet is the harrassment, lies, and coercion that go on in some pediatricians offices.  Threats of calling Child Protective Services for medical neglect, horror stories about how your baby will die, and refusal to see a patient that doesn’t toe the line.  We interviewed 4 pediatricians before we found one that was respectful or our legal right not to vaccinate.

3. Separate vaccines – We can not have vaccine choice without separate vaccines.  Companies are deliberately reducing single-vax manufacturing in order to stop deviation from the standard CDC schedule.  What they are doing is reducing choice.  Can you imagine if your zoloft were ONLY available in a combo with Xanax?  Or how about if Lipitor came ONLY with Metaformin.

The fact is that each vaccine carries its own benefit and risk.  Look at DTaP – there couldn’t be three more different diseases.  One is non-communicable (T), another for a disease that nearly every child gets anyways (P), and the other for a horribly virulent disease.  Someone, like me, who might consider Diptheria vaccination is cut short because it is not offered alone.

Merck stopped production of the separate measles, mumps, and rubella vaccine in order to outsmart Dr. Sears’ alternate vaccine schedule. Now women who need the rubella vaccine after pregnancy must get the MMR even though they have immunity to M and M.  They are forcing unneeded medication in an attempt at coerce vaccine compliance.

This is what I mean when I say unfettered vaccine choice.  The exemptions laws should be uniform in every state and plainly available to parents.  Notification of the option of exemption should be a required part of the informed consent discussion with a pediatrician prior to vaccination.  I have no problem with a doctor letting his opinion be told (wouldn’t a cardiologist do the same?) but it should not be disrespectful or coercive or full of lies.

In echo of “get your rosaries off my ovaries” I have to say “get your vaccine law out of my bloodstream!”

4. Restructure the Advisory Committee on Immunization Practice and the Vaccines and Related Biological Products Advisory Committee

There are two government advisory committees involved heavily in the vaccines our children are given.  One is the Vaccines and Related Biological Products Advisory Committee (VRBPAC) which advises the Food and Drug Administration (FDA) on the licensure of new vaccines and the Advisory Committee on Immunization Practice (ACIP) advises the Center for Disease Control and Prevention (CDC) on recommending vaccines to doctors and state health departments.  The problem is both are plagued by serious conflicts of interest.  To see the extent of these conflicts check out the US House of Representatives Committee on Government Reform’s report on Conflicts of Interest in Vaccine Policy Making.

 

5. Stop Shielding Pharma from Justice

The fact that injuries and death result from some vaccines is not in dispute.  It should not take decades and thousands in legal fees for these parents to be compensated for their loss or medical burden.  The argument is that pharmaceutical companies won’t make vaccines if they have to be liable for harm.  I understand that drugs can have unavoidable risks and in an ideal world pharma could be trusted to provide the safest drugs possible through responsible development, trials, and post-market surveillance.  However, Pharma has proven time and again that they can not be given our trust in this manner.  Their devotion to their investors and the bottom line have made their decisions questionable at best.  See Vioxx as an example.  It wasn’t just that Vioxx was dangerous but they knew and did nothing.

Because the government line is that vaccines are a miracle, I understand the need for a “special” court for vaccine litigation.  However, special can not mean a black box that is designed to shield Pharma and place the burden unduly on the injured.  This court needs an overhaul in the worst way.  In the 2011 Supreme Court decision that upheld the law stating that parents can not sue in state court, dissenting Justices Sotomayor and Ginsburg (the ruling was 6-2 in favor of Pharma shielding), stated that by shielding drugmakers from lawsuits, what the government is actually doing is removing the pressure to create better and safer vaccines.  I agree.


I think these steps would go a long way to having a vaccine system that has integrity.  I’m certain that most of the vaccine pushers would say all these things are pointless.  That’s fine but please stop pretending you “have no idea” why people don’t trust the system or that you are truly trying to ensure a fair and safe vaccine program.

