Does the process of vaccination represent good science? What is the proof that the numerous vaccines given to infants are safe? Do the manufacturers and physicians who provide them support conjecture or sound scientific practice? Our society rarely looks at the safety and efficacy of the products of medical manufacturers that have enormous power to influence the decisions of the Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration (FDA), and the National Institute of Allergy and Infectious Diseases (NIAID).1-8 Although the public rarely hears of the tragedies and side effects associated with vaccines, we do hear that vaccines promise to prevent a new condition (such as cervical cancer and genital warts9).
The reality is that we are inundating the developing baby's body with a growing list of vaccines,10 often overwhelming the immune system with resultant negative effects. A full picture of the effects of immunization has not emerged due to a deep-seated under-reporting of the adverse events associated with vaccinations.11-13
Our Acceptance of Vaccines
Public health officials have long put forth the basic assumptions that vaccinations are safe and effective.14-16 The public and our legislators have, by and large, accepted these assumptions as true. We think of vaccinations as panaceas and look to science to develop new ones for many illnesses. Vaccines are now in the Research and Development (R&D) pipeline for diseases such as chlamydia, herpes simplex type 2, hepatitis C, West Nile virus, Epstein-Barr virus, and others.17 The World Health Organization (WHO) notes that intensive efforts also are underway to develop effective vaccines for malaria, tuberculosis, dengue, and other diseases.18
Jamie Murphy, author of What Every Parent Should Know About Childhood Immunization, attributes society's acceptance of vaccinations largely to state laws that dictate children must receive vaccines to attend school.19 Each state determines which vaccines it will mandate for daycare and school entry, and state officials often rely on the recommendations of the CDC's Advisory Committee on Immunization Practices (ACIP) and other advisers in the process of mandating specific vaccines.20
The Growing Roster of Childhood Vaccines
The CDC's 2007 recommended immunization schedule includes more than two dozen doses of vaccines, targeting 14 diseases for children under the age of two. These diseases are diphtheria, tetanus, pertussis, Haemophilus influenzae type b, pneumococcal, polio, hepatitis B, measles, mumps, rubella, varicella, influenza, hepatitis A, and rotavirus. The CDC recommended the latter two - hepatitis A and rotavirus - for routine vaccination of children in 2005 and 2006, again expanding the vaccination protocol for young children.21
By contrast, vaccines for seven diseases were included in the CDC's first childhood immunization schedule in 1983. The vaccines (for diphtheria, tetanus, pertussis, polio, measles, mumps, and rubella) were recommended for children up to 18 months of age.
In addition to the vaccines received in the first two years of life, children aged four to six receive vaccines for diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, and varicella (chickenpox). This second dose of chickenpox vaccine is new, recommended by the ACIP for all children in 2006.
Recently Approved Vaccines
As noted, a new rotavirus vaccine (RotaTeq) was recommended by the ACIP for all infants in 2006. In addition, the government has recommended several vaccines for adolescents in the past few years: a diphtheria, tetanus, and acellular pertussis (Tdap) vaccine; a meningococcal conjugate vaccine (MCV4); and the first human papillomavirus (HPV) vaccine (Gardasil), which is approved for females nine to 26 years of age. Gardasil is designed to protect against HPV types 16 and 18, which cause approximately 70% of cervical cancers, and types 6 and 11, which cause about 90% of genital warts.22 For adults, the FDA approved in 2006 the first vaccine to prevent herpes zoster, also called shingles. This vaccine (Zostavax) is approved for people 60 years of age and older.
Types of Vaccines
Four main types of vaccines are used in the US, each with its own strengths and weaknesses. As described by Kurt Link, MD, in his book The Vaccine Controversy, these types are as follows:23
Live Virus Vaccines
These vaccines contain an attenuated strain of the wild virus that causes a disease. Live viruses can trigger a strong and long-lasting immunity, but they may cause serious infections and even death in people who are immune-compromised and sometimes may cause serious infections in people who are apparently healthy. Live virus vaccines include measles, mumps, rubella, chickenpox, and oral polio (the live polio vaccine is no longer used in the US).24
Killed Whole Vaccines
This type of vaccine cannot cause an infection, because the infectious organism has been killed with heat or substances such as thimerosal or phenol. Multiple initial doses and booster doses are needed to stimulate and maintain immunity. This category includes vaccines for pertussis, polio (the inactivated version), and anthrax.25
These vaccines contain relatively pure chemical components of an infectious microbe and cannot cause an infection. The hepatitis B vaccine, in particular, is manufactured with a recombinant technology in which the hepatitis surface antigens are produced in yeast cells. Like killed whole vaccines, purified vaccines may require multiple doses and boosters to sustain immunity. In addition to hepatitis B, purified vaccines include pneumococcal pneumonia and haemophilus influenza.26
In this case, a toxoid causes the body to produce antibodies against toxins secreted by a type of bacteria, not against the organism itself. Diphtheria and tetanus are examples of toxoid vaccines.27
As noted by Dr. Link, today's vaccines not only contain material from animals, such as monkeys, chicks, horses, and cattle, but also toxins and chemicals such as formaldehyde, aluminum salts, and antibiotics. In the future, we hope to have DNA vaccines that are free of impurities. With these purified vaccines, genetic material from a microbe will be inserted directly into a person's cells, prompting them to produce the vaccine and mobilizing a long-lasting immune response. (Theoretically, there is a downside: if vaccine DNA is integrated into a person's genetic makeup, the adverse effects could include cancer and autoimmune diseases.)28
Challenging Our Assumptions
As the list of vaccines used in the US grows, we must take a close look at our assumptions and ask: are we seeing the full picture? The reasons we should challenge our beliefs about vaccination include the following:
Vaccine Safety Issues
Significant adverse effects have been reported with every type of vaccine.29,30These reactions may occur soon after vaccination or several months to years later.31 Delayed reactions are more insidious and less obviously linked to vaccination and thus necessitate large-scale epidemiological studies to be proven.
The recent history of immunization demonstrates the perils associated with vaccines. In 1999, a vaccine for infants was removed from the market due to its serious adverse effects. RotaShield was approved by the FDA in 1998 for the prevention of rotavirus in infants but was withdrawn after reports to Vaccine Adverse Event Reporting System (VAERS) and a subsequent review showed the vaccine was associated with intussusception, a bowel disorder.32 In 1991, an experiment with a high-titer measles vaccine in infants was halted when studies found an increased mortality rate among female recipients compared with those receiving the standard measles vaccine.33 And in the past few decades, some studies have found that an increased risk of certain cancers is associated with polio vaccines given to children from 1955 to 1963 that were contaminated with a monkey virus.34
The CDC recently studied the safety of immunization by analyzing reports made to VAERS during the first 11 years of the system's operation, from 1991 to 2001. There were 128,717 reports made, 14.2% of which described serious adverse events that "by regulatory definition include death, life-threatening illness, hospitalization or prolongation of hospitalization, or permanent disability." The CDC concluded that reviews of VAERS reports and studies based on those reports during the 11-year period "have demonstrated that vaccines are usually safe and that serious adverse reactions do occur but are rare."35
It should be noted that VAERS is a passive surveillance system and that only an estimated one-tenth of reactions are reported (by some estimates, this figure is even greater).36,37 The result is that reported data greatly underestimate the real incidence of vaccine-associated complications. Furthermore, associations are not made when adverse events occur long after the time of vaccination.38 Indeed, a 1998 study in the Lancet and a recent review claim that no link exists between the MMR vaccine and subsequent long-term health events such as autism or bowel obstruction.39,40
One would think that before injecting children worldwide with hundreds of millions of doses of vaccines, enough clinical trials would be performed to determine exactly what the effects of this large-scale human experiment would be. Lack of funding is not the problem. Each year, Congress appropriates more than $1 billion41,42to federal health agencies to develop, purchase, and promote the mass use of vaccines in the US, but not to fund independent researchers to investigate vaccine-related health problems.
