Ask Richard: A Tricky Situation about Infant Vaccinations

Richard,

I think it’s great you’re doing an advice column for us skeptics. My question:

My wife’s office has become a maternity ward. Of the 10 eligible women, 5 are pregnant. In the last couple of weeks, they have begun passing books around and talking about their plans for their newborns. Unfortunately, one of the books they are reading is by the leader of the pro-disease movement Jenny McCarthy. These are all smart, educated women, but the fear mongering of McCarthy has them second guessing the need for vaccinations. Whenever I’m in the office, I hope to start up a conversation about vaccines, but with no luck so far. I asked my wife permission to write an open letter, but she asked me not to. I value the friendship they have with us, and don’t want to alienate them. How can I, or should I, start a conversation about vaccines with these ladies?

Sick About Vaccines

Dear Sick, 😉

It’s often a delicate matter to intervene and correct the erroneous ideas of indirect friends, (friends of a close friend or a spouse) because the indirect, second-stage relationship you have with them increases the likelihood that they will see it as an intrusion, and take the attitude, “Who the hell are you? Mind your own business.”

Your wife’s reluctance to have either herself or you educate them with an unsolicited opinion may be about the complexities of office politics as well as the intricacies of friendships. She has to be their co-worker as well as their friend, and such dual roles often have conflicts of purpose. I know that you are concerned for the health of the babies, but at the same time that is the mothers’ final responsibility, and your wife’s comfort and standing in the office is an important factor that you should take seriously, which I’m sure you do.

Since the precedent has already been established in the office about sharing prenatal and child care books, perhaps there is a book or some kind of literature written in lay terms that refutes McCarthy’s ideas, one that your wife could casually offer to them, suggesting that knowing both sides of the issue is a good idea. Since they are smart and educated women, this approach might work.

Another way would be to discretely leave that material somewhere in the office for the mothers to find. I don’t really recommend this, because such backdoor tactics often backfire. Definitely do not do anything without your wife’s agreement. Your relationship with her and your respect for her situation should take precedence.

Richard

You may send your questions for Richard to .

Ron in Houston

I don’t know if it’s the same everywhere but the schools usually will force the vaccination issue.

My kid’s doctor gave a vaccine 1 month before his 3rd birthday so the bureaucrats in the school district wouldn’t count that as a “valid” vaccine.

I told them that was absurd and one year actually made up a “religious exemption” letter. When it kept coming up I finally just gave in and had my kid re-vaccinated (poor kid – he’s so needle phobic!).

I do agree with the advice seeker that this issue needs to be addressed. I’m glad people were calling Oprah on the carpet for helping to propagate this crap.
penn

I understand that it is the parent’s final responsibility, but it’s more than the health of their individual child at stake. There are a number of people who cannot be vaccinated for legitimate medical reasons, or for whom the vaccines just do not work. These people should be protected by herd immunity that is being put at risk by scare-mongers.

These scare tactics have already reignited endemic levels of measles in the UK and the US is not far behind.
Philosos

Nice post Richard.

The problem all reasonable people face is trying to explain something that is based in reason to someone who is unreasonable. This is an exceptionally daunting task that makes you want to rip your eyes, ears and hair out at the same time. Sometimes you just have to step aside, but in this case… I would simply say. “So what do you guys think about the book ____insert name of title after reading it completely?” And that’s it… and just listen to what they have to say.

P.S.
I think an excellent book everyone should read at least once is How To Win Friends and Influence People by Dale Carnegie.
Aj

How smart and educated can they be if they take medical advice from Jenny McCarthy? If they’re passing books around maybe only one of them is an anti-vaccination nut. If they are smart and educated then I imagine the book will not persuade them so perhaps it’s worrying over nothing. When health agencies promote vaccinations to them then if they’re reasonable they’ll be persauded to get their child vaccinated.

If you have no social capital in the group then trying to influence them probably will probably backfire. If you turn one of the group, preferably one who’s influential in the group, then you might have a shot at getting some dissent in.
jemand

suggest that there are alternative vaccination schedules… if they are concerned about vaccines but also about disease, delaying the shots several months reduces the number needed to achieve immunity, and thus reduces the chances of “vaccine cause damage” from happening.