I am not a loon or too young or a hyper-protective mother.  I am not “anti-vax” a term that just inflames and misses the point. I do not get all my information from “some random webiste”.  I am an intelligent woman who cares about my child’s health and that of my community.  I am not a conspiracy theorist nor do I wear a tinfoil hat.  I have sincere doubts about vaccines being a positive thing for our individual and communal health.  My doubts are enough to stop me from vaccinating my children.  Other mothers make different decisions.  None of us make them lightly.  Stop patronizing us.  It is misogynistic (those silly mothers!) and counterproductive to your mission.


note: my numbering was off due to multiple drafts of this post and there are actually FIVE listed!  I sold myself short on the post title.  I have fixed the numbering and the title but kept the permalink the same so any incoming links would still work!  Sorry!  Can I blame mommy brain?

Hib Vaccination: Missing the Forest for the Trees

I realize that I kind of dropped the ball on writing about vaccines.  I wrote about it a lot when I was researching it to make a decision for my family.  Then, there came a point where I was 100% convinced not to vaccinate and I stopped writing about it.

I would like to continue sharing my research about vaccines in the context of why we made the choice not to vaccinate.  Please use the information as a launching point for your own research.

Remeber you can always decide to vaccinate later but you can never unvaccinate.

What is Hib?

Haemophilus influenza type b is a bacterium that colonizes the nasopharynx of healthy people.  Most are asymptomatic while a few individuals, primarily children under the age of 5, will develop invasive disease where the bacterium causes infection.  Infection of the brain and spinal column, called meningitis, is the most frightening possibility and the one the vaccine is designed to avoid.

Remember, meningitis is not a virus or bacteria.  It is a type of infection, like pneumonia, that can be caused by a variety of things including various viruses, bacterium, or fungi.  You can’t “catch” meningitis.

I find that discussion of this vaccine often frame it as a vaccine against meningitis.  I feel this causes a false sense of security.  This is only one way that a person could get meningitis.

Hib is one type of Haemophilus influenza.  There are 6 different types (a-f) as well as “nontypeable” types.  Type b caused the most cases of invasive disease prior to the vaccine.

What are my child’s risk of catching Hib?

According to the CDC’s Pink Book risk factors for Hib include:

  • household crowding,
  • large household size,
  • child care attendance,
  • low socioeconomic status,
  • low parental education levels,
  • school-aged siblings,
  • not breastfeeding

It is also more prevalent in African Americans, Hispanics, and Native Americans and in males more than females.

As with all disease, risk of invasive infection is compounded by poor health or chronic disease such as sickle cell, cancer, etc.

Passive immunity conferred at birth to an infant from the mother is observed in Hib.  As a result infection in babies younger than 6 months is uncommon.

Breastfeeding offers a protective benefit to babies.  The effect was so strong that each additional week of breastfeeding confered measurably more protection.  For example, in this study in the International Journal of Epidemiology

The association of decreased risk for invasive HI infection and long duration of breastfeeding was persisting beyond the period of breastfeeding itself. This finding supports the hypothesis of a long-lasting protective effect of breastfeeding on the risk for invasive HI infection. 

This study also notes that Hib infection skyrocketted in the 70s at a time when breastfeeding rates were at an all time low.

Furthermore, nearly all children develop immunity to Hib before the age of 5 through asymptomatic exposure (see CDC Pink Book pg 88).

What is the Hib Vaccine?

Currently available Hib vaccines are conjugate vaccines.  This means they use a “carrier protein” to elicit an immune system response.  In this case the tetanus bacterium is used with the polysaccharide portion of the Hib bacterium.
Vaccine reactions include:

irritability, sleepiness, injection site pain/soreness, injection site erythema, injection site swelling/induration), unusual high-pitched crying, prolonged crying (>4 hr), diarrhea, vomiting, crying, pain, otitis media, rash, and upper respiratory infection.

Other reactions include transverse myelitis, Guillain-Barre syndrome, thrombocytopenia, anaphylaxis and sudden infant death syndrome.  Additionally, Hib disease can be a result of vaccination.

Does the vaccine work?

Let’s see.

