Vaccine Education Resource Links

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Vaccine3As many people know, I believe vaccination is something every family should educate themselves about and make the decision that best fits their family beliefs, needs, and history.  I don’t believe that there is a one-size-fits-all answer to the question of vaccination because I simply can’t tell a family with a history of severe allergic reactions to suck it up and risk their child’s well-being for the greater good.  I also know that I myself have questions about vaccines – for example, can we identify people most at risk for severe reactions and can we do more research on the adjuvants please? – so how can I ask others to not ask questions.  But asking questions and asking for more research is not akin to saying “don’t do it”.  Most people I know vaccinated on schedule and fully and have no regrets on their decisions.  I know people who have family histories of severe reactions and so opted not to vaccinate (sometimes after their first child had severe reactions) and I know people who have family allergies to ingredients in vaccines and opted to wait to get their child tested for the allergy before doing vaccines.  I also know those who have read the research, spoken to health professionals, and decided to forego vaccination altogether.  The one thing that the people I know have in common is that they all are well-educated on the topic.  They didn’t go to sites that promote “quack” theories, etc., but did their research from credible sources and came to a conclusion.  It may not be mine or yours, but they were certainly educated about it and considered their own family variables in the process.

But not all people do that.  In a time when fear runs rampant and numerous anti-vax sites exist that are not based on research, people can end up reading information that is based on fear, not facts; I have also seen pro-vax sites and individuals make claims about vaccination that isn’t supported by research, but instead also is based on fear.  What I wish we had was an unbiased place where we could really summarize what we know and what we don’t know and just leave it at that so families can make their decisions.  (Better yet, I wish all the research was being done on questions that parents want to know the answer to, but sadly it seems that won’t happen anytime soon.)  However, there are resources that are offer good, solid information which I will share here (if you feel I’m missing something feel free to email me and I will look it over and add it if I feel it is worthwhile).  What you conclude based on that information will be up to you.

Websites

The Center for Disease Control (CDC): Offers lots of research-based information on vaccines, vaccine efficacy, and side effects for vaccines.  They also have a Q&A section for certain vaccines where they are quite honest about interpretation of the findings.  For example, although many people believe the higher peaks in Whooping Cough are due to non-vaccinating individuals, the CDC argues that it is actually due to the switch to the DTaP vaccine which is acellular and does not carry the same length of protection as the previous whole-cell vaccine.  Thus the issue is that people are not getting boosters yet they actually need them to protect themselves and those younger who are not protected.  (You can read on the acellular waning times here.)

Cochrane Collaboration Reviews: Considered the best systematic reviews on any topic they look at, they examine vaccine efficacy across all studies that meet criteria.  Their criteria tend to be quite strict (which is good) but it means they will examine fewer studies or be clear about the poor methodological quality of studies, as they have shown with respect to Hepatitis B vaccination.  Anything you read here will be clear and up front about the quality of studies, the outcomes, and how applicable the findings are.

World Health Organization (WHO): The WHO is incredibly pro-vaccine and offers a lot of research to back their view; however, the quality of research is not always considered as stringently as it is for other sources.  They will cite papers that the Cochrane reviews would not due to lower methodological qualities; for example, Hepatitis B vaccine at birth is widely promoted by the WHO whereas the Cochrane Collaboration has concluded that the evidence for mass vaccination for Hepatitis B is of very poor methodological quality and high quality studies are mixed.  However, they focus a lot of their vaccine work in developing nations with very high rates of disease and where the risks of vaccination are far less than the risks of disease.

Project Tycho: From the University of Pittsburgh, this is a compilation of health records from 1888 to the present from the USA.  You can search for diseases pre- and post-vaccine, rates relative to vaccine refusal rates, etc.  Now, you can’t necessarily interpret the data in only one way (and in fact you will need to be careful not to make causal conclusions based on the data because it cannot account for things like 3rd variable problems), but you can at least get some hard numbers.

Books

The Vaccine Book by Dr. Sears.  Dr. Sears’ book talks about each disease, vaccine, side effects, rates of side effects, etc.  He also proposes an alternate schedule for those interested.  Some people consider this book “anti-vaccine” though having read it I see no way in which it could be seen that way as most of the vaccines on the schedule are recommended as being safer to get than risk of the disease.  However, questions are raised about schedules and some of the other ingredients in vaccines, but more as a call to research than a “don’t vaccinate” stance.

Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver by Arthur Allen.  Less a guide for parents and more a history of vaccines in the USA with all the political and financial issues surrounding vaccination programs, this book is one for people who truly want to understand the history of vaccines (as the majority of the book focuses on the first efforts).  Mr. Allen also discusses the very crux of the vaccine debate: How do you ask parents to put their child at risk for the greater good?

Vaccine Safety Research, Data Access, and Public Trust by the US Institute of Medicine.  If you prefer your information in book-form, this is a summary of some of the CDC data that you can access online.

Polio: An American Story by David M. Ochinsky.  Basically a verbal documentary of the fear caused by polio in the United States, the fight to find a cure and vaccine, how disease has been and is portrayed in the United States, and also the real truth about what polio was: a rare, but serious disease that somehow led to fear and myths about its preponderance.

