vaccines
© Gary Taxali
Mother Jones Magazine
Recently, an article by Joanna Nix was published in Mother Jones magazine titled "There is a Whole Cottage Industry of Doctors Helping Parents Skip Their Kids' Vaccines".1 The aim of the piece appears to be to attack and try to discredit physicians who exercise professional judgment and provide medical vaccine exemptions for children they conclude may be at increased risk for harm if they are vaccinated according to the Centers for Disease Control and Prevention's (CDC) childhood vaccination schedule.

Nix is uncomfortable with doctors who, according to her, seem "eager" to "flout the recommendations" of the CDC in the name of "parent choice."1 The implication here is two-fold. First, that such doctors are somehow irresponsible for exercising independent professional judgment when it comes to their patients and vaccination. And second, that the informed consent rights of parents to make important decisions for their children that involve medical risk taking are less important than strictly adhering to the CDC's one-size-fits-all vaccination schedule.

Nix pointed out that pediatrician Bob Sears, MD is a co-founder of the Physicians for Informed Consent (PIC), which she described as a "coalition of about 200 doctors, scientists, and attorneys who vehemently oppose mandatory vaccine laws." She went on to note, "PIC's membership is confidential, but its list of founding members and board members is public."1 Her description seems intent on conveying the sense of a secretive and irresponsible physician organization-as if there were something wrong with doctors defending the informed consent ethic and wanting to work collaboratively and respectfully with their patients.

Dr. Sears has frequently stated publicly that he commonly administers vaccines in his practice. What appears to bother Nix is that Sears is willing to work with parents on how and when to vaccinate their children and to provide medical care to children regardless of their vaccination history. I wrote an opinion piece about Sears in 2016 and stated, "He also provides care to unvaccinated children and he is careful to screen for vulnerable children, who have already experienced reactions to previous vaccinations that could make them more susceptible to serious harm if more vaccines are given."2

There are many other principled doctors like Sears who simply prefer not to force parents to give their children every dose of every CDC recommended vaccine on the precise schedule the CDC prescribes. That's not a crime. That's ethical medical practice, particularly given that the CDC's childhood vaccine schedule has not been adequately tested for safety. While Nix casually cited a 2013 report by a committee of the Institute of Medicine (IOM) that "found no evidence that the schedule was unsafe,"1 that's not the entire story told by the report.

As Barbara Loe Fisher of the National Vaccine Information Center (NVIC) noted in 2013:
The [IOM] committee repeatedly pointed out the astonishing lack of quality scientific studies to support the safety of the CDC-recommended numbers of doses and timing of vaccinations for children 0 to 6 years old in the child vaccine schedule. The committee confirmed there are large knowledge gaps, especially about children with increased biological susceptibility to suffering vaccine reactions and injuries.3
In its report, the IOM committee wrote:
First, the concept of the immunization "schedule" is not well developed in the scientific literature. Most vaccine research focuses on the health outcomes associated with single immunizations or combinations of vaccines administered at a single visit. Even though each new vaccine is evaluated in the context of the overall immunization schedule that existed at the time of review, individual elements of the schedule are not evaluated once it is adjusted to accommodate a new vaccine. Key elements of the immunization schedule-for example, the number, frequency, timing, order, and age at the time of administration of vaccines-have not been systematically examined in research studies.4,5
In an article for The Vaccine Reaction in 2016, Fisher and Rishma Parpia noted that the IOM committee frequently cited a lack of enough quality scientific studies and that it was "unable to determine whether the numbers of doses and timing of CDC recommended vaccines children receive in the first six years of life are-or are not-associated with health problems in premature infants or the development of chronic brain and immune system disorders in children."4

Nix's remark about there being no evidence the schedule is unsafe is a bogus one when you consider the depth and breadth of what the IOM report says. After all, not finding evidence that the CDC's childhood vaccination schedule is unsafe is not the same as providing evidence that it is safe. In fact, there's a very big difference.

Doctors promote and states mandate vaccines based on the federal childhood vaccine schedule. The burden of proof is on CDC health officials to conclusively demonstrate the safety of the childhood vaccine schedule, but that has never been done.

As the IOM report stated, the experts who reviewed the evidence related to the current federally recommended childhood vaccine schedule confirmed that, "existing research has not been designed to test the entire immunization schedule."3 Thus, the schedule is not based on sound science. That is why some doctors have a problem with it and prefer to adopt a more cautious and flexible approach with regard to administering childhood vaccinations.

Ultimately, the only way to prove whether the childhood vaccination schedule is safe (or vaccines in general, for that matter) will be to perform both basic science research describing the biological mechanisms and high risk factors for vaccine injury and death, while also conducting methodologically sound independent studies comparing the health outcomes of entirely unvaccinated populations of children and fully vaccinated children.

The 2013 IOM report specifically stressed that studies are needed to examine the long-term cumulative effects of vaccines; the timing of vaccination in relation to the age and health of the child; the effects of the total load or number of vaccines given at one time; the effect of vaccine ingredients in relation to health outcomes; and the biological mechanisms of vaccine-associated injury.6

The gap in the safety science for vaccines is much wider than many doctors and many parents really understand.

References
  1. Nix J. There is a Whole Cottage Industry of Doctors Helping Parents Skip Their Kids' Vaccines. Mother Jones January/February 2018.
  2. Cáceres M. Lynching the Vaccine Freethinker Bob Sears. The Vaccine Reaction Sept. 10, 2016.
  3. Fisher BL. IOM Issues Report on Safety of the Child Vaccine Schedule: When Will the Real Science Begin? NVIC Newsletter Jan. 16, 2013.
  4. Parpia R, Fisher BL. Childhood Vaccine Schedule: Where is the Science? The Vaccine Reaction Oct. 6, 2016.
  5. Institute of Medicine. The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies. The National Academies Press 2013.
  6. Mercola J. New Studies Reveal Vaccine Harm. Mercola.com June 6, 2017.