  • 41-55% of Hib disease post-vaccination occurs in those having received at least one shot of the vaccines.
  • The vaccine manufacturers state the efficacy between 59-98% although studies have found efficacy numbers of 31% and lower (source).

Worse yet is what has replaced the previous Hib infections in 0-4 year olds:

  •  56% of invasive disease now occurs in individuals aged >10 years.
  • ” total numbers of invasive Hi infections increased due to a large rise in infections caused by non-capsulated Hi (ncHi) strains (source).”
  • “The number of cases of invasive nontypeable H. influenzae disease increased by 657%, from a low of 7 cases in 1996 to a high of 53 cases in 2004; as a proportion of annual cases, nontypeable H. influenzae disease increased from 17.5% in 1996 to 70.7% in 2004. Overall, the case-fatality rate was 12.7%, with the highest rate observed in persons aged > or = 65 years (20.6%) (source). “
  • The Journal of Infectious Diseases published  a study  which found:
    “The incidence of Hib meningitis decreased 69% during the 1-year period after initiation of Hib immunization (from 2.62 to 0.81 cases/100,000 person-years; P<.001). In contrast, the incidence for H. influenzae type a meningitis increased 8-fold.herefore, Hib immunization contributed to an increased risk for H. influenzae type a meningitis through selection of circulating H. influenzae type a clones.”

In other words, the type b infections have been replaced by and increase in nontypeable HI disease and has shifted outside the normal childhood infection age group.  Meningitis, the main fear behind creating the vaccine, has actually increased 8 fold.

Has this made us safer?  Healthier?

I think the Hib vaccine is a case of saving a tree and not noticing that the forest is burning down around you.  I have ways of protecting my kids from Hib (breastfeeding, healthy living conditions, nutrition, and medical care) without risking the side effects of the vaccine or contributing to the deterioration of global health through tampering with the balance of HI disease.

2009: A Year in the Life of a Blogger

Some of my favorite blog highlights from 2009.

What a year!  Thank you to all my readers and especially those who comment!  Comments are like virtual hugs and the women I’ve met in the blogosphere have really changed my life.  Happy New Year!

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    Vaccines are Like Seat Belts

    “We have seat belt rules,” [Offit] says. “Seat belts save lives. There was never a question about that. The data was absolutely clear. But people didn’t use them until they were required to use them (http://www.wired.com/magazine/2009/10/ff_waronscience/all/1).”

    Vaccines are like seat belts if seat belts were made of arsenic that *may* or *may not* seep into your skin and kill you.

    Vaccines are like seat belts if seat belts sometimes randomly caused your car to drive into oncoming traffic. But this wouldn’t be called a car accident because everyone knows seat belts CAN’T cause car accidents.

    Vaccines are like seat belts if seat belts had not one, but two government organizations that exist specifically to “market” and “recommend” their use.

    Vaccines are like seat belts if not wearing a seat belt and getting in a small fender bender caused ER staff to “assume” you have a worst case scenario and insisting on a spinal tap, MRI, tracheotomy, and a mandatory stay in the ICU.

    Vaccines are like seat belts if not wearing one caused people to accuse you of causing other people’s cars to lose control and thus killing innocent children.

    For the record, I try not to be one of those people who hate Paul Offit (or anyone for that matter).  I’ve read his story and know he has good reasons for being a vaccine advocate.  He is clearly not an evil man out to harm children.  I respect his right to vaccinate.  Where I strongly disagree with him is that he does not believe in vaccine exemption.  He thinks it should be mandated and forced.  He does not believe in informed consent or parental choice.  That sickens me way more than his belief in vaccines.

    I feel the same about parents who vaccinate.  I’m not anti-vax in the sense that I think everyone should not vax.  It is a difficult decision.  It is balancing the risks of now vs. the risks of what if and that is a soul searching experience.  I don’t, however, have a shred of respect for someone that thinks their choice is the only one and I (or my baby) should be forcibly vaccinated and/or quarantined.  When I hear people call exemptions “so called” as in “the so called religious exemption” that is truly insulting.  It implies that I’m hiding behind a shield to excuse my choice.  My choice doesn’t need an excuse.

