[full of it]

Vaccines: A Novel

Posted in Uncategorized by susieyarbs on October 14, 2010

Vaccines vaccines vaccines.  I figured it’s time to compile my thoughts and random bits of research and make some actual decisions.  Most of my information comes from The Vaccine Book by Dr Robert Sears.  It is the most objective source of information I’ve come across, because, while he does give his opinion in a separate section following each vaccine analysis, he basically just took the information from the product inserts and translated them into english for us.  No hype, no propaganda.

When I look at each vaccine and consider whether or not to give it to my child, the first thing I consider is the disease itself.  Is it common?  Is it serious?  Is it treatable?  With a few of these (like varicella), that’s enough information for me to make a decision.  But for most of them I look at the whole picture (or as complete a picture as I can paint for myself).  So I’m going to go through each vaccine and try to break down my thoughts on each one.  And I’m sure this could look neater; forgive me, I’m a formatting idiot.

With each vaccine I’m taking into consideration that I will be exclusively breastfeeding and our child will not attend daycare, putting him/her in the lowest risk group for contracting any of these diseases.  So if it’s rare for the general population, then it’s really rare for our kid.

I also understand that most of these diseases are rare because we vaccinate against them.  I’m thankful that vaccines exist, they’ve saved generations from devastating diseases like smallpox and polio.  But I believe that we vaccinate against far too many diseases, some that aren’t even serious.  I think that once a disease is vaccine-preventable, we become more frightened of it.  We talk about measles outbreaks like it’s the bubonic plague, and while it no doubt sucks to have to measles, for most people we’re talking about a bad couple of weeks and that’s it.  Of course there are high risk groups, and here’s everyone’s cue to yell, “But you’re putting MY baby in danger!” but the fact of the matter is that there are risks to vaccinating as well as to not vaccinating, and anyone who tells you otherwise has either succumbed to propaganda and fear-mongering (there’s plenty on either side) or is outright lying to you.  When risks lie on both sides, it becomes a personal decision.  And, if your baby is vaccinated, you should have nothing to worry about, because that’s the whole point of a vaccination.  And if it’s under two months old, then I recommend breastfeeding and limiting contact with strange children.  And I promise that if my kid is sick I will keep him/her at home.

MMR

For this one I looked at each disease separately, then at the vaccine as a whole.

Measles:
-currently rare, 50-100 cases per year
-usually not serious (1 in 1,000 cases fatal)
possible disease complications are similar to side effects of the vaccine (this actually goes for mumps and rubella as well)

Mumps:
-also rare, ~250 cases per year
-not serious.  There was an outbreak in 2006 with about 3,000 cases — 20 were hospitalized and there were no deaths.  Most of these people were vaccinated; immunity wears off by adulthood.

Rubella:
CDC declared eradicated in 2005 with fewer than 20 cases per year.
-so mild it often goes unnoticed.  This portion of the vaccine is only still in use because rubella can cause birth defects if a pregnant woman catches it.  It’s suggested that women who want to get pregnant have their titers checked for immunity.

The rarity and mildness of each disease is enough to say no to this one.  Beyond that, the vaccine itself is highly controversial and has been in the spotlight a lot recently, mostly in connection with autism claims.  The vaccine contains some pretty gross ingredients – cow fetus serum, chick embryo proteins, and human albumin.  It has one of the more serious side effect profiles of the vaccines; 1 in 20 who receive it will experience some kind of mild reaction (fever, rash, body aches, malaise).  So we’ll pass on this one.

A quick, but serious digression — we all know that I believe my rheumatoid arthritis all began with the MMR vaccine I got as a baby.  Here is a quote from The Vaccine Book in the MMR section under the heading Chronic Arthritis:

“The product insert cites three research studies that have shown a 12 to 26 percent chance that teenage and adult women who get the MMR […] may experience significant arthritis for days, months, or, rarely, years.  Infants, children, and adult men don’t seem to have this risk.”

