The Truth About Vaccines.
June 20, 2019 Mary Catherine Scott
Deep breath, and here we go!
It started in early April when I was having a conversation with my husband, Jordan, and his parents about vaccines. Our son is about 18 months, and Jordan's sister has a 6-month-old. We were discussing the measles outbreaks all over the country, and kept asking ourselves, "Why wouldn't people just get vaccinated?
Before we go on, I want to say two things plainly and up front.
The first is that I am not a doctor or medical professional of any kind. I am an English and Religious Studies major from a small, liberal arts college in Alabama. The information reflected in this post is a result of my own reading, conversations, and research as a lay person, seeking information and answers to be better informed in my conversations around this issue.
The second is that I am pro-vaccination. I was before diving into this topic for my blog, and my research has only caused me to double down on that stance. My child has received all the vaccines available to him at this age, and I do not agree with or support the choice not to vaccinate unless specifically advised not to do so by a pediatrician because of life-threatening risk factors.
When I originally began kicking the idea for this post around, it was over a month ago. I thought I'd spend two weeks on it, but one conversation has led to another, which has led to e-mails back and forth with award-winning epidemiologists, moms who've chosen not to vaccinate, and vaccine experts. I have read and listened to so much - so many hours of work writing, reading, and learning - but what I've been exposed to is ultimately a tiny drop in the bucket of the loads of information out there to consume.
To be totally candid, one of the reasons I've spent so long working on this post because I've been trying to strike exactly the right, reverent chord of stating my opinions and the opinions of medical professionals, while still respecting the women who were kind enough to help me understand the reasons they chose not to vaccinate their children. The doctors I interviewed implored me not to be overly sympathetic to the anti-vaccination movement; the women I spoke to who didn't vaccinate urged me to make sure I was doing my own research. It has been overwhelming, and so the best I can do here is relay the facts, as plainly as possible, and with the context I feel is important in understanding them.
What this month+ of reading, research, podcasts, and trading e-mails with new friends and with doctors has reinforced to me is that this is a very complicated issue.
In an effort to actually get a conclusive answer to my "Why not just get vaccinated?" question, I posed it to my Instagram followers. Because of some partnerships I've done, I have a few hundred followers I don't know personally, and I knew I'd have a broad spectrum of young moms with differing opinions. I asked them to Direct Message me if they had chosen not to vaccinate their children. I expected one or two replies and wound up with a little over a dozen.
Two women in particular offered themselves as guides through the mindsets of parents who choose not to vaccinate their kids. I took them up on their offers, and wound up with loads of information they provided to me in the way of explaining their rationale. There were tables, articles, and counterarguments to popular scientific theories. They poured so much effort and compassion into helping me get a clear window into their minds.
As I delved into the resources they sent, it became clear that lots of it was hyper-specific and in-depth. I decided I needed someone who knew more about this than I did to help walk me through the various anti-vaccination arguments.
Through some friends, I was able to hook up with two epidemiologists, one of whom is an MD/PhD and the other of whom is a PhD. I won't mention them by name here to avoid any unwanted attention, but both women teach at major universities and have published very well-known papers, made discoveries, and are considered top-tier experts in their fields. For the sake of this post, we'll call them Dr. Brown and Dr. Jones. I synthesized the basic arguments from my new friends and sent them to Dr. Brown (MD/PhD) first, then Dr. Jones (PhD) a few weeks later. They were both kind enough to reply with articles, data points, and research of their own.
When I polled Instagram that day, I'll admit: I did so with a very particular preconception in mind. The only people I'd ever met or heard about in the "anti-vaxx" community seemed to be willfully ignoring important data. I didn't have much sympathy or empathy for them because I felt they were putting people at large (and now my child specifically) at risk.
Since polling my Instagram followers a few weeks ago, I have learned so much. As is usually the case when I have a strong (if uninformed) opinion about a group of people, getting to know parents of unvaccinated kids personally has softened my heart enormously.