Dr. Link points out that different people will react to the same vaccine in different ways. Each person's reaction depends on a variety of factors, including his or her genes, history of infections and vaccinations, and general health. "The same vaccine will be totally ignored immunologically by one individual, but create immunologic chaos in another," he writes. Reactions also differ for the very young and very old.43
The people who suffer adverse reactions to vaccines often are infants and children; 45% of reports to VAERS concern children age six and under.44 The problems incurred as a result of vaccination go far beyond sore arms and transitory fever. Adverse events such as anaphylaxis, Guillain-Barre syndrome, brachial neuritis, thrombocytopenia, poliomyelitis (caused by the oral polio vaccine, no longer used in the US), acute encephalopathy, and hypotonic/hyporesponsive episodes have been linked to vaccines.45-48
Some research also has suggested that sudden infant death syndrome (SIDS) is associated with vaccinations.49-51 A study by FDA researchers of reports to VAERS from 1991 to 1994 found that most of the reported deaths were attributed to SIDS. The researchers concluded, however, that "the peak age of deaths at ages one to three months could be expected on the basis of prior studies showing that sudden infant death syndrome deaths peak at that age."52 Similarly, the CDC's study of VAERS data from 1991 to 2001 found that the majority of deaths reported were ultimately designated as SIDS. This report also concluded that the age distribution and seasonality of the infant deaths reported to VAERS matched those of SIDS. The CDC cites other research discounting an association between vaccinations and untimely deaths of infants.53,54 Critics have noted, however, that a comparison with the background rate of SIDS among vaccinated populations, rather than comparable unvaccinated groups, is not meaningful.55
Unsound Principles of Vaccination
When children contract a disease such as measles or mumps, they generally develop a permanent protection against that disease. Such is not the case with vaccines. As Jamie Murphy observes,
"The medical profession does not know how long vaccine immunity lasts because it is artificial immunity. If you get measles naturally, in 99% of the cases you have lifelong immunity. If you have German measles, you will have lifelong immunity [with rare second infections].... However, if you get a measles vaccine or a DPT vaccine, [it does not give you 100% assurance that] the vaccine will prevent you from getting the disease."56The Vaccine Controversy notes that by vaccinating infants and children, we shift upward the age at which people may become ill from an infectious disease. "Mild illnesses of children can be devastating in the adult," the author states. "This is an issue far from resolved."57 Widespread outbreaks of pertussis and mumps in the past few years bear out the notion that waning immunity from childhood vaccines can leave adolescent and adults vulnerable to infection.58,59
Walene James, author of Immunization: The Reality Behind the Myth,60 believes the full inflammatory response is necessary to create real immunity.61 James summarizes the work of Dr. Richard Moskowitz, past president of the National Institute of Homeopathy, as stating:
"Vaccines trick the body so that it will no longer initiate a generalized inflammatory response. They thereby accomplish what the entire immune system seems to have evolved to prevent. They place the virus directly into the blood and give it access to the major immune organs and tissues without any obvious way of getting rid of it. These attenuated viruses and virus elements persist in the blood for a long time, perhaps permanently. This, in turn, implies a systematic weakening of the ability to mount an effective response, not only to childhood diseases but to other acute infections as well."Studies of vaccines show that they prompt the body to produce antibodies to a particular antigen, called seroconversion. However, as Alan Phillips, co-founder of Citizens for Healthcare Freedom, writes in "Vaccination: Dispelling the Myths," it is not clear whether the production of antibodies constitutes immunity.
"For example, a-gamma globulinemic children are incapable of producing antibodies, yet they recover from infectious diseases almost as quickly as other children....Natural immunization is a complex phenomenon involving many organs and systems; it cannot be fully replicated by the artificial stimulation of antibody production....[Our] immunological reserves may thus actually be reduced, causing a generally lowered resistance."62,63Phillips also questions so-called "herd immunity," in which the immunization of enough people in a community confers protection to all. "There are many documented instances showing just the opposite - fully vaccinated populations do contract diseases. With measles, this actually seems to be the direct result of high vaccination rates...," he states.64,65
Comment: Herd mentality is for the birds:
The Natural Evolution of Disease
A CDC fact sheet states that vaccination programs in the US have significantly reduced or eliminated many infectious diseases. However, this communication does not discuss factors besides vaccination that coalesced to improve public health in the twentieth century.66
A working paper from the National Bureau of Economic Research (NBER) makes the following points about the rates of mortality in the twentieth century:67
Mortality rates declined steadily and rapidly throughout the century. As stated by David Francis in a summary of the research, "Except for a ten-year period between 1955 and 1965 when the mortality rate was essentially flat, mortality rates have declined at the relatively constant rate of approximately one to two percent per year since 1900."68 If vaccines are responsible for the decline of disease, then shouldn't mortality rates have fallen more rapidly in the latter half of the century when more and more vaccines were required?
In the mid-twentieth century, the continuing decline in death from infectious diseases was due more to medical measures such as penicillin, sulfa drugs, and antibiotics. As Francis states, "These help the elderly as well as the young, thereby reducing mortality across the age spectrum. By 1960, 70% of infants could be expected to survive to age 65."69 Vaccinations were not mentioned in this paragraph.
In one analysis of health trends among Americans in the twentieth century,70 the authors state that nearly 85% of the "spectacular" reduction in child mortality occurred before World War II, and nearly 90% of the decline in child mortality from infectious diseases occurred before 1940. Few antibiotics or vaccines were available during that time. The major declines in child mortality in the first third of the century, they say, have been credited to public health measures involving water treatment, food safety, organized solid waste disposal, and education regarding hygienic practices. Housing improvements and less crowding in cities also played a part.71
Given the factors involved in declining death rates, are vaccinations the magic bullets we believe them to be? Dr. Harris Coulter, an expert on the pertussis vaccine and co-author of A Shot in the Dark,72 concludes otherwise.73 Regarding infectious diseases of the past, he states,
"The incidence of all of these infectious diseases was dropping very rapidly, starting in the 1930s. After World War II, the incidence continued to drop as living conditions improved. Clean water, central heating...these are the factors that really affected people's tendencies to come down with infectious diseases much more than vaccines. The vaccines might have added a little bit to that downward curve, but the curve was going down all the time anyway."Toxic Vaccine Ingredients and Processes
Walene James cautions parents to consider the content of vaccines that enter a child's body without benefit of the digestive or liver functions. She says there are three main types of vaccine ingredients:
- Cultured bacteria and viruses
The medium of cultivation may include "dog kidney tissue, monkey kidney tissue, chicken or duck egg protein, chick embryo, calf serum, pig or horse blood, and cowpox pus."
James notes that these foreign proteins, which are injected directly into the body, contain the genetic material of animal cells. Live viruses in a vaccine may pick up the genes of these cells and implant alien genetic material into the human system.