Hey, herd immunity would be preserved for the rest of us, and the kids would eventually be protected.

Really not ideal, but sometimes “split the difference” gets you at least some of what you want.
«bønez_brigade»

SAV,
Get your wife to send the other future mumz some info which explains the lack of credibility of McCarthy’s sources, whilst also explaining the risks of not vaccinating.

A couple of starting points:
http://factsnotfantasy.com/vaccines.html
http://www.chop.edu/consumer/jsp/division/generic.jsp?id=84662
hoverFrog

Definitely leave it alone. If they are stupid enough to put their children in danger then let them. There are stories in the press almost every week about kids dying or suffering long term illness because they were no immunised. Find some and leave them around the office coffee room. I would hope that maternity or parenting magazines and books would feature such things regularly but I’m probably being naive.
Jen

I do not understand why a community of skeptics seems to be on the pro-vaccine side.
Have you checked the facts? Are you just looking at “oh, the book is by Jennie McCarthy, she obviously doesn’t know what she’s talking about.”
I have not read the book in question, so I cannot say anything about its contents.
I do take exception with this statement: “There are stories in the press almost every week about kids dying or suffering long term illness because they were no immunised.”

There are stories in the press about swine flu every week, because they want us to be afraid of it.
From CNN: The World Health Organization says at least 105 cases have been confirmed worldwide, including 64 in the United States; 26 in Mexico; six in Canada; three in New Zealand; and two each in Spain, the United Kingdom and Israel. WHO has confirmed deaths only in Mexico, where seven people have died from swine flu.

From the CDC itself, concering REGULAR influenza: * 5% to 20% of the population gets the flu;
* more than 200,000 people are hospitalized from flu-related complications; and
* about 36,000 people die from flu-related causes.

okay, how come people don’t panic every year when the regular flu comes along?

And yet, even the CDC numbers aren’t necessarily accurate:
according to one researcher, the National Center for Health Statistics lists only a few hundred deaths a year as directly caused by influenza – and the NCHS website is part of the CDC website! http://www.cdc.gov/nchs/

just below the CDC’s “facts” about flu, they go into the get-your-vaccine song and dance. Some suspect that the inflated numbers are to scare people into getting the vaccines, when they are not really needed.

Who is fear-mongering then?

Let me share a passage I found by searching the transcripts of a talk given at a meeting of the FDA Advisory Committee on Vaccines and Blood Products in 2008:

“With respect to some of these risks there is an infectivity risk associated with tumorigenic cell substrate and high instance of viral contamination is pretty much endemic in many labs I am afraid and there is the long histories of the cells that that is a concern that if a cell has been around for a long time it may have been infected, contaminated by viruses that are inapparent just for normal passages.”
http://www.fda.gov/ohrms/dockets/ac/08/transcripts/2008-4384T1_2.htm

the context is, the good doctor is speaking about the cells that labs use as a “substrate” or growing medium to GROW those attenuated viruses necessary to make vaccines. If you can read and understantd the whole talk, he is talking about how those cells are not well-documented or even understood in terms of whether they are likely to cause TUMORS, or be otherwise contaminated, and hence CAUSE disease in the subjects receiving the vaccines.

Please help me understand why a person who is anti-vaccine is automatically assumed to be uneducated or uninformed, as I am obviously not uneducated or uninformed.

I work in an administrative office supporting a telesales division that sells Glaxo-SmithKline vaccines. It makes me sick to listen to how hard they pump their salespeople, how hard they lean on doctors to immunize. GSK does not care about the public health. They care about how many sales they make, how many dollars they can put in their own pockets.

I believe that vaccination should be a choice, not mandatory. You want to vaccinate, okay, I want to not vaccinate, okay – what I fear is the pressure that drug companies are putting on the government to make it mandatory.
mathyoo

It’s not just the drug companies putting pressure on the government, it’s also parents like myself who don’t want their child exposed to polio and other horrible diseases because the rest of the parents with kids in my daughters class buy into the anti-vax woo. Are there potential downsides or side effects to vaccination? Of course. But most people these days have no clue how deadly and debilitating diseases like measles, polio, etc. can be. My ex father in law contracted polio when he was a child, and gone through life with one leg nearly useless and experienced a great deal of pain. Measles is not only potentially deadly but can cause corneal scarring which results in blindness.

