Unencumbered by facts: what upsets me most about the anti-vaccine movement

Recently I watched a clip of Andrew Wakefield being interviewed on Good Morning America, and it gave me the chills.

Andrew Wakefield, if you haven’t heard of him, is the guy who pretty much singlehandedly scared thousands of parents away from the MMR vaccine with a study he published in the Lancet linking the vaccine with autism. The study has since been retracted, something journals almost never do, after it was discovered that data in it was falsified. Not only that, Wakefield lost his medical license.

But is he backing down? No way. On the contrary: he is suing the British Medical Journal (from Texas) for defamation. And he is still defending his findings. 

It was stunning to watch. George Stephanopoulos, who was interviewing him, pointed out that his colleagues who worked with him had backed away from the study. Wakefield said they hadn’t. Stephanopoulos pointed out that no scientist had been able to replicate the study; Wakefield said it wasn’t true, that his study had been replicated. He sat there and said none of it was true.

How do you fight someone who feels free to ignore facts?

Not that I want to fight him. For me, this isn’t about fighting. I’m not on a pro-vaccine crusade. My only crusade as a pediatrician is to keep my patients healthy—and vaccines are part of what I use to do just that.

That’s what gets me angriest about the anti-vaccine rhetoric: those of us doctors who think vaccines are a good idea, if we aren’t portrayed as out to hurt children, are portrayed as brainwashed by pharmaceutical companies or the government. As if being anti-vaccine was somehow more free or enlightened.

In medical school, we are taught to make decisions based on evidence, on solid science. We are taught to be aware of the risks of anything we do (primum non nocere, first do no harm), and weigh those risks against the benefits. Well, the science abundantly shows that immunizations are both effective and safe. Yes, side effects are possible and sometimes vaccines don’t work—that’s true of any medical treatment. That’s why we have a whole system for collecting information about any problems with vaccines—it was that system that caught problems with the first rotavirus vaccine, and we stopped giving it and made a better one. We take immunizations as seriously as we take any other medical treatment, and work diligently to be sure we are doing the right thing, always.

“My only crusade as a pediatrician is to keep my patients healthy—and vaccines are part of what I use to do just that.”

We stick to the facts. But people like Andrew Wakefield don’t, and as Seth Mnookin writes about in his book Panic Virus, it doesn’t take much to scare parents. Some guy like Wakefield gets up and says authoritatively, as he did in the interview I watched, that the vaccine system in the United States isn’t safe, and what responsible parent wouldn’t be at least a little worried? And somehow, people like Wakefield and Jenny McCarthy keep getting airtime and headlines (I guess I’m contributing to that myself now), while the thoughtful people like Paul Offit get drowned out.

I have been at this doctoring stuff for more than 20 years, long enough to have seen kids with meningitis and epiglottitis from haemophilus influenzae—we don’t see that anymore. I’ve seen kids die of pneumococcal disease and chickenpox—we immunize against both now. I’m not quite old enough to have seen polio—but isn’t that amazing enough for people, that in the U.S. we have wiped out a disease that could paralyze you forever? It’s really clear that vaccines save lives.

As for the argument that getting the illness gives you stronger immunity—this comes up a lot with chickenpox—that may be true, but the illnesses we immunize against have real risks. Kids with chickenpox might have a mild case and be fine, but they could also end up with infected blisters (some of those infections are very serious), dehydration, pneumonia, or a brain infection. Is that a chance you’d really want to take with your child?

At the end of the interview, Wakefield encouraged parents to get educated, and to read about immunizations. He even suggested the CDC website. He said, emphatically, that there are two sides to the story.

I couldn’t agree more. But just one of them is grounded in facts.




144 thoughts on “Unencumbered by facts: what upsets me most about the anti-vaccine movement

  1. My father contracted polio as a toddler more than 80 years ago and has lived with the effects of the disease since then.  He is one of the lucky ones — he survived.  He was treated at Children’s Hospital Boston beginning in the late 1920s.  Parents today usually don’t know anyone who has ever suffered from these diseases so they think that the risks are exaggerated.  I applaud your pro-vaccine stance and wish more people would be vocal about the craziness from the anti-vaccine crowd.   

  2. Wonderful post, Claire! Thank you again for being an advocate for children by speaking the truth about vaccines. One question though…wasn’t Wakefield’s “study” published in the Lancet not the BMJ.   I believe thsi is the retracted citation: 
    Wakefield AJ, Murch SH, Anthony A, Linnell, Casson DM, Malik M, et al. Ileal lymphoid nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children [retracted].Lancet1998;351:637-41

  3. Thank you Dr. McCarthy, and I agree with your statements. It is frightening to know that many parents in the US are choosing not to vaccinate. Communicable diseases are only a jet flight away, as evidenced by the measles out break recently. We should never wish to go back to the days when childhood diseases were deadly or had severe consequences. When you vaccinate your child you not only protect them, but also a pregnant woman who may be in their lives, infants under 6 months old who are not fully immunized, and persons of all ages who may need to be on steroids or chemotherapy whose immune systems are compromised. Thank you again for your timely article.   

  4. If vaccines are so safe, why can’t I SUE, for a severe reaction or death? Why don’t doctors hand out the ingredient list, which by law I’m entitled to and most people don’t know they can ask (on the CDC website it says you can).  I don’t argue that they do save lives, but if and when they do KILL AND CAUSE SEVERE REACTION, the parent should have the right to sue the manufacture and as of 1986 the manufactures have a no-fault clause (which just screams unsafe) 250,000 dollar does not equal what a life is worth, a life is worth a heck of a lot more….
    .  and how can a parent make a true informed decision without knowing the actual ingredients?  And research that is funded by the manufacture or the gov’t who gets major kickbacks in elections, is hardly evidence that the vaccinations are safe.  A little incentive there, I would say….I do believe that vaccinations safe lives, we’ve come along way in the last century but I also believe a parent has the right to not vaccinate.As of this year, we will no longer vaccinate.  My son was injured by a vaccination and no it wasn’t worth it….not to me, his life is more valuable to me than anyone on this earth…..and pediatricians tend to refuse to report vaccination injuries.  

    1. You can sue. Ever heard of the Vaccine Injuries Court? The plaintiff need only demonstrate a correlation (which is not causation) and the court awards damages at a capped amount. That is why the damages are capped – because the amount of scientific evidence to demonstrate causation is impractical for a plaintiff to demonstrate but the courts only demand a correlation. Which means that companies that produce vaccines, which are not a tremendous revenue generator, and are sued for prodigious amounts will stop producing them. And vaccination rates will drop. And diseases with low incidents will pop up again. Which means your child will get measles, mumps, rubella, pertussis, etc. And probably die or be tremendously injured AND pass on the disease to other people. You have the LUXURY of not vaccinating because there is herd immunity that grants your children protection. But in a world without vaccines, your decision would be tantamount to criminal neglect of your children. 

      Herd immunity is not designed for those who indulge in conspiracy theories and don’t understand that causation and correlation are not the same thing (a reason why a responsible pediatrician would not attribute a disorder to a vaccine – their medical training trumps your intuition and they understand that temporally related events are not necessarily related to each other [after all, global terrorism and global global warming both started up in public awareness at around the same time so does that  mean one causes the other]). Herd immunity is intended to protect those who cannot me immunized for legitimate reasons (HIV/AIDS, elderly, immunocompromised, etc.).

      And, finally, you bring up the whole “funded by the companies and government” conspiracy gambit. That might work…if researchers weren’t required to disclose all possible conflicts of interests. They tell you up front where they got the funding for those projects. Those that do not are ripped apart. If you don’t like where they got the funding, where do you think they should get it from? An organization like NVIC or Age of Autism, both of which have very clear biases from the get go? The NIC and NSF only goals are the promotion of science and truth, not some hocus-pocus, mumbo jumbo made up by charlatans and the legitimately concerned but misguided and scientifically illiterate parents who lend them an ear. Perhaps you’d like to bring up the fact that Wakefield did not disclose that he was paid by lawyers of a plaintiff to demonstrate that vaccines cause injuries and that he had a patent for an alternate vaccine to the one that he was studying. And, in order to grease the wheels, he abused children, bribed them and their parents, and falsified and cherry picked data in order to get his results. And that he has been stricken from the registry in the UK and his study retracted based on the fact that it is on public record that he is a fraud. Alas, so easy to ignore your own stance’s faults and pick on the other team’s.

      P.S. No scientist would EVER say that vaccines are 100% safe. There is a very small risk of possible injuries (think 0.00001%). But without vaccines, the risk of diseases that harm children and adults is very high.

    2. My son, who could not be vaccinated for medical reasons, got pertussis as a result of an outbreak caused by a fall in vaccination rates. He suffered for weeks, it was horrible to watch and I will never forget it. He was lucky, as several children died in the same outbreak. If your son was really injured by a vaccine (how can you be so sure?), you can go to the Vaccine Court which has much lower burden of proof than suing the manufacturer would have.