- Stabilizers, neutralizers, carrying agents, and preservatives
These include toxins such as formaldehyde (a carcinogenic material used to embalm corpses) and aluminum phosphate.
In What Every Parent Should Know About Childhood Immunization, Jamie Murphy seconds the views of James: "What could formaldehyde, aluminum, phenol...or any number of other deadly chemical substances used in vaccines possibly have to do with preventing disease in children? The fact that they are needed at all in the vaccine formula argues that the product is toxic, unstable, and unreliable with or without their presence."75
The Use of Thimerosal in Vaccines
One aspect of vaccination that has fueled considerable controversy is the use of thimerosal (which is approximately 50% ethylmercury by weight) as a preservative. This substance was contained in vaccines for many decades before the US Public Health Service (PHS) and the American Academy of Pediatrics (AAP) issued a statement in 1999 urging its removal.76 Although the PHS agencies and AAP said this step was being taken as a precautionary measure - not because the mercury in vaccines had caused harm - the fact remains that as more vaccines were being mandated for children, the cumulative level of mercury to which some infants were exposed through vaccination exceeded that deemed safe by a federal guideline.77,78
Thimerosal has since been eliminated from or reduced to trace amounts in all the vaccines routinely given to children age six and younger, reports the FDA. The only exception for this age group is the influenza vaccine, for which a limited supply of a preservative-free version was available in 2006.79 (Trace amounts of thimerosal may remain in some vaccines given to children, because it is used in the manufacturing process, not from its use as a preservative). With the new vaccines (excluding influenza), the maximum cumulative amount of ethylmercury an infant would be exposed to in the first six months of life through routine vaccinations is now < 3 mcg. This exposure is down from a maximum of 187.5 mcg previously.80
While this change is certainly welcomed, we should ask why a neurotoxin such as mercury was allowed to be used in vaccines in the first place. Mercury exposure has been associated with nerve cell degeneration,81 adverse behavioral effects,82and impaired brain development.83 It also has been linked to degenerative chronic conditions such as Alzheimer's disease. The developing fetal nervous system is the most sensitive to its toxic effects, and prenatal exposure to high doses of mercury has been shown to cause mental retardation and cerebral palsy.84
At the center of the debate over the use of mercury in vaccines is whether this substance has contributed to an increased incidence of autism in the US. An analysis of VAERS and the Vaccine Safety Datalink found that mercury exposure from thimerosal-containing vaccines (TCVs) was a significant risk factor for neurodevelopmental disorders (NDs).85 Other research, as discussed by David Kirby in Evidence of Harm, has suggested an association between mercury in the body and autism.86-89 However, a number of population studies have found that there is no association between TCVs and the incidence of autism spectrum disorders.90-92 The Institute of Medicine determined in a 2004 report that "the body of epidemiological evidence favors rejection of a causal relationship" between TCVs and autism and between the MMR vaccine, in particular, and autism.93
Concerns about the safety of mercury in vaccines continue. In 2006, Washington State passed a law banning the use of thimerosal in vaccines given to young children and pregnant women. This law made Washington the seventh state - after Iowa, California, Delaware, Illinois, Missouri, and New York - to limit the use of mercury in vaccines. More than a dozen other states have introduced similar legislation.94
A study published in 2006 provides the first epidemiological evidence that the number of neurodevelopment disorders has decreased in the US as thimerosal was removed from vaccines. This study analyzed certain NDs - including autism, mental retardation, and speech disorders - reported to VAERS from 1991 to 2004. It found "significant reductions in the proportion of NDs reported to VAERS as thimerosal was [beginning] to be removed from childhood vaccines in the US from mid-1999 onwards."95
A continuing concern is the use of thimerosal in vaccines that may be given to children age seven and older (such as some flu and tetanus-diphtheria vaccines) and to adults who are elderly or immune-compromised. The CDC recommended in 2004 that children six to 23 months of age receive the flu vaccine each year, and in 2003, it approved the "first live attenuated influenza vaccine licensed for five- to 49-year-old persons."96 As late as the 2004-2005 flu season, however, two types of influenza vaccines were still on the market: some contained thimerosal as a preservative, and some were preservative-free. The CDC said then that the amount of preservative-free flu vaccine would continue to increase as the capabilities of manufacturers grew.97 However, one wonders how many children are still suffering the effects of mercury-toxic injections from past flu seasons.
The FDA, for its part, says that with the maximum cumulative exposure to mercury for children under six months reduced to less than 3 mcg, "an infant could receive a thimerosal-containing influenza vaccine at six and seven months of age." The FDA reasons that the maximum exposure from routine vaccinations would be 28 mcg, which is "well below the EPA calculated exposure guideline for methylmercury of 65 micrograms for a child in the 5th percentile body weight during the first six months of life."98
Vaccine Failure and Waning Immunity
The medical literature documents many cases in which vaccines have failed to protect recipients from the targeted disease, either due to primary failure (a lack of seroconversion) or secondary failure (the waning of protection over time). In recent years, for example, large outbreaks of pertussis and mumps among both fully vaccinated and unvaccinated people have brought these two "vintage bugs," as Newsweek referred to them in 2006, back into the news.99-103
Pertussis is the only vaccine-preventable disease that is increasing in the US.104 It is re-emerging even though estimated rates of childhood vaccination coverage with three or more doses have exceeded 90% since 1994.105 Reported cases of pertussis reached 25,827 in 2004, compared with a low of 1,010 in 1976106 - two years before the DTP vaccine was mandated for school admission. This represented the largest pertussis outbreak in more than 40 years, and the actual incidence is likely higher due to underreporting. The majority of reported cases are now occurring in adolescents, who the CDC says become susceptible to pertussis some six to ten years after receiving their childhood vaccines,107 and in adults. But younger children who have been vaccinated against pertussis may be affected as well.108
The re-emergence of pertussis is not limited to the United States. Canada, Australia, and some European countries also have experienced a resurgence of this disease. A 2005 report concludes that "pertussis is far from being controlled in Europe."109 Another analysis from the same year states that "an increased incidence of infant, adolescent, and adult pertussis has been observed worldwide since the introduction of widespread vaccination."110
Like pertussis, mumps also has had a resurgence in the US. The largest outbreak of mumps since the late 1980s occurred in 2006, when 5,783 cases were reported to the CDC between January 1 and October 7. Although the CDC does not have complete data on vaccination status in this nationwide outbreak, vaccination coverage for 1,798 patients in Iowa, where the outbreak started, was 49% for two doses of the MMR vaccine and 14% for one dose. The vaccination status of 30% of these patients was not known.111 Other outbreaks of mumps have occurred in vaccinated populations.112,113
Another vaccine that may fail to protect recipients during an outbreak is the varicella (chicken-pox) vaccination. Numerous studies have found that vaccinated schoolchildren are still at risk of contracting this disease.114,115 In an outbreak of 25 cases of chickenpox at a daycare center, the authors concluded that "vaccination provided poor protection" (44% against varicella of any severity) and that "breakthrough infections in vaccinated, healthy persons can be as infectious as varicella in unvaccinated persons."116 In other studies of chickenpox outbreaks, the numbers of vaccinated people among infected individuals were: 29 of 54 cases,117 26 of 83 cases,118 43 of 49 cases,119 18 of 21 cases,120 and 14 of 41 cases.121 Vaccine effectiveness against varicella of any severity in these studies ranged from 59% to 87%.