Vaccine A by Gary Matsumoto.  Not anything related to the childhood vaccines that dominate discussions of parents today, but this is a rather disturbing look at how US Army has served as guinea pigs for new vaccines, specifically one that is implicated in Gulf War Syndrome.  It is one research journalist’s work and take, but definitely offers food for thought that many might find interesting.

[I am sure some would like to see books by individuals like Paul Offit or Neil Miller here, but I will not add them because I find them both rather disrespectful to the other side (they are on opposite sides if you don’t know the names).  As such, I find they speak to people who agree with them and will probably cause others to push against their ideas given the sometimes abrasiveness or fear-mongering in their writing.  However, feel free to look up some of their work yourself if you are interested.]

Schedules by Country

If you are thinking of an alternate schedule, these are the schedules of different countries.  I know in the USA there is a big push to follow the US schedule, but as many families are not comfortable with it, looking at the schedules in other countries may provide either reassurance or ideas for an alternate schedule that is also based on the research out there (and can highlight the potential arbitrariness of a given schedule, though some decisions are based on country-specific factors).

Japan Canada USA UK
New Zealand Australia Germany France
Finland Sweden Norway

 

Titers

One thing that is rarely, if ever, discussed as an alternate to schedules is the use of titers.  A titer, in brief, is a measure of how many antibodies we have in response to either exposure to a virus or from a vaccine.  This can tell us if a given vaccine has been effective in having our body produce the antibodies needed to fight off infection.  As many know, one of the concerns people have about vaccines is that they are not 100% effective.  Using titer tests, individuals may discover that one shot is enough for them to have developed an antibody response or they may need more than the recommended dosage in a vaccine schedule (for example, one friend reported that her husband needed four shots to obtain an appropriate antibody level for a particular vaccine).

The cons of using titers include more blood work, more needles (because of drawing blood), and cost if it is not covered by your insurance.  Titers also do not address some of the other concerns parents have about vaccines.  However, the pros are potentially fewer vaccines and an awareness of the efficacy of a given vaccine for your child and the other members of your family (if you are considering getting boosters while pregnant or when your baby is young).  In line with research on the efficacy of vaccines, typically 6-8 weeks or so is needed after a vaccine to do a titer test so this may delay the vaccination schedule (talk to your doctor or the lab where titer testing will be done to determine the exact interval needed for a particular vaccine/test).  Some doctors may not want to do this, instead preferring to stick to the set schedule.  This is something you will have to discuss with your doctor or find an alternate way around if this is something you’d like to do.  Note that getting the tests is generally quite do-able as many people need these tests to prove immunity in certain fields of work, like nursing.

Note that people who want to use titer tests are not “anti-vaccine”.  They are anti-unnecessary-vaccines and may end up taking more vaccines than recommended in order to get a sufficient immune response.  It is a personalized view of vaccination instead of a mass one, and as such, it actually requires more visits, more tests, and more time.  It won’t be for everyone, but it may be something some families are interested in exploring.

Vaccine Skeptics

Contrary to some beliefs, there are real scientists who question vaccination as it is currently done, or question the safety testing, or question specific vaccines.  They are not “anti-vaccine”, but rather skeptical of various issues in current vaccination programs.  Instead of looking to sites that pedal in fear-mongering, if you are interested in reading the other side, you should be reading it from people who have been there and been knee-deep in the research and science.  There is a great article here that summarizes the views of some very prominent vaccine-skeptics including Dr. Bernadine Healy, former head of the National Institute for Health, Dr. Walter Spitzer, professor of epidemiology at McGill University and former chair of the department (now deceased), and Dr. Peter Fletcher, former chief scientific officer at the United Kingdom Department of Health.  None of them are against vaccines, but as Dr. Healy has mentioned, we need to try to identify those who are most vulnerable to the effects of vaccines and work to make them as safe as possible, and sadly that is something that is being pushed against by the current “powers that be”.

Taking Risks and Changing Minds

For many parents, the risk of a side effect is what detracts them from vaccination.  We must remember that as parents we take risks regularly and vaccines are no exception.  As Katie Hinde (Harvard professor and creator of the awesome blog Mammals Suck – go read it) said to me when chatting about the subject of vaccine risk, “We still put our kids in cars despite the risk of car accidents.”  We cannot guarantee our children will not be hurt by vaccines; however, based on statistics, the likelihood is very small, like getting into a car accident – it can happen, but it’s highly unlikely.  Most people will live their lives without ever being in a serious car accident, but some will, even through no fault of their own, and the same risk is there for vaccine injury but the question families have to ask is which risk they are willing to take: That of the disease or that of the vaccine.  Now, as I responded to Katie in our discussion, “Exactly, and it’s why we also need to respect that some people are at higher risk through family histories or known reactions, kind of like how we wouldn’t put our kid in the car with a drunk driver because the risk is substantially higher.”  This is why I personally believe that families need to take their own situations and histories into account when making a decision, but these decisions should also be based on the evidence we have, not fear.