      1. Your views of the Vaccine Court are very skewed.  It is becoming an uphill battle just to be SEEN by the court let alone overcoming the severe burden of proof that is on the parents of the injured child. Add to this the drastic changes in the compensation chart and it has become much harder for children killed or injured by vaccines to be compensated.

        1. “Your views of the Vaccine Court are very skewed.  It is becoming an
          uphill battle just to be SEEN by the court let alone overcoming the
          severe burden of proof that is on the parents of the injured child. Add
          to this the drastic changes in the compensation chart and it has become
          much harder for children killed or injured by vaccines to be

          @ Paige, I don’t know where you are getting your information from so perhaps you would like to post your source(s).  Anyone can file an NVICP claim and as long as it’s in good faith (almost all are) then the petitioner’s legal fees are compensated win or lose.  The burden of proof is also much lower than in civil court and you must only demonstrate that the vaccine, “more likely than not” contributed to the claimed injury.

        2. That ‘severe’ burden of proof is much less than would be required if you were to get your wish and have to go through ordinary civil courts to sue for damages.  Changes to the compensation lists happen because of research and changes in the underlying knowledge about various vaccines and reactions to them.

  5. Great blog. It is an international disease, this bold acceptance of non-evidence based claims. Here in Asutralia we have the same debate raging. On one side, us doctors with clear peer-reviewed science and on the other a very loud, very small minority who have conspiracy theories.

    1. “On one side, us doctors with clear peer-reviewed science and on the
      other a very loud, very small minority who have conspiracy theories.”

      Unfortunately, when faced with those who have no compunction against lying, all the peer-reviewed science in the world won’t do any good.  It’s the creation/evolution debate all over again.  The creationist stands up and rattles off a list of factually incorrect dribble, while the scientist’s jaw drops to the floor in disbelief that anyone could say anything so clearly incorrect.  The science side either has to ignore it, leaving it unaddressed, or try to refute it, and come of as on the defensive.  Scientists end up being put in a bad position merely as a result of not having to lie.

      Sometimes you wish it would be as simple as Joe Pesci’s opening remarks in My Cousin Vinny:  “Everything that guy just said is bull***.  Thank you.”

  6. Thanks for the well written post. Too much fear and gullibility and too little scientific knowledge on the anti-vaccine side. Causation does not equal correlation is a mantra for science.

    Vaccination is one of biggest factors in reducing childhood disease and death. Its success has been one of the main factors against it. People forget the horrors, don’t know anyone who was killed or maimed by vaccine preventable disease. Their short memories and lack of empathy has contributed to the re-emergence of these dreaded diseases.

    Use all the purell you like, wash often, eat good food, get fresh air, but don’t forget the vaccinations; They are the most potent weapons in the arsenal.

  7. I’m very heartened to see this post – and also continually surprised by the attitude that the anti-vaccinationists have towards doctors – pediatricians in general. Since having children, we’ve had numerous well-vists, sick visits, etc & it has always been obvious that our doctor (her staff, the other doctors in the practice, etc) have nothing but the best intentions and desire to make sure their patients (our children) have the best care possible. They take the time to address our concerns – whatever they may be, ask detailed questions, and provide detailed, rational, and logical information whenever they can.

    This taking a brush to tar the entire profession is both unseemly and extremely annoying – and dangerous at the same time.

  8. I’d like to address a “problem” with the VAERS reports.  Notorious anti-vax websites encourage their “supporters” to report non-events that end up “loading the dice” for their anti-vax views.  Reports such as deaths by drowning or deaths in a motor vehicle accident, suicides or the onset of a totally unrelated illness, months or years after immunization with a particular vaccine, are reported to VAERS.  Then the notorious  anti-vax websites report these events on their websites…right now they are “fixated” on the HPV vaccine.

    A much more reliable system. VSDL (The Vaccine Safety Data Link) has been in place since 1990.  This system monitors, practically in real time, any and all minor and serious adverse events, following the administration of vaccines.  Ten huge health care systems including the Kaiser health care system, report the vaccines administered to millions of their insured patients…representing tens of millions of individual individual vaccines administered each year.  “Reporters” to the system are doctors and nurses from the ten huge health care system and their affiliated hospitals.

    The Vaccine Safety Data Link data and the 75 + published reports issued by their staff, are available on the internet.

    Great article, Dr. McCarthy and thanks.

    1. It actually comes down to why bother suing, when the VICP is quicker and easier, and you are more likely to win?

  9. Thanks for the excellent discussion of this topic.  Working with families with autism leads back to this often and it will be nice to have a local resource at the well respected CH-Boston to point them to.

    Anyone thinking that Dr. Claire is in the bag for industry should read her post on BPA.

  10. Thanks for the post.
    On the medical front, as someone who was vaccinated with whatever there was when I was a child (many years ago), and who had my own child given whatever vaccinations there were, I can’t agree with you more. Chickenpox as a child may not kill, though you mention real risks of it, but I can assure the world that shingles as an adult is no fun. Parents who refuse to vaccinate are playing stupid games with their children’s health.
    On the legal front, it’s important to note that, while Dr. Wakefield is now suing Brian Deer and the BMJ, this is the second time he has sued Deer albeit not on exactly the same words. The first was several years ago, in libel plaintiff-friendly England, and he ultimately withdrew the suit and paid Deer’s legal fees. A couple of legally qualified commentators (Popehat and the Skeptical Lawyer) have suggested that the current suit is unlikely to go far.

    1.  “Chickenpox as a child may not kill, though you mention real risks of it,
      but I can assure the world that shingles as an adult is no fun.”

      As far as I can remember, having chickenpox as a child was no fun, either!

      As a parent, I really don’t understand the “don’t get the chickenpox vaccine but expose them to it so they get it naturally” approach.

      With the vaccine, there is a reasonable possibility that the child will have a little soreness at the injection site (although not certainty – neither of my kids did) that might last a day or so, although 1 year olds can be have some ibuprofin for pain relief.  Less likely is fever, and there are very, very rare serious complications.

      In contrast, with the disease itself you can count on a week or more of a pretty miserable child, many of whom also have fevers, and most of whom are scratching themselves silly, and need to be quarantined from public for a week.  Moreover, about 1/20000 die, in addition to the complications Dr. McCarthy notes.

      How in the blazes is that preferable to the vaccine?  It’s one thing to say, “I won’t get the vaccine, but will take my chances and hope I don’t get the disease.”  I don’t like the attitude, but at least it makes far more sense than, “I won’t get the vaccine, and will deliberately get the disease.”

      I don’t like my kids having to get shots as much as anyone, but it’s preferable to two weeks of being at home miserable.  I don’t like it when my kids are sick.  I feel terrible for them.  So given the option of soreness at the injection site and a low-grade fever for a few hours and two weeks of miserable, it’s not even close.

      Now, let’s work on a vaccine for hand, foot, and mouth. 

      1. I can’t believe parents WANT their children to go through chickenpox.
        When I was about five, I went through a particularly nasty bout of
        chickenpox, which as you say was no fun, followed by osteomyelitus courtesy of an infected sore. I
        couldn’t walk for nearly two months.

        Then you look at something like rotavirus, which clearly kills, and it is astounding that folks would rather their kid gets sick.  Within my own family, my daughter, born in 2005 was not vaccinated against rotavirus–as there wasn’t a vaccine available until 2006–and caught the virus, as did nearly every kid in her daycare. A number of them were hospitalized. (And, yeah, we stopped going to that daycare.) My son, born in ’08, was vaccinated.

    2. Are you aware of the increase in shingles cases in increasingly younger people due to the chicken pox vaccine.  The lack of natural immunity and immunity boosting exposure in parents is creating a shingles epidemic.  I would much rather my child get chicken pox and be protected for life.

      1. The same virus causes both shingles and chicken pox.  If you were vaccinated against chicken pox, you wouldn’t get shingles later in life.  The chicken pox vaccine is good for life, by the way.

        1. The chicken pox vaccine does not last for life.  Not sure where you get that information.

          I am aware that shingles is caused by varicella lying dormant.  My point is that in the pre-vaccine era adults had their immunity boosted by re-exposure to the virus when children in their community got chicken pox.  Now with the vaccine there are no natural boosts and shingles is creeping down from being an octagenerian problem to those under 50 getting it.

          I’m not arguing that zoster is caused by wild or vaccine-strain varicella.  My point is that our “erradication” of chicken pox has shifted the incidence of shingles into a younger population.

          I personally prefer my children to get chicken pox.  

          Hi Science Mom, I’m pretty sure I’ve debated with you before about this type of stuff on TWWS.

          1. Paige:  even with the “boosting” the adult immune system got with exposure to children with chicken pox, shingles was very prevalent and caused a lot of misery.  However, IF we can get through the “adolescence” of the vaccine and those of us with a history of (1 or more) chicken pox illness will eventually die out and no one will get shingles because they didn’t have the disease and because they were vaccinated.  Yes, the middle stage sucks (but plenty of young people had shingles – or worse, repeat cases of chicken pox in the ‘olden days’) but looking toward the future of my grandchildren and great-grandchildren, I think it would be wonderful if they could know chicken pox was eradicated, just like my younger sibling and my children never needed the small pox vaccine.

