Sears claims that the most important reason to space out and separate vaccines is to avoid one ingredient: aluminum. “The alternative schedule suggests only one aluminum-containing vaccine at a time in the infant years,” he writes. “By spreading out the shots, you spread out exposure so infants can process the aluminum without it reaching toxic levels.” Sears explains that “some studies indicate that when too many aluminum-containing vaccines are given at once, toxic effects occur.” In fact, studies show just the opposite.
Various preparations of aluminum salts have been used in vaccines since the late 1930s. So, the safety of aluminum in vaccines has been assessed for more than seventy years. Aluminum salts act as adjuvants, enhancing the immune response. Inclusion of aluminum salts in vaccines that otherwise wouldn’t evoke a good immune response makes it possible to reduce the number of doses and the quantity of immunological components within each dose.
Although Sears claims that avoiding aluminum-containing vaccines is an important way to avoid aluminum, it’s not. Aluminum, the third most abundant element on earth, is everywhere. It’s present in the air we breathe, the food we eat, and the water we drink. The single greatest source of aluminum is food; present naturally in teas, herbs, and spices, aluminum is also added to leavening agents, anti-caking agents, emulsifiers, and coloring agents, and is found in pancake mixes, self-rising flours, baking powder, processed cheese, and cornbread. Adults typically ingest 5-10 milligrams (thousandths of a gram) of aluminum every day. Babies are no different; all are exposed to aluminum in breast milk and infant formula. Infants exclusively breast-fed will have ingested ten milligrams of aluminum by six months of age; those fed regular infant formula, thirty milligrams; and those fed soy formula, one hundred and twenty milligrams. All recommended childhood vaccines combined contain four milligrams of aluminum.
Sears is right in stating that aluminum can be toxic, specifically causing brain dysfunction, weakening of the bones, and anemia. But he’s wrong in claiming that the small quantities of aluminum in vaccines can be harmful. That’s because aluminum has been found to be harmful in only two groups of people: severely premature infants who receive large quantities of aluminum in intravenous fluids, and people on chronic dialysis (for kidney failure) who receive large quantities of aluminum in antacids. In other words, for aluminum to cause harm, a child’s kidneys would have to work poorly or not at all and the child would have to have received large quantities of aluminum from other sources, such as antacids, which contain more than three hundred milligrams of aluminum per teaspoon.
Other studies are reassuring. Because it’s unavoidable, everyone has aluminum circulating in the body, even babies, who have 1-5 nanograms (billionths of a gram) per milliliter of blood. Researchers have studied the quantity of aluminum in blood before and after receipt of aluminum-containing vaccines. No difference. The quantity of aluminum in vaccines is so small and the body eliminates it so quickly (about half of the injected aluminum is completely eliminated in one day) that it is undetectable following vaccination.
To avoid giving more than one aluminum-containing vaccine at a time, Sears advises that children visit their doctors when they are two, three, four, five, six, seven, nine, twelve, fifteen, eighteen, twenty-one, and twenty-four months old (at least twice the number of typical visits). That’s a lot of work to avoid a component in vaccines that has never been found to cause harm and is otherwise unavoidable, assuming that babies ingest breast milk or infant formula.
Like Jenny McCarthy, Sears states that vaccines should be spaced out to avoid a buildup of potentially toxic chemicals. “[The alternative schedule] gives no more than two vaccines at any one time to limit and spread out exposure to the numerous chemicals so a baby’s system can process each more individually,” he writes. “Of course, we don’t know whether this precaution is necessary, but it’s reasonable.” Sears describes the chemicals contained in vaccines. In addition to aluminum he lists mercury, formaldehyde, polysorbate 80, monosodium glutamate (MSG), ethylenediaminetetraacetic acid (EDTA), 2-phenoxyethanol, sodium borate, octoxynol, and sodium deoxycholate (all used to promote cell viability, prevent contamination, or inactivate bacterial toxins or viruses). He explains that each of these chemicals is potentially harmful: formaldehyde can “cause kidney damage and genetic damage”; monosodium glutamate is an “excitotoxin” that “can affect how the brain functions and ... can damage nerve tissue in a pattern similar to Alzheimer’s disease”; 2-phenoxyethanol “may cause reproductive defects and is severely irritating to the eyes and skin”; octoxynol is “used as a spermicide”; and sodium deoxycholate “is harmful if swallowed, inhaled, or absorbed through the skin.” For each of these chemicals Sears concludes that the quantity contained in vaccines is “minuscule,” “negligible,” or “considered harmless.” Then, in an apparent contradiction, he advises parents to separate out vaccines to limit exposure and possible harm.
