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Immunizations

Agatha M. Thrash, M.D.
Preventive Medicine

Problems with Vaccines

While immunizations have been successfully used for many decades to control infectious disease in the world population, they are not entirely without ill effects or risks. Part of these ill effects are due to inadequacies of the vaccines themselves, as the following items attest:

  • DPT vaccination was followed by 4 deaths that occurred within 24 hours after the receipt of a vaccine in 1978-1979, compared with 2 deaths within 24 hours after DPT vaccination in the earlier 8 month period in Tennessee.
  • A scientific "scare" occurred in 1960. It was discovered that during the previous five years, millions of school children had been inoculated with polio vaccine that was contaminated with SV40 (a virus that causes cancer in hamsters), present in the monkey cell cultures used to produce the vaccine. To the present time, SV40 has not caused any known harm.

How Immune State Is Achieved

To achieve immunization, we are dependent on a proper reaction of the immune mechanism of the body. The immune mechanism is composed of a large number of different, interacting, usually related structures of the body including lymph nodes, bone marrow, liver, spleen, reticuloendothelial system, and other structures scattered throughout the body, from the skin to the lungs.

Among the substances produced to help fight germs are blood proteins, opsonins, complement, antibodies, various globulins, etc. To get ready for each factor to fill its role, an amazing array of steps is required. As an example, "complement" is a cascade of complex protein interactions in which the cell membranes are chiefly involved. Complement is composed of numerous separate chemicals which activate an antibody, release histamine, and cause eventual breakdown of germs. There is evidence that complement may turn and work against us if the immune system gets confused, as in the so-called hypersensitivity diseases such as rheumatoid arthritis, lupus erythematosus, and glomerulonephritis. Some authorities believe that it is possible that routine immunizations may play a part in the confusing of the immune system that leads to this type of disease.

Reactions to Immunizations

Dr. Howard M. Temin, who won the 1975 Nobel Prize in Medicine said, "When you manipulate the immune system, it is not easy to predict what will happen ... It might take an entire lifetime to find out what the anticancer vaccine had wrought." Varied persons or projects take credit for the virtual disappearance of some epidemic diseases such as smallpox, diphtheria, polio, etc. It could be that at least a part of the reduction in these diseases is similar to the swindling of cholera, plague, leprosy, swine flu, tuberculosis, etc. The decline of all these diseases was concurrent with extensive environmental improvements.

Polio had apparently started its decline a while before the Salk Vaccine was introduced. It is widely believed that polio vaccine is "one of the most effective vaccines ever devised." The first documented death in a fully immunized person was reported in an 11-year-old boy who died in Ohio in 1978, and millions of polio vaccines have been given since the beginning of polio immunization.

Some manufacturers have discontinued the production of polio virus, measles, and DPT vaccines, because of concern over their liability for reactions which may be delayed in their appearance. It is believed by some that suppression of the immune system by vaccinations could leave us vulnerable to other infections or conditions such as cancer. While the serious nervous system disorder, Guillain-Barré syndrome, may appear spontaneously, it may also follow influenza immunization as well as minor respiratory and intestinal infections. One case of Guillain-Barré syndrome occurs among each 100,000 vaccine recipients. The swine flu vaccinations in 1976 were productive of many cases of this neurologic disorder. It is usually expected that five percent of young children routinely immunized will develop febrile seizures. Vaccines are generally used for polio, measles, mumps, rubella, diphtheria, tetanus, and pertussis.

Smallpox

Smallpox vaccination was once used as universally as those listed above, but the mandatory smallpox vaccine rule has been relaxed because of the world-wide reduction, possibly even the eradication of smallpox. For decades, there has been little chance of getting smallpox; yet, smallpox vaccinations were required for entering many schools and many countries. Mexico required vaccinations from most countries except the United States. The bad reactions to the vaccine were reported to the Center for Disease Control almost on a weekly basis, according to David Miller, a CDC spokesman. He stated, "People are still dying from being stupidly vaccinated." School enrollment vaccinations were abandoned in 1971. In 1968, there were 9 deaths, 16 developing encephalitis, 11 with vaccinia necrosum and 126 who developed eczema vaccinatum. These were called "minimum estimates" and were from 5.6 million primary vaccines and about 8.6 million repeat vaccinations.

Most adverse reactions to immunizations are not publicized. The serious reactions to smallpox vaccinations were not generally known until smallpox vaccine began to be discontinued in 1971, and then actively campaigned against in the late 1970s. At that time, the ill-effects were publicized.