The Use of Unproven Vaccines
A contentious area of vaccination is the use of experimental vaccines in the US military, particularly with personnel of the Gulf War of 1990-91, without their informed consent. Approximately 150,000 service members deployed to the Gulf received the anthrax vaccine.122 Some Gulf troops also received the botulinum vaccine. In addition, the anthrax vaccine has been given to hundreds of thousands of military personnel since 1998,123 when the Department of Defense (DOD) began a mandatory mass vaccination program to inoculate all 2.5 million members of the military against a potential attack with anthrax.124
Although the FDA licensed the anthrax vaccine in 1970, it was not approved for inhalation exposure. The DOD's mandatory anthrax vaccine program was ruled illegal in 2004 when a federal judge said the FDA had not followed its licensing regulations for the vaccine. The DOD was directed to "stop giving the experimental vaccine to military personnel without their voluntary, informed consent," according to the National Vaccine Information Center (NVIC), which recently launched the Military and Biodefense Vaccine Project to provide information on related vaccines. However, the FDA issued a Final Order in December 2005 stating the anthrax vaccine was safe and effective, and the DOD's anthrax vaccination program was again made mandatory in October 2006.125
The NVIC reports that when the FDA issued its Final Order in 2005, it "failed to provide evidence the vaccine was effective against inhalation (weaponized) anthrax and failed to address published research studies and 5,000 adverse event reports received by FDA demonstrating that anthrax vaccine is causing serous health problems."126
The anthrax vaccine is one possible cause of what is commonly referred to as Gulf War syndrome, the collection of chronic symptoms (such as fatigue, joint pain, headaches, skin rashes, and cognitive problems) that have been reported by veterans of this war. According to the Institute for Molecular Medicine, which studies chronic diseases, it is likely that a variety of exposures are responsible for the illnesses experienced by veterans with Gulf War Illness. These exposures include chemical mixtures, such as organophosphates, antinerve agents, and possibly nerve agents; radiological sources, including depleted uranium ammunition and possibly fallout from destroyed nuclear reactors; and biological sources, such as bacteria, viruses, and toxins.127 (It should be noted that the Institute of Medicine stated in September 2006 that there is no unique cluster of symptoms that comprise a Gulf War syndrome.128)
Regarding vaccines, a study of Kansas Gulf War veterans found that veterans who were vaccinated during the war but were not deployed to the region "may experience some of the same health problems" as veterans who served in the war. Among nondeployed veterans, 12% of those who received the vaccines had Gulf War illness, compared with four percent who did not receive the vaccines.129 This researcher cites other studies that have found that vaccines against biologic warfare agents (such as anthrax and plague) and multiple routine vaccines in Gulf War veterans were associated with multisymptom illness as classified by the CDC.130,131
Comment: Read Gary Null's articles on Gulf War Veterans and their multi-symptom illnesses:
In Part 2, we look at the effects of specific vaccines, including those for diphtheria, pertussis, tetanus, polio, chickenpox, hepatitis B, measles, mumps and rubella.
DIPHTHERIA, TETANUS AND PERTUSSIS VACCINE
According to the Centers for Disease Control and Prevention (CDC), the incidence of diphtheria was reduced to zero by 2004, from an estimated average of 21,053 cases per year in the 20th century.1 But as with other infectious diseases, much of the decline in mortality from diphtheria had occurred before the vaccine was used. This mortality rate fell from 40 deaths per 100,000 in 1900 to approximately 16 per 100,000 in 1920, when the diphtheria vaccine was introduced in the US.2
Despite high levels of childhood vaccination coverage for pertussis (whooping cough), the largest outbreak of this disease in four decades has occurred in recent years. There were 25,827 reported cases of pertussis in 2004 (the actual incidence could be higher due to underreporting), compared with a low of 1,010 in 1976.3
According to the CDC, the reported rate of pertussis per 100,000 population increased from 1.8 in 1994 to 8.9 in 2004. The 2004 rate was the third consecutive annual increase in the incidence of pertussis. The CDC notes that two-thirds of reported cases of pertussis now occur among adolescents and adults due to the waning of vaccine-induced immunity. This waning occurs five to ten years after receipt of the vaccine. 4
Similar trends in pertussis were noted nearly 20 years ago in a 1988 report. After the US mandated whooping cough vaccination in 1978, the incidence of the disease in the next eight years trebled. The highest incidence was in infants less than one year old. However, the highest relative increase was in adolescents and adults.5
In 2006, the CDC's Advisory Committee on Immunization Practices (ACIP) addressed the rise of whooping cough among adolescents by recommending that they receive another dose of pertussis vaccine. The Tdap vaccine (which also contains tetanus and diphtheria toxoids) is now recommended for all children age 11 to 18 and replaces the tetanus-diphtheria booster previously given to adolescents. The Tdap booster adds to the five doses of diphtheria, pertussis, and tetanus that children already receive before their seventh birthday.6
Several research papers suggest that immunization programs have not yet brought pertussis under control. A 2006 article reports that pertussis "has reemerged worldwide as a cause of substantial morbidity and mortality in infants, children, and adolescents, despite high vaccination rates."7 Another report, published in 2005, states that an increased incidence of pertussis "has been observed worldwide since the introduction of widespread vaccination." These researchers say that there has been "a general shift in the age distribution of pertussis toward older groups" and that "despite high coverage rates for primary immunization in infants and children, pertussis continues to be a global concern, with increased incidence widely noted."8
On the other hand, the merit of the pertussis vaccine is indicated by a 2006 paper. This research evaluated state-level rates of nonmedical exemptions (those based on religious or personal beliefs) to mandatory vaccination from 1991 to 2004 and the incidence of pertussis among people 18 and younger from 1986 to 2004. The study found that an increased incidence of pertussis was associated with state policies granting personal-belief exemptions and the easier granting of exemptions.9
Replacement of the whole cell pertussis vaccine. The US made a major vaccine substitution in the 1990s when it replaced the diphtheria, tetanus, and whole cell pertussis vaccine (DTP) with a diphtheria, tetanus, and acellular pertussis vaccine (DTaP).10 The whole cell vaccine has been associated with serious adverse reactions (such as seizures and encephalopathy).11
Studies have since found a decline in the number of adverse reactions to pertussis-containing vaccines. An analysis of reports made to the Vaccine Adverse Event Reporting System (VAERS) from 1991 to 2001 found that the overall reporting rate decreased substantially after use of the acellular petussis vaccine compared with the whole cell version (12.5 vs. 26.2 reports per 100,000 net doses distributed).12
An analysis of VAERS data from 1995 (when the whole cell vaccine was in use) to 1998 (when the acellular vaccine was predominant) found that the number of reports concerning pertussis fell from 2071 in 1995 to 491 in the first half of 1998. Events categorized as "nonfatal serious" fell from 334 in 1995 to 93 (first-half '98). However, the decrease in reports involving deaths was modest, from 85 deaths in 1995 to 77 in 1997 and 41 in the first half of 1998.13