Rubella, especially if contracted by a pregnant woman, can be pretty vicious too. From Wikipedia:

“Rubella can cause congenital rubella syndrome in the newly born. The syndrome (CRS) follows intrauterine infection by Rubella virus and comprises cardiac, cerebral, ophthalmic and auditory defects.[4] It may also cause prematurity, low birth weight, and neonatal thrombocytopenia, anaemia and hepatitis. The risk of major defects or organogenesis is highest for infection in the first trimester. CRS is the main reason a vaccine for rubella was developed. Many mothers who contract rubella within the first critical trimester either have a miscarriage or a still born baby. If the baby survives the infection, it can be born with severe heart disorders (PDA being the most common), blindness, deafness, or other life threatening organ disorders. The skin manifestations are called “blueberry muffin lesions.””

So, before you go off on the “big pharma” scare, consider the dangers of dropping herd immunity for these potentially dangerous diseases.

Check this page out on the CDC site:

http://www.cdc.gov/vaccines/vac-gen/why.htm
Jen

I think I got a little carried away there. I guess what I am saying is this.

I do not consider myself an atheist. I believe in God, but I do not believe in organized religion or churches. I believe in what I have recently learned is called “freethought”. That one should be free to evaluate facts for oneself, and make up one’s own mind, and not have the beliefs of others forced upon them.

It seems to me that those who are anti-vaccine are subject to unwarranted ridicule and harassment simply because they are making up their own minds about the issue.

Rather than anyone saying “everyone should vaccinate” or “everyone should NOT vaccinate”, I would think the skeptic community would instead encourage everyone to do their own research, learn, share information with one another, discuss and debate, to question everything, and above all, that each shall be free to choose for themselves what they will do when it comes to their child.

As for herd immunity – if you were the only parent who had their kid immunized, and the rest of the kids get the disease, and your kid does not, how does dropping herd immunity harm you?

It is like I am saying – each parent should at least be free to make the choice themselves.
Tanya

@Jen –

As for herd immunity – if you were the only parent who had their kid immunized, and the rest of the kids get the disease, and your kid does not, how does dropping herd immunity harm you?

In the situation you describe, it’s unlikely that the “dropping” of herd immunity would harm me – but that kid down the street with infantile lukemia that can’t be vaccinated? That child is certainly at risk of contracting a preventable disease that could kill him.

Allowing parents to make that choice for themselves puts other lives at risk in the same way allowing individuals to drink and drive does.

In regards to the article you presented referring to tumorigenic cell substrate, Dr. Peden makes it clear that he’s speaking only of the MDCK cell line from which an innactivated flu vaccine was derrived. Dr. Peden also specifically states that the MedImmune strain of the MDCK cell line was found to be nontumorigenic and that the lines used to create other vaccines have a”very good safety record”.

As we’re speaking specifcally of scheduled immunity, the vaccines made from lines Dr. Peden specifically states are “safe”, your assumed assertation that scheduled vaccines may increase disease and/or cancer risk is not only unwarrented, but directly refuted within the article.
Tanya

@Jen –

As for herd immunity – if you were the only parent who had their kid immunized, and the rest of the kids get the disease, and your kid does not, how does dropping herd immunity harm you?

In the situation you describe, it’s unlikely that the “dropping” of herd immunity would harm me – but that kid down the street with infantile leukemia that can’t be vaccinated? That child is certainly at risk of contracting a preventable disease that could kill him.

Allowing parents to make that choice for themselves puts other lives at risk in the same way allowing individuals to drink and drive does.

In regards to the article you presented referring to tumorigenic cell substrate, Dr. Peden makes it clear that he’s speaking only of the MDCK cell line from which an inactivated flu vaccine was derived. Dr. Peden also specifically states that the MedImmune strain of the MDCK cell line was found to be nontumorigenic and that the lines used to create other vaccines have a”very good safety record”.