  • Smallpox vaccine, a live virus vaccine, is contraindicated in persons with malignancies of the blood-forming organs or in persons on immunosuppressive therapy, and in pregnant women.
  • Smallpox vaccine should not be used for fever blister or other herpetic infections, as there has been no demonstration of effectiveness and danger has been proven in this therapy.
  • The military was advised by the Center for Disease Control to discourage smallpox vaccination of dependents. Travelers should note that most international regulations do not now require it.
  • Vaccinia, a disease resembling smallpox occurring in individuals who are vaccinated, can occur in babies of mothers who are vaccinated.
  • Occasionally a vaccinations scar develops a malignancy in it. Apparently there is a fixation of virus or toxic material at the site of the vaccination, which develops into a skin cancer.

Even though smallpox vaccinations of school children was discontinued in 1971, and of U.S. hospital employees in 1976, 4.4 million doses of smallpox vaccination were distributed in the U.S. during 1978, clearly a useless and dangerous procedure.

Vaccinia antibodies have been found in the cerebrospinal fluid of 30% of patients with multiple sclerosis. This seriously implicates the vaccinia virus which was used to immunize individuals against smallpox. Measles virus antibodies had previously been described as being elevated in the cerebrospinal fluid of patients with multiple sclerosis.

Measles

Before live measles vaccines were introduced in 1963, the yearly measles toll in the U.S. had reached about 4 million cases by estimate, with about 4,000 cases of measles encephalitis, and 400 to 500 measles-associated deaths. Occasional children were left mentally retarded, deaf, or with visual defects. During the first three years that measles vaccination was available, 15 million were immunized, and the number of cases of measles dropped by 50%. By 1968, the number of cases of measles actually reported was 22,000 (the number actually reported to the Center for Disease Control when the estimate was 4 million cases yearly is not given). With the dropping of state supported vaccination efforts, the incidence of reported measles went up to 47,000 cases in 1970 and 75,000 cases in 1971. Whether this variation represents a natural rhythm of the disease, or is the result of fewer vaccinations, has not been elucidated.

In 1973, 25 to 30 children died from measles and its complications. If one figures out the death rate, there was one death in every 3,000 cases, a marked increase in the death rate from measles. Either the number of complications or the virulence of the virus increased in 8 years. The Center for Disease Control records one death from every 1,000 reported cases of measles.

About one million cases of measles occurred in 1977. Children about one year of age have a high rate of susceptibility, followed by a decrease during the preschool years, rising again at about 6 years of age.

An unexpectedly high incidence of clinical disease occurred in children who had received live measles vaccine during one measles epidemic. Apparently, this was vaccination failure, a condition much more common in children immunized before their first birthday. Infants immunized with measles vaccine under the age of 12 months may simply fail to develop immunity. Only infants older than one year should be given the measles vaccine. About half of the infants given the vaccine before the age of 12 months show complete failure to achieve immunity.

Dr. Albert Cook of Long Island College Hospital in Brooklyn, New York has found evidence that multiple sclerosis may be caused by a persistent measles infection in the small intestine. Childhood measles may get a foothold in the small intestine, and, because of a malfunction of the body's immune system, be in a permanent stronghold. Because live measles vaccine may do the same thing, Dr. Cook calls for further study on this possibility.

Other Diseases

Diphtheria in the U.S. has declined from 350,000 cases per year in the 1920s to approximately 200 to 300 cases in recent years. There were estimated to be 100,000 cases per year of whooping cough in the 1940s and now only about 2,000 cases.

It is impossible to predict what disease will do in a community. Influenza epidemics have been predicted and have failed to materialize. In January-February, 1976, a swine flu epidemic was predicted and Congress appropriated $135 million to effect widespread immunizations. The epidemic never occurred. Twenty million deaths had occurred from swine flu pandemic in 1918-1919, including an estimated 584,000 in the United States. Even without vaccination, the swine flu has been rarely observed in man in recent decades and then apparently only in persons who had direct contact with swine. There have been no known instances of human-to-human transmission of the disease since the 1930s. We do not understand what causes the virulence of a disease to wax and wane. Many infectious diseases have shown this pattern: plague, tuberculosis, whooping cough, and possibly polio.