          2. What your saying would make sense if the vaccine strain did not lay dormant in the ganglia.  It has been shown to therefore erradicating childhood chicken pox will not erradicate shingles.

          3. Paige, do you know what “eradicated” means or that it takes a few generations?  Once eradicated, there is no virus left in the wild.  Such is the history of the polio virus, which is why we are no longer vaccinated for polio.

          4. Are you thinking of smallpox?  Smallpox is eradicated, polio isn’t.  We still get polio vaccinations as part of multivalent vaccines, it’s referred to as IPV.  Polio is still endemic in some countries, and the re-emergence of polio in China (from Pakistan) is a pretty big deal, as China had been free of polio for a dozen years.

          5. You are correct about the reduction in “natural boosting” now that cpox is uncommon in the population.

            However I don’t think there is evidence the average age of onset of shingles has dropped below 50. Perhaps you could link to a citation for this?

            The answer of course is that as natural or vaccine-induced immunity wanes, people should get vaccine boosters.

            Problem solved. No infant cpox (no deaths/pneumonia); no shingles (no scarring and horrible pain)

      2. Get chicken pox and be protected for life?  From what?  Chicken pox leads to shingles.  It’s the same virus, lying in wait in the nerve ends.  Chicken pox won’t protect them; it will make them more vulnerable to this painful and possibly deadly condition.

        1. Actually, you can still get shingles from the vaccine.  My cousin has
          never had chicken pox, just the vaccine, and got shingles at age 12. 
          I’ve also seen medical reports where young children, 6 and 7 got
          shingles.  Never had the actual chicken pox, just the vaccine.  You
          think shingles is bad as an adult?  How about having them as a child!  The varicella vaccine is actually a live virus vaccine, so you ARE still exposed to the virus, just in a weakened form.  People can also still get the actual chicken pox, even after the vaccination and booster. 

      3. Paige, what do you think your child is protected from if s/he gets chicken pox? Not shingles, for sure; the majority of those who have developed shingles got the virus from a “natural” chicken pox infection in the pre-vaccine era.

  11. Those of us with no science/medicine background but who were born before vaccines for childhood diseases were readily available, remember the bad old days and don’t want to repeat them.  Why would any sane parent wish measles, mumps or chicken pox (or whooping cough!) on the children they supposedly love and cherish.

    1. I’m a youngster at 23 and I know that I would have had another aunt on my mother’s side, had vaccines been available before the sixties.

  12. It’s nice to see busy physicians take time to write these kinds of articles.  Just yesterday I was talking to my nephew who has just graduated from medical school, and he said that the very worst experience he has had so far is witnessing a 7 year old girl die from measles-induced meningitis.  Her mother was devastated (her only child), and sobbed that she had believed the antivix press, and was afraid the MMR would cause autism.  What a tragedy to fall upon a parent who really only wanted to do to the right thing.

  13. This statement ”
     it doesn’t take much to scare parents’ is offensive. And then calling Offit thoughtful as if parents who do not vax are not thoughtful.  Whatever else we have to stop stereotyping the opposition.  As you said, being stereotyped as ‘out to get kids’ or brainwashed by pharma is false and derails the discussion.  I don’t think you are brainwashed or out to get kids.  I feel you (and my pro-vax pediatrician) are doing the best for your patients and that you believe the benefits outweigh the risk.  You aren’t wrong – your conclusions are just different than mine.   I’m not wrong either – nor am I not being thoughtful, “scared”, or reading bad information online (or, heaven forbid, following Jenny McCarthy).  I have simply looked at the facts (largely from the CDC’s own Pink Book) and made a different decision for my children.  Luckily, in the US I have that right.

    1. Your idea that both sides are right, but have reached different conclusions might work for matters of opinion.  This is not one.  This is a matter of facts.  You may have looked at the facts, but that doesn’t mean you have understood them, nor that you haven’t been too much influenced by wrong explanations of them.

      1. It is a matter of opinion – or more a matter of choice.  For example, I have read the epidemiology of HepB and the risk factors for infection AND the side effects of the vaccine and decided that it is not for me or my kids. Etc. with other vaccines (I research and decide on a case by case basis per my child’s unique condition e.g. an egg allergy in one).

        I am not anti-vax and trust me I know the difference.  I’m virulently anti-circumcision meaning not only would I never cut my sons but I don’t think you should be ables to either. That is called being ANTI something.  With vaccinating I have no problem with people choosing vaccination but I reject the idea that one size fits all or than my child’s benefits/risks are equal to another child’s.

        @ChrisKid – how would  you determine a parent’s understanding or influence?  You can’t say that “disagreeing with me” = “lack of understanding”

        1. Selfish acts such as yours reduces herd immunity creating pockets of susceptibility for infectious agents to spread.  And face it, it is selfish.  You are basing a decision that affects community and society on your own fears.

        2. Paige, you are not informed about the new recommendations for immunizing children with an “egg allergy”.  See ACIP General Recommendations for Immunization-2011 “Egg Allergies”.

          You say you have read the CDC Pink Book for immunization information.  I say you don’t comprehend fully, what the book contains.  An excellent reader-friendly website for those who are not in the professional health care field is Immunize.org.

          No Paige, the sciences of immunology, biochemistry and epidemiology of vaccine-preventable diseases are not open to “opinion”, “mommy intuition” or

          Please do not compare your decision for your child against circumcision with the decision to put your unvaccinated children, infants and immune-compromised people at risk.  Furthermore, this blog is devoted to childhood immunizations-not circumcision.

          1. I wasn’t comparing the two except to explain the difference between being “anti” something and just not doing something.

            I do not believe in herd immunity – a discussion all its own but just as an example, pertussis vaccination does not stop spread of the virus.  A child (or adult) with sub-clinical infection can still pass it on to a susceptible person.  I actually think community health is very important and I don’t think vaccines are in the best interest of humanity.  That isn’t me saying that vaccines don’t do what they say.  I think the have lowered disease rates.  I’m not a vaccine denier – but I do not believe they are overall good for human health.

            This discussion has actually helped me understand one of the roadblocks of the “vaccine debate”.  (I AM in fact interested in finding common ground.)  When I discuss this I am not arguing the facts (for the record I do not believe vaccines cause autism and my reasons are not fear based) or the science.  I have truly just taken the facts and made a different decision than you.  

            Each vaccine is different so it is hard to talk about all of them carte blanche.  But, I’ll use HepB as an example since it was the one that launched me into my vaccine research. I agree with the facts provided by the Pink Book:
            * 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.

            I also understand the public health perspective on hep B vaccination -namely catching the population in the early years.  

            If we were having a science debate we would probably agree at this point and then perhaps we could argue about engineered vaccines or what not.

            However, I have to move beyond the facts and look at how those facts play into the individual circumstances of my children.  Things like *my* risk factors, *my* child’s health history and *my* parenting choices (e.g. breastfeeding, day care or home, etc.).  For example, the CDC’s MMWR shows that the risk of HepB infection is almost non-existent in children under 10.  Then I make a choice (not an opinion) based on both perspectives.

            The fact is that HepB vaccination is completely unneccesary for my children at this time.  Later, based on travel, their jobs, or other lifestyle choices (yikes!) they may choose to get the vaccine.  My 12 hour old infant did NOT need it.

            It isn’t about disagreeing with the facts or about pseudoscience.  It is making a different choices based on the given facts.

            If you meet someone that says “well Jenny McCarthy says it causes autism” then fine go ahead and tell them they are not understanding but it is not true of all conscientious non-vaxers.

            If we can move past that hen maybe we can really talk about vaccine refusal in the US.

          2. Paige:  The reason why horizontal transmission in early childhood is less prevalent now is because newborns at risk of infection from their mothers are  identified and provided with appropriate prophylaxis at birth and because the vaccine is part of the Recommended Childhood Vaccine Schedule.  The “birth dose” was instituted to begin immunization against this chronic, often deadly disease.

            But, horizontal transmission in early childhood still takes place…in child care centers, by “sharing” toys and toothbrushes.  One of your child’s playmates whose parent also “opted out” of the vaccine, could also be infected and asymptomatic and pass the virus through the routes I have mentioned. 

            You do know, don’t you, that other close household contacts who are chronic carriers of the virus, within an unimmunized child’s home can easily  infect that child, don’t you? 90% of infants infected at birth will become carriers of the virus…for life.  Approximately 50 % of unimmunized children will be infected for life.

            Paige, people who have educated themselves in epidemiology and then state they “don’t believe in herd immunity, are IMO free-riders…who depend on other parents to have their children fully immunized…whilst the “opt out”.

          3. Exactly my point! If I and my partner are not carriers and I breastfeeding and my child is not on day care and… Then my risk factors are much lower than another’s. It is a child by child decision not a carte Blanche medical decision.