Unfortunately, Sears fails to educate his reader about the importance of quantity—that is, that it’s the dose that makes the poison—and that spacing out vaccines to avoid exposure to quantities of chemicals so small that they have no chance of causing harm will accomplish nothing. For example, Sears claims that formaldehyde is a “carcinogen” (cancer-causing agent) but omits the fact that formaldehyde is a natural product: an essential intermediate in the synthesis of amino acids (the building blocks of proteins) and of thymidine and purines (the building blocks of DNA). Everyone has about two and one-half micrograms of formaldehyde per milliliter of blood. Therefore, young infants have about ten times more formaldehyde circulating in their bodies than is contained in any vaccine. Further, the quantity of formaldehyde contained in vaccines is at most one six-hundredth of that found to be harmful to animals. It would have been valuable if Sears had informed his readers of these facts rather than scaring them with the notion that formaldehyde in vaccines could cause cancer.
The “Green Our Vaccines” rally headed by Jenny McCarthy and Jim Carrey expressed the concern that vaccines contained dangerous toxins and chemicals. (Courtesy of Christy Bowe/Corbis.)
In the preface of his book Sears states, “I want to be clear on something right up front. This is not an anti-vaccine book. There are plenty of books out there that overemphasize the potential dangers of vaccines and leave parents even more fearful and confused.” But Robert Sears’s book isn’t what he’d like it to be. Throughout, he implies that vaccines have a high rate of serious side effects, that they aren’t adequately tested for safety, that diseases prevented by vaccines aren’t that bad, and that pharmaceutical companies misrepresent data. And he makes many claims that are refuted by science. That’s exactly what anti-vaccine books do. Indeed, the themes in Sears’s book are the same as those trumpeted in Charles Higgins’s Horrors of Vaccination Exposed and Illustrated, Lora Little’s Crimes of the Cowpox Ring, Barbara Loe Fisher’s A Shot in the Dark, and pamphlets produced by anti-vaccine activists dating back to the mid-1800s.
Sears makes the following arguments:
Vaccines have a high rate of serious side effects. Sears reviews data from the Vaccine Adverse Events Reporting System (VAERS), claiming that between 1991 and 2001 people reported eighteen thousand severe side effects that “resulted in a prolonged hospital stay, a severe life-threatening illness, a permanent disability, or death.” Sears concludes that, given the number of doses of vaccines administered during that ten-year period, children had a one in twenty-six hundred chance of suffering serious harm by age twelve. That’s a remarkably high rate of serious side effects.
VAERS can, at its best, alert public health officials to the possibility of a serious side effect from a vaccine. VAERS, however, cannot determine whether a vaccine caused a side effect. Only controlled studies can do that. The problem with VAERS is that two groups of people never report to it: people who get a vaccine and don’t suffer any side effects and people who suffer the same illness as is reported to VAERS but never got the vaccine. This information is critical to d
etermining whether the risk of a possible side effect is greater in the vaccinated group. Sears also fails to address another problem with VAERS: biased reporting. For example, 80 percent of people who reported to VAERS that vaccines caused autism weren’t doctors or nurses or nurse practitioners or parents; they were personal-injury lawyers.10
The reason that Sears fails to distinguish whether a side effect following a vaccine is actually caused by the vaccine is that, like anti-vaccine activists before him, he simply doesn’t believe in coincidence. He writes, “Sometimes infants and children develop medical problems ... within days or weeks of a vaccination. Although it can be highly suspected that the vaccine was the cause, it can’t be proven. I’m sure the truth of the matter is somewhere in between causality and coincidence.” Sometimes epidemiological studies find that vaccines cause a problem (e.g., measles-containing vaccine causes a short-lived low platelet count in the blood) and sometimes studies find that they don’t (e.g., thimerosal in vaccines doesn’t cause autism). In each of these studies a truth has emerged. Sometimes it takes months or years or decades for a truth to emerge. Sometimes it never emerges. But there is one truth: a vaccine either causes a problem or it doesn’t. Sears’s protests notwithstanding, there’s no middle ground between coincidence and causality.