The truth is that these parents love their children. They are nurturing, kind people, two of whom went to great lengths to type out pages and pages of their rationale for not vaccinating. Putting a human face on something that was simply an "issue" before has helped me so much in beginning to understand how people arrive at the conclusion not to vaccinate. It's easy to call a point of view ignorant when you don't actually know anyone in that camp; I am very appreciative of the moms who took time out to respond to me. These women are college-educated - certainly not ignorant, as is a popular refrain from the pro-vaccination camp - and have made this choice with that they feel is the best possible information that they can find. It's very important to me that this post offers a kinder view of people with this opinion. I don't think they're right, but in all the cases I've encountered, they're also trying their dead-level best to protect their kids. Like every issue, just because I disagree with someone doesn't mean I have to demonize them.
And we don't agree. In fact, we almost categorically disagree. But I have relished the opportunities they each provided: a chance to have respectful, intelligent conversation across lines of difference, especially with fellow women.
Having said all that, let's dive into the data. I hope you're ready to nerd out.
What are some of the major objections to having one's child vaccinated?
Mistrust of government.
Mistrust of the medical community.
Mistrust of Big Pharma.
Fear of vaccine injury or overwhelming a child's immune system.
Fear of autism caused by vaccines.
Lack of clarity about ingredients, AKA the "heavy metals" argument.
Ethical issues over "aborted fetal cells" being included in vaccine content.
Believing that natural is best, and that the body can fight off illnesses on its own.
Belief in information dispensed by groups like Robert F. Kennedy Jr.'s Children's Health Defense.
Concerns about vaccine shedding, herd immunity, and lack of adult vaccination.
What does the medical community say?
Mistrust of the government. It's hard to argue against a feeling, but Dr. Peter Hotez (MD, PhD, and vaccine expert) made a great point in a podcast where I heard him interviewed: "You don't have to trust the current administration or any of its policies to believe that vaccines are effective and important. Plenty of people who don't work for the government promote the benefits of vaccines." The doctors I spoke to for this post are not affiliated with the government. Although it's possible that they've taken advantage of government grant programs I'm not aware of, they both work for private organizations. (Dr. Hotez also works for a private organization: Baylor College of Medicine.)
Mistrust of the medical community. Any parent of a new baby has grappled with the thousands of decisions, both large and small, that come as a part of caring for a newborn. If the first time you hear about vaccines and their benefits is in the first appointment with your 2-week-old when your #1, hyper-vigilant concern is keeping them from harm, the idea of injecting them with live viruses could seem daunting and frightening. I don't share this concern, but I can empathize deeply. There often simply isn't enough time in those first appointments to have the types of long, careful conversations needed to satiate the minds of fearful new parents.
Mistrust of Big Pharma. Another great quote here from Dr. Hotez: "One of the things that anti-vaxxers say to pro-vaccination advocates is that they're being 'propped up' by Big Pharma." For this reason, I specifically chose to listen to or speak with doctors or epidemiologists who have no association to the pharmaceutical industry to my knowledge. Like the government point above, these people aren't being compensated by the pharmaceutical industry for advocating for vaccines. HOWEVER - it is 100% understandable that people would be suspicious of Big Pharma in the midst of the opioid crisis happening in this country. To those people, I'd say: It's possible to condemn the over-peddling of painkillers while still acknowledging the benefits of vaccines.
Vaccine injury/adverse reactions. The term "vaccine injury" refers to extreme shoulder injury, encephalitis, and other serious consequences as defined by the National Vaccine Compensation Act. Soreness at the injection site and even a fever for up to 24 hours are perfectly normal as a vaccine stimulates your immune system.
Vaccine injury is extremely rare. According to the Health Resources and Services Administration (HRSA), here are the numbers:
Between 2006 and 2017, 3.4 billion doses of vaccines were given in the United States.
Out of those 3.4 billion doses, 4,328 people brought cases of vaccine injury before the court and received compensation.
