How Your Doctor Is Taught To Deal With Questions About Vaccines

This post is dedicated to Erica and her husband – along with all other parents out there that have presented questions to their doctors about the safety, efficacy and, ultimately, the use of vaccines and are met with crap responses.

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The American Academy of Family Physicians (AAFP) has a curriculum to help doctors “deal with” parents who are concerned about vaccine safety, efficacy and necessity.[1]

Nah nah nah nah nah nah nah nah nah

The AAFP’s curriculum includes real-life scenarios of parental concerns and suggests responses for doctors to become familiar with and use in their future interaction with parents.

Here are a few… with my commentary.

Concern: Parents who think vaccines cause autism

Response: There is no scientific evidence showing a link between vaccines and autism. Children’s immune systems can handle the vaccines.

Why do all physicians think parents who delay, select or decline vaccines do so solely on the basis of the autism debate?

I personally don’t touch this subject with a ten foot pole for this fact alone. Ok, I did ONE time. (You can read about that here: Aluminum Adjuvants and The Rising Prevalence of Autism)

Here’s the thing – doctors are most notably referring to gastrointestinal surgeon Dr. Andrew Wakefield’s research in 1998 regarding the exposure to the measles virus and subsequent development of Crohn’s disease, and in many cases, autism.



Oh sht, did he just go there?
Yup, he did. Now we're all screwed.



Pretty old school – let’s fast forward to May 2011 (over a decade later) to the Journal of Toxicology and Environmental Health:[2]

This publication used a regression analysis, the relationship between the proportion of children who received the recommended vaccines by age 2 years and the prevalence of autism in each U.S. state from 2001 and 2007 was determined and evaluated.

What did they find?  …

A positive and statistically significant relationship was found: The higher the proportion of children receiving recommended vaccinations, the higher was the prevalence of AUT or SLI. A 1% increase in vaccination was associated with an additional 680 children having AUT or SLI. Neither parental behavior nor access to care affected the results, since vaccination proportions were not significantly related (statistically) to any other disability or to the number of pediatricians in a U.S. state. The results suggest that although mercury has been removed from many vaccines, other culprits may link vaccines to autism. Further study into the relationship between vaccines and autism is warranted.

This was published last year. So to simply write off the concern about the administration of vaccines and ASD is impetuous.

This isn’t just one random publication that I found sifting through tons research. There are many.

Please note: I am in no way trying to prove or say that autism is caused by vaccines. I’m trying to say that we need to use caution and diligence when deciding if a particular vaccine is needed – not brush off parental concern.

Here are a few more:

Published in 2011

Tomljenovic, Lucija. Christopher Shaw. Do Aluminum Vaccine Adjuvants Contribute to the Rising Prevalence of Autism? Journal of Inorganic Biochemistry. Aug 2011

The positive correlation between Al exposure from vaccines and prevalence of ASD does not necessarily imply causation. However, if the correlation is strong (criterion 1), consistent (criterion 2), and if there is a biologically plausible mechanism by which it can be explained (criterion 6), as well as an appropriate temporal relationship between the proposed cause and the outcome (criterion 4), then the satisfaction of these criteria supports the notion that the two events may indeed be causally related.

Our results satisfy not only all four of the criteria applicable for establishing causation in neuropsychiatry, but also four others.

Published in 2008 

David Geier & Mark Geier. A meta-analysis epidemiological assessment of neurodevelopmental disorders following vaccines administered from 1994 through 2000 in the United States. Neuroendocrinology Letters. Vol 27, No4. 2006

There is very current research now questioning the use of aluminum in vaccines and its ability to cause ASD.

Published in 2004

Lynne Levitshy. Childhood Immunizations and Chronic Illness. The New England Journal of Medicine. 350:1380-1382. Apr 2004.

We have traded the morbidity and mortality associated with many acute, infectious childhood diseases for the morbidity and mortality associated with more chronic disorders whose causes are as yet uncertain.

Concern: Parents who believe the vaccine schedule is a “money-fueled conspiracy”

Response: Doctors and public health officials support the schedule. Ask, “Do you really think I would recommend something that I didn’t think was best for your child?”

