So I've hijacked my wife's outdated blog to respond to a comment made by a friend about vaccinating children. I posted a link on my facebook account to an article (http://www.bluntmoms.com/hey-non-vaccinators-youre-welcome/) and in response to this he stated the following:
"We haven't and won't vaccinate our kids, even though I would like to, simply because of all the combination vaccines and the adjuvants (like aluminium) and preservatives (like thimerosal). When BT was born I tried to get single dose vaccines and even contacted manufactures, but I kept getting laughed at. I am terrified that my kids might contract a disease preventable by vaccines and am also terrified that they could be carriers, but after years of research, this decision made the most sense to us. If I could do my PhD over again I would do it in biochemistry and start manufacturing safer more socially (less fiscally) responsible vaccines, because I do believe they work. Also, I didn't like the bluntmoms article you posted, it is written by a bully who uses scare tactics and not science to back up her argument. It took me nearly two hours to read all the comments and as a doctor you know how personal people take this issue. I do love reading the current research on this issue so please post some quality, scientific links on here so we can be educated and not scared into making informed decisions."
So here is my response... I've put it here instead of on facebook just because it would have been the longest post ever.
I understand your frustration. This is a hot topic and there is so much out there that it is so easy to get bogged down with conflicting information.
Firstly, why did I post a link to that blog? Obviously there is more then one way to present information/opinion. Depending on the person, the most effective way to get your point across will depend on whom you are talking to. In my experience there are three key ways in which we try to convey opinion:
1. Emotionally
2. Anecdotally
3. Scientifically
To explain this by example, the blog post I shared by the 'blunt mom' was an emotional argument. Although she did share some credible facts, her conclusion was based on guilt. 'I vaccinate my kids so you don't have to'. The anecdotal argument is 'my friend's child was vaccinated and then got really sick, so vaccines are bad' (The Jenny McCarthy approach). Both these methods are flawed, however they can still be extremely compelling in swaying public opinion. Finally there is a scientific argument founded on evidence-based medicine. Evidence-based medicine is a term used in medicine to describe research void of bias and emotion and rooted in LARGE sample randomized controlled trials combined for analysis and peer reviewed. When studies go through this difficult and rigorous format they are no longer opinion or well founded hypotheses. They are medical facts (e.g. MMR vaccine is not associated with autism). So back to why I posted the article when I've just stated that it is not evidence based. As I’ve already alluded to, just like we can present information in different ways, we also accept information in different ways. Many times when seeing parents who do not vaccinate their children in clinic they do not respond to scientific fact. Sometimes I have offered copies of published peer reviewed, evidenced-based research and attempted to share it. In my limited experience the majority ignore the evidence and are not even interested in taking a copy of the paper home to review on their own time. I've had parents site articles from researchers who draw conclusions from studies with six participants as fact, or mention a blog from a non-medical, non-expert but well articulated person as a reference. Basically some people don't respond to well founded evidence, but do much better with emotional/anecdotal arguments, so I shared such a blog post in the attempt that it could possibly effect someone in a way that, for whatever reason, evidence-based medicine just doesn't.
Now to your concerns. I'm the first to say that I don't have all the answers and I don't think the medical community at large has all the answers. There are still numerous studies and research that needs to be done. Heck we have been working on perfecting vaccines for over 60 years. There are valid concerns, which I will mention shortly, and there are celebrity/conspiracy theorists fuelled concerns, which have been proven to be false... autism! Lets talk about adjuvants, meaning agents that enhance the effect of the vaccine to cause immunity. You mentioned aluminum, but there are others as well. Recently there have been significant post marketing and/or case reports linking (notice I didn't say causing) adjuvants like aluminum and Guillain-Barre syndrome (GBS). GBS is a neurologic syndrome causing inflammatory neuropathy with progressive muscle weakness, which can lead to respiratory failure. Well crap, I hear that and say I am not vaccinating my child. What parent guardian would hear that and not cancel tomorrow’s vaccination appointment? What people don't look at is the incidence in these case reports. You see by law all cases of adverse events must be reported, even if there is uncertainty whether an adverse event is caused by the vaccine (just because B happens soon after A, does not mean that A caused B). So how many cases of GBS were seen? 77 cases in over 23 million vaccinations. After statistical analysis was applied to this there was shown to be an increase in 1.6 cases of GBS per 1,000,000 vaccinations. To put that in perspective if you vaccinated everyone in the province of Saskatchewan, 1 or 2 people would possible develop GBS. That is a very low risk. Now switching gears lets look at the history of Haemophilus Influenzae type b (Hib), whose vaccine contains adjuvants including aluminum. In 1985 1 in every 300 Canadian children under the age of 5 developed meningitis or other severe Hib infections. To put that in perspective, if we took the whole population of Saskatchewan again, 3333 people would have a life threatening meningitic infection or other serious Hib infection. Now, that number is relatively low as well, but still much more likely... exponentially more likely. By 1996 in Canada there were only 8 cases of meningitic Hib infections because a vaccine was created. That is why most non-immunized children are safe from this bacteria. It has been almost eradicated from the western world. Now if you feel that 'herd immunity' keeps your child safe and so you will not vaccinate him/her, then that is a whole other ethical dilemma, which I don't have the desire nor time to cover. I will say this though, if that is anyone’s reason then in my opinion they are ethically irresponsible and selfish.
In summary I think the other article I posted on facebook (http://www.abc.net.au/local/stories/2013/06/06/3776327.htm) sums up the argument I'm trying to make very clearly when the father of the boy stated "The mistake that we made was that we underestimated the diseases and we totally over-estimated the adverse reactions [to vaccines]". I don't think you are unfounded in worrying about adjuvants or preservatives. More research is being done and will continue to be done, especially when we as people voice our concerns, which you are, but in the last 60 plus years there has been millions of lives saved because of vaccinations and adverse outcomes are one in a million.