The HRSA is careful to say, though, that around 70% of those cases were not, in fact, paid out because the court concluded that vaccine injury had taken place. Rather, because the court and the client reached a settlement. (You'll often hear the number of $4 billion being referenced as the amount of money that has been paid out by the vaccine court; this context is helpful in understanding that that number does not represent anything about the validity of the cases or verdicts.)
That means out of 3.4 billion doses, 1,299 led to vaccine courts compensating families.
Another important point to consider: it's impossible to say how many of those cases were caused by an unidentified and underlying immune deficiency. Roughly, the odds are 1 in 1 million that you will experience vaccine injury. For context, the chances of being struck by lightning are 1 in 700,000. So - yes. There is a risk in getting vaccinated. But it's very, very small. For further interesting reading, the New York Times just published a piece on this topic.
Overwhelming a child's immune system. This was a really interesting and important set of facts that I came to understand. Babies are exposed to hundreds of antigens from the second they're born, which means they're perfectly capable of handling the immune response triggered by vaccine antigens. However, a child's immune system is NOT strong enough to withstand an infectious disease, which is why they're vaccinated so early for things like measles. For a deeper understanding of how scientists have combined vaccines to make them more effective and even safer, this article is a great read.
Fear of autism caused by vaccines. The idea that the MMR vaccine (or any other vaccine) causes autism has been definitively and roundly debunked. Andrew Wakefield, the former MD who alleged that there was a link between vaccines and autism, has been stripped of his medical license and the study he published has been discredited for a number of reasons (both scientific and ethical). Interestingly, Andrew Wakefield is also the person who directed and starred in the popular anti-vaxx documentary, Vaxxed. (The not-so-subtle subtext I'm trying to get across here is that Vaxxed was created by a man who's had his medical license revoked, so the material in it is questionable.)
Lack of clarity about ingredients; concerns about "heavy metals" or aluminum. The most helpful piece I found here is this great article that breaks down exactly what's in a vaccine and how vaccines are made. I won't even try to paraphrase it here - she says it best.
For parents concerned about thimerosal, From Dr. Jones: "Some vaccines did contain thimerosal, a mercury salt, but that's like saying that table salt = chlorine gas. Basic chemistry demonstrates that compounds have different properties than the elements from which they come. And thimerosal was removed from childhood vaccines almost a generation ago. It is present in some multi-dose flu vaccines but one can ask for those to be thimerosal-free, and it has never been demonstrated to have caused any harm. Aluminum is not a heavy metal, and again, is in the form of salts and not metallic aluminum in vaccines."
From Dr. Brown: "Aluminum is not a heavy metal. Aluminum is used in vaccines as an adjuvant – meaning a substance that is added to vaccines that stimulates a stronger immune response. There is no aluminum in any live vaccines, including MMR. Aluminum is naturally present in the environment. There is normally a very small amount of aluminum in (the) human body. The amount used in vaccines is so small that it does not make an impact on the total."
From Dr. Hotez, when asked, "What's in a vaccine?": "Liquid, like saline or saltwater plus antigens."
Ethical issues about aborted fetal cells being used:
From Dr. Brown: "No, there are no fetal cells in the vaccines. Viruses require human cells to grow in the lab, and some grow better in fetal cells. Also, fetal cells divide well, which means that they can be preserved long term to grow the vaccine virus – because every batch you make you need to make it the same way. The original fetal cells which were used in vaccine development came from elective pregnancy terminations. These cells have resulted in medical products that have saved the lives of millions of people."
From Dr. Jones: "Many viruses can only be grown in human cells, so fetal cells are the best way to grow these. The cells are removed during processing--think of it like the dirt in which we grow carrots or potatoes. Even religious bodies have demonstrated that they are fine with these types of cells, though of course would prefer an alternative (that does not currently exist)."
