Vaccines—I Finally Address The Issue (Heaven Help Me…)

PH achievements

Despite my pediatrician background, one topic I’ve avoided on this blog is vaccination. Having personally experienced the transition from near-complete parental acceptance of vaccines to near-daily opposition during my time in clinical practice, the topic has left me dismayed and weary.

But while I was able to have intelligent and thoughtful conversations with my patients’ parents—conversations that led to full immunization of their children 99+% of the time—the same does not happen online. The amount of anti-vaccine vitriol and misinformation out there, not to mention the harshness with which people sling it, has left me silent and stunned.

But after recently hearing the ridiculous comments about vaccines made by Donald Trump during the latest GOP debate and the sorry excuse for a counterattack by the two physician candidates on the stage (who squandered a great opportunity to inform the public, in my opinion), I can’t hold back any longer.

Immunizations

I’m not going to talk about the benefits of vaccines, which are many. One need only read articles, watch historic films, or talk to their grandparents to see how effective and life-saving vaccines are.

I’m not going to get into the risks of vaccines, because although serious outcomes exist, they are very rare, especially since the acellular pertussis (whooping cough) vaccine came along. (It was the whole-cell pertussis vaccine that caused more side effects.) But oftentimes the adverse event is only temporal to the immunization, meaning a condition developed within a few weeks of the vaccine but can’t be said to be caused by the vaccine. Kids get vaccines every two to three months the first year of life. That makes immunizations an easy target to blame.

I’m not going to address the non-existent link between autism and vaccines. It’s been thoroughly debunked by now. But thank you Andrew Wakefield and Jenny McCarthy for making the job of every pediatrician, family practitioner, and nurse practitioner enormously more difficult.

And I’m definitely not going to discuss the bizarre and false accusation that doctors make lots of money from immunizations. In fact, it’s often the opposite. Many practices lose money on vaccine administration. But we give vaccines to keep people healthy. Pediatricians love kids, and we want to see them thrive and develop to their full potential. The last thing we want to do is hurt them.

The Immune System

What I do want to address is the common misconception that too many vaccines overwhelm the child’s immune system.

This is simply not true. Here’s why:

1) Yes, there are more vaccines today than there were in the past, but because of improved vaccine development, today’s immunizations contain far fewer antigens (a foreign substance that produces an immune response) than yesterday’s immunizations, even with the greater number of vaccines given. Though it’s older, this table taken from Pediatrics, the official journal of the American Academy of Pediatrics, illustrates that statement.

vaccine proteins 2

Paper was from 2002. It’s about 315 antigens now. (Click to enlarge)

2) The antigens children encounter in the environment on a daily basis are far more numerous than the antigens they’re exposed to from the vaccine schedule. One lick from the dog, one mouthful of dirt, one suck on the pacifier Mom just stuck in her mouth, and you’re looking at a kaleidoscope of organisms Junior has now eaten, inhaled, or topically absorbed. And that’s okay. That’s how we build immunity. We do this over our lifetime, and the antibodies we make to vaccines are a grain of sand in the sandbox.

Slowing down the recommended immunization schedule does nothing to protect an infant’s immunity. Rather it puts him or her at risk for preventable infectious diseases.

So that’s what I wanted to say. As always, I appreciate your time and thank you for reading.

aap statement

American Academy of Pediatrics response to GOP candidate statements. Click to enlarge

Related Articles:

For a number of excellent articles on vaccines, see Dr. Jen Gunter’s series on the topic.

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Rubin4Carrie Rubin is the author of The Seneca Scourge and the upcoming Eating Bull. For full bio, click here.

291 Responses to “Vaccines—I Finally Address The Issue (Heaven Help Me…)”

  1. Gold Standard Test

    This. A thousand times this. It’s a polarizing issue, frustrating for both deeply entrenched sides, but I bow at the altar of evidence based medicine and patient best interests and explain again (and again and again) the benefits of immunizations. Sometimes I win (and so patients and the community win), sometimes I lose (le sigh). Thank you for broaching the issue here.

    Liked by 2 people

    • Carrie Rubin

      Yes, it can be exhausting to have the same conversation over and over again. It’s as if we have to defend ourselves for why we want to promote the health of our patient. The attitudes have definitely changed since I was in residency.

      Thanks so much for reading and commenting!

      Liked by 2 people

  2. Kourtney Heintz

    Carrie, thank you for weighing in on this topic. You raise terrific logical and factual points that make it clear that we are incredibly fortunate to live in a vaccine available era.