          4. Thought you might like to know you are not the only person who investigated that particular vaccine and also came to the same conclusion based on the same reasoning.

          5. Let’s just get to the question then. After all this “research” you have done … which vaccine have you found to be safe and effective?

          6. Excellent question and one that few people ever ask. I would consider vaccination for polio and for diphtheria. Unfortunately diphtheria is not offered alone. I’m considering polio when my children are older it has a very good safety record (the IPV obviously).

            I don’t think I would ever vaccinate for childhood illnesses (MMRCP) non-communicable diseases (T) or diseases with appropriate medical and no medical interventions unless I were traveling to an area with less access to are.

          7. Just in fear that you think my “belief” is some kind of religious experience.  I do not think that herd immunity applies to all vaccines as vaccine promoters claim. 

            For example several vaccines do NOT eradicate the virus/pathogen but allow for subclinical infections.  So pertussis, for example, can stop a child from becoming ill but it does not stop infection and transmission.  Even 100% coverage of vaccination will NOT rid the world of pertussis.I could probably say Polio has a herd immunity factor.Tetanus? not even communicable.etc.The blanket statement that non-vaxers are hiding in the herd just aren’t true.

          8. No one in this thread will address the fallacy of herd immunity in cases like pertussis and it has come up several times. I have never in all my years of vaccine debates ever have anyone respond. Sigh. This goalpost statement is familiar. Does offit teach a seminar on it?

          9. And the Offit comment shows you’re nothing more than a denialist that hangs out on anti-vax blogs.  You aren’t a scientist, unlike myself and many other commenters here.

          10. It was addressed above and you apparentlydon’t recognize that you are not credible on the subject.  Herd immunity is important in reducing the spread of pertussis. You are not a scientist, paige, stop pretending.

          11. People wearing seatbelts sometimesdie in car crashes, too.  That doesn’t mean they don’t help.   Are you seriously trying to maintain that a subclinical infection is going to be as transmissible as full-blown whooping cough?  You are gambling with other children’s lives, not just you own.

          12. “Are you seriously trying to maintain that a subclinical infection is going to be as transmissible as full-blown whooping cough? ”
            EXACTLY. This is what I don’t understand about the anti-vaxers’ position on pertussis.  They seriously believe that the viral load and transmission will be the same.

          13. Uh, Pertussis is a bacterial disease, not a virus. I can see how well informed you are.

  14. I’m a Certified Pediatric Nurse and you know what? I’m not sold on vaccines. I’m not sold on the idea that they work and I’m not so
    I do a LOT of research.

    Your statement that “but just one of them is grounded in facts.” is arrogant and insulting. I’m sure you’re frustrated… but honestly, so are families who are trying to get real information and being told “Oh, just trust us, it’s safe!” It isn’t safe for everyone all the time. Maybe YOU as a physician are careful about that, but there are a lot who AREN’T.

    Just because the problems with vaccinations may be unintended doesn’t mean that there aren’t problems with them. How much research have you looked at that shows the problems with vaccinations that you didn’t just dismiss out of hand?

    It’s easy to point to Wakefield and cry “fraud”… whether you know anything about his work or not (I’m sure Stephanopolous is a credible medical expert….right…) because it’s the safe thing to do. How about Laurence Palevsky, MD? Or Mendelssohn? Even Sears warns that not every vaccine is right for every child.

    Oh, and speaking of facts… the rotavirus vaccine has been pulled THREE times, not once. It has caused life threatening intussusceptions to prevent a disease that, in the United States, can be treated medically. Rotavirus vaccines may make sense where there is no clean water and a lack of access to things like pedialyte and IV fluids or antibiotics… but your citing it here as a bastion of “how the vaccines get improved to help us” is really sad.

    1. Actually, it is very easy to point at Wakefield & say fraud. Given the mountains of evidence that was produced against him – and that he produced none (not a single bit of evidence in his own defense) or even bothered to appeal the decision to take away his medical license, I’d say that’s pretty definitive by his own actions (or inaction).

      And the side-effects from vaccinations, which are well articulated, not only in the vaccine materials, provided by manufacturers themselves and also spoken about by the doctors (every single one that I’ve been in contact with) are both magnitudes rarer and less dangerous than the diseases that they prevent.

    2. What about Mendelssohn?  He died many years ago.  He said a lot of insulting things about how his colleagues couldn’t treat heart disease, and then died of it himself.

      And it is indeed easy to point to Wakefield and cry “fraud” — because his research was, indeed, fraudulent.  His “measles detection” lab results were completely bogus, for example.

    3. “I do a LOT of research.”

      Doing “a lot” of research does you no good if the sources you choose are antivaccine quack sites.

    4. Thanks for having the courage to stand up and get involved in this important discussion.

    5. You don’t think that the pulling of the rotavirus vaccine is actually an indication that the system is working to make vaccinations as safe as possible?  That seems to be a bit narrow minded.  And when you say that it “can be treated medically”, that seems to match almost all of the vaccine-preventable diseases.  There are reasons why preventing diseases is far preferable to treating disease, the least of which is the ability of those diseases to transfer to other people.  

    6. I’m sure you haven’t done a lot of research Ms. Halligan…if you make reference to doctors who are considered quacks in the nursing and medical professions.

      And speaking of facts…please provide citations for the current rotavirus vaccines and the instances of intussusception.  Make certain to compare the “background rates” for intussusception in early childhood-vs-rates of intussusception in children immunized against rotavirus.  Please also provide citations about the decrease in the number of hospitalizations of infants diagnosed with rotavirus since the introduction of the current vaccines-vs-the number of hospitalizations, before the current rotavirus vaccines were developed and available.

      I think Ms Halligan will be quite surprised after she researches and provides citations about intussusception rates, the decrease in numbers of hospitalizations, the extraordinary decrease in the costs to provide hospital care for children with diagnosed rotavirus infections…and the need to have such vaccines in this country with our clean water, Pedialyte, IV Hydration and antibiotics.

    7. Bringing up Robert Sears, MD shows your lack of critical thinking as it concerns vaccines. This is a physician, who in an attempt to generate fame and sell books, created his own vaccine schedule without any actual scientific evidence to back it up. Now, with the storyline, turning against the anti-vax movement, Sears is dialing back his retoric and has a less prominent place on he family website.

    8. What do you mean you do a lot of “research”?

      Can we have a few links to your publications?
      Oh, maybe you mean you read up a lot about vaccines, and call that “research”. It is one acceptable meaning of the word I guess.
      So tell us which sources you tend to use for your research, please, Elizabeth.

  15. I was personally injured by the Hep B vaccine as an adult.  I have a Ph.D. and am certainly the opposite of uneducated and appreciate facts very much.  However, it is a FACT that I developed Guillain Barre and was permanently damged.  I took the shot because my internship required it.  I was there for 1 year and it took 6 months to finish the vaccine series.  My chances of contracting Hep B in my field are slim to none, but now my medical bills are sky high and will be as there is no way of reversing the damage.  You can try to argue, but I have seen rheumatologists, hematologists, infection disease, immunologists, etc and all concur that indeed my reactions were to the vaccine.  Why is this so hard to accept that some people are injured? People will concede that they are not 100% safe, but then bash the people who were damaged.  It doesn’t make sense to me.

    1. I agree.  Why is it ok to spout the “nothing is 100% safe” and then demean parents that choose not to vaccinate?

      1. So Paige, driving is not 100% safe.  Does that mean we shouldn’t demean (much less imprison) people who drink and drive?  That is the logical consequence of what you have said.

      2. Because although a vaccination may not be 100% safe, it is much, much safer than leaving everyone unvaccinated and allowing disease to run rampant.

        Nothing is 100% safe. There is some element of danger in absolutely every activity we perform, every day. The key is to minimise the danger.

    2. No one is arguing that there won’t be injured people. Any treatment incurs risks, meaning there will be some people that experience a negative effect. BUT there are also risks incurred when no treatment is given. The question becomes is the probability of a reaction more or less likely with the treatment than without?

      1. The drunk driving thing is a little baffling. A better analogy would be choosing not to drive because it isn’t 100% safe.

        And I agree with what guest said above. The risk benefit analysis is what each person needs to do. So why is everyone upset when a family chooses to not vaccinate? Is it that you don’t believe in the individual liberty of self determination in medicine?

        1. Do you know what a “social contract” is, Paige?  So no, most people that understand immunology and herd immunity don’t think that “individual liberty of self determination” is a very good thing when unvaccinated children spread dangerous diseases throughout the population.  Smallpox was eradicated at the barrel of guns.  It can happen again.

          1. Small pox is a good example of a pathogen subject to herd immunity.  Others are not.  (see above somewhere).

            Yes I know what a social contract is.  I do not believe my child will spread disease.  

            So do you think the right of parents to not vaccinate should be eradicated?  Do you believe in forced vaccination?