Recent comparisons of the whole cell and acellular pertussis vaccines confirm that the older version caused more adverse reactions. One study of VAERS evaluated the number of emergency room visits, life-threatening reactions, hospitalizations, disabilities, deaths, seizures, infantile spasms, encephalitis/encephalopathy, autism, sudden infant death syndrome (SIDS), and speech disorders that began within three days of receipt of pertussis-containing vaccines. The study found statistical increases for all of these events, except cerebellar ataxia, following whole cell vaccination compared with acellular vaccination.14 In Japan, an analysis of two decades of use of the acellular vaccine showed that while neurological illnesses were rare with both types of pertussis vaccine, the incidences of encephalopathy/encephalitis and status epileptics/frequent convulsions, febrile seizures/provocation of convulsions, and sudden deaths were significantly lower with the acellular than the whole cell vaccine.15 A study in Canada reported a 79% decrease in febrile seizures and a 60% to 67% decrease in hypotonic-hyporesponsive episodes following the introduction of the acellular vaccine there.16
Other research has associated the whole cell vaccine with neurological complications, including convulsions, hypotonic-hyporesponsive episodes, paralysis, and encephalopathy.17,18,19,20,21,22 Sadly, the DTP vaccine also has been associated with SIDS, the unexpected death of an infant for which autopsy cannot reveal a determining cause. In 1982 William Torch reported that his investigation of 70 SIDS cases (which was triggered by a report of 12 such deaths occurring within three-and-one-half hours to 19 hours of DPT vaccination) found that two-thirds of the victims had been vaccinated from a half-day to three weeks prior to death.23
Torch reaffirmed a link between DTP and SIDS in 1986, when he presented 11 new cases of SIDS and one of near-miss syndrome occurring within 24 hours of DTP injection24 Analysis of these and more than 150 cases of DTP post-vaccinal deaths reported in the literature—about half of which were sudden or anaphylactic—led Torch to conclude: "Although many feel that the DPT-SIDS relationship is temporal, this author and others maintain a casual relationship exists in a yet-to-be-determined SIDS fraction."25
Other researchers also have uncovered a relationship between DTP and SIDS.26,27However, the CDC reported in 199628 that several studies conducted in the 1980s did not find an association between DTP vaccination and SIDS.29,30
Pertussis vaccination and asthma. A 1994 study found that children immunized against whooping cough were five times more likely to suffer from asthma than those who did not receive the vaccine.31 Another study of almost 2,000 children born between 1974 and 1984 showed that vaccination against whooping cough was associated with a 76% increased risk of developing asthma and other allergic diseases later in life.32 On the other hand, a study published by the CDC of more than 160,000 children did not find an association between the DTP vaccine and the risk of asthma.33 A 2006 report from the Netherlands also found that receipt of the DTP/polio vaccine in infancy was not related to reported atopic disorders at primary school age.34
The literature includes articles on neurological reactions to the tetanus vaccination35-40 and other adverse reactions.41-43
Three types of polio vaccines have been used throughout the world: 1) the OPV, or oral polio vaccine (Sabin vaccine), consisting of live attenuated poliovirus; 2) the IPV, or inactivated polio vaccine (Salk vaccine), consisting of killed poliovirus and given by injection; and 3) the eIPV, an enhanced potency inactivated polio vaccine, consisting of killed poliovirus with high viral antigen content.
In the United States, the IPV (enhanced potency version) has been recommended for routine childhood vaccination against polio since 2000. Before that, the live attenuated OPV was the polio vaccine of choice for more than three decades. This vaccine, however, actually caused polio—vaccine-associated paralytic poliomyelitis (VAPP)—in a small percentage of recipients.44 The risk of VAPP "became more difficult to justify" as polio was controlled worldwide and importations of wild poliovirus to the US became less likely, according to an article in the Journal of the American Medical Association.45
As a result, in 1996 the government recommended a sequential schedule using both IPV and OPV for the childhood polio vaccination series. The ACIP then recommended the all-IPV schedule in 2000.
According to the CDC, the overall risk for VAPP is approximately one case in 2.4 million OPV doses distributed, while the first-dose risk is one case in 750,000 doses distributed. The OPV has caused the only indigenous cases of polio reported in the US since 1979. Between 1980 and 1998, 144 cases of VAPP were reported.46 Another VAPP case occurred in 1999, and in 2005, a case of imported VAPP was reported in the US after an unvaccinated American woman traveled to Central America and was exposed to an infant vaccinated with OPV.47 In late 2005, four cases of vaccine-derived poliovirus (VDPV) involving a poliovirus strain used in the OPV were identified in unvaccinated children in an Amish community in Minnesota. The source of these infections is not known, since the OPV has not been used in the US since 2000.48
During the time that the trivalent OPV was used in the US (from 1963 to 1999), an inactivated polio vaccine was available. The original IPV, developed by Jonas Salk, was used to immunize American children from 1955 to 1962. According to the JAMA article, the OPV became preferred to the IPV because it provided better intestinal immunity, was able to indirectly vaccinate susceptible contacts through transmission of vaccine polioviruses, was easier to administer, and cost less.49
Although IPV does not cause VAPP, the severity profiles of reports to VAERS on IPV and OPV in infants up to six months of age were "remarkably similar." Among the most frequent symptoms reported for IPV were fever, SIDS, convulsions, agitation, apnea, and stupor. Reports of fatalities in 1998 per 100,000 doses distributed were somewhat higher for IPV than for OPV. Of 142 fatalities reported for both IPV and OPV in 1997-1998, 89 indicated SIDS.50
Polio vaccine and Guillain-Barre syndrome. GBS is a disease that involves the nervous system and is characterized by muscle weakness, numbness, loss of reflexes, and paralysis.
In Finland, in 1985, there was an increase in the incidence of GBS a few weeks after the implementation of a nationwide campaign using OPV.51,52 And in Brazil, an analysis of 38 cases of paralysis diagnosed as GBS led in all cases to the isolation of the vaccine strains of the poliovirus. All patients had been vaccinated with the OPV months or years before the onset of symptoms.53 In contrast, two other studies failed to find a correlation between GBS and the OPV.54,55
Vaccine viruses also have been isolated from patients with paralysis diagnosed as transverse myelitis (TM), and in patients with facial paralysis (FP).56 Most individuals with TM and FP had received the OPV months or years prior to the onset of disease, indicating that the virus may remain latent and revert to virulence later in time.
Polio vaccine and SV40-related cancers. Research conducted in the past few decades has revealed that several types of cancer may be associated with the receipt of polio vaccines more than 40 years ago that were contaminated with a monkey virus.
In 1960, it was discovered that the Salk IPV was contaminated with SV40 (simian virus 40), which was derived from the monkey cells used to grow the vaccine viruses. The SV40 survived inactivation with formaldehyde, the method used to kill the poliovirus for use in the vaccine. More than 98 million Americans were vaccinated during the time period (from 1955 to 1963)57 that injectable and oral doses of the polio vaccine were contaminated with SV40. These people today have SV40 sequences integrated into their genetic code.
