This reader is upset:

It is with great disappointment that I respond to the PediaBlog titled “Running Out of Excuses”. It is upsetting that a member of my pediatrician’s practice would write such a piece regarding vaccinations. I am absolutely appalled and disgusted by the “Penn and Teller” clip that was posted to the blog by Dr. Ned Ketyer on February 19, 2014. Information from this blog and video clip are false, misleading, and crude.

 

I’m sorry the reader was appalled and disgusted by the video that I linked to.  I disagree that the information on the clip was false and misleading.  Yes, it was crude, which I mentioned before posting the link to another’s blog, where the video could be viewed.  It did effectively illustrate how vaccines work as a protective shield for children — and those around them — and why immunizing is so important.

The reader continues:

Please let me start by saying, my children are fully vaccinated. I do have a child with autism – and yes he was affected by vaccinations. Am I saying that is what completely caused his autism – absolutely not.

Children with autism have a genetic predisposition to being affected by environmental toxins. We often hear the saying “Genetics load the gun, and the environment pulls the trigger.” Some children’s immune systems can tolerate more than others. This includes any toxins – environment, food, medicinal, etc..

With that being said why wouldn’t a parent separate their child’s vaccinations? It only makes sense. Where are the studies saying this is harmful? If I want to give my child one vaccine a month , instead of 6 at one time – it is not harming anyone. Is it more difficult for me, absolutely! Is it more difficult for the nurse to have to get one injection at a time – probably, but those are the only downfalls. Additionally, if there is an adverse reaction after vaccination– if one is given at a time, the culprit is known. If your children are vaccinated, then why do you mind?

 

Why would I mind?  Please read Tuesday’s PediaBlog for the answer.

Look.  Most pediatricians are willing to work with parents if they want to space out vaccines in order to insure their children are completely vaccinated.  But there is potential harm to the child for doing it this way, beyond the inconvenience to the parents or to the pediatrician and office staff (which, really, we can handle!). First of all, spacing out vaccines means giving one now and delaying the rest for another time.  A baby is at risk for pertussis, tetanus, polio, HiB, pneumococcus, and rotavirus at 2 months of age AND at 2 months and one week of age.  Delaying even for a week keeps them at risk.  And what does our reader mean by spacing out the vaccines?  Will you bring your child back for the next vaccine tomorrow?  Next week?  Next month?  Next year? Life happens — kids get sick, a snowstorm or cold snap hits — and things get pushed back even further.  (This happens all the time in practice.) Finally, asking your doctor to ignore what is recognized throughout the world and based on scientific evidence as the standard of care is probably not a good idea for any patient or practitioner of medicine.

I agree that with many conditions, the genetic “switch” is turned on by something in the environment.  My guess is that when the story of autism is finally written, it will be something toxic in the environment that turns on that particular switch.  More studies need to be done to find that culprit.  Many, many, many studies conclude it’s not vaccines.  Despite healthy skepticism and hypotheses predicting harm, no peer-reviewed scientific study has concluded that any vaccine, or combinations of vaccines, cause any neurodevelopmental or other physical harm to children. Skepticism might tell you “it only makes sense” to space out vaccines.  Good, objective, repeatable science reassures me it’s safe to give them together.

More skepticism:

Vaccines are life saving and necessary. Most people will not argue this. 99% of parents who have concerns about vaccines, have that, only concerns. About things like preservatives such as Thimerosol, Aluminum, and Formaldehyde to name a few.

Parents are concerned about giving 6 vaccinations at one time. As of today we do not have research from the CDC stating that giving mass vaccinations is hurting our children – we also do not have empirical research showing that it is not hurting our children. Until we do – everything is on the table for discussion.

As an educated person who believes in spacing out vaccines I am extremely disappointed in the negative tone of your article. Please, stop making educated parents who care about their child’s well being out to be criminals. We all know the importance of vaccinations – posting a crude video mocking parents of children with autism is the not the way to make your point.

 

What we know in life is what we’ve heard from others, what we’ve read, and what we’ve seen for ourselves.  Most people do believe vaccines are life-saving and necessary.  And the reader is probably correct: most parents may indeed be concerned — even skeptical — about vaccine safety in general, and things like preservatives in particular.  But when numerous peer-reviewed scientific studies conclude that thimerosal, aluminum, and formaldehyde used in the production of vaccines do not cause harm, skepticism should give way to acceptance.

Skepticism is healthy and constructive — and leads to good science.  It’s cynicism (and I believe the reader here is not being cynical) that’s not helpful in this discussion.  It’s cynicism (and I’ve heard it all — vaccines as a government mind-control scheme, doctors getting rich from Big Pharma, doctors conspiring to poison kids so they need more medical care, etc), not skepticism, that drives most pediatricians bonkers.  We all don’t know the importance of vaccines, unfortunately. (And I will take the criticism of the mentioned video constructively — perhaps there was a better way to make my point.)

In conclusion:

I was encouraged to see your post February 21st titled Children “Pre-Polluted” . I do agree that toxins in our environment are negatively affecting our kids,. I am puzzled though, as to how you do not question the ingredients or number of vaccines that are being given to our children today. You must treat some children with developmental disabilities in your practice. Haven’t you seen evidence of children having negative reactions to vaccines? In my peer group of parents of children with autism, as well as the parents of children I work with, I have heard countless experiences that are almost identical. These children, hours after being given vaccines have had 105 degree fevers, seizures, loss of speech, and just plain loss of developmental milestones. How do you explain that…or is it just a coincidence?

 

It’s not that I don’t question the ingredients in vaccines or the numbers of antigens given at a given time.  It’s that all the data educating my skeptical mind — what I’ve heard from others, what I’ve read in the scientific literature, what I’ve seen with my own eyes —  points not to danger, but to safety.  Speaking from the perspective of my personal experience, I have not seen a child have a 105 degree fever and seizures (from the high fever, called febrile seizures) since the whole-cell DTP vaccine was replaced by the acellular DTaP vaccine in 1991. (You can read about that vaccine’s history  here and here. I’m proud to say that I, along with many pediatricians at Pediatric Alliance and others in Pittsburgh and around the world, participated in clinical studies in our offices, validating the safety and efficacy of modern vaccines, including DTaP.  In fact, all three of my sons participated in vaccine safety and efficacy studies when they were younger.)  In nearly 27 years as a pediatrician, I have never seen (or heard from my colleagues or read a case report) of a child who developed a loss of speech or other developmental milestones as a consequence of immunizations. And yes, I have the great pleasure and privilege to treat many children with developmental disabilities in my practice.

I would never say that such a terrible outcome could never happen.  I agree with the reader that “some children’s immune systems can tolerate more than others.”  There’s no question people react differently to different things.  Proving causation can be a tricky thing in medicine.  And that’s why, despite abundant evidence-based science that says the standard practice of giving immunizations is safe, skepticism persists.