    So, I really didn’t want to talk about the Swine Flu vax because it is a no-brainer for me.  I certainly won’t be getting it for me or my family.  This decision isn’t driven by fear of the vaccine or the belief that the swine flu is some type of government conspiracy.  I’m not getting the vaccine for the same reason I don’t wear a helmet (or bubble wrap) everywhere I go.  A helmet could save me in an accident or slip and fall, right?  I choose to live out from under the cloud of what could happen and live with what is happening.

    Right now?  There is a particularly virulent flu going around.  I’m living in the now by washing my hands (but not too much), coughing in my elbow, eating right, getting enough sleep, taking my vitamins (including a healthy dose of D), etc.  I’m not worried enough to make extreme choices like never leaving the house, wearing a face mask, not letting my kids eat their Halloween candy*, and injecting pathogens int my body.

    *obviously, my 8 month old isn’t getting any candy anyways.

    Gardasil:”The rate of serious adverse events is greater than the incidence rate of cervical cancer.”

    All I have to say is: Duh.

    I saw this one coming when I first reviewed this horrible “cancer vaccine.

    Gardasil Researcher Drops A Bombshell

    Harper: Controversal Drug Will Do Little To Reduce Cervical Cancer Rates

    Dr. Diane Harper, lead researcher in the development of two human papilloma virus vaccines, Gardasil and Cervarix, said the controversial drugs will do little to reduce cervical cancer rates and, even though they’re being recommended for girls as young as nine, there have been no efficacy trials in children under the age of 15.

    At the time, which was at the height of Merck’s controversial drive to have the vaccine mandated in schools, Dr. Harper remained steadfastly opposed to the idea and said she had been trying for months to convince major television and print media about her concerns, “but no one will print it.”

    “It is silly to mandate vaccination of 11 to 12 year old girls,” she said at the time. “There also is not enough evidence gathered on side effects to know that safety is not an issue.”

    When asked why she was speaking out, she said: “I want to be able to sleep with myself when I go to bed at night.”

    Since the drug’s introduction in 2006, the public has been learning many of these facts the hard way. To date, 15,037 girls have officially reported adverse side effects from Gardasil to the Vaccine Adverse Event Reporting System (VAERS). These adverse reactions include Guilliane Barre, lupus, seizures, paralysis, blood clots, brain inflammation and many others. The CDC acknowledges that there have been 44 reported deaths.

    Why would anyone get this for themselves let alone their young daughter?  I want to be “one less” source of revenue for Merck to recover from their Vioxx scandal, thank you very much.

    Vaccines 101

    I’ve posted before about my views on vaccines but I’ve never started at the beginning. I had various reasons why vaccines felt wrong to me before I started my research. But, where do you start if you’ve never even thought of questioning vaccines? This is my guide for learning about your choices with special thanks to Emmeline II over at Mothering.com

    Mandatory?

    The first thing I want everyone to know, whether you choose to vaccinate or not, is that it is a choice! Since we have an opt-out instead of an opt-in system the default is vaccination and providers can sometimes wrongly make you feel that vaccines are mandatory. Also, school districts actually refer to them as mandatory vaccinations leading parents to believe they are completely compulsory. Most of the time this isn’t malicious sometimes even the schools aren’t aware of the law. So here goes: Vaccinations are NOT compulsory. This is a free country and you can not be forced to inject anything into yourself or your child. In all 50 states you can legally waive the requirement for vaccination. There are 3 types of exemptions:

    1. medical – for children who can not receive a vaccine for health reasons. For example, the flu vax is made with eggs so those allergic to eggs can not receive it. The Hep B vax is made with yeast.
    2. religious – vaccination is against your religious beliefs (each state has a different level of “proof” for this).
    3. philosophical – vaccination is against your sincerely held beliefs.

    You can find the laws for you state here.

    Now What?