In response to information cited by RFK Jr. and Children's Health Defense, particularly the data about "wild measles" being preferable to the MMR vaccine:
From Dr. Jones: "There is just no evidence to support what he claims. We know wild measles is associated with deaths in around 1-2 per 1000, encephalitis, pneumonia, and years of immune amnesia, not to mention the chance of SSPE which is universally fatal and horrific. Yes, there was a clinical trial that showed measles eliminated cancer in *one patient*--but they gave her a megadose of a *genetically-modified measles vaccine*, not the wild virus. There also is one epidemiological study that suggested fevers from measles is protective against later cancers but it's pretty poorly done and doesn't have other support (it has not been repeated or supported by other investigators)."
Vaccine shedding and questions about herd immunity.
The concept of vaccine shedding simply means that for a few days after a person receives a vaccine, they threaten to expose immunocompromised people around them to the diseases for which they were vaccinated. In the end, this concept is one that doesn't hold water. This article was recommended to me by Dr. Jones and does a great job of addressing that concern, even including a tweet from Johns Hopkins stating specifically that it's okay for recently vaccinated children to visit immunocompromised patients in their hospital.
Herd immunity is a simple enough concept: vaccinated people (or people who have naturally encountered and survived a germ or disease) protect immunocompromised people from contracting a particular disease. It's important for exactly that reason - there are lots of people who are vulnerable. (think: children who are too young, chronically ill people, and people who can't be vaccinated for a specific medical reason) and rely on the rest of us to vaccinate ourselves in order to protest them.
For herd immunity to be effective, a certain percentage of the population has to be vaccinated against or immune to a disease (and it's different for every disease - measles, for example, requires 92-95% of the population to be immune to keep from spreading. An important note here is that an outbreak can still occur, but it can't spread if effective herd immunity is in play.) Obviously, in many cases in the U.S., there's low herd immunity because so many unvaccinated people have contracted measles. Here's a great piece on Mental Floss that does a deep-dive into the hard math behind how herd immunity works, how diseases spread and at what rate, and why diseases seem to "favor" children.
The TLDR version of this is: vaccine shedding does not pose a threat to the immunocompromised; herd immunity effectively prevents immunocompromised people from contracting contagious and potentially fatal diseases.
My personal takeaways:
The anti-vaccination lobby is extremely powerful, and has done a truly remarkable job of making it a challenge to find clear, scientific data about vaccines online. I am now quite clear on why so many people have deeply held opinions that they feel are based in science, but are actually based on misinformation.
The anti-vaccination lobby is also a bit of a mystery. I still have big questions: who's backing it? Where is all the money coming from? What's the ultimate goal?
There are some things that are black and white - easy to understand and digest. For example: vaccines do not cause autism. Full stop.
There are other pieces of the puzzle that take a lot of digging to understand. For example: the truth behind vaccine injury and whether the number $4 billion in payouts is accurate. It's frustrating to me that this information is so misrepresented and has confused or misled so many people. It shouldn't take hours of reading to figure out the truth.
I understand that time is always pressed at the doctor's office, but I would love it if it was possible for vaccine education to begin as early as prenatal visits. The pressure parents feel at the pediatrician to just say, "Okay - whatever you think is best!" is heavy, especially for first-time parents. Having the space to talk through and ask any questions you might have is essential to eliminating misinformation and fear around vaccinations, and I think that's a huge area for growth in our system. (A caveat here that I love our pediatrician, who always gives us time to ask questions. Shout out to Dr. Templeton!)
I understand why people are suspicious of Big Pharma. No need to elaborate. It just makes sense to me.
It is not only unkind, but unhelpful to assume that people who choose not to vaccinate are ignorant about risks, research, or data. At least in the conversations I've had, these parents are dutiful, involved, and extremely caring. If you're curious or concerned, opening up a conversation can be helpful and informative for everyone.
Okay, folks. That's it. I ask for your grace and understanding in reading and processing all this, welcome your questions, and am grateful for your time. Hopefully you're leaving this post with a few more tools in your belt so that you can engage one another in conversation about this stuff. It's been a fascinating journey for me.
In Current Events, Motherhood, Personal
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