Now, this doesn’t exactly apply to me, per se.  I received the vaccine as an infant, not an adult.  There isn’t any more information in the paragraph, so I’m not sure if “don’t seem to have this risk” means they studied it and the risk isn’t there, or no one has studied it.  I also take it to mean that children who receive the vaccine don’t show signs of arthritis as children, but I doubt very highly that anyone has studied adults with arthritis in connection to childhood vaccines.  Probably because anyone who suggests it to their rheumatologist gets the same brush-off that I did.  He also doesn’t specify what type of arthritis, although since it seems temporary I doubt it’s RA.  Regardless – here’s a study, three of them, in fact, connecting the MMR to arthritis.  I don’t think I’m crazy after all.  Moving on.

Haemophilus Influenzae Type B (HIB vaccine)

-can be as mild as a cold or, rarely, can cause serious infection like pneumonia or meningitis
-rare: 25 (serious) cases per year, mostly in kids under 3
-serious: HIB meningitis has a 5% fatality rate, 25% chance of residual brain damage, difficult to diagnose in early stages.
-treatable: antibiotics usually prevent fatalities, but brain damage a big concern

This is a tough one, and I haven’t made up my mind on it yet.  On the one hand, it’s very rare.  On the other hand, it can be serious if it causes meningitis.  On that same hand, you probably have a greater chance of getting meningitis from a bacterium (or a virus) other than HIB.  The vaccine has a (relatively) safe side effect profile, and while one brand contains aluminum, there are two brands available that don’t have any controversial ingredients.  I’m on the fence.

Diphtheria, Tetanus and Pertussis (DTaP)

Diphtheria (remember Balto?!)
-throat infection, swelling can completely close off airways
-very rare, about 5 cases per year, often with many years passing between cases
-serious, 10% fatality rate. Treatment is available but sometimes too much damage has been done before treatment is given

Tetanus
-50-100 cases per year, almost all in adults
-serious, 15% fatality rate worldwide, but not usually an issue where medical care is available and wounds are kept clean

Pertussis
-respiratory infection, awful cough
-in kids older than 6 months and adults, usually just causes a crappy month (or two…) with an awful cough. Can be fatal in kids under 6 months.

I’m torn on this one as well.  Cross diphtheria off the list because it’s so rare, and forget about tetanus for an infant because it’s an adult disease, but pertussis…it’s a tricky one.  Pertussis can never be eradicated because neither the disease nor the vaccine provides lifelong immunity.  The disease very predictably cycles and peaks every 5 years or so, and we happen to be in one of those peaks right now.  While I do think that there’s a lot of fear-mongering going on, it is still a concern because I know that it’s out there and neither John nor I is probably immune, and thus could bring it home.  That being said, there have only been 26 cases in my county (last I checked).  In a county of almost 800,000.  That number could be underreported, but I doubt it since everyone is on “high alert” and peeing their pants every time there’s a new case.  Nine infants in California have died, all under 3 months of age, which is too young for them to have immunity from the vaccine anyway (8 of them, I believe, were hispanic…I have no idea what that could possibly mean, but it’s worth mentioning).  Full immunity isn’t acquired until 6 months (following the schedule), which happens to be the age at which pertussis deaths become unheard of, even among unvaccinated babies.  So – since the vaccine won’t necessarily prevent the disease until after the age at which it becomes not so serious, the question is really whether John or I should get it.  Oh, and since there currently isn’t an option to vaccinate an infant against pertussis only.  To get the pertussis vaccine is has to be in the form of the DTaP, and I’m completely uninterested in vaccinating against diphtheria or tetanus.  There’s a tetanus only shot for infants, there’s a diphtheria only shot for infants, there’s a DT combo, and there’s a pertussis only for adults, but that’s it.  I’m hesitant to get any vaccine myself because I already have a whacked out immune system.  And since John will be going back to work and commuting, and as far as I know has never had any issues with a vaccine, it might be worth looking into before the babe gets here.