Animal studies have demonstrated the ability of SV40 to integrate its DNA into that of the host cell and induce malignancy. Unfortunately, studies show that the virus retains these same properties in humans and is associated with increased rates of certain cancers.58 Integration and replication of SV40 has been documented in 13% to 43% of non-Hodgkin's lymphomas,59,60 47% to 83% of mesotheliomas (malignant tumors of the lining of the lungs),61,62 11% to 90% of different types of brain tumors,63-66 50% of osteosarcomas,67 more than 33% of other types of bone tumors,68,69 and 28% of bronchopulmonary carcinomas.70
A continuing concern is that SV40 may be transmitted from person to person. The virus has been detected in people born in the 1980s and 1990s, decades after the tainted polio vaccine was no longer in use.71 SV40 is now present in children, as noted by Kurt Link, MD, in his 2005 book The Vaccine Controversy, and the CDC takes this as evidence that SV40 is a naturally acquired infection unrelated to exposure to the contaminated polio vaccine. But as Dr. Link states, it is more likely that people infected by the vaccine have transmitted SV40 to others or to their offspring (such as through semen). The implication, he says, is that "any SV40 problems may not, as had been hoped, fade away with time. There is even now, ironically, work being done to provide a vaccine against SV40."72
It should be noted that other research indicates there is no association between SV40 and an increased risk of rare cancers such as ependymomas, osteosarcomas, and mesotheliomas. One study compared rates of cancer after 30 years in birth cohorts who were likely to have received SV40-contaminated vaccine as infants and children with rates in people who not unexposed. Age-specific cancer rates were not significantly elevated for those exposed to the tainted vaccine.73 Another study found no increased number of cancer deaths among 1,073 people who received SV40-contaminated vaccine,74 and a 35-year follow-up found no deaths from the types of tumors that have been linked to SV40.75
In this final installment, we look at the rotavirus, meningococcal, and smallpox vaccines. We also discuss provocation diseases associated with vaccines, economic and legal issues of vaccination, the right to refuse vaccination, and the need to achieve freedom of choice.
In 2006, the Advisory Committee on Immunization Practices (ACIP) recommended vaccination of all infants at two, four, and six months of age with a new vaccine designed to prevent rotavirus gastroenteritis. RotaTeq (Merck & Co.) is a live, oral vaccine that contains five reassortant rotaviruses developed from human and bovine strains.1 The American Academy of Pediatrics (AAP) also recommended routine use of this vaccine in infants in 2006.2
The RotaTeq vaccine will almost certainly draw comparisons with a previous oral rotavirus vaccine, RotaShield, which was released by Wyeth Laboratories in 1998. The ACIP and AAP recommended universal use of RotaShield for healthy infants. A year later, however, RotaShield was removed from the market after the Vaccine Adverse Event Reporting System (VAERS) received reports of bowel intussusception—an obstruction in which one segment of the intestine telescopes inwardly into another—in babies who had received RRV-TV, as RotaShield was called. By the end of 1999, 121 reports of intussusception in infants administered RRV-TV had been received by VAERS.3 (Of the first 15 reported infants who developed intussusception, eight required a surgical reduction.)
The Centers for Disease Control (CDC) points out that RotaShield was rhesus-based. By contrast, the parent rotavirus strains of the newly released RotaTeq are human and bovine.4 RotaTeq was not associated with an increased risk of intussusception compared with placebo in a trial involving more than 70,000 children.5 The CDC does note, however, that children who have already had this bowel obstruction should not get the rotavirus vaccine, because anyone who has had intussusception is at an increased risk of getting it again.6
An estimated one million US infants were vaccinated with RotaShield following its approval. This vaccine's history is made worse by the fact that prelicensure trials demonstrated that RotaShield caused bowel intussusception at rates 30 times higher than those expected. This is what emerged from an analysis of prelicensure trial data by the Association of American Physicians and Surgeons.7
If it was already known that the vaccine could cause a potentially lethal condition, why did the FDA approve it? Why had nobody warned doctors to watch for this complication? These and other questions prompted the AAPS to request a Congressional investigation of the vaccine approval process. As Dr. Jane Orient, executive director of the AAPS, wrote in a letter to Representative Dan Burton, "The situation with the rotavirus vaccine may be a clue to a far more serious problem with the vaccine approval process." Dr. Orient makes the important point that "Decisions about vaccines given to children should be made by parents in consultation with the child's attending physician, not mandated by a small group of 'experts' with minimal accountability."8
In its first year on the market, the new meningococcal conjugate vaccine (MCV4) was potentially associated with an increased risk of Guillain-Barre syndrome (GBS), a rare neurological disorder that causes increasing weakness in the limbs. The meningococcal vaccine (Menactra) was recommended by the ACIP in May 2005 for routine vaccination of adolescents, college freshmen who live in dormitories, and other high-risk individuals.9
By September 2006, 17 confirmed cases of GBS in recipients of MCV4 had been reported to VAERS (all affected individuals had recovered or were recovering).10Although this association does not necessarily mean the vaccine caused the illness, the CDC has reported that the timing of the onset of GBS symptoms—within one to five weeks of vaccination—is of concern. As of October 2006, the Food and Drug Administration (FDA) and CDC were monitoring the situation, and the CDC continued to recommend the vaccine for adolescents and others.11
The smallpox vaccine was given to infants in the US until 1972. At that time, the global incidence of this disease was well under control, and routine vaccination against smallpox ended. According to the National Network for Immunization Information, it was believed then that the risk of serious adverse events from the smallpox vaccine, including death, outweighed the risk of contracting the disease itself in the US.12 The World Health Organization (WHO) certified that smallpox was eradicated worldwide in 1980.
After the terrorist threats of 2001, the US developed a plan to reintroduce the smallpox vaccine, if necessary,13 to counter a potential attack using the virus as a biological weapon. In State of Immunity, author James Colgrove reports that the Bush Administration announced an ambitious plan in 2002 to vaccinate emergency personnel, health care workers, and adults in the general public on a voluntary basis. The administration failed to win the support of the program from health care providers, however, and less than a year later, the smallpox vaccination plan was ceased.14 Approximately 39,000 civilian health care and public health workers received the smallpox vaccine in 2003.15
Although this vaccination program failed, the proposal to immunize Americans against a biological attack with smallpox should cause us to take a closer look at this vaccine. (The old smallpox vaccine is stockpiled in the US, and new smallpox vaccines are in development.16)
An Unknown Virus
The modern smallpox vaccine does not contain the smallpox virus itself, but rather a virus called "vaccinia" whose origins are unknown. The CDC states, "The vaccinia virus is the 'live virus' used in the smallpox vaccine. It is a 'pox'-type virus related to smallpox. When given to humans as a vaccine, it helps the body to develop immunity to smallpox. The smallpox vaccine does not contain the smallpox virus, and it cannot cause smallpox."17 The University of Florida College of medicine information page adds this: "Vaccinia is the virus that was used for vaccination against smallpox. Its exact origin is unknown, however, as it does not appear to be related to any other known pox virus. Some people think that it is a recombinant of smallpox and cowpox, while others think that it may be a derivative of horsepox, a virus that no longer exists (if it ever did)."