As we’re speaking specifically of scheduled immunity, the vaccines made from lines Dr. Peden specifically states are “safe”, your assumed assertation that scheduled vaccines may increase disease and/or cancer risk is not only unwarranted, but directly refuted within the article.
Tanya

Damn it. Sorry about the double post, the window “crashed”. *sighs*
jemand

well, if you’re the only one vaccinated, you MIGHT be very badly hurt by lack of herd immunity– vaccines aren’t 100% effective or “take” in every case, there’s a 10-20% chance that you will be the one who the vaccine DOESN’T render immune. But if everyone is vaccinated, EVERYONE is protected, EVEN given that failure rate.

So that is why all children SHOULD be vaccinated… and come on, talking about problems with the flu vaccine is NOT THE SAME as talking about problems with the regularly scheduled vaccines for the heavy hitting diseases. I couldn’t care less if you never get a flu shot and babies don’t generally get them anyway.

But all children should eventually be vaccinated for polio, measles, tetanus, diptheria, etc. etc.
Maurice

Really. Jen, I know your rabid anti-vax stance. You’re an idiot and you’re responsible for infant deaths. Your convictions are more important to you than human lives. You’re a despicable person. A huge body of evidence and countless cases support vaccination as useful in preventing death from infectious disease. There is NO EVIDENCE for the kinds of side effects that you are mentioning.
You should be sued for manslaughter at least.
Aj

I do not understand why a community of skeptics seems to be on the pro-vaccine side.

Vaccines… WORK. Smallpox was eradicated because of mandatory vaccination. Childhood diseases are less prevalent, TB was almost wiped out of some countries, yet because people aren’t getting vaccinated childhood diseases and TB are back on the rise.

Are you just looking at “oh, the book is by Jennie McCarthy, she obviously doesn’t know what she’s talking about.”

You can read what she says, and about the Doctor behind the autism vaccination “link” that she has used to justify her insane views without buying her book. Anyone who thinks there’s evidence that MMR causes autism doesn’t know what they’re talking about.

the context is, the good doctor is speaking about the cells that labs use as a “substrate” or growing medium to GROW those attenuated viruses necessary to make vaccines. If you can read and understantd the whole talk, he is talking about how those cells are not well-documented or even understood in terms of whether they are likely to cause TUMORS, or be otherwise contaminated, and hence CAUSE disease in the subjects receiving the vaccines.

Or if they CAUSE tumors or diseases at all, or if they do how many, what type, and in how many people. Are you also afraid that CERN will suck the EARTH into a BLACK HOLE?

I believe that vaccination should be a choice, not mandatory. You want to vaccinate, okay, I want to not vaccinate, okay – what I fear is the pressure that drug companies are putting on the government to make it mandatory.

Vaccinations work in part because of the opportunity of infection is decreased, they’re not magic shields. If vaccination drops below the required amount for herd immunity more than just the non-vaccinated population is involved depending on how effective the vaccine is. That’s why vaccinations are whole population initatives not just individual choice. Also, as we’re talking about children in this case, they don’t make the choice and they can’t help their parents are ignorant fools.
grneyedmonster

You have to look at the odds. What are the odds that the vaccine will have a negative effect versus the odds that the child will contract a disease for which he/she isn’t immunized? Are there other risk factors involved, such as other illnesses or birth defects that need to be taken into consideration? For me, the bottom line is that you take a big risk by not immunizing. I would feel horrible if my child contracted a preventable illness that resulted in disability or death. I don’t think I could ever recover from that kind of guilt.

Regarding whether “Sick About Vaccines” should say something to the mothers in question, he should defer to his wife, but should push her to at least tell these women to talk to their doctors and ask about vaccine research and whether the doctor receives sales incentives from any drug company.
Thefremen

As a parent I really have no problem with the idiots who want their children to die of easily curable diseases. It will mean my fully vaccinated child will have much less competition to get into schools, secure a good job in the work place and have less competition for resources.