    Liked by 1 person

  3. Nightwriter11

    Great article Carrie. With politicians debating the subject I prefer to see the facts from a physician. On a side note, I am a little worried about trolls and their negativity. I see no reason why anyone should do that on your blog. I really love your posts. I don’t know how you find the time.

    Like

  4. Sue Archer

    That’s very interesting information on the reduction in antigens – thanks for sharing that, I hadn’t run across it before. I am grateful for anything that will help protect my child from serious illness. Enough said!

    Like

  5. hilarycustancegreen

    Well done. This really needs saying over and over again just to balance the misinformation out there. I am a coward on the internet and tend to duck when I read stuff that I should take issue with.

    Liked by 1 person

    • Carrie Rubin

      Thank you. It’s easy to shy away from heated topics on the Internet because some people can be pretty ruthless in their responses, especially those who visit sites anonymously. But I figured it was time to bite the bullet, and luckily I came out the other side unscathed! (Excuse my mixed metaphors…)

      Like

      • hilarycustancegreen

        I wish I had your courage. There are people I follow – nice, friendly, garden, child and animal-loving people, who will every now and then repeat Fox news vitriol as if it were fact. Each time I hover over suggesting alternative interpretations, then I read the comments and think, I don’t want these guys dropping into my (non-political) blog.

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        • Carrie Rubin

          I hear you on that. I tend to avoid commenting on those types of posts too. And as much as I love politics, I leave it off my blog except on a rare occasion (like this post and pointing out Trump’s false information about vaccines).

          Like

  6. thomasreich

    Trying to convince some parents about the need to immunize is most likely tying to convince parents of the need to teach critical thinking skills.. I’m seeking to teach basic college English skills. I find it incredibly frustrating.

    “Why can’ts I writes like I talk?”

    These people have passed high school. The mind boggles…

    The lack of critical thinking is what;s missing Much as like what is happening in Wisconsin due to teaching to a test and not skills that will help these people later in life

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    • Carrie Rubin

      I know what you mean about the writing. I’ve heard more than one college professor voice frustration about students’ inability to write properly. Even some grad students out there haven’t learned how to write a proper paper. It’s a shame, and I don’t suppose the digital age has helped any with this. Everything’s a shortcut now.

      Liked by 1 person

  7. Celine Jeanjean

    Great post Carrie. It’s so easy to sensationalise this kind of thing and breed fear if the plain and simple facts aren’t made known. IT’s really sad that a number of children are missing out on important vaccines because of fearmongering.

    Like

    • Carrie Rubin

      Thank you. Yes, the conspiracy theories out there regarding vaccines are a shame, no doubt. Leaves kids and other high-risk people vulnerable to disease.

      Liked by 1 person

  8. Joanne

    Oh, what a topic, and good for you, girl, for going there. (I’m not sure how I missed this last week. 😐 )

    Both my kids got at least one 4-in-1-“super vac”–not that I knew to ask their doc to break it up at the time. Both are just fine, and I’m pretty sure they were immunized against chicken pox, too.

    Definitely agreed on pregnant moms being exposed to unvaccinated kids, but aren’t we assuming the expectant ladies were immunized as kids–or would that be specific to chicken pox b/c it came later in the game?

    IMHO, religion should NOT be a reason to hold back.

    Flu vacs for the pre-k crowd SHOULD be an option, not a mandate (as in my district.)

    I do need to touch on one case I’m directly familiar with. I had a student on home instruction who had a severe reaction to vaccination(s) who has been comatose for 10 years. He was supposedly tested prior to the vacs being administered b/c his docs believed him to be at risk for such.

    As per his mom, he got a green light to be immunized and she did so. (He was 9 mos at that time and reportedly “normal.” ) Within 24 hours he went to the ER and came home 18 months later, in the state he’s been in since. (I’m thinking he had an encephalopathy and never progressed past a Ranchos Level 1-2.)

    His younger sister is now in 2nd grade. Mom has never had her immunized. I’m sure I would have done the same.

    Okay, I be done now. Thanks, Carrie!

    Like

    • Carrie Rubin

      Thanks, Joanne. The older whole cell DTP vaccine could cause some severe reactions. That may have been what that child had. Very sad to hear. The newer, acellular pertussis vaccine has far few side effects, but it’s not as effective. As a result, our immunity wanes so now we give a booster. In terms of mothers, it’s as much to protect the fetus, if not more. A mother who’s not immune to rubella, for example (say she never got vaccinated), can pass the infection onto her fetus if she’s exposed. Though she won’t have a serious illness, the infant is at risk for congenital rubella syndrome, a very serious disorder. So that’s why we want to keep pregnant moms well protected.