          2. The only one that’s legitimately not subject to herd immunity (according to real science, that is) is tetanus, which is the only vaccine-preventable disease that’s infectious but not contagious. I have no idea why Paige would think other diseases aren’t subject to herd immunity; I posted two days ago asking which of the mathematical facts underlying herd immunity she is disputing, but no reply has shown up yet.

  16. What a well-conceived, thoughtful, and personal post from the front lines. Thank you very much, Dr. McCarthy.

  17. This article ignores the fact that there has never been a peer reviewed study comparing vaccinated children to unvaccinat­ed children with respect to autism rates. All we know from the available autism/vac­cine research is that one vaccine ingredient (thimerosa­l) does not appear linked to autism and that children who received the MMR combo shot are not at higher risk of autism compared to children who received separate shots for measles, mumps and rubella.  However, to determine whether vaccinated children are at higher risk of autism or not, you need to compare vaccinated children to unvaccinated children with respect to autism rates.  This has not been done. Parents are understand­ably concerned because no one knows what is behind the dramatic increase in autism rates; also, these parents hear countless reports from other parents regarding previously normally developing children who suffered adverse vaccine reactions, followed by regression into autism. Additional­ly, vaccines contain known neurotoxic ingredient­s, including processed free glutamate, which has been shown in peer reviewed research to cause brain lesions when injected into laboratory animals (http://www.asdresearchonline.com/ ). While none of this proves that vaccines are linked to autism, it’s certainly enough to demand appropriat­e research comparing vaccinated children to unvaccinat­ed children with respect to autism rates, which currently does not exist.

    1. #1)  The study you suggest has been done.  
      Madsen, K. M., Hviid, A., Vestergaard, M., Schendel, D., Wohlfahrt, J., Thorsen, P., Olsen, J., … Melbye, M. (January 01, 2002). A population-based study of measles, mumps, and rubella vaccination and autism.The New England Journal of Medicine, 347, 19, 1477-82.
      #2)  Ethically, no review board should ever sanction a study that leaves children unvaccinated and open to disease and the danger of spreading it throughout communities.  

      The link you attached is not unbiased, as it begins by openly ignoring the case that ASD is only a recently categorized spectrum disorder, and the rapid growth in positive detection is well accounted for by diagnostic bias.  You also seem to have forgotten the basic premise of biochemistry, that the dose makes the poison, not the chemical itself.

      1. As mentioned above I do not believe that vaccines cause autism but the lack of true longitudinal, placebo-based, clinical studies is a problem.  The article you posted is a population study not bench research.

        I also disagree with #2 (although that is the standard response).  According to The Declaration of Helsinki, the World Medical Associations governing document on combining medical research with medical treatment, there are 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 a placebo during a massive diptheria outbreak? unethical.  A placebo in the US with current conditions? Not unethical.  

        I understand why vaccine promoters don’t want to do this kind of research: they are already convinced of the safety and efficacy and doing more research would just waste money.  That’s fine, however, this is one of the reasons for the increasing rate of vaccine refusal.  Not “dumb mothers following Jenny McCarthy”.  I think if we can stop stereotyping each other then we might be able to move forward.

        1. You still don’t seem to understand the concept of herd immunity and the damage that a study of significant size could create.  That is why it is unethical.  You’re fitting every single stereotype of the anti-vax denialist, Paige.  You gloss over very real concerns, you gloss over the mathematics of herd immunity, you gloss over the real implications of your demands, because you have an irrational fear of vaccines.  

          1. I do not believe in the theory of herd immunity as presented by vaccine proponents. I talked about this elsewhere on this thread. My reasons for not gazing are not at all fear based but lack of fear. I do not buy into he fear of most vaccine available diseases.

            I point out the info about the placebo studies because from time to time a vaccine proponent will imply they really want to address he concerns of vaccine refusal. Usually they do not really want to address the concerns but demean the opposition.they don’t want

          2. Herd Immunity isn’t just presented by vaccine proponents.  It is a well documented theory supported by massive amounts of evidence.  You are rejecting a very basic part of medical science.  I don’t think you’re very well educated at all, I think you’re making decisions based on your own confirmation bias and rationalizing it with bogus claims and all sorts of other justifications that don’t stand up to inspection.

          3. It is certainly your right to believe that.  I will not get into a list of my research/science credentials but I think writing off the opposition as uneducated is kind of a cop out.  What if I *am* really smart, educated, and working in the field and I *still* don’t vaccinate?  I completely support your right to vaccinate.

            I shouldn’t say I don’t believe in herd immunity – I just don’t believe it applies to all vaccines.  Many of the childhood illness stuff.  I talked about it above.

          4. There are plenty of smart, educated vaccine denialists.  They’re called quacks.  Dr. Sears, Dr. Jay Gordon and quite a few others are easy enough to find.  

            Attempting to educate you on social contracts, herd immunity and the importance of disease prevention is pointless, you’ve made that quite clear.

          5. I don’t comprehend the level of arrogance that makes “doesn’t agree with me” = quacks. Actually I do, it is called fanaticism and it makes discourse impossible (that’s what we were supposed to be doing – discourse- not you “educating” me.)

          6. sorry for all the typos here I was on my phone!  I hope you can interpret autocorrect speak.

          7. How can you not believe in herd immunity? It’s plain mathematics.

            For a disease to keep circulating in the population, it needs three things: it needs people who have the disease and are contagious; it needs people who are vulnerable to catching the disease; it needs contacts between people in the two groups. If you protect people so that they don’t enter the second group, they don’t enter the first group either. If you reduce the number of people who enter both groups, contacts between them decrease in turn. Even if you can’t move *everyone* out of the group of vulnerable people, moving those you *can* out of that group reduces the threat to those still in the vulnerable group.

            Now if you don’t believe that, please explain what part you don’t believe – and *how*? Are you saying that you can cut the number of people who can transmit the disease and the number of people who can catch the disease by 80% each, and the number of transmissions of disease will *not* decrease? How??

          8. Because not every vaccine decreases the people that fall into group #1. Creating sub clinical infection, while desirable, does not stop infection or transmission. Get it? So herd immunity is not applicable to those diseases.

          9. Ah, now I understand where your misunderstanding is.  You think that herd immunity cannot kick in until the chances of an individual catching a disease they’ve been vaccinated against goes down to zero.

            I’m not sure where your misunderstanding comes from, but again, it’s wrong simply  as a matter of mathematics.  When X% of the population gets a vaccination which Y% of the time will let their immune systems fight off an infective agent instead of catching and transmitting it, neither X nor Y has to be 100 for the spread of the infection to be massively slowed; they just have to be sufficiently high.

      2. The study you referenced compares children who received the MMR combo shot, to children who did not receive that one specific combo shot.  It’s not a study comparing vaccinated children to unvaccinated children with respect to autism rates.
        Additionally, considering the large and growing number of parents who refuse to vaccinate their children, withholding vaccines from children who would otherwise get them would not be necessary, eliminating the ethical concerns regarding such a study.  

        1. I think pvgv definitely needs to learn more about study design; she doesn’t seem to understand the difference between prospective and retrospective studies.

          A prospective study on the current vaccine schedule would probably produce some very useful information. It would also be unethical because with near-certainty – almost by definition – we would be inflicting disease, with its attendant risks of maiming and death, on randomly selected children to whom we had denied adequate preventative care.

          pvgv is correct that there is no *additional* ethical problem with locating those children whose parents have already made the decision to deny them adequate preventative care, and make them the unvaccinated arm of a “vacc. vs. unvacc.” study. What pvgv does not realize is that such a retrospective study would tell us almost nothing!

          In a prospective study, subjects are randomly assigned to either an experimental or control group. What’s the point of making the assignment random? To make all groups, to the extent possible, alike in every respect other than the treatment they’re getting; if you then see a statistically significant difference in outcome between the groups, you can reasonably attribute it to the treatment.

          If you take away that random assignment, then you might see a difference in outcome, but you have no way of knowing whether it was the treatment that was responsible, or whether it was a factor that led the subjects to pick *that* arm of the trial, or any factor associated with a factor that led the subjects to pick that arm of the trial, and so on. Suppose we recruited one group of people who liked to listen to Limp Bizkit, and another group who liked to listen to Lawrence Welk, had them each listen to that music and only that music for a year, and then checked how many of them had developed liver spots within that year. If the Lawrence Welk group had far more liver spots, would it prove that Lawrence Welk’s music causes liver spots? No, because a far more likely explanation would be that older people are both more likely to choose Lawrence Welk to listen to and to develop liver spots.

          pvgv probably thinks there is something special about parents who aren’t vaccinating their children. He/she probably thinks such parents are smarter, more perceptive, less easily swayed by propaganda, more independent in their thinking, et cetera. What pvgv doesn’t realize (because he/she doesn’t understand basic issues of study design) is that if he/she is correct about unvaccinating parents being different, that very difference drastically lowers the potential of the study he/she proposes to tell us anything of use!