Vaccines aren’t adequately tested for safety. Sears writes, “A new medication goes through many years of trials in a select group of people to make sure it is safe. Vaccines, on the other hand, don’t receive the same type of in-depth, short-term testing or long-term safety research.” In fact, vaccines are tested in larger numbers of people for longer periods of time than any drug. HPV vaccine was tested in thirty thousand women, the conjugate pneumococcal vaccine in forty thousand children, and the current rotavirus vaccines in one hundred and thirty thousand children before licensure; all were tested for more than twenty years. No drug receives this level of scrutiny. And the post-licensure surveillance system for vaccines, specifically the Vaccine Safety DataLink, is a model to detect rare adverse events after a vaccine is licensed. If Vioxx were a vaccine, the fact that it was a rare cause of heart attacks would have been detected far more quickly.
Vaccine-preventable diseases aren’t that bad. Sears tells the following story: “A six-month-old unvaccinated infant had a pneumococcal ear infection that spread to the skull bones behind the ear, called mastoiditis. She required surgery and IV [intravenous] antibiotics. Afterward, I asked the parents if they regretted their decision not to vaccinate. They said no. They were both well-educated professionals, had done a lot of reading on this issue, and still felt comfortable with their decision.” Sears implies that, because the child survived, pneumococcal infections aren’t really that bad (or that surgery isn’t really that bad). It doesn’t always work out that way. Every year many children suffer pneumococcal pneumonia, bloodstream infections, and meningitis. And those who don’t die from meningitis are often left blind, deaf, or mentally disabled. For example, in 2001 Shannon Peterson of Minnesota decided not to give her two children the pneumococcal vaccine. Both suffered severe pneumococcal infections. Her five-year-old son survived; her six-year-old daughter didn’t. “I can’t tell parents enough the importance of vaccines,” said Peterson. “I hope that no one else has to hold their child when they die.” Sears could have told a story like this one. It certainly happens often enough. But he didn’t. Instead he referred in glowing terms to the parents of a child who needlessly suffered mastoiditis. The truth is these parents had made a terrible decision for their child—one that could have killed her.
Vaccines contain dangerous ingredients. In the mid-1800s, antivaccine activists claimed that vaccines contained the “poison of adders, the blood, entrails, and excretions of bats, toads and suckling whelps.” When, a hundred and fifty years later, Jenny McCarthy said that she wanted the ether and anti-freeze removed from vaccines, she had carried forward the centuries-old tradition of claiming that vaccines contain ingredients that aren’t there. Vaccines of old didn’t contain products derived from adders, bats, toads, or whelps; today’s don’t contain ether or anti-freeze.
Sears, like McCarthy, claims that vaccines contain phantom ingredients. He writes that some vaccines are made using serum obtained from calves before they’re born. That’s true. Then he takes an illogical step, raising the specter of mad-cow disease. “All animal and human tissues are carefully screened for all known infectious diseases,” he writes. “Some vaccine critics are still worried, however, that there may be other viruses or infectious agents called ‘prions’ ... that are much smaller than viruses and that we don’t yet know how to screen for.” Proteinaceous infectious particles (prions) cause mad-cow disease, a progressive dementia that often results in death. Mad-cow disease swept through the British beef industry in the 1980s, killing one hundred and sixty British citizens; with stricter regulations, the disease has been eliminated. It would have been helpful if Sears had mentioned several reassuring facts: prions grow in the nervous system, not in cells used to make viral vaccines; prions have never been found to contaminate serum obtained from calves before they’re born; mad-cow disease isn’t a problem in New Zealand (where calf serum is obtained); and children receiving vaccines during the mad-cow epidemic weren’t at increased risk of mad-cow disease. Although most parents probably never considered mad-cow disease before they read his book, Sears concludes, “If exposure to animal tissues worries you, you may want to choose the brand that doesn’t use cow extract.”
Sears’s fear of phantom vaccine ingredients didn’t end with prions. Regarding the MMR vaccine, he wrote, “The measles and mumps vaccines are nourished for years in a culture of chicken embryo cells [that contain] human albumin, a protein filtered out of human blood units.” Sears is correct in stating that MMR is stabilized using human serum albumin. And he’s right in stating that it’s a blood protein. But the human albumin in MMR isn’t made from human blood; it’s made using recombinant DNA technology. Human blood is never part of the process. Sears’s misstatements are a far cry from claims that vaccines contain the blood of bats and toads—just not far enough.