      Like

  9. philosophermouseofthehedge

    I remember the polio era. Our neighbor died. No one got to go outside and play and the pools were closed for the summer. Adults were scared. I remember the joy of Salk’s vaccine and standing in a line that stretched for blocks.
    In the 80’s local pediatricians actually ran the vaccinations schedule a bit closer together as there is so much international travel and the border traffic was wide open. We would get calls saying, doses are becoming scarce, we are calling all our patients to come in now to make sure they are covered.
    It is appalling that people pay so much attention to unqualified loud mouths. Swayed by emotional words. Part of the problem is science is not taught well in schools anymore, so adults do not have the foundation knowledge or experience of history of preventative health. It’s all trendy info and celebrities that gets noticed instead of facts.
    Unfortunately people are not alike and there are individuals that some vaccines may trigger something – but this is rare.
    (Sad and horrid when it’s your child.We have friends who’s son is autistic and is in the original lawsuit. Talking with the father a few years ago, I asked him about the solid evidence showing there is no connection, but it looks like autism is/was first recognized about the same time as the vaccine dosing. He said, “I know. It looks true, but if there’s any money to be had, my son will need it when we are gone.” So there’s that. What can I say.)
    Vaccines should be mandatory to protect the entire “herd”. It’s not right that pregnant women can do everything right and then be unknowingly exposed to a unvaccinated child with a light case of measles or chicken pox at the mall or grocery store. (You know sometimes parents don’t realize their kid is sick!) Selfish and cruel. Cruel also to risk a child’s own future by not protecting them for a preventable illness.
    I do have a question though. Some pediatricians here are not delaying vaccines, but dividing the combos up into 2 groups of vaccine combos instead of 1 big multiple combo. (hope that makes sense). The 2 shots ( which are normally 1 shot) are given very close together – but it means 2 trips to the doc instead of one which is why the health dept dislikes the idea – too easy not to come back. But if it makes parents feel more comfortable? Do you know anything about this method/research?
    Need those vaccines. Street immunity just goes so far.
    (Do wish the vaccines/major drugs were all made in US – quality control and access are pretty important to me)
    Terrific post – hope it does go viral

    Like

    • Carrie Rubin

      Thank you, and thank you for sharing your thoughts. It seems anyone who remembers polio affecting a family member is very much for vaccines.

      Without knowing the details, I’m not sure what it is your pediatricians are doing, but I imagine it’s something–as you allude to–that puts the parents’ minds more at ease than any other reason. This whole notion of overwhelming the immune system is bizarre and untrue, and yet now it’s difficult to get people to see that. So I suppose your area’s pediatricians are taking the lesser of two evils, getting those shots in in whatever fashion they can.

      I think you’re right about science not being well taught in schools anymore. Kids should learn about the scientific method early on. I’m not so sure they do.

      Thanks for weighing in!

      Liked by 1 person

      • philosophermouseofthehedge

        The tv, newspapers, and movie theater news were full of images of children in iron lungs with little mirrors hanging over their heads. There was a big ward here at TX Children’s.. Terrifying images. Terrifying.
        Why would anyone risk it? Maybe those pictures should take center stage again.

        Like

        • Carrie Rubin

          There are others ones we could use too. For example, necrotizing fascitis from chicken pox (“flesh-eating strep”). Not easy to look at, that’s for sure. Seeing one case of that is enough to sell me on the chicken pox vaccine.

          Liked by 1 person

          • philosophermouseofthehedge

            Or maybe the beautiful 9th grade girl that caught chicken pox over Christmas vacation. Apparently her own vaccination coverage wasn’t good enough (70’s) to fight it off. She ended up in the hospital and returned to school later terribly terribly scarred.
            And polio survivors who have lived their lives in wheel chairs and seem to be now fighting again as the disease reappears in their bodies.
            The general population must be protected – especially teachers, mothers-to-be, and the elderly. Life here has been too sheltered from a reality the rest of the world lives with.
            Vaccinations. All of them. On schedule.
            (OK I will sit down and be quiet now. Your post is an important one)

            Like

            • Carrie Rubin

              The chicken pox vaccine didn’t come into play routinely until the 90s, but I’m certainly grateful for it. Thanks for the support.