So please, go out and educate yourself.  If only so that when someone asks you why you made your decision, you can feel confident about the answer you give.

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Comments

  1. says

    When addressing parental vaccine concerns it’s important to direct parents to evidence-based research and such media resources. While I agree with many of the above source you’ve provided, I think it’s apparent that that you may have fallen victim to the ‘balance’ issue.

    http://www.abc.net.au/mediawatch/transcripts/s3601416.htm

    Two websites that I think deserve to be on that list are The Vaccine Education Center (http://www.chop.edu/service/vaccine-education-center/home.html) and The History of Vaccines (http://www.historyofvaccines.org/) What I like about CHOP is that they have an easy to use format to find information and answer questions about a specific topic. The HoV is great site to browse for those just looking to learn in general about vaccines, their history and the infectious diseases they prevent.

    I do thank you for writing this blog post though. Vaccines are complex subject. The conversation about immunizations has been dominated in recent by much misinformation and blog posts such as this allow for healthy and productive discussion.

    • says

      What ‘balance’ issue are you concerned about with respect to the links that have been shared? If you believe nothing on the issues around vaccines should be discussed then I have to respectfully disagree. I think there are things that should be looked into further, but it doesn’t mean you throw the baby out with the bathwater. But thank you for the other sites for people to look at.

    • says

      I have to say, when you ask to include CHOP, you are suggesting that Ms. Cassels include the mouthpiece for one of the most vehement critics of alternative medicine, as well as someone who obviously has a bias, Dr. Paul Offitt. He is trying to eliminate dietary supplements and promote prescription medications in their place. He owns the patent on the Rotavirus vaccine. He definitely has an agenda.

  2. Steph says

    I think the ‘balance’ issue that Melody is referring to is what can often happen in the media as well – to appear impartial or fair on an issue, there is sometimes an impulse to present both sides and opinions of an issue, which gives the impression that there is equal weight and research to support both sides. For example, this happened a lot with global warming and newspapers (esp 5-10 years ago) having ‘both sides’ of the issue in discussions and debates. Giving naysayers a very strong voice in the name of being balanced. That’s my guess as to what she may have been referring to.

  3. says

    Steph, I don’t think Tracy has given any naysayers a voice, other than Dr. Sears (and most anti-vaccine people don’t consider him to be anti-vaccine, since he still supports most vaccines, albeit spread out.

  4. Kirsten D. says

    Thank you for posting something that I have not heard from ANYONE as grounds for considering NOT vaccinating. I have a family history of vaccine allergies, food allergies and other disorders.

    I am sick of hearing from doctors that I am a moron for not vaccinating myself on these grounds. I have had a direct reaction to the flu vaccine but my husband who has NEVER had an allergic reaction to anything other than Tagaderm is totally past convinced I am an idiot. I have been looking for studies done on people who had family histories of allergies like mine and then having side effects and damage done because of vaccines.

    For those that can handle them I have full respect for. But for myself I feel like I am under fire because I am not willing to scar myself to satisfy the people who blindly don’t do any homework and think that doctors are gods.

    • Dingo says

      Jennifer, I hope you aren’t just using this forum to post multiple random citation links about vaccines, rather than using it as a place for sensible discussion.
      There are literally millions of studies any one of us could choose to link to – just posting links without comment, context or any relevance to any ongoing discussion is tantamount to spamming, imo.

  5. Roxana B says

    I did all the vaccines for my 2.5 years old son (mandatory and additional) – we live in Europe, in a previously communist country. However, I started to have doubts now and I want to research more until my second son is born.

    Basically, I believe in the power of vaccination – I was vaccinated myself as a child (we were having 2 or 3 vaccines if I remember).

    However, now I feel the vaccination became less of a health issue and more of a corporation pursuit of profits.

    I really do not think that ALL the vaccines out there in the market are really necessary.

    I will check out all the sites/books you mentioned.

    Again, thank you for your work. Keep it up

  6. Rene says

    I agree that “naysayers” haven’t really been given a voice here. While I appreciate someone who obviously supports and chooses to vaccinate questioning the complete safety and wanting more research, it was obvious by the suggested reading material that this is a “for” vaccine list and why you should get them. I didn’t see any that are “against” vaccines. Listing the CDC as a resource to learn ALL about vaccines almost made me chuckle. They promote vaccines. They are biased. They have been caught skewing their data to further push vaccines so I don’t care to rely on their word. I have read their list of ingredients but it needs to be researched independently because the CDC, FDA and government will tell you that vaccines are safe and the ingredients are within the safe limits, which they are not. I don’t mind the sites that recommend vaccines but would like to see some that don’t as well. For someone who relies completely on this article and it’s recommendations, it wouldn’t be a well-rounded approach to researching vaccines. That’s all I want for parents. To be educated on all aspects of vaccines. The risks of the vaccines and the risks of the diseases they are supposed to prevent. I would highly recommend this article. It lists all of the resources at the end. I love reading about and researching anything medical so I loved this article! http://vactruth.com/2011/06/06/part-1-of-3-an-interview-about-vaccines-with-helen-v-ratajczak-phd/

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