          1. pvgv serves as a useful example of just why antivaccine tropes are difficult to overcome with the facts.  The assertion that “there has never been a peer reviewed study comparing vaccinated children
            to unvaccinat­ed children with respect to autism rates” is false, as demonstrated by the citation to Madsen et al. above; also Mrozek-Budzyn et al. 2010.  One would think that pvgv would modify his/her position in the face of the studies that supposedly do not exist, or at least move on to another argument.  Not so, though.  When confronted with a comparison of autism rates in vaccinated vs. unvaccinated children, pvgv simply objects that the unvaccinated children were not really unvaccinated, according to some vague but demanding standard. 
            Ultimately, it is a mug’s game to try to force facts on someone wedded to a faith-based belief system.  Our best hope lies in educating the vast majority of the public who are still willing to consider the evidence.

          2. Madsen et al was already addressed above, which leaves Mrozek-Budzyn et al. 2010Here is a fulltext version of that article: http://journals.lww.com/pidj/Documents/Lack_of_Association_Between_Measles_Mumps_Rubella.pdfIt’s hardly necessary to apply “vague but demanding standards” to see this is not an example of research which compares vaccinated children to unvaccinated children with respect to ASD rates.  All you need to do is bother to actually read it. 1 comment collapsed CThis study compares children who received the MMR combo shot to children who received the measles only vaccine. It also references a small group of nine children who received neither the MMR combo shot nor the measles only vaccine (it calls this group “nonvaccin­ated” but these children are only unvaccinat­ed with respect to measles, not unvaccinat­ed in general)  

          3. The type of study I’m suggesting is actually quite common in medical and social science research.  
            I assume you are familiar with research showing that smokers have higher rates of lung cancer than non-smokers.  Do you discount such research?  I ask because all of your mentioned concerns similarly apply to that research.

          4. I’m afraid you’re mistaken about your history of science, though the mistake is understandable. Retrospective studies certainly showed a correlation between smoking and lung cancer, but those studies alone *were not* what led us to the conclusion that there was a causal relationship. Prospective studies on laboratory animals were required to substantiate the hypothesis; without those studies, it would have remained simply a hypothesis.

            So, I’m sure you’re asking, why can’t we do the same with vaccines? Why can’t we do retrospective studies with those children whose parents have chosen to deny them mainstream medical care, and then follow those up with prospective studies in animals?

            Well, two reasons, one of which you’re not going to like but remains true anyhow. The *other* reason is that most of the things that the anti-vaccine movement thinks are linked with vaccines are things we just can’t study in animals. Autism, attention-deficit disorder? We just don’t know enough about how animals think and communicate to think we can diagnose disorders that impair the same.

            The other thing – well, let’s put it this way. *Before* we knew about the link between smoking and lung cancer, both smoking and not smoking were pretty reasonable, normal options. But vaccinations? Vaccines eradicated smallpox, a disease that killed and maimed countless millions throughout centuries. They turned polio from something that every parent feared into something most people will now never see a case of. Schools for the blind and deaf are closing down; why? Because vaccines have so drastically reduced the diseases that blinded and deafened so many people in previous generations! Turning your back on that is not a rational decision, and the kind of parents who would make that irrational decision just cannot be treated as if they were identical to parents who actually give their children good medical care.

          5. Actually, it may well be an entirely rational decision.   I am bothered by this common, yet  provable wrong 
            (see Paige’s posts) assumption about the reasoning that led to that decision.  

          6. See, all these parents keep *saying* it’s a rational decision, but when it comes time to weigh the risks and benefits of vaccinating vs. not vaccinating, we’re still waiting to see a rational, fact-based assessment that doesn’t come out in favor of vaccination. Fears of Big Pharma conspiracies are not a rational thing to let drive your decision-making.

          7. Nice condescenscion. Weak argument.

            It goes without saying that, whether parents choose to vaccinate or not vaccinate their children, they will be doing so with their child’s best interests at heart. So either group would be about as likely to pursue other healthy lifestyle choices, or what have you.

            It’s impossible to totally adjust for every confounder in a comparative study. Nonetheless, a study comparing totally unvaccinated children to vaccinated ones would be able to determine the validity of your assertion, for instance:  “It would also be unethical because with near-certainty – almost by
            definition – we would be inflicting disease, with its attendant risks of
            maiming and death, on randomly selected children to whom we had denied
            adequate preventative care.”

            The above is a fully faith-based statement; you admit it freely. Yet there is evidence it is not true. For example:

            ‘Hepatitis B triple series vaccine and developmental disability in US children aged 1-9 years’ [available @- http://sanevax.org/wp-content/uploads/2011/02/Gallagher-HepB-ASD-study121.pdf%5D,
            states: “This study found statistically significant evidence to
            suggest that boys in United States who were vaccinated with the triple
            series Hepatitis B vaccine, during the time period in which vaccines
            were manufactured with thimerosal, were more susceptible to
            developmental disability than were unvaccinated boys.”

          8. Your second-paragraph argument rests on a premise so weak that it boggles me anyone would attempt to argue it to be true: that as long as two different groups of parents share a similar vague *intent*, namely, “give our children the best health,” the actions that they actually choose as the best means to accomplish that goal will be so close to identical as to make no difference – even if the very factor that separates the parents into distinct groups to begin with is that one group makes good use of one of the highest-benefit-for-risk interventions that has ever come from medical science and the other chooses to reject that intervention entirely. One might as well say, “Just because one group puts all their paychecks into the bank, and the other puts all their paychecks into lottery tickets, doesn’t mean they handle money differently. They both want *more* money and that makes them scientifically the same.”

            You claim that somewhere I “admitted” to something being a “faith-based statement.” Since you do not write clearly I can only guess which statement you mean, and which other statements of mine you misconstrued as somehow feeding into your belief that viewpoints that do not agree with yours are “faith-based.”

            I will have to guess that it has something to do with the quoted statement about a prospective vacc. vs. unvacc. unethically subjecting children to disease, to whom we’d denied adequate medical care; that statement is based not in faith, but elementary logic which even you should be able to follow. No vacc. vs. unvacc. study could even pretend it was giving us useful information unless it employed such a large group of children over such a long period of time *that some children were sure to be exposed to the disease.* By the nature of a prospective study some of those children exposed to disease would be those we had denied their best protection against the disease.

            Finally, you attempt to counter the argument about the weaknesses inherent in a retrospective study, by posting a link to … a retrospective study. What of it? If you tell me a perpetual motion machine violates the laws of thermodynamics, I can’t refute you simply by posting the schematics for a perpetual motion machine; I have to show you a perpetual motion machine that *works.* Your link comes from SaneVax, which is not exactly a source known for its scientific rigor.

      3. ..The study done by Danish researcher  Thorsen, P., as in the Paul Thorsen who stole taxpayer dollars intended for medical research? Thttp://www.ageofautism.com/2011/04/natural-news-takes-on-the-growing-poul-thorsen-autism-vaccine-research-scandal.html  

    2. To add to Jkanta’s point about biological plausibility – considering that the vaccines contain the same antigens as the organism against which they protect, it is highly unlikely that if the exposure to the antigens by getting infected with the organism does not cause autism, exposure to select antigens of the organism by way of vaccines should not cause autism either.

      Also, for a moment, let us consider the hypothesis to be true, that exposure to those antigens does cause autism. Then also, even without vaccination, there should be nearly the same incidence of autism. This is because prior to widespread vaccination, almost everyone was exposed to these pathogens and hence to the antigens.
      There is nothing new about exposure to the concerned antigens. The only difference is that with natural exposure, you get the disease and risk death or a high risk of disability. While with vaccine based exposure you have a very low risk of injury.

      No one says that vaccines are 100% safe, but the risks associated with vaccination are far lower and less severe than those associated with getting the actual disease.

  18. I cannot agree more. Thank-you Dr. McCarthy, my only qualifier on this article would be to point out that even if chickenpox can be benign in children it sets people up for the potential of further suffering as adults. My mother suffered horribly from shingles after a “harmless” bout of chickenpox in her youth.

    1. Eradicating chicken pox in children does not eradicate shingles.  The vaccine-strain does enter the ganglia and can in fact cause shingles.  

      ” in 32 patients with zosteriform rashes, the vaccine strain was identified in 22 samples, and the wild-type strain was identified in 10 samples.”

      Viral strain identification in varicella vaccinees with disseminated rashes.  Infectious Disease Journal:November 2000 – Volume 19 – Issue 11 – pp 1037-1039

      1. The pubmed id for that paper is
        11099082. For background the authors note:

        Approximately 15% of recipients of live attenuated varicella vaccine may develop mild breakthrough varicella months to years after immunization. Although some vaccinees will develop zoster, it is less common in recipients of vaccine than in those who have had natural varicella.

        and their conclusion is

        Wild-type virus was identified in all generalized rashes occurring after the immediate 6-week post vaccination period. When reactivation of vaccine strain
        occurred, it presented as typical zoster. We find no evidence that
        reactivation of vaccine virus occurs with the clinical picture of
        generalized rash.