              Like

            • philosophermouseofthehedge

              About ’75-’76 there was a huge chicken pox epidemic here. The vaccine’s usefulness became more apparent, so by ’80 this vaccine was pretty much expected for all kids.Although parents seem to fear “new” ones.I remember the controversy of that time
              You’d think with it being so warm and more outdoor time, there would be fewer mass outbreaks here, but that hasn’t been the case. Maybe it’s the larger metro populations crowded together instead? Children have less street immunity or immune systems aren’t as strong these days?
              My dad remembered the Spanish Flu epidemic wiping out families in his rural area when he was a kid- and Whooping cough. He had Scarlet Fever. As a result, he was big on keeping immune systems up with fresh air, good diet, and vaccines.
              Good to remember lessons of the past.
              (OK seriously, sitting down now. Zip.)

              Like

  10. Smaktakula

    Oh, hey–it looks like you accidentally left the comments closed on this. 99% of the comments would have been about how right you are, and perhaps might have offered up a personal anecdote about someone who wasted his or her life looking through the lens instead of looking at real life. Certainly, no one would have disabused you of this notion.

    That’s why it’s so fortunate I’m here. When people say things like, “I came here to WATCH a concert, not to film it,” they’re really saying, “I’m clued in to living life, and I look with not a little bit of pity on those poor unenlightened souls who choose to experience life differently.”

    Myself, I like to film short snippets of events, snatches of music at concerts–things I can re-experience later on or share with my kids if they didn’t get to go. I find that it doesn’t detract from my experience at all, but rather keeps me focused on it.

    Of course, I’m probably wrong. Paying undivided attention to something is the only way to remember it. That’s why teachers ask their students not to take notes in class, because if they’re taking notes, they’re not really experiencing the lecture.

    Like

    • Carrie Rubin

      Always the thorn in the issue, aren’t you? 😉

      I don’t think there’s anything wrong with taping some things, especially when it involves our kids. If it’s a short solo or a blackbelt testing, sure, I’d tape that too. But I don’t tape long events. I’ll never watch them again anyway, and I find my mind keeps going back to my filming. Best solution? Get my husband to do it instead…

      Liked by 1 person

  11. Nurse Kelly

    Good Lord – how did I miss this? I saw it at the bottom of your post today and clicked back! I agree with everything here and I applaud you for stating the facts accurately and honestly. People are always so inherently good, in my opinion, and they just need good information! You just did your part in serving them well as a physician. Thanks, Carrie!

    Like

  12. frederick anderson

    I frankly knew very little about vaccines and this was an informative article. I learned a great deal. The problem as I see it is trust. I think it is true of both the new and old worlds, that we no longer believe anything the establishment tells us. There have been too many breaches of that contract which should prevail between the populace and the State; for monetary gain, or political convenience, or whatever reason, we are lied to incessantly. Trust no longer exists. Given the very emotional nature of the immunization issue, directly affecting as it does the strong bond between mother and infant child, I feel it should perhaps be possible to discover a less combative, more sympathetic means of approach – not just in this area but in many interactions between ‘us’ and ‘them’ that is something I see too rarely, I’m afraid.

    Like

    • Carrie Rubin

      Trust has been eroded, no doubt. Sometimes it’s warranted; other times it’s a result of conspiracy theories, often bred online. Until that’s corrected, I suspect this issue will remain a divisive one, which is a shame because it leaves people vulnerable to disease. Thank you for weighing in!

      Liked by 1 person

  13. Luanne

    I know you have science on your side, Carrie, and I can’t argue with that. I certainly vaccinated my kids and would do so all over again. That said, after vaccinations my son encountered a very strange and terrifying set of symptoms. It might have been a coincidence. It might have been related to an underlying condition. It might have been some strange encephalitis. No one knows. But the alternative (to vaccinating) is too scary. After all, I do genealogical research and see the deaths of children from epidemics on paper all the time.
    That said, I do have a distrust of the CDC and institutions in general when it comes to–well, anything–and that always makes me suspicious of new drugs, new vaccines, etc. I like the time-tested stuff and have had enough troubles with medications taken by loved ones and myself that I like to err on the light side.

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    • Carrie Rubin

      Thank you for your thoughts and for sharing your experience. I wonder, was it the old DTP your son had? The old, whole cell DTP could indeed cause reactions like that. The new one doesn’t. Of course, it’s not as effective, but it’s worth it to have a safer vaccine. Just means we need a booster.

      Liked by 1 person

  14. Letizia

    What a great piece, Carrie. It’s so easy for people to get scared and, equipped with little information and media sensationalism, that becomes a deep fear.