    Ok, so you know you don’t have to vaccinate but should you?  This is the harder question to answer and each person needs to make the decision for themselves.  Instead of making a blanket decision to vax or not think of each vaccine in turn and answer these questions (from Emmeline II):

    1. Name of the disease
    2. Description of the disease
    3. Length of time from initial infection to end of all symptoms
    4. Infectious period (how long are you contagious?)
    5. Normal symptoms of the disease
    6. Known serious consequences of the disease
    7. Proportion of persons infected developing serious consequences
    8. Transmission route of the disease
    9. Prevalence of the disease
    10. Treatments of the disease and efficacy of those treatments
    11. Relevant research about the disease
    12. Name of the vaccine
    13. Company that makes the vaccine
    14. Contents of the vaccine
    14A. The significance of whether or not the vaccine is live
    15. History of development of the vaccine
    16. Known side-effects of the vaccine and rate of incidence of those side-effects
    17. Possible side-effects not yet acknowledged by the vaccine maker
    18. Relevant research into the vaccine
    19. How effective is the vaccine at preventing the disease?
    20.What is the vaccine meant to do? (Many vaccines are not meant to prevent infection or transmission).
    21.Number of cases reported each year.
    22.Number of deaths reported each year from the vaccine and natural disease.

    Wow!  So where can you find this information?  Here are some sources to help you out:

    Inside Vaccines – A great source for disease by disease research and numbers.  Considered anti-vax in bias.

    Vaccines-The Risks, the Benefits, the Choices  By Sherri J. Tenpenny.  Considered anti-vax in bias.

    Mortality and Morbidity Weekly Report – this is the Center for Disease Control and Prevention (CDC) weekly report of disease prevalence.  You can download the current and back issues and you can search for a specific topic.  (note, the CDC’s website has what we call in the industry a “craptacular” search function so here’s a tip:  use Google!  You can enter your search terms and then restrict your search with site:www.cdc.gov/mmwr  Try it:  chicken pox site:www.cdc.gov/mmwr ).  This is considered pro-vax in bias.

    The CDC Pink Book – This is the CDC’s book of Epidemiology and Prevention of Vaccine Preventable Diseases.  A great source for information on disease statistics.  This is considered pro-vax in bias.

    Vaccine Package Inserts – Don’t take any other sites’ word for it.  Read the package insert to see what is in the vaccine and what side effects have been found.  The vaccine manufacturers tend to be more inclusive with their side effects due to threat of law suits.

    National Vaccine Information Center – A great resource for vaccine facts and advocacy.  Considered anti-vax in bias.  Also, check out their 8 questions to ask:

    1. Is my child sick right now?
    2. Has my child had a bad reaction to a vaccination before?
    3. Does my child have a personal or family history of:
    4. vaccine reactions convulsions or neurological disorders severe allergies immune system disorders

    5. Do I know if my child is at high risk of reacting?
    6. Do I know how to identify a vaccine reaction?
    7. Do I know how to report a vaccine reaction?
    8. Do I know the vaccine manufacturer’s name and lot number?
    9. Do I know I have a choice?

    Here are two other videos I found to be very helpful.  The first is a speech and the second is a documentary.  I strongly recommend the second if you want to introduce someone to the topic but think they will glaze over at a scientific slant.  These are considered anti-vax in bias.:

    Are Vaccines Safe? by Mary Tocco
    Vaccine Nation a documentary by Gary Null

    Land of the Free? Someone Forgot to Tell 1/2 of These People

    There is a thread on a very popular parenting message board entitled “Should non-vaccinated kids be allowed to attend public school? “

    I couldn’t even believe the question but I was certainly not prepared for the results of the poll.   Yes, 53% of respondents thought that children whose parents conscientiously object to vaccination should be banned from attending public schools.  I will avoid the obvious problem this addresses about public school in the first place (these people are greatly lacking in an American History or Government education with their blatant lack of understanding of important concepts like “individual freedom,” “religious liberty,” and “public education.”).  The bigger problem is the lack of understanding about vaccines and the diseases they are meant to prevent.