Pharmaceutical companies misrepresent data. Sears writes, “Twenty years ago a group of doctors from the CDC, several U.S. medical centers, and two pharmaceutical companies—Glaxo-SmithKline and Merck—undertook the task of determining just how common the hep[atitis] B infection was in infants and children. If they found that hep[atitis] B was very common in kids, it would make sense to begin vaccination of all newborns. The consensus of the researchers was that [thousands of] infants and children were being infected with this virus each year.” Sears didn’t believe it. Taking a closer look, he found only “about 360 cases reported in kids from birth through age nine each year.” Sears implied that the CDC, GlaxoSmithKline, and Merck had misled the public.
It’s not hard to appeal to the public’s distrust of government and pharmaceutical companies. Lora Little did it in Crimes of the Cowpox Ring and Barbara Loe Fisher in A Shot in the Dark. But like Fisher’s and Little’s claims, Sears’s aren’t supported by the facts. Before the hepatitis B vaccine was recommended for babies in 1991, every year about sixteen thousand children less than ten years old were infected with the virus. Given that many hepatitis B virus infections occur without symptoms—and are not reported to the CDC—this estimate is probably low.
On January 20, 1961, during his inaugural address, President John F. Kennedy said, “Ask not what your country can do for you. Ask what you can do for your country.” Twenty years later, Ronald Reagan, during a debate with President Jimmy Carter, asked, “Are you better off now than you were four years ago?” Both men understood the prevailing mood. Kennedy had appealed to a sense of community, sending thousands of young people into programs like the Peace Corps and Volunteers in Service to America (VISTA); he asked Americans to see themselves as part of something greater, to take responsibility for something greater. Reagan appealed to the “Me Generation”; now it was time for me to get mine.
> A parallel can be drawn with vaccines. On February 2, 2009, a show titled “The Polio Crusade” aired on public television’s American Experience. The program described a polio outbreak in the summer of 1950 that devastated the town of Wytheville, Virginia. And it told the story of America’s efforts to make the first polio vaccine. It’s a remarkable program. Throughout the documentary are heard the voices of Americans sixty years ago, and they reveal a heart-warming sense of community. People saw polio as a shared tragedy, giving millions of dollars to the March of Dimes to make a vaccine. And they gave more than their money; thousands of community organizers volunteered to conduct the largest field trial of a vaccine ever performed—one that included about two million children. When it was over—when a polio vaccine emerged that eliminated the disease from the Western Hemisphere—Americans were proud. They felt that they, more than anyone else, had developed the vaccine. Individuals saw themselves as part of a group—a public that cared about public health. It was this sentiment that John F. Kennedy so deftly touched during his inaugural address.
Sears, like Reagan before him, is appealing to a generation that doesn’t consider a larger cooperative—an immunological commons. Toward the end of his book, under the heading “Is It Your Social Responsibility to Vaccinate Your Kids?” he writes, “This is one of the most controversial aspects of the vaccine debate. Obviously, the more kids who are vaccinated, the better our country is protected and the less likely it is that any child will die from a disease. Some parents, however, aren’t willing to risk the very rare side effects of vaccines, so they choose to skip the shots. Their children benefit from herd immunity—the protection of all the vaccinated kids around them—without risking the vaccines themselves.” Sears then asks the critical question. “Is this selfish? Perhaps. But as parents you have to decide. Are you supposed to make decisions that are good for the country as a whole? Or do you base your decisions on what’s best for your own child as an individual? Can we fault parents for putting their own child’s health ahead of other kids around him?” In another section of the book, Sears doesn’t hide the deceit. Regarding parents who are afraid of the MMR vaccine, he writes, “I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.” In other words, hide in the herd, but don’t tell the herd you’re hiding. Otherwise, outbreaks will ensue. Sears’s advice was prescient. Within a year of the publication of his book, the United States suffered a measles epidemic that was larger than anything experienced in more than a decade. (It was an outbreak fueled by the unfounded fear that MMR vaccine caused autism—a fear that Sears fails to allay in his book.)
Deadly Choices: How the Anti-Vaccine Movement Threatens Us All Page 20