Of course you think it’s best for children, you just spent 8 years being told that children need vaccines, antibiotics, Tylenol and Sudafed to be healthy. Ok, I’m sorry, that was out of line.

I doubt many parents who present concerns to their doctor about the vested interests of the pharmaceutical company and it’s professional relationship between the FDA think of it as a “money-fueled conspiracy”. That’s harshly judgmental.

I see dead people and aliens and chem trails and Illuminati

Bottom line - Conspiracy means to plan and act secretly together to perform something unlawful.

What is happening here is completely legal. So, no –there is no conspiracy. 

What the CDC and FDA do is completely lawful. That’s what is so disheartening.

What we should be discussing is conflict of interest.

Since the first vaccine was introduced, there has been conflicts of interest.

There is a myriad of conflicts of interest incorporated into the arrangement and structure of how vaccines come to be recommended to the public.[3] If you think it’s all ponies and rainbows then you’re sadly mistaken.

Pharmaceutical companies trial, evaluate, and assess their own research and drugs. Published research has determined that pharmaceutical company sponsorship of safety and efficacy trials is associated with reduced likelihood of reporting unfavorable results. How can that not be a conflict of interest?[4][5]

Increasingly, medical doctors receive concessions (such as gifts, continuing medical education [CME] and samples) from pharmaceutical representatives when using their drugs and vaccines.[6][7] How is that not conflict of interest?!

The professionals on the committee that make the recommendations to the CDC for their immunization schedule are shady too. The ACIP consists of 15 professionals that provide a vote on the guidance given to the CDC. (Just FYI the ACIP is the only entity within the federal government that makes recommendation for routine administration of vaccines.)[8]

Here is the ACIP committee’s conflict of interest forms completed on the Annals of Internal Medicine and see for yourself.

https://www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2988

Now if you think these forms are double checked to confirm accuracy and conflict of interest, then you might be surprised to find out that the Department of Health and Human Services issued a report in 2009 that examined disclosure forms in special governmental employees on federal advisory committees.[9]

All data analysis was done on the basis of the financial disclosure forms and other documents provided by the advisors. The study did not do any investigations into the advisors' lives to attempt to find conflicts of interest. All problems found were based on disclosed information.

If an expert didn't provide any information about a conflict of interest, it was not investigated and the HHS's study didn't find it. In other words, as bad as the study's findings are, they could be only the tip of the iceberg.

“We found that CDC had a systemic lack of oversight of the ethics programs for SGEs.”[9]

What does that mean – well it means: the CDC did not identify or resolve conflicts of interests for special government employees. It means that financial disclosure forms were incomplete.

The CDC relies on the suggestions of its advisors to determine what the nation's vaccination programs will be – yet, conflict of interest is not being examined or resolved to the extent that it should be.

Concern: The source of vaccine-hesitant parents’ information

Response: Ask why they’re “taking medical advice from a celebrity, friend, relative, or magazine instead of from their child’s doctor.” Credible, scientific information comes from “reliable/stable groups” such as the AAP, NIH, and WHO. It’s not anecdotal, and nothing is being sold, such as a book, which would indicate a conflict of interest.

Now when a parent says conflict of interest they are labeled a conspiracy theorist, but it’s completely acceptable for your doctor to use the term on you when it is in their best interest.

Isn’t that calling the kettle black, much?! (Review prior section)

Besides, you think we are using scientific information from unreliable sources just because it doesn’t agree with what you’ve been told to parrot. Bah.

Concern: Parents who want to follow an alternate schedule

Response: Unvaccinated children can get sick and make other kids sick. Delaying shots delays protection. Ask, “You don’t delay putting your baby in a car seat. Why do you want to delay protection from vaccines?”

First off - Is the AAFP seriously comparing a woven safety harness worn in a motor vechile to the injection of a medical grade vaccine directly into the body? Seriously?!?!

Wow, they mus’ think we be purrrrtty dum.

Thanks for completely brushing off my concern though.

Did they really just indicate that vaccinated children don't get sick or make other kids sick??!

Neat. Stargate SG1

Oh that’s right, my kid is going to get hepatitis B by intravenous drug use and give it to your kid if they aren’t up to date on their vaccinations.  Nonsense.

First thing - Immunization does not prevent transmission of disease.