    On a positive note, many of the comments on the thread are in favor of freedom of choice to vax (and yet the poll tips the other way – did the “no” people not have anything intelligent to say?).  But, there are plenty of stupid comments like “you have the right to freely practice your religion, but that right stops where my child’s right to a safe school environment begins.”

    If you need a refresher on how non-vaccinated kids are not a threat to vaccinated kids…read this post.  I don’t judge people who choose to vaccinate but I whole heartedly believe in the freedom of choice in parenting (which applies to more than medical care, homeschooling for example).  If we don’t have the freedom of deciding what goes into our (or our childrens’) bodies then what freedom do we have?

    Vaccine Debate: Herd Immunity Fallacy

    Momversation.com currently has a discussion about vaccinations.   Here is the original video and my response.

    I agree that there is no evidence currently that vaccinations cause autsim. I also wouldn’t vaccinate my child for any reason.
    Autism seems to always been seen as the reason parents don’t vaccinate and I can tell you that, for me, it couldn’t be farther from the truth. The multitude of other reactions (Guillain-Barré, SIDS, Juvenile Diabetes, Rheumatoid Arthritis, anaphylactic shock, death, etc.) had a much larger impact on me. Also, I’m not inherently distrustful of the medical industry (I conceived through IVF so I LOVE modern medicine!) but when they are pushing a HepB vaccine on a 12 hour old infant their motives become suspect.
    It is frustrating to me that the vaccine debate swirls around Autism, MMR, and Jenny McCarthy. It is like this is a *new* problem! Have we forgotten Barbara Loe Fisher and her fight to get DTP off the market? It was killing kids and causing developmental disabilities in others and they’ve since changed it (to DTaP, the “a” being acelular). For some reason the media loves the Autism link – perhaps because it is so pervasive and not understood disorder? Regardless, it is the least of the problems with vaccines – so please research beyond Autism when you are exploring vaccines.
    I also wanted to point out a major flaw in the panelists discussion of non-vaxers. There is this persistent idea that vaccinating is a societal obligation and moral imperative. This theory stems from the thought that non-vaccinated children are relying on the “herd” to protect them from illness. Also, since some people can’t get vaccines for medical reasons that non-vaccinated children are posing a threat to them. There are several major flaws with this idea. the largest of which is children are only a minority of the human “herd” – what about the adult population that harbor NO IMMUNITY to illnesses because they have waned from vaccines and were never developed naturally through illness. Even the CDC shows grave numbers for adult vaccination.http://well.blogs.nytimes.com/2008/07/14/vaccinations-for-grown-ups/

    “only 2.1 percent of adults ages 18 to 64 are immunized against tetanus, diphtheria and whooping cough, the journal reports. A vaccine against shingles is recommended for all adults over 60, but only 1.9 percent of adults have been immunized.”

    How can the non-vaccinated children be responsible for the lack of eradication of these vaccine available diseases? If herd immunity requires 70-90% immunity levels, how can we pretend to have herd immunity?
    Second, if you believe that vaccine’s work, why are you worried about your vaccinated child? This doesn’t apply to those too young to be vaccinated and those who can not – however I’ve heard parents of vaccinated kids blame the non-vaccinated kids. Why aren’t they upset at the medical community because their vaccine didn’t work?
    Lastly, read up on what vaccines actually do. Many don’t prevent transmission of an disease but decrease the severity of the illness. Whooping Cough, for example, does not stop transmission. That means your vaccinated child can have the pathogen and pass it to others but may not have any symptoms or very light symptoms. If a baby or immuno-compromised person gets Pertussis how do we know it is a non-vaccinated person’s fault? Once again, why aren’t we railing at the medical community that these vaccines aren’t living up to their *miracle status*?

    I respect anyone’s decision to vaccinate or not vaccinate. Trust me, thinking that my child would be the one that got HepB from some freak accident and died kept me up late at night! It isn’t an easy decision but let’s protect everyone’s right to make an informed decision.

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