Whooping Cough

There is still a controversy over the safety and efficacy of the pertussis vaccine. The vaccine's toxicity may have contributed to declining immunization rates. Some experts feel that impoverished living conditions are more responsible for the spread of whooping cough than failure to vaccinate. Of 85 children vaccinated in Wales in 1978, 46 or more developed whooping cough. Among 144 children involved in an outbreak of pertussis in 1977 in Walls, Shetland, the rate of infection was as great in those who had been immunized as among those not immunized. In 1974, the pertussis immunization had been discontinued in Walls, yet the incidence during the outbreak was as great in those born before 1974 as those born later. One child began having convulsions on the night of his second pertussis immunization (in 1969 and required antiepileptic treatment) until 1976, yet he developed pertussis in the 1977 outbreak.

Also being discussed is the particular validity of the pertussis in the DPT series. From 1967 to 1974, an annual average of 227,000 were given pertussis vaccine in Great Britain. Four percent got moderate reactions such as unusual crying, and about 2% severe symptoms. The symptoms might persist and result in permanent paralysis, blindness, deafness, and epilepsy.

About three-fourths of whooping cough deaths typically occur among children less than one year old. Whooping cough vaccinations may be surprisingly severe in a teenager or adult, although not in an infant or young child.

Complications with pertussis vaccination include febrile seizures, hyperirritability, and inconsolable crying beginning two hours after vaccination, and continuing as long as 24 hours. Only temporary immunity is achieved with pertussis, and adults who had been immunized as children may lose their immunity later and contract whooping cough from exposure to infected children.

Chickenpox and Shingles

There is a vaccine for chickenpox and shingles. The hazards of the vaccine have not been elucidated, and three possible hazards are considered: 1) The vaccine could cause shingles, and it may take decades to find out it will. In naturally occurring chickenpox, shingles (herpes zoster) occurs decades later, usually after the person is 65 years of age. Shingles is usually a much worse disease than chickenpox, and the vaccine could cause an even worse form of shingles. 2) The immunity may not be long-lasting, but the natural disease may be contracted at a time in life when the complications, particularly the central nervous system complications of encephalitis, etc., could be much worse, resulting in disease of such severity as to leave the individual maimed. 3) Since chickenpox can be fatal in weakened children, these receiving steroids, children who are congenitally deformed in some way, or children who have malignant disease, it is a question to whether the live, attenuated virus might not be capable of the same type of behavior in weakened children.

Recommendations

There is no sound basis for assuming that every infant or child must be inoculated with every available vaccine. On the contrary, there may be valid reasons for omitting any or all available antigens. The incidence of vaccine-induced morbidity and mortality has increased. The immune mechanism of infants is immature and may react improperly in certain babies. It would seem wise to breastfeed infants to at least the age of one year, during which time exposure of the baby to disease carriers should be minimized. Determined by the obligatory exposure of the infant, the immunizations should be delayed at any rate until the child is 6-12 months of age, rather than 4-8 weeks which is commonly practiced, in order that the immune mechanism can mature somewhat.

We do not have hard and fast recommendations on immunizations. We believe that the circumstances dictate what course one should take. Some parents are conscientiously opposed to immunizations on religious grounds. Others have a fear of immunizations because of an unfortunate calamity due to a vaccine. Some infants may have prohibiting physical conditions. Certainly one should not feel that immunizations, because they are widely used, are therefore completely without risk. On the other hand, unless one is in a position that he can have above ordinary facilities for sanitation, can wage a successful warfare against pollution, can keep his children out of public streams, lakes, and pools, and enrolled in a very small or home school, it may be better to immunize. With the simple remedies, it is often possible to minimize the severity of the childhood diseases. If one does not use animal products in the diet nor expose children to pets, a large source of exposure is eliminated.The parent should bear in mind that even though it is likely that polio is a much milder disease than we saw in the decades between 1930-1950, prior to 1950 as many as 20,000 cases annually of polio were estimated to occur. In 1975, there were but 8 cases of paralytic polio throughout the U.S. In February, 1979, there was a report of 6 cases of paralytic polio in Canada in a group who had refused vaccination "for personal beliefs." Four of the cases occurred in one family.

On the other hand, we read of cases of joint pain caused by rubella vaccines, atypical measles developing from killed virus vaccines, and acute hemolytic anemia related to DPT vaccination.

The person contemplating vaccinations either for himself or for his children should be aware that there are some risks involved in vaccinations, but there are also risks in being unimmunized. The risks should be weighed and an intelligent decision made, based on a study of circumstances.

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