That would be great if it did, but it doesn’t. Hand washing is better at preventing transmission then a vaccine.

Vaccination holds the potential to increase the levels of antibodies within that specific person’s body. Period. (plus other not so good effects)

It’s like saying if I wear my seat belt driving my car, then everyone else will automatically be wearing theirs. It doesn’t make any logical sense.

Secondly – I believe they are hinting at the concept of herd immunity here which can be a very useful theory and tool in assessing natural immunity within a closed group– although it gets really tricky when that is altered. A vaccination campaign entails a massive disruption of the natural occurring balance which destabilizes epidemiologic patterns for many years (we are experiencing this now with chicken pox and it’s effects on shingles).[10]

Herd immunity is extremely dynamic. There are many different models of herd immunity such as the mass action model, the reed-frost heterogeneous approach and case reproduction – all of which use widely divergent estimates.[10]

Bottom line – if your doctor isn’t receptive to an individualized vaccine schedule, then find a new doctor.

Concern: Serious side effects

Response: Serious side effects are extremely rare (1 in 100,000 children). Say, “Billions of people have received some vaccines. If they clearly caused a significant side effect, we would know about it.”

If they clearly caused significant side effects wouldn’t they tell you in the manufacturer’s package insert? Oh, wait, they do. [11]

Package inserts: http://www.immunize.org/packageinserts/

Interesting side question - What about the side effects not tested? Long term effects on the brain, body, immune function. Ugh.

Oh, oh – and what about the fishy use of unregulated placebo groups used in clinical safety trials.[12] Specifically, not utilizing saline solution placebos in vaccine safety trials.

Don’t even try and talk to me about dismissing the effects of administering vaccines on infants when I’ve met so many mothers and fathers dealing with these repercussions for the rest of their child’s life.

It’s nauseating. 

Doctors should not down play the effects of administering a vaccine – whether it be considered minor or major.

Concern: The purpose and safety of vaccine ingredients

Response: Each ingredient serves a purpose and is necessary. There is “no known toxicity” to any of them.

Liar.

How are we supposed to trust doctors when they are instructed to blatantly lie to our face?! How is that the best interest for anyone?

God I hope doctors aren’t telling parents this.

Be straight with me for gosh sakes and maybe I would have a bit of respect for you and your field of work.

Firstly, in February of last year the US Supreme Court ruled that vaccine manufacturers are immune from lawsuits charging them that the design of a vaccine is defective.[13] In layman’s terms, that means a vaccine may harbor ingredients known to be caustic to human life and they don’t have to change a damn thing about it.

Aluminum adjuvants being found to be harmful to infants when injected that the level of some vaccines – doesn’t matter.

It also means that if they find out a vaccine is ineffective at the current formulation or dose – it doesn’t matter. The manufacturer doesn’t need to change crap. AND they aren’t accountable for it!

A good example of this is the DTaP vaccine. Just this past March a publication reported that the current vaccine is ineffective at preventing occurrences in the preadolescent population.[14] Do they demand the manufacturer to reformulate? No – because they are protected by law not to!

They just recommend more booster doses!

Ok, maybe I’ll give them the benefit of the doubt –they are just parroting what they are being told to say – still, that seems pretty reckless not to do the research yourself.

Here, I’ll start the ball rolling for them. I’m not going to list each ingredient and its toxicity to the human body as that would too lengthy for this post – instead I’ll post this:

Recently published this year in Lupus:[15]

According to the US Food and Drug Administration, safety assessments for vaccines have often not included appropriate toxicity studies because vaccines have not been viewed as inherently toxic. Taken together, these observations raise plausible concerns about the overall safety of current childhood vaccination programs. When assessing adjuvant toxicity in children, several key points ought to be considered: (i) infants and children should not be viewed as “small adults” with regard to toxicological risk as their unique physiology makes them much more vulnerable to toxic insults; (ii) in adult humans Al vaccine adjuvants have been linked to a variety of serious autoimmune and inflammatory conditions (i.e., “ASIA”), yet children are regularly exposed to much higher amounts of Al from vaccines than adults; (iii) it is often assumed that peripheral immune responses do not affect brain function. However, it is now clearly established that there is a bidirectional neuro-immune cross-talk that plays crucial roles in immunoregulation as well as brain function.