        The wording in the abstract is a little confusing because they refer to developing or presenting as “zoster” which could be either varicella zoster (chickenpox) or herpes zoster (shingles).

        But, the reference to “mild breakthrough varicella” helps clarify.

        A quick search for that term came up with a Maine state information sheet
        which gives this definition.

        Q. What does breakthrough varicella disease look like?A. Breakthrough disease—varicella disease in vaccinated children—typically exhibits:• Shorter duration of illness• Fewer constitutional symptoms• Fewer than 50 skin lesions (sometimes even fewer than 10)• A rash that may be atypical in appearance (maculopapular with few or no vesicles)

        It is clear from this definition that breakthrough varicella is not shingles. It is just a mild, limited outbreak of chickenpox in vaccinated children due to the lower effectiveness of a single shot compared to a follow-up with a second booster shot which they recommend for children 3 months after the first immunization.

  19. Dr. Claire McCarthy, I think it is time to seriously address concerns of many physicians and parents across the world. I myself am a parent, a scientist and a biotech professional with years in biomedical research. I do understand the complexity of the medical/ scientific matter as well and the business behind the scene. These are two separate concerns I have – ingridient quality/safety and combination vaccination. What is the probability of someone contracting 3 or 5 antigens at once and what do we know about immune response to such an event apart from vaccination? Here is a quote one of many that illustrates how the decisions are being made: “A desire to simplify the regimen is fueling a trend toward combination vaccines. Although many combined vaccines have been used historically (e.g., diphtheria, pertussis, and tetanus), new combinations are being approved for children (e.g., pentavalent vaccines such as GSK’s Pediarix [diphtheria, acellular pertussis, tetanus, hepatitis B, and inactivated polio vaccine]) and for adults (e.g., GSK’s Twinrix for hepatitis A and B)…The main challenge will be to balance immunogenicity in the newer formulations while maintaining their benefits of easier administration and lower costs.” (J. McCullers, P T. 2008 Jan). I hope to see singe vaccines available for all diseases as an option for physician and parents like myself who are not comfortable with combination vaccination and to see safety put first above cost and ease of administration. Also I hope to see serious research and discussions on this topic in addition to the shallow “vaccines are good for you” and “5 in one are better – only one injection” statements. It does not sound persuasive to me, what about you?

    1. There is more than enough research on the safety and immunogenicity for many of the combo vaccines available through Pubmed and similar science citation sources. By the time combos get to market they are demonstrably effective at generating adequate immune responses against the antigens they contain. The immune response is quite capable of responding specifically and well to multiple antigen exposures simultaneously.

      The risks of individual vaccines versus combo vaccines are something you should think about. Individual M, M and R vaccines have a higher overall anaphylaxis rate, febrile reaction/convulsion rate etc than does the combined vaccine, for example. Then there is the inconvenience angle and discomfort angle – avoiding multiple shots is generally better.

      Some combos did have higher risks of febrile reactions (MMRV for example) and limitations were therefore placed on its use. But most of the research on the combos is reasuring in terms of their safety. I think your idea that safety may be sacrificed on the altar of convenience/profit/cost is not valid, although these are clearly relevant factors in the production and marketing of the vaccines by the companies concerned.

  20. I couldn’t agree more. But just one of them is grounded in facts. — Exactly. The support for not-vaccinating is grounded in fact. The “pro-vaccination” side is grounded in money and lies. There have been AMPLE studies on the cons FAR outweighing the “pros” of vaccination. I just shake my head because the medical community IS brainwashed. Most aren’t out to do harm, they just don’t know better.

    1. I just want to say, as a non-vaxer, I do not agree with firestar01010.  I think the pro-vax side does care about kids and isn’t brainwashed.  I don’t think the cons outweigh the pros for all kids just some.  

      I would REALLY love to see a discussion of vaccines that does not include “provax is brainwashed” or “novax is uneducated moms”.  that really get us no where.

    2. Ample studies? Could you please share them with the rest of us? Or did you just make that up for effect?

  21. The Antivaxxers are so similar to the creationist mindset (generalized reality denial) that you can even spot which comments below belong to them from the paragraph structure.  I wonder if anyone’s done a study on language patterns of the anti-science kooks.
    By the way, awesome article!

    1. Your comment is so respectful and non biased.  Thanks for that.  I’m sure that someone who writes in a conversational blog style would never be capable of academic discourse. Good thing we have you!

  22. I add my personal experience of preventable childhood disease to some of the anecdotes presented here. I am just short of 50 years old. That is old enough to remember people who were deformed or maimed by diseases now mostly prevented by vaccines.

    Two of my aunts survived scarlet fever. Both aunts had heart damage afterwards, one ended up with a leg shorter than the other. As a boy, I met at least one man blinded by measles in his childhood. Of several close childhood friends, one was made sterile by mumps.

    Professionally, I work as a massage therapist. My specialty is working with people who have long term disability, especially chronic pain. I don’t do fluffy massage; I do very direct therapy to improve mobility and decrease pain. Among my clients, I have six full time or occasional clients who are dealing with post-polio syndrome. The youngest client who has post-polio is 63, the oldest is 79.

    So I have seen damage from preventable diseases. I hope no child ever has to be disabled again by a disease the affects of which can be rendered almost invisible to the rest of society. Maybe someone should dig up the old pictures from polio hospitals of the early 20th century. And some pictures of deformities caused by scarlet fever. Pictures of disease effects might help convince parents to consider vaccines more seriously.

  23. Dr McCarthy
    Thank you for writing such an excellent article. It is so important to have qualified medical professionals challenge the pseudoscience that is out there.
    Well done

  24. perhaps you white coats, who know EVERYTHING there is to know, could address my one question and then I will believe all of your thorough “science.”  -What happened to the death rates from Scarlet Fever over the last century?  There is no vaccine for Scarlet Fever.

    1. No, I’m afraid you wouldn’t believe science, since the answer it gives isn’t the one you want. The scarlet fever vaccine was in fact developed in 1924; the reason it isn’t in general use today is because antibiotics such as penicillin, developed in the 1940s, turned out to be a better way to control the spread of the disease.

      This is the problem with getting your talking points from antivax sites: they phrase things in a deliberately deceptive way so that what you *think* you read is not actually what the facts support, and then when you try to enlighten other people with your “information” you get embarrassed because it’s misinformation that you could have realized was untrue if you’d taken two minutes with a search engine to check it yourself.

      1. perhaps you might save me from misusing my internet again and tell me what caused the death rates to drop before 1940?  Also, any information on why Measles death rates dropped to baseline before the vaccine came into use would be most educational.

        1. Let me save you some time. You are pretty clearly trying to put together a syllogism in the following form:

          1) There are medical triumphs, such as lowering the death rates of many VPDs, that were not accomplished by vaccines.
          2) (premise that never gets explicitly stated because then it can be seen clearly as nonsensical)
          3) Therefore, there are *no* situations for which we *do* need vaccines.

          That’s where you’re going with that, isn’t it? Ah, wait a minute – perhaps I’ve been too hasty. We already know that you like to repeat antivax talking points, without necessarily being aware of how carefully they were crafted to give a false impression while remaining TECHNICALLY true.

          So, let me ask you: are you okay with people being blinded?

          Are you okay with people going deaf?

          Are you okay with people being left sterile?

          Are you okay with people suffering severe brain damage?

          If you *aren’t* okay with all those things, then instead of asking what brought down the *death* rate, you should be asking what brought down the rates of *all* those negative outcomes. And – you should be looking carefully at those who encouraged you to look at *only* the death rates as if that was the full story.

          1. Can you hear me from inside that glass house, man? WHAT CAUSED THE RATES TO FALL BEFORE THE 1940’s? You see, you are looking at an outcome and deciding what caused it. You might be right- except for the fact that GERM THEORY came out around 1900. Have you seen the studies indicating how much disease was spread by doctors alone, before then?I am very happy there is less blindness in the world. Just don’t tell me it was the automobile that caused it because it came out at roughly the same time, was forced on us, and it is “unethical” to do the studies that would prove otherwise. That is a joke. THIS IS SCIENCE, MAN!You lab coats use the “double-blind placebo testing” crap to worm your way out of looking at things that contradict your textbooks. Yet the things you force on us with such righteous necessity don’t even have to meet this standard? That sounds alot like faith, to me, doc.

          2. Your reply, “Doc,” is full of sound and fury, but almost completely lacking in accuracy (as well as coherence.)  Just as you confidently asserted that there is no scarlet fever vaccine (which is untrue) and that measles death rates “dropped to baseline” before measles vaccine (also untrue) you are completely wrong in your claim that the vaccines we use today were not put through double-blind placebo testing, and also wrong in your claim that the only evidence of the success of vaccines is crude temporal correlation.

            I have to ask, how can you with a straight face hurl accusations that mainstream medicine doesn’t do or hasn’t done enough to verify the tenet that vaccines protect against disease – when you don’t take two minutes with a search engine to check your own claims??