Adverse Effects of the Vaccine
The CDC reports that while the smallpox vaccine is safe for most people, serious and life-threatening reactions do occur in rare cases. Serious reactions include a rash or outbreak of sores in one area of the body (the virus may be spread from the vaccination site to other parts of the body or to other people); a widespread vaccinia rash that occurs when the virus spreads from the vaccination site through the bloodstream; and a toxic or allergic reaction to the vaccine. Life-threatening reactions to the smallpox vaccine include eczema vaccinatum (a serious rash involving widespread infection of the skin in people with conditions such as eczema or atopic dermatitis), progressive vaccinia (an infection of the skin with tissue destruction that often leads to death), and postvaccinal encephalitis (inflammation of the brain).18
Another potential complication of the smallpox vaccine is myopericarditis, or inflammation of the heart. The CDC says that while the link between the smallpox vaccine and this condition is not proven, data from recent smallpox vaccinations are "consistent with a causal association" between the two.19 In 2005 the FDA added a new black-box warning to Dryvax (the smallpox vaccine produced by Wyeth) regarding the increased risk of cardiac problems experienced by some recipients of the smallpox vaccine.20
What might the consequences of mass smallpox vaccination be? That was the question addressed in a 2002 article. Using historical data on adverse reactions to the vaccine, the authors estimated that, after excluding high-risk people and their close contacts, a vaccination strategy targeting people one to 29 years old would result in approximately 1,600 serious adverse events and 190 deaths. Vaccination of people from one to 65 years old would result in approximately 4,600 adverse events and 285 deaths. The researchers note that the smallpox vaccine "has a higher complication rate than any other vaccine currently being used." They conclude that a mass vaccination campaign would have to be careful to exclude high-risk people and their contacts to minimize the complications, but that this approach would leave some people susceptible to the disease.21
In a 2006 paper, researchers estimated the expected frequencies of post-vaccinal encephalitis and death from smallpox vaccines containing two different strains of vaccinia virus: the New York City Board of Health (NYCBH) strain and the Lister strain. They note that other studies of the consequences of smallpox vaccination commonly have used an incidence of approximately one death per million vaccinations. However, these analyses "may give serious underestimates of the number of deaths resulting from vaccination." This study estimates that vaccination with the NYCBH strain (stockpiled in countries such as the US) would lead to an average of 1.4 deaths per million vaccinations. Vaccination with the Lister strain (stockpiled in countries such as Germany) would lead to an average of 8.4 deaths per million vaccinations.22
Activists Speak Out on Vaccine Dangers
Those who take issue with universal immunization point out that the programs do not distinguish between children who may benefit from a certain vaccine and those who may be hurt by it. Infants are given blanket immunization regardless of their previous or current state of health and their varying susceptibilities to side effects. Ideally, the vaccination system should be much more selective, with parents being given complete information, so they can decide whether the risks associated with a particular procedure outweigh its potential benefits. Just as different races may suffer disproportionately from allergies and food sensitivities, studies indicate that they may experience different reactions to vaccines.
People engaged in the fight against government-mandated vaccines share their concerns here about several vaccination issues.
One of the most hazardous and insidious effects of vaccination lies in its potential to induce other forms of disease, a phenomenon known as provocation disease.23-27 The mechanisms that cause this to happen are unclear, although many scientists believe that latent viruses—those already existing in a person—may be stimulated by vaccinations and that this process may be enough to activate a particular illness. Vaccination, therefore, may not be the sole cause but rather the final trigger of an illness.
In his book Vaccination and Immunization: Dangers, Delusions and Alternatives,28 Leon Chaitow states that there is no way of knowing when such latent or incubating situations may be operating, and therefore no way of knowing when a vaccine may produce this sort of provocation.29 He warns that provocation of a latent virus is a potentially dangerous possibility with every vaccination procedure.
Many diseases thought to be caused at least partially by vaccinations do not surface until years later, by which time it is difficult to prove a connection. Two examples of conditions that may be provoked by vaccines are as follows:
- Allergies - According to Dr. Harris Coulter, co-author of A Shot in the Dark,30 and other experts,31 vaccines and allergies are clearly connected. "What does allergy mean? It means that your body is ready to react very, very quickly when exposed a second time to a substance to which it is allergic. If you are allergic to ragweed, [a small amount] of ragweed will start you sneezing. Now, if you vaccinate a person against pertussis or some other bacillus, you are making that person 'allergic' to that bacillus. That's what being vaccinated actually means. It means you are 'allergic' to that bacillus, in the sense that your body will react very, very rapidly if exposed to that bacillus a second time."
- Immunosuppression and Autoimmune Disease - The body needs to experience a full inflammatory response to create immunity, and vaccines do not allow this to happen. Instead, a chronic condition is created that can set the stage for autoimmune disease. Autoimmune diseases such as Guillain-Barre syndrome and thrombocytopenia have been associated with vaccinations.32
In Immunization: The Reality Behind the Myth, author Walene James suggests that vaccinations may induce autoimmune disorders because "live viruses, the primary antigenic material of [some] vaccines, are capable of surviving or remaining latent in the host cell for years, without provoking acute disease."33 Live virus vaccines include those for chickenpox, measles, mumps, rubella, and oral polio.34
Cynthia Cournoyer, author of What About Immunizations?, believes a key principle involved in the many negative effects of vaccines is that the immune system can tolerate only so many challenges, especially before it is given a chance to develop to maturity. "Every child," she writes, "is born with a finite ability to combat disease. This is his total immune capacity. Once a child experiences a particular disease, permanent immunity is extremely efficient, using probably three percent to seven percent of the total immune capacity of an individual. In the case of routine childhood vaccination, it is likely that as much as 30% to 70% of total immune capacity becomes committed."35
Cournoyer proposes that this effect on immunity may substantially reduce a child's immunological reserves. "Far from producing a genuine immunity, a vaccine may actually interfere with or suppress the immune response as a whole, in much the same way that radiation, chemotherapy, and corticosteroids and other anti-inflammatory drugs do."36-38Cournoyer continues, "Although the body will not make antibodies against its own tissues, viruses becoming part of the genetic make-up may cause cells to appear foreign to the immune system, making them a fair target for antibody production.... Under proper conditions, these latent pro viruses could become activated and cause a variety of diseases, including rheumatoid arthritis, multiple sclerosis, lupus erythematosus...and cancer."39
- Temporary Immunity of Vaccines - Vaccines provide only temporary immunity, whereas the contraction of an actual disease confers permanent immunity most of the time. Viera Scheibner, a retired research scientist, writes that "generations of children with this inadequate immunity would grow into adults with no placental immunity to pass on to their children, who would then contract measles at an age when babies are normally protected by maternal antibody....
"Perhaps the most unfortunate thing about the idea of eliminating infectious diseases by vaccination is that indeed there is no need to do so. As pointed out by the group of Swiss doctors opposing the US-inspired policy of mass vaccination against measles, mumps, and rubella in Switzerland, 'We have lost the common sense and the wisdom that used to prevail in the approach to childhood diseases. Too often, instead of reinforcing the organism's defenses, fever and symptoms are relentlessly suppressed. This is not always without consequences...'"40-42
Lastly, Scheibner states, "There is no need to artificially immunize our children and ourselves. The body has proper, natural mechanisms to create immunity to diseases. The diseases themselves are the priming and challenging mechanisms of the maturation process leading to the competence of the immune system...."43
- Parashar UD, Alexander JP, Glass RI. Prevention of rotavirus gastroenteritis among infants and children. MMWR. 2006; 55(RR12):1-13.
- American Academy of Pediatrics. Pentavalent rotavirus vaccine implementation for 2006. Posted Nov. 6, 2006.
- Centers for Disease Control and Prevention. Surveillance for safety after immunization: Vaccine Adverse Event Reporting System (VAERS)—United States, 1991-2001. MMWR Surveill Summ. 2003; 52(No. SS-1):1-24.
- Parashar, op. cit.
- US Food and Drug Administration. FDA approves new vaccine to prevent rotavirus gastroenteritis in infants. Press release, February 3, 2006.
- Centers for Disease Control and Prevention. Rotavirus vaccine: what you need to know. April 12, 2006.
- Centers for Disease Control and Prevention. RotaShield (rotavirus) vaccine and inusssussception: Q&A. Available [PDF] (59KB)
- Devitt M. CDC calls for suspension of childhood rotavirus vaccine. Dynamic Chiropractic. 1999;17(21). Available here. Accessed September 21, 2007.