….the same components of the neuro-immune axis that play key roles in brain development and immune function are heavily targeted by Al adjuvants

In summary, research evidence shows that increasing concerns about current vaccination practices may indeed be warranted. Because children may be most at risk of vaccine-induced complications, a rigorous evaluation of the vaccine-related adverse health impacts in the pediatric population is urgently needed.

Conclusion

Ultimately, I know doctors are trying their best (to the best of their ability) to help children. That counts for a lot.

But as parents, we must also do our part to understand what recommended medical interventions entail and the research behind them. This doesn’t just include vaccines, but a host of procedures.

For parents this holds the possibility for so much – to learn and become a better parent each day. We owe it to children and ourselves to develop and thrive in our role as mom or dad. Don’t sell yourself short! 

Life is change. Growth is optional. Choose wisely.

This post reflects the research and concern that I have about vaccination.  It doesn’t represent my opinion of people who choose to vaccinate.  Please know that, while my family has made this decision, we respect the right of all parents to choose to vaccinate if they feel this is best for their child.  I don’t have all the answers.  Most of us don’t.  We’re all in the same boat in that we need to make the best decision we can with the information we have.  And, ultimately, I believe that the Divine is in control – what is meant to be will prevail, no matter our decision.

Reference:

[1] Jennifer Hutchinson. Vaccines: What Your Doctors Know and Don’t Know. Sovereign Independent UK. Aug 8 2012

[2] Gayle DeLong. A positive association found between autism prevalence and childhood vaccination uptake across the US population. Journal of Toxicology and Environmental Health, Part A: Current Issues. Vol 74, Issue 14. 2011.

[3] Bernard Le et all. Conflict of interest policies for investigators in clinical trials. The New England Journal of Medicine. 343:1616-1620. Nov 200

[4] Mark Friedberg et all. Evaluation of conflict of interest in economic analyses of new drugs used in oncology. JAMA. Vol 282, No 15. Oct 1999

[5] Joel Lexchin. Lisa Bero. Ben Djulbegovic. Otavio Clark. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ. 326:1167. May 2003.

[6] J P Orlowski. L Wateska. The effects of pharmaceutical firm enticements on physician prescribing patterns. Chest Journal. 102(1): 270-273. 1992.

[7] ICMJE Forms. Annals of Internal Medicine. American College of Physicans. 2012

https://www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2988

[7]Mark Cicero. Michael Curi. Mark Mercurio. Ethics for the pediatrician: physician interaction with the pharmaceutical industry. Pediatrics. Vol 32. No 1. Jan 2011.

[8] Recommended Adult Immunization Schedule: United States

, 2012. Advisory Committee on Immunization Practices. Annal of Internal Medicine Jan 31, 2012. http://www.annals.org/content/early/2012/01/30/0003-4819-156-3-201202070-00388.full

[9]Daniel Levinson (Inspector General). CDC’s ethics program for special government employees on federal advisory committees. Department of Health and Human Services - Office of Inspector General. Dec 2009. http://oig.hhs.gov/oei/reports/oei-04-07-00260.pdf

[10]Fine, Paul. Herd Immunity: History, Theory, Practice. The John

Hopkins University School of Hygiene and Public Health. Vol 15, No 2. 1993

[11]Package Inserts. Immunization Action Coalition http://www.immunize.org/packageinserts/

[12]Golomb, Erickson, Koperski, Sack, Enkin, Howick. What’s in Placebos: Who Knows? Analysis of Randomized, Controlled Trials. Research and Reporting Methods. http://www.annals.org/content/153/8/532.abstract

[13] Aaron Kesselheim. Safety, Supply, and Suits — Litigation and the Vaccine Industry. The New England

Journal of Medicine. Vol 364: 1485-1487. Apr 2011

[14] Maxwell Witt. Paul Katz. David Witt. Unexpected limited durability of immunity following acellular pertussis vaccination in preadolescents in a north American outbreak. Clinical Infectious Diseases. Vol 54 (12) 1730-1735. Mar 2012.

[15]L Tomljenovic. Mechanisms of aluminum adjuvant toxicity and autoimmunity in pediatric populations. Lupus. Vol 21:No2. Feb 2012.