          3. Please cite 2 randomized double-blind placebo studies of the efficacy of the MMR.

          4. The MMR vaccine is a combination vaccine, made by combining three other vaccines that have been individually proved through double-blind placebo testing. If you mean (as I suspect you do) a study that tests the MMR vaccine against a placebo that does not provide ANY protection against mumps or measles or rubella, I have to remind you that such a study would be unethical. You DO grasp that NOT protecting your children against diseases that can kill them is a BAD thing, right? And that “some guy on the Internet, who posts things he’d know were BS if he took two minutes to search for himself, doubts the efficacy of vaccines” is NOT a compelling reason to put children at risk for such a study?

            But frankly, even if you were asking for something reasonable, like a placebo-controlled RCT study that tests whether the “adverse reactions” reported to the MMR vaccine actually come from the vaccine (fun question: how do you think that study was designed, so that the protection of the children was NOT sacrificed?) there’s little point in digging up such citations for you. There might be some point in doing it for someone who wasn’t too lazy to even try searching for himself… or someone who was at least honest enough to learn from their mistakes when they discovered that something they declared as fact was completely false. But for you? You’ve made it clear that time spent trying to reach your closed mind is time wasted.

          5. Auntie Feldspar, I think if those studies were available to the common schmuck, like myself, it might go along way toward educating people, no? If you have to do battle with every idiot who comes down the pike, why would you not use the Big Guns?You keep telling us that it would be unethical to do the studies I ask for, yet they’ve already been done. If nothing else, it would be fair sport to see a study which we would now call “unethical” but so much of our modern medical health is derived from.I surrender, I am an idiot. I cannot use my internet properly. Please fire off the Big Guns and dispose of me. Randomized, double-blind, placebo-controlled, “prospective” studies proving the efficacy of the mumps vaccine. Or measles, or rubella.

          6. Well, here are three citations for you. They weren’t hard to find through PubMed, which is a tool freely available to ordinary schmucks like you and me. Because I limited my search to only those articles where the complete text was available free online, I couldn’t find the early studies I’d been looking for – I’d really been hoping for the first trials of Edmonston B, for example. Nevertheless, there’s certainly enough to debunk the claim that vaccines somehow bypassed randomized clinical trials.

            Bull World Health Organ. 1965; 32(6): 779–789.  Comparative trial of live measles vaccines in Czechoslovakia.  L. Syrůček, J. Helcl, J. Šejda, E. Švandová, M. Staninec, H. Grantová, J. Mertenová, E. Mílek, J. Mirovský, J. Procházka, J. Strauss, and J. Zdražílek

            Bull World Health Organ. 1975; 52(1): 81–85.  Clinical evaluation of a new measles-mumps-rubella combined live virus vaccine in the Dominican Republic.  N. Joel Ehrenkranz, Arnoldo K. Ventura, Edward M. Medler, Joseph E. Jackson, and Michael T. Kenny

            Am J Public Health Nations Health. 1967 August; 57(8): 1333–1340.  Edmonston B and a further attenuated measles vaccine–a placebo controlled double blind comparison.  G Miller, J Gale, V Villarejos, W James, C G Arteaga, H Casey, and D A Henderson

            To say it would be unethical to do these studies now is completely correct, but also misses completely the point of WHY it would be unethical: because they won’t tell us anything we don’t already know! If a vaccine was developed for a dangerous disease we never had a vaccine for before, would it be ethical to test it for efficacy? Yes, it would, because we’d need to know whether it really worked. But would it then be ethical, AFTER we knew that it worked, to do a trial that involved withholding its protection from some subjects, just because some people didn’t want to believe that it worked? Of course not!

  25. Take a look at this fascinating case
    study, ‘Apparent Paradox of Measles Infections in Immunized Persons’


    We found 18 reports of measles outbreaks in very highly immunized school
    populations where 71% to 99.8% of students were immunized against
    measles. Despite these high rates of immunization, 30% to 100% (mean,
    77%) of all measles cases in these outbreaks occurred in previously
    immunized students. In our hypothetical school model, after more than
    95% of schoolchildren are immunized against measles, the majority of
    measles cases occur in appropriately immunized children.


    The apparent paradox is that as measles immunization rates rise to high
    levels in a population, measles becomes a disease of immunized persons.
    Because of the failure rate of the vaccine and the unique
    transmissibility of the measles virus, the currently available measles
    vaccine, used in a single-dose strategy, is unlikely to completely
    eliminate measles. The longterm success of a two-dose strategy to
    eliminate measles remains to be determined.”
    Why haven’t we been beaten over the head with
    this information? Why is reporting always so skewed towards scare
    tactics that one-sidedly tout the purported necessity of vaccination?
    Why do the authors conclude that the solution might be a ‘two-dose
    strategy’, and fail to consider that the children would be better off
    not getting vaccinated at all, as their data suggest?
    “Unencumbered by facts”, indeed.

    1. Bryan, I’m afraid you’ve misunderstood the basic implications of the study; it does not at all support the idea that “the children would be better off not getting vaccinated at all.”

      If we checked the handedness of students who came down with measles, we’d surely find that right-handed students outnumbered left-handed students. Does this imply that right-handedness causes especial vulnerability to measles? That if we could somehow change the right-handed students to left-handedness, they’d be less likely to catch or develop measles? Clearly not; right-handed people predominate in the population of measles cases simply because they predominate in the general population.

      The same is true of immunization: when the number of immunized people greatly outnumbers the number of unimmunized people, even a small percentage out of that immunized population may outnumber a larger percentage of that small unimmunized population. Suppose we had a school with 1000 students, and 99% of those students were immunized. If 10 out of the 10 unimmunized students all get the disease and only 20 out of the 990 immunized students get it, does that imply that students are “better off getting not vaccinated at all”? When the *rate* of disease of the immunized students is about 2% of that of the unimmunized? Surely you can see how ludicrous that is.

  26. antivax?? Calling parent who complied and had their kids vaccinated “anti-vax” makes no sense. My son received all his recommended shots. afteer his MMR and flu shot he became very ill and deteriorated. To this day I think his system was overloaded. Too many parents are coming and saying something happened after shot. You can’t ignore what many paretns ha

  27. antivax?? Calling parent who complied and had their kids vaccinated “anti-vax” makes no sense. My son received all his recommended shots. afteer his MMR and flu shot he became very ill and deteriorated. To this day I think his system was overloaded. Too many parents are coming and saying something happened after shot. You can’t ignore what many paretns ha

  28. Dr. M-  Just a quick note to say thanks and keep up the good work.  Relentless good information is the vaccine against anti-vaxism.  

    BTW, in the past I never bothered to get a flu shot, thinking that it was better to not use something “just for my own benefit” that someone else might need.  But once I understood herd immunity I started getting them: not for my sake, but for the sake of contributing to herd immunity that protects others.  I suspect there are a lot of people out there who mistakenly forego flu shots for more or less altruistic reasons, for whom an understanding of herd immunity would be a good motivator to get their shots.    

  29. Chickenpox?  It’s true many children will grow up with automobiles.  And driving cars might well serve that child in the future, but undoubtedly some of those children will die of severe trauma, decapitation, and blood loss in crashes.  So we must immunize all people against the automobile.  Straight science, baby!  Boy, it really is so simple when you highly paid scrubs spell it all out for us.

  30. I apologize for the disrespect I’ve shown.  I was reacting to the insinuation that I was unencumbered by facts.
    Can you tell me if The Cochrane Library is an anti-vax site?
    “No credible evidence of an involvement of MMR with either autism or Crohn’s disease was found. No field studies of the vaccine’s effectiveness were found but the impact of mass immunisation on the elimination of the diseases has been demonstrated worldwide.”

    How scientific does that last statement sound?  Not 1 “real world” study?

  31. antivax?? Calling parents who complied and had their kids vaccinated “anti-vax” makes no sense. My son received all his recommended shots by age 2. After his MMR and flu shot he became very ill and his development deteriorated and he was diagnsoed with autism at age 3. To this day I think his immature immune system was overstimulated and that impacted his neurodevelopment. Too many parents are reporting something happened after shot. You can’t ignore what many parents have experienced first hand. This is not about Wakefield its about the kids. The CDC reports that 1 in 70 boys in the US has an autism diagnosis. Estimated cost for lifetime care $3.2.milllion per child.

    When researchers look deeper it’s been diiscovered that many of our children have an underlying mitochondrial problem, GI imbalance and brain inflammation. Some children even have denovo mutations in their DNA not present in either parent. So what is triggering all this? Aren’t doctors curious as to why? Isn’t that what’s most important? To get to the bottom of all this?

    Calling autism parents “anti vax” simply because we question the wisdom of all these shots to a baby is unfair and shows extreme bias the medical community has for pushing immunization over parental concerns that perhaps all these shots are just too much for some children. We may have a sensitive population that is being ignored. Keep the focus on the kids!

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