Pneumococcal Disease (Pc)

-can be mild as a cold, serious as pneumonia, sepsis, or meningitis
-the bacteria is very common, most common cause of infant meningitis
-data reporting just began in 2001 when the vaccine was introduced, but it’s estimated that there are 10,000 severe cases in kids, 20-30,000 severe cases in adults
-treatable, but still serious
-only one brand of vaccine is available, and it contains aluminum

This is the one I’m most seriously leaning towards saying yes to, although probably delayed until 6 months at least.  It’s definitely not rare, even though we would be in the lowest risk category.  Meningitis is always serious.  The vaccine has a higher-than-average association with seizures, which would be the one thing that would keep me away from it.  The aluminum is a small concern as well, although it concerns me more when babies get several vaccines at once with it, and we’d be talking about one.

Hepatitis B

-can cause liver damage and sometimes liver failure
-is acquired through risky behavior — unprotected sex, infected needles, direct contact with body fluids

I doubt my baby will be having any unprotected sex or doing any needle drugs, so we’ll go ahead and pass.  If you’re wondering, the reason they vaccinate babies against this (starting usually the day they’re born), it’s because there is a minuscule chance that it could be transmitted via blood transfusion.  Minuscule.  I got this vaccine when I was 16 and working at a birth center and was around other people’s body fluids.  It probably makes sense for health care professionals.  Not for babies.  We’ll pass.

Rotavirus

-causes vomiting and diarrhea
-very common
-severe dehydration is a concern, but with access to medical care and IV fluids it’s not a big deal.  Mostly a big deal in the third world where dehydration/electrolyte imbalance isn’t as easily treatable.

Rotavirus is super common and can spread its way through schools and daycares like wildfire, but as an infant our babe will be at particularly low risk.  We also have access to medical care so any dehydration would be treatable.  This one isn’t for us.

Polio

Everyone knows polio is a devastating disease.  Thank goodness for vaccines, because we’ve managed to completely eradicate it in the western hemisphere.  There hasn’t been a case of polio in the US (that wasn’t caused by a vaccine) in my lifetime.  It is still vaccinated against because polio exists in pockets in other parts of the world (although we don’t still vaccinate against smallpox, which I believe also still exists in pockets…so…).  Anyway, I’m not going to vaccinate against a disease that doesn’t exist on my half of the globe.

Varicella (chicken pox)

Chicken pox is a nuisance disease.  It’s fatal in 1 in 65,000 cases.  I’m actually quite concerned that we are vaccinating against it.  No one knows yet how long the vaccine will last.  It’s entirely possible that when this first wave of kids to have been vaccinated get to be about 60 we’ll have a shingles epidemic.  I’ve also heard that getting chicken pox gives us lifelong immunity, but it could be due to the fact that most of us get a “booster” by being exposed to it multiple times in adulthood.  If I’m not getting my boosters because the kids around me are no longer getting the disease, am I going to get shingles?  Then I’m sure there would be an adult version of the vaccine, and everyone would be advised to get it when they’re 50 to ward off shingles, and we’ll have a vaccine solution to a vaccine problem.  So no, we won’t be getting the varicella vaccine.  But if we hear a kid in the neighborhood has chicken pox, we might go hang out over at their house for a day 🙂

Hepatitis A

-when kids get it, the probably won’t even act sick.  30% of kids under 6 act sick.
-teens and adults can get bad intestinal symptoms, but virtually all recover fine

This vaccine wasn’t routinely given to kids until 2006, and is given only as an effort to eradicate the disease.  Why?  Who knows.  Pass.

Flu

No.  It’s experimental every single year.  Educated guesses are made as to which flu strains will be active in the upcoming season, and safety studies are done very rapidly.  And depending on which brand you get, it can contain mercury (so when you hear that vaccines don’t even have mercury anymore, it’s not the case).  One pediatrician we interviewed told us he wouldn’t get it if he wasn’t a medical professional.  And, rumor has it that the neurologists at one Texas hospital aren’t getting it because it increases the risk of Alzheimer’s.  Don’t know whether they were talking about this year’s flu vaccine, all flu vaccines, or all vaccines, but I’ll pass on it either way.

So there they are, my reasons for passing on just about all of the vaccines in the schedule.  I’m sure there are folks who could look at the exact same literature and make totally different conclusions, and that’s fine.

Now I need a nap.

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