- Centers for Disease Control and Prevention. Update: Guillain-Barre syndrome among recipients of Menactra meningococcal conjugate vaccine - United States, June 2005 - September 2006. MMWR. 2006; 55(41):1120-1124.
- Centers for Disease Control and Prevention. Frequently asked questions about Guillain-Barre syndrome and Menactra meningococcal vaccine. Last modified October 20, 2006.
- Centers for Disease Control and Prevention. Update: Guillain-Barre syndrome among recipients of Menactra meningococcal conjugate vaccine - United States, June 2005 - September 2006. MMWR. 2006; 55(41):1120-1124.
- National Vaccine Information Center. Vaccine information: smallpox. Last updated October 13, 2005.
- Centers for Disease Control and Prevention. Vaccines timeline. Available here. Accessed September 21, 2007.
- Colgrove J. State of Immunity: The Politics of Vaccination in Twentieth-Century America. Berkeley and Los Angeles: University of California Press; 2006:245-247.
- Centers for Disease Control and Prevention. Adverse events following civilian smallpox vaccination - United States, 2003. MMWR. 2004; 53(05):106-107.
- National Network for Immunization Information, op. cit.
- Centers for Disease Control and Prevention. Smallpox fact sheet: The live virus smallpox vaccine. Page last reviewed February 21, 2006. Available here. Accessed September 21, 2007.
- Centers for Disease Control and Prevention. Smallpox Fact Sheet: Reactions after smallpox vaccination. March 28, 2003.
- National Network for Immunization Information, op. cit.
- Kemper AR, Davis MM, Freed GL. Expected adverse events in a mass smallpox vaccination campaign. Eff Clin Pract. 2002; 5(2):84-90.
- Kretzschmar M, Wallinga J, Teunis P, et al. Frequency of adverse events after vaccination with different vaccinia strains. PLoS Med. 2006; 3(8) [Epub ahead of print].
- Landrigan PJ, Witte JJ. Neurologic disorders following live measles-virus vaccination. JAMA. 1973; 223(13):1459-1462.
- Pollock TM, et al. Symptoms after primary immunisation with DPT and with DT vaccine. Lancet. 1984 July; 21:146-149.
- Hirtz DG, et al. Seizures following childhood immunizations. Journal of Pediatrics. 1983; 102(12):14-18.
- Goldwater PN, et al. Sudden infant death syndrome: a possible clue to causation. Medical Journal Aust. 1990; 153:59-60.
- Denborough MA, et al. Malignant hyperpyrexia and sudden infant death.Lancet. 1982 Nov 13: 1068-1072.
- Chaitow L. Vaccination and Immunization: Dangers, Delusions & Alternatives.Beekman Publishing; 1996.
- Gary Null Report, November 15, 1994.
- Coulter HL, Fisher BL. A Shot in the Dark. Garden City Park, NY: Avery; 1991.
- Merritt HH. Textbook of Neurology. 6th Edition. Philadelphia: Lea and Febiger; 1979:160.
- Molina V, Shoenfeld Y. Infection, vaccines and other environmental triggers of autoimmunity. Autoimmunity. 2005; 38(3):235-245.
- James W. Immunization: The Reality Behind the Myth. Massachusetts: Bergin & Gervey; 1988.
- Link K. The Vaccine Controversy: The History, Use and Safety of Vaccinations. Westport, Conn.: Praeger Publishers; 2005:14.
- Cournoyer C. What About Immunizations? 6th edition. Nelson's Books; 1995:34.
- Immunization. Special Edition. Santa Fe, NM: Mothering Publications; 1984.
- Moskowitz R. The Case Against Immunizations. Washington, DC: National Center for Homeopathy.
- Cournoyer, op. cit., p. 35.
- Scheibner V. Vaccination: 100 Years of Orthodox Research Shows that Vaccines Represent a Medical Assault on the Immune System. Victoria, Australia: Australian Print Group; 1993:88-89.
- Black FL, et al. Inadequate Immunity to Measles Immunity in Era of Vaccine-Protected Mothers. Bull WHO. 1984; 62(92):315-319.
- Lennon JL, Black FL. Maternally derived measles immunity in era of vaccine-protected mothers. Journal of Pediatrics. 1986; 108(1):671-676.
- Scheibner, op. cit., p. 199.
- Cournoyer, op. cit., p. 160.
- "Interview with Barbara Loe Fisher." National Vaccine Information Center Newsletter Website.
- Colgrove J. State of Immunity: The Politics of Vaccination in Twentieth-Century America. Berkeley and Los Angeles: University of California Press; 2006:215.
- National Vaccine Information Center. Press release: Parent coalition for vaccine injured children calls on congress to slow down compensation bill. March 18, 2003.
- National Vaccine Injury Compensation Program: monthly statistics report, September 30, 2002. US Department of Health and Human Services, Health Resources and Services Administration. Available at: www.hrsa.gov/osp/vicp/monthly.htm. Accessed September 21, 2007. (Dec. 2007: Link doesn't work. Statistics reports now online:here)
- Cournoyer, op. cit., p. 156.
- The National Childhood Vaccine Injury Act of 1986 Public Law 99-690, The Compensation System and How it Works. National Vaccination Information Center; 1990.
- Vaccine injury compensation program statistics. NVIC News. August 1994;10.
- Phillips A. Vaccination: dispelling the myths. Nexus. October-November 1997.
- National Vaccine Injury Compensation Program, Health Resources and Services Administration, Rockville, MD.
- Neustaedter R. Do vaccines disable the immune system? Internet document. Available at: her9. Accessed September 21, 2007.
- National Vaccine Information Center. Legal exemptions to vaccination. Available at: here. Accessed September 21, 2007.
- Smith PJ, Chu SY, Barker LE. Children who have received no vaccines: who are they and where do they live? Pediatrics. 2004; 114(1):187-195.
- Link K. The Vaccine Controversy: The History, Use and Safety of Vaccinations. Westport, Conn.: Praeger Publishers; 2005:170.
- Smith, op. cit.
- Feikin DR, Lezott DC, Hamman RF, et al. Individual and community risks of measles and pertussis associated with personal exemptions to immunization.JAMA. 2000; 284:3145-3150 [cited by Smith].
- Fair E, Murphy TV, Golaz A, et al. Philosophic objection to vaccination as a risk for tetanus among children younger than 15 years. Pediatrics. 2002; 109(1) [cited by Smith].
- Omer SB, Pan WK, Halsey NA, et al. Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence. JAMA. 2006; 296(14):1757-1763.
- Flanagan-Klygis EA, Sharp L, Frader JE. Dismissing the family who refuses vaccines: a study of pediatrician attitudes. Arch Pediatr Adolesc Med. 2005; 159(10):929-934.
- National Vaccine Information Center. Legal exemptions to vaccination. Available at: here. Accessed September 21, 2007.
- Fisher BL. The Consumer's Guide to Childhood Vaccines. Vienna, Virginia: National Vaccine Information Center; 1997.
- Fisher, op. cit.
- Fisher, op. cit, p. 48.
- Gary Null Interview with Barbara Loe Fisher, April 11, 1995.
- Gary Null Interview with Alan Phillips, December 17, 1997.
- Gary Null Interview with Dr. Dean Black, April 7, 1995.
- Gary Null Interview with Barbara Loe Fisher, April 11, 1995.
- Gary Null Interview with Dr. Dean Black, April 7, 1995.
- Gary Null Interview with Curtis Cost, December 17, 1997