    Liked by 1 person

    • Carrie Rubin

      Yes, it’s amazing–and sad–the level of mistrust that has developed over the issue.

      Thank you. I hope you’re doing okay. I’ve thought of you over the past week.

      Liked by 1 person

      • Letizia

        Thanks, Carrie; that’s so sweet. I’ll have moments when it suddenly hits me but having her ashes back has given me a little closure. But I miss my little darling.

        Like

        • Carrie Rubin

          They become so much a part of our lives. I still miss the dogs I had when I was younger and often think of them. They’re as much a part of our memories as people are.

          Liked by 1 person

  15. blondieaka

    Being a parent/ grand parent with no medical knowledge and who relied on my GP to guide me. My children were all vaccinated except for my eldest daughter who had all vacs apart from measles. This was on my GP’s advice as she had temperature fits while teething. Apart from a raised temperature and maybe being a little grizzly no apparent side effects were or have been apparent in any of my children . Yes, I have read scare stories and also done a little research myself. What I did notice among friends and aquaintances who didn’t vaccinate their children has been the worrying increase in severe cases of measles, whooping cough and my thoughts are that this will happen and more diseases that were thought to be under control or eradicated are again on the increase. That worries me and I think your article is a good one and shows both sides…thank you for sharing 🙂

    Like

    • Carrie Rubin

      Thank you! You’re right–if we get complacent with vaccines, the diseases we thought were a thing of the past come back, just like measles have. And as you point out, we’re seeing much more whooping cough too. That one has to do more with waning immunity. The newer form of the vaccine isn’t quite as effective as the older whole cell was–doesn’t last as long. But it’s safer than the older one so it’s better to use. But we give a booster dose now so that should help.

      Thanks for reading and commenting. Much appreciated!

      Liked by 1 person

  16. Katie

    Thanks for the info! I had been wondering about the schedule and increased # of vaccines. Had not bothered to look it up yet since I am far from childhood and I do not work with children. >Feeling better informed for the next time someone asks me< Although, my usual response is discuss it with your doctor 🙂

    Like

  17. dr. james willingham

    The benefits of American medicine are well known, but we are experiencing a loss of confidence in our government and the safeguards originally designed to ensure the reliability of the medical procedures. Our daughter-in-law teaches nursing and is now working on her Ph.D. Like her there are many medical personnel who are devoted to rendering the best service to patients.

    However, the loss of confidence has to do with knowledge of instances of failure. There are the examples of autism which seem to be linked to the vaccines. There are the examples of careless medical practice or even deliberate malpractice. I have been witness to carelessness, when one person in a hospital laid a syringe down on the table with the needle resting on the table. I told her she could not give me that shot and would have to sterilize it before she did the procedure.

    But there are worse cases than carelessness, namely, the deliberate with holding of necessary helps that would either help the patient or ease the individuals suffering. In talking with a retired chaplain I learned of serving patients in a VA hospital with their food in plastic bags and no way to open them. Basically the patients starved to death, being to weak to handle the packages and having no one to feed them. Another veteran, whose wife was also a veteran, had a doctor try to oppose him for turning up her oxygen so she could breathe a bit better even though she had not long to live. Seems the doctor did not want to use the oxygen to help ease her struggles. Unbeknownst to him, he put himself in danger from that husband.

    We also have the pathological personnel who think they are called on to exterminate patients to get them out of their misery – with the latter making request for such help. And then there is an examples of a person who had t insulin withheld, resulting in death and another who had medicine for dementia withheld which led to the patient’s climbing the walls.

    Today, we have a leading wealthy individual who said, though he later apologized for it, that f.5 billion people ought to die. The very thought is inscribed on what are called the Guidestones of Georgia. Just Google that. Thirty two years ago our son who was age 11 was given a two weeks scholarship to attending a school of math and science for bright kids. His mentor on the computer for that period was a 20 year old Black college kid. One day, when we picked him up, our son said, “There was a strange question on that computer today. It asked, “If you were an employee in a world government and had an over population problem with a country in Africa, how would you handle it: a. Have a war and kill them off. b. Use an infectious agent, germ, or disease and kill them off. c. Let them starve.” I found on the internet that there were 12 of those schools in as many states.

    There is more, much more, but the aim of such stuff by the powers that be seems to be the removal of what H.G. Wells called “useless eaters” in his work, The Open Conspiracy, published in the thirties (I think). People who do rsearch and who have a multitude of contacts are becoming more aware of a developing problem of behind the scene leaders with